Endometriosis of the skin

　　The causes of endometriosis include the implantation theory, serosal theory, immunological theory (including cellular immune function defect, humoral immune function defect), etc. Skin endometriosis is mainly caused by mechanical implantation during surgery. Any surgical incision that comes into contact with endometrial tissue may cause endometrial implantation. The ability of endometrial implantation at different stages is: postmenstrual period > menstrual interperiod > secretory period > premenstrual period > menstrual period > early pregnancy > late pregnancy. The endometrium during the postmenstrual period is mainly composed of basal layer cells, which are the most vital. However, a small number of individuals with umbilical and vulvar endometriosis have no history of surgery, which may be related to lymphatic metastasis.

　　Patients with skin endometriosis may also present with menorrhagia, infertility, dysmenorrhea, coital pain, and other symptoms:

　　1. Menorrhagia refers to excessive menstrual bleeding during several consecutive menstrual cycles, but the interval and bleeding time of the menstrual period are regular, without intermenstrual bleeding, post-coital bleeding, or sudden increase in menstrual blood.

　　2. Infertility refers to individuals with normal sexual life who have not taken contraception measures and have not been pregnant.

　　3. Menstrual disease mainly manifested by cyclical abdominal pain, pain in the lumbar sacral region, or even severe pain and fainting during the menstrual period, before or after the menstrual period.

　　4. Coital pain refers to the feeling of discomfort or even pain during sexual intercourse rather than pleasure for couples.

　　The damage of skin endometriosis is a single brown or blue nodule with a diameter of 0.5 to 0.6 cm, which is only seen in adult women. There is often mild tenderness and pain, most commonly found in the surgical scars of the abdomen or genitalia, especially in the scars after cesarean section, and there are also those that occur naturally at the umbilicus and inguinal region, which are especially significant during the menstrual period, can swell or bleed with the menstrual period, and the damage is benign rather than progressive.

　　To reduce the occurrence of skin endometriosis, women should pay attention to adjusting their emotions, maintaining an optimistic and cheerful mindset, and restoring the normal function of the body's immune system; they should keep warm and avoid catching a cold; during their period, they should not engage in intense sports or heavy physical labor; patients should pay special attention to maintaining stable emotions during their menstrual period or mid-menstrual period, and avoid overexertion.

　　The histopathology of skin endometriosis can be seen that irregular acinar cavities are embedded in the stroma with obvious cell and vascular components, the cells and acinar cavities are similar to functional endometrium, and there may be periodic changes.

　　To help patients with skin endometriosis get better recovery, it is recommended that everyone should pay attention to the following dietary principles:

　　1, You can choose traditional Chinese medicine that regulates Qi and blood circulation, fills the lower焦, and nourishes the liver and kidney, and combine it with food rich in protein, vitamin C, and vitamin E to make a medicine diet, which can tonify deficiency without retaining evil, and transform blood stasis without harming the body.

　　2, Alcoholic beverages can warm Yang and promote pulse, disperse cold and can be appropriately drunk to exert the effect of dispersing blood stasis and alleviating pain. Mustard, fennel, Sichuan pepper, etc., also have the property of warming and promoting. Rose can regulate Qi and relieve anxiety, harmonize blood and disperse blood stasis, and is good for seasoning. Brown sugar cooked with ginger, with the sweetness of brown sugar to invigorate Qi and relieve the center, disperse cold and activate blood, adding the warmth of ginger to help its power to disperse blood stasis, can be drunk daily and is very beneficial.

　　3, Eat more flaxseed oil, walnuts, pumpkin seeds, flaxseeds, kale, bok choy, radish, broccoli, cauliflower, rapeseed, mushrooms, oyster mushrooms, carrots, dark green vegetables, perilla, mushrooms, lean meat, quail eggs, celery, spinach, seaweed, fruits, etc.

　　4, Eat more tonifying Qi and nourishing food. It can help Qi circulation and blood flow, and can alleviate pain. It is especially suitable for those with endometriosis and deficiency of Qi and blood.

　　5, Cereals, beans, and tubers can be eaten as staple foods without avoidance.

　　6, Poultry, livestock, eggs and milk, fresh fish can generally be eaten. For those with deficiency of Qi and blood, it is better to use it for invigorating Qi and nourishing blood.

　　Most advocates for the surgical removal of the lesion in skin endometriosis. Generally speaking, the operation time is best before the period, when the ectopic lesion is clearer and it is easy to be completely removed. The range of resection should be at least 0.5cm larger than the nodule, and the original surgical scar should also be removed.

　　If the scar lesion is greater than 6cm, the infiltration is extensive, and the boundary is unclear, drug treatment can be used first for 3 months, and then surgery after the lesion is localized. The principle is to remove the lesion as much as possible, and pay attention to avoiding organ damage caused by peritoneal involvement and organ adhesion after surgery.