Department of Dermatology, Shaanxi Baoji People's Hospital, Shaanxi, Wang MengMelanosis is a skin disease by brown black. In traditional Chi
Department of Dermatology, Shaanxi Baoji People's Hospital, Shaanxi, Wang Meng
Melanosis is a skin disease by brown black. In traditional Chinese Literature "blackish facial patch". The characteristics of the early flushing, consciously itching, the sun is more important, good hair on the facial light brown, dark brown and black pigmentation. Some people think it is a photosensitive dermatitis or allergic dermatitis after the mutation. The cause of the disease has not yet been made clear. Chinese literature is often the disease and chloasma together, in the "golden mirror of medicine. Surgical method." in the dark dark secret least said: "this card a blackish facial patch. At the beginning of improvement such as dirt, long shaped black as coal. Dry and dark, different sizes. Small like millet red bean, lotus seed, Gorgon like big. Or long or oblique or round, flat on the skin."
Modern medicine thinks that this disease is associated with the following factors: 1, malnutrition, lack of vitamins; 2 cases with a lot of coal tar or asphalt contact history; 3 cosmetic products such as paint or even some components of actors in the domestic cosmetics can cause melanosis; 4 nerve endocrine dysfunction; thiol reducing sulfur 5 skin inflammation, tyrosinase activity enhanced, often aggravate the sun sun; similar to Chinese medicine surface dust.
Etiology and pathogenesis
1 blood stagnation of liver qi stagnation, blood can not nourish the skin, sunlight, natural cosmetics poison, so that a lag in burn knot.
2 kidney deficiency diet adjustment, and the inactivation of blood can not nourish the skin and kidney.
[clinical features] in adults, women often see. Skin lesions can occur in the skin, mainly involving the face, neck, upper limbs and other parts. After a slow course of disease, more than a few months after the cessation of development, the pigment exists for a long time, a small number of self extinction. At the beginning of erythema or light brown spots, after the gradual expansion of dark brown or green gray diffuse patches, sometimes accompanied by mild itching. Or accompanied by dizziness, fatigue, anorexia, weight loss and other symptoms. It can also be seen in the chest, hands, chest. In addition to pigmentation, can see localized telangiectasia, follicular keratotic papules and a little small scaling, resulting in face was grey. The disease does not involve the mucosa.
Several common melanosis
1 Riel melanosis of the disease mainly involving the face, from the two temple began, gradually spread before and after the forehead, cheeks, ears, and extended the whole face, even involving the neck, armpits, forearm navel and other body parts. But the mouth and chin often peripheral invasion, mucosal involvement. The lesions as reticular pigmentation, early flushing, gradually by yellow to pale pigmentation, black. In the perifollicular, slowly forming diffuse plaques, but the facial and neck front central pigment is light. Often accompanied by mild mesh telangiectasia, in the neck are often chaff like tow chip. Appearance as if a layer of white powder, in the normal state of the skin is not bright.
2 tar melanosis mainly in long-term exposure to coal tar, asphalt and smoke, distribution in the face, neck and other exposed parts of the forearm, and orbital zygomatic, is the most obvious. Early lesions of erythema, edema, or its scaly, visible follicular papules and comedones, with a characteristic of acne like change. After the gradual deepening of the color, light brown to dark brown, diffuse or reticular pigmentation, often accompanied by telangiectasia, lichen like papules, follicular keratosis. Often in the sun after aggravating.
3 is a kind of inflammation after melanosis following acute and chronic inflammation of the skin pigmentation. In general, the rapid occurrence of dermatitis, pigmentation spots for light brown, purple brown to dark brown. Confined to the skin inflammation area, subsided slowly, often for several months. After the sun or re inflammation of the pigment to further deepen, and even mild lichen. In general after the lichen planus, pityriasis rosea, herpes zoster, lupus erythematosus, fixed drug eruption, dermatitis herpetiformis, neurodermatitis, insect bite dermatitis, pyoderma caused varying degrees of pigmentation.
The epidermal basal cells were liquefied, and the superficial lymphatic vessels and tissue cells infiltrated in the superficial dermis.
1.Addison disease: the disease in addition to pigmentation of skin, mucous membrane with brown black patch, accompanied by systemic symptoms such as dizziness, fatigue, anorexia, hypoglycemia, cold, fat tongue pulse fine symptoms.
2 reticulate pigmented skin diseases as the basic lesions of reddish brown reticular pigmentation, with pale white atrophic spots, and has obvious telangiectasia, more symmetrical distribution in the face and neck.
Traditional Chinese Medicine
1 liver blood deficiency syndrome: in the early, often accompanied by brash, anorexia nausea, flushing skin itching, the sun even more, red tongue moss, pulse breakdown. Spleen deficiency, Qi and blood, skin dystrophy
[Methods] Shugan Jieyu, nourishing blood and clearing heat.
Bupleurum 9 grams Angelica 9 grams of red and white spoon (each) 9 grams, 15 grams of Astragalus Radix Rehmanniae 30 grams of Millettia 30 grams Yinhua 9 grams 9 grams of Scutellaria Gardenia 9 grams 9 grams 3 grams of licorice
2 kidney deficiency: common in later period, the patient was dark, accompanied by dizziness tinnitus, lumbar leg soft, fat tongue moss peeling, fine soft pulse.
[Methods] nourishing kidney yin.
Dried rehmannia root (each) 15, 9 grams of Cornus yam 9 grams of Epimedium 15 grams medlar 9 grams 9 grams 30 grams of Ligustrum Eclipta alba Angelica 9 grams 9 grams Chuanxiong 9 grams 3 grams of licorice.
Unilateral medicine six taste glutinous rehmannia pill, Xiaoyao pill.
1 cloud Poria powder rubbed the affected area, 2 times a day.
2 her 10 grams Angelica 10 grams 10 grams, 10 grams of white muscardine silkworm Ampelopsis baifuzi 10 grams 10 grams of white moss skin white lentils 15 grams. Once a day, Decoction fumigation.
3 Atractylodes 40 grams, 250 ml vinegar, soak 5~7 days, local inunction, 2 times a day.
Acupoints: Zusanli, Taichong, liver Yu, Guan Yuan, yinlingquan, Sanyinjiao, Shenshu, Mingmen points, each with 2~4 empirical point, with the reducing method, deficiency with the reinforcing method, for 15~20 minutes, when necessary and moxibustion.
1 systemic therapy
(1) vitamin C orally, serious can intravenous drip daily or every other day for 1 times, each time 1~5 grams, 4 weeks for 1 courses.
(2) oral vitamin E or vitamin E cream can also be used to improve skin nutrition 1%.
2 local treatment
3~5%, 10% hydroquinone cream and 3% hydrogen peroxide topical urea cream.
Integrated traditional Chinese and Western medicine oral vitamin C 3~4 grams per day. Compound Dan Cen injection every day 10~20 ml. Ahylysanfinfarctase every 0.5~0.75 grams of alternating intravenous injection, and given a variety of vitamins and calcium. Topical 19~20% salicylic acid ointment and 20% Urea Ointment sooner or later alternating external, the drug concentration gradually increased markedly after 10% Zinc Oxide Ointment and mold therapy.
The prevention of melanosis
1 general principles: to avoid the sun, when going out sunscreen
2 prevention: to strengthen labor protection, and if there is a close relationship with the occupational factors (such as contact coal tar, asphalt, etc.) should be considered out of contact. Do not use inferior cosmetics, patients need to maintain a pleasant mood, with the treatment can be twice the result with half the effort.