1*新 编 临 床 实 用 医 学 英 语Unit 14 Dermatological DiseasesText B Acne VulgarisIntroductionThis article is about a skin disease commonly found during adolescence.Acne vulgaris (cystic acne or simply acne) is a common human skin disease,characterized by areas of skin with seborrhea ( scaly red skin)，comedones (blackheads and whiteheads)， papules (pinheads) , pustules (pimples)，nodules (large papules) and possibly scarring. Acne affects mostly skin with the densest population of sebaceous follicles ； these areas include the face, the upper part of the chest, and the back (Fig. 14-3). Severe acne is inflammatory, but acne can also manifest in noninflammatory forms. The lesions are caused by changes in pilosebaceous units,skin structures consisting of a hair follicle and its associated sebaceous gland， changes that require androgen stimulation.这篇文章是关于青春期常见皮肤病。寻常痤疮（囊性痤疮或粉刺）是一种常见的皮肤病，以局部皮肤出现脂溢性皮炎（,鳞状红色皮肤），黑头粉刺（黑头和白头粉刺），丘疹（针头），脓疱（青春痘），结节（大丘疹）和疤痕为特征。痤疮通常分布于皮肤毛囊皮脂腺最密集处；其中包括面部，胸的上部和背部（图 14-3）。重度痤疮是一种炎症反应，但也可以以非炎症形式存在。这种损害的原因来自于毛囊皮脂腺单位功能的改变，该单位是由毛囊和皮脂腺组成，而功能改变需要雄激素的刺激。Acne occurs most commonly during adolescence, and often continues into adulthood. In adolescence，acne is usually caused by an increase in testosterone, which accrues during puberty, regardless of sex. For most people, acne diminishes over time and tends to disappear or at the very least decreases by age 25. There is，however ，no way to predict how long it will take to disappear entirely, and some individuals will carry this condition well into their thirties, forties, and beyond.青春痘最常发生在青春期，并经常持续到成年。在青春期，无论男女，睾酮的分泌量均明显增加，这将导致痤疮的发生。对于大多数人来说，痤疮随着时间的推移而逐渐减少，并且会逐渐消失，或者至少到 25 岁时开始减少。但是，没有办法预测多久会完全消失，而有些人会一直好发痤疮直到他们三十岁、四十多岁或更大的年龄段。Some of the large nodules were previously called “cysts” and the term nodulocystic has been used to describe severe cases of inflammatory acne. The “cysts”，or boils that accompanycystic acne,can appear on the buttocks,groin,and armpit area,and anywhere else where sweat collects in hair follicles and perspiration ducts. Cystic acne affects deeper skin tissue than does common acne.一些大的结节以前被称为“ 囊肿” ，同时结节性囊肿一直被用来描述炎症性痤疮。 “囊肿”或疖病，伴随囊性痤疮，可以出现在臀部，腹股沟和腋下地区，以及其他一些富含分泌汗液的毛囊及汗腺导管的地方。囊肿性痤疮对皮肤组织的影响比普通痤疮更大。Aside from scarring, its main effects are psychological, such as reduced self-esteem and in very extreme cases, depression or suicide. Acne usually appears during adolescence, when people already tend to be most socially insecure. Early and aggressive treatment is therefore advocated by some to lessen the overall long-term impact to individuals.疤痕比较突出，它会影响心理健康，如减少自尊，在非常极端的情况下会导致抑郁症或自杀。痤疮通常出现在青春期，此时人们已经往往开始活跃的社交活动。因此，提倡早期积极的治疗以减少对个体的长期影响。2.新 编 临 床 实 用 医 学 英 语Signs and symptomsTypical features of acne include ： seborrhea (increased oil-sebum secretion) , comedones (blackheads and whiteheads )，papules ( pinheads )，pustules ( pimples )，nodules ( large papules)，and possibly scarring. The appearance of acne varies with skin color. It may result in psychological and social problems.痤疮的典型特征包括：脂溢性皮炎（增加皮脂分泌），黑头粉刺（黑头和白头粉刺），丘疹（针头），脓疱（青春痘），结节（大丘疹），和可能的疤痕。痤疮的出现会导致皮肤颜色变化。这可能会引起心理和社交问题。ScarsAcne scars are the result of inflammation within the dermis brought on by acne. The scaris created by the wound trying to heal itself resulting in too much collagen in one spot.Physical acne scars are often referred to as “ice pick” scars. This is because the scars tend to cause an indentation in the skins surface. There is a range of treatments available. Although quite rare,the medical condition atrophia maculosa varioliformis cutis also results in “acne- like” depressed scars OR the face.疤痕痤疮疤痕是痤疮诱发真皮层发炎的结果。疤痕是伤口愈合过程中过多的胶原蛋白沉积在一个地方的结果。身体上的痤疮疤痕常被称为“冰锥”疤痕。这是因为这些疤痕会导致皮肤表面的压痕。针对上述情况有一系列的有效治疗方法。虽然非常罕见，但天花样斑疹样萎缩性皮肤也导致在皮肤表面形成“ 痤疮” 样的凹陷疤痕Ice pick scars ： Deep pits, that are the most common and a classic sign of acne scarring.Box car scars： Angular scars that usually occur on the temple and cheeks,and can be either superficial or deep, these are similar to chickenpox scars.Rolling scars： Scars that give the skin a wave-like appearance.Hypertrophic scars ： Thickened, or keloid scars.冰锥疤痕：类似皮肤上的深坑，这是最常见的最典型的痤疮疤痕。棚车疤痕：带角的伤痕，通常发生在太阳穴和脸颊处，可 浅cFig. 14-3 Different types of Acne Vulgaris A: Cystic acne on the face； B： Subsiding tropical acne of trunk;C: Extensive acne on chest and shoulders可深， 类似于水痘疤痕。滚动疤痕：使皮肤呈现波浪般的外观。属于增生性瘢痕或瘢痕疙瘩。PigmentationPigmented scars is a slightly misleading term，as it suggests a change in the skins pigmentation and that they are true scars； however，neither is true. Pigmented scars are usually the result of nodular or cystic acne (the painful bumps lying under the skin). They often leave behind an inflamed red mark. Often，the pigmentation scars can be avoided simply by avoiding aggravation of the nodule or cyst. Pigmentation scars nearly always fade with time taking between three months to two years to do so, although can last indefinitely if untreated.色素沉着色素沉着疤痕这一名称有误导作用，因为它提示色素沉着是疤痕的必要条件。然而，事实并非如此。色素沉着疤痕通常是由结节性或囊肿性痤疮所致（皮下疼痛性结节样红斑），消退后遗留炎性红色斑点。通