Pimples on the chest

Introduction Chest papules are localized protrusions that are higher than the skin, as small as needles, as large as soybeans, may be tall or flat, smooth or scorpion-like structures, or have pigments that are the same color as the surrounding skin (called more than 1 cm in diameter, called plaques). Many skin diseases begin with lesions originating from pimples and should be closely observed and diagnosed. A variety of skin diseases can manifest as papules. Some only show pimples alone, and some are accompanied by other skin lesions. The pathogenesis of papules is located in the epidermis or the upper part of the dermis. Therefore, from the pathological point of view, the mechanism of causing papules is the accumulation of certain metabolites in this part; or the localized hyperplasia of epidermal or dermal cells; or inflammatory edema and various parts of the site. Infiltration of cells can manifest as papules. Deposition of metabolites: The papules such as amyloidosis of the skin are caused by dermal papillary amyloid deposition. The new type of edema of the edema of the moss is a large amount of protein deposition from the upper part of the dermis. The papules of the gelatinous measles are caused by the infiltration of homogeneous gel-like masses in the dermal papilla. The papules caused by the localized hyperplasia of epidermal or dermal cells, such as common warts, flat warts, and psoriasis, are hyperproliferative epidermal cells that cause epidermal bulging.

Cause

First, inflammatory papules

(1) Infectious inflammatory papules

1. Virus-infected papules: measles, rubella, infantile acute rash, echovirus rash, infantile papular dermatitis, common warts. Flat warts, condyloma acuminata, verrucous epidermal dysplasia, varicella, herpes zoster, Bowenoid papulosis.

2. Bacterial infection of papules: folliculitis, sores, sputum, verrucous skin tuberculosis, papular necrotic tuberculosis, inguinal granulation month, soft under cancer.

3. Mycoplasma infected with spirochetes: hard sores, l-mycosis, yaw.

4. Fungal infection of papules: handcuffs, athlete's foot, femoral hernia, body lice, sputum rash, coloring fungal disease.

5. Parasitic insects infected with papular hook dermatitis, hair follicle dermatitis, pruritus, acne, rickets, bed bugs, bites, and mosquito bites.

(2) Non-infectious inflammatory papules

1. Pain in allergic skin diseases: contact dermatitis, eczema, atopic dermatitis, drug eruption, papular and other measles.

2. Pimples of papular scaly skin disease: psoriasis. Parapsoriasis, flat moss dance, sclerosing atrophic premolar, red pityriasis, gestational papular dermatitis, golden yellow moss, lustrous moss, small spine moss.

3. Pimples of neurological dysfunction skin disease: neurodermatitis, pruritus, nodular pruritus, pregnancy pruritus.

4. Vascular inflammatory papules: allergic purple episodes allergic skin vasculitis, persistent erythema, and malignant atrophic papulosis.

5. Physical factors of papules: red miliary rash, keratotic hemangioma, pleomorphic sun rash, photolinear reticulosis, corns, frictional moss-like rash.

6. Papular sebaceous gland secretion factors: seborrheic dermatitis, acne vulgaris, neonatal acne, rosacea, perioral dermatitis.

Third, non-inflammatory papules

1. Metabolic factors of papules: skin amyloidosis, edema edematous moss, progressive lipid necrosis, xanthomatosis, vitamin A deficiency.

2. Genetic keratotic papules: follicular keratosis, keratosis of the hair, keratosis of the sweat tube, keratoderma of the palm of the palm, sacral keratosis, nodular sclerosis.

3. Papular manifestations of skin tumors: pigmentation, hemangioma, syringoma, periplasmic keratoses, fur epithelial tumors, lymphoid reticuloma, municipal granuloma, lymphomatoid papulosis.

an examination

Related inspection

Skin smear microscopy skin test skin fungal microscopy skin scratch test skin prick test

Physical examination

The size, number, color and shape of the papules are related to the diagnosis. For example, the tip of the needle is found in rubella, the emergency of the child, the needle is seen in the scorpion, the sweat herpes, the miliary is seen in the flat wart, the folliculitis, the bean is found in the common warts, and the psoriasis. The number of pimples is only one or a few pimples, and the measles-like drug eruption is widespread. The roads vary in color, such as red for psoriasis and yellow for yellow tumors. The shape is conical in folliculitis, hemorrhoids, flat in flat warts, flat moss dance, central depression is contagious soft palate, central necrosis is seen in papular necrotizing tuberculosis, mound rubella is seen in banded pityriasis, surface papillary is seen in common Hey, silvery white scales on the surface are seen in psoriasis.

The arrangement of papules is linear in the arrangement of lines. The papules produced by the homomorphic reaction are found in the flat moss, the flat sputum, and the papules distributed along the lymphatic vessels. The nodules are found in the arrangement of the sclerotium. The shape or rainbow shape is characteristic of pleomorphic erythema.

Chest papules are more common in: psoriasis, pityriasis rosea, drug eruption, viral rash, disease, acne, contagious soft palate, sputum sputum folliculitis, eczema, herpes-like dermatitis, herpes zoster, etc.

Laboratory inspection

Virus-infected papules, the total number of white blood cells is low or normal. Can detect the DNA gene detection of pathogenic microorganisms. Bacterial infection with papules associated with fever blood neutrophils can be elevated. The pus culture is bacteriologically positive. Fungal papules are directly mirrored, positive for fungal culture or culture. The syphilitic papules can be tested positive for the syphilis test. Tuberculous papules can be tested or cultured for tuberculin. Various papules can be taken for pathological examination of living tissue when necessary to aid diagnosis.

Differential diagnosis

(a) virus infected pimples

1. Measles: Measles virus infection, more common in children under 5 years old, rash on the 4th day after fever. The lesion is characterized by a rose rash.

2. Rubella: It is a rubella virus infection, which is more common in young children. There is mild fever in the first 1-2 days before rash and lymph node enlargement in the neck. It is a reddish rash or pimples.

3. Children's acute rash: For Coxsackie BO virus infection, more common 6 months to 2 years old infants. The damage is rose rash.

4. Echo virus rash: Infected by Echo virus, more common in children. Often 2-5 rashes after fever, the lesions are purple-red maculopapular rash. There are red and yellow papules in the phlegm and throat.

5. Infant papules: Sexual acral dermatitis is generally considered to be a primary infection of the hepatitis B virus through the skin round membrane primary hepatitis virus through skin mucositis. More often in young children. There was no obvious anterior area symptoms and a sudden rash. No needle to mung bean large flat fully papules, dark red, first in the back of the hand and foot 3 to 4d in turn extended to the thigh, buttocks, limbs and face, the trunk is less rash. May be associated with systemic lymphadenopathy and acute recurrent hepatitis, with a course of 2-8 weeks.

(b) bacterial infection of pimples

Folliculitis

Mostly red inflammatory papules caused by Staphylococcus aureus infection. It is characterized by a large needle or miliary, a small yellow pus on the top, and conscious pain. Occasionally on the face, neck, chest and back.

2. Sore

A folliculitis that occurs in the beard. Occurs between the upper lip and the nose and the forehead. For the follic inflammatory papules, there is a hairy perforation in the center, which has a slight itching or burning pain. Can develop into small follicular pustules.

3.

It is a deep folliculitis caused by staphylococcal infection and inflammation around the hair follicle. Occurs in the face and neck, tube. Initially a follicular red inflammatory papule, which in turn increases to small or larger inflammatory nodules. Local redness and heat pain, the top suppuration is yellow.

4. Sickle skin tuberculosis

Infected skin for Mycobacterium tuberculosis At the beginning, the bean has a large dark red papule, which later grows into a nodule, which is hard and continues to expand to form a keratinized plaque.

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