dcantor: April 8, 2019, 6:18pm
I’ve seen a number of patients with dry arms and legs but an oily, acne-prone face. Do you ever prioritize the oily
face when making a diagnosis, or is the quality of the skin on the extremities more important in determining wet or
dry?
Tobydaly1: April 8, 2019, 8:27pm
There’s no extra importance given to the skin on the face, but if the total body skin isn’t uniformly dry or moist
then it has less clinical “weight” in making the diagnosis.
ngmatthews: October 4, 2021, 5:15pm
That is very helpful, because I see a lot of mixed skin dry/damp in clinic. But last week I saw a true Lung excess
with dry skin all over and it was amazing. Skin on arms and legs was rough and scaly in a lady who was wheezing.
I’m glad I saw that extreme case because now I have that to refer to. Often I ask people if they use moisturizer in
the summer on their bodies. That can also reveal something that is not clear on physical exam.
michaelmax: April 27, 2019, 12:47pm
You can also pinch the skin a little and see how it feels.
People who use moisturizer will often have a kind of oily feel to their skin, and when you pinch it a bit it looks
crinkly.
Also Dr Huang Huang would often check a person’s legs for dry skin, he saw it as a sign of blood deficiency.
dcantor: May 9, 2019, 12:23am
25/01/2024, 11:34Assessing Skin Quality – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/assessing-skin-quality/60/print2/3
@michaelmax, do you know if there is a reason Dr Huang Huang would check the legs in particular for dry skin
when assessing blood deficiency, rather than hands, arms, etc?
As an aside, I’ve noticed dry flakey skin on the eyelids of several patients that definitely seemed to fit with an
overall blood xu picture…
michaelmax: May 9, 2019, 1:55am
Hi @dcantor, H2 thought that the lower legs were a good indicator of blood deficiency.
Interestingly I was talking with a patient whose legs were a little dry, and when I commented she said “Oh, when I
was going chemo, my lower legs were dry to the point of flaking.” But it sounds like her arms were not as dry.
Which put another tick in that box about lower legs showing blood deficiency.
Of course there are other ways to access. I’ll keep my eyes peeled for the eyelids!
martine: October 22, 2019, 4:53pm
Hi Michael, I remember Dr Huang Huang mentioned the dry skin on the legs as a diagnostic sign particularly in
relation to Guizhi Fuling Wan, as he said it was a sign of bloodstasis. I can see the connection with blooddeficiency
though: I would think that in Sa’am system that would point to SI, as this would help to move stagnant blood and
bring fresh blood in.
KristinWisgirda: October 22, 2019, 5:36pm
Hi @martine,
While I understand your thinking, I can see you traveling down a path that isn’t helpful when learning Saam, ie
correlating other systems with Saam. Sticking with the basic teachings of Saam will serve your patients much
better.
Dry skin could be explained by blood stasis for sure, but you want to see clear signs of blood stasis or Kidney
excess before using SI+. With dry skin you also want to look at Lung excess and LI excess. Include SI excess on
that list if the medial heel is the prime area of dry/cracked skin.
michaelmax: October 23, 2019, 7:12pm
25/01/2024, 11:34Assessing Skin Quality – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/assessing-skin-quality/60/print3/3
I agree with @KristinWisgirda that it is helpful to stick with the Saam parameters. At the same time, as you grow
in this system, there are all kinds of other things we have learned that will come into focus in a new way.
I think starting out “pure Saam” is a good idea, as you’ll get a firm foundation that will help you to understand the
system. Then after the foundation is there, all kinds of other things tend to “snap to gird.” But before that
happens… you need the foundation.