Thickened skin refers to the localized thickening and dryness of the skin surface.

This condition has similar records in classical medical texts, such as Suwen. Yinyang Bie Lun mentions "Suoze," which refers to rough, dry, and withered skin; Zhubing Yuanhou Lun mentions "callus"; and Waike Zhengzong describes "chapped pain," all of which fall within the scope of such symptoms. However, widespread thickening and hardening of the skin over larger areas of the body are different from this condition.

bubble_chart Pattern Analysis

1. Spleen Deficiency with Blood Dryness︰The skin is rough and thickened, with noticeable cutaneous pruritus, appearing dark red or brown, often occurring on the palms. Sometimes there is surface scaling or grade I exudation. The tongue texture is pale, the tongue body is enlarged with a white coating, and the pulse is deep and slow or slippery. This condition is often due to innate deficiency, dysfunction of the spleen in transportation, accumulation of dampness that fails to transform, stagnation turning into dryness, and malnutrition of the skin leading to the disease. Skin itching is prominent, with a dark red surface, usually accompanied by scaling, and sometimes exudation. The tongue texture is pale, and the tongue body is enlarged.
2. Blood Deficiencywind-dryness︰The skin appears in patches, rough and thickened, often occurring on both sides of the neck or the eyelid area, presenting as light brown with intermittent itching, accompanied by palpitation, severe palpitation, forgetfulness, insomnia, a pale tongue texture, and deep, thin pulse. This is mostly due to blood deficiency transforming into dryness and generating wind, stagnating between the skin's striae and interstices, leading to malnutrition of the skin and resulting in thickening. The skin lesions itch intermittently and appear pale in color, commonly occurring on the sides of the head or the face, accompanied by palpitation, shortness of breath, etc. For spleen deficiency with blood dryness, treatment should focus on invigorating the spleen and drying dampness, nourishing blood and moistening the skin. A commonly used formula is the Jianpi Runfu Decoction with modifications. For blood deficiency with wind-dryness, treatment should aim to nourish blood, disperse wind, and moisten the skin to stop itching. A commonly used formula is the Nourishing Blood and Moistening Skin Decoction with modifications.
3. Wind-dampness Stagnation︰The skin lesions are slightly dark in color, appearing as patches or merging into larger areas, with a rough and thickened surface. They commonly occur on the extensor aspects of the limbs but may also appear in other areas. There is paroxysmal itching, especially at night. The tongue coating is thin or white and greasy, and the pulse is slow and moderate. This condition is often caused by the stagnation of wind-dampness pathogens in the skin, leading to impaired dispersion. The lesions present as patches or merge into larger areas, frequently appearing on the limbs, accompanied by paroxysmal intense itching. Treatment should focus on dispelling wind and draining dampness to relieve itching, typically using modified Quan Chong Fang (Whole Insect Formula).
4. Qi Stagnation and Blood Stasis︰The skin appears dark red or purplish-red, with obvious thickening and prominent skin ridges and grooves. Grade I bleeding may occur after scratching. It often occurs in areas subjected to pressure and is usually accompanied by irritability, depression, insomnia with dreamfulness, vertigo, palpitation, a red tongue tip or edges with ecchymosis, and a sluggish or choppy pulse. The condition is primarily caused by stagnation of qi and blood, leading to congelation in the skin. The lesions manifest as dark purplish-red, rough, and thickened skin, commonly found in pressure-prone areas, with a dull or ecchymotic tongue and a sluggish, unsmooth pulse. Treatment should focus on soothing the liver and regulating qi, invigorating blood and resolving stasis. The modified Huoxue Runfu Decoction is often used.

bubble_chart Documentation

1. Waike Zhengzong．cervical neurodermatitis》"psoriasis is like the skin of a cow's neck, stubborn and hard, scratching it feels like rotten wood."
2. Zhubing Yuanhou Lun．cervical neurodermatitis condition》："cervical neurodermatitis is like a type of ringworm, it grows on the neck causing itching and pain, and is exacerbated by the rubbing of the collar. It is said to be caused by the friction of the collar, hence it is called cervical neurodermatitis."