PEDIATRIC DERMATOLOGY
PEDIATRIC DERMATOLOGY
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小儿皮肤科
DOI：
10.1542/peds.21.3.502
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发表时间：
1958
期刊：
影响因子：
8
通讯作者：
A. B. Falk
中科院分区：
文献类型：
--
作者：
H. H. Perlman;A. B. Falk
关于皮肤病治疗的讨论，对比了皮肤病学家珀尔曼博士和虚无主义者福尔克博士的观点。两位发言者的评论都是基于个人经历。参与者被预先警告，这些言论往往会违背经典的皮肤病学教学。
组织学检查显示婴儿的皮肤缺乏发育良好的角质层。表皮的这种角质化外层组织松散且呈花边状，从而对细菌的进入提供了较差的防御屏障。角化不良也解释了婴儿期频繁出现流泪、渗出性皮肤病的原因。真菌感染的皮肤是罕见的，在婴儿期，因为松散的角质层不提供一个有利的表面生长的真菌。婴儿皮肤的娇嫩和缺乏保护性的角质层使其特别容易受到过度治疗的伤害。事实上，今天皮肤科医生看到的40%的皮肤病是由于过度热情的局部治疗的影响。
儿科医生常见的皮肤病问题在以下一般标题下进行了讨论：
(1)湿疹性皮肤病：接触性皮炎、毒性皮炎（毒藤）、尿布皮炎、擦烂、感染性湿疹样皮炎、特应性皮炎、特应性红皮病、钱币状湿疹和局限性神经性皮炎。
(2)脓皮病：皮肤剥脱性皮炎（Ritter病）、传染性脓疱病、脓疮、链球菌性红斑、婴儿坏疽性皮炎和葡萄球菌性周孔炎。
(3)斑丘疹性鳞状皮肤病：玫瑰糠疹、脂溢性皮炎（摇篮帽）、银屑病、副银屑病、扁平苔藓、毛发红糠疹、光泽苔藓和条纹苔藓。
以下是对圆桌讨论会与会者特别感兴趣的某些疾病的诊断和治疗的评论。
毒性皮炎（毒常春藤）
毒葛的刺激性成分是一种二元酚，漆酚，一种儿茶酚样物质，它包含在毒葛植物的每一部分，包括叶，茎，花和果实。
THIS DISCUSSION of dermatologic therapy contrasted the opinions of an empiricist, Dr. Perlman, with those of a nihilist, Dr. Falk. Both speakers based their comments upon personal experience. Participants were forewarned that these remarks would frequently be contrary to classic dermatologic teaching.
Histologic examination reveals that the infant's skin lacks a well-developed stratum corneum. This keratinized outer layer of the epidermis is loosely organized and lace-like, thereby providing a poor defensive barrier against the entrance of bacteria. Poor cornification also explains the frequency of weeping, exudative dermatoses during infancy. Fungus infections of the skin are rare during infancy because the loose stratum corneum does not provide a favorable surface for superficial growth of fungi. The delicacy of the infant's skin and its scanty protective cornification make it particularly vulnerable to damage by overtreatment. Indeed, 40% of the dermatoses seen by dermatologists today are due to the effects of overly-enthusiastic topical therapy.
Dermatologic problems commonly seen by pediatricians were discussed under the following general headings:
(1) Eczematous dermatoses: contact dermatitides, dermatitis venenata (poison ivy), diaper dermatitis, intertrigo, infectious eczematoid dermatitis, atopic dermatitis, atopic erythroderma, nummular eczema and circumscribed neurodermatitis.
(2) Pyodermas: dermatitis exfoliativa neonatorum (Ritter's disease), impetigo contagiosa, ecthyma, erythema streptogenes, dermatitis gangrenosum infantum and periporitis staphylogenes.
(3) Maculopapular squamous dermatoses: pityriasis rosea, seborrheic dermatitis (cradle cap), psoriasis, parapsoriasis, lichen planus, pityriasis rubra pilaris, lichen nitidus and lichen striatus.
Comments regarding the diagnosis and treatment of certain of these conditions, which seemed to be of special interest to participants in the round table discussion, follow.
DERMATITIS VENENATA (POISON IVY)
The irritant principle of poison ivy is a dihydric phenol, urushiol, a catechol-like substance which is contained in every portion of the poison-ivy plant, including leaves, stem, flowers and fruit.