Skin white spots, also known as "white patches," refer to the symptom of white changes in the skin appearing as dots or patches.

This symptom is referred to as "white blemish" and "white vitiligo" in the Zhubing Yuanhou Lun; the Shengji Zonglu calls it "speckled white" (i.e., blemish white), "patchy white," and "speckled blemish"; later generations refer to it as "flower spots," "purple-white vitiligo," etc.

"Vulvar leukoplakia" is a gynecological miscellaneous disease and is listed as a separate entry.

bubble_chart Pattern Analysis

1. Disharmony of Qi and Blood︰Round white patches suddenly appear on the skin and gradually expand, with darkened edges and possible brown spots at the center. The affected area may feel burning and turn red after sun exposure, and the hair within the patches may turn white. These patches commonly occur on the face, neck, around the navel, external genitalia, and other areas, progressing slowly. Symptoms may also include emotional depression, dysphoria, irritability, insomnia with dreamfulness, distension in the hypochondriac region, and irregular menstruation in women. The pulse is wiry and slightly rough, and the tongue texture may show ecchymosis with a thin white coating. Any of the seven emotions causing internal damage can lead to disorder of qi movement, or compounded by exposure to wind pathogens, which clash with the skin, causing stagnation of qi and blood and blockage of hair follicles, resulting in this condition. The key diagnostic features are: sudden appearance of white patches on the skin that gradually enlarge, varying in size, milky white in color, possibly with dotted darker pigmentation at the center. The edges are irregular but clearly defined, and the surrounding skin is often darker than normal, without scales on the surface. For mild cases, treatment may involve dispelling wind and harmonizing blood, using the Vitiligo Pill; or harmonizing qi and blood, using the Free Wanderer Powder. If ecchymosis is present on the tongue and the pulse is slightly rough, the treatment should focus on invigorating blood and resolving stasis, using the Orifice-Openning Blood-Activating Decoction.
2. Summerheat-dampness Stagnating in the Skin︰It often occurs in summer, appearing on the neck, armpits, chest, back, and extensor surfaces of the limbs. The lesions manifest as white or grayish-white spots or patches, nearly round, about the size of watermelon seeds, with a slightly shiny surface and mild itching. Scratching may produce fine, bran-like scales, while the tongue and pulse are usually normal. In summer, when summerheat qi prevails, the combination of dampness-heat invades the skin and muscles, becoming trapped and unable to disperse, leading to the formation of white patches. The key diagnostic features are: nearly round white patches, about the size of watermelon seeds, with fine bran-like scales on the surface. They commonly appear on the neck, armpits, chest, back, and extensor surfaces of the limbs, with a slightly shiny surface. Treatment involves clearing summerheat and dispelling dampness, along with topical application of tinea versicolor liniment.
3. Parasitic Accumulation︰It is commonly seen on the faces of children. Initially, the lesions vary in size, appearing as round or oval, white or grayish-white patches with indistinct edges. The surface is slightly dry, with a small amount of grayish-white fine bran-like {|###|}scale{|###|}, occasionally accompanied by grade I itching. It is often associated with symptoms such as {|###|}complexion shallow yellow{|###|}, emaciation, umbilical and abdominal pain, irregular bowel movements, {|###|}tongue coating{|###|} with geographic peeling, and a {|###|}pulse manifestation{|###|} that is thin and slippery. Unhygienic dietary habits lead to internal parasitic infestation, which depletes qi and blood, preventing them from nourishing the face. As a result, the skin loses its moisture, leading to a {|###|}complexion shallow yellow{|###|} and the appearance of white patches. The key points for diagnosis are: the condition mostly occurs in children and adolescents, with white or grayish-white patches typically appearing on the face. The patches have indistinct borders, are coin-sized, round or oval, and covered with fine, dry, bran-like {|###|}scale{|###|}. The treatment principle is to expel parasites and regulate the spleen, using the formula Chubby Child Pill, and applying {|###|}Sophora{|###|} wine externally.

bubble_chart Documentation

1. Shengji Zonglu．Volume 18: "It is said that the condition of vitiligo is characterized by wrinkled skin and the appearance of white spots. It is caused by lung heat congestion, wind evil taking advantage, the combination of wind and heat, spreading through the nutrient and defensive systems, congestion..."

bubble_chart Symptomatic Therapy

1. Malaytea scurfpea fruithas photosensitizing effects and can be used to treat vitiligo. Grind it into powder and soak it in alcohol to make a 20% to 30% tincture, then apply it topically to the affected area.
2. Puncturevine caltrop fruit, Qianjin Fangcan be used alone by grinding it into powder and applying it to the eyes to treat vitiligo.