多形渗出性红斑【精品-ppt】

多形渗出性红斑Erythema multiforme exsudativumErythema multiforme exsudativum多形渗出性红斑 也称 多形红斑 。由于病变多种多样，其形态及颜色不一致，故有多形之称。为皮肤、粘膜的急性渗出性炎症，男性多见，好发于青年人。发病时有全身症状，如高热、头痛、咽痛、关节痛及疲倦等。Erythema multiforme exsudativum皮损常突然发生，有红斑、丘疹、结节、水疱及大疱。 典型病变可有虹膜样损害，即中央为一大疱，周围为荨麻疹样水肿区，再外有红斑环绕。 病变多见于手背、足背、四肢伸侧，面、颈、躯干也可发生，多为对称性。生殖器及眼结膜也可发病。Erythema multiforme exsudativumErythema multiforme exsudativuml 病程约为 14 周，本病的重症型又称 Stevens Johnson综合征。其病因可能为抗原 抗体引起的变态反应性疾患。Erythema multiforme exsudativumErythema multiforme exsudativum口腔粘膜病变为充血的红斑，继而形成水疱、脱皮、渗出，结痴、糜烂及溃疡等多形变化。好发于舌、腭、颊、唇及牙龈。一般水疱 1 2日破裂,形成溃疡，表面可形成坏死性渗出物或伪膜。Erythema multiforme exsudativumErythema multiforme exsudativumErythema multiforme exsudativumErythema multiforme exsudativumErythema multiforme exsudativum血管周C3沉积Erythema multiforme exsudativum【 病理 】上皮细胞内和细胞间水肿，上皮内可有疱或裂形成，也可在上皮下形成大疱。本病无棘细胞松解，可与寻常性天疱疮鉴别。结缔组织有水肿，且有炎症细胞浸润，早期为嗜酸性粒细胞多，逐渐中性粒细胞居多。Erythema multiforme exsudativum【 病理 】血管扩张，血管内皮细胞肿胀及管壁增厚，血管周围主要为淋巴细胞浸润，其中也掺杂中性粒细胞和嗜酸性粒细胞。有时血管周围有红细胞外渗。Erythema multiforme exsudativum上皮内疱Erythema multiforme exsudativum上皮下疱Erythema multiforme exsudativum上皮萎缩Erythema multiforme 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