2. CUTANEOUS SYMPTOMS AND SIGNS

3. Cutaneous symptoms ： Subjective symptoms Pruritus ： moderate or severe ， long or short time ， local or generalized Pain ： infection （ bacteria ， virus――Zoster ）， Sweet’s syn., Angioleiomyoma, Dermatomyositis Numbness ： Leprosy with superficial sensory disturbance, hypoesthesia in temperature,pain and touch. Systematic symptoms

4. Signs ： Leisions can be seen or palpable primary lesions Definition ： Leisions with diagnostic value and produced by the pathological changes of skin

5. macule Circumscried changes in skin color Without elevation and depression ， <1cm Classified as inflammatous and noninflammatous macules, petechia and abnormal pigmentation. patch ： macules progress to greater leision 1.

6. macule

8. Inflammatous erythema

9. Noninflammatous erythema

10. Hemorrhagic macule-- ecchymosis

11. Depigmented macule

12. Hyperpigmented patch

13. Hypopigmented macule

14. patch

15. Patch and macule

16. 2. papule Circumscribed, Solid elevation ， diameter <1cm maculopapule ： mild,flap-topped papule plaque ： confluence of papules

17. papule

21. plaque

22. Plaque and Papule

23. 3. vesicles and bullae Circumscribed, fluid-containing, epidermal elevated lesion ， >0.5cm is bullae papulovesicle ： obvious dermal cell edema in papule with topped little vesicle

24. Vesicle and Bullae

26. vesicles

27. bullae

28. papulovesicle

29. 4. pustule Vesicle with purulent material ， often surrounded by a red areola ， Primary lesions or come from vesicles

32. pustule

33. 5. wheal Acute, circumscribed, edematous elevation in superficial layer of dermis Ofen last several to over ten Hours, then disappear without any trace. Usually accompanied with intense itching

34. wheal

36. 6. nodule Circumscribed, solid lesion centered in dermis or the subcutaneous fat Circular or oval, Elevated or just palpable

37. nodule

42. Cystic lesion with a wall located in dermis or subcutus, containing fluid, dope or debris of cells Elevated or just papable Circular or oval, Palpation with resilience cyst 7.

43. cyst

46. secondary lesion defition ： lesions follow primary eruptions with scratching, therapy, infection or the process of recovery.

47. 1. scale Laminated masses of keratinocytes

48. scale

50. 2. crust Dried serum, pus, blood, usually mixed with epithelial and sometimes bacterial debris

51. crust

53. Blood crust

54. Serum crust

55. Pus crust

56. 3. Maceration and erosion Maceration: keratinocytes absorb more water for skin in the moist circumstance, then skin becomes soft, white and crinkled. Erosion : Loss of all or portions of the epidermis alone, may become crusted,but it heals without a scar.

57. maceration

58. erosion

61. 4. ulceration Complete loss of the epidermis plus some portion of the dermis and subcutaneous tissue

62. ulcer

65. 5. excoriation Linear abrasion produced by scratching, sometimes covered with blood crust.

66. excoriation

67. 6. fissure Linear cleft through the dermis ， Usually with pain and bleeding.

68. fissure

70. 7. scar New connective tissue replace lost substance in ulcer Smooth without appendages and elasticity.

71. scar

73. 8. atrophy Degenerative changes of skin

75. atrophy

76. 9. lichenification Circumscribed thickness and coarseness of skin ， Striaes become deeper and wider, Lesion is crossed as rhombus or polygon

77. lichenification

79. attention ： 1.Basic lesions can evolve 2.Primary to secondary lesions 3. Primary and secondary lesions are not unchangeable. Such as pustules and pigmention