1、皮肤性病学示教皮肤性病学示教皮皮 疹疹SKIN LESIONS1 表皮表皮真皮真皮皮下皮下2皮疹的分类皮疹的分类 原发性皮损原发性皮损（primary lesionsprimary lesions）由皮肤病理变化的直接结果由皮肤病理变化的直接结果 斑疹、斑块、丘疹、结节、风团、水疱、大疱、斑疹、斑块、丘疹、结节、风团、水疱、大疱、脓疱、囊肿等脓疱、囊肿等 继发性皮损继发性皮损（secondary lesionssecondary lesions）指原发性皮损因自然演变而来，或因搔抓、治疗指原发性皮损因自然演变而来，或因搔抓、治疗不当所致的继发性改变。不当所致的继发性改变。鳞屑、糜烂、浸渍、裂隙
2、、萎缩、溃疡、结痂、鳞屑、糜烂、浸渍、裂隙、萎缩、溃疡、结痂、抓痕、苔藓样变等抓痕、苔藓样变等3 原发性损害原发性损害（primary lesionsprimary lesions）斑疹、斑块、丘疹、结节、风团、水疱、大斑疹、斑块、丘疹、结节、风团、水疱、大疱、脓疱、囊肿等疱、脓疱、囊肿等4Macule:Macule:A macule is a A macule is a circumscribed,circumscribed,flat lesion that flat lesion that differs from differs from surrounding surrounding
3、skin because of skin because of its color.its color.1.斑疹：斑疹：皮肤黏膜的局限性皮肤黏膜的局限性颜色颜色改变，与皮面改变，与皮面平齐平齐。5分类：(1)按大小分：1cm斑疹(macule)；1cm斑片（patch)678(2)(2)按性质分：按性质分：红斑：红斑：充血性，压之褪色充血性，压之褪色出血斑：出血斑：渗出性，压之不褪色渗出性，压之不褪色色素沉着斑色素沉着斑色素减退斑色素减退斑9出血斑：2mm瘀斑10112.斑块（斑块（plaque)：直径直径大于大于1cm1cm的的隆起隆起、浅表、扁平性皮损。、浅表、扁平性皮损。12Papule
4、Papule：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.3.3.丘疹：丘疹：直径直径小于小于1cm1cm的局限、实质、浅表、的局限、实质、浅表、隆起隆起性损害。性损害。13141.丘疹融合后可以形成斑块；2.介于斑疹和丘疹稍隆起之间的称“斑丘疹”；3.顶部有小水疱时称“丘疱
5、疹”4.顶部有小脓疱时称“丘脓疱疹”。15WhealWheal：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.4.风团：风团：真皮浅层水肿引起的真
6、皮浅层水肿引起的暂时性暂时性、局限性、局限性隆起性隆起性损害，持续时间损害，持续时间通常通常短于短于2424小时小时，消退后，消退后不留痕迹不留痕迹，常伴，常伴剧痒。剧痒。16171819205.5.水疱：水疱：1cm1cm:1cm:大疱大疱.Vesicle and bulla:Vesicle and bulla:A vesicle is a circumscribed,A vesicle is a circumscribed,elevated lesion that contains fluid.A bullae is a vesicle elevated lesion that conta
7、ins fluid.A bullae is a vesicle larger than 0.5cm.Can be epidermal or subepidermal.larger than 0.5cm.Can be epidermal or subepidermal.21水疱水疱222324疱疹：疱疹：含有液体高出皮面的损害。含有液体高出皮面的损害。25大疱：大疱：含有液体高出皮面含有液体高出皮面的损害，直径大于的损害，直径大于1cm1cm。262728293031Pustule:Pustule:A pustule is a A pustule is a circumscribed,raise
8、d circumscribed,raised lesion that contains a lesion that contains a purulent exudate.purulent exudate.6.6.脓疱脓疱:局限、隆起、内含局限、隆起、内含脓液脓液的腔隙性损害。的腔隙性损害。32细菌性脓疱33非细菌性脓疱34NoduleNodule：A nodule is a palpable,A nodule is a palpable,solid,round or ellipsoidal solid,round or ellipsoidal lesion.lesion.Depth of i
9、nvolvement 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.7.结节：结节：局限、实质、深在性皮损。局限、实质、深在性皮损。3536高出皮面基本平齐皮面37Cyst:Cyst:A cyst is a sac that contains A
10、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.8.8.囊肿囊肿:含有液体和细胞成份的囊性损害。含有液体和细胞成份的囊性损害。383940 继发性损害继发性损害（secondary lesionssecondary lesions）指原
11、发性皮损因自然演变而来，或因指原发性皮损因自然演变而来，或因搔抓、治疗不当所致的继发性改变。搔抓、治疗不当所致的继发性改变。鳞屑、糜烂、浸渍、裂隙、萎缩、溃疡、鳞屑、糜烂、浸渍、裂隙、萎缩、溃疡、结痂、抓痕、苔藓样变等结痂、抓痕、苔藓样变等41Erosion: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
12、 from loss of all or a portion of the or a portion of the viable epidermis.viable epidermis.1.糜烂：糜烂：表皮或粘膜上皮缺损导致的浅表湿润创面，愈表皮或粘膜上皮缺损导致的浅表湿润创面，愈后不留疤痕后不留疤痕4243444546Ulcer: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
13、 at least the upper dermis have upper dermis have been destroied.been destroied.2.溃疡：溃疡：皮肤或粘膜破溃后形成的皮肤或粘膜破溃后形成的深达真皮及以下深达真皮及以下的创面。的创面。愈合后常形成瘢痕。愈合后常形成瘢痕。4748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49Scale,Scale,desquamation:desquamation:Abnormal shedding or Abnormal shedding or accumulation of accumulation of
14、stratum corneum in stratum corneum in perceptible flakes is perceptible flakes is called scaling.called scaling.3.鳞屑：鳞屑：已经脱落或即将脱落的角质层细胞已经脱落或即将脱落的角质层细胞50鳞屑：鳞屑：脱落的表皮细胞脱落的表皮细胞及其它成及其它成分分51525354554.浸渍（浸渍（meceration)：因角质层含水过多所致的皮因角质层含水过多所致的皮肤变软发白肤变软发白565.裂隙裂隙(fissure)：线状皮肤裂口，可深达真皮线状皮肤裂口，可深达真皮576.瘢痕：瘢痕：真皮
15、或深部组织缺损后，由新生真皮或深部组织缺损后，由新生结缔组结缔组织修复织修复而成。而成。增生性：萎缩性：5859Atrophy: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.7.萎缩：萎缩：因皮肤退行性变导致的表皮、真皮或皮下组织减少因皮肤退行性变导致的表皮、真皮或皮下组织减少6061
16、62Crust:Crust: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.8.痂：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6364659.抓痕：抓痕：因搔抓或摩擦导致的线状或点状表皮或真皮因搔抓或摩擦导致的线状或点状表皮或真皮浅层的剥脱性缺损。浅层的剥脱性缺损。6610.苔藓样变（苔藓样变（lichenification)：因反复机械性刺激因反复机械性刺激导致的皮肤局限性粗糙增厚，皮脊隆起，皮沟加深，常导致的皮肤局限性粗糙增厚，皮脊隆起，皮沟加深，常伴剧痒。伴剧痒。6768
