Vulvar erysipelas

　　1. Etiology

　　Any condition that lowers the body's resistance, such as long-term malnutrition, diabetes, uremia, and so on, can become a pathogenic factor for this disease. If the patient's body is weak and the immune function is low, the pathogen can enter through minor traumas, such as minor scratches or scratches in the vulvar area, and the wound surface becomes the breach for the invasion of bacteria.

　　2. Pathogenesis

　　The causative bacteria enter the dermal reticular lymphatic vessels through microscopic surface breaks in the vulvar skin and mucosa, and then rapidly spread, causing acute diffuse inflammation. The toxin of hemolytic streptococcus not only causes local redness and swelling but can also trigger systemic toxic symptoms. The lesion is mainly located in the dermis and epidermis, with marked edema of the dermis, expansion of blood vessels and lymphatic vessels, inflammatory cell infiltration. In severe cases, edema may occur within the epidermis, even leading to the formation of bullae.

　　Erysipelas of the vulva develops rapidly, often preceded by prodromal symptoms such as chills, fever, headache, nausea, and vomiting, followed by the appearance of rashes. The rash initially presents as a nodular erythema, rapidly spreading to form a patch of redness around it, with clear boundaries. Local redness, swelling, fever, and pain are common. In severe cases, the surface of the red patch is hot to the touch, with marked tenderness and tension, appearing shiny. Bilateral inguinal lymph nodes may be swollen and painful. The regional lymph nodes of the lesion are often swollen. Infection may continue to spread to deeper layers, forming vulvar abscesses.

　　Erysipelas of the vulva develops rapidly, often preceded by prodromal symptoms such as chills, fever, headache, nausea, and vomiting, followed by the appearance of rashes. The rash initially presents as a nodular erythema, rapidly spreading to form a patch of redness around it, with clear boundaries. Local redness, swelling, fever, and pain are common. In severe cases, the surface of the red patch is hot to the touch, with marked tenderness and tension, appearing shiny. Bilateral inguinal lymph nodes may be swollen and painful. Some patients may develop large blisters or even gangrene, known as gangrenous erysipelas. In some severe cases, due to the spread of bacteria and the action of toxins, visceral lesions and thrombosis may occur, such as nephritis, myocarditis, and cavernous sinus thrombosis. In addition, inflammation of the pleura, peritoneum, and meninges may occur, and even death may result from bronchopneumonia or sepsis. This condition is common in elderly and weak patients, as well as infants.

　　After treatment: Vulvar erysipelas has a tendency to relapse. It is of great significance to actively treat the primary disease to prevent the occurrence of erysipelas.

　　Vulvar erysipelas has an acute onset, often preceded by prodromal symptoms such as chills, fever, headache, nausea, and vomiting, followed by skin rash. The rash starts as a nodular red macule and quickly spreads to form a large red macule with clear boundaries, local redness, swelling, fever, and pain. In severe cases, the surface of the rash is hot to the touch, with significant tenderness and a tense, shiny surface. Bilateral inguinal lymph nodes are swollen and painful. Some patients may develop large blisters or even gangrene, known as gangrenous erysipelas. Some severe patients may also develop visceral lesions and thrombosis, such as nephritis, myocarditis, and cavernous sinus thrombosis. In addition, pleurisy, peritonitis, and meningitis can also occur, and even death due to bronchopneumonia and sepsis can occur. This situation is more common in elderly and weak patients and infants.

　　The skin damage of vulvar erysipelas is typical and easy to diagnose. In the early stage of the disease, local skin appears bright red macular rash, clear boundary, slightly raised, accompanied by burning pain. When the lesion area fades immediately under finger pressure, the center of the lesion starts to fade. Sometimes there are blisters or blood blisters of different sizes. There are often systemic symptoms such as aversion to cold, high fever, headache, fatigue, etc.

　　Laboratory examination shows significant increase in peripheral white blood cells and neutrophils. Pathogen culture and drug sensitivity test, and check blood electrolyte status for severe cases.

　　First, Dietary therapy for vulvar erysipelas

　　1, Fresh reed rhizome juice

　　Composition: Fresh reed rhizome 2000 grams.

　　Usage: Wash the fresh reed rhizome, squeeze the juice, drink it in divided doses as tea, 100 milliliters each time, three to five times a day.

　　Effects: Clear heat, detoxify and promote diuresis.

　　Indications: Early stage of erysipelas with bright red color, accompanied by aversion to cold, fever, headache, dry mouth, and red tongue.

　　2, Portulaca oleracea and Chrysanthemum Porridge

　　Composition: Fresh Portulaca oleracea 60 grams, Chrysanthemum 15 grams, glutinous rice 100 grams.

　　Usage: Wash and chop the fresh Portulaca oleracea, clean the rice, put them in a pot with 1000 milliliters of water, cook with low heat to make porridge; dry and grind Chrysanthemum flowers before the frost falls into powder. Add the powder to the porridge when it is about to be done, boil for a while and it is ready, take three times a day, continue for several days.

　　Effects: Clear heat, detoxify, relieve liver dampness.

　　Indications: Acute stage of erysipelas with limited lesion location.

　　3, Mixed Lysimachia christinae

　　Composition: Lysimachia christinae 500 grams.

　　Usage: Wash the Lysimachia christinae, blanch in boiling water for several minutes, squeeze slightly, chop, add dried Tofu skin powder, sugar, salt, monosodium glutamate, and sesame oil, mix well and eat. Drink the water as tea, three times a day.

　　Effects: Clear heat, detoxify and promote diuresis.

　　Indications: Suitable for both acute and chronic stages of erysipelas.

　　4, Adzuki Bean and Coix Seed Decoction

　　Composition: Adzuki Bean 100 grams, Coix Seed 100 grams.

　　Usage: Soak Adzuki Bean and Coix Seed for half a day, add 500 milliliters of water, cook with low heat until soft, take in divided doses, three times a day.

　　Effects: Promote diuresis and reduce swelling

　　Indications: Obvious swelling of the lower limbs due to erysipelas, or accompanied by blisters.

　　5, Poria and Safflower Porridge

　　Composition: Poria 30 grams, Coix Seed 30 grams, Safflower 5 grams. Usage: Boil Poria and Safflower to extract the juice, remove the residue, add Coix Seed and a certain amount of rice, cook with low heat to make porridge, take twice a day in the morning and evening.

　　Effects: Strengthen the spleen, promote diuresis, activate blood circulation, and remove blood stasis.

　　Indications: Chronic erysipelas, skin rash with dark red color, purple tongue with thin fur.

　　6. Loofah and Lonicera Drink

　　Composition: Old loofah 500 grams, Lonicera caerulea 100 grams.

　　Usage: Wash the herbs, add 1000 grams of water, boil the juice and remove the dregs, drink as tea, 200 milliliters each time, 3-5 times a day.

　　Effects: Activate blood circulation and connective tissues.

　　Indications: Chronic erysipelas.

　　Second, what foods are good for the body for vulvar erysipelas

　　1. Eat more vegetables and fruits.

　　2. Drink more tea or light beverages.

　　3. Eat foods that cool the blood and detoxify. Mung beans, glutinous rice, cucumber, bitter melon, purslane, green tea, etc.

　　Third, what foods should not be eaten for vulvar erysipelas

　　1. Avoid smoking, alcohol, and spicy刺激性 foods.

　　2. Avoid greasy, fried, moldy, and preserved foods.

　　3. Avoid foods that may cause eruptions, such as rooster and goose.

　　4. Avoid seafood and刺激性, allergenic foods when itching is severe.

　　5. Avoid warm and spicy foods such as mutton, chives, ginger, pepper, cassia, etc. if there is ulceration or bleeding.

　　First, before treatment:

　　Note to rest in bed, drink plenty of water, and pay attention to electrolyte balance.

　　Second, Chinese medicine treatment method for vulvar erysipelas

　　Chinese medicine treatment: differential diagnosis and treatment:

　　1. Damp-heat type: skin damage, redness, swelling, and fever, treatment should be to drain dampness, clear heat, and detoxify, the formula chosen is Wushen Decoction combined with Baijie Shen Shi Decoction with modifications.

　　2. Wind-heat type: redness and swelling, pain, fever, aversion to cold, treatment should be to disperse the wind, cool the blood, clear fire, and detoxify, the formula chosen is Puji Xiaoyi Drink with modifications.

　　3. Damp-heat type: redness and swelling spreading, treatment should be to clear the liver and drain heat, and relieve dampness, the formula chosen is Longdan Xiegan Decoction with modifications.

　　Third, Western medicine treatment method of vulvar erysipelas: magnesium sulfate

　　1. Used for constipation, abnormal fermentation in the intestines, and can also be used with vermifuges; when combined with activated carbon, it can treat food or drug poisoning.

　　2. Used for obstructive jaundice and chronic cholecystitis.

　　3. Used for convulsions, eclampsia, uremia, tetanus, hypertensive encephalopathy, and acute renal hypertension crisis.

　　4. Also used for angina pectoris patients with frequent attacks and poor response to other treatments, and has a good effect on patients with hypertension.

　　5. External application of hot compress, anti-inflammatory and edema reduction.