Dermatology

Authors: Dr. Wong Lin Ho, MD, MSc, Prof Wong Pang Ong, PhD 

Skin is the largest organ within the body. It acts as a natural barrier to prevent surrounding bacteria and viruses from entering the human body. It also helps to regulate the body temperature through the sweat glands and allow for the formation of Vitamin D with the help of sunlight. However, being the largest organ in the body, it is also the most prone to diseases. According to Traditional Chinese Medicine Theory, dermatological disorders are related to the dysfunction of organs within the body. In addition, as many of these diseases appear unsightly or are infectious, they not only result in discomfort but also causes unnecessary stigmata and discrimination. 

Cellulitis Before and After Treatment

Eczema (Atopic Dermatitis)

 Eczema is a common condition, about 1 in 5 people will get it in their entire life. However, people at different stages of their life will experience different forms of eczma. For example, children are more prone to get atopic dermatitis whereas people of older age group acquire venous eczema, asteatotic dermatitis, and nummular eczema.

Eczema can be divided into acute, subacute and chronic cases, each of which presents differently. Acute eczema will demonstrate redness or swelling, papulation, vesiculation (formation of vesicle), oozing and weeping, and even blistering. Chronic eczema will show skin thickening with accentuation of the skin creases, hyperkeratosis, scaling, fissuring, excoriation, and hyperpigmentation. Subacute dermatitis will demonstrate features of both.

Eczema can be further divided into many different subcategories based on their individual causes. For instance, it can be caused by exogenous (outside the body) or endogenous causes (within the body). Exogenous causes includes triggers like irritants, allergens, UV light and drugs. Endogenous causes on the other hand, are poorly understood internal causes.

Management of eczema requires the use of topical lotions together with oral medications. These medications usually consists of herbs which helps to regulate the internal immunological environment, reduces inflammation and itch such as Glycyrrhiza glabra, Zingiber officinale and Angelica dahurica. The topical lotion (OFJ’s Eczema Soothe) is further combined with moisturising creams to reduce the dryness and itch.

Psoriasis

Psoriasis is an chronic inflammatory autoimmune condition which affects 2-4% of people worldwide. It usually begins at two different age groups,  those who fall between the 15-25 and 50-60 years old category. The causes of it is multi-factorial, but is frequently attributed to the immune system and as such is classified as an autoimmune disorder. Factors which trigger psoriasis includes streptococcal infection, stopping or starting of strong steroids, sunburns, obesity, smoking, alcohol, drugs such as beta-blockers and lithium. 

Psoriasis usually presents with symmetrically distributed, red, scaly plaques with well-defined edges. The scale is typically silvery white, except in skin folds where the plaques often appear shiny with a moist peeling surface. The most common sites are scalp, elbows, and knees, but any part of the skin can be involved. The itch involved is usually very mild.

Psoriasis can be further sub-classified into different types: Guttate, small/big plaque psoriasis, unstable, flexural, palmoplantar and nail psoriasis based on the different causes and location. Severity can also be classified by different scoring systems such as Psoriasis area and severity index (PASI), Body surface area and SKINDEX-16.

Treatment options include the usage of topical lotions and oral containing herbs which reduces the overgrowth of skin and reduce underlying inflammation such as Lonicera Japonica Thunb, Glycyrrhiza Uralensis Fisch, Rhizoma Coptidis and Centella Asiatica(L.) Urban can be used.

Shingles

Shingles is a localised area of inflammation caused by Varicella Zoster Virus (VZV). It usually results in chickenpox earlier on in childhood and remains within our nervous system (dorsal root ganglion). During an acute episode, the virus is reactivated and affects a particular nerve around the body, usually around the face, trunk or limbs causing blistering and sharp pain. The acute episode is usually triggered by a particular stress event such as prolonged exposure to sunlight, infection, surgery, stress or recent contact with someone with the virus. The rash usually resolves by itself in 3-4 weeks. However in some patients, they continue to experience pain along the area of the nerve for months to years, this is known as post-herpetic neuralgia. Treatment would usually require neuroacupuncture along the area of the peripheral nerves (see under Neurology), together with the aid of herbs which inhibits neuropathic pain, such as Yanhusuo and Chuanxiong.  Topical lotion which consists of herbs with antiviral effects can also be used to ensure a speedier recovery.

OFJ In house production of topical lotions:

Ong Fujian’s topical lotions are produced in-house via the extraction of herbs, thus reducing unpleasant odor and discolouration.

1. Moisturising lotion: Suitable for burns injury. It reduces pain, prevents infection and formation of corns, and accelerates the regrowth of skin.
2. Dr Eczema Relief Gel: Suitable for Eczema and Psoriasis. It is effective, colourless and odorless, and is suitable for patients with widespread eczema and psoriasis. Applying it topically helps to reduce the unnecessary side effects from prolonged consumption of oral medications.

The treatment of dermatological diseases require the consumption of oral medications, application of topical lotions and possibly an alteration of diet. Duration of treatment is usually lengthier than other conditions and would require strict compliance with the doctors/physicians for the best outcome.

Commonly encountered dermatological conditions: Acne Vulgaris, Eczema, Psoriasis, Warts, Corns, Shingles, Pityriasis rosea, Cold Sore, Palmoplantar Pustulosis, Pemphigoid Vulgaris, Bullous Pemphigoid, Systemic Sclerosis (Scleroderma), CREST Syndrome and Tylosis.

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