單擊此處編輯母版標題樣式,單擊此處編輯母版文本樣式,第二級,第三級,第四級,第五級,*,2016.1,皮膚科皮疹規(guī)范化描述,2016.1皮膚科皮疹規(guī)范化描述,1,皮疹的分類,原發(fā)性損害（,primary lesions,）,由皮膚病理變化直接產(chǎn)生的病變,斑疹、丘疹、斑塊、結(jié)節(jié)、風(fēng)團、水皰、膿皰、囊腫。,繼發(fā)性損害（,secondary lesions,）,由原發(fā)損害轉(zhuǎn)變而來，或由于治療、搔抓等引起,鱗屑、糜爛、浸漬、萎縮、潰瘍、結(jié)痂、裂隙、瘢痕、抓痕、苔蘚化。,皮疹的分類原發(fā)性損害（primary lesions）,2,Macule:,A macule is a circumscribed,flat lesion that differs from surrounding skin because of its color.,斑疹：,局限性皮膚顏色改變，不高起或凹陷皮面,。,Macule:斑疹：局限性皮膚顏色改變，不高起或凹陷皮面。,3,A,C,斑疹：,局限性色素改變,色素沉著斑（,A,）,色素減退板（,B,）,炎癥性充血（,C,）,B,AC斑疹：局限性色素改變B,4,Papule,：,A papule is a small,solid,elevated lesion.,Papules are usually smaller than 1 cm in diameter.,丘疹：,局限性實質(zhì)性隆起，直徑小于,1cm,。,Papule：丘疹：局限性實質(zhì)性隆起，直徑小于1cm。,5,丘疹：,局限性實質(zhì)性隆起，,直徑通常小于,0.5cm,炎癥性丘疹（,左上圖,）,病毒感染性丘疹（,左下圖,）,斑塊：,丘疹融合而成，直徑大于,1cm,丘疹：斑塊：,6,Nodule,：,A nodule is a palpable,solid,round or ellipsoidal lesion.,Depth of involvement and/or substantive palpability rather than diameter differentiate a nodule from a papule.,結(jié)節(jié)：,實質(zhì)性隆起，侵犯深度與直徑大于丘疹,Nodule：結(jié)節(jié)：實質(zhì)性隆起，侵犯深度與直徑大于丘疹,7,結(jié)節(jié)：,實質(zhì)性隆起,腫瘤性結(jié)節(jié),（,A,）,代謝異常性結(jié)節(jié),（,B,）,A,B,結(jié)節(jié)：實質(zhì)性隆起AB,8,Wheal,：,A wheal,or hive is a round or flat-topped papule or plaque that is characteristically evanescent,disppearing within 24 hours.,風(fēng)團：,暫時性、局限性皮膚水腫性隆起，持續(xù)時間通常短于,24,小時,Wheal：風(fēng)團：暫時性、局限性皮膚水腫性隆起，持續(xù)時間通,9,風(fēng)團：,暫時性、局限性皮膚水腫性隆起,風(fēng)團：暫時性、局限性皮膚水腫性隆起,10,Vesicle and bullae:,A vesicle is a circumscribed,elevated lesion that contains fluid.A bullae is a vesicle larger than 0.5cm.Can be epidermal or subepidermal.,水皰：,含有液體高出皮面的損害。直徑大于,0.5cm,為,大皰,.,A,B,Vesicle and bullae:A vesicle,11,水皰：含有液體高出皮面的損害。,水皰：含有液體高出皮面的損害。,12,大皰：,含有液體高出皮面的損害，直徑大于,0.5cm,。,大皰：含有液體高出皮面的損害，直徑大于0.5cm。,13,Pustule:,A pustule is a circumscribed,raised lesion that contains a purulent exudate.,膿皰,:,含有膿液的皰疹。與此類似的損害如,血皰,Pustule:膿皰:含有膿液的皰疹。與此類似的損害如血,14,膿皰,:,含有膿液的皰疹,.,膿皰:,15,Cysts:,A cyst is a sac that contains liquid or semisolid material(fluid,cells,and cell products),on palpation,it is resilient.,囊腫,:,含有液體或半固體物質(zhì)的囊性損害,觸之有彈性,.,Cysts:囊腫:含有液體或半固體物質(zhì)的囊性損害,觸之,16,囊腫,:,含有液體或半固體物質(zhì)的囊性損害,觸之有彈性,.,囊腫:含有液體或半固體物質(zhì)的囊性損害,觸之有彈,17,Scale,desquamation:,Abnormal shedding or accumulation of stratum corneum in perceptible flakes is called scaling.,鱗屑：,脫落的表皮細胞及其它成分,Scale,desquamation:鱗屑：脫落的表皮細胞,18,鱗屑：,脫落的表皮細胞,及其它成分,鱗屑：脫落的表皮細胞及其它成分,19,Erosion:,A erosion is a moist,circumscribed,usually depressed lesion that results from loss of all or a portion of the viable epidermis.,糜爛：,表皮的缺損，愈后不留疤痕。,Erosion:糜爛：表皮的缺損，愈后不留疤痕。,20,糜爛：,表皮的缺損，淺表,糜爛：表皮的缺損，淺表,21,Ulcer:,An ulcer is a depressed lesion in which the epidermis and at least the upper dermis have been destroied.,潰瘍：,皮膚缺損達到真皮或真皮以下,Ulcer:潰瘍：皮膚缺損達到真皮或真皮以下,22,潰瘍：,皮膚缺損達到真皮或真皮以下,潰瘍：皮膚缺損達到真皮或真皮以下,23,Atrophy:,Atrophy refers to a diminution in the size of a cell,tissue,organ or part of the body.,萎縮：,指機體某部分（包括皮膚）減少,Atrophy:萎縮：指機體某部分（包括皮膚）減少,24,萎縮：,指機體某部分（包括皮膚）減少,萎縮：指機體某部分（包括皮膚）減少,25,Crusts:,Crusts are hardened deposits that result when serum,blood,or purulent exudate debris on the skin surface,and they are characteristic of pyogenic infections.,結(jié)痂：,創(chuàng)面上多種成分混合干燥物,Crusts:結(jié)痂：創(chuàng)面上多種成分混合干燥物,26,結(jié)痂：,創(chuàng)面上多種成分混合干燥物,。,結(jié)痂：創(chuàng)面上多種成分混合干燥物。,27,皮疹的描述,專業(yè)術(shù)語,位置：,按照實際位置描述，屈側(cè)，伸側(cè),性質(zhì)：,原發(fā)疹，繼發(fā)疹,大小：,以實物為參照,:,針頭大，粟粒大，綠豆大，黃豆大，核桃大，雞蛋大,數(shù)目：,單發(fā)，多發(fā),顏色：,正常皮色，紅色，黃色，黑色，藍色，白色，棕色等,分布：,對稱,單側(cè)；局限,播散；沿神經(jīng)血管分布,排列：,散在,融合；孤立,群集；線狀，環(huán)狀，帶狀，不規(guī)則狀,皮疹的描述 專業(yè)術(shù)語位置：按照實際位置描述，屈側(cè)，伸,28,常用術(shù)語,自覺癥狀常用術(shù)語,：,瘙癢、疼痛、水腫、腫脹、壓痛、針刺樣痛、燒灼感,常用術(shù)語 自覺癥狀常用術(shù)語：瘙癢、疼痛、水腫、腫脹、,29,皮膚檢查規(guī)范化描述,紅斑：水腫性紅斑；,白斑：色素減退斑、色素脫失斑；,色素沉著斑,瘀點、瘀斑,丘疹：毛囊性丘疹、炎性丘疹、毛周角化性丘疹、粉刺,皮膚檢查規(guī)范化描述紅斑：水腫性紅斑；,30,鱗屑：,銀白色鱗屑、糠秕狀鱗屑、,粘著性鱗屑、油膩性鱗屑,結(jié)痂：血痂、厚痂、蜜黃色痂,瘢痕：萎縮性瘢痕、增生性瘢痕,鱗屑：銀白色鱗屑、糠秕狀鱗屑、,31,散在分布、密集分布、群集性分布、簇集性分布、對稱分布、單側(cè)分布、全身泛發(fā)、彌漫性、線狀排列、帶狀排列、串珠狀排列、沿血管分布、沿肋間神經(jīng)分布、向心性分布、伸側(cè)、屈側(cè)、間擦部、皺折部、暴露部位、接觸部位,散在分布、密集分布、群集性分布、簇集性分布、對,32,