课件：脂溢性皮炎.ppt

龙胆泻肝汤 龙胆草、栀子、黄芩、柴胡、生地、车前子、泽泻、木通、甘草各适量。红斑较甚者加用防风、荆芥；继发感染者加用金银花、菊花；痒剧者加用苦参、白鲜皮；皮损局限于下半身者加牛膝、黄柏。水煎，分２～３次服，每日１剂，３剂为１疗程。本方出自《医方集解》，有泻肝胆实火，清下焦湿热之功。配合外用肤脂平治疗。 脂 溢 性 皮 炎 脂溢性皮炎：是发生在头、面、胸背部或会阴部等皮脂溢出部位的一种红斑性皮疹，有油腻性鳞屑，可伴有不同程度瘙痒。 【病因和发病机制】：病因不明，本病是在皮脂溢出的基础上所发生的一种炎症反应，主要见于婴儿头皮、面部及尿布区及成年人皮脂溢出部位，但与皮脂腺分泌多少无关。目前认为与卵圆糠秕孢子菌有关，临床上，使用酮康唑有效支持糠秕马拉色菌与本病有关，易患脂溢性皮炎的个体，可因疲劳、情绪紧张或感染所诱发，饮食关系目前不明确、 [临床表现] 分为婴儿型及成人型 1婴儿型 发生在生后3~4周，在头皮、面部，包括眉弓，双颊、驱干部、尿布区以及腋部，出现油腻细小的鳞屑性红色斑片，易结成淡黄色痂，严重者可伴有糜烂、渗出，瘙痒不明显，有自限性。可继发细菌或者念珠菌感染。 2 成人脂溢性皮炎 可累及头皮机胸骨前区、腋部、乳房下及腹沟处皮肤。头皮的脂溢性皮炎分为炎症性及非炎症性两种。炎性者表现典型性红斑及油腻性脱屑，常扩展至发际及耳后部位，轻度瘙痒;非炎症性者表现为轻重不等的糠样脱屑，即平常所说的头皮屑，又称干燥性糠屑，而无明显炎性表现。面部脂溢性皮炎常由头皮蔓延而来，常累及眉弓、眼睑、鼻唇沟及胡须区域，呈黄红色、油腻性鳞屑性斑片。 头皮损害的两种类型：1鳞屑性：常呈红斑或红色毛囊丘疹并有小片糠状脱屑，头发干燥、细软、稀疏或脱落：2结痂型：多见于肥胖者，头皮厚积片状、粘着油腻性黄色或棕色痂，痂下炎症明显，间有糜烂、渗出 Seborrheic Dermatitis also known as seborrheic eczema “ is an inflammatory skin disorder affecting the scalp, face, and trunk causing scaly, flaky, itchy, red skin. It particularly affects the sebum-gland rich areas of skin. Etiology The cause of seborrhoeic dermatitis remains unknown Malassezia globosa, may play a role. Seborrhoeic dermatitis may be aggravated by illness, psychological stress, fatigue, change of season and reduced general health. Etiology Neurologic conditions, including Parkinsons disease, head injury, and stroke may be associated with seborrheic dermatitis. Human immunodeficiency virus (HIV) has also been linked to increased cases of seborrheic dermatitis. Etiology In children, excessive vitamin A intake can cause seborrhoeic dermatitis. Lack of vitamin B6 and vitamin B2 may also be a cause Etiology and Pathogenesis 遗传性皮脂溢出 感染马拉色菌、痤疮丙酸杆菌等 皮脂成分改变 感染性变态反应 脂溢性皮炎 精神、饮食、维生素B缺乏、嗜酒 Clinical Manifestation Seborrheic dermatitis can occur on many different body areas. Typically it forms where the skin is oily or greasy. Lesion papule oily and yellow scales , severe cases, yellowish to reddish scaly papule appear along the hairline, behind the ears, ear canal,