玫瑰糠疹共享精品课件

玫 瑰 糠 疹 Pityriasis rosea 是一种有特征性皮损的急性、自 限性、炎症性皮肤病 l病因： 病因不明，有认为与病毒感染 有关 人类疱疹病毒-7、8。 l临床表现： 多见于中青年 春秋季节多发 有不同程度的前驱症状 好发于躯干及四肢近心端，面 及小腿一般不受累 自觉症状轻 有自限性 l临床表现： 母斑：孤立的淡红玫瑰色斑 12周后皮疹泛发 躯干四肢多数大小不等的淡红 色斑片，表面敷细糠状鳞屑，状同 母斑 皮疹呈椭圆形，长轴与皮纹一 致 躯干部椭圆形皮 疹，长轴与皮纹 一致 与皮纹一致的椭圆形皮疹，表面敷细薄糠状鳞屑 与皮纹一致的椭圆形皮疹，表面细糠状鳞屑 l特殊类型皮损： 顿挫型：仅出现母斑无子斑。 渗出型：有渗出倾向。 其他型：丘疹型、水疱型、荨麻 疹型、 紫癜型、脓疱型、多形红斑 型等。 l诊断及鉴别诊断： 诊断：根据临床病史、典型的临 床表现诊断不难。 鉴别诊断： 体癣 银屑病 花斑癣 二期梅毒 l体癣 损害范围局限， 境界清楚的红斑，边缘有鳞屑、 丘疹 皮疹呈环形或多环形 真菌镜检阳性 l银屑病 l二期梅毒 有婚外性行为或感染史 皮疹广泛对称，常累及掌跖 有黏膜损害 淋巴结肿大 梅毒血清学反应阳性 l治疗： 自限性，缩短病程，缓解减 轻症状 *外用药物治疗 炉甘石洗剂或低浓度皮质激 素霜剂 *口服抗组胺药物 开瑞坦10，每日1次或 赛庚啶2，每日3次口服 *小剂量激素 *紫外线照射 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