A papule is a localized protrusion that is higher than the skin. It has various shapes, colors and sizes. Its manifestations include flat, round, etc. The color can be purplish red, light yellow or dark brown.There are many common diseases causing papules, includingInfectious dermatosis、diseases of skinappendages 、allergic skin diseases 、Physical dermatosisandKeratodermaEtc.The main principle of papule isepidermisorgenuine leatherLocalized substantive processes of skin caused by proliferation of superficial cells, accumulation of metabolites or infiltration of inflammatory cells.
Symptoms of papules may be accompanied by itching, burning pain and other discomfort, which may affect daily life.The transmission routes vary depending on the cause of the disease. For example, infectious skin diseases are generally transmitted through contact with people, while skin appendage diseases are usually not infectious.
If the skin has papule symptoms, go to the hospital for relevant examinations, such asroutine blood test、Etiology、Allergen test、Dermatoscope, skin biopsy, etc. to determine the detailed etiology.The treatment after the diagnosis is clear is mainly based on the primary disease, including drug treatment, physical therapy and surgical treatment.In terms of prevention, it mainly includes crowd separation, healthy diet, sanitary life and other measures.
TCM disease name
papule
Visiting department
Dermatology Department, General Surgery Department, Rheumatology and Immunology Department
Multiple population
No specific multiple population, related to primary disease
Some drugs can cause allergic skin manifestations and papules.
Medical treatment
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If the skin has papules, accompanied by itching, burning and other symptoms, and affects daily life, you should seek medical advice, improve blood routine, etiology, allergen detection, dermatoscope, skin biopsy and other examinations, and treat after a clear diagnosis.
Preparation for medical treatment
If you have seen a doctor recently, please bring relevant medical records, inspection reports, test sheets, etc. to help doctors understand the condition.
If you have taken medicine recently, you can bring the kit or instructions.
Emergency indications
The papule does not improve and needs to be treated in time.Patients generally have no indication of first aid and do not need emergency medical treatment.
Visiting department
Patients generally choose dermatology department for treatment. If the diagnosis is clear, they can go to the corresponding department of the original disease, including general surgery, rheumatology and immunology department, oncology department, etc.
Relevant inspection
physical examination
Observe the size, shape, color, number and distribution of papules, and palpate to check the texture of papules, whether the lesions are adhered to surrounding tissues, etc., to assist in judging the condition.
laboratory examination
includeroutine blood testPathogen culture, such as blood routine examinationWhite blood cell count、Acidophilic, percentage of neutrophils and other indicators to determine whether the etiology is related to bacterial infection, viral infection or allergy. Pathogen culture can also be carried out through rash to determine the primary type of papule.
Skin patch test
To determine whether papules are related to contact allergens.
Pathological examination
For patients with unknown diagnosis or considering skin tumors, skin rashes can be taken for pathological examination to clarify the nature of the lesions, which is applicable to the diagnosis of amyloidosis, mucinous lichen, hair follicle keratosis and other diseases.
Dermatoscopy
It can be used for auxiliary diagnosis of various skin diseases.
Fungal microscopic examination
It can be used for auxiliary diagnosis of fungal infectious dermatosis.
Other inspections
Including liver function, kidney function, and other imaging examinations, you can select appropriate examination items according to the specific condition.
diagnosis
The papule is a symptom, not a disease, so there is no diagnostic problem.Generally, according to the color, shape, distribution, number, etc. of papules, the disease diagnosis can be confirmed by laboratory examination, dermatoscopy, pathological examination, etc.
disease diagnosis
Clinically, there are many diseases with papular manifestations, including verruca vulgaris, chickenpox, herpes zoster, folliculitis, pustulosis, tinea corporis and cruris, eczema, papular urticaria, contact dermatitis, acne, hair follicle keratosis, etc. The details are as follows.
Verruca vulgaris
It tends to occur on the back of the hand, fingers and foot margin. At first, it is a large papule on the needle head, gradually growing to beans or larger, round or irregular. The surface is rough and keratinized, with obvious papillary hyperplasia, hyperkeratosis, and hard contact.
Chicken pox
It usually occurs in children. Before eruption, it has mild fatigue and low fever. At first, it is a small red macula and papule. After 1-2 days, it turns into papules or blisters. Most of them are found on the scalp and trunk, with a centripetal distribution.
Folliculitis
At first, the skin lesions were red inflammatory papules, which were characterized by large needles or millets, small yellow pustules on the top of some of them, and red halos around them. After the pustules dried up or collapsed, yellow scabs were formed, and the scabs generally fell off without leaving scars.
Tinea cruris
At first, the skin lesions were papules or papular herpes, which soon expanded to form a ring-shaped rash. The central inflammation was reduced, the peripheral papules were scaly, the boundary was clear, the patient felt itchy, and the fungus test was positive.
eczema
It is characterized by polymorphous rash. On the basis of erythema, there are often papules and papules of different sizes from needle to millet, which are often fused into tablets. The boundary is unclear, and the conscious itching is intense, which can occur on the face, hands and feet, cubital fossa, anus, etc.
Papular urticaria
The skin lesion is a red wheal like papule, which is spindle shaped or round. There may be a blister in the center, which is manifested as papular herpes. The itching is obvious, and it often occurs in the limbs, buttocks, waist, etc.
Contact dermatitis
It refers to that after the skin or mucous membrane contacts a certain substance, the boundary of the contact part is clear erythema, papule, and papular herpes. In severe cases, the erythema is obvious, and the fusion forms bullae, exudates, and itching is obvious.
acne
It usually occurs on the face, such as forehead, cheek and chin, but also on the upper chest and back. The skin lesions are follicular red papules, accompanied by white head or blackhead acne, and can also be manifested as pustules, nodules or cysts.
Keratosis of hair follicle
The skin lesions are small follicular papules, which are gradually enlarged and verrucous, brown, dusty or dark brown, covered with greasy adhesive scales or scabs, and can be densely fused into patches.
differential diagnosis
The papule needs to be differentiated from the macula and plaque.The rash belongs to the localized skin color change, which is neither higher nor lower than the normal skin. The size and shape of the rash are uncertain. It can be divided into erythema, pigmentation spot, bleeding spot, etc. according to the color and the cause of formation.Plaque refers to the flat and protuberant superficial lesions with a diameter of more than 1 cm, most of which are caused by the expansion or fusion of papules.
treatment
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Papilla is a symptom, which is mainly treated for the primary disease. The treatment methods include drug treatmentphysicotherapeutics, surgical treatment, etc., according to the type of primary disease and severity of the disease, select appropriate treatment methods to improve symptoms.
General treatment
General treatment mainly includes diet care, skin care, and environmental care.
Diet care: It is related to the primary disease and does not necessarily require diet.Generally speaking, it is recommended to keep a light diet, reduce the intake of allergenic food, eat more fresh vegetables and fruits, and avoid tobacco, alcohol, spicy and irritant food.
Skin care: keep the skin clean and dry, avoid scratching the skin, avoid excessive scalding, avoid using irritant toiletries, and wear loose cotton clothes.
Environmental care: At ordinary times, attention should be paid to keeping the humidity and temperature of the living environment appropriate, more ventilation, regular cleaning of carpets and bedding, and keeping pets clean to avoid skin infection when children play with them.
Professional treatment
medication
Different drugs are selected according to the primary diseases of the above papules.
External drugs: There are many types of external drugs, mainly for the etiology and pathogenesis of primary diseases.If bacterial dermatosis chooses antibacterial topical drugs, the commonly used drugs areBenzoyl peroxide、Erythromycin ointment、Mupirocin OintmentEtc;Select antifungal topical drugs for fungal dermatosis, such asMiconazole ointmentKetoconazole ointment, terbinafine ointment, etc;Select antiviral topical drugs for viral skin diseases, such asAciclovir Ointment Etc.If it is allergic disease, you can chooseGlucocorticoidOr calcineurin inhibitor for anti inflammation, antipruritic agent for pruritus, keratin enhancer for dyskeratosis, and keratin enhancer for hyperkeratosisExfoliating agentEtc.In addition, the same drug can have different external dosage forms such as ointment, lotion, gel, solution or ointment, which can be used for different rash manifestations.When there is only papule and no exudation in acute dermatitis, choose powder or lotion;For severe inflammation, erosion and exudation, wet packing with solution is preferred, and for chronic dermatitis, ointment and ointment are preferred.
Systemic drugs: also for different primary diseases, such asdiphenhydramine、loratadine、CetirizineAnd other antihistamines, andHydrocortisone、PrednisoneSuch glucocorticoids are commonly used in the treatment of drug eruptions, erythema multiforme, urticaria, allergic dermatitis, contact dermatitis and other diseases.Antibiotics, including penicillin, ceftriaxone sodium, tetracycline, erythromycin, etc. are commonly used in the treatment of bacterial skin diseases.In addition, there are also antifungal drugs, antiviral drugs, immunosuppressants, biological agents, and retinoic acid drugs, which need to be selected according to the doctor's advice.
physicotherapeutics
Including photoelectric therapy, microwave therapyCryotherapyLaser treatmentRadiotherapyPhotodynamic therapy, different primary diseases can choose different physical therapy.
surgical treatment
It can be used for excision of skin tumors, treatment of skin wounds, and living tissue sampling.In addition, for patients with advanced rosacea, incision can be selected to destroy the local hyperplastic capillaries and connective tissue.
