This disease is similar to ringworm, money ringworm and pen tube ringworm recorded in ancient Chinese medicine literature. For example, it is recorded in "On the Causes of Diseases and Symptoms of ringworm": "The ringworm is like a round pattern, and it is red on all sides, which is also itchy and painful, and there are also insects in it. Another example is the long-term tinea syndrome: "The appearance of tinea disease, such as Qian Wen's skin rash, gradually grows, or round or oblique, itchy and painful with a broad outline, scratching with juice." 」
Etiology and pathogenesis
Traditional Chinese medicine believes that this disease is caused by the fact that the natural endowment is not affected, or the contact with infected unclean things leads to the relapse of rheumatic fever, which is caused by the skin.
Modern medicine believes that the disease is caused by skin infection with Microsporum, Trichophyton or Trichophyton rubrum.
cardinal symptom
Incidents: tinea corporis is more common in children and adults, and tinea cruris is more common in male adults.
Predisposing parts: tinea corporis mainly occurs on face, neck, trunk and limbs. Tinea cruris is more common in groin, perineum and around * * *. Can form a ring, can also form a concentric ring.
Characteristics of skin lesions: ringworm lesions are round or coin-shaped erythema, the number is uncertain, the center of the lesion often heals itself, and the periphery is active, with inflammatory papules, blisters, scabs and scales. Tinea cruris is a erythema with a clear edge and slightly raised, which gradually expands, is covered with debris, and gradually turns from red to brown or normal skin color. The center heals itself and gradually expands to the periphery, with obvious marginal inflammation, blisters, erosion and scabs on it.
Symptom: Itching.
Course of disease and prognosis: after a slow process, it is heavier in summer and autumn, and it is relieved in winter, and it occurs again in the following year.
Diagnostic points
Location (face, trunk or groin)+Rash (annular erythema with clear boundary, slightly raised edge and slight desquamation)+Symptoms (itching)+Laboratory (positive by fungal microscopy).
Syndrome differentiation
Erythrotinea: lack of inflammation, the affected skin is brick red, and there is no inflammatory ring at the edge, which is not itchy.
Seborrheic dermatitis: the lesions are follicular papules or dark red spots covered with greasy scales, which can be identified by fungal examination.
Chinese traditional treatment
Syndrome differentiation and treatment: this disease generally does not require oral administration of traditional Chinese medicine
External treatment:
1.Cortex Pseudolaricis 30g, Radix Stemonae 30g, Fructus Cnidii15g, 240ml of 50% alcohol, soaked for 3 days and nights, filtered and applied externally, twice a day.
2. 60 grams of sheep's hoof root, 240 ml of 50% alcohol, soaked for 3 days and nights, filtered and applied externally, twice a day.
Western medicine treatment
External medication: 1% clotrimazole cream for external use. Compound benzoic acid alcohol for external use. 10% undecylenic acid alcohol. 5% lauric alcohol. 10% sulfur emulsion.
Systematic drug therapy
1.Oral itraconazole, 200mg each time, twice a day for 7 days.
2. Take terbinafine 250 mg orally, once a day/kloc-0, and the course of treatment is 1 ~ 2 weeks.
The author believes that the difficulty of the two diseases mentioned in this chapter lies in how to prevent the recurrence of the disease. Patients should pay attention to clean clothes, avoid close contact with other patients or sick animals, avoid using towels and tubs used by patients, avoid taking drugs that affect the body's resistance, such as corticosteroids, and treat the original consumptive diseases such as diabetes in time.