皮膚科二三小事

Erythema multiforme

昨天乾媽打電話問我，醫生為她手上的小皰疹寫了個診斷：

HSV引起之「多型性紅班」。

多型性紅班？聽起來挺專門的，對老人家來說這名字聽起來有恐怖到。
於是皮膚科門外漢的我做了一點小功課。
Definition：Erythema multiforme is a skin disorder resulting from an allergic reaction in response to medications, infections, or illness. ->其實就是過敏反應引起的皮膚紅，感覺沒啥特別。

Causes：Approximately 90% of erythema multiforme cases are associated with herpes simplex or mycoplasma infections.

Symptoms ：

。That may appear as nodule, papule, or macule
Central lesion surrounded by concentric rings of paleness and redness, also called "target", "iris", or "bull's eye" 下面的圖就是"target sign"

。May have vesicles and bullae (blisters of various sizes)
。Located on the legs, arms, palms, hands, or feet
。May involve the face or lips
。Trunk is usually not involved
。Usually symmetrical

然後說到HHV，這裡有張漂亮的herpes viridae分類表。我覺得乾媽手肘上的是VZV(即HHV type3，會水痘+皮蛇的那隻），不過醫生覺得是HSV-1(type1)，或許因為也會長上嘴唇邊的關係吧！

Mycosis Fungoides

蕈狀肉芽腫（Mycosis fungoides） is the most common of the cutaneous T-cell lymphomas, a group of rare cancers that grow in the skin.->太好了！這廝跟黴菌一點鳥關係都沒有。

Henoch-Schoenlein Purpura

Acute, self-limited arteritis, often follows Strep infection, symptoms: purpura, nephritis, abdominal pain, joint pain, thick small bowel folds, thumbprinting in small bowel or colon.->類過敏性紫班症，要和PSGN之IgA nephropathy放在一起想。