WESTERN MEDICINE: Allergic purpura is an acute or chronic vasculitis primarily affecting skin, joints, and the GI and renal systems. It results from the effusion of blood and plasma into the subcutaneous, submucous, and subserous surfaces. The pathogenesis is unknown, but indirect evidence suggests an allergic reaction which damages the vascular endothelium.
SYMPTOMS AND SIGNS: Skin lesions vary in appearance, but purpura is usually associated with one of the common manifestations of allergy, such as erythema or urticaria. In contrast to other purpuras, the lesions may be pruritic. Fever and malaise are often present, and effusions into the joints or viscera may produce protean symptoms; e.g., joint pain, bouts of abdominal pain. The later may mimic acute abdominal conditions. Acute glomerulitis has been reported.
ETIOLOGY AND PATHOLOGY: Chinese medicine consider the symptoms of allergic purpura as "Bleeding Syndrome". Its causative factors are due to the exogenous wind attacking; or affected by the heat and poison; or interior damp-heat factors.
1. Allergic Purpura due to Wind Factor:
Indications: Erythema everywhere, red in color, itching and hot feeling, facial edema, aversion to cold or wind, poor appetite, or general soreness or pain, constipation, thin and greasy tongue coating, slippery and rapid pulse.
Treatment & Formulas: Dispel wind, clear heat and poisonous factors.
- Jing Fang Bai Du San (Schizonepeta and Siler Formula, Item No. 2166)
2. Allergic Purpura due to Poisonous Heat:
Indications: Erythema everywhere, with purplish color in certain pattern, especially appearing at lower legs, fever, deep red tongue, yellow coating, strong and rapid pulse.
Treatment & Formulas: Clear heat, eliminate the poisonous fire.
- Huang Lian Jie Du Tang (Coptis and Scute Formula, Item No. 2212): It is a strong formula to clear the interior heat and poisonous factor. It also can be combined with Si Sheng Wan (Rehmannia and Lotus Leaf Formula, Item No. 2058) which cools the blood so to assist the stop of bleeding.
- Dang Gui Liu Huang Tang (Tang- kuei and Six Yellow Combination, Item No. 2231 ): It also can be used when there are signs of blood deficiency plus the interior heart and deficient heat.
3. Allergic Purpura due to Damp - Heat:
Indications: Erythema or urticaria, mostly showing at lower legs, sore, or heavy, or painful limbs, fatigue, scanty urine, thin and white or yellowish tongue coating, thready and rapid pulse.
Treatment & Formulas: Eliminate the damp heat and cool the blood.
- Long Dan Xie Gan Tang (Gentian Combination, Item No. 2267): It clears the damp-heat of liver and gallbladder.
- Yin Chen Wu Lin San (Capillaris and Hoelen Five Formula, Item No. 2143): It clears the damp - heat by its function of diuresis.
- Si Sheng Wan (Rehmannia and Lotus Leaf Formula, Item No. 2058) also can be combined with other formulas which strengthen the function of blood cooling.
- Zhu Ye Shi Gao Tang (Bamboo Leaves and Gypsum Combination, Item No. 2091 ): It treats the purpura due to the interior heat and fluid deficiency.
1. Hong Zao (Red date, Zizyphus Fructus, Item No. 1149) can be used all time for allergic purpura.
2. Always try to avoid those allergic factors, such as certain drugs, food or certain specific environment, and etc.