中醫治療綿延難癒玫瑰糠疹之病例報告與理論推導

Traditional Chinese Medicine for Refractory Pityriasis Rosea: Case Report and Theory Discussion

本病例為一年輕學生，全身開始起紅色斑塊已七年，不癢不痛，表皮無潰爛，微高於肌膚，無水泡滲液，曾至某醫學中心皮膚科做切片檢查，診斷為玫瑰糠疹，未接受西醫或中醫治療。於民國101年09月26日至本院中醫科就診，其暗紅色斑塊除臉部外全身皆有，軀幹、大腿及臀部特別密集，病灶呈橢圓形或圓型，大小不一，界限明顯，斑塊出時並無癢痛感，斑塊上微鱗屑，秋冬換季時加重，無其它加重緩解因子，且癒後留下色素沉澱，針對患者的體質情況，辨證為陰寒凝於肌表，採用陽和湯加減治療後，出斑速度減緩，且色素沉澱情形較為改善，症狀平穩。

We presented a case of one young student who had red plaques over whole body for seven years. The red plaques were slightly higher than skin surface without any ulceration, vesicles, painful and itching sensation. According to the report of pathological biopsy, he had been diagnosed with pityriasis rosea. Due to above problems, he went to our Traditional Chinese Medicine clinics on Sep. 26th, 2012. At first visit, the dark-red plaques with several scrapes were over whole body, especially trunk, thighs and buttock, except face. The shapes of the plaques were oval or round with different sizes and significant margins. There were no painful or itching sensation related to the skin lesions, but pigmentation was noted after skin healing. It became worse during the autumn and winter season. Under the impression of congealing cold over fleshy exterior and yin vacuity, we prescribed Harmonious-Yang-Decoction as main formula for treatment. After that, the plaques were reduced with less skin lesions and less pigmentation. All of the symptoms were improving gradually under stable condition