Scleroderma is a kind of skin disease of connective
tissue caused by sclerosis of the skin. It is divided into two types: localized
and systemic types. Generally, it undergoes through three stages, red swelling,
sclerosis and atrophy. At the advanced stage, the affected skin will be adhered
to the deep tissue and produce functional disturbance of corresponding organs.
This disease is called (scleroderma).
Main Points of Diagnosis
Localized
Scleroderma
1. Skin Lesion: Part of the skin has a sensation of burning heat
and itching, then slightly elevated patches in red or purple color. The lesion
may be tenioid or elliptical in shape, and its border is clear with purple halos
around them. The central part is sunken and then the color of patches will become
yellow, brown and pale. The skin will be indurated and adhesive to the subcutaneous
tissue, then the cleavage lines will disappear. Its surface is smooth and then
will become atrophied and thin, and will lose elasticity. There are branny desquamations
and pigmentations on the skin lesion.
2. Symptoms and Signs: At first the
patient may have an unusual feeling or a sense of itch, then the skin becomes
blunt and insensitive.
3. It often occurs on the head, face, neck and limbs,
especially among the young and middle-aged women. Scleroderma which occurs at
the terminal end of limbs of the young women, is known as "acrosclerosis."
The course of this disease is chronic.
Systemic Scleroderma
1. Skin Symptoms
and Signs
1) The skin lesion begins in the face or the skin of the distant
end of limbs, symmetrical in distribution, then gradually spreads throughout the
whole body. Or the skin lesion is generalized from the beginning. It often attacks
the face, limbs, neck and trunk, mostly among middle-aged women.
2) At first
the skin becomes thick and swollen, its surface is smooth and cleavage lines disappear.
The skin shows parenchy-matous edema (at edema stage), then gradually becomes
adhered to the subcutaneous tissue and it becomes hard, sallow in color and its
border is clear (at sclerosis stage). Finally, the skin becomes atrophied and
thin, and the hair may fall off. And sweat obstacle may appear. The skin and muscle
will be stick to the bone and become stiff (at atrophy stage).
3) At the beginning,
there are unusual, tense and itching sensations locally, and then the sensations
become blunt gradually or entirely lost.
2. General Constitutional Symptoms
1) At the beginning, there are such symptoms as general malaise, arthralgia,
loss of weight, stiff fingers and spasm of terminal arteries of limbs. The features
at the advanced stage are emaciation, weakness with low fever.
2) The face
may be involved and looks awkward. The nose will be sharp and the ears thin. The
movement of the mouth and eyes and chewing will be restricted. In case thoracic
wall is involved, respiration may be limited. In case four limbs are invaded,
the joints will become stiff and motions limited. In case the digestive tract
is involved, there will be difficulty in swallowing, accompanied with vomiting,
nausea, abdominal distention and diarrhea. In case the lung is invaded, vital
capacity will be reduced. If the heart is involved, heart failure will occur.
If the heart is involved, heart failure will occur. If the kidney is involved,
renal hypertension and uraemia may appear.
Differentiation and Treatment of
Common Syndromes
Internal Treatment
1) Blood Stasis Type
Main Symptoms
and Signs: The skin becomes hypertrophic and elevated or sunken and hard. It may
be bright red, purplish red or yellowish red or brown is color. The tongue is
light purple with ecchymosis on it. The pulse is rapid.
Therapeutic Principle:
Promoting blood circulation and expelling stasis.
Recipe: Decoction of Four
Herbs plus Safflower and Peach Kernel and other ingredients
astragalus root
red peony root
red sage root
spatholobus stem
dried rehmannia
root
Chinese angelica root
chuanxiong rhizome
honeysuckle flower
peach
kernel
safflower
pangolin scale
earth worm
dried body of ground
beetle
licorice root
All the above herbs are to be decocted in water for
oral administration.
2) Type of Kidney Deficiency and Blood Stasis
Main
Symptoms and Signs: The skin becomes thick, sclerotic, or atrophied and thin,
accompanied with pain in the knees and waist, tinnitus, vertigo, impotence, premature
ejaculation, low fever, spontaneous perspiration, ecchymosis on the tongue and
deep and fine pulse.
Therapeutic Principle: Nourishing the kidney and warming,
promoting blood circulation and removing blood stasis.
Recipe: Kidney Reinforcing
Bolus and Decoction of Four Herbs plus Safflower and Peach Kernel
prepared
rehmannia root
multiflower knotweed root
dogwood fruit
eucommia bark
epimedium
morinda root
peach kernel
safflower
red peony root
red sage root
Chinese angelica root
ligusticum rhizome
All the
above herbs are to be decocted in water for oral administration.
3) Type of
Splenic Asthenia and Blood Stasis
Main Symptoms and Signs: The skin is sclerotic
and atrophied, accompanied with fatigue, loss of appetite, abdominal pain and
distension, loose stool, ecchymosis on the tongue, thready and moderate pulse.
Therapeutic Principle: Strengthening the spleen and replenishing qi, promoting
blood circulation and removing blood stasis.
Recipe: Decoction for Invigorating
the Spleen and Nourishing the Heart with additional ingredients
astragalus
root
red peony root
red sage root
codonopsis root
big-head atractylodes
rhizome
spatholobus stem
poria
Chinese angelica root
aucklandia
root
tangerine peel
amomum fruit
longan aril
fresh ginger
Chinese
date
All the above herbs are decocted in water for oral use.
4. Other
Therapies
1) 10 ml of salvia miltiorrhiza injection with 500 ml of 5% glucose
is used for intravenous drip, once a day, The whole course of treatment will be
10 days running and then stop dripping for 7 days. Curative effects can be seen
after a month's treatment.
2) Four Worms Pill
Ingredients:
dried body
of scorpion
dried body of centipede
dried body of ground beetle
dried
earthworm
All the above drugs are made into pills in equal amount each. The
size of the pill is the same as that of a mung bean. Take 3-5g each time, three
times a day.
3) Pill of Rhubarb and Ground Beetle
Ingredients:
rhubarb
dried body of ground beetle
licorice root
lactiflora peony root
dried
ginger rhizome
rehmannia root
scutellaria root
peach kernel
apricot
kernel
gradfly
dried leech
dried grub
All the above herbs are
to be ground into fine powder to make pills. 10 grams for each pill. Take one
pill each morning and evening.
Dr. Ming's TCM Medical Center,
Hua Xi Xiao
Yuan, Hutian Developing Area,
Huaihua city, Hunan province
China