Post on 02-Jan-2016
CUTANEOUS SYMPTOMS AND SIGNS
Cutaneous symptoms : Subjective symptoms
Pruritus : moderate or severe , long or short time , local or generalized
Pain : infection ( bacteria , virus――Zoster ), Sweet’s syn., Angioleiomyoma, Dermatomyositis
Numbness : Leprosy with superficial sensory disturbance, hypoesthesia in temperature,pain and touch.
Systematic symptoms
Signs : Leisions can be seen or palpable
primary lesions
Definition : Leisions with diagnostic value and produced by the pathological changes of skin
macule
Circumscried changes in skin colorWithout elevation and depression , <1cmClassified as inflammatous and noninflammatous macules, petechia and abnormal pigmentation.
patch : macules progress to greater leision
1.
macule
Inflammatouserythema
Noninflammatous erythema
Hemorrhagic macule-- ecchymosis
Depigmented macule
Hyperpigmented patch
Hypopigmented macule
patch
Patch and macule
2. papule
Circumscribed, Solid elevation , diameter <1cm
maculopapule : mild,flap-topped papuleplaque : confluence of papules
papule
papule
plaque
Plaque and Papule
3. vesicles and bullae
Circumscribed, fluid-containing, epidermal elevated lesion , >0.5cm is bullaepapulovesicle : obvious dermal cell edema in papule with topped little vesicle
Vesicle andBullae
vesicles
bullae
papulovesicle
4. pustule
Vesicle with purulent material ,
often surrounded by a red areola ,
Primary lesions or come from vesicles
pustule
5. wheal
Acute, circumscribed, edematous elevation in superficial layer of dermisOfen last several to over ten Hours, then disappear without any trace. Usually accompanied with intense itching
wheal
6. nodule
Circumscribed, solid lesion centered in dermis or the subcutaneous fat
Circular or oval, Elevated or just palpable
nodule
nodule
nodule
Cystic lesion with a wall located in dermis or subcutus, containing fluid,dope or debris of cells
Elevated or just papable
Circular or oval,Palpation with resilience
cyst7.
cyst
cyst
secondary lesion
defition : lesions follow primary eruptions with scratching, therapy, infection or the process of recovery.
1. scale
Laminated masses of keratinocytes
scale
scale
2. crust
Dried serum, pus, blood,usually mixed with epithelialand sometimes bacterial debris
crust
Blood crust
Serum crust
Pus crust
3. Maceration and erosion
Maceration: keratinocytes absorb more water for skin in the moist circumstance, then skin becomes soft,white and crinkled.Erosion : Loss of all or portions of the epidermis alone, may become crusted,but it heals without a scar.
maceration
erosion
erosion
4. ulceration
Complete loss of the epidermisplus some portion of the dermisand subcutaneous tissue
ulcer
ulcer
5. excoriation
Linear abrasion producedby scratching, sometimes covered with blood crust.
excoriation
6. fissure
Linear cleft through the dermis ,Usually with pain and bleeding.
fissure
fissure
7. scar
New connective tissue replace lost substance in ulcerSmooth without appendages and elasticity.
scar
scar
8. atrophy
Degenerative changes of skin
atrophy
9. lichenification
• Circumscribed thickness and coarseness of skin ,
• Striaes become deeper and wider,
• Lesion is crossed as rhombus or polygon
lichenification
lichenification
attention :
1.Basic lesions can evolve
2.Primary to secondary lesions
3. Primary and secondary lesions are not unchangeable.
Such as pustules and pigmention