skin disease
Introduction
Introduction to skin diseases In medicine, skin diseases are diseases related to the skin, and are one of the common and frequently-occurring diseases that seriously affect people's health, such as leprosy, acne fungal diseases, and skin bacterial infections. Skin disease is the change of morphology, structure and function of skin (including hair and nail) after internal and external factors, resulting in pathological processes, and correspondingly produced various clinical manifestations. The incidence of skin diseases is very high, more light, and often does not affect health, but a few are heavier and can even be life-threatening. Common skin diseases include psoriasis (psoriasis), vitiligo, herpes, rosacea, impetigo, pyogenic infections, acne, scars, warts, ichthyosis, odor, acne, folliculitis, alopecia areata, hair loss, infants Diaper rash, corns, freckles, sweat herpes, aphid dermatitis, eczema, urticaria, onychomycosis, scleroderma, itchy skin, hair loss, chloasma and sexually transmitted diseases are syphilis, genital warts, gonorrhea, non-gonococcal urethra Inflammation and so on. basic knowledge The proportion of illness: 1% Susceptible people: no special people Mode of transmission: some are contagious, and the mode of infection is mainly contact and spread. Complications: pustules
Cause
Cause of skin disease
Physiological factors (30%):
As the body's first physiological defense line and the largest organ, the skin is always involved in the functional activities of the body, maintaining the unity of the body and the natural environment. Any abnormality of the body can also be reflected on the surface of the skin.
Disease factor (30%):
For example: psoriasis, psoriasis, vitiligo, allergic pruritus, lupus erythematosus, visceral cancer skin manifestations, etc., are not only abnormal cell division, pathogenic microbial infection and toxins produced by the body, metabolic disorders, immune function imbalance, Endocrine disorders, metabolic disorders of free radical toxins, and even indirect or direct relationship with pathological changes in the mind and nervous system.
Environmental factors (25%) :
Mechanical: such as sputum, rubbing erythema, trauma, etc. Physical: such as frostbite, burns, sunburn, radiation dermatitis, etc. Chemical: Most contact dermatitis is caused by exposure to chemicals such as dyes and chemical raw materials. Biological: Animals such as acne, insect bite dermatitis, mink bites, poisonous fish hedgehogs, etc. Plants, such as contact with lacquer trees, nettles, etc. Microorganisms such as bacteria, germs, molds, spirochetes, etc.
Other factors (15%):
Many skin diseases, after the pathogenesis of the disease has been removed, continue to develop or prolonged, which may be due to other stimuli such as scratching, rubbing (mechanical), hot water, sun exposure (physical), soap washing, medication The constant effects of factors such as improper (chemical) and drinking. Among them, it is most important to grasp the most prominent. Due to the mechanical stimulation often caught, the damage is often thickened or enlarged, and the disease is prolonged. On the other hand, if you stop scratching, chronic eczema, scrapie, or neurodermatitis, which is not easy to cure, can often heal faster. In addition, factors such as age, gender, occupation, season, environment, and lifestyle are also related to the occurrence of skin diseases.
Prevention
Skin disease prevention
Eating habits
The health of food and human skin is also related to rest. The lack of certain nutrients can cause some diseases to be less well known. However, the lack of nutrients has prompted the occurrence of certain skin diseases that have not yet attracted people's attention. There are many kinds of skin diseases: such as various dermatitis, eczema, etc. These diseases are related to nutrient deficiency. All patients with skin diseases related to nutritional deficiencies must supplement the lack of nutrients. For example, patients with pellagra, which are mainly characterized by dermatitis, digestive tract and neuropsychiatric symptoms, must be given high-protein, vitamin-rich foods. Such as eggs, milk, meat, beans, peanuts, eat more fruits and vegetables and miscellaneous grains.
Dressing
Eczema patients should wear pure cotton clothes, such as nylon, cold shirt and other textures should not be worn. Washing powder should be non-biological, and there will be instructions on the washing powder package.
In addition, a small number of patients will have a sensitive reaction to the pet's edgy. As for the dust mites hidden in the quilt sheets, it has only a reduced effect on the eczema. As for smoking, it can also cause irritation. Adults should avoid smoking in front of children with eczema. Apply a non-irritating moisturizer to the affected area, moisturize the affected area, it will reduce itching, naturally won't catch so much, reduce the deterioration of the affected area, and the moisturizing cream with drugs will speed up the treatment.
There are several types of moisturizers, usually the more greasy, but if you are covered with eczema, it will make your child feel uncomfortable. It is best to apply a greasy ointment in a more serious range. The place is painted with a refreshing emulsion. Especially in the summer sweating, the refreshing emulsion will not be on the skin, but for the dry skin itching in winter, oily ointment is more suitable.
Weather factor
Pay attention to prevent four major skin diseases during wet weather:
1. Anti-eczema: After the typhoon storm, the climate is humid. If the legs of the person are soaked in the dirty water for a long time, the skin of the lower limbs is easily affected by various microorganisms, erythema, papules may occur, and sometimes pus seeps out. Severe blistering can occur. Experts advise that after rain and rain, try to avoid soaking your legs in the water for a long time. If you must start the water, you can apply a waterproof ointment in advance, or soak the legs with 1% salt water for about half an hour after washing out, then wash and dry with clean water.
2, anti-ankle: experts reminded that rain boots should be worn when walking and working in the rain. If the water level is too high and the rain boots are not used, apply a waterproof grease before the water is sprayed. If you accidentally get your ankle, you should use an antibiotic-containing ointment for the local area with mild erosion to avoid bacterial infection.
3, anti-mosquito bites: days and rainy days, the climate is humid, many people have a musty smell at home, attracting a lot of mosquitoes. Many people are itchy after being bitten by mosquitoes, and there will be small flaws on the skin. Experts advise that mosquito nets should be used as much as possible in the summer, and the skin should be kept clean and hygienic, and appropriate external protective agents such as "snow water" and "mosquito" should be applied. For insect bite dermatitis, topical antipruritic agents can alleviate symptoms, and topical hormonal creams can also be used.
4, anti-scrotum eczema: scrotal dermatitis is the skin erythema and exudative skin disease that occurs in the scrotum and its adjacent parts, commonly known as "rotten". Experts reminded that people who participated in flood fighting should immediately dry their lower body after washing ashore. After washing, apply some hazelnut powder and put on clean underwear. If conditions permit, it is best to put on waterproof pants before launching. If the skin of the lower body is found to be ruptured, the water should be temporarily avoided.
Complication
Dermatological complications Complications
Pustules: The skin forms soft, such as rounded uplift from rice to egg, including pus, due to echinococcosis, pyoderma, and abscess.
Blister: The surface formed by the skin is soft, such as a needle-to-pea-like rounded bulge with transparent liquid-like water. The cause is dermatitis caused by acute contact dermatitis or burns.
Scales: The dandruff that peels off from the outermost surface of the skin, such as powder, or forms a dry sheet, which may be dermatitis caused by ascaria, echinococcosis or Xenopus.
Suede: The surface of the diseased nest where the skin appears, with exudates, blood or dander, and a thin, hard, thin piece, commonly referred to as "crust". The cause is eczema, pyoderma and pus.
Nodules: On the skin, such as rice grains to peas, deeper than the pimples deep into the skin, like a tumor bulge, when touched with a finger, feels "hard". The cause is a tumor or sarcoma.
Scar: A trace of a skin wound that is buried by new fibrous tissue. When contracted, the skin wrinkles and shrinks. It usually occurs in burns, burns, etc. and pyoderma, which forms scar-like scars.
Erosion: As the epidermis smashes, causing a shallower part of the skin, leaving no scars and healing, such as eczema.
Ulcer: The lesions that appear further in the erosion, the epidermis has almost been destroyed, and even spread to the dermis, causing skin damage. The diseased nest is covered with blood, exudate, serum or exudates such as pus. The surface is damp and red, which is the worst skin condition. Even if it continues to be treated, it will leave scars. May cause acute eczema and pyoderma.
Mossy: The skin becomes thicker, swollen, and forms large wrinkles. The overall color looks like lead or skin like skin. The cause is a skin disease caused by an endocrine abnormality.
Pigmentation: Increased melanin, caused by precipitation on the skin. The cause may be an endocrine abnormality leading to a skin disease or hypothyroidism, which may also occur after the skin disease is cured.
Keratinization: The stratum corneum of the epidermis is abnormally thickened, causing keratinization due to the proliferation of cells in this part. This symptom often occurs in the nose of the healthy dog or on the ankle of the limbs (inside the limb). The thick skin is very dry and feels like a crack.
Symptom
Skin disease symptoms Common symptoms Spotted seasonal hand peeling skin scaly skin blackening itching skin yellowing but sclera... Skin blackening skin splitting skin non-case granulomatous sticky exudative film itching
Contact dermatitis: dermatitis is generally non-specific, and the form, extent and severity of dermatitis vary depending on the contact, the way of contact, and the individual's response. In mild cases, there are local erythema, reddish to bright red, slightly edema, or dense papules. In severe cases, erythema swelling is obvious. On this basis, there are many papules and blisters. When the inflammation is severe, bullae can occur. The blister ruptures with erosion, exudation and scarring. If it is a strong primary stimulus, it can cause necrosis of the epidermis, and even deep ulceration of the dermis. When dermatitis occurs in the loose parts of the tissue, such as the eyelids, lips, foreskin, scrotum, etc., the swelling is obvious, there is localized edema without clear edges, the skin is bright, and the surface texture disappears.
The location and extent of dermatitis are consistent with the contact area of the contact, and the boundary is very clear. However, if the contact is gas or dust, the dermatitis is diffuse without a clear boundary, but it occurs mostly in the exposed part of the body.
Most of the symptoms are itchy and burning or painful. In a few serious cases, there may be systemic reactions such as fever, chills, headache, and nausea.
The course of the disease is self-limiting. Generally, after the cause is removed, it can be cured properly and can be cured within 1 to 2 weeks. Repeated contact or improper treatment, can be converted to subacute or chronic dermatitis, reddish brown mossy or eczema-like changes.
Irritant contact dermatitis can manifest as erythema, blisters, and exudation in the clinical acute phase. Subacute, chronic can show erythema, roughness, scaling, and splitting. According to the nature of the contact irritant and the length of contact time, it can be clinically characterized as acute irritant dermatitis, delayed acute irritant dermatitis, irritating reaction, cumulative irritant dermatitis, pustular irritant dermatitis, mechanical stimuli-induced dermatitis. Wait.
psoriasis:
1, psoriasis vulgaris: the most common type, more acute onset. Typical manifestations are erythema with clear boundaries and different shapes and sizes, surrounded by inflammatory redness. Slightly infiltrated and thickened. The surface is covered with multiple layers of silvery white scales. The scales are easy to scrape off, and the translucent film is reddish after being scraped, and the small bleeding point (Auspitz sign) is visible on the film. Skin lesions occur on the head, ankles and limbs. Some patients consciously have varying degrees of itching.
2, pustular psoriasis: less common, divided into general hair style and palmar type. Generalized pustular psoriasis is a cluster of superficial aseptic pustules on the erythema, some of which can be fused into a pus. The whole body can be ill. More common in the flexion and wrinkles of the extremities, the oral mucosa can be involved at the same time. Acute onset or sudden exacerbation is often accompanied by systemic symptoms such as chills, fever, joint pain, general malaise, and increased white blood cell count. Frequent episodes of psoriatic lesions often occur during remission. The psoriasis lesions are limited to the hands and feet, symmetry occurs, the general condition is good, the condition is stubborn, and repeated attacks.
3, erythrodermic psoriasis: also known as psoriatic exfoliative dermatitis, is a serious psoriasis. Often due to topical irritant drugs, long-term use of glucocorticoids, excessive reduction or sudden withdrawal. It is characterized by diffuse flushing, swelling and scaling of the skin, accompanied by systemic symptoms such as fever, chills and discomfort. Superficial lymph nodes and white blood cell counts are increased.
4, joint disease type psoriasis: also known as psoriatic arthritis. Psoriasis patients with rheumatoid arthritis-like joint damage can affect the whole body size joints, but the most characteristic of the interphalangeal joint lesions. The affected joints are red and swollen, and the skin around the joints is often red and swollen. Joint symptoms often aggravate or reduce with skin symptoms. Blood rheumatoid factor is negative.
Seborrheic dermatitis: Skin lesions mainly occur in the scalp, brow arch, nasolabial fold, cheeks, behind the ears, upper chest, interscapular region, umbilical cord, vulva and groin. The initial manifestation is an inflammatory papule around the hair follicle, which can then manifest as a clear, slightly yellowish dark red patch with a greasy scale or suede. Self-consciously mild itching. The lesions that occur in the trunk are often ring-shaped. Skin lesions start from the scalp and gradually spread down. In severe cases, the whole body can be spread and develop into erythroderma.
Infant seborrheic dermatitis often occurs 2 to 10 weeks after birth, and the scalp is covered with greasy yellow-brown scales and the base is flushed. The eyebrows, nasolabial folds, and the back of the ear may also be affected, showing a greasy, fine scaly red patch. It is often gradually relieved and healed within 3 weeks to 2 months. For those who are persistent, the possibility of atopic dermatitis should be considered.
Cosmetic dermatitis: More women than cosmetic dermatitis, some occupations are prone to the disease, such as stage actors, etc., 30 to 40 years old are more common. The disease is mild in the early stage, and it is characterized by localized erythema and fine scales. It is mostly located around the eyes and is not easy to attract the attention of the patients. After the disease is aggravated, the area of the lesions is enlarged, the skin is erythema and swelling in a wide range, consciously itching, the skin is dry, the skin shrinks, and becomes thin. If the hormone is contained in the cosmetic, the skin loss will suddenly increase after the suspension.
Hair follicle keratosis: This disease usually begins at 20 to 30 years old. The summer is aggravated and the patient is sensitive to heat. The typical part is the sebum overflowing parts, such as the small, solid, normal skin color of the face, the forehead scalp and the chest and back. The acne, grayish brown, black enamel covers the concave surface of the papule, and the papule gradually enlarges into a shape. Fusion forms irregular plaques. Excessive sweating and frictional damage such as flexion, gluteal sulcus and genital tract are particularly pronounced, and malodorous papilloma-like and proliferative lesions are formed, which are covered with cleft palate, impregnation and purulent exudate. The disease may have keratosis of the palm of the hand, hyperkeratosis of the nail, and fragility and fragmentation of the nail. In addition, it can also affect the oropharynx, esophagus, larynx and anorectal mucosa.
Yellow water sores: yellow water sores occur in summer and autumn, mostly in exposed parts such as face, mouth, around the nostrils and limbs, and more secondary to lice, eczema and so on. The skin lesions began as scattered erythema or papules, which quickly turned into blisters. The size of the rice grains to the soybeans quickly became turbid and turbid, surrounded by inflammatory redness. The pustules begin to be full and tense. After a few hours or 1 to 2 days, the pus turbid and sinks, showing a half-moon shape. At this time, the blister wall is thin and slack, and is prone to rupture, exposing the erosion surface. After drying, a yellow suede is formed.
Wet sores: It is more common in hairy legs and feet. Acute symptoms see the beginning of the affected part of the skin flushing, followed by papules, blisters, itching, broken yellow water dripping, immersed into a piece, often symmetrical, is damp heat is heavy; while chronics are often accompanied by blood deficiency, Zheng Jian The skin is thick and rough, desquamation, itching is no degree, the course of disease is prolonged, and it is a blood-deficiency type.
Examine
Skin disease check
First, physical examination
Focus on the distribution of lesions, the type, size, size, shape, surface and substrate of the lesions, color, blister content and its color, arrangement characteristics and boundaries are clear.
The auxiliary physical inspections are:
1, slide examination method: the slide is pressed hard on the damage for 10 to 20 seconds, the color of inflammatory erythema and hemangioma can disappear.
2, skin scratches: use a blunt to scratch the skin, such as in the stroke to produce a wind group, known as skin scratches positive.
3, feeling check: including temperature, touch and pain.
4, filtered UV inspection: such as jaundice hair is dark green fluorescence, white peony is bright green fluorescence.
5, acanthosis cell release phenomenon test method (Niss's sign): the blister spreads to the surrounding, normal skin is pushed and the normal appearance of the blister is wiped off and is positive.
Second, laboratory inspection
1, skin histopathological examination: some skin diseases have their own unique pathological changes, according to this diagnosis and differential diagnosis.
2, skin test.
(1) Spot towel test: used to check for contact allergens.
(2) Scratch test or Pigon test: used to determine whether a substance has an allergic reaction (type I).
(3) Leprosy test: used to determine the immune status of leprosy patients.
(4) The sputum test: it is helpful for the diagnosis of sputum rash.
3, microbiological examination: skin fungus, leprosy, rash inspection to help the diagnosis of the corresponding skin disease.
Diagnosis
Diagnosis of skin diseases
Differential diagnosis
Common classification of skin diseases
1, fungal diseases: common with hands and feet, body femoral hernia and nails (nail nails).
2, bacterial skin disease: common erysipelas and leprosy.
3, viral skin disease: common chickenpox, flat warts and herpes.
4. Skin diseases caused by arthropods: such as hemorrhoids.
5, sexually transmitted diseases: such as syphilis, gonorrhea and genital warts.
6, allergic skin disease: common contact dermatitis, eczema, hives and multi-type erythema; drug reactions, such as taking sulfa, muscle injection penicillin allergy.
7, physical skin diseases: common sunburn, polymorphic sun rash and corns.
8, neurological dysfunction skin disease: common pruritus, neurodermatitis and parasitic paranoia.
9, erythema papular scaly skin disease: common psoriasis (psoriasis), simple pityriasis and pityriasis rosea.
10, connective tissue disease: common with lupus erythematosus, scleroderma and dermatomyositis.
11, rash skin disease: common with herpes zoster, herpes zoster and palmoplantar pustulosis.
12, pigmented skin disease: common with chloasma, vitiligo, tattoo, freckles, pigmented plaque, coffee spots, chloasma, freckles-like sputum, Riehl melanosis, perioral meson, Ota , pigmented hair Epidermis, generalized sunspot disease, facial-neck hair follicle erythema sputum, pigmented pityriasis rosea, cantharidin, congenital pigmented nevus, pleated reticular pigment abnormalities, Mongolian plaque, tattoo, vitiligo, no pigment, eccentric leukoplakia, hereditary symmetrical pigment abnormalities, anemia and so on.
13, dermatological diseases: common red hair pityriasis.
14, sebum, sweat gland skin disease: common acne, rosacea and odor sweat.
15, skin tumors and skin diseases.
16, parasites, insects, animal skin diseases.
17, hair, nail skin disease: hirsutism, alopecia, seborrheic alopecia, edema, seborrhea, alopecia areata, senile white hair, mentally ill white onset, less whitehead, funnel folliculitis, abscess wear Excisive head around hair follicle inflammation, deck malnutrition, nail sag, deck longitudinal fissure, nail rupture, fragile nail disease, transverse sulcus, thick nail disease, hook nail, nail stripping disease, scorpion, point A, A trauma, a week of swelling and pain.
18, other: rosacea, acne, multiple edema, hand and foot peeling, senile pruritus, pruritus in pregnancy, Kawasaki disease (acute febrile skin mucosal lymph node syndrome), foot edema, no sweat, summer Itchy rash, sputum (old cockroach), frostbite, pleomorphic sun rash, hemorrhoids, body odor, foot odor, systemic lupus erythematosus, drug eruption, cheilitis, millet rash (miliary rash), skin rash, scar, skin blight, granuloma Sexual skin relaxation.
19. Hereditary skin diseases.
20, all kinds of warts; herpes zoster, herpes simplex, measles, infectious erythema, pediatric papular acromegaly, Kaposi varicella-like rash, rubella, children with acute rash.
