Erythematous scales

Introduction Scales are cuticles of the epidermis that are about to fall off or have fallen off. Its size, shape, thickness, quantity, color are different, some are dry, some are greasy; most of them are secondary damage of skin diseases with erythema or papule damage. Erythema is a local or systemic red spotted rash that is localized or systemicly dilated by the dermal papillary capillary network. Psoriasis, seborrheic dermatitis, pityriasis rosea, parapsoriasis, discoid lupus erythematosus and other diseases can be expressed as erythema scales.

Cause

Scales are produced by inflammation-stimulated epidermis, and some are non-inflammatory, such as congenital hereditary ichthyosis, scaly follicular keratosis scaly is non-inflammatory. Erythema is a local or systemic red spotted rash that is localized or systemicly dilated by the dermal papillary capillary network. Psoriasis, seborrheic dermatitis, pityriasis rosea, parapsoriasis, discoid lupus erythematosus and other diseases can be expressed as erythema scales.

an examination

Exfoliated or exfoliated cuticle of the epidermis. Its size, shape, thickness, quantity, color are different, some are dry, some are greasy.

Observe the location, size, number, degree of edge rule, and color of the scale.

First, physical examination

Taking a medical history gives us a first impression and revelation, and also guides us to a concept of the nature of the disease.

Second, laboratory inspection

Laboratory examinations are based on objective data learned from medical history and physical examination, and are summarized and analyzed. Several diagnostic possibilities are proposed, and then further examinations are performed to confirm the diagnosis.

Differential diagnosis

(1) Psoriasis: the erythema border is clear, the basal infiltration is obvious, and it is patchy. The surface covered with scales is thick and dry, and it is silvery white. After the scales are scraped off, a bright translucent film can be seen, and then the film can be seen. Bleeding. This is the key to the identification of psoriasis and other erythematous scaly diseases.

(2) Seborrheic dermatitis: The edge of the erythema is not very sharp, the base is infiltrated lightly, the scales are few and thin, and it is pale yellow and greasy. There is no film phenomenon and punctiform bleeding after scraping.

(3) pityriasis rosea: occurs in the trunk and the proximal extremities. It is a large oval patch with its long axis arranged along the ribs and skin lines. The scales are small and thin. Most patients can heal themselves after a few weeks and are less likely to relapse after regression. There is usually a mother spot in the onset of the disease, which gradually increases in the future.

(4) Parapsoriasis: less common. The surface scale is thin, the surrounding inflammation is mild, there is no film phenomenon and punctiform bleeding, and there is no self-conscious symptoms.

(5) Discoid lupus erythematosus: it occurs on the face, especially on the cheeks and nose, and is distributed in a butterfly shape. The erythema is clear and the surface is visible with telangiectasia. The scales are adhesive scales, which are closely adhered to the erythema, and the scales are peeled off, and the dilated hair follicles are visible under the scales. The scales have many thorny horny protrusions on the underside. After a long course of disease, it can be seen that the center of the lesion is atrophy and the pigment changes.

(6) Chronic eczema: often manifested as erythema, overlying scaly, especially in the calf. However, chronic eczema is accompanied by severe itching. The lesions are bilaterally symmetrical. The degree of infiltration is heavier than that of psoriasis. The surface scales are thin, not silvery white, the base color is red, and there may be water seepage.

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