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Erythema Nodosum

How Chinese medicine differentiates erythema nodosum into the five patterns you'll actually meet in practice, and the points for each. Distinct from this site's Skin Lesions and Arthritis pages. Acupuncture only — no herbs.

This page is educational, for practitioners and students — it is not a diagnostic tool and does not replace a proper in-person assessment. Erythema nodosum can signal an underlying infection or autoimmune condition and needs medical evaluation to identify the cause; this page addresses only supportive care alongside that workup.
General Acupuncture Points

Acupuncture points traditionally used for erythema nodosum — 3 key points, used across the patterns below rather than tied to just one.

PointKey action
SP-6Strengthens the Spleen. Resolves Dampness. Promotes the function of the Liver and the smooth flow of Liver-Qi.
SP-9Regulates the Spleen. Resolves Dampness. Opens the Water passages.
ST-36Benefits Stomach and Spleen. Tonifies Qi and Blood. Tonifies the Original Qi.
The Five Patterns

↑ reinforcing   ↓ reducing   ⊥ even method.

1. Toxic-Heat Stagnation

Clinical manifestations: Bright red, hot, swollen nodules with burning or throbbing pain; fever; a sore throat; intense thirst for cold drinks; restlessness; dark, scanty urine; constipation.
Tongue: Deep red or crimson with prickly papillae, thick dry yellow coating. Pulse: Rapid and forceful, possibly overflowing.
Treatment principle: Clears toxic Heat from the Blood, cools the Blood and invigorates circulation to resolve stasis.
Note: no moxa. This site's decks have no standalone Toxic-Heat slide — no pattern link is given here.

2. Damp-Heat in the Lower Burner View full pattern →

Clinical manifestations: Red, swollen, hot nodules on the shins with a heavy, dragging leg sensation; thirst without a desire to drink; scanty, dark yellow urine; poor appetite.
Tongue: Red with yellow greasy coating thickest at the root. Pulse: Slippery and rapid, more pronounced at the rear position.
Treatment principle: Clears Damp-Heat from the Lower Burner, dries Dampness, strengthens the Spleen and resolves inflammation.
Note: no moxa. Linked to this site's own Damp-Heat-in-the-Liver slide, its established Lower-Burner Damp-Heat convention.

3. Painful Obstruction with Wind-Cold-Damp

Clinical manifestations: Dull red, purplish, or skin-coloured cool nodules; heaviness and stiffness in the joints and limbs; aversion to cold; symptoms worsening in damp weather.
Tongue: Pale, slightly swollen, teeth-marked, white greasy moist coating. Pulse: Wiry and tight, or slow and soggy if Dampness predominates.
Treatment principle: Warms the channels, dispels Cold-Damp obstruction and gently moves Blood and Qi.
Note: moxa is strongly indicated. This site's decks have no Painful-Obstruction/Bi-syndrome slide, confirmed absent again — no pattern link is given here.

4. Spleen Deficiency with Dampness

Clinical manifestations: Recurrent, dull, flesh-coloured or slightly red nodules; fatigue; poor appetite; abdominal bloating; loose stools; heaviness in the limbs.
Tongue: Pale, swollen, teeth-marked, white greasy coating, moist surface. Pulse: Soggy and slow, or slippery, soft and weak.
Treatment principle: Tonifies Spleen Qi, strengthens digestive function and drains accumulated Dampness from the lower body.
Note: moxa is appropriate. No standalone Spleen-Deficiency-with-Dampness slide exists on this site's decks — no pattern link is given here.

5. Qi Deficiency Causing Blood Stagnation

Clinical manifestations: Dull, fixed, non-hot nodules; marked fatigue and weakness; a pale or dusky complexion; shortness of breath on mild activity, worse with exertion.
Tongue: Pale-dark or pale-purple with possible stasis spots and teeth marks, thin white coat. Pulse: Deep, fine, weak and choppy.
Treatment principle: Tonifies Qi to restore propulsive force, invigorates Blood circulation and unblocks the channels.
Note: moxa is appropriate. No combined Qi-Deficiency-causing-Blood-Stagnation slide exists on this site's decks — no pattern link is given here.
Related conditions

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