Maculopapular eruption

Eruption of macules or papules. Macules are colored (usually red) patches that are unraised above the surface of the skin and vary in size. Papules are like grains of millet in shape and size (or may be larger), raised above the surface of the skin. The appearance of maculopapular eruptions in externally contracted febrile diseases indicates heat penetrating provisioning-blood. In internal damage miscellaneous diseases, they are attributed to frenetic movement of hot blood due to internal heat.

Patterns

Externally contracted disease (外感热病 wài gǎn rè bìng): The appearance of maculopapular eruptions in externally contracted febrile diseases indicates heat penetrating blood-provisioning. Provided that they are not too dense or widespread, maculopapular eruptions indicate that right qì is capable of expelling evil qì from the body. Thus it is said, The appearance of macules and papules is a favorable sign, provided they are not in excess. The absence of such maculopapular eruptions may indicate an evil blockage. In excess, they indicate that the evil is strong. Macules reflect more severe conditions than papules; for example, intense toxic heat in the blood aspect. Therefore, careful attention should be paid to them. Maculopapular eruptions are a favorable sign when red in color, and an unfavorable sign when dark and stagnant-looking. Deep red indicates intense heat, whereas purplish black indicates intense toxic heat in the blood aspect, a sign that the condition is extremely serious. A dark blackish color indicates that right qì is seriously debilitated, and the condition is critical. However, the significance of maculopapular eruptions can only be judged in correlation with other signs. On Warm Heat (温热论 wēn rè lùn) states, They [macules and papules] must be viewed together with other external signs before a diagnosis can be made. Papules in febrile disease are sometimes referred to as sand (shā).

Internal damage (内伤 nèi shāng): Maculopapular eruptions occurring in internal damage miscellaneous diseases usually indicate blood heat. If they continually appear and disappear, are purplish red in color, and if signs of blood heat are absent, maculopapular eruptions indicate the failure of the qì to contain the blood or qì vacuity with blood stasis. If the eruptions are deep-seated and well-defined, the condition is serious. Deep-seated eruptions do not blanch when pressure is applied. Well-defined eruptions have clear edges or are characterized by localized tissue necrosis. If the edges are not well-defined, and the color fades under pressure, the condition is mild.