A Case of Chronic Pityriasis Lichenoides with Cholinergic Urticaria Improved by Mahwang-tang

Ju-Hyun Lee; Eun-Heui Jo; Min-Cheol Park; Lee, Ju-Hyun; Jo, Eun-Heui; Park, Min-Cheol

doi:10.13048/jkm.25040

JKM > Volume 46(3); 2025 > Article

Lee, Jo, and Park: A Case of Chronic Pityriasis Lichenoides with Cholinergic Urticaria Improved by Mahwang-tang

Case Report

The Journal of Korean Medicine 2025; 46(3): 150-160.

Published online: September 1, 2025

DOI: https://doi.org/10.13048/jkm.25040

A Case of Chronic Pityriasis Lichenoides with Cholinergic Urticaria Improved by Mahwang-tang

Ju-Hyun Lee¹

, Eun-Heui Jo²^{, 3}^{, *}

, Min-Cheol Park³^{, 4}^{, *}

¹Department of Medical Support, Imsil-gun Medical Center

²Department of Acupuncture and Moxibustion, Wonkwang University Korean Medicine Hospital

³Research Center of Traditional Korean Medicine, Wonkwang University

⁴Department of Korean Medicine Ophthalmology, Otolaryngology and Dermatology, Wonkwang University Korean Medicine Hospital

Corresponding author: Eun-Heui Jo, Department of Acupuncture and Moxibustion, Wonkwang University Korean Medicine Hospital, 99, Garyeonsan-ro, Deokjin-gu, Jeonju-si, Jeollabuk-do, 54887, Republic of Korea, Tel: +82-63-270-1022, Fax: +82-63-270-1199, E-mail: freezo@wonkwang.ac.kr

Corresponding author: Min-Cheol Park, Department of Korean Medicine Ophthalmology, Otolaryngology and Dermatology, Wonkwang University Korean, Medicine Hospital, 895 Muwang-ro, Iksan-si, Jeollabuk-do, 54538, Republic of Korea, Tel: +82-63-859-2821, Fax: +82-63-841-0033, E-mail: spinx11@wonkwang.ac.kr

Received April 30, 2025 Revised June 24, 2025 Accepted August 12, 2025

Abstract

Objectives

This study aims to report a case of chronic pityriasis lichenoides with cholinergic urticaria improved by Mahwang-tang.

Methods

The patient visited our hospital with symptoms such as redness, erythema, papule, pruritus and stinging sensation all over the body. The patient was diagnosed with chronic pityriasis lichenoides with cholinergic urticaria based on the aggravating factors and symptom patterns. Considering the patient’s condition and symptoms, Mahwang-tang was prescribed.

Results

Skin symptoms improved by half (Total Score 10 → 5). Pruritus (NRS 7 → 1) and stinging sensation (NRS 7 → 0) almost disappeared, and sleep quality also improved (NRS 4 → 0). Liver function values (AST 46, ALT 64), which were high at the first visit, also improved. The patient started to sweat more and lost about 4 kg while taking Mahwang-tang.

Conclusion

This study is significant in that the patient’s skin symptoms and overall condition improved after administration of Mahwang-tang.

Keywords: Case Report, Pityriasis Lichenoides, Cholinergic Urticaria, Mahwang-tang

Fig. 1

Treatment Timeline

Fig. 2

Clinical Progress of Pityriasis Lichenoides with Cholinergic Urticaria (1)

Fig. 3

Clinical Progress of Pityriasis Lichenoides with Cholinergic Urticaria (2)

Fig. 4

Clinical Progress of Pityriasis Lichenoides with Cholinergic Urticaria (3)

Table 1

Systematic Examination

大便	대변을 보고 나면 시원하다. 대변을 며칠 보지 못해도 크게 불편하지 않다.대변이 굳다.
小便	소변을 시원하게 본다. 소변을 하루 6회 가량 본다.
寒熱	더위를 못 참는다. 열이 머리 위로 오를 때가 종종 있다. 얼굴에서 열이 나는 것 같다.
汗出	땀이 잘 나지 않는다. 사우나 가거나 운동할 때만 땀이 난다. 얼굴에서만 땀이 난다. 땀을 내고 나면 기분이 좋다.
食慾	입맛이 좋다. 요즘 살이 찌고 있다. 담배를 핀다 (하루 1갑)
胸部	목이나 가슴을 조이는 옷은 답답해서 싫다.
消化	소화가 잘 된다. 차멀미가 심하다.
睡眠	잠을 잘 자지 못한다. 잠에 잘 들지 않는다. 아침 기상한 후에도 한참 동안 몽롱하다.
口渴	건강에 좋다니까 물을 마신다. 조금씩 조금씩 물을 마신다.
皮膚	피부가 잘 빨개진다. 피부가 많이 건조하다. 여드름, 피부염 같은 피부 트러블이 많이 생긴다.
其他	목, 어깨가 자주 아프다.

Table 2

Symptom Evaluation Index

		Symptom Severity
Objective Symptoms	Redness Erythema Papule Scale	0=Absence 1=Mild 2=Moderate 3=Severe
Subjective Symptoms	Pruritus Stinging Sensation Sleep Loss	0 (None) ~ 10 (Severe)

Table 3

Prescription of Mahwang-tang

Name of Natural Medicine (Herbal Medicine)		Weight(g)
杏仁	Amygdalus communis L.	6
桂皮	Cinnamomum cassia (L.) J.Presl	4
甘草	Glycyrrhiza uralensis Fisch.	2
麻黃	Ephedra sinica Stapf	6

Total Amount		18

Table 4

Symptom Progress of Pityriasis Lichenoides with Cholinergic Urticaria

		2022.11.03	2022.12.12	2023.01.25	2023.02.24
Objective Symptoms	Redness	2	2	2	1
	Erythema	3	2	2	2
	Papule	3	2	2	1
	Scale	2	2	1	1

Subjective Symptoms	Pruritus	7	4	3	1
	Stinging Sensation	7	3	2	0
	Sleep Loss	4	1	0	0

	Total	28	16	12	6

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