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