皮肤性病学精品教学：Contact Dermatitis.pptVIP

Contact Dermatitis Eczema Atopic Dermatitis 上海交通大学医学院附属仁济医院皮肤科 吴伊旋 Contact Dermatitis Definition: Contact dermatitis is an inflammatory reaction of skin and mucous membrane caused by stimulating or allergic substances that coming in contact with them. Pathogenesis: 1. Primary irritation 2. Allergic reaction Pathogenesis of allergic contact dermatitis Delayed Type Hypersensitivity (DTH) 1.sensitization phase (4 days) semi-antigen protein carrier → virgin T cell → mother T HLA-DR antigen (EDJ) (local lymph node) ↗memory T cell cell ↘ sensitized T cell → circulation system 2.elicitation phase (1~2 days) semi-antigen protein carrier → sensitized T cell HLA-DR antigen →lymphokine releasing → inflammatory reaction Etiology: chemicals: most common cosmetics topical medicaments daily used articles agricultural industrial chemicals animals plants Clinical manifestation: 1.latent stage 2.skin lesion edematous patches of erythema or papules→ papulovesicles → vesicles → bullae → erosion ,exudation,crusting The lesion has a clear border. 3.lesion position 4.subjective sensation 5.course Diagnosis: contact history clinical features patch test Eczema Definition: Eczema is a repeated inflammatory reaction of skin to multiple stimuli, both endogenous and exogenous. Etiology and Pathogenesis: exogenous factors: foods - fish, crab, shrimp inhalants –dust mite, pollen, fungus, cat, dog contactants – silk, wool, soap, artificial fabric physical factors – sunlight, dryness, heat chemical irritants – paint, dye endogenous factors: chronic infection metabolism and endocrine disorders circulation impediment mental stress allergic quality Clinical manifestation of eczema 1.skin lesion: acute eczema: edematous patches o