Division of Dermatology, Department of Internal Medicine, Ohio State University Comprehensive Cancer Center, Columbus, Ohio; Department of Dermatology, University of Cincinnati College of Medicine, Cincinnati, Ohio.
Department of Dermatology, University of Cincinnati College of Medicine, Cincinnati, Ohio.
J Am Acad Dermatol. 2017 Mar;76(3):538-550. doi: 10.1016/j.jaad.2016.08.034. Epub 2016 Oct 26.
Although classic viral exanthems of childhood are well described, they are rarely differentiated in adults. Laboratory techniques for viral identification have advanced without substantial literature to suggest how a dermatologist ought to conduct a cost-effective and diagnostic viral panel. Certain clinical features such as petechiae, vesicles, and dusky macular or morbilliform exanthems point strongly toward a viral exanthem. Differentiation of drug and viral causes of morbilliform eruptions has proven difficult. It is possible that with further diagnostic refinement that unnecessary and fruitless workups of an exanthem and unneeded discontinuation of drugs can be avoided. We review viral exanthems based on clinical features and discuss the available and optimal laboratory techniques to assist the dermatologist in a targeted workup.
虽然儿童时期的经典病毒疹描述得很好，但在成人中很少进行区分。病毒鉴定的实验室技术已经得到了发展，但没有大量的文献表明皮肤科医生应该如何进行具有成本效益和诊断价值的病毒检测。某些临床特征，如瘀点、水疱和暗斑或麻疹样疹，强烈提示病毒疹。药物和病毒引起的麻疹样皮疹的鉴别诊断一直很困难。随着诊断方法的进一步改进，可能会避免对皮疹进行不必要的、无益的检查和不必要地停用药物。我们根据临床特征对病毒疹进行综述，并讨论了现有的最佳实验室技术，以帮助皮肤科医生进行有针对性的检查。
