Chapter10 Dermatoses and sexually transmitted diseases (Lecture-9hrs, SDL-9-hrs)
Concept
[Teaching Aim]
1. Master the morphological characteristic of skin injury and the discipline of syndrome differentiation.
2. Familiar with the internal treatment of common dermatoses, functions and applying principle of external applying herbs.
[Teaching Content]
1. There are eight pathogenesis: wind, damp, heat, worm, toxin, and blood stasis, blood deficiency with wind dryness, liver and kidney deficiency, give the example to explain their clinical features.
2. Syndrome differentiation of generalized syndrome is similar with internal medicine, there is syndrome differentiation for local self-conscious symptoms such as itchiness, pain, burning heat and numbness.
3. The morphological characteristic and syndrome differentiation of skin injury.
4. The functions, suitability and common formula and herbs for common internal treatment.
5. Introduce preparation, suitability, usage of the common external applying herbs such as solution, powder, lotion, tincture, ointment and oil solution respectively.
6. The applying principle of external herbs.
[Teaching Method]
Multimedia lecture.
Fever blisters
[Teaching Aim]
1. Master the clinical characteristic and treatment of disease.
2. Understand the etiology and pathogenesis of the disease.
[Teaching Content]
1. Etiology and pathogenesis: Wind heat toxin accumulated in the lung, repeated episodes which lead to yin deficiency with internal heat.
2. Syndrome differentiation: A cluster of transparent vesicles on the erythema, often happen at the border of skin mucosa.
3. Treatment: Use lotion on the local area which is not rupture, use ointment on area which is rupture, severe condition should follow syndrome differentiation.
[Teaching Method]
Self-study.
Herpes Zoster (CBL-1hr)
[Teaching Aim]
1. Master the characteristic of the herpes and the treatment of the main syndromes.
2. Understand the differential diagnosis of the disease.
[Teaching Content]
1. Overview: The different name and characteristic of this disease can illustrate that it can happen at any location.
2. Syndrome differentiation: the main symptoms are girding fire cinnabar, a cluster of vesicles arrange in belt position and pricking pain of the skin.
3. Treatment:
(i) Internal: Clear liver fire, drain dampheat, modified LongDanXieGan Tang
(ii) External: follow the external treatment in outline.
4.Differential diagnosis: Differentiate with fever blisters.
[Teaching Method]
Multimedia lecture.
Warts
[Teaching Aim]
1. Understand the different type of warts.
2. Master the characteristic and treatment method of different warts.
[Teaching Content]
1. Etiology and pathogenesis: Wind heat toxin attack the skin.
2. Syndrome differentiation: Common location and morphology characteristic of verruca vulgaris, verruca plana, verruca plantaris, molluscum contagiosum, verruca filiformis.
3. Treatment:
3.1: Internal: Activate the blood and detoxify.
3.2: External: Use soak method for verruca plana, use push method, mounting method, rubbing method, excavation method, electrocautery, freezing method, microwave treatment and so on for verruca vulgaris, use stir up method for molluscum contagiosum.
[Teaching Method]
Multimedia lecture.
Impetigo
[Teaching Aim]
Master the skin injury characteristic, syndrome differentiation and prevention of the impetigo herpetifomis.
[Teaching Content]
1. Etiology and pathogenesis: Summer dampheat toxin accumulated on the skin.
2. Syndrome differentiation: pustule, erythema, erosion after broken, scab
3. Treatment:
3.1: Internal: Use clear dampheat, remove dampness and detoxify method for dampheat syndrome. Use strengthen spleen and drain dampness method for spleen deficiency syndrome.
3.2: External: use lotion for pustule, or external application of QingDaiSan, use sesame oil for erosion.
4. The method of prevention.
[Teaching Method]
Self-study.
Tinea
[Teaching Aim]
1. Master the characteristic and treatment principle of different tinea.
2. Understand the causes, route of transmission, and prevention of tinea, emphasize the importance of both prevention and treatment.
[Teaching Content]
1. Overview: the definition and classification of tinea.
2. The type, treatment and prevention of tinea capitis and favus.
3. The syndrome differentiation and treatment of tinea manuum, tinea pedis.
4. The syndrome differentiation and treatment of tinea unguium.
5. The syndrome differentiation and treatment of tinea circinata.
6. The syndrome differentiation and treatment of tinea versicolour.
[Teaching Method]
Multimedia lecture.
Scabies
[Teaching Aim]
1. Master the pathogenesis of the disease.
2. Master the clinic characteristic, treatment method and prevention of the disease.
[Teaching Content]
1. Etiology and pathogenesis: transmitted by sarcoptic mite.
2. Syndrome differentiation: There are scatter papules, vesicles, tunnel on the skin fold, accompany with violent itchiness, history of contact, and sarcoptic mite can be found as the characteristics.
3. Treatment and prevention: apply Sulphur ointment, pay attention to the applying method, group treatment, clothes scalding and radical therapy.
[Teaching Method] Self-study. Insect dermatitis - Multimedia teaching [Teaching Aim] 1. Master the diagnosis of insect dermatitis. 2. Understand the normal treatment method of insect dermatitis. [Teaching Content] 1. Etiology and pathogenesis: cause by worm toxin. 2. Syndrome differentiation: Rash usually seen in exposure area, there are tiny blood spot, papule and wheal, accompany with different degree of burning heat, itchiness and pain, thorny prick can be seen at the middle of skin injury. 3. Treatment: Mainly external treatment, applying herbs on local area with taking clear heat and detoxify herbs. [Teaching Method] Self-study. Contact dermatitis [Teaching Aim] 1. Understand the causes of the disease. 2. Master the clinical characteristic and differential diagnosis of disease. [Teaching Content] 1. Overview: Definition, different contactors have different disease name. 2. Etiology and pathogenesis: Mainly due to congenital weakness, allergic to some material. 3. Syndrome differentiation: History of contact, common area, morphology of skin injury, progress of onset. 4. Treatment: 4.1: Internal: According to different syndrome differentiation 4.2: External: According to different morphology of skin injury to apply herbs. 5. Prevention and point worthy of notice. 6. Differential diagnosis: differentiate with eczema, erysipelas. [Teaching Method] Multimedia lecture. Eczema (CBL-1hr) [Teaching Aim] Understand the different type of eczema, different disease name at different location, master the syndrome differentiation. [Teaching Content] 1. Overview: definition, characteristic and disease name at different location. 2. Etiology and pathogenesis: Mainly due to dampheat in acute condition, spleen deficiency with dampness in subacute condition, blood deficiency with wind dryness in chronic condition. 3. Syndrome differentiation: skin injury usually have polymorphic, symmetry, itchiness, easy to recur and chronic tendency. 4. Treatment: oral administration for dampheat accumulation, spleen deficiency with dampness, blood deficiency with wind dryness syndrome, choosing external treatment according to the skin injury. 5. Differential diagnosis: differentiate with contact dermatitis and oxhide lichen. [Teaching Method] Multimedia lecture. Baby Eczema [Teaching Aim] Understand the causes, syndrome differentiation and cautions of baby eczema. [Teaching Content] 1. Overview: definition and characteristic. 2. Etiology and pathogenesis: Dampheat, blood deficiency with wind dryness. 3. Syndrome differentiation: erythema, papule, yellow crust, erosion, exudation and others. 4. Treatment: oral administration with clear heat and drain dampness herbs, tonify blood and nourish dryness herbs. External treatment according to the skin injury. [Teaching Method] Self-study. Dermatitis Medicamentosa [Teaching Aim] Understand the causes of the disease, master the different clinical characteristic, syndrome differentiation and cautions of the disease. [Teaching Content] 1. Etiology and pathogenesis: mainly due to congenital weakness, Chinese medicine toxin attack interior. 2. Syndrome differentiation: Different clinical syndromes such as dampheat syndrome, heat toxin syndrome, injury of Qi and Yin syndrome. 3. Treatment: 3.1: Internal: Clear heat, drain dampness and detoxify, clear Ying and detoxify, nourish Qi, Yin and remove wind. 3.2: External: According to the skin injury. 4. Cautions: rational drug use, avoid or use allergic medicine cautiously, pay attention to the skin injury during the progress of applying herb in precaution. [Teaching Method] Self-study. Urticaria (CBL-1hr) [Teaching Aim] Understand the causes of the disease, master the syndrome differentiation of the disease, familiar with the cautions of the disease. [Teaching Content] 1. Etiology and pathogenesis: associated with wind cold, wind heat, dampheat in the intestine and stomach, deficiency of Qi and blood, disharmony of conception and thoroughfare vessels. 2. Syndrome differentiation: Wind cold syndrome, wind heat syndrome, blood deficiency and wind dryness syndrome. 3. Treatment: treat according to the syndrome. 4. Cautions: Look for the causes of onset, avoid spicy and fishy food, pay attention whether there is hoarse voice, difficulty breathing, abdominal pain and so on, and take reaction according to the situation. [Teaching Method] Multimedia lecture. Oxhide Lichen [Teaching Aim] Master the clinical characteristic and syndrome differentiation of the disease. [Teaching Content] 1. Overview: Characteristic and the disease name. 2. Etiology and pathogenesis: wind dampheat attacking, blood deficiency and wind dryness, associated with emotional factors. 3. Syndrome differentiation: other than common area, lichenification of the skin, there is wind dampheat syndrome, wind deficiency and wind dryness syndrome. 4. Treatment: remove wind, clear heat and drain dampness, nourish blood, remove wind and nourish dryness method, apply external herbs according to the skin injury. 5. Differential diagnosis: differentiate with chronic eczema and psoriasis. [Teaching Method] Self-study. Pruritus of the skin - Multimedia teaching [Teaching Aim] Master the syndrome differentiation of the disease. [Teaching Content] 1. Etiology and pathogenesis: due to wind heat and blood heat or blood deficiency with hyperactivity of liver. 2. Syndrome differentiation: Wind heat and blood heat syndrome, dampheat accumulated syndrome and blood deficiency with hyperactivity of liver syndrome. 3. Treatment: remove wind, clear heat and cool blood method, nourish blood and subdue liver method, remove wind and nourish dryness method. [Teaching Method] Self-study. Pityriasisrosea [Teaching Aim] Master the characteristic and treatment method of the disease. [Teaching Content] 1. Etiology and pathogensis: due to congenital blood heat with the attack of wind heat pathogen. 2. Syndrome differentiation: there will be pale red colour “mother spot’, and appear smaller “son spot” with oval shape, long uranium is parallel with the dermatoglyph and margin, there is chaff like scales on it. 3. Treatment: oral administration with remove wind and clear heat or cool blood and clear heat formula, apply detoxify lotion externally. 4. Differentiate with tinea corporis, tinea versicolor, psoriasis and second stage of syphilis. [Teaching Method] Self-study. Psoriasis [Teaching Aim] 1. Understand the causes, familiar with the clinical type and stages. 2. Master the syndrome differentiation of the disease and the treatment of main syndromes. [Teaching Content] 1. Overview: Characteristic and associated disease name. 2. Etiology and pathogenesis: External contraction of wind pathogen lead to blood heat, blood dryness or blood stasis, injury of liver and kidney, disharmony of thoroughfare and conception vessels and so on. 3. Syndrome differentiation: well demarcated erythema, multiple layer of silver white scales on it, there is phenomenon of membrane, phenomenon of dew, isomorphic reaction and others. Differentiate different symptoms and unusual type, arthritis type, erythrodermic type and pustular type. 4. Treatment: internal treatment such as cool blood and clear heat, nourish blood, remove wind and nourish dryness, activate blood and remove stasis method, apply ointment or cream for external treatment. [Teaching Method] Multimedia lecture. Facial seborrheic dermatitis [Teaching Aim] Familiar the syndrome differentiation of the disease. [Teaching Content] 1. Etiology and pathogenesis: wind heat and blood dryness generate wind, dampheat toxin accumulated in the intestine and stomach. 2. Syndrome differentiation: Light yellow colour of erythema on the sebaceous area with unclear demarcated area. 3. Treatment: Internal treatment such as nourish blood, remove wind and nourish dryness for dry type, clear heat, resolve dampness and unblock Fu organ for wet type, apply herbs according to the skin injury for external treatment. [Teaching Method] Self-study. Acne (CBL-1hr) [Teaching Aim] Familiar with the causes and master the treatment of different syndromes. [Teaching Content] 1. Etiology and pathogenesis: wind heat in the lung channel, accumulated of phlegm dampness. 2. Syndrome differentiation: common in the face of youth with the characteristic of follicle papules and comedones. 3. Treatment: Internal treatment such as clear the lung and dissipate wind, clear heat and resolve dampness, resolve phlegm and drain dampness, external treatment such as using DianDaoSan lotion, acne lotion. 4. Pay attention to the care. [Teaching Method] Multimedia lecture. Rosacea [Teaching Aim] 1. Understand the causes of the disease, familiar with the clinical types. 2. Understand the syndrome differentiation of the disease. [Teaching Content] 1. Etiology and pathogenesis: accumulated of heat in the lung and stomach with the ataack of wind cold, lead to accumulate of blood stasis. 2. Syndrome differentiation: commonly happen in the nose, differentiated erythema stage, papule stage, nose stage. 3. Treatment: 3.1: internal: clear and disperse lung heat, cool blood and clear heat, harmonize Ying and eliminate blood stasis. 3.2: external: DianDaoSan lotion. [Teaching Method] Self-study.. Erythema nodosum [Teaching Aim] 1. Understand the characteristic of rashes. 2. Master the treatment of different stage and symptoms. [Teaching Content] 1. Etiology and pathogenesis: external contraction of wind pathogen, down pouring of dampheat or deficiency of Qi and blood, cold damp attack lead to accumulation of blood stasis. 2. Syndrome differentiation: There is chills and fever, joint pain, bright red colour of nodule on the leg during early stage. Fever relieve and purple red colour of nodule at the late stage. 3. Differential diagnosis: differentiate with erythema induratum and cutaneous vasculitis. 4. Treatment: internal treatment is according to the syndromes such as dampheat and cold dampness. External treatment with JinHuangGao or YuLuGao. [Teaching Method] Self-study. Lupus erythematosus [Teaching Aim] Familiar with the types, characteristic and syndrome differentiation of the disease. Understand the laboratory test of the diagnosis of lupus erythematosus systemically. [Teaching Content] 1. Etiology and pathogenesis: congenital weakness with induce of heat toxin in the liver and kidney. 2. Syndrome differentiation: 2.1. Discoid lupus erythematosus: other than normal appearance, usually belong to yin deficiency with internal heat type, usually treat with nourish yin, clear heat and tonify kidney method. 2.2. Systemic lupus erythematosus: other than normal appearance, usually can be differentiated to the type of: exuberant of heat toxin, yin deficiency with hyperactivity of fire, spleen and kidney yang deficiency, spleen deficiency with hyperactivity of liver, Qi stagnation with blood stasis. [Teaching Method] Multimedia lecture. Gonorrhea [Teaching Aim] Understand the syndrome differentiation and treatment of the disease. [Teaching Content] 1. Overview: Definition, characteristic and the condition of onset. 2. Etiology and pathogenesis: External contraction of dampheat obstructing the bladder and liver channel lead to kidney yin deficiency and accumulated of blood stasis. 3. Syndrome differentiation: with the history of sexual contact, usually latent. Frequent, urgent and painful urination, pus in the urethral orifices and other symptoms in male, erosion, swollen, yellowish green secretion of the cervix, accompany with frequent, urgent and painful urination, bartholinitis and other symptoms. 4. Differential diagnosis: differentiate with acute urinary tract infection and prostatitis. 5.Treatment: oral administration according to the syndrome for acute and chronic gonorrhea accompany with complication and septicemia. Relevant antibiotic can be used in other treatment. 6.Prevention. [Teaching Method] Multimedia lecture. Syphilis [Teaching Aim] 1. Understand the route of transmission and syndrome differentiation of syphilis. 2. Master the treatment for syphilis. [Teaching Content] 1. Overview: definition and characteristic. 2. Etiology and pathogenesis: route of transmission such as through sperm, air and fetus. 3. Syndrome differentiation: 3.1: Route of transmission: congenital or acquired 3.2: progression, symptoms, infectious, early stage and late stage 3.3: characteristic: malnutrition boils, buboes, YangMei syphilis, YangMei poison. 3.4: others: congenital and laten syphilis 4. Treatment: internal treatment according to the syndromes such as dampheat in the liver channel, accumulation of phlegm and stasis, spleen deficiency with dampness, deficiency of Qi and blood, deficiency with Qi and yin. External treatment : ZhenZhuSan, ChongHeGao, HongYouGao, penicillin for other treatment. 5. Prevention. [Teaching Method] Multimedia lecture. Condylomata acuminata [Teaching Aim] Understand the diagnosis and treatment of condylomata acuminate. [Teaching Content] 1. Overview: definition and onset of disease. 2. Etiology: sexually transmitted, contracted with toxin lead to accumulate of dampheat at the skin mucosa. 3. Syndrome differentiation: latent stage, soft neoplasm can be found at the external genitalia and anus area 4. Treatment: internal treatment according to the syndromes such as damp toxin accumulated, exuberant of fire toxin. External treatment such as eliminate method or electrocauterization, laser and microwave therapy. 5. Prevention. [Teaching Method] Self-study.