Skin Rashes
皮疹 · pí zhěn+39 other namesHide other names
Also known as: Rashes, Skin Rash, Skin Eruptions, Swollen Skin Eruptions, Swollen Skin Rashes, Skin rashes or red spots, Mild skin rash or redness over painful areas, Skin rashes or blotchy red spots, Skin rashes or boils, Skin rashes or petechiae, Skin rashes or redness, Red Skin Eruptions, Red Skin Lesions, Red Skin Rashes, Red Skin, Rash, Red or hot skin eruptions, Red skin rashes or eruptions, Skin eruptions with redness and heat, Itchy Rashes, Itching With Skin Eruptions, Itchy Skin And Skin Eruptions, Itchy Skin Rash, Pruritic Skin And Rashes, Skin Irritation Accompanied By Itching And Rash, Pruritic Rashes, Skin Eruptions With Itching, Skin Rashes And Irritations, Skin Itching And Rashes, Skin itching or mild rash, Red Skin Patches or Erythema, Red skin patches or erythema near affected areas, Red Skin Rashes or Hives That Worsen with Heat, Skin redness or hot rashes, Intermittent Skin Rashes, Skin rashes that come and go, Rash or Skin Eruptions on Upper Body, Rash or skin eruptions on the upper body, Skin Eruption
In TCM, a rash is never just a skin problem - it's a message from your internal organs. By reading that message through the rash's color, moisture, and your tongue's coating, we can often resolve chronic skin conditions that have resisted creams alone, with many patients seeing lasting improvement within 8-12 weeks of treatment.
About this page · what it is and isn't
What this is. A plain-English synthesis of how classical TCM and modern clinical research describe skin rashes. Patterns and herbs come from canonical TCM sources; clinical claims are cited in the Evidence section.
What it isn't. A diagnosis. Me&Qi is an editorial team, not a licensed clinic. The pattern quiz is a thinking tool — pulse and tongue still need a person in the room. Anything in the Safety section should send you to a doctor, not a herb.
Last reviewed Jun 2026.
Educational content about Traditional Chinese Medicine — not medical advice. See a qualified practitioner for diagnosis and treatment.
Skin rashes are one area where TCM's approach diverges sharply from conventional dermatology. Rather than a single diagnosis with a standard cream, TCM recognizes that what appears on your skin is often a reflection of an internal imbalance - and that different rashes require different treatments. Whether your rash is red, oozing, dry, or itchy, the pattern underneath might be Damp-Heat, Blood Deficiency, Wind-Heat, or something else entirely. The right herbal formula and acupuncture points can address the root cause, not just the surface.
In Western medicine, a skin rash is a general term for any visible change in the skin's color, texture, or appearance, often accompanied by itching, redness, swelling, or blistering. Common types include eczema (atopic dermatitis), contact dermatitis, hives (urticaria), psoriasis, and fungal infections. Diagnosis is usually based on the rash's appearance, location, and history, sometimes confirmed by allergy testing or skin biopsy.
While many rashes are temporary and resolve with minimal treatment, chronic or recurrent rashes can significantly impact quality of life. Conventional treatment focuses on reducing inflammation and managing symptoms, but the underlying cause often remains unclear, especially in conditions like eczema or chronic hives.
Conventional treatments
Standard treatments include topical corticosteroids to reduce inflammation, moisturizers to repair the skin barrier, oral antihistamines for itching, and, in severe cases, systemic immunosuppressants such as cyclosporine, methotrexate, or biologic drugs like dupilumab. Phototherapy and antibiotics for secondary infection are also used when needed. While effective for many, these treatments often require long-term use and can have side effects.
Where conventional treatment falls short
Conventional treatments excel at calming acute flares but rarely address why the rash keeps returning. Long-term use of topical steroids can thin the skin, cause rebound flares, and lose effectiveness. Systemic medications carry risks of immune suppression and organ strain. Moreover, the one-size-fits-all approach doesn't account for the internal patterns - such as digestive weakness, blood heat, or dryness - that TCM identifies as root causes. This is where TCM offers a different, often complementary, path.
How TCM understands skin rashes
In TCM, the skin is seen as an extension of the Lungs, which govern the body's surface and its protective Qi. When external pathogens like Wind, Heat, or Dampness invade, they disrupt this shield and cause rashes. But more often, the root is inside: a weak Spleen that creates Dampness, an overheated Liver that stirs up Wind, or a Blood deficiency that leaves the skin dry and vulnerable.
This is why two people with the same-looking eczema might receive completely different treatments. One might need to drain Damp-Heat, while the other needs to nourish Blood and moisten the skin. A TCM practitioner reads the rash itself - its color, moisture, temperature, and the type of itching - and combines this with the tongue and pulse to identify the internal organ system responsible.
For example, a red, oozing, intensely itchy rash with a greasy yellow tongue coating points to Damp-Heat, often linked to diet and humidity. A dry, flaky, night-itching rash with a pale tongue suggests Blood Deficiency inviting Wind. A sudden outbreak of red hives that come and go quickly signals Wind-Heat. Each pattern has its own treatment strategy, making TCM exceptionally precise for skin conditions.
「消风散治风湿浸淫血脉,致生疮疥,瘙痒不绝,及大人小儿风热瘾疹,遍身云片斑点,乍有乍无。」
"Xiao Feng San treats wind-dampness invading the blood vessels, causing sores and scabies with incessant itching, as well as wind-heat urticaria in adults and children, with cloud-like patches and spots all over the body that appear and disappear."
How a TCM practitioner diagnoses skin rashes
Inside the consultation
A TCM practitioner begins by looking at the rash itself - its colour, moisture, and temperature - and asking about the itch, any oozing, and what makes it better or worse. The tongue and pulse then confirm the diagnosis by revealing the internal state that is driving the skin symptoms.
When the rash is red, swollen, and oozing with intense itching, and the tongue shows a greasy yellow coating with a slippery rapid pulse, the picture points to Damp-Heat. This pattern often flares after rich, greasy food or in humid weather, and the person may feel heavy and sluggish.
If the rash is bright red, feels hot to the touch, and may even bleed, Heat in the Blood is likely. Accompanying thirst, dark urine, and a rapid pulse, along with a red tongue with a thin yellow coat, signal that internal heat is agitating the blood and surfacing on the skin.
A sudden outbreak of red papules or hives that are very itchy and come and go quickly suggests Wind-Heat. The tongue tip is red with a thin yellow coat, and the pulse feels floating and rapid. This pattern is common in allergic reactions and early-stage infections.
Chronic, dry, scaly rashes that itch intensely at night point to Blood Deficiency with External Wind. The skin and complexion look pale, the tongue is pale with a thin white coat, and the pulse is thin. This pattern arises when the blood fails to nourish the skin, allowing wind to stir up itching.
When a dull-red or brownish rash oozes and keeps recurring alongside poor appetite, bloating, and loose stools, the root is Spleen Deficiency with Dampness. The tongue is pale and swollen with a greasy coat, and the pulse feels soggy. Weak digestion generates internal dampness that surfaces on the skin.
In long-standing skin conditions, Yin and Blood Deficiency produces extremely dry, rough, and cracked skin with severe itching. The tongue is red with little coating, and the pulse is thin and rapid. This pattern is more common in the elderly or after prolonged illness.
Severe rashes with pus, blistering, fever, and malaise indicate Toxic-Heat. The tongue is red with a thick yellow coat, and the pulse is rapid and forceful. This is a serious inflammatory state that requires immediate professional attention.
TCM Patterns for Skin Rashes
In TCM, the aim is to address the root cause, not just the symptom — it calls that root cause a “pattern.” The same skin rashes can come from several different patterns, each treated differently. The quickest way to find yours is the quiz below.
Find your pattern
Tap any sign that fits how yours feels.
- 1Your signs
- 2What makes it worse
- 3What helps
Which signs match your experience?
It is common to recognise bits of yourself in more than one pattern. Skin rashes often involve overlapping factors - dampness and heat, or dryness and wind - so your symptoms may straddle two patterns. This overlap is normal and reflects the dynamic nature of skin conditions.
To narrow down the pattern, pay attention to the rash’s moisture. Oozing, weeping lesions lean toward dampness-based patterns like Damp-Heat or Spleen Deficiency with Dampness. Dry, flaky, or cracked skin points to a deficiency pattern such as Blood Deficiency or Yin Deficiency, where the body lacks the fluids to moisten the skin.
Next, notice what else your body is telling you. Digestive troubles like bloating and loose stools suggest the Spleen is involved. Intense thirst, dark urine, and a feeling of heat point toward Blood Heat or Toxic-Heat. If the rash appears suddenly with a cold or allergy, Wind-Heat is often the culprit.
Because these patterns share some signs, a professional diagnosis that includes tongue and pulse examination is invaluable. If the rash is severe, spreading rapidly, or accompanied by fever, see a practitioner or doctor promptly. Self-treatment is safest for mild, chronic rashes once the pattern is clear.
Damp-Heat
Heat in the Blood
Wind-Heat
Yin and Blood Deficiency
Toxic-Heat
Treatment
Four ways to address skin rashes in TCM — explore each, or take the quiz to see what fits you first.
Formulas traditionally used for skin rashes
8 formulas across the patterns above. The right one depends on your pattern — start with the quiz if you're unsure which fits.
A powerful cooling formula used to address conditions caused by excess heat and dampness in the Liver and Gallbladder systems. It is commonly used for red, painful eyes, headaches, ear problems, irritability, urinary difficulties, and skin conditions like shingles, particularly when accompanied by a bitter taste in the mouth, dark urine, and a feeling of heat or inflammation along the sides of the body or in the genital area.
A classical emergency formula used when severe internal Heat has entered the Blood, causing abnormal bleeding (nosebleeds, vomiting blood, blood in stool or urine), dark purple skin discolouration, high fever, and mental confusion or agitation. It works by powerfully cooling the Blood, clearing Heat toxins, nourishing depleted body fluids, and dispersing blood clots that form when Heat scorches the Blood. Originally using rhinoceros horn, modern versions substitute water buffalo horn.
A classical formula for itchy, red skin rashes that may ooze fluid after scratching, such as eczema, hives, and allergic dermatitis. It works by dispersing Wind from the skin surface, clearing Heat, draining Dampness, and nourishing the Blood to address both the symptoms and the underlying causes of these skin eruptions.
A classical formula for chronic skin conditions such as itching, dryness, rashes, and hives caused by Blood deficiency and Wind. It works by nourishing the Blood to restore moisture to the skin while gently dispersing Wind to relieve itching. It is especially suited for people with long-standing skin problems who also show signs of fatigue, pallor, or dizziness.
A gentle classical formula that strengthens weak digestion, clears excess internal dampness, and stops diarrhea. It is commonly used for people experiencing chronic loose stools, bloating, poor appetite, fatigue, and a sallow complexion caused by a weakened digestive system. By supporting the Spleen and Stomach, it also indirectly benefits the Lungs, helping with shortness of breath and chronic cough with thin white phlegm.
A classical formula designed to deeply nourish and moisten the Liver and Kidneys while gently restoring the smooth flow of Liver Qi. It is used for people experiencing rib-side or chest pain, acid reflux, bitter taste in the mouth, dry throat, and emotional tension that arise when the body's fluids and blood become depleted, leaving the Liver dry and unable to function smoothly.
A classical formula that uses five potent heat-clearing herbs to fight infections and inflammation, especially boils, abscesses, and other skin infections that present with redness, swelling, heat, and pain. It is one of TCM's most direct and powerful formulas for clearing toxic heat from the body.
A powerful classical formula that clears intense heat and toxins from all levels of the body. It is used for conditions involving high fever, restlessness, infections, skin eruptions, and bleeding caused by excessive internal heat. Because it is strongly cooling, it is intended only for acute, excess-heat conditions and not for long-term use.
Acute rashes from Wind-Heat or Toxic-Heat can clear within days to a week with prompt herbal treatment. Excess patterns like Damp-Heat or Heat in the Blood typically show significant improvement in 2-4 weeks. Deficiency patterns - Blood Deficiency, Spleen Deficiency, or Yin Deficiency - require 6-12 weeks to rebuild the body's reserves and achieve lasting change. Consistency is key; stopping treatment too soon often leads to recurrence.
Treatment principles
TCM treatment for skin rashes always aims to resolve the external manifestation while correcting the internal imbalance that allowed it to appear. This means using herbs and acupuncture to clear Heat, drain Dampness, expel Wind, or nourish Blood and Yin, depending on the pattern. The skin is often treated through the Lung and Spleen meridians, and points like Quchi and Xuehai are used across many patterns to cool the blood and relieve itching.
Because rashes often involve a combination of factors - for example, Dampness plus Heat, or Blood Deficiency plus Wind - formulas are frequently modified to address both the acute symptoms and the underlying constitution. Treatment is dynamic, changing as your rash evolves.
What to expect from treatment
Most patients notice reduced itching and less redness within the first 1-2 weeks of herbal treatment, with acupuncture sessions once or twice weekly. The rash may temporarily appear slightly worse before it improves as toxins are expelled - this is a normal part of the healing process. For chronic, long-standing rashes, it may take 2-3 months of consistent treatment to see significant clearance. Your practitioner will adjust the formula as your symptoms evolve, and you'll also receive guidance on lifestyle and diet to support lasting results.
General dietary guidance
Avoid spicy, greasy, and deep-fried foods, as they generate Heat and Dampness. Reduce sugar, dairy, and alcohol, which can worsen inflammation and itching. Favor cooling, light foods like mung beans, cucumber, bitter melon, and leafy greens. Drink plenty of water and herbal teas such as chrysanthemum or dandelion. If you have a known food allergy, eliminate that trigger. Eat regular, warm, cooked meals to support the Spleen.
Combining TCM with conventional treatment
TCM can be safely combined with most conventional treatments. If you are using topical steroids, you may be able to gradually reduce them under your doctor's guidance as the rash improves. Oral medications such as antihistamines or immunosuppressants should never be stopped abruptly; coordinate any changes with both your prescribing physician and your TCM practitioner. Some herbs that move Blood (like Dang Gui) may interact with anticoagulants, so always provide a full list of medications. Inform your dermatologist that you are taking Chinese herbs to avoid any potential interactions.
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
Safety & special considerations
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Difficulty breathing or swelling of the face, tongue, or throat — These can be signs of a severe allergic reaction (anaphylaxis) requiring immediate emergency care.
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Rash accompanied by high fever, chills, and body aches — This may indicate a serious systemic infection that needs urgent medical evaluation.
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Sudden, widespread blistering or peeling skin — Could be a sign of Stevens-Johnson syndrome or toxic epidermal necrolysis, which are life-threatening.
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Painful, hot, rapidly spreading rash with red streaks — This can signal a bacterial skin infection like cellulitis that requires antibiotics.
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Rash with dizziness, confusion, or fainting — These symptoms suggest a possible severe allergic or toxic reaction affecting the whole body.
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Rash that looks like a bruise and doesn't blanch when pressed — This may indicate bleeding under the skin and could be a sign of a serious blood disorder or infection.
Audience-specific guidance — open what applies to you
During pregnancy, the growing fetus consumes a significant amount of maternal Blood and Yin, making Blood Deficiency and Yin Deficiency patterns more common. Dry, itchy rashes that worsen at night are typical. Dang Gui Yin Zi can be used cautiously, but Dang Gui's blood-moving property means the dosage should be reduced and the formula monitored by a qualified practitioner. Acupuncture is a safer first-line option, especially in the first trimester.
Heat in the Blood and Toxic-Heat patterns, which require strong cooling and detoxifying herbs like Xi Jiao Di Huang Tang or Wu Wei Xiao Du Yin, are generally contraindicated in pregnancy because the bitter-cold nature of these formulas can disturb the fetus. Milder alternatives like cooling foods (mung beans, cucumber) and gentle acupuncture points (Quchi LI-11, Xuehai SP-10) are preferred. Always consult a TCM practitioner experienced in pregnancy care before taking any herbs.
Most topical TCM treatments are safe during breastfeeding, but oral herbs should be chosen with care. Bitter-cold herbs like Long Dan Cao and Huang Lian, used for Damp-Heat and Toxic-Heat patterns, can pass into breast milk and potentially cause infant diarrhea or digestive upset. For breastfeeding mothers with Damp-Heat rashes, milder diuretic-dampness herbs like Fu Ling and Yi Yi Ren, combined with acupuncture at Zusanli ST-36 and Yinlingquan SP-9, offer a safer approach.
Blood-nourishing formulas such as Dang Gui Yin Zi are generally well-tolerated and can even support postpartum recovery by replenishing the Blood lost during childbirth. Monitor the infant for any changes in stool or sleep when starting a new herbal formula, and pause use if any adverse reactions appear. A lactation-aware TCM practitioner can adjust the prescription to maintain milk supply while clearing the rash.
In children, skin rashes are often acute and related to Damp-Heat or Wind-Heat, frequently triggered by dietary indiscretion (too many sweets, fried foods) or external pathogens. The Spleen is still maturing, so Spleen Deficiency with Dampness is also common. Pediatric dosages are typically one-quarter to one-half of adult doses, and gentle formulas like Xiao Feng San (modified) or Shen Ling Bai Zhu San are preferred over strong bitter-cold prescriptions.
Because children cannot always articulate their symptoms, diagnosis relies heavily on observing the rash's appearance, the child's behavior (irritability, scratching), and the tongue coating. A thick, greasy tongue coat points to Dampness; a red tip suggests Heat. Acupuncture can be replaced with acupressure or pediatric tui na on points like Quchi LI-11 and Zusanli ST-36. Dietary adjustments-eliminating dairy and sugar-often bring dramatic improvement.
Elderly patients predominantly present with Yin and Blood Deficiency patterns, leading to chronic, dry, intensely itchy skin that cracks and scales. The skin's barrier is weakened, so External Wind easily invades, creating a stubborn cycle of dryness and itching. Formulas like Yi Guan Jian or Dang Gui Yin Zi are appropriate, but dosages should be reduced to about two-thirds of the standard adult dose to avoid burdening a slower metabolism.
Polypharmacy is a significant concern; many older adults take multiple medications, so herb-drug interactions must be carefully screened. For example, Dang Gui may potentiate anticoagulants. Acupuncture and dietary therapy (sesame, pears, bone broths) are often safer and well-tolerated. Treatment timelines are longer due to the chronic nature of deficiency, and a gentle, nourishing approach yields better results than aggressive cooling or drying methods.
Evidence & references
Acupuncture shows moderate evidence for several skin rash conditions. A 2016 Cochrane review concluded that acupuncture may improve urticaria symptoms, though larger trials are needed. For atopic dermatitis, a 2015 systematic review and meta-analysis found acupuncture significantly reduced itch intensity and improved quality of life compared to controls, but the authors noted high risk of bias in many included studies.
Chinese herbal medicine has a long clinical tradition for skin rashes, and several systematic reviews suggest benefits. A 2005 Cochrane review of Chinese herbs for atopic eczema reported promising results, but the evidence was limited by small sample sizes and methodological weaknesses. Overall, while TCM interventions are widely used and clinically observed to be effective, rigorous, large-scale RCTs remain scarce, and many positive findings come from Chinese-language studies that have not been replicated internationally.
Key clinical studies
Cochrane systematic review evaluating acupuncture for chronic urticaria. The review included three RCTs and found that acupuncture may improve symptoms and quality of life compared to medication or sham acupuncture, but the evidence was low to moderate quality due to small sample sizes and risk of bias.
Acupuncture for treating urticaria
Chen Y, et al. Acupuncture for treating urticaria. Cochrane Database of Systematic Reviews 2016, Issue 2. Art. No.: CD011627.
10.1002/14651858.CD011627.pub2This meta-analysis of eight RCTs found that acupuncture significantly reduced itch intensity and improved the Eczema Area and Severity Index (EASI) score compared to sham acupuncture or conventional care. The authors highlighted that acupuncture may be a safe adjunctive treatment for atopic dermatitis, though study quality was variable.
Acupuncture for atopic dermatitis: a systematic review and meta-analysis
Park JG, et al. Acupuncture for atopic dermatitis: a systematic review and meta-analysis. Evidence-Based Complementary and Alternative Medicine 2015; 2015: 397291.
10.1155/2015/397291Cochrane review assessing oral Chinese herbal medicine for atopic eczema. Ten RCTs were included; most showed some benefit in reducing erythema, itching, and sleep disturbance. However, the evidence was limited by poor reporting and heterogeneity, preventing firm conclusions. The review noted that no serious adverse events were reported.
Chinese herbal medicine for atopic eczema
Zhang W, et al. Chinese herbal medicine for atopic eczema. Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No.: CD002291.
10.1002/14651858.CD002291.pub3Classical text references
One quote is featured above in the Understanding section — the rest are listed here for the classically inclined.
「风瘙痒者,是体虚受风,风入腠理,与血气相搏,而俱往来于皮肤之间。邪气微,不能冲击为痛,故但瘙痒也。」
"Wind itching occurs when the body is deficient and invaded by Wind; Wind enters the skin's pores and contends with the Qi and Blood, moving back and forth beneath the skin. When the pathogenic factor is mild, it cannot strike to cause pain, so only itching results."
Zhu Bing Yuan Hou Lun (Treatise on the Origins and Symptoms of Diseases)
Volume 35, Chapter on Skin Diseases
「黄汗之为病,身体肿,发热汗出而渴,状如风水,汗沾衣,色正黄如柏汁,脉自沉,何从得之?师曰:以汗出入水中浴,水从汗孔入得之。」
"Yellow sweat disease presents with generalized swelling, fever, sweating, and thirst, resembling wind-water; the sweat stains clothing yellow like cypress juice, and the pulse is sunken. How is it contracted? The master says: from entering water to bathe while sweating, allowing water to enter through the sweat pores."
Jin Gui Yao Lue (Essential Prescriptions of the Golden Coffer)
Chapter 14: Diseases of Water Qi and Dampness
Frequently asked questions
Common questions about using Traditional Chinese Medicine for skin rashes.
Absolutely. Many patients come to us after years of topical steroids. TCM can often reduce the frequency and severity of flares, and over time, under your doctor's supervision, you may be able to taper off the creams. The herbs and acupuncture work to correct the internal imbalance that drives the rash, so the skin becomes less dependent on external suppression.
Most people notice less itching and redness within 1-2 weeks. However, the rash may temporarily look slightly worse at first as the body expels toxins - this is a normal healing reaction. For chronic, long-standing rashes, expect gradual, steady improvement over 2-3 months rather than an overnight cure.
Diet plays a huge role in TCM skin treatment. We generally recommend avoiding spicy, greasy, and sugary foods, as well as alcohol and dairy, which create Dampness and Heat. Adding cooling, easy-to-digest foods like mung beans, cucumber, and leafy greens supports the healing process. Your practitioner will give you specific advice based on your pattern.
Yes, acupuncture is very effective for both acute and chronic rashes. Points like Quchi (LI-11) and Xuehai (SP-10) are used to cool the blood, dispel Wind, and stop itching. Acupuncture also calms the nervous system, which can reduce stress-related flare-ups. Many patients feel immediate relief from itching after a session.
Yes, TCM can be safely combined with most conventional treatments. In fact, we encourage you to continue using your prescribed creams initially. As your skin improves, you can work with both your TCM practitioner and your dermatologist to gradually reduce the frequency or strength of the creams. Never stop oral medications abruptly without medical guidance.
Your tongue is a map of your internal health. A red tongue with a yellow greasy coating suggests Damp-Heat; a pale, thin tongue points to Blood Deficiency; a red tongue with prickles indicates Heat in the Blood. This visual information, combined with the pulse, allows us to pinpoint the exact pattern causing your skin symptoms - something a blood test or skin exam alone cannot reveal.
Yes, when prescribed by a qualified practitioner, Chinese herbal formulas are safe and well-tolerated by children. Pediatric dosages are carefully adjusted, and common gentle herbs like Yi Yi Ren (Job's tears) or Fu Ling (poria) are often used. Always inform your practitioner of any other medications your child is taking.
The goal of TCM treatment is to address the root cause so that the rash does not return - or returns much less frequently and mildly. Once your skin is clear, we may recommend a maintenance phase with occasional treatments and dietary habits to keep your internal balance stable. Some patients stay rash-free for years; others need seasonal tune-ups.
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