Skin diseases are the most challenging problems in the veterinary practice. This topic will present how to use acupuncture, herbal medicine and food therapy for treatment of skin conditions in dogs.
Introduction
Case Study--7 YO c/m, Ibizan hound
Skin problems for past 3 years; using pred, antibiotics, anti-allergy; but still itching, red skin rash
Worsened this year (spring)
Etiology and Pathology
External Factors
Wind: Urticaria, skin rash, rubella, itchy, dryness
Dampness: Papular eruption, excretion, eczema or erosion
Heat: Red and hot, sore with heat sensation, papular eruption, itching and pain, erosion with pus
Parasite: Scabies (Jie Man), fungi, intestinal worm, pinworm
Allergy to food/drug
Internal Factors
Stagnation: Liver Qi stagnation, or Blood stagnation
Blood deficiency with Wind and dryness
Deficiency of Liver & Kidney Yin
Differentiation and Diagnosis
Whole Body
Pulse: Strong and fast: Heat, Damp-heat or Excess
Thready/thin: Yin/blood deficiency
Weak pulse: Blood/Qi deficiency
Wiry: Stagnation, Wind
Tongue Red/dry: Heat
Pale: Blood deficiency
Yellow: Damp
Appearance: Heavy/strong: Heat, Damp-heat, or Excess
Skinny and weak: Deficiency of Yin or Blood
Itchy
Can be caused by wind, damp, heat, parasite and blood deficiency.
Wind: upward: head and face
Varies quickly: spread around the whole body
Dampness: downward: ventral abdomen, hindlimbs
Erosion, yellow-watery secretion from the affected area
The process is relatively long and hard to cure
Heat-induced itchy: red skin with rash
Heat + Damp: erosion with odor, extremely itchy
Parasite-induced itch: widely, skin test
Blood deficiency-induced itch: thicken-skin, dry/peeling
The process is mostly chronic
Inflammation
Heat, or Heat-toxin
Redness, swelling, heat and pain 
Heat or Heat toxin
Acute inflammation: Red, swelling, erosion, heat, itchy, blister or pus
Mostly Excess type, Related to lung, spleen and heart
Chronic inflammation: Dry skin, thick, pigmentation, or losing hair and abnormal toes or nails
Mostly deficiency, related to liver and kidney
Local Conditions
Macular eruption (exanthema maculosum):
Red macula: blood Heat or Blood stagnation
White macula: Qi stagnation
Papular eruption: Blood Heat, or Wind-Heat
Vesiculation: Damp-Heat, Heat toxin
Pus-pocket: Extreme Heat toxin
Tuberculum: Qi and Blood stagnation
Urticaria: Red (or darker) urticaria: Wind-Heat
White (or lighter) urticaria: Wind-Cold
Dandruff/Squama: Heat, or Skin Wind due to Blood deficiency
Erosion: Damp-Heat
Crusta: Heat-toxin
Crack (rhagades): Wind-Dryness due to Blood deficiency
Lichenification: Blood deficiency
Body Regions
Upper: Wind or Wind-Heat
Middle: Qi stagnation or Heat/Fire
Lower: Damp-Heat, or Cold-Damp
Special Areas
Nasal skin conditions: Lung
Lips: Spleen and stomach
Hypochondriac and genital: Liver
Patterns and Treatment
I. Wind-Heat
Etiology and Pathology: Seasonal allergy, pollen/food allergy, springtime, External wind/Heat invasion, pruritus, contact dermatitis, flea allergy dermatitis
Clinical Signs: Worse in spring and summer, pruritus, itching, scratching (upper part); Tongue: red or slight dry; Pulse: Wiry or fast
Food Therapy: Cool/cold diets
Chinese Herbal Medicine: Xiao Feng San or Wind-Heat toxin
Acupuncture Points: GB-20, BL-10/11/12, BL-17, SP-10, Er-jian, Wei-jian
Other Supplements: Flax seed oil, barley green powder
II. Damp-Heat
Etiology and Pathology: Dermatitis, eczema, skin rash/itching, otitis, hot spot
Clinical Signs: .Eruption, erosion, redness; thick/yellow excretion with stink smell; Itching, scab formation or alopecia; Pulse: Forceful, rapid; Tongue : Red
Food Therapy: Cool/cold diets
Chinese Herbal Medicine: Damp Heat Skin formula
Acupuncture Points: Er-jian, Wei-jian, SP-6/9, ST-40, BL-17, SP-10
Other Comments: Fast one day a week
Table 1. Cold or cool diets and food.
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Meats, oil & sausage
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Grains and beans
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Vegetables
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Fruits and tea
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Turkey
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Millet
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Spinach
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Watermelon
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Deep Ocean fish, cod
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Brown rice
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Broccoli
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Bitter melon
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Rabbit
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Buckwheat
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Celery
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Pear
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Frog
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Wheat flour
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Kelp
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Banana
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Turtle
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Barley
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Chinese Cabbage
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Sugarcane
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Clam
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Barley sprouts (green)
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Egg plant
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Gingko, persimmon (shi zi)
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White fish
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Seed of Job's tear (Coix)
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Cucumber
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Chrysanthemum, green tea
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Sesame oil, Flax seed oil
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Tofu
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Winter melon
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Sausage (wheat)
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Mung Bean
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III. Blood Heat
Etiology and Pathology: DLE, SLE, and other autoimmune-mediated diseases
Clinical Signs: Depigmentation, crusting, or erythema, Ulceration of the planum nasale or skin, erosions; Tongue: Red or purple, Pulse: Surging and fast
Food Therapy: Cool/cold diets
Chinese Herbal Medicine: Blood Heat formula
Acupuncture Points: GB-20, Er-jian, Wei-jian, Liv-3, GB-34, BL-17, SP-10
Other Comments: Fast one day a week
IV. Blood Deficiency
Etiology and Pathology: Geriatric dryness, or chronic skin problems
Clinical Signs: Chronic itching, in aged animals; dandruff, dry/burned skin/haircoat, alopecia; Tongue: pale and dry; Pulse: deep, thready and weak
Food Therapy: Neutral or cool diets
Chinese Herbal Medicine: Yang Xue Xi Feng
Acupuncture Points: SP-10, BL-17, ST-36/SP-6, An-shen, HT-7, GB-20/BL-10
V. Deficiency of Liver and Kidney Yin
Etiology and Pathology: Geriatric dryness, or chronic skin problems
Clinical Signs: Chronic itching, in aged animals; Dandruff, dry skin/haircoat, alopecia, or crusting; hyperactivity or abnormal behavior at night; Tongue: red or deep red, and dry; Pulse: Thready, deep and fast
Food Therapy: Cool diets
Chinese Herbal Medicine: Yang Yin Zhi Yang
Acupuncture Points: Kid-3, BL-23, SP-6/9/10, An-shen, HT-7, GB-20/BL-10