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About Tinea

A. Tinea Corporis; Ti Xian

[ Pathogenesis and pathophysiology ]

This is referred to as dao xian (knife tinea) or yuan xian (circular tinea) in the Classics. This condition results from the invasion of the surface of the body by damp heat pathogens (from the TCM point of view) and is caused by mycosal infection (from the modern Western point of view).

[ Diagnosis ]

Most sufferers of tinea corporis are adults. It tends to occur inthe summer and gets better in the winter. It is called tinea corporis because every part of the body is susceptible to it, except for the head, hands, feet, hips, fingers and toes. The lower abdomen and waist are the most likely area to be stricken. It manifests as circular plaques of various sizes with a clear border which is demarcated by pinhead-sized papules, watery blisters, pustules, scabs, or scaling and desquamation which stand in relief. )It is also characterized by) the tendency to heal in the center and to expand (on the periphery) and is accompanied by a subjective sensation of itching.


B. Tinea Cruris; Gu Xian (Jock Itch)

[ Pathogens and pathophysiology ]

Another name for this condition is yin xian (private parts tinea). It is due to the same causes of tinea corporis.

[ Diagnosis ]

As its name implies, this condition affects the internal aspects of the thigh, the perineum, and the buttocks. The majority of sufferers are adults in whom it islikely to recur in the summer and be relieved in winter. The lesions themselves are similar to tinea corporis in appearance.


C. Tinea Palmaris; shou xian

[ Pathogenesis and pathophysiology ]

This condition is referred to as e zhang feng (goose palm wind) in the Classics. Heat in the spleen and stomach and wind due to blood heat are the causative factors. (According to modern Western medicine,) it is due to fungal infection. A Compendium of Wai Ke states, 'At the onset, goose palm wind presents as (a series of) purpurae with white dots. (As it evolves,) the skin turns dry and thick. Consequently,) fissures or cracks are inevitable.'

[ Diagnosis ]

Tinea Palmaris tends to apear between the fingers and on the palms. It may crawl to the dorsal aspect of the hand. It is typically aggravated during the summer and improves somewhat in winter. (As far as its) morphology, it is usually classified into three categories. Although all three may be simultaneously present, one variety is usually more pronounced.

  1. Blister type
    The lesions take the form of deep blisters with severe itching. Secondary infections may arise after scratching or pricking with needles in an attempt to relieve the intolerable itching sensation.

  2. Erosive type
    Most of the lesions lie between the fingers and especially between the third and fourth fingers. The surface of the skin is pale as if immersed in water, while the deep layers of the skin are scarlet and ulcerous. There is severe itching accompanied by pain. Secondary infection is also very possible.

  3. Squamous cornification type
    Here there is cornification and scaling over the palm with a pink base. There may or may not be itcing. During the winter, when the skin cracks, there is pain.


D. Tinea pedis; zu xian

[ Pathogenesis and pathophysiology ]

This condition is due to the downward percolation of damp heat from the spleen and stomach channels. (According to modern Western medicine,) it is caused by fungal infection. In the Classics, the erosive type is called chou tian luo (stinking river snail,) while the blister type is called tian luo bao (river snail blisters)

[ Diagnosis ]

  1. Blister type
    This condition tends to occur around the arch of the foot or on both sides of the toes. It can be composed of concentrated or scattered little blisters. As these become perforated or absorbed, they may produce a certain amount of scaling. With an increase in the number of blisters, semicircular or irregular shaped plaques may fall off. Recurrence of this condition renders the skin rough and thick and cracks develop easily in winter. (Moreover,) itching is also present. Secondary infection may turn the blisters into pustules with a burning sensation.

  2. Erosive type
    This type tends to occur between the toes, especially between the third and fourth toes. The skin looks pale due to moisture and is productive of fluid. A red wound surface is exposed when the skin is taken off. There is itching, pain, and a particular malodor.

  3. Squamous cornification type
    This tends to occur between the toes, on the sides of the heels, and on the soles. The symptoms are excessive cornification, dryness, roughness, desquamation, and rhagas. This type of tinea often evolves from the water blister type.


E. Tinea Unguium; Jia Xian

[ Pathogenesis and pathophysiology ]

This condition is also called hui jia (ashy nail) or e zhua feng (goose claw wind). Its pathogenesis is similar to tinea palmaris. It is a fungal infection.

[ Diagnosis ]

The finger and toenails lose their normal shape and color. They lose their lustre, become fragile and may become either atrophic or hypertropic. (In addition,) the finger or toenails are often separated from the nail bed. In most cases, tinea unguinum will not evolve into parnychia unless it becomes infected by moniliasis. However, this condition is often a percursor to tinea palmaris or tinea pedis. Culturing and other tests are positive for fungus.

[ External treatment ]

1. Toad dermal ointment
2. Fungal dissipation herbal lotion