什么是痤疮.doc

什么是痤疮？
从非炎性粉刺到炎性丘疹、脓疱、结节，甚至是囊肿，解读痤疮的各个阶段。
痤疮，又称粉刺、青春痘、暗疮，这是一种常见的皮肤病，由毛孔堵塞、细菌滋生引起。好发部位通常为脸部、下巴，也会出现在胸部、背部、肩膀、颈部等。其症状轻者表现为粉刺，包括开放性黑头粉刺和闭合性白头粉刺，严重时会形成丘疹、脓疱、结节和囊肿。

痤疮有两种类型：非炎性和炎性
1. 非炎性痤疮
非炎性痤疮没有引起炎症反应，主要症状表现为白头粉刺和黑头粉刺。
白头粉刺：这是一种闭合性粉刺，不与外界相通，在皮肤表层下形成稍稍突起的白头。
黑头粉刺：这是一种开放性粉刺，毛囊口开放，堵塞毛孔的皮脂与空气接触被氧化为黑色，形成黑头。[12-13]

2. 炎性痤疮
粉刺进一步发展，滤泡壁破裂，可能引发炎症反应，从而形成丘疹、脓疱，或更加严重的结节、囊肿等。
丘疹： 皮肤表面小的、红色的突起。
脓疱： 含有白色或黄色脓液的疱疹。
结节： 大小不等、质地较硬的深在性皮损，往往有痛感。
囊肿： 有脓液，破溃后可形成瘢痕，触摸有痛感。[1,12-13]

当丘疹或脓疱进一步发展，会影响到周围皮肤，引起更为严重的炎症反应，形成结节或囊肿。[1,13]
图表来源: 美国国立卫生研究院

参考资料 
1. "Questions and Answers About Acne." National Institute of Arthritis and Musculoskeletal and Skin Diseases Jan. 2006. National Institutes of Health. 2001.
2. Kligman AM and Plewig G. Acne and Rosacea. Berlin: Springer, 2000.
3. Bek-Thomsen M, Lomholt HB and Kilian M. "Acne is not associated with yet-uncultured bacteria." Journal of Clinical Microbiology. (2008); 46(10): 3355-3360.
4. Zouboulis CC. "Propionibacterium acnes and sebaceous lipogenesis: A love-hate relationship?" Journal of Investigative Dermatology. 2009; 129(9): 2093-2096.
5. Pappas A, et al. "Sebum analysis of individuals with and without acne." Dermatoendocrinology. 2009; 1(3): 157-161.
6. Akaza N, et al. "Effects of Propionibacterium acnes on various mRNA expression levels in normal human epidermal keratinocytes in vitro." Journal of Dermatology. 2008; 36(4): 213-223.
7. Picardo M, et al. "Sebaceous gland lipids." Dermatoendocrinology. 2009; 1(2): 68-71.
8. Pappas A. "Epidermal surface lipids." Dermatoendocrinology. 1(2): 72-76.
9. Youn SW. "The role of facial sebum secretion in acne pathogenesis: Facts and controversies." Clinics in Dermatology. 2010; 28(1): 8-11.
10. Dessinioti C and Katsambas AD. "The role of Propionibacterium acnes in acne pathogenesis: Facts and controversies."Clinics in Dermatology. 2010; 28(1): 2-7.
11. Makrantonaki E, Ganceviciene R and Zouboulis CC. "An update on the role of the sebaceous gland in the pathogenesis of acne." Dermatoendocrinology. 2011; 3(1): 41-49.
12. Bettoli V, Layton AM and Thiboutot D. Fast Facts-Acne. Oxford, UK: HealthPress Limited, 2004.
13. Fry L. The Encyclopedia of Visual Medicine Series: An Atlas of Dermatology. New York: The Parthenon Publishing Group, 1997.
14. Morelli JG. "Diseases of the neonate." In: Kliegman RM, Behrman RE, Jensen HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, PA: Saunders Elsevier;2007:Chapter 646.
15. "Questions and Answers About Acne." National Institute of Arthritis and Musculoskeletal and Skin Diseases Jan. 2006. National Institutes of Health. 2001.
16. Akaza N, et al. "Effects of Propionibacterium acnes on various mRNA expression levels in normal human epidermal keratinocytes in vitro." Journal of Dermatology. 2008; 36(4): 213-223.
17. Picardo M, et al. "Sebaceous gland lipids." Dermatoendocrinology. 2009; 1(2): 68-71.
18. Pappas A. "Epidermal surface lipids." Dermatoendocrinology. 1(2): 72-76.