The Sector of Dermatology and Post-Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Brazil.
The Sector of Dermatology and Post-Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Brazil.
Clin Dermatol. 2020 Jan-Feb;38(1):42-51. doi: 10.1016/j.clindermatol.2019.10.021. Epub 2019 Nov 16.
Skin rashes have exanthema as a synonym, a term derived from the Greek words exanthem, meaning "to appear," and anthos, which denotes "flourishing." The relevant factors for characterization of a rash include distribution, configuration, and organization of the lesions, in addition to evidence of systemic involvement through toxemia, adenopathy, and conjunctive lesions, hepatosplenomegaly, excoriations or phlogosis, neck rigidity, or neurologic dysfunction. A rash may evolve to cutaneous ulceration in many instances, which is relevant for the diagnosis, the followup, and the therapeutic management of the patient. Systemic diseases with exanthemas that result in ulcerations prevail over diseases that are restricted to signs and/or merely cutaneous clinical manifestations. A variety of etiologies can present cutaneous rashes with ulcers, subject or not to systemic involvement by the underlying disease, among which stand out the bullous diseases, infectious and parasitic diseases, noninfectious granulomatous diseases, vasculitis, paraneoplastic syndromes, autoimmune diseases of the connective tissue, neutrophilic diseases, lichen planus, and drug hypersensitivity syndrome. The authors present a detailed review of some diseases corresponding to each one of the mentioned etiologies, updating the clinical manifestations and therapeutic proposals.
皮疹的同义词为发疹，这个术语源自希腊语单词 exanthem，意思是“出现”，anthos 表示“繁荣”。皮疹特征的相关因素包括分布、形态和病变组织，此外还包括通过中毒、淋巴结病和结膜病变、肝脾肿大、搔抓或炎症、颈部僵硬或神经功能障碍等全身受累的证据。在许多情况下，皮疹可能会发展为皮肤溃疡，这对于诊断、随访和治疗管理患者非常重要。出现发疹的全身性疾病比仅局限于体征和/或仅表现为皮肤临床表现的疾病更为常见。多种病因可导致伴有溃疡的皮肤疹，其基础疾病可能或可能不伴有全身受累，其中包括大疱性疾病、感染性和寄生虫性疾病、非感染性肉芽肿性疾病、血管炎、副肿瘤综合征、结缔组织自身免疫性疾病、中性粒细胞疾病、扁平苔藓和药物超敏反应综合征。作者详细回顾了每种病因所对应的一些疾病，更新了临床表现和治疗建议。
