Name: Li.

Sex: Male.

Age: 21 years.

0ccupation: A college-student.

Chief Complaint: Erosion and swelling-pain of preputium for 2 weeks.

History of Present lllness: Two weeks ago, the patient washed his perineum with a liquid of "Potassium Permanganate" before his sleeping. At that night, he got a feeling of burning pain in the groins and preputium. In the next morning, many various-sized blisters appeared on the surface of the glans penis and corpus penis. After ulceration of the blisters, the affected surface became wet and erosive, the penis got severe swelling with insufferable distending pain. Many large pieces of red maculae appeared on the skin of groins with burning sensation. Then the patient went to hospital and was treated by external applying a liquid (its name was unknown) for 2 days, the swelling and the distending pain were as same as before. Then he went to the local clinic and was treated by intramuscular injecting "Benzylpenicillin" and external applying "Chlortetracycline Eye Ointment" for 6 days, but there was no effect on him either. At last, he was sent to a hospital in Jiangsu Province and was treated by intravenous dripping some antibiotics and antianaphylaxis, after 6 days' treatment, there was no obvious curative effect on him too. Then he came here for treatment on June 2,1996. After the illness came on, his appetite, urination and defecation were all normal. But his sleeping was not smooth and steady due to the suffering from the illness. There was not other complaint.

Physical Examination: The patient was conscious with a normal general condition. The pulse was rapid and thready. The tongue was red with a thick layer of white fur. Many large pieces of red maculae were seen on the skin of the groins. There were large pieces of erosion and redness on the glans penis and corpus penis. The penis was severe swelling and thickened, accompanied with severe tenderness. There was not other abnormal sign.

Diagnosis: Contact Dermatitis.

Differentiation: This disease, in TCM, belongs to the category of "ZhongYaoDu"(being hurt by drug poison). It's damage of the skin and mucosa caused by the liquid of " Potassium Permanganate," whose concentration was too strong for daily using. The drug poison got into the blood and turned into virulent fire evil in blood, which hurt the local skin and mucosa.

Therapeutic Principle: Clearing away heat to eliminate toxin, cooling blood and expelling dampness.

Recipe:

ShengDiHuang,Dried Rehmannia Root 20g

ZhiMu, Windweed Rhizome 15 g

HuangQin,Scutellaria Root 12g

HuangBai,Phellodendron Bark 15g

LongDanCao, Gentian Root 15g

CangZhu,Atractylodes Rhizome 20g

FuLing, Tuckahoe 25g

MuDanPi,Tree Peony Bark 15g

QinPi,Ash Bark 15g

DiFuZi,Broom Cypress Fruit 12g

NiuXi,Achyranthes Root 12g

GanCao,Liquorice Root 10g

All the above drugs were to be decocted in water for oral taking. 5 doses were prescribed. Hot and greasy food was forbidden during the treatment.

Effect Observation: After taking the decoction, the partial swelling and the distending pain disappeared, the red maculae on the skin of the groins disappeared too. In the period of the treatment, Sulfamylon was applied on the erosive preputium, once BNa day, but it's not helpful to astringe the erosion. After 5 days of applying it, the erosion was as same as before. So it's necessary to strengthen clearing away heat and removing toxin and expelling dampness, and external treatment of Chinese herbs should be used:

ShengDiHuang,Dried Rehmannia Root 20g

ZhiMu,Windweed Rhizome 6g

HuangQin,Scutellaria Root 12g

HuangBai,Phellodendron Bark 15g

LongDanCao, Gentian Root 15g

ShanZhi,Capeiasmine Fruit 10g

CangZhu,Atractylodes Rhizome 25g

TuFuI.ing, Smilax Glabra Rhizome 20g

ZeXie,Oriental Water Plantain Rhizome 15g

QinPi,Ash Bark 15g

JinYinHua, Honeysuckle Flower 15g

GanCao,Liquorice Root 10g

All the above drugs were to be decocted in water for oral taking. 5 doses were prescribed. In the same period, external drugs should be applied to dry pathogenic dampness and astringe the erosion on the preputium.

Recipe:

BaiJi, Hyacinth Bletilla 50g

HuangBai,Phellodendron Bark 50g

All the above drugs were to be ground into fine powder and mixed together, applying a little powder onto the affected surface, once a day. Hot and greasy food was forbidden during the treatment.

After 5 days of above treatment, the erosive preputium was cured completely. After 1 month of follow up, the illness didn't recur. Then it' s ending.