Pathology Skin Lesion (integumentary system)
P运动学 皮肤 Lesion (外皮系统)
Skin has two layers: epidermis (epithelium tissue, contains keratinocytes and melanocytes) and dermis (connective tissue include collagen and elastin, bloods vessels, free nerve ending, follicles, sweat glands, sebum glands...)
皮肤有两层:表皮(上皮组织,包含角质形成细胞和黑色素细胞)和真皮(结缔组织包括胶原蛋白和弹性蛋白、血管、游离神经末梢、毛囊、汗腺、皮脂腺......)
Exfoliation---- remove 4-5 layers of coronium tissue
去角质----去除 4-5 层冠状组织
Peeling (microbrasion)--- remove 8-10 layers of coronium
去皮(微损伤)---去除 8-10 层冠状体
Primary skin lesion: (may be only involved epidermis)
原发性皮肤病变:(可能仅累及表皮)
Macula: hyper-pigmentation, change in skin color, flat, circumscribed, such as (freckles); not change the skin texture; if large than 1 cm, called patch
黄斑:色素沉着过度,皮肤颜色改变,扁平,局限性,如(雀斑);皮肤纹理不改变;如果大于 1 厘米,称为斑块
Papule (plaque): raised, solid, circumscribed, due to thickening of the epidermis (pimples)
丘疹(斑块):凸起、实性、局限性,由于表皮增厚(丘疹)
Pustule: contains pus, raised (impetigo ---- bacterial infection of skin condition)
脓疱:含有脓液,凸起(脓疱病----皮肤病的细菌感染)
Nodule: solid, raised, sometimes, deep as dermis; small benign “tumor”, such as lipoma, hemangioma
结节:坚实,隆起,有时像真皮一样深; 小的良性“肿瘤”,如脂肪瘤、血管瘤
Vesicle: elevated, filled with clear fluid
水疱:隆起,充满透明液体
Very small vesicle is called blisters (may be virus infection)
非常小的水疱称为水疱(可能是病毒感染)
herpes simplex I infection= cold sore, is virus infection; the blisters with rash macula base is seen around corner of lips, or mucus membrane (inside of mouth or nose, even membrane of eye lid)
I 型单纯疱疹感染 = 唇疱疹,是病毒感染; 带有皮疹黄斑基底的水泡可见于嘴角或粘膜(口腔或鼻子内部,甚至眼睑膜)周围
** this is highly contagious, reschedule the massage appointment
** 此行程具有高度传染性,请重新安排按摩预约
herpes simplex II infection = genital sore, also is virus infection; sexual transmitter disease (STD)
单纯疱疹 II感染 = 生殖器疮,也是病毒感染; 性递质病 (STD)
*** Both sore are highly contagious, if client has cold sore, reschedule the appointment
这两种疮都具有高度传染性,如果客户患有唇疱疹,请重新安排预约
Shingles: in the childhood, infected chicken pox; post chicken pox, virus Herpes (Varicella) Zoster latent in ganglion (inside of ganglion contains collection of cell bodies for sensory neurons) of spinal nerve; when the person is in lower immunity, the virus reactivates, cause red rash macula with blisters lesion and very painful, pain patterns are as dermatome pattern; acute shingles lesion: NO massage, reschedule the appointment
Shingles:在童年时期,感染了水痘; 水痘后,病毒 Herpes (水痘) Zoster latent 在脊神经的神经节(神经节内部包含用于感觉神经元的细胞体集合);当人免疫力较低时,病毒重新激活,导致红疹黄斑伴有水泡病变,非常 痛苦, 疼痛模式与皮节模式相同;急性带状疱疹病变:无按摩,重新安排预约
no massage until all the skin lesion gone
直到所有皮肤病变消失才按摩
the shingle pain is called residual pain may last many months, even 2 years after the skin lesion healed
带状疱疹疼痛称为 残余疼痛,可能会持续数月,甚至在皮肤病变愈合后 2 年
Large vesicle is called bulla
大水疱称为大疱
Wheal: transient, superficial, red, irregularly shaped raise, edematous; single wheal---- such as mosquito bite
风团:短暂、浅表、红色、形状不规则的隆起、水肿; 单风团----如蚊子叮咬
Group of wheals = hive, urticaria (common seen in allergy reaction= hypersensitive)
风团组 = 荨麻疹、荨麻疹(常见于过敏反应 = 过敏反应)
Associate the itchy; should see Dr. to diagnosis find out the allergen and reschedule massage appointment
关联瘙痒;应去看医生诊断,找出过敏原并重新安排按摩预约
Lyme disease: transmitted from animal to human through a bite from an arthropod vector such as a deer ticks which carrier spirochetes (bacteria) called Borreliae burgborferi; get the Lyme disease
莱姆病:通过节肢动物媒介(如鹿蜱)的叮咬从动物传播给人,这种媒介携带称为伯氏疏螺旋体(Borreliaeburgborferi)的螺旋体(细菌);得莱姆病
CM: “Bull’s eye” rash is initial sign indicate Lyme disease;
CM:“牛眼”皮疹是莱姆病的初始体征;
Cause Lyme arthritis (infected arthritis), involved large joint such as knee, hip or TMJ, also the patients complain chills, fever, headache, and expanding erythematous skin eruption that precedes joint manifestations (ECM erythematous chronicus migrans)
引起莱姆关节炎(感染性关节炎),累及膝关节、髋关节或颞下颌关节等大关节,患者还主诉发冷、发烧、头痛和关节表现前出现扩大性红斑皮疹(ECM 红斑性慢性游走性)
Muscle pain and soreness, also involved cardio condition or nerve system condition
肌肉疼痛和酸痛,还涉及心脏疾病或神经系统疾病
Symptoms appear and recur in episodes, lasting about 1 week, at intervals of 1 or several weeks, declining in severity over 2-3 years
症状在发作中出现和复发,持续约 1 周,间隔 1 周或数周,严重程度在 2-3 年内下降
Cyst: contain the fluid in the capsule, sometimes deep to dermis or subcutaneous
囊肿:囊内有液体,有时深入真皮或皮下
Baker’s cyst: is located at popliteal fossa in Rheumatoid arthritis
贝克囊肿:位于类风湿性关节炎的腘窝
Warts (疣): small, benign growths caused by varieties of human papilloma virus (HPV) that invade keratinocytes.
疣:由侵入角质形成细胞的各种人瘤病毒 (HPV) 引起的小的良性生长物。
CM: warts look like hard, cauliflower shaped growths on the skin; if the warts growth at plantar surface, may cause pain or discomfort when walk
CM:疣看起来像皮肤上坚硬的花椰菜状生长物;如果疣在足底表面生长,可能会引起行走时的疼痛或不适
Massage: local contraindication, don’t touch, don’t scratch
按摩:局部禁忌,不要触摸,不要抓挠
- HPV (human papilloma virus): virus consisting of over more than types of 150 -200 HPV virus infection, small, round, light brownish (not touch, do not scratch, local contraindication for massage)
- HPV(人瘤病毒):由超过 150 -200 种 HPV 病毒感染组成的病毒,小、圆、浅棕色(不能触摸、不要抓挠、局部按摩禁忌症)
- Plantar warts: warts at plantar of foot, to prevent this, do not bear foot on public area.
- 足底疣:足底疣,为防止这种情况,请勿在公共区域用脚。
local contraindication for massage
按摩的 当地禁忌症
Caused by variety of HPV, some of which are associated with cancerous and precancerous conditions through the sexual contact and is a precursor of cervical cancer; these viruses are called oncogenic virus (cancer caused by virus);
由多种 HPV 引起,其中一些通过性接触与癌症和癌前病变有关,是宫颈癌的前兆; 这些病毒被称为致癌病毒(由病毒引起的癌症D);
Vaccine is available;
疫苗是可用的;
Lesion on hands, feet or other area of skin or mucous membranes of the oral, anal and genital cavities. Don’t touch or scratch, it is virus infection, contagious; local contraindication for massage
手、脚或其他皮肤区域或口腔、肛门和生殖器腔的粘膜病变。 不要触摸或抓挠,这是病毒感染,会传染;按摩的局部禁忌症
diagnosis: women need to have pap smear test regularly to screen exam the precancerous conditions.
诊断:女性需要定期进行子宫颈抹片 检查,以筛查癌前病变。
Secondary skin lesion:
继发性皮肤病变:
Atrophy: depressed scar tissue, sometimes permanent (such as stretch marks)
萎缩:凹陷的疤痕组织,有时是永久性的(如妊娠纹)
Erosion: scratch injury, depression, moist but no blood, usually heal without scar tissue formation
侵蚀:抓伤、凹陷、潮湿但无血,通常愈合后无疤痕组织形成
Lichenification: on elbow (olecranon process)
苔藓样变:肘部(鹰嘴突)
Scales: flakes of skin (psoriasis), dry/ greasy, dandruff
鳞屑:皮肤片状(银屑病)、干燥/油腻、头皮屑
Psoriasis: is a papulosquamous disease, may be is autoimmune disease; idiopathic, the epidermal cell turnover with thickening the epidermal (coronium layers), the migration time of the keratinocyte from the basal cell layer of the stratum corneum, granulosum of the epidermis is thinner or absent, and neutrophils are found in the stratum corneum (hyperkeratosis);
银屑病:是一种丘疹鳞屑病,可能是自身免疫性疾病;特发性,表皮细胞更新随着表皮(冠状层)的增厚,角质形成细胞从角质层基底细胞层的迁移时间,表皮颗粒较薄或不存在,在角质层中发现中性粒细胞(角化过度);
Cause: idiopathic, stress, trauma or use some medications, alcoholic is thought to possible precipitate or aggravate the condition
原因:特发性、压力、创伤或使用某些药物、酒精被认为可能会诱发或加重病情
CM: circumscribed red, thickened plaques with an overlying silvery white scale; sometimes bleeding and itchiness; alcohol, or spicy food or sea food may irritate the condition; common seen the lesions at extension parts of body bilaterally and symmetry
CM:边界红色、增厚的斑块,上面覆盖着银白色鳞屑;有时出血和发痒;酒精、辛辣食物或海鲜可能会刺激病情;常见于身体双侧伸展部位的病变,对称性
Medical treatment: corticosteroid cream (topical) or oral corticosteroid; no medication cures the disease; the result???
药物治疗:皮质类固醇乳膏(外用)或口服皮质类固醇; 没有药物可以治愈这种疾病; 结果呢???
Indicate for massage, but avoid to irritate the lesion area
适合按摩,但避免刺激病变区域
Crust (结痂): mixed with blood, pus, dried fluid, scab such as impetigo
结痂(结痂):混有血液、脓液、干液、脓疱疮等结痂
Ulcer: local tissue death(necrosis), bed sore/ pressure sore/ decubitus --- due to compress ---- local area ischemia (lacking blood circulation) --- hypoxia (lacking oxygen) --- cell death--- ulcer
溃疡:局部组织死亡(坏死)、褥疮/褥疮/褥疮---因压迫----局部缺血(缺乏血液循环)---缺氧(缺氧)---细胞死亡---溃疡
Early stage: stage 1: the skin is red, no open lesion yet, skin is still intact; but actually, damage is deeper. to prevent this happen, frequently massage the area and cold wash to prevent bed sore/ decubitus happen.
早期:1期:皮肤发红,尚无开放性病灶,皮肤仍完好无损; 但实际上,损害更深。为防止这种情况发生,请经常按摩该区域并冷洗以防止发生褥疮/褥疮。
Risk factors: quadriplegics (高位截瘫), inactive elder, femur bone fracture or pelvic bone fracture, diabetes patient, dementia patient (immobility)
风险因素:四肢瘫痪者(高位截瘫)、不活跃的老年人、股骨骨折或骨盆骨折、糖尿病患者、痴呆患者(不动)
Fissure: cracks, moist/dry, deep, due to poor circulation,
裂缝:cracks、潮湿/干燥、深、由于血液循环不良、
To prevent: exercises, massage lower limb, lymph drainage, apply olive oil or coconut oil, orally taking Omega 3 oil: salmon fish, extra virgin olive oil
预防方法:锻炼身体,按摩下肢,引流淋巴液,涂抹橄榄油或椰子油,口服 Omega 3 油:鲑鱼,特级初榨橄榄油
Other lesions:
其他病变:
Contusion: crush injury; bruise
挫伤:挤压伤; 瘀 伤
Keloid: over production of collagen, scar tissue growth above the skin surface
瘢痕疙瘩:胶原蛋白分泌过多,瘢痕组织在皮肤表面以上生长
Petechia: red or purple dots (may indicate vitamin C deficiency)
瘀点:红点或紫点(可能表明维生素 C 缺乏症)
Telangiectasis: spider vein, capillaries vessel dilation abnormal
毛细血管扩张:蜘蛛静脉、毛细血管扩张异常
Tele (remote/ peripheral); angio --- = blood vessels
Tele (远程/外围设备); angio--- = 血管
Ecchymosis: discoloration skin with red or purplish
瘀斑:皮肤变色,呈红色或紫色
Inflammatory skin conditions:
炎症性皮肤病:
Lichen planus: 扁平苔癬
Lichen planus: 扁平苔癣
Idiopathic/ unknown cause of the disease, the disease happens spontaneously.
特发性/未知原因的疾病,疾病自发发生。
Polygonal (many sides) papule, severe pruritis = very itchy.
多边形(多侧)丘疹,严重瘙痒 = 非常痒。
It is not infection condition, may associated with medications or some chemicals; may involve cell mediated immune response (hypersensitivity);
它不是感染状况,可能与药物或某些化学物质有关;可能涉及细胞介导的免疫反应(超敏反应);
New lesions develop as a result of scratching, esp. wrists, ankle, trunk even in the oral
由于抓挠而出现新的病变,尤其是手腕、脚踝、躯干,甚至在口腔中
Pityriasis rosea 玫瑰糠疹: may be virus infection, may be contagious. No massage;
玫瑰糠疹:可能是病毒感染,可能具有传染性。没有按摩;
Erythematic (redness), on the back, “Christmas tree” rash, is called “herald patch”, pruritis/ itchiness mild or moderate
红色(发红),背部,“圣诞树”皮疹,称为“先驱斑”,可能是/瘙痒轻度或中度
Self-limited 6-8 weeks to heal
自限性 6-8 周愈合
Eczema dermatosis: skin inflammation due to some antigen (hypersensitivity); not contagious
皮肤湿疹增生: 由某些抗原引起的皮肤炎症(高森性);不具有传染性
Contact dermatitis: mild erythematic (red), edema (swelling), vesicles (blister or bulla), tend to 2nd skin infection (bacteria) due to itchy and scratch
接触性皮炎:轻度红肿(红色)、水肿(肿胀)、水疱(水泡或大疱)、由于瘙痒和抓挠而倾向于第 2次皮肤感染(细菌)
Therapist avoid to use latex gloves
治疗师 avoid to use latex gloves
Atopic eczema / dermatitis: inherited, allergy dermatitis, more common seen in young childhood or infant and elder people
特应性湿疹/皮炎:遗传性、过敏性皮炎,更常见于幼儿或婴儿和老年人
Eczema lesion usually bilateral, symmetry, in the folding area/ flexion, rash, blister
湿疹病变通常为双侧、对称、折叠区/屈曲、皮疹、水泡
Eczema: not infection condition, not contagious, no massage direct on lesion area; we can massage on other area/ intact area
湿疹:无感染情况,无传染性,无直接按摩病灶区域; 我们可以按摩其他区域/完整区域
But if patient scratch the lesion, may cause 2nd skin infection
但如果患者抓挠病变,可能会导致第 2次皮肤感染
Psoriasis 牛皮癬: idiopathic, chronic condition, with occasional acute episodes when the epithelial cells replicate too rapidly. The cells died every 2-4 days, the result is a pile-up of excess coronium cells that are itchy, red or pink and scaly.
牛皮癬:特发性慢性疾病,当上皮细胞复制过快时,偶尔会出现急性发作。细胞每 2-4 天死亡一次,结果是多余的冠状细胞堆积,发痒、发红或粉红色和鳞屑。
The lesion area, the skin become thickening. The condition comes and goes, no permanent cure is available. The lesion usually bilateral, symmetry, in the extension area (back of neck, olecranon of elbow, patella…)
病变区域,皮肤变厚。 病情来来去去,没有永久的治愈方法。 病变通常是双侧对称的,在伸展区域(颈后部、肘部鹰嘴、髌骨......
Etiology: it is immunity abnormality, T cell when the chemical signal they release, trigger the epithelial cell proliferation and fast died in 4-5 days, dead skin cell accumulates at lesion (may be autoimmune disease)
病因: 是免疫异常,当T细胞 释放化学信号时,触发上皮细胞增殖并迅速在4-5天内死亡,死皮细胞在病灶处积聚(可能是自身免疫性疾病)
Massage is indicated, no friction directly on the lesion; massage use by jojoba oil (before use, ask if the client allergy or not)
按摩指示d,不得直接 对病灶进行摩擦;按摩使用荷荷巴油(使用前,询问客户是否过敏)
Medical treatment: topical medications on lesion by Vitamin D, corticosteroid creams; phototherapy limited symptoms, exposure to violet ray, do not over exposure;
药物治疗:维生素 D 对病变的局部药物治疗,皮质类固醇乳膏;光疗限制症状,暴露在紫光下,不要过度暴露;
Photosensitivity: avoid apply Essential oils (use in aromatherapy) or perfume or any skin lotion with fragrance under the sun exposure
光敏性:避免在阳光下涂抹精油(用于芳香疗法)或任何香水或任何带有香味的化妆水
Infection inflammation skin conditions:
感染炎症皮肤状况:
Antibiotics (made from fugus) only treat the bacterial infection
抗生素(由河豚制成)仅治疗细菌感染
Acne skin: include blackhead (comedone), whitehead, papules, pustules, post pimple scar spot
痤疮皮肤:包括黑头(粉刺)、白头、丘疹、脓疱、粉刺后疤痕斑
Acne vulgaris: 90% adolescents, multifactorial condition. Involve face, back or back of neck
寻常痤疮is:90% 的青少年,多因素条件。累及面部、颈部后部或颈部后部
Holly berry oil =mineral oil: hypoallergenic
冬青浆果油 =矿物油:低过敏性
Hypocomedongenic
致粉刺减少
Fungus (真菌) infection is contagious: the fungus lives on dead keratinized cells of epidermis, the fungus produces the enzyme to digest keratin, cause superficial skin scaling, destruction of skin, nails and hairs
真菌(真菌)感染具有传染性:真菌生活在表皮的死角化细胞上,真菌产生消化角蛋白的酶,导致浅表皮肤脱屑,破坏皮肤、指甲和毛发
Fungus includes yeast and mold
真菌包括酵母菌和霉菌
Tinea: fungus infection
癣:真菌感染
Tinea pedis /Athlete’s foot: fungus infection at foot/ between the toes or sole area,
足癣/脚癣:足部/脚趾之间或足底区域真菌感染,
CM: red, itchy, blister or scaling;
CM:红色、发痒、水疱或脱屑;
local contraindication to massage
按摩的局部禁忌症
tinea corpus/Ringworm: fungus infection on body skin; highly contagious; do not touch!
癣体/癣:体表真菌感染;传染性强;请勿触摸!
tinea capitis: fungus infection on hair scalp, cause lot of dandruff, lose hair patch
头癣:头发头皮真菌感染,导致大量头皮屑,失去发斑
onychomycosis (Fungus infection on nail), cause grey nail, destruction the nail;
甲癣(指甲上的真菌感染),导致指甲变灰,破坏指甲;
Massage: local contraindication
按摩:局部禁忌症
The fungus infection inside the body:
体内的真菌感染:
Candidiasis/candidosis/ candida albicans: a fungal infection
念珠菌病/念珠菌病/白色念珠菌:真菌感染
Etiology: caused by a species of candida, common seen is candida albicans, transmitted in a variety of ways depending on location of infection. may be a result of inappropriate response or over-activity of normal populations present in the body
病因:由一种念珠菌引起,常见的是白色念珠菌,根据感染部位的不同,以多种方式传播。可能是体内正常人群反应不当或过度活动的结果
CM: pruritis (itchy), white exudate, peeling and easy bleeding, topical manifestations: diaper rash, vaginitis, and thrush (mouth inflammation). In immune-suppressed patients may infected candida in endocarditis; infection of the kidney, spleen, liver and lungs.
CM:瘙痒(痒),白色渗出物,脱皮易出血,局部表现:尿布疹,阴道炎和鹅口疮(口腔炎症)。在免疫抑制患者中,心内膜炎可能感染念珠菌;肾脏、脾脏、肝脏和肺部感染。
Oral infection without recent history of antibiotic therapy, chemotherapy, corticosteroid therapy, radiation to the head or neck, or other immunosuppressive disorder, may indicate the possibility of HIV infection
口腔感染,近期无抗生素治疗、化疗、皮质类固醇治疗史、头部或颈部放疗或其他免疫抑制疾病,可能提示 HIV 感染的可能性
Treatment: topical or oral antifungals
治疗:局部或口服抗真菌药