Pathology skin 2
病理皮肤 2
Bacterial infection on the skin
皮肤上的细菌感染
Impetigo: contagious skin infection caused by group A streptococci bacteria; spread from person to person or the skin contact, clothing, towels and bed linens that were touched the infected person’s skin
脓疱病： 由 A 组链球菌引起的传染性皮肤感染;在人与人之间传播或皮肤接触、衣服、毛巾和床单接触感染者皮肤
CM: itchy with tiny blisters, around mouth, nose, blister will break and pus, dry, crusty---- even crusty lesion still contagious;
CM：发痒有小水泡，口鼻周围，水泡会破裂，脓液、干燥、结痂----甚至硬皮病变仍然具有传染性;
Treatment: topical use antibiotic cream; NO massage until the skin lesion healed.
治疗：局部使用抗生素乳膏;在皮肤病变愈合之前不要按摩。
When you changing linens, massage therapist should always handle soiled linen as little as possible and with minimum agitation
更换床单时，按摩治疗师应始终尽可能少地处理弄脏的床单，并将搅动降至最低
As RMT, laundry sheets and blankets and towels in the cabinet with the door closed;
作为 RMT，晾衣单、毯子和毛巾在柜子里关着门;
Soiled linen should separate area from cleaned ones
弄脏的亚麻布应将区域与清洁的区域分开
Boils = furuncles: staphylococcal skin infection which begins deep in the root of hair follicle; acute infection inflammation
疖子 = 疖：葡萄球菌皮肤感染，始于毛囊根部深处;急性感染炎症
CM: start reddened, tender area, overtime the area becomes firm and hard. Very painful, eventually the center of the boil softens and filled with pus which are the white cells and debris of bacteria
CM：开始发红，触痛区域，随着时间的推移，该区域变得坚硬和坚硬。非常痛苦，最终疖子的中心软化并充满脓液，脓液是细菌的白细胞和碎片
Most frequently are found on the scalp, face, underarms and buttocks
最常见于 scalp、面部、腋下和臀部
Cause: picky the acne/ pimples, splinter or other foreign material lodged in the skin; or skin cut cause bacterial infection
原因：挑剔痤疮/粉刺、碎片或其他异物卡在皮肤上;或皮肤割伤导致细菌感染
NO massage, referral to medical treatment
禁止按摩，转诊就医
Erysipelas = ST. Anthony’s fire: acute skin infection by bacteria streptococcal;
丹毒 = 圣安东尼火：链球菌引起的急性皮肤感染;
Highly contagious, sometimes fatal and often hard to catch right away; initially, the bacteria infection on the epidermis then become systemic infection (high fever, red, painful at the skin lesion)
传染性强，有时致命，通常很难立即感染;最初，表皮上的细菌感染随后变成全身感染（高烧、发红、皮肤病变疼痛）
Cause some skin open lesion such as some scratch, small cuts, athlete’s foot scratch or mosquito bite or insect bite
引起一些皮肤开放性病变，如一些抓痕、小伤口、脚癣抓伤或蚊虫叮咬或昆虫叮咬
Common seen the lesion at head or lower leg, this infection can be quite hazardous, the bacteria can spread through blood stream and poisoning the blood even death
常见于头部或小腿的病变，这种感染可能非常危险，细菌可以通过血液传播并毒害血液甚至死亡
Antibiotic mediation
抗生素介导
** antibiotic medication only effect to treat bacterial infection disease
** 抗生素药物仅对治疗细菌感染疾病有效
Parasite infection:
寄生虫感染：
Pediculus/ lice:
虱子/虱子：
Pediculus humanus capitis: the lice on scalp: stay at shift of hair, lice (female) before lay down the eggs: she is going to scalp to suck the blood, she goes back on shift of hair to lay down the eggs;
头状虱 子：头皮上的虱子：保持头发轮换，虱子（雌性）在产卵前：她要去头皮吸血，她要 轮流头发来产卵;
Pediculus humanus corporis: lice on body lay down the eggs on edge of underwear, frequently laundry the clothes are best way to prevent the lice stay.
Pediculus humanus corporis： 虱子在身上产卵，在内衣边缘产卵，经常洗衣服是防止虱子停留的最佳方法。
Flea:
跳蚤：
Tick: deer ticks carry Borrelia if person is bit by the ticks, may infected Lyme disease (see skin note 1)
蜱虫：鹿蜱携带疏螺旋体，如果人被蜱虫叮咬 ，可能会感染莱姆病（见皮肤注 1）
Skin conditions or some disease related skin lesion:
皮肤状况或一些与疾病相关的皮肤病变：
Lupus (SLE= system lupus erythematosus)
狼疮（SLE= 系统性红斑狼疮）
Lupus= Greek means “wolf” (autoimmune disease)
狼疮= 希腊语的意思是“狼”（自身免疫性疾病）
Etiology: the anti-nucleus auto-antibody attacks own connective tissue and internal organs;
病因： 抗核自身抗体攻击自身的结缔组织和 内脏器官;
Acute to chronic (remission) ---------- chronic --------- acute/ flare up (common seen flare up at spring and early summer, sun shine is trigger) ------- chronic (never cured)
急性至慢性（缓解期）----------慢性---------急性/发作（常见于春季和初夏发作，阳光照射是诱因）-------慢性（未治愈）
CM:
厘米：
Initial sign of lupus, skin lesion start from face, may involve back, chest; facial lesion called “butterfly rash” also called malar rash= discoid rash
狼疮的初始体征，皮肤病变从面部开始，可累及背部、胸部; 称为“蝶形皮疹”的面部病变，也称为颊部皮疹 = 盘状皮疹
Photosensitivity (the patient should avoid sun exposure!!!)
光敏性（患者应避免日晒!!）
inflammatory arthritis
炎症性关节炎
eventually the antibody attacks various body systems, leading to systemic conditions (skin rash, arthritis, fibromyalgia, headaches, the antibody attack the blood vessels cause blood vessel inflammation such as arteritis or phlebitis, die of organ failure (renal/ kidney failure or heart failure)
最终，抗体攻击各种身体系统，导致全身性疾病（皮疹、关节炎、纤维肌痛、头痛，抗体攻击血管引起血管炎症，如动脉炎或静脉炎，死于器官衰竭（肾/肾衰竭或心力衰竭）
Massage: indicate relaxation massage in remission period, but with precaution: no deep tissue works or friction technique (the concept is not to stimulate and trigger of the inflammation reaction) ------ if the patient is taking anti-inflammation medication (corticosteroid: the side effect is slower healing process of any tissue injury, tissue become fragile)
按摩：表示缓解期的放松按摩，但要注意：没有深层组织工作或摩擦技术（概念不是刺激和触发 炎症反应）------如果患者正在服用抗炎药物（皮质类固醇：副作用是任何组织损伤的愈合过程变慢，组织变得脆弱）
scleroderma: autoimmune disease, skin and connective tissue become thickening and hardening due to over production of collagen
硬皮病：自身免疫性疾病，由于胶原蛋白的过度产生，皮肤和结缔组织会变厚和变硬
idiopathic, no medical treatment to cure
特发性，无药物治疗可治愈
there are some environmental factors related to this disease including the person exposure to silica duct, vinyl chloride, epoxy resins and organic solvents
有一些与这种疾病相关的环境因素，包括暴露于二氧化硅管道、氯乙烯、环氧树脂和有机溶剂的人
this disease seen more in females than in males, many reports cases of scleroderma and other autoimmune disorders among women who have had breast implants
这种疾病在女性中比在男性中多见，许多人报告了在植入乳房的女性中患有硬皮病和其他自身免疫性疾病的病例
CM:
厘米：
initial, skin lesion: single or multiple, violet, firm, “chalky”, inelastic macules or papules, this is the sign of this disease
初始、皮肤病变：单个或多个、紫色、坚硬、“白垩”、无弹性的斑疹或丘疹，这是这种疾病的标志
secondary lesions: effect internal organs, systemic scleroderma, involved lung, gastric intestine tract, heart
继发性病变：影响内脏器官、系统性硬皮病、受累肺、胃肠道、心脏
no treatment to stop over production of collagen
无需治疗即可阻止胶原蛋白的过度产生
the medication reduces symptoms only
药物只能减轻症状
massage: relaxation and palliative care with rich moisturizer
按摩：使用 Rich Moisturizer 进行放松和姑息治疗
urticaria = hives, it is acute hypersensitivity, idiopathic, caused by food or some chemical (such as smell something, or medications), allergy reaction, stress or emotional
荨麻疹 = 荨麻疹，它是急性超敏反应，特发性，由食物或某些化学物质（如闻到某物或药物）、过敏反应、压力或情绪引起
pathogenesis: cause by irritants (allergen) ------ mast cell (in the connective tissue) release histamine and prostaglandin------ blood vessels dilated / increase permeability------- cause edema----- the blood may pool in peripheral area------swelling compress on nerve -------cause itchy /pruritis or tingling or pain-----not enough blood go back to the heart ( but blood pressure drops)
发病机制： 由刺激物（过敏原）引起 ------ 肥大细胞（在结缔组织中）释放组胺和前列腺素------血管扩张/通透性增加-------引起水肿-----血液可能在外周区域淤积------肿胀 压迫神经-------引起瘙痒/瘙痒或刺痛或疼痛-----血液回流到心脏不足（但血压下降）
CM: pink, red surrounded by pale halo edematous plaques/ wheals
CM：粉红色、红色，周围环绕着淡淡的光晕水肿斑块/风团
Treatment: anti-histamines medication
治疗：抗组胺药
More severe case: angioneurotic edema (血管神经性水肿)： blood vessel and nerve swelling, severe allergy condition, call 911
更严重的情况： 血管神经性水肿 （血管神经性水肿） ： 血管和神经 swelling， 严重过敏情况， 拨打 911
vitiligo /dark skin: idiopathic, the skin become very sensitive, sun burn easily, do not exposure to sun, not irritate the skin surface
白癜风/深色皮肤：特发性，皮肤变得非常敏感，容易晒伤，不要暴露在阳光下，不会刺激皮肤表面
nevi = mole, benign, well-defined border; massage is indicated, but do not irritate/scratch the surface of moles
痣 = 痣，良性，边界清晰;需要按摩，但不要刺激/抓挠痣表面
if you see lesion “moles”
如果您看到病变 “痣”
Asymmetry
不对称
Boarder: irregular
寄宿生：不定期
Color uneven
颜色不均匀
Diameter: > 6mm
直径： > 6mm
Elevated: not smooth surface
凸起：表面不光滑
if you see these lesion, you should referral to medical doctor: may indicate skin cancer malignant melanoma (due to chronic sun exposure damage)
如果您看到这些病变，您应该转诊给医生：可能表明皮肤癌恶性黑色素瘤（由于慢性阳光照射损伤）
local contraindication for massage
按摩的当地禁忌症
neoplasia: abnormal growth “new cells (benign tumor or malignant cancer); no physiological function, purposeless, but occupied normal anatomy space, “grips” the nutrient form normal tissue
肿瘤：异常生长“新细胞（良性肿瘤或恶性癌症）;没有生理功能，无目的性，但占据了正常的解剖空间，“抓住”了正常组织的营养物质
caner stage 0 = in situ: means the cancer only locally
Caner 0 期 = 原位：仅指局部癌症
--- oma = tumor
--- OMA = 肿瘤
if the cancer raises from epithelium tissue, called ------ carcinoma (for examples: skin cancer: basal cell carcinoma, squamous cell carcinoma) and these are skin cancers which rise from epidermis tissue; most risk factor is chronic sun damage the skin
如果癌症从上皮组织升高，称为 ------癌（例如： 皮肤癌：基底细胞癌、鳞状细胞癌）和SE 是从表皮组织起源的皮肤癌; 大多数风险因素是慢性阳光对皮肤的伤害
malignant melanoma is very malignant skin cancer, metastasis to vital organ (common sites is lung or brain), quickly cause death;
恶性黑色素瘤是极恶性的皮肤癌，转移至重要器官（常见部位为肺或脑），迅速导致死亡;
(If the cancer rises from the connective tissue: ---- sarcoma (is suffixes mean cancer from connective tissue (osteosarcoma is bone cancer)
（如果癌症起源于结缔组织：----肉瘤（后缀表示癌源于结缔组织（骨肉瘤是骨癌）
Metastasis: the tumor cells spread via lymphatic system, or vascular circulation or serous sacs / neighboring tissue or organs:
转移：肿瘤细胞通过淋巴系统、 血管循环或浆液囊/邻近组织或器官扩散：
Lymphatic system: most common, tumor cells move into tissue spaces, picked up by the lymph vessels, travel to lymph nodes and multiply. The nodes get hard, large and irregular (breast cancer)
淋巴系统：最常见的是，肿瘤细胞进入组织间隙，被淋巴管吸收，移动到淋巴结并繁殖。 淋巴结变硬、变大且不规则（乳腺癌）
Blood vessels: tumor cells invade veins; cells are carried to other parts of the body where they settle. area settle depends on vessels invaded (originate in gut (digestive organs), spread to liver.
血管：肿瘤细胞侵入静脉; 细胞被带到身体的其他部位，在那里它们定居。区域沉降取决于被侵入的血管（起源于肠道（消化器官）），扩散到肝脏。
spread via serous sacs: if develop in peritoneal, plural or pericardium can spread beyond to outer surface
经浆液性囊传播：如果在腹膜中发生，复数或心包可扩散至外表面
prickly heat: heat rash, tiny blister with pruritis/ itchy
痱子：痱子，伴有瘙痒/瘙痒的小气泡
seborrheic keratoses: is benign skin growth in which epithelial cells proliferate in isolated areas. Common seen in older adults, most are benign tumor; is not skin cancer;
脂溢性角化病：是良性皮肤生长，其中上皮细胞在孤立区域增殖。常见于老年人，大多数为良性肿瘤;不是皮肤癌;
See doctor to diagnosis
看医生诊断
Senile lentigines: liver spots, brown patches in sun exposure area
老年性雀斑：肝斑、日晒区域出现棕色斑块
Burns:
烧伤：
1st degree burn, is mild, involves damage to outer layers epidermis; skin function remains intact, local pain, redness, blister, mild systemic reaction (such as mild fever, headache….)
1度烧伤，轻度，涉及外层表皮损伤;皮肤功能完好无损，局部疼痛、发红、水泡、轻度全身反应（如轻度发热、头痛......
Mild sun burn is first degree burn; no scar, lasts 3-4 days
轻度晒伤是一级烧伤;无疤痕，持续 3-4 天
To prevent, apply sun screen before go under the sun; reapply sun protection cream every hour if go to the water
为了防止，在进入阳光下之前涂抹防晒霜; 如果下水，每小时重新涂抹一次防晒霜
Apply the post-sun cream to sooth and moisturize the skin
涂抹防晒霜以舒缓和滋润皮肤
Local CI for massage @ acute stage
按摩的局部 CI @ 急性期
2nd degree burn: (involves epidermis and dermis)
2 度烧伤：（涉及表皮和真皮）
Partial thickness: involves epidermis and some of the dermis; some loss of skin function, appears red to ivory, thin-walled blister appears within minutes, skin is sensitive to temperature, air and touch; some scaring, heals in 1-2 weeks
部分厚度：涉及表皮和一些真皮;皮肤功能部分丧失，呈红色至象牙色，几分钟内出现薄壁水泡，皮肤对温度、空气和触摸敏感;有些吓人，1-2 周内痊愈
Full thickness: epidermis and dermis are involved, pains’ receptors remain intact; tactile sensation decreases or disappears, appears red, pink or waxy white, blister form, edema present; scarring and possible loss of sensation, heals in approximal more than one month
全层触觉：表皮和真皮受累，疼痛感受器保持完整;触觉减弱或消失，呈红色、粉红色或蜡状白色，M 出现水泡，存在水肿;瘢痕形成和可能的感觉丧失，大约一个月后愈合
3rd degree burns: involves subcutaneous tissue and possibly muscle or bone, loss of all function in the dermis (hair, follicle, sweat gland, blood vessels and free nerve end); appears waxy white and yellow / brown, red back area is hard and leathery, edema present, NO pain
3度烧伤：累及皮下组织，可能累及肌肉或骨骼，真皮（头发、毛囊、汗腺、血管和游离神经末梢）丧失所有功能;呈蜡白色和黄色/棕色，红色背部坚硬和坚韧，存在水肿，无痛
If occurs over an area greater than 1.5 inches requires skin graft; heals in moths with large amount of scarring
如果发生在大于 1.5 英寸的区域需要植皮;在有大量疤痕的飞蛾中愈合
Extent of injury due to burn: use the “Rule of 9’s”
烧伤造成的伤害程度：使用“9 法则”
Head 9%, upper limb 9% x2=18%, lower limb18% x2= 36 %; trunk anterior and posterior 18%x2 =36%; perineum 1%
头部 9%， 上肢 9% x2=18%， 下肢 18% x2= 36 %;躯干前后 18%x2 =36%;会阴 1%
Medical treatment:
医疗：
When the burn victim is in the hospital, the first thing that Dr. need to save his life, re-establish his vital function (blood pressure? Blood circulation and heart function? Respiratory rate? Body temperature?)
当烧伤患者在医院时，医生需要的第一件事是挽救他的生命，重建他的生命机能（血压？血液循环和心脏功能？呼吸频率？体温？
Burn shock: --- cause hypovolemic shock (burned the blood vessels, lost blood volume); the blood become thicken, causing increased peripheral resistance and decreased cardiac output; decrease blood to organs and tissues
烧伤休克： ---引起低血容量性休克（烧灼血管，血容量丢失）;血液变稠，引起外周阻力增加和心输出量减少;器官和组织血液减少
Replace the fluid to the body is very important with burn victims
对于烧伤患者来说，将液体补充到体内非常重要
Respiratory dysfunction: thermal injury, if victim inhales smoke causes increased carbon monoxide in the body which can lead to bronchia spasm, destruction of mucus membranes, edema and poor oxygen exchanged
呼吸功能障碍：热损伤，如果受害者吸入烟雾会导致体内一氧化碳增加，从而导致支气管痉挛、粘膜破坏、水肿和氧气交换不良
Metabolic changes: increase stress hormone, high fever, body need more oxygen and glucose
代谢变化：增加压力荷尔蒙，高烧，身体需要更多的氧气和葡萄糖
Kidney function? Digestive function? Nervous system?
肾功能？消化功能？神经系统？
Sepsis: bacterial infection, leading to blood poisoning, skin immune cell may be destroyed (Langham cell and mast cell)
败血症：细菌感染，导致血液中毒，皮肤免疫细胞可能被破坏（Langham cell 和 Mast 细胞）
The pain is managed all these vital functions re-established and energy requirement are met; the last treatment is to reduce pain.
疼痛得到控制，所有这些重要功能得到重建，能量需求得到满足; 最后一种治疗方法是减轻疼痛。
Emotion stress: social consultation and psychological treatment, cosmetic surgery; deal with possible disfigurement, amount of time needed for treatment, may have several operations
情绪压力：社会咨询和心理治疗、整容手术;处理可能的毁容，治疗所需的时间，可能要进行几次手术
Shingles: herpes zoster (varicella) virus (in childhood infected chicken pox);
带状疱疹 s：带状疱疹（水痘）病毒（儿童感染的水痘）;
But after chicken pox infection, this virus latent/dormant in ganglion (collection of sensory neuron cell bodies) of spinal nerve; once the person has very stressful, immunity lower, shingles inflammation: the virus reactivates, skin rash with blister and very painful, after skin lesion is gone; but neuroglia pain may last for months or years (residual pain)
但是在水痘感染后，这种病毒潜伏在/休眠在脊神经的神经节（感觉神经元细胞体的集合）中;一旦人压力很大，免疫力下降，带状疱疹炎症：病毒重新激活，皮疹起水泡，非常痛苦，皮肤病变消失后;但神经胶质细胞疼痛可能持续数月或数年（残余疼痛）
Cold sore: this is Herpes simplex I virus infection; lesion is red and blister and pain at corner of lips, inter oral, nose or eyelid membrane recurring when the person has lower immunity; reschedule the massage appointment.
唇疱疹：这是单纯疱疹 I 型病毒感染;皮损发红和水泡，唇角、口内、鼻子或眼睑膜疼痛，当免疫力较低时，会反复出现;重新安排按摩预约。
To keep body high immunity, healthy diet and good life style: vegetables and (fruits); vitamin B2 protect the mucus membrane and prevent inflammation (carrot, orange, tomato, papaya, sweet potatoes, all yellow or orange color vegie or fruits)
保持身体高免疫力、健康饮食和良好的生活方式：蔬菜和（水果）;维生素 B2 保护粘膜并防止炎症（胡萝卜、橙子、番茄、木瓜、红薯、所有黄色或橙色蔬菜或水果）
Genital sore: Herpes simplex II virus infection, sexual transmitter disease.
生殖器溃疡：单纯疱疹 II 病毒感染、性传递病。