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　　What are the causes of vulvar ulcers?

　　The cause of vulvar ulcers often includes damp-heat descending, accumulation into toxins, or due to weakness of the body's vital energy, leading to cold-damp congealment.

　　What complications can vulvar ulcers easily lead to?

　　1. The vulva has sores, red, swollen, painful, the edge is unclear, and even localized abscess and ulceration, flowing yellow, smelly water or bloodwater dripping continuously.

　　2. Or there are lumps like silkworm cocoons on the sides of the vulva, lingering without subsiding, even ulcerating and healing, gradually thinning, often accompanied by low fever in the afternoon and night盗sweating.

　　Pay attention to personal skin cleanliness and hygiene, avoid scratching and squeezing the affected area; most of them are related to dampness, heat, sweating, and personal constitution, so avoid捂, heat, and excessive sweating, do not wear too tight or too hard pants. In addition, use breathable cushions (avoid using too hard or too soft cushions, and can use Mahjong tiles as cushions in summer), ventilation and cooling to reduce sweat渍 on the buttocks. If there is vulvar itching, pain, and ulceration, seek medical attention in time and do not delay to worsen the condition.

　　1. Direct immunofluorescence:Take the examination of normal skin around the skin lesions or newly formed skin lesions, showing IgG and C3 deposited in a net-like pattern between epidermal cells, other components have C1q, C4 deposition, the positive rate is 80％～95％, and can reach 100％ in active lesions. A few antibodies can be IgM, IgA.

　　2. Indirect immunofluorescence:80％～90％ of patients can detect antibodies against intercellular substances of epidermal cells, i.e., pemphigus antibodies, mainly IgG, a few can be IgM, IgA. The level of antibody titer is highly correlated with the activity of the disease, but it can be false-negative in the early stage of the disease. Electron microscopy shows that the early change is the partial or complete dissolution of the intercellular matrix or glycocalyx of epidermal cells, widening of cell gaps, separation of desmosomes, and in the later stage, the tensile filaments fall off from the desmosome attachment plate, and desmosomes disappear.

　　1. What foods are good for vulvar sores

　　Diet should be nourishing Yin and clearing heat.

　　2. What foods should be avoided for vulvar sores

　　Avoid spicy and hot foods.

　　(The above information is for reference only, for detailed information, please consult a doctor)

　　Traditional Chinese medicine treatment methods for vulvar sores

　　Firstly, distinguish between Yin and Yang. Redness, swelling, heat, and pain, sudden onset of fever, thick and malodorous pus, or accompanied by whole-body fever, is damp-heat syndrome belonging to Yang; hardness of the mass, unchanged skin color, not disappearing after a long time, or thin and dripping pus after ulceration, emaciated body, is cold-dampness belonging to Yin. Secondly, distinguish between good and bad. Ulcers with mild symptoms, shallow toxicity, and healthy body, mostly belong to good prognosis; ulcerated sores, not healing for a long time, thin and dripping pus, malodorous, mostly belong to the bad prognosis of heat-toxicity accumulation and Qi and blood deficiency. The treatment principle should be based on clearing heat for heat, warming for cold, transforming dampness, reducing hardness, reinforcing for deficiency, and supporting for sinking. The commonly used method is the combination of internal and external treatment.

　　1. The main symptoms of damp-heat type:There is a sore in the genital area, red, swollen, hot, and painful, which may even ulcerate and discharge pus, sticky and malodorous, dizziness and blurred vision, bitter mouth and dry throat, fever and restlessness, constipation with dry stools. The tongue is red with a yellow coating, and the pulse is slippery and rapid.

　　1. Analysis of Syndrome:The lower part of the body is damp-heat, Qi and blood are stagnant, accumulating into toxicity, rotten flesh turns into pus, so there is a sore in the genital area, red, swollen, hot, and painful; with ulceration and pus flowing, sticky and malodorous; due to damp-heat steaming, there is dizziness and blurred vision, bitter mouth and dry throat; internal heat-toxicity leads to restlessness and fever, constipation with dry stools. The tongue is red with a yellow coating, and the pulse is slippery and rapid, indicating signs of damp-heat toxicity.

　　2. Treatment Principles:Drain Liver Heat, Detoxify and Remove Dampness.

　　3. Examples of Prescriptions:Long Dan Xie Gan Decoction added Tu Fu Ling, Pu Gong Ying.

　　For those with severe heat-toxin syndrome, symptoms such as fever that does not subside, thirst for cold drinks, and foul-smelling pus, treatment should be given to clear heat and detoxify, transform stasis and remove dampness, using Xian Fang Hua Ming Drink (from 'Annotated Formula for Women').

　　Bai Zhi, Bai Mu, Fang Feng, Chi Shao, Dang Gui Wei, Sophora Root, Chuan Shan Jia, Tian Hua Fen, Ru Xiang, Mo Xiang, Jin Yin Hua, Chen Pi, Gan Cao Jie, among which Jin Yin Hua clears heat and detoxifies; Bai Zhi, Fang Feng disperse wind and remove dampness; Chi Shao, Dang Gui Wei, Ru Xiang, Mo Xiang activate blood and transform stasis to reduce swelling; Chuan Shan Jia, Sophora Root activate blood, soften hardness, and disperse masses; Chen Pi, Bai Mu regulate Qi and resolve phlegm; Tian Hua Fen nourish Yin and clear heat; Gan Cao detoxifies and harmonizes various herbs. If the boils do not heal for a long time, the vital energy is insufficient, and the pathogenic toxins are internally invading, it is advisable to strengthen the vital energy and disperse toxins, using Bu Zhong Yi Qi Decoction.

　　For those with prolonged injury to Yin, treatment should be given to nourish Yin, clear heat, and detoxify, using Bai He Di Huang Decoction (from 'Jin Gui Yao Lue') formula: Bai He, Sheng Di Huang.

　　Secondly, the main symptoms of cold and dampness type:The Yin boils are hard, the skin color does not change, or there may be pain, and after ulceration, pus and blood drain, the spirit is tired, appetite is poor, and the tongue is pale, the coating is white and greasy, and the pulse is fine and weak.

　　1. Analysis of Syndrome:Cold and dampness stagnation, phlegm and blood stasis obstructing, the skin and muscles lose nourishment, so the Yin boils are hard, the skin color does not change, or there may be pain, and after ulceration, pus and blood drain; cold and dampness stagnation, the spleen Yang is not vigorous, so there is fatigue, lack of appetite, and poor appetite. The tongue is pale, the coating is white and greasy, and the pulse is fine and weak, indicating cold and dampness stagnation.

　　2. Treatment Principles:Warm meridians and transform dampness, activate blood and disperse masses.

　　3. Examples of Prescriptions:Yang He Decoction (from 'Complete Works of External Medicine') added Cang Zhu, Poria, Zao Shu, Sophora Root.

　　Shu Di, Lu Jiao Jiao, Jiang Dan, Rou Gui, Mahuang, Licorice, Bai Jie Zi, among which Shu Di, Lu Jiao Jiao replenish essence and blood and assist Yang; Jiang Dan, Rou Gui warm meridians and promote circulation; Mahuang, Bai Jie Zi open Yang and disperse stagnation to eliminate boils; Zao Shu, Sophora Root move Qi and activate blood to disperse masses; Cang Zhu, Poria dry dampness and promote diuresis to transform turbidity; Licorice detoxify and harmonize various herbs.

　　For those with deficiency of vital energy and excess of pathogenic factors, symptoms such as boils that do not heal for a long time, palpitations, and shortness of breath, treatment should be given to disperse toxins and strengthen the interior, using the formula of Disperse Toxins and Strengthen the Interior from 'Women's Authenticity'. The formula includes Ginseng, Astragalus, Licorice, Poria, Angelica Sinensis, White Peony, Chuanxiong, Lonicera, Baizhi, Sophora Root, Platycodon, among which Ginseng, Astragalus, Licorice tonify Qi and assist Yang; Angelica Sinensis, White Peony, Chuanxiong nourish blood and harmonize blood; Lonicera, Baizhi, Sophora Root detoxify and reduce swelling to drain pus; Astragalus, Platycodon elevate and disperse toxins.