皮肤科基础皮损描述课件

2016.1皮肤科皮疹规范化描述1大家好2016.1皮肤科皮疹规范化描述1大家好皮疹的分类原发性损害（primary lesions）由皮肤病理变化直接产生的病变斑疹、丘疹、斑块、结节、风团、水疱、脓疱、囊肿。继发性损害（secondary lesions）由原发损害转变而来，或由于治疗、搔抓等引起鳞屑、糜烂、浸渍、萎缩、溃疡、结痂、裂隙、瘢痕、抓痕、苔藓化。2大家好皮疹的分类原发性损害（primary lesions）2大家Macule:Macule:A macule is a A macule is a circumscribed,circumscribed,flat lesion that flat lesion that differs from differs from surrounding surrounding skin because of skin because of its color.its color.斑疹：斑疹：局限性皮肤颜色改变，不高起或凹陷皮面局限性皮肤颜色改变，不高起或凹陷皮面。3大家好Macule:斑疹：局限性皮肤颜色改变，不高起或凹陷皮面。AC斑疹：斑疹：局限性色素改变局限性色素改变色素沉着斑（色素沉着斑（A A）色素减退板（色素减退板（B B）炎症性充血（炎症性充血（C C）B4大家好AC斑疹：局限性色素改变B4大家好PapulePapule：A papule is a A papule is a small,solid,small,solid,elevated lesion.elevated lesion.Papules are Papules are usually smaller usually smaller than 1 cm in than 1 cm in diameter.diameter.丘疹：丘疹：局限性实质性隆起，直径小于局限性实质性隆起，直径小于1cm1cm。5大家好Papule：丘疹：局限性实质性隆起，直径小于1cm。5大家丘疹：丘疹：局限性实质性隆起，局限性实质性隆起，直径通常小于直径通常小于0.5cm0.5cm炎症性丘疹（炎症性丘疹（左上图左上图）病毒感染性丘疹（病毒感染性丘疹（左下图左下图）斑块：斑块：丘疹融合而成，直径丘疹融合而成，直径大于大于1cm1cm6大家好丘疹：斑块：6大家好NoduleNodule：A nodule is a palpable,A 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 from a papule.结节：结节：实质性隆起，侵犯深度与直径大于丘疹实质性隆起，侵犯深度与直径大于丘疹7大家好Nodule：结节：实质性隆起，侵犯深度与直径大于丘疹7大家结节：结节：实质性隆起实质性隆起肿瘤性结节肿瘤性结节（A）代谢异常性结节代谢异常性结节（B）AB8大家好结节：实质性隆起AB8大家好WhealWheal：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,disppearing evanescent,disppearing within 24 hours.within 24 hours.风团：风团：暂时性、局限性皮肤水肿性隆起，持续时间通常短于暂时性、局限性皮肤水肿性隆起，持续时间通常短于2424小时小时9大家好Wheal：风团：暂时性、局限性皮肤水肿性隆起，持续时间通风团：风团：暂时性、局限性皮肤水肿性隆起暂时性、局限性皮肤水肿性隆起10大家好风团：暂时性、局限性皮肤水肿性隆起10大家好Vesicle and bullae:Vesicle and bullae:A vesicle is a circumscribed,elevated lesion that A vesicle is a circumscribed,elevated lesion that 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.水疱：水疱：含有液体高出皮面的损害。直径大于含有液体高出皮面的损害。直径大于0.5cm0.5cm为为大疱大疱.AB11大家好Vesicle and bullae:A vesicle 水疱：含有液体高出皮面的损害。水疱：含有液体高出皮面的损害。12大家好水疱：含有液体高出皮面的损害。12大家好大疱：大疱：含有液体高出皮面的损害，含有液体高出皮面的损害，直径大于直径大于0.5cm0.5cm。13大家好大疱：含有液体高出皮面的损害，直径大于0.5cm。13大家好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.脓疱脓疱:含有脓液的疱疹。与此类似的损害如含有脓液的疱疹。与此类似的损害如血疱血疱14大家好Pustule:脓疱:含有脓液的疱疹。与此类似的损害如血脓疱脓疱:含有脓液的疱疹含有脓液的疱疹.15大家好脓疱:15大家好Cysts:Cysts:A cyst is a sac that contains 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.囊肿囊肿:含有液体或半固体物质的囊性损害含有液体或半固体物质的囊性损害,触之有弹性触之有弹性.16大家好Cysts:囊肿:含有液体或半固体物质的囊性损害,触之 囊肿囊肿:含有液体或半固体物质的囊性损害含有液体或半固体物质的囊性损害,触之有弹性触之有弹性.17大家好 囊肿:含有液体或半固体物质的囊性损害,触之有弹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.鳞屑：鳞屑：脱落的表皮细胞及其它成分脱落的表皮细胞及其它成分18大家好Scale,desquamation:鳞屑：脱落的表皮细胞鳞屑：鳞屑：脱落的表皮细胞脱落的表皮细胞及其它成分及其它成分19大家好鳞屑：脱落的表皮细胞及其它成分19大家好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.糜烂：糜烂：表皮的缺损，愈后不留疤痕。表皮的缺损，愈后不留疤痕。20大家好Erosion:糜烂：表皮的缺损，愈后不留疤痕。20大家好糜烂：糜烂：表皮的缺损，浅表表皮的缺损，浅表21大家好糜烂：表皮的缺损，浅表21大家好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.溃疡：溃疡：皮肤缺损达到真皮或真皮以下皮肤缺损达到真皮或真皮以下22大家好Ulcer:溃疡：皮肤缺损达到真皮或真皮以下22大家好溃疡：溃疡：皮肤缺损达到真皮或真皮以下皮肤缺损达到真皮或真皮以下23大家好溃疡：皮肤缺损达到真皮或真皮以下23大家好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.萎缩：萎缩：指机体某部分（包括皮肤）减少指机体某部分（包括皮肤）减少24大家好Atrophy:萎缩：指机体某部分（包括皮肤）减少24大家萎缩：萎缩：指机体某部分（包括皮肤）减少指机体某部分（包括皮肤）减少25大家好萎缩：指机体某部分（包括皮肤）减少25大家好Crusts: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 infections.pyogenic infections.结痂：结痂：创面上多种成分混合干燥物创面上多种成分混合干燥物26大家好Crusts:结痂：创面上多种成分混合干燥物26大家好结痂：结痂：创面上多种成创面上多种成分混合干燥物分混合干燥物。27大家好结痂：创面上多种成分混合干燥物。27大家好皮疹的描述皮疹的描述 专业术语专业术语位置：按照实际位置描述，屈侧，伸侧性质：原发疹，继发疹大小：以实物为参照:针头大，粟粒大，绿豆大，黄豆大，核桃大，鸡蛋大数目：单发，多发颜色：正常皮色，红色，黄色，黑色，蓝色，白色，棕色等分布：对称单侧；局限播散；沿神经血管分布排列：散在融合；孤立群集；线状，环状，带状，不规则状28大家好皮疹的描述 专业术语位置：按照实际位置描述，屈侧，伸常用术语自觉症状常用术语自觉症状常用术语：瘙痒、疼痛、水肿、肿胀、压痛、针刺样痛、烧灼感29大家好常用术语 自觉症状常用术语：瘙痒、疼痛、水肿、肿胀、皮肤检查规范化描述皮肤检查规范化描述红斑：水肿性红斑；白斑：色素减退斑、色素脱失斑；色素沉着斑 瘀点、瘀斑 丘疹：毛囊性丘疹、炎性丘疹、毛周角化性丘疹、粉刺30大家好皮肤检查规范化描述红斑：水肿性红斑；30大家好鳞屑：银白色鳞屑、糠秕状鳞屑、粘着性鳞屑、油腻性鳞屑 结痂：血痂、厚痂、蜜黄色痂瘢痕：萎缩性瘢痕、增生性瘢痕31大家好鳞屑：银白色鳞屑、糠秕状鳞屑、31大家好散在分布、密集分布、群集性分布、簇集性分布、对称分布、单侧分布、全身泛发、弥漫性、线状排列、带状排列、串珠状排列、沿血管分布、沿肋间神经分布、向心性分布、伸侧、屈侧、间擦部、皱折部、暴露部位、接触部位32大家好 散在分布、密集分布、群集性分布、簇集性分布、对界限清楚、界限不清、圆形、椭圆形、多角形、不 规则形、环状 表面光滑、表面粗糙、扁平、隆起、半球形、圆锥形乳头状、疣状、菜花状、中央脐凹 基底较宽、基底较窄、基底呈蒂状、周围绕有红晕 浸润增厚、萎缩变薄 水疱松驰、紧张 质硬、柔软、融合、互不融合、蜡样光泽 尼氏征、薄膜现象、点状出血现象、Auspitz征、皮肤划痕征33大家好 界限清楚、界限不清、圆形、椭圆形、多角形、不 规Bye Bye34大家好Bye Bye34大家好