Psoriasis Vulgaris

Psoriasis vulgaris is a common, relapsing chronic inflammatory skin disease caused by various internal and external factors. It is characterized by red inflammatory papules, papulosquamous lesions, and plaques of varying sizes covered with multiple layers of silvery-white scales. Scraping off the scales may reveal a shiny, thin membrane, with pinpoint bleeding sometimes visible beneath it.
In Traditional Chinese Medicine (TCM), psoriasis is known as bai bi (白疕), a term found in Waike Dacheng (《外科大成》), “Bai Bi.” Based on its clinical features, TCM literature has also used names such as “pine-bark psoriasis,” “dry psoriasis,” “white-crust sores,” “snake lice,” “snake wind,” “stubborn psoriasis,” “bi wind,” and “wind psoriasis.”

TCM Pattern Differentiation and Treatment Reference

| Common Symptoms

Clinical Description:

This pattern is most commonly seen during the progressive stage of psoriasis vulgaris. Primary symptoms: ① bright-red skin lesions; ② new lesions continue to appear or rapidly expand; ③ existing lesions are thickened and infiltrated or macerated. Secondary symptoms: ① irritability; ② yellow urine; ③ pharyngeal congestion and enlarged tonsils; ④ a red or crimson tongue; ⑤ a wiry, slippery pulse or a thin, rapid pulse. Pattern identification: The pattern may be identified when all primary symptoms are present; secondary symptoms may also occur.

In Plain Language:

  • More commonly seen during the progressive stage of psoriasis vulgaris.
  • The lesions are bright red.
  • New lesions continue to appear or quickly spread over a larger area.
  • Existing lesions may become thickened and infiltrated, or become moist and macerated.
  • Irritability and a tendency to become angry are common.
  • Urine may appear yellow.
  • The throat may look red and congested, and the tonsils may be enlarged.
  • The tongue may be red or deep crimson.
  • The pulse may feel taut and smooth, or thin and relatively rapid.
  • This pattern is identified when all three primary symptoms are present; secondary symptoms may also be present.

| Treatment Approach

Clinical Description:

The primary approach is to cool the blood and resolve toxins. Methods such as clearing heat, eliminating dampness, dispelling wind, and promoting blood circulation may also be used.

In Plain Language:

  • The main aim is to cool the blood and help clear undesirable substances from the body, with the goal of easing redness, sores, swelling, pain, or pinpoint bleeding on the skin.
  • Other approaches may include clearing internal heat, promoting the elimination of dampness, dispelling wind, or promoting blood flow, with the goal of easing sensations such as feeling hot and irritable, heaviness in the body, severe itching, pain, or bruising.

| Related Products

The products below are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a doctor or pharmacist.

| Common Symptoms

Clinical Description:

This pattern is most commonly seen during the regressive and stationary stages of psoriasis vulgaris. Primary symptoms: ① pale-red skin lesions; ② dry scales. Secondary symptoms: ① dry mouth and throat; ② a pale tongue with little coating, or a red tongue with little moisture; ③ a thin pulse or a thin, rapid pulse. Pattern identification: The pattern may be identified when all primary symptoms are present; secondary symptoms may also occur.

In Plain Language:

  • More commonly seen during the regressive and stationary stages of psoriasis vulgaris.
  • The lesions are pale red.
  • The scales are dry.
  • Dry mouth and throat.
  • The tongue may be pale with very little coating, or red with little moisture.
  • The pulse may be thin or thin and slightly rapid.
  • This pattern is identified when both primary symptoms are present; the secondary symptoms listed above may also occur.

| Treatment Approach

Clinical Description:

The primary approach is to nourish the blood, moisten dryness, dispel wind, and relieve itching. Methods such as clearing heat, cooling the blood, and promoting blood circulation may also be used.

In Plain Language:

  • The main aim is to nourish the blood, moisten dryness, and dispel wind to help relieve itching, with the goal of easing dry, flaky skin, itchy red lesions, or repeated scratching.
  • Other approaches may include clearing internal heat, cooling the blood, or promoting blood flow, with the goal of easing discomfort such as irritability, thirst, pinpoint skin bleeding, or painful bruising.

| Related Products

The products below are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a doctor or pharmacist.

| Common Symptoms

Clinical Description:

This pattern is most commonly seen during the stationary stage of psoriasis vulgaris. Primary symptoms: ① dark-red skin lesions; ② thickened, dry lesions that persist for a long time. Secondary symptoms: ① dark menstrual blood or blood clots; ② a purplish-dark tongue or purple spots and patches; ③ a choppy pulse or a thin, moderate pulse. Pattern identification: The pattern may be identified when all primary symptoms are present; secondary symptoms may also occur.

In Plain Language:

  • More commonly seen during the stationary stage of psoriasis vulgaris.
  • The lesions are dark red.
  • The lesions are thickened and dry, and persist for a long time.
  • Menstrual blood may be dark or contain clots.
  • The tongue may be purplish-dark, with purple spots or patches.
  • The pulse may feel choppy, or thin and relatively slow.
  • This pattern is identified when both primary symptoms listed above are present; other features may also occur.

| Treatment Approach

Clinical Description:

Promote blood circulation, resolve blood stasis, move qi, and unblock the channels and collaterals.

In Plain Language:

  • Help promote blood flow and disperse stasis, with the goal of easing features such as bruising, pain, or menstrual irregularities.
  • Help regulate qi and unblock the channels and collaterals, with the goal of easing discomfort such as fullness in the chest and flanks, numbness in the limbs, or difficulty bending and straightening the joints.

| Related Products

The products below are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a doctor or pharmacist.

References

  1. Dermatology Committee of the Chinese Association of Integrative Medicine, Chinese Association of Dermatologists. Expert consensus on Chinese patent medicines for the treatment of psoriasis vulgaris[J]. Chinese Journal of Dermatology, 2014, 47(3): 215–216.
  2. Zhang Lixin, Yang Dingquan, Song Peihua, et al. Application of Pulian Ointment in the treatment of psoriasis[J]. Journal of External Therapy of TCM, 2000, 9(5): 22.
  3. Zhao Bian. Chinese Clinical Dermatology[M]. 1st ed. Nanjing: Jiangsu Science and Technology Press, 2010: 1008–1024.
  4. Wu Jun, Wang Bo. Clinical Surgery in Chinese and Western Medicine[M]. 1st ed. Beijing: China Medical Science Press, 2004: 601–605.
  5. Zhang Fengchuan, Sun Lina, Zhang Yingjie. Clinical analysis of triggers and prognosis in psoriasis vulgaris[J]. Chinese Journal of Leprosy and Skin Diseases, 2002, 6(18): 124–125.