皮膚科基礎(chǔ)皮損描述rjw

1、渭南海成醫(yī)院渭南海成醫(yī)院2016.1皮膚科皮疹規(guī)范化描述皮疹的分類 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。Macule:Macule: A macule is a A macule is a circumscribed, circumscribed, flat lesion that flat lesion that differs from diffe

2、rs from surrounding surrounding skin because of skin because of its color.its color.斑疹：斑疹：局限性皮膚顏色改變，不高起或凹陷皮面局限性皮膚顏色改變，不高起或凹陷皮面。AC斑疹：斑疹：局限性色素改變局限性色素改變色素沉著斑（色素沉著斑（A A）色素減退板（色素減退板（B B）炎癥性充血（炎癥性充血（C C）BPapulePapule：A papule is a A papule is a small, solid, small, solid, elevated lesion. elevated lesion.

3、 Papules are Papules are usually smaller usually smaller than 1 cm in than 1 cm in diameter.diameter.丘疹：丘疹：局限性實質(zhì)性隆起，直徑小于局限性實質(zhì)性隆起，直徑小于1cm1cm。丘疹：丘疹：局限性實質(zhì)性隆起，局限性實質(zhì)性隆起，直徑通常小于直徑通常小于0.5cm0.5cm炎癥性丘疹（炎癥性丘疹（左上圖左上圖）病毒感染性丘疹（病毒感染性丘疹（左下圖左下圖）斑塊：斑塊：丘疹融合而成，直徑丘疹融合而成，直徑大于大于1cm1cmNoduleNodule：A nodule is a palpable, A

4、 nodule is a palpable, solid, round or ellipsoidal solid, round or ellipsoidal lesion. lesion. Depth of involvement Depth of involvement and/or substantive and/or substantive palpability rather than palpability rather than diameter differentiate a diameter differentiate a nodule from a papule.nodule

5、 from a papule.結(jié)節(jié)：結(jié)節(jié)：實質(zhì)性隆起，侵犯深度與直徑大于丘疹實質(zhì)性隆起，侵犯深度與直徑大于丘疹結(jié)節(jié)：結(jié)節(jié)：實質(zhì)性隆起實質(zhì)性隆起腫瘤性結(jié)節(jié)腫瘤性結(jié)節(jié)（A）代謝異常性結(jié)節(jié)代謝異常性結(jié)節(jié)（B）ABWhealWheal： A wheal, or hive is a A wheal, or hive is a round or flat-topped round or flat-topped papule or plaque that is papule or plaque that is characteristically characteristically evanescent,

6、 disppearing evanescent, disppearing within 24 hours.within 24 hours.風(fēng)團：風(fēng)團：暫時性、局限性皮膚水腫性隆起，持續(xù)時間通常短于暫時性、局限性皮膚水腫性隆起，持續(xù)時間通常短于2424小時小時風(fēng)團：風(fēng)團：暫時性、局限性皮膚水腫性隆起暫時性、局限性皮膚水腫性隆起Vesicle and bullae:Vesicle and bullae: A vesicle is a circumscribed, elevated lesion that A vesicle is a circumscribed, elevated lesion t

7、hat contains fluid. A bullae is a vesicle larger than 0.5cm. Can be contains fluid. A bullae is a vesicle larger than 0.5cm. Can be epidermal or subepidermal.epidermal or subepidermal.水皰：水皰：含有液體高出皮面的損害。直徑大于含有液體高出皮面的損害。直徑大于0.5cm0.5cm為為大皰大皰. .AB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。大皰：大皰：含有液體高出皮面的損害，含有液體高出皮面的

8、損害，直徑大于直徑大于0.5cm0.5cm。Pustule: Pustule: A pustule is a A pustule is a circumscribed, raised circumscribed, raised lesion that contains a lesion that contains a purulent exudate.purulent exudate.膿皰膿皰: : 含有膿液的皰疹。與此類似的損害如含有膿液的皰疹。與此類似的損害如血皰血皰膿皰膿皰: : 含有膿液的皰疹含有膿液的皰疹. .Cysts:Cysts: A cyst is a sac that con

9、tains A cyst is a sac that contains liquid or semisolid material liquid or semisolid material (fluid, cells, and cell (fluid, cells, and cell products), on palpation, it is products), on palpation, it is resilient.resilient.囊腫囊腫: : 含有液體或半固體物質(zhì)的囊性損害含有液體或半固體物質(zhì)的囊性損害, ,觸之有彈性觸之有彈性. . 囊腫囊腫: 含有液體或半固體物質(zhì)的囊性損害

10、含有液體或半固體物質(zhì)的囊性損害, ,觸之有彈性觸之有彈性. .Scale, desquamation:Scale, desquamation:Abnormal shedding or Abnormal shedding or accumulation of accumulation of stratum corneum in stratum corneum in perceptible flakes is perceptible flakes is called scaling.called scaling.鱗屑：鱗屑：脫落的表皮細胞及其它成分脫落的表皮細胞及其它成分鱗屑：鱗屑：脫落的表皮細胞

11、脫落的表皮細胞及其它成分及其它成分Erosion:Erosion: A erosion is a moist, A erosion is a moist, circumscribed, usually circumscribed, usually depressed lesion that depressed lesion that results from loss of all results from loss of all or a portion of the or a portion of the viable epidermis.viable epidermis.糜爛：糜爛：表皮

12、的缺損，愈后不留疤痕。表皮的缺損，愈后不留疤痕。糜爛：糜爛：表皮的缺損，淺表表皮的缺損，淺表Ulcer: Ulcer: An ulcer is a An ulcer is a depressed lesion in depressed lesion in which the epidermis which the epidermis and at least the and at least the upper dermis have upper dermis have been destroied.been destroied.潰瘍：潰瘍：皮膚缺損達到真皮或真皮以下皮膚缺損達到真皮或真皮以下

13、潰瘍：潰瘍：皮膚缺損達到真皮或真皮以下皮膚缺損達到真皮或真皮以下Atrophy: Atrophy: Atrophy refers to a Atrophy refers to a diminution in the diminution in the size of a cell, tissue, size of a cell, tissue, organ or part of the organ or part of the body.body.萎縮：萎縮：指機體某部分（包括皮膚）減少指機體某部分（包括皮膚）減少萎縮：萎縮：指機體某部分（包括皮膚）減少指機體某部分（包括皮膚）減少Crusts

14、: Crusts: Crusts are hardened Crusts are hardened deposits that result deposits that result when serum, blood, or when serum, blood, or purulent exudate debris purulent exudate debris on the skin surface, and on the skin surface, and they are characteristic of they are characteristic of pyogenic inf

15、ections.pyogenic infections.結(jié)痂：結(jié)痂：創(chuàng)面上多種成分混合干燥物創(chuàng)面上多種成分混合干燥物結(jié)痂：結(jié)痂：創(chuàng)面上多種成創(chuàng)面上多種成分混合干燥物分混合干燥物。皮疹的描述皮疹的描述 專業(yè)術(shù)語專業(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)則狀常用術(shù)語 自覺癥狀常用術(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、燒灼感皮膚檢查規(guī)范化描述皮膚檢查規(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 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