Secondary vulvar hyperkeratosis

　　First, etiology

　　Any vulvar pruritic skin disease can cause secondary vulvar hyperkeratosis. Common diseases include the following:

　　1. Vulvar chronic contact dermatitis.

　　2. Vulvar chronic eczema, dermatitis.

　　3. Vulvar neurodermatitis.

　　4. Vulvar pruritus.

　　5. Vulvar lichen planus.

　　6. FOX-Fordyce disease.

　　7. Scabies.

　　Second, pathogenesis

　　Under normal circumstances, the vaginal mucosa has no granular layer and stratum corneum. Secondary hyperkeratosis of the vulva results in the appearance of granular layer and keratotic layer. The skin or mucosal transition areas of the vulva, labia majora, etc., show obvious hyperkeratosis, granular layer, thickening of the stratum spinosum, and infiltration of lymphocytes and other cells in the dermis. At the same time, pathological changes of certain primary diseases can also be seen.

　　1. Bacterial infection is an acute systemic infection caused by the growth and reproduction of pathogenic bacteria or opportunistic pathogens in the blood circulation, producing toxins and other metabolic products. It is characterized by chills, high fever, rash, joint pain, and enlargement of the liver and spleen in clinical practice. Some may have septic shock and migrating lesions. Acute systemic infection caused by pathogenic microorganisms entering the blood from wounds or internal infection foci.

　　2. Fungal infectious diseases are divided into four categories according to the parts of the human body invaded by fungi: superficial mycosis, cutaneous mycosis, subcutaneous tissue mycosis, and systemic mycosis; the first two are called superficial mycosis, and the latter two are called deep mycosis.

　　In addition to the skin lesions of the primary disease, long-term itching and scratching can lead to infiltration and thickening of the skin of the perineum and labia majora, lichenoid changes and hyperkeratosis, white scales, long-term repeated stimulation of the labia minora, and the clitoris can become enlarged due to infiltration and thickening. The patient experiences abnormal pain.

　　The scope of this disease is relatively broad, belonging to a collection of systemic diseases. Its causes include allergies, infections, non-infectious stimuli (such as using poor-quality sanitary napkins), and unclean hygiene, which can all lead to this disease. Therefore, the focus of preventive measures is on personal hygiene, regularly cleaning the vulva, avoiding infection-induced disease, avoiding exposure to pollen in parks and other places during the transition from spring to summer to trigger allergies, and using high-quality hygiene products can also reduce the incidence rate of the disease.

　　1. Vaginal secretion examination.

　　2. Histopathological examination. Under normal circumstances, the vaginal mucosa has no granular layer and stratum corneum. Secondary hyperkeratosis of the vulva results in the appearance of granular layer and keratotic layer. The skin or mucosal transition areas of the vulva, labia majora, etc., show obvious hyperkeratosis, granular layer, thickening of the stratum spinosum, and infiltration of lymphocytes and other cells in the dermis. At the same time, pathological changes of certain primary diseases can also be seen.

　　One, dietary therapy for secondary vulvar hyperkeratosis

　　1. Kochia and Stemona Formula

　　(1) Composition: 30 grams of Kochia scoparia, 20 grams each of Taraxacum mongolicum, Psoralea corylifolia, and Stemona root, 10 grams each of Alum, Realgar, and Leptochira spinosa.

　　(2) Method: Boil the above medicine in water for 20 minutes, remove the dregs, take the medicine liquid, first fumigate and then wash the affected area, 15 minutes each time, twice a day.

　　2. Cnidium Monnieri and Epimedii Formula

　　(1) Composition: 45 grams of Epimedii, 30 grams of Cnidium monnieri, 15 grams of Dictamnus dasycarpus, 9 grams of Mentha haplocalyx.

　　(2) Method: Boil the above medicine in water for 20-25 minutes, remove the dregs, take the liquid, wash the affected area externally.

　　3. Others

　　(1) Composition: 10 grams each of Epimedii, Sichuan pepper, Cnidium monnieri, Dictamnus dasycarpus, Poria cocos, mugwort, Schizonepeta tenuifolia, Apium graveolens, and Phellodendron amurense.

　　(2) Method: Put the traditional Chinese medicine in an enamel pot, soak in cold water for half an hour, boil for 15 minutes, remove the dregs, take the liquid, cool slightly, wash the vulva with gauze, then take a bath, boil it again next time, each dose can be used for 4 times, wash once in the morning and evening.

　　4. Chrysanthemum and Mugwort Formula

　　(1) Composition: 10 grams each of chrysanthemum, mugwort, trichosanthes, Dictamnus dasycarpus, Sichuan pepper, wolfberry, Strychnos nux-vomica, and Sichuan pepper, 15 grams each.

　　(2) Method: Boil the above medicine in water for 20 minutes, remove the dregs, take the liquid, wash the affected area externally, twice a day.

　　5. Beehive and Coptis Formula

　　(1) Composition: 10 grams each of coptis, Phellodendron amurense, Dictamnus dasycarpus, cicada slough, beehive, Sichuan pepper, Schizonepeta tenuifolia.

　　(2) Method: Boil the above medicine in water for 20 minutes, remove the dregs, take the liquid, wash the affected area externally, twice a day.

　　Two, what is good to eat for patients with secondary vulvar hyperkeratosis

　　1. Eat more foods with anti-vulvar tumor and leukoplakia effects, such as sesame seeds, almonds, wheat, barley, loofah, black-bone chicken, cuttlefish, black garter snake, pork pancreas, chrysanthemum, black plum, peach, lychee, shepherds purse, chicken blood, eel, abalone, crab, horseshoe crab, sardine, clam, tortoise shell.

　　2. For pain, eat horseshoe crab, red, lobsters, sea asparagus, sea cucumber, tiger fish, beetroot, mung beans, radish, chicken blood.

　　3. For itching, eat amaranth, cabbage, mustard, taro, kelp, purple kelp, chicken blood, snake meat, pangolin.

　　4. To enhance physique and prevent metastasis, eat silver ear, black fungus, mushrooms, monkey head fungus, gizzard, sea cucumber, Job's tears, walnuts, crabs, lizard, needlefish.

　　Three, what is not good to eat for patients with secondary vulvar hyperkeratosis

　　1. Prohibited foods

      Alcohol, scallions, garlic, chili, freshwater fish (carp, crucian carp, grass carp, crucian carp), shrimps and crabs, chicken, duck, and goose meat.

　　2. Avoid moist vulva

      Eat more iron, copper, manganese and other trace elements rich foods such as walnuts, sesame seeds, mushrooms, tofu, green vegetables, black fungus, carrots, lean meat, pork blood, oysters, sea snails and sea cucumber, etc., for sugar, sweets, apples, cold and greasy foods.

　　Precautions before the treatment of secondary vulvar hyperkeratosis:

　　1. Treatment Method for Downward Flow of Damp-Heat: Clear Heat and Drain Dampness to Remove Spots

　　1, Formula: Modified Kudzu Decoction (prescription)

　　2, Kudzu 15 grams, Sophora 12 grams, Phellodendron 10 grams, Coix Seed 12 grams, Bishopleura 12 grams (decocted in cloth), Saposhnikovia 9 grams, Cnidium 9 grams, Scrophularia 10 grams, Patrinia 12 grams,加减：Leukorrhea with yellow color, infiltrating the vulva, add Anemarrhena 10 grams, Phellodendron 9 grams, Myrobalan 10 grams, Atractylodes 12 grams; Severe vulvar itching, add Haplophyllum 15 grams, White Peony 12 grams, Smilax 15 grams.

　　2. Treatment Method for Liver Depression Leading to Fire: Clear the Liver and Drain Fire to Remove Spots

　　1, Formula: Modified Long Dan Xie Gan Decoction.

　　2, Gentiana 9 grams,茵陈10克， 生Ganoderma lucidum 9 grams, Dried Rhubarb 3 grams (added later), Phellodendron 9 grams, Dictamnus 15 grams, Eclipta 15 grams, Su Mu 12 grams, Alisma 10 grams,加减：Vulvar skin dry and cracked, add Ophiopogon 15 grams, Anemarrhena 12 grams, Collagen 9 grams (dissolved), White Peony 10 grams; Constipation, add Ophiopogon 12 grams, Trichosanthes saponins 9 grams (ground).

　　3. Treatment Method for Deficiency of Qi and Blood: Nourish Qi and Blood to Remove Spots

　　1, Formula: Modified Ba Zhen Decoction.

　　2, Codonopsis 12 grams, Astragalus 10 grams, Atractylodes 9 grams, Poria 10 grams, Angelica sinensis 9 grams, White Peony 10 grams, Raw Rehmannia 10 grams, Collagen 9 grams (dissolved), Epimedii 9 grams, Cnidium 10 grams, Licorice 3 grams,加减：Vulvar atrophy, add Chinese dogwood fruit 9 grams, Anemarrhena 10 grams, Ba Ji Tian 9 grams, Epimedii 12 grams, Prepared Polygonum multiflorum 12 grams.

　　4. Treatment Method for Kidney-Yin and Liver-Yin Deficiency: Nourish the Kidney and Liver to Remove Spots

　　1, Formula: Modified Zuo Gui Wan.

　　2, Freshly dried Rehmannia 15 grams, Chinese yam 10 grams, Chinese dogwood fruit 9 grams, dodder 12 grams, Chinese wolfberry 10 grams, Achyranthes 9 grams, Turtle Shell Gelatin 12 grams (dissolved), Cnidium 10 grams, Schisandra 12 grams, Cuscuta 9 grams, Ba Ji Tian 9 grams,柏子仁9克，加减：Vaginal dryness and itching, add Polygonatum 12 grams, Prepared Polygonum multiflorum 10 grams, Angelica sinensis 9 grams.

　　5. Treatment Method for Kidney Deficiency and Essence Decline: Tonify the Kidney and Fill Essence to Remove Spots

　　1, Formula: Modified Sui Gui Wan.

　　1, Raw Rehmannia 12 grams, Chinese yam 10 grams, dogwood fruit 9 grams, Chinese wolfberry 10 grams, eucommia 10 grams, dodder 10 grams, prepared aconite 9 grams (boiled first), deer antler gelatin 12 grams (dissolved), Polygonatum 10 grams, Astragalus 12 grams.