9/20, began having nose/ nasal planum and periocular alopecia, erythema, crust, blister, depigmentation
this was never pruritic
Improved with prednisone
the pred was tapered due to PU/PD, increased alk phos (since resolved)
Atopica 50 mg PO q 24 improved but did not acheive remission
Atopica was recently increased 75 mg AM/ 50 mg PM with further improvement.
pulse slippery, does not improve with needling GB34 or BL 40 though those points were active
tongue lavender
weight =31 lbs bcs 5/6
had a sebaceous cyst left shoulder which ruptured
rapid diet change has resulted in diarrhea with mucus and urgency
seeks hard surfaces and cold areas.
he is active if someone plays with him but not very high energy
current diet: Fromm chicken and turkey kibble with added grains
We are planning to change to a higher protein homemade diet or as close as we can get to it.
I feel that Damp Heat is the most prominent pattern I see so my first thought would be Si Miao San if I didn’t have the pemphigus diagnosis. Or maybe San Ren Tang, I would call him moderately hot.
My other thought is Xiao Chai Hu Tang since the lavender tongue indicates stagnation and GB34 was super active
However, it looks like something like Hoxsey like formula or Qing Yin Tang is more frequently used with pemphigus, however those don’t really match his presentation.
Would SMS be appropriate for pemphigus? Or something I'm not thinking of?