It's hot in summer, and there are small pimples on my finger skin, which are dense and similar to blisters the size of millet. I always suspected rice and pork.

Many people have blisters, itching and peeling on their hands in summer. With all kinds of treatment, they can't cure it, and they are worried about it every year.

This phenomenon is relatively common, medically known as herpes simplex. The cause of this disease is still not completely clear. Most people think that it is a non-specific eczema-like skin reaction, which is related to personal physique, autonomic nerve dysfunction and mental factors. This disease is characterized by repeated papules and blisters of millet size on palms and fingers, no obvious inflammation around them, thick blister wall, transparent blister fluid at first, and turbidity later. After 2 ~ 3 days, the blister fluid absorbs itself, and after drying, it forms desquamation, exposing pink new epithelium, forming linear chapped skin when fingers flex and stretch, and the rash is symmetrically distributed, consciously itching and burning pain in the affected area. Hot flashes mostly occur in summer, but they can be cured in autumn and easily recur after a few years.

There is no specific prevention and treatment for this disease. Avoid spicy food, wine, coffee and other irritating foods, smoke less or not, and wash your hands with or without alkaline soap, washing powder and detergent. Don't puncture the blister, let alone tear the skin. The local treatment is mainly astringent and antipruritic, such as calamine lotion, 5% formalin or 1% urotropine, miliaria powder, etc. Blisters can obviously be soaked or wet-packed with 0.5% aluminum acetate solution or 5% alum solution. Patients with obvious itching can use corticosteroid preparations such as triamcinolone acetonide, compound colarone cream and Zhiluosong. If erythema, desquamation and chapping are the main symptoms, 10% urea cream, silica cream, vitamin e cream and salicylic acid ointment can be used externally, 1 ~ 2 times a month. Antihistamines and vitamins B 1, B2, A and E can be used for systemic treatment. If there are many rashes and the symptoms are obvious, you can take corticosteroids such as prednisone for a short time, each time 10 mg, three times a day, and the symptoms will be relieved after taking it for 5 to 7 days.

What are the characteristics of traditional Chinese medicine in treating herpes simplex?

Herpes zoster not only affects the beauty of hands, but also often affects patients' lives because of itching. In severe cases, it can cause secondary infection, resulting in swelling and pain in the hands. Because the cause of this disease is not very clear, western medicine has no satisfactory treatment to eradicate it.

Traditional Chinese medicine has a long history of treating this disease, which was called "ant hole" as early as the Ming Dynasty. Because it is mainly manifested as deep blisters, it should belong to dampness. The treatment of traditional Chinese medicine is carried out in many ways. Internal and external training, emotional conditioning of diet;

(1) internal processing

① Most of the blisters on the palms and soles of patients with damp-heat syndrome are deep, clustered and needle-tip-sized, itchy and penetrating, wet and yellow, red tongue with greasy fur and slippery pulse. Treatment should clear away heat and remove dampness. Medicinal purposes: Scutellaria baicalensis Georgi 10g, Coptidis Rhizoma 10g, Rhizoma Atractylodis 10g, Pericarpium Citri Tangerinae 10g, Poria cocos 10g, Liuyi Powder 10g (stir-fried), 30g of raw Coicis Semen, and Cortex Moutan. Decoct with water, daily 1 dose.

② The palms and soles of patients with spleen deficiency and dampness are scattered in blisters, the tip of which is about the size of millet, translucent, and the blister fluid is thin and sometimes itchy, accompanied by slippery tongue coating and slippery pulse. Treatment should strengthen the spleen and remove dampness. Medicinal purposes: Poria cocos 12g, Atractylodes macrocephala 10g, Alisma orientalis 10g, White Lablab 10g, Plantago asiatica 10g (stir-fried), parched Coicis Semen 60g, parched Chinese yam 30g and waxgourd peel 60g. Decoct with water, daily 1 dose.

(2) External treatment According to the characteristics of the disease, the method of eliminating dampness and astringing blisters can be adopted: Vaccaria seed is decocted with 60g, alum 30g and pomegranate peel 30g to get juice, and the affected part is soaked for 5 minutes each time, twice a day.

(3) Dietotherapy ① Eat more fruits and vegetables with the functions of invigorating spleen and removing dampness, such as yam, sweet potato, wax gourd, watermelon, adzuki bean and pumpkin. Eat less spicy, thick, fatty and sweet wine and cheese.

(4) Others reduce contact with soap, alkali, washing powder, detergent, gasoline and alcohol; Keep your feelings open and avoid seven emotions; Don't tear off the molt by hand to avoid infection and suppuration.

Differential diagnosis of herpes zoster from tinea manuum, eczema, contact dermatitis and exfoliative keratosis

Tinea manus, commonly known as Liriodendron chinense, is caused by fungal infection. Suffering from tinea manuum, you will often feel itchy, and the skin on your hands will also appear papules, blisters, erythema and desquamation. At first, it was a small piece, then the damage gradually expanded and the boundary was clear. After a long time, the hand skin will become rough, dry and thick, and may be accompanied by chapped and bleeding. But if there are symptoms such as itchy fingers and peeling, can you say that it must be tinea manus? Of course not. There are many skin diseases that can be manifested as itchy fingers and peeling skin, such as eczema, herpes zoster, contact dermatitis and exfoliative keratosis. , should be carefully identified, otherwise it will delay the diagnosis and treatment.

Eczema often occurs in the palm of your hand, and your hands are symmetrical. Skin lesions are multiform, with papules, blisters, erosion, exudation and scabbing coexisting, and two or three of them are often dominant. The change of illness is closely related to the season, as well as diet and rest. If the palm comes into contact with water and soap, the injury will be aggravated. The fungal test was negative.

The occurrence of herpes zoster has obvious seasonality, mostly at the turn of spring and summer, and it heals itself in winter, mainly among young people. Skin lesions are also symmetrically distributed, mainly blisters, which appear in batches and can be seen on the palm, fingertips and fingertips. Blisters fall off after drying out, exposing new skin, often accompanied by varying degrees of itching and burning sensation. The occurrence of this disease is related to poor sweating or allergic reaction, and the fungal examination of the damaged part is negative.

Contact dermatitis is caused by contact with allergic substances, which is an allergic reaction of the skin and has obvious contact history. Skin lesions appear at the contact site, with clear boundaries and consistent shapes, mainly erythema and edema, and blisters and bullae can be seen in severe cases. After disengagement, it can gradually fade to recovery. Local fungal examination was negative.

Exfoliative keratosis is a superficial exfoliative dermatosis of palmoplantar, often accompanied by local hyperhidrosis, which is prone to occur in warm and hot seasons. Skin lesions mainly involve hands, feet and bilateral symmetrical hearts, showing small white spots formed by loose keratin and easily falling off tissue-like scales. The underlying skin is normal and the itching is not obvious. The fungal test was negative. The cause of the disease is unknown, which may be related to hand sweat, mental stress and other factors. If the symptoms are not serious, there is no need to deal with them, because diseases often heal themselves. However, when a rash occurs, try to avoid contact with alkaline substances such as soap detergent and alcohol, and don't tear the upturned skin with your hands, which will aggravate skin damage. 10%-20% urea grease can be used externally, 1 ~ 2 times/day.

Hydrocortisone itself is a kind of hormone, which has the functions of anti-allergy, relieving itching and inhibiting inflammation. Ointment or cream is mostly used for external use, generally used for allergic dermatoses, such as eczema, urticaria, drug dermatitis, contact dermatitis, prurigo and so on. Every drug has treatment and side effects on patients. Long-term use of topical hormones can be addictive, with about 20 side effects. The most common are: skin atrophy, telangiectasia, purpura, fungal infection, acne-like dermatitis and so on.

The process of exogenous hormone addiction is roughly as follows: the condition improves rapidly after taking the medicine and continues to use it for several months. Once the drug is stopped, redness, tenderness, itching, chapping and desquamation may appear on the application site (especially on the face) within one or two days, resulting in pustules and aggravating the primary disease, which is called rebound dermatitis. When the hormone is reapplied, the above situation will improve or disappear soon; If the drug is stopped again, the rebound dermatitis will recur and it will be more serious than before. In order to avoid the pain after drug withdrawal, patients rely entirely on the application of hormones. After several months or years, the skin becomes thinner obviously, the capillaries dilate, and sometimes purpura appears, especially on the face, which can cause deep persistent erythema. The longer the application time, the heavier the rebound dermatitis will be.

Therefore, when using topical corticosteroids, you must follow the doctor's advice. Generally, the standard for choosing corticosteroids is only to control the disease. Some patients have become dependent on hormones, and drug withdrawal has brought great pain to patients. We should do a good job in patients' ideological work and enhance their confidence in overcoming diseases. It may be painful to start using 2.5% hydrocortisone, but it will improve greatly in a few weeks. Later, we will change it to 1% hydrocortisone and then to skin care fat to protect the skin. As long as we have a full understanding of the role and side effects of hormones, we can use them reasonably.

Suggestions; Stop taking medicine under the guidance of a doctor!

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