chronic acne for 5 year

Record of first visit

Date of first visit: 11/08/2008

Name: Ms.Liu

Gender: female

Age: 25

Chief complaints: chronic acne for 5 year

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Descriptions (4 diagnostic methods)

A: Asking

Current condition: the patient has got this acne since she came to NZ five years ago. Her facial skin is oily and hot sensation. She likes fried and spicy food, but she stops eating that kind of food recently. No chills and fever, no sweating but only sweat in both palms. No headache. Her sleeping is good about 8 hours but she gets up once during the night to go toilet. Urine is slightly yellowish and defecation sometimes needs some effort. She always feels hot sensation on upper part of her body, but she feels both feet cold.

Past history: she has T.B. at 3 years old.

Life style: busy working style,

Family history: NAD

Menstruation: the first time at 12 y/o, period is 28 days, duration is 5 days, last time is on 9^th of July, 2008. Virginal discharge is milky white colour.

B: Inspection

General: flush complexion,

Others: NAD

Tongue: red tip, dry, thin coating, red tongue body,

C: Auscultation/ Olfaction

Sound: NAD

Odour: NAD

D: Palpation

Body area: NAD

Pulse: rapid, and weak in chi,

Case Summary

Diagnosis

A) Diagnosis: chronic acne

B) Syndrome differentiation: lung and stomach heat underlying kidney deficiency

C) Explanation:

Lung dominates the skin. The patient has got hot sensation on upper part of the body always. The heat is coagulated on the face. The wind and heat in blood will coagulate on the face, so the acne occurs. With greasy and spicy food constraints at spleen; it generates damp- heat. She has yellowish urine and little constipation. Kidney fails to consolidate the urine so she needs to get up once during her sleep. Kidney yin deficiency generates deficient fire in five centers, so her both palms sweating.

Treatment

(A)Treatment principles

Clear lung heat and stomach heat and tonify kidney,

(B) Treatment Methods

Yuji (LU10), Zhongfu (LU1), Feishu ( BL13) and Hegu (LI4),

San yin jiao (SP6)

(C) Explanation

Hegu is to regulate the flow of qi and clear away the heat from the exterior.

Yuji and Zhongfu are the lung meridian, can clear the heat from lung. Feishu serves to restore the dispersion of lung qi in order to remove the stagnation from the skin and hair. San yin jioa is the crossing point of Spleen, Liver and Kidney meridian, is to tonify the kidney.

(D) Life style advice

The patient has to give up the preference of greasy and spicy food and take more vegetable and food with fibers. She also needs to sleep enough time. And the more water would benefit her also.

TCM

Acne:

It is a facial skin disease characterized by pellet-like pustules, from which the white-oily powder-like substance can be squeezes out. The disease is also known in TCM as “alcohol horn” or “ acne of lung wind”, and is apt to occur on the face and on the chest and back in both male and female youth. It is mainly considered that the occurrence is due to the heat in blood.

Etiology and Pathogenesis:

(1) Overeating of greasy food

(2) Lung Meridian accumulated with heat and is invaded with wind.

(3) The blood and heat are coagulated on the head and face.

Differentiation

At the onset, there is a comedo as big as the pintip, or the millet, from which linear cream can be squeezed out. Subsequently, a pustle develops on the top of the comedo and is hardened, slightly painful and scarring.

Treatment Principle:

Points from Pericardium and Bladder meridians are primarily selected. Reducing technique is employed to eliminate the excessive heat.

Prescription: Yuji (LU10), Zhongfu ( LU1 ), Feishu ( BL13), Hegu ( LI4)

Explanation: Lung dominates the skin and hair. Yuji and Zhongfu are used together to clear the heat from lung. Feishu serves to restore the dispersion of lung qi so as to remove the stagnation from the skin. Hegu regulated the flow of qi to clear the heat and soothe the exterior.

WMS

Acne

Acne is the term for plugged pores (blackheads and whiteheads), pimples, and even deeper lumps (cysts or nodules) that occur on the face, neck, chest, back, shoulders and even the upper arms. Acne affects most teenagers to some extent. However, the disease is not restricted to any age group; adults in their 20s - even into their 40s - can get acne. While not a life threatening condition, acne can be upsetting and disfiguring. When severe, acne can lead to serious and permanent scarring. Even less severe cases can lead to scarring.