皮肤性病学教案及讲稿授课专General年级课程名称2006级留学生Dermatology and Veneraolgy业Contents授课方教师陈瑾职称助教示教学时2大课式题目章节Eczema作者教材名称Lin TongDermato-venereologyDean's office of Xi'an Jiaotong University版次出版社FirstNovember2004教1.tomaster:theclinical manifestations ofthreephases ofeczema学2.tomaster:thedifferentialdiagnosis between eczema andcontactdermatatis目3:tomaster:theruleoftreatment的4.to wellknown:the pathogen and pathogenesis of eczema and the clinical manifestations of some要special type ofeczema.求1.theclinical manifestationsofthreephases ofeczema教2.thedifferentialdiagnosisbetween eczemaandcontactdermatatis学3.the rule of treatment难点教1.the differential diagnosis between eczema and contact dermatatis学2.theruleoftreatment重点外语全英语教学要求教学方法利用Powerpoint幻灯片教学，手段参考安德鲁斯皮肤病学资料教研室意见教学组长：单葵教研室主任：李惠2009年9月6日
皮肤性病学教案及讲稿 课程名称 General Contents 年级 2006 级留学生 授课专 业 Dermatology and Veneraolgy 教 师 陈瑾 职称 助教 授课方 式 大课 示教 学时 2 题目章节 Eczema 教材名称 Dermato-venereology 作者 Lin Tong 出 版 社 Dean’s office of Xi’an Jiaotong University November 2004 版次 First 教 学 目 的 要 求 1. to master: the clinical manifestations of three phases of eczema. 2. to master: the differential diagnosis between eczema and contact dermatatis. 3. to master: the rule of treatment 4. to well known: the pathogen and pathogenesis of eczema and the clinical manifestations of some special type of eczema. 教 学 难 点 1. the clinical manifestations of three phases of eczema. 2. the differential diagnosis between eczema and contact dermatatis. 3. the rule of treatment 教 学 重 点 1. the differential diagnosis between eczema and contact dermatatis. 2. the rule of treatment 外语 要求 全英语教学 教学 方法 手段 利用 Powerpoint 幻灯片教学， 参考 资料 安德鲁斯皮肤病学 教研 室意 见 教学组长： 单葵 教研室主任：李惠 2009 年 9 月 6 日
辅助手段教学内容时间分配10m1. Etiology and pathogenesis:The real causes are not clear, many factors are involved in eczema which include internaland external factors and so eczema is induced by interactionof many internal and externalfactorsAllergy of type IV take part in pathogenesis of eczema as same as contact dermatitisHereditarytendency(atopy)todevelop eruption, it is importantfactorInternal factors include(1)chronic infection,(2)blockofbloodcirculation,(3)changeofendocrine and metabolism, (4)hereditary tendency to allergies so onExternal factors include (1)food, (2)inhaled substances, (3)chemical materials, (4)animalhair and fur skin so onOtherfactors40m2. Clinical manifestationsA morphologic phases:acute eczema,subacute eczemachronic eczemaRegional (localized) eczemas:hand eczema,breast eczema,anal or genital eczemastasis dermatitisOther eczemas:nummular eczema, pompholyx, autosensitization dermatitis, infectious eczematoiddermatitis and xerotic eczema?Acute eczema: primary and multiform lesions, the boundary is not clear,commonly place symmetrically and easy to be found on exposed areas,itch isoutstanding, easy to cause erosion and exudation(moist with oozing)0Inacutephase,thepatientoften infectedand theeruptionwillbecomepustules andscab, lymph node will swell, fever will ariseSubacute eczema: relieve from the above symptoms,colors oferuption becomeOdark, a little scales or crusts can be seen?If patient gets in touch with allergic or irritanic factors again, acute stroke or severecondition will appear repeatedly?Ifpatient is not cured for a long time, it will become chronic eczemaChronic eczema:alwayscomingfromacuteor subacuteeczema,the lesionsbecome thicken, rough and concomitance with pigmentation or depigmentation?ThisconditioncankeepforafewmonthsoryearsRemember:Eczema is tendencyto recurand persistence and so itisa chroniccourseRegional (localized)eczemas.Hand eczema.Breast eczema (nipple eczema).Vulva,scrotum,andanuseczema.StasisdermatitisHand eczema
教学内容 辅助手段 时间分配 1. Etiology and pathogenesis: The real causes are not clear, many factors are involved in eczema which include internal and external factors and so eczema is induced by interaction of many internal and external factors Allergy of type IV take part in pathogenesis of eczema as same as contact dermatitis Hereditary tendency(atopy) to develop eruption, it is important factor Internal factors include (1)chronic infection, (2)block of blood circulation, (3)change of endocrine and metabolism, (4)hereditary tendency to allergies so on External factors include (1)food, (2)inhaled substances, (3)chemical materials, (4)animal hair and fur skin so on Other factors 2. Clinical manifestations A morphologic phases: acute eczema, subacute eczema chronic eczema Regional (localized) eczemas: hand eczema, breast eczema, anal or genital eczema stasis dermatitis Other eczemas: nummular eczema, pompholyx, autosensitization dermatitis, infectious eczematoid dermatitis and xerotic eczema ⚫ Acute eczema: primary and multiform lesions, the boundary is not clear, commonly place symmetrically and easy to be found on exposed areas, itch is outstanding, easy to cause erosion and exudation(moist with oozing) ⚫ In acute phase, the patient often infected and the eruption will become pustules and scab, lymph node will swell, fever will arise ⚫ Subacute eczema: relieve from the above symptoms, colors of eruption become dark, a little scales or crusts can be seen ⚫ If patient gets in touch with allergic or irritanic factors again, acute stroke or severe condition will appear repeatedly ⚫ If patient is not cured for a long time, it will become chronic eczema ⚫ Chronic eczema: always coming from acute or subacute eczema, the lesions become thicken, rough and concomitance with pigmentation or depigmentation ⚫ This condition can keep for a few months or years Remember : Eczema is tendency to recur and persistence and so it is a chronic course Regional (localized) eczemas ⚫ Hand eczema ⚫ Breast eczema (nipple eczema) ⚫ Vulva, scrotum, and anus eczema ⚫ Stasis dermatitis Hand eczema 10m 40m
1.Many allergens and irritant,as well as emotional and stress can induce it and maybe amajoroccupationalproblem2.The lesions often show chronicvesiculobullous, or chronic hyperkeratoticeruptions inthe palms3.Dermatophytid, atopic dermatitis, allergic contact dermatitis, palmoplantar pustulars,eventheautoimmunebullous disorders must all be consideredBreasteczema1.The euption may affectthenipples,areolae, or thefolds beneath ofbreast2.The lesions always show the moist type with oozing and crusting.Painful fissuring isfrequently seen, especially in nursing mothers3.Ifit isunilateral,or/and persistedformorethan3months,abiopsy ismandatorytoruleoutthepossibility ofPaget'sdisease ofthebreastVulva, scrotum and anus eczema4.The outstanding symptom of the patient is itch5.the eruption manifests red swelling, erosion and exudation because often scratching orrubbing6.It always outbreaks repeatedly,and thenbecomes chronic eczema7.Over-bathing withhot water,over-scratching,chemical substances aggravate theeczema outbreaks10m3. DiagnosisFive key diagnostic features1. primary and multiform lesions, easy to exudation when irritated by many factors2. eruption symmetrically distribution3. often on exposed areas4.usually severe pruritus5.chronic, persistent or relapsing5m4.Differentialdiagnosisacute eczema.etiologynot clear, many factors.Lesionprimaryand multiform whichtendto oozing,boundarynot clear.Eruptionsymmetricallydistribution,usually.Easy to recur and chroniccontact dermatitis.etiologyclear, recent contact with irritants or allergens.Lesionoften simple,boundaryclear.Eruptionplaceononlycontactareas.Self-limited, eliminating contactfactors can be cured5. Treatment15mGeneral therapyProtecting·Everydoubtfulfactormustbeavoided.Allergens,irritants,infections.Psychologic treatmentRegulating emotional and stressO.Moisturizing
1.Many allergens and irritant,as well as emotional and stress can induce it and may be a major occupational problem 2.The lesions often show chronic vesiculobullous, or chronic hyperkeratotic eruptions in the palms 3.Dermatophytid, atopic dermatitis, allergic contact dermatitis, palmoplantar pustulars, even the autoimmune bullous disorders must all be considered Breast eczema 1.The euption may affect the nipples,areolae, or the folds beneath of breast 2.The lesions always show the moist type with oozing and crusting. Painful fissuring is frequently seen, especially in nursing mothers 3.If it is unilateral, or/and persisted for more than 3 months, a biopsy is mandatory to rule out the possibility of Paget’s disease of the breast Vulva, scrotum and anus eczema 4.The outstanding symptom of the patient is itch 5.the eruption manifests red swelling, erosion and exudation because often scratching or rubbing 6.It always outbreaks repeatedly, and then becomes chronic eczema 7.Over-bathing with hot water, over-scratching, chemical substances aggravate the eczema outbreaks 3. Diagnosis Five key diagnostic features 1. primary and multiform lesions, easy to exudation when irritated by many factors 2. eruption symmetrically distribution 3. often on exposed areas 4.usually severe pruritus 5.chronic, persistent or relapsing 4. Differential diagnosis acute eczema ⚫ etiology not clear, many factors ⚫ Lesion primary and multiform which tend to oozing, boundary not clear ⚫ Eruption symmetrically distribution, usually ⚫ Easy to recur and chronic contact dermatitis ⚫ etiology clear, recent contact with irritants or allergens ⚫ Lesion often simple, boundary clear ⚫ Eruption place on only contact areas ⚫ Self-limited, eliminating contact factors can be cured 5. Treatment General therapy Protecting ⚫ Every doubtful factor must be avoided ⚫ Allergens, irritants, infections ⚫ Psychologic treatment ⚫ Regulating emotional and stress ⚫ Moisturizing 10m 5m 15m
0Protecting impaired skin and dry skin with lubricants, especially each after washingoratnightsuchaswith10%ureacreamorEucerincream soon40mTopical therapyCorticosteroid therapy is the dominant method:milder or potency steroids, must bestrong enough to control the pruritus and remove the inflammation·General say: infants or face should be milder steroids, while thick plaques andlichenified eruption should be very potent steroids (sometimes with coal tar added)·Corticosteroid has many adverse reaction such as skin atrophy, persistent erythemasoon
⚫ Protecting impaired skin and dry skin with lubricants, especially each after washing or at night such as with 10%urea cream or Eucerin cream so on Topical therapy ⚫ Corticosteroid therapy is the dominant method: milder or potency steroids, must be strong enough to control the pruritus and remove the inflammation ⚫ General say: infants or face should be milder steroids, while thick plaques and lichenified eruption should be very potent steroids (sometimes with coal tar added) ⚫ Corticosteroid has many adverse reaction such as skin atrophy, persistent erythema so on 40m
Acuteeczema:primary andmultiform lesions,theboundary is not clear,commonlyplace symmetrically and easytobefound onexposedareas,itch isoutstanding,easy to cause erosion and exudation(moist with oozing)2.acuteeczema?etiologynotclear,manyfactors?Lesion primary and multiform which tend to oozing, boundary not clear?Eruption symmetrically distribution,usuallyEasy to recur and chroniccontactdermatitisetiologyclear, recent contact with irritants or allergens小结·Lesionoftensimple,boundaryclear?Eruptionplaceononlycontactareas?Self-limited, eliminating contact factors can be cured1.Themanifestationofacuteeczema2.Thedifferencebetween acute eczemaand contactdermatitis思考题及预习教案讲稿质量评价表
小结 1. Acute eczema: primary and multiform lesions, the boundary is not clear, commonly place symmetrically and easy to be found on exposed areas, itch is outstanding, easy to cause erosion and exudation(moist with oozing) 2. acute eczema ⚫ etiology not clear, many factors ⚫ Lesion primary and multiform which tend to oozing, boundary not clear ⚫ Eruption symmetrically distribution, usually ⚫ Easy to recur and chronic contact dermatitis ⚫ etiology clear, recent contact with irritants or allergens ⚫ Lesion often simple, boundary clear ⚫ Eruption place on only contact areas ⚫ Self-limited, eliminating contact factors can be cured 思考 题及 预习 1.The manifestation of acute eczema 2. The difference between acute eczema and contact dermatitis 教案讲稿质量评价表