University of Iowa Carver College of Medicine, 200 Hawkins Dr., Iowa City, IA 52242, USA.
Am Fam Physician. 2010 Mar 15;81(6):726-34.
Physicians often have difficulty diagnosing a generalized rash because many different conditions produce similar rashes, and a single condition can result in different rashes with varied appearances. A rapid and accurate diagnosis is critically important to make treatment decisions, especially when mortality or significant morbidity can occur without prompt intervention. When a specific diagnosis is not immediately apparent, it is important to generate an inclusive differential diagnosis to guide diagnostic strategy and initial treatment. In part I of this two-part article, tables listing common, uncommon, and rare causes of generalized rash are presented to help generate an inclusive differential diagnosis. The tables describe the key clinical features and recommended tests to help accurately diagnose generalized rashes. If the diagnosis remains unclear, the primary care physician must decide whether to observe and treat empirically, perform further diagnostic testing, or refer the patient to a dermatologist. This decision depends on the likelihood of a serious disorder and the patient's response to treatment.
医生在诊断全身性皮疹时常常会遇到困难，因为许多不同的病症都会产生相似的皮疹，而且一种病症可能会表现出不同的、外观不同的皮疹。快速、准确的诊断对于做出治疗决策至关重要，特别是在不及时干预可能会导致死亡或严重发病的情况下。当无法立即明确具体诊断时，重要的是要制定全面的鉴别诊断，以指导诊断策略和初始治疗。在这篇由两部分组成的文章的第一部分中，列出了常见、不常见和罕见的全身性皮疹病因表，以帮助生成全面的鉴别诊断。这些表格描述了关键的临床特征和推荐的检查，以帮助准确诊断全身性皮疹。如果诊断仍然不明确，初级保健医生必须决定是观察和经验性治疗、进一步进行诊断性检查，还是将患者转介给皮肤科医生。这个决定取决于严重疾病的可能性和患者对治疗的反应。
