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。


Normal follicle

正常的毛囊

Microcomedone

微粉刺(毛囊被堵塞)

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]


whitehead
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白头粉刺

当皮脂和细菌堵塞在皮肤表层下,会形成稍稍突起的白头,称之为白头粉刺,这是一种闭合性粉刺,与外界不想通。 [1,13]
blackhead
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黑头粉刺

黑头粉刺是一种开放性粉刺,当毛囊口与外界相通,堵塞毛孔的皮脂暴露在皮肤表面,从而被氧化变成黑色,形成黑头。[1,13]

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]


papule
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丘疹

当毛囊壁破裂,白细胞进入引发炎症反应,从而引起丘疹。在皮肤表面表现为较小的、红色的突起。 [13]
pustule
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脓疱

丘疹进一步发展、加剧,白细胞增多并到达皮肤表面,就会形成脓疱,在疱疹表面可以看到含有白色或黄色的脓液。[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]


64x64

结节

结节性痤疮在脓疱的基础上形成,是一种深在性皮损,质地较硬,有脓液,触摸有肿块的感觉。 [1,13]
64x64

囊肿

囊肿的炎症较重,控压有较强的痛感,常伴随有继发性化脓感染,破溃后容易形成瘢痕。[13]

图表来源: 美国国立卫生研究院

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