Cupping Comes to the Boondocks

The patient is a 65 yo man who came in for a dermatitis of his scalp.  He requested a complete skin exam  This was remarkable for circular ecchymoses on his left back.  I asked about this.  He sees a massage therapist for back pain and she recommended cupping.  His wife was horrified to see these bruises until he explained how they were acquired.

Clinical Image: 

 With cupping, traditionally, a cotton ball soaked in alcohol is burned inside the glass cup and removed right before placement to create the vacuum. Bamboo and other materials can be used as alternatives to glass. The procedure breaks superficial blood vessels in the papillary dermis, creating ecchymoses, purpura, and petechiae, which is seen as evidence that the ailment is being drawn from the body.

Clearly, this traditional Asian remedy is entering the mainstream in Western Massachusetts. Our Asian readers probably see this all the time.  
For a few laughs, see Cupping Video.

Reference:

1. Dermatoses caused by cultural practices: Therapeutic cultural practices.

Vashi NA. J Am Acad Dermatol. 2018 Jul;79(1):1-16.

Abstract: With globalization and widespread immigration, physicians increasingly encounter patients from varying backgrounds and diverse customs. Although certain cultural practices are widely performed, there is limited medical literature describing their dermatologic and systemic effects and complications. Population diversity and sharing of traditions make it increasingly important for dermatologists to understand the role of cultural practices and recognize physiologic and pathologic sequelae. In addition, dermatologists are often adjured to assess skin findings that may be mistaken for abuse. Child abuse misdiagnosis can be traumatizing to all those involved, and immigrant families with limited English proficiency may have difficulty explaining their traditional practices. The first article of this 2-part continuing medical education series begins with a review of therapeutic cultural practices, including traditional Chinese medicine, Ayurveda, acupuncture, cupping, moxibustion, and coining, and the clinically relevant complications that may occur. Therapeutic practices can cause a range of complications, including contact dermatitis, heavy metal toxicity, and severe cutaneous adverse reactions.