Psoriasis - Blood-Heat Pattern
Dr. Li Wei, DACM
Psoriasis · Blood-Heat Pattern
Updated: June 23, 2026
Reviewed by: Dr. Li Wei, DACM
Reading Time: 7 min
Body Area: Skin
Pattern Overview
Blood-Heat is the most common pattern in progressive psoriasis, characterized by excessive keratinocyte proliferation, T-cell-mediated inflammation, erythematous plaques, silvery scales, and pin-point bleeding (Auspitz sign). The core pathogenesis is Blood-Heat in the skin, leading to rapid keratinocyte turnover and immune inflammation.
Key Symptoms and Differentiation Points
| Differentiation Dimension | Manifestations |
| :— | :— |
| Primary Symptoms | Erythematous plaques, silvery scales, pin-point bleeding, rapid lesion spread |
| Associated Symptoms | Thirst, irritability, red face, constipation, yellow urine |
| Tongue and Pulse | Red tongue with yellow coating, slippery and rapid pulse |
| Pathogenesis | Blood-Heat in the skin causing rapid keratinocyte proliferation |
| Etiology | Stress, infection, trauma, spicy food intake, immune triggers |
Acupuncture Point Prescription
| Point | Location | Function |
| :— | :— | :— |
| Dazhui (GV14) | Below the spinous process of C7 | Clears Heat and cools Blood |
| Quchi (LI11) | Lateral end of the elbow crease | Clears Heat and stops itching |
| Hegu (LI4) | Dorsum of the hand, between the 1st and 2nd metacarpals | Disperses Wind and clears Heat |
| Xuehai (SP10) | On the medial thigh, 2 cun above the patella | Cools Blood and stops itching |
| Geshu (BL17) | Lower back, 1.5 cun lateral to T7 | Back-Shu point of the Blood; cools Blood |
Clinical Recommendation: Filament needle, reducing method; may combine with pricking at Dazhui to enhance Heat clearing.
Herbal Formula
Base Formula: Xi Jiao Di Huang Tang (犀角地黄汤) or Liang Xue Huo Xue Tang (凉血活血汤)
Composition:
Water Buffalo Horn (Shui Niu Jiao), Rehmannia (Sheng Di), Moutan (Mu Dan Pi), Red Peony (Chi Shao), Arnebia (Zi Cao), Imperata (Bai Mao Gen), Licorice (Gan Cao)
Action: Cools Blood, clears Heat, and stops itching.
Modifications
| Associated Symptoms | Additions/Subtractions |
| :— | :— |
| Severe erythema | Add Jin Yin Hua, Lian Qiao to clear Heat and detoxify |
| Intense itching | Add Bai Xian Pi, Ku Shen to stop itching |
| Thirst | Add Tian Hua Fen, Ge Gen to generate fluids |
| Constipation | Add Da Huang to drain heat |
Western Mechanism Reference
Excessive keratinocyte proliferation with T-cell-mediated immune inflammation, TNF-α/IL-17/IL-23 axis hyperactivation. Blood-Heat corresponds to progressive psoriasis, where the IL-17/IL-23 axis hyperactivation drives keratinocyte hyperproliferation and inflammation.
References
Dermatology of TCM - Progressive Psoriasis with Blood-Heat.
WHO. (2023). Skin health. World Health Organization.
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