CUTANEOUS SYMPTOMS AND SIGNS Cutaneous symptomsSubjective symptoms Pruritusmoderate

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

1. macule Circumscried changes in skin color Without elevation and depression，<1 cm Classified as inflammatous and noninflammatous macules, petechia and abnormal pigmentation. patch：macules progress to greater leision

macule

Inflammatous erythema

Noninflammatous erythema

Hemorrhagic macule-- ecchymosis

Depigmented macule

Hyperpigmented patch

Hypopigmented macule

patch

Patch and macule

2. papule Circumscribed, Solid elevation， diameter <1 cm maculopapule：mild, flap-topped papule plaque：confluence of papules

papule

papule

plaque

Plaque and Papule

3. vesicles and bullae Circumscribed, fluid-containing, epidermal elevated lesion，>0. 5 cm is bullae papulovesicle：obvious dermal cell edema in papule with topped little vesicle

Vesicle and Bullae

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 dermis Ofen 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

7. cyst 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

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

2. crust Dried serum, pus, blood, usually mixed with epithelial and 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 epidermis plus some portion of the dermis and subcutaneous tissue

ulcer

ulcer

5. excoriation Linear abrasion produced by scratching, sometimes covered with blood crust.

excoriation

6. fissure Linear cleft through the dermis， Usually with pain and bleeding.

fissure

7. scar New connective tissue replace lost substance in ulcer Smooth without appendages and elasticity.

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

attention ： 1. Basic lesions can evolve 2. Primary to secondary lesions 3. Primary and secondary lesions are not unchangeable. Such as pustules and pigmention