The papulae are flat and smooth at first, then rapidly develop not erythemata in different shapes, with clear demarcations and covered with many layers of silver white scales. There appears a layer of fat-like lustrous film on removing the scales. This is called film phenomenon. If the film is wiped off, cribriform bleeding will appear.

2. The course of this disease has three stages:

Active stage: The scales on erythemata appear continuously, expand, coalesce and spread throughout the skin of the body. The patient feels serious itching.

Resting stage: Skin lesion has stopped extending. The condition is fairly stable. Itching has weakened gradually and finally disappeared.

Regressive stage: The scales on erythema reduce gradually and then disappear completely. The pigmentation will be left and itching will be milder and then disappear completely.

3. The course of this disease is chronic. The patient himself can recover from it, but it may easily relapse. The attack of this disease is influenced by weather. It is mild in summer and serious in winter.

1) Wind-Heat Type

Symptoms and Signs: Serious itching, red papule, scaly erythematous lesion with red halo around them, red tongue, with thin and yellow fur, and taut and rapid pulse.

Therapeutic Principle:  Clearing away pathogenic heat to remove toxin materials, cooling the blood and dispersing pathogenic wind.

Recipe: Lonicera and Smilax Glabra Decoction

honeysuckle flower

smilax glabra rhizome

sophora flower-bud

dried rehmannia root

red peony root

red sage root

scutellaria root

anemarrhena rhizome

arnebia or lithosperm root

bupleurum root

cicada slough

dried body of black-tail snake

All the above herbs are to be decocted in water for oral administration.

2) Blood Stasis Type

Main Symptoms and Signs: The scales on erythema or the erythema with silver scales on the skin may not subside. Itching is mild or not obvious.

Recipe: Decoction for Promoting Blood Circulation and Expelling Pathogenic Wind

red peony root

red sage root

peach kernel

safflower

Chinese angelica root

ligusticum rhizome

dried body of scorpion

pangolin scale

cicada slough

tribulus fruit

All the above herbs are to be decocted in water for oral administration.

3. Blood Dryness Type

Main Symptoms and Signs: Brown patches or pigmentation with fine furfures on the affected part of skin.

Recipe: Decoction of Chinese Angelica Root

dried rehmannia root

white peony root

multiflower knotweed root

Chinese angelica root

ligusticum rhizome

schizonepeta

ledebouriella root

tribulus fruit

astragalus root

licorice root

All the above herbs are decocted in water for oral use.

For those with greasy fur on the tongue, add 9 grams of atractylodes rhizome, 9 grams of dittany bark, 15 grams of capillary artemisia herb. For those who have serious itching, add 9 grams each of dried whole scorpion, and honeylocust spine. If the erythema can not subside, add 9 grams each of dried ground beetle, rhubarb, turmeric rhizome, burreed rhizome, zedoary turmeric rhizome.

2. External Treatment

1) Therapy of Soaking Bath in Herbal Lotion

Recipe:

alum

pepertree pricklyash peel

wild chrysanthemum flower

mirabilite

All the above ingredients are to be decocted in water for a soaking bath in hot water. The bath should last 30-60 minutes each time, once a day.

2) Operative Therapy of the External Ear

Sterilize the cartilage crest above the orifice of the external auditory meatus first with 75% alcohol, make two shallow incisions with the tip of the knife on the epidermis and dermis to let a little amount of blood ooze out, then spread some Compound Powder of Black Pepper on the wound, cover them with sterilized dressing and knead for one minute, and then use adhesive plaster for fixation. This method can be done once a week. Curative effects can be seen after 2-3 times of treatment.

Recipe: Compound Powder of Black Pepper

fruit of black pepper

pangolin scale