荨麻疹和药疹.pptVIP

* 2021/3/26 * 2021/3/26 * 2021/3/26 * 2021/3/26 * 2021/3/26 * 2021/3/26 冰块试验 * 2021/3/26 巨大荨麻疹-血管性水肿 * 2021/3/26 * 2021/3/26 诊断及鉴别诊断: 根据瘙痒及忽起忽消不留痕迹的风团等特点可作诊断. 需鉴别的疾病有: (一)丘疹性荨麻疹:为枣核形的风团,中央有丘疱疹或水疱 (二)症状性荨麻疹:风团色深,持续时间长,伴有原发病 (三)急腹症,胃肠炎,感染等 * 2021/3/26 处理 (一)寻找并祛除病因 (二)内用药 1.一般选用抗组胺药,如第一代的扑尔敏, 二代的西替利嗪,也可加用维生素C,钙剂等 2.若伴有休克,喉头水肿等,应进行抢救.伴感染者加用抗生素 3.慢性及特殊性荨麻疹,在抗组织胺药基础上,加用特殊方法,或联合用药,中医中药 (三)外用药:安抚止痒剂. 2021/3/26 * 谢谢! * * * * 1 * 2021/3/26 9.大疱性表皮松解型:大批红斑,松弛性大疱,尼氏征阳性,糜烂,结痂,伴全身症状。 * 2021/3/26 * 2021/3/26 * 2021/3/26 10.剥脱性皮炎型 * 2021/3/26 11.光敏性药疹 （磺胺药引起） * 2021/3/26 12.萎缩性药疹 43 year old male with psoriasis. Chronic use of topical clobetasol for more than 15 years. Steroid atrophy resulted. Comments:This 43-year-old man with psoriasis developed steroid-induced atrophy from chronic use of topical clobetasol for 15 years. * 2021/3/26 13.角皮病（钙通道阻滞剂引起,剂量依赖） symmetric thick yellow scaly plaques on a red base. Comments:This 48 year old man developed a progressive keratoderma on his palms shortly after starting oral verapamil for hypertension. The plaques and erythema worsened as the dose was increased and decreased and cleared when the dose was decreased and finally discontinued. A punch biopsy from the palm showed a perivascular lymphocytic infiltrate with basilar vaculopathy and dyskeratosis. * 2021/3/26 14.色素沉着 美满霉素引起 * 2021/3/26 15.皮炎、湿疹型 肌注维生素K引起 局部注射药物引起 * 2021/3/26 16.玫瑰糠疹样药疹 铋剂引起 * 2021/3/26 17.AGEP （Acute generalized exanthematous pustulosis） 万古霉素引起 * 2021/3/26 * 2021/3/26 diffuse hyperpigmented lichenoid papules. Comments:A 52 year old woman complained of an widespread itchy rash present for 3 years. A skin biopsy of the lichenoid hyperpitmented papules showed a lichenoid interface dermatitis. Direct immunofluorescence and serologic studies for connective tissue disease were negative. Further history revealed that the rash started within 6 weeks of starting distiazem. The medication was discontinued and she was treated with a tapering course of o