Scales are thin flakes of epidermal keratin layer that are about to be shed or have been shed. Its size, shape, thickness, quantity and color vary, some are dry, some are greasy; most of them are secondary damages of skin diseases with erythema or papule damage (such as psoriasis, seborrheic dermatitis, pityriasis rosea). There are also inflammatory scales and non-inflammatory scales, how to diagnose inflammatory scales?
1.Viral infectious diseases
Viral infectious rash diseases, mostly seen in infants and children, are mostly epidemic. The course of the disease is generally short, and the scales are often fine and furfuraceous.
(1) measles: its rash period of only 1 week, with the rash receding from the bran-like fine flakes and healed.
(2) rubella: only 3-4 days from the onset of the rash to recede, the rash recede then off fine flakes.
(3) Emergency rash: only 3 days from the onset of the rash to recede, the rash recedes with a little fine flakes, or see no flakes.
2. Coccidioidomycosis
(1) Scarlet fever: the rash is diffuse scarlet red on the 5th day of illness, and the rash lasts only 2-4 days.
(2) Tantric fever: erythema swelling subsides after the remains of a mild chaff-like fine flakes, if there are water sores, there is scab formation.
3. Mycobacterial infectious diseases
(1) Erysipelas: caused by microscopic rod-shaped bacilli, mostly seen in the axillae and groin as brown-red patches, older damage with wrinkles and microscopic scales covering the surface, Gram stain positive for rod-shaped bacilli.
(2) Common lupus: The disease can last for decades. In the flat type damage surface is lamellar, its surface is smooth and a small amount of scales are visible.
(3) tuberculosis-like leprosy: large red plaques with a dry and coarse surface, hair loss and sensory impairment, and a surface covered with fine dry scales.
4.Fungal infectious diseases
(1) Leukoderma head: It mainly invades the head hair and hair follicles of children. Round furfuraceous scaly white patches appear on the head, which are often surrounded by small satellite-like scaly round patches.
(2) Tinea capitis: Papules of the papular scaly type often appear as circular or arcuate arranged papules with small flakes of desquamation at the margins, mainly invading the cutaneous stratum corneum.
(3) Tinea corporis: It mainly invades the stratum corneum of the skin and can cause a mild inflammatory reaction. The damage is arranged in a circular or concentric ring shape with raised dyke-like edges and consists of scaly papules.
(4) Tinea corporis: It mostly invades the inner part of the femur in a fan shape with raised dyke-like edges and consists of scaly papules.
(5) Lichen planus: It is caused by round and oval spores of S. furfuraceum, easily invades the neck, chest, and back, and is a round tan or white rash with dense and thin flaps on the surface.
(6) ringworm: seen in the tropics and subtropics, caused by concentric Trichophyton rubrum, mostly found on the trunk and extremities. It is parasitic on the skin stratum corneum and forms concentric circles or fuses with each other to form snail spiral pattern. The scales are characterized by one end attached to the epidermis, and the other end is free and tends to the center.
5.Spirochete infectious disease
(1) Phase II syphilis rash: It is often red rosacea-type rash on the trunk and round erythema on the palms of the hands and feet, and it is characterized by no symptoms. The trunk rash may have fine bran-like flakes.
(2) Phase II syphilis psoriasis-like scaly plaque: damage of varying sizes often dark red, the surface is covered with thick silvery white scales.
6, allergic skin disease
(1) eczema and contact dermatitis.
(2) exfoliative dermatitis.