一、痤疮的分类：

1、粉刺性痤疮：初发者有白头和黑头粉刺两种。白头粉刺又称闭合性粉刺，为皮色丘疹，开口不明显，不易挤出；黑头粉刺有称开放性粉刺，位于毛囊口的顶端，可挤出，叫硬脂栓。

2、丘疹性痤疮：疮炎症可继续发展扩大并深入，表现为炎性丘疹和黑头粉刺者称丘疹性痤疮。

3、脓包性痤疮：表现以脓包和炎性丘疹为主者称为脓包性痤疮。

4、脓肿性痤疮：现以大小不等的皮脂腺囊肿内含有带血的粘稠脓液，破溃后可形成窦道及瘢痕称囊肿性痤疮

5、萎缩性痤疮：丘疹或脓疱性痤疮破坏腺体而形成凹坑状萎缩性瘢痕者，称萎缩性痤疮。

6、聚合性痤疮：数个痤疮结节在深部聚集融合，有红肿，颜色青紫，称为融合性痤疮或聚合性痤疮

7、恶病质性青春痘：超重型青春痘，虽极少见，但也相当严重。损害为小米至黄豆大的紫红色丘疹、脓疱或结节，黑头粉刺不多，经久不愈；并多发于贫血、结核病或其他全身性疾病。

1. Classification of acne:

1. Acne acne: There are two types of whiteheads and blackheads for first-onset acne. Whiteheads, also known as closed acne, are skin-colored papules with inconspicuous openings and are not easy to squeeze out; blackheads are called open acne, located at the top of the hair follicle opening and can be squeezed out, called stearic plug.

2. Papular acne: The inflammation of the sore can continue to develop, expand and deepen, and those with inflammatory papules and blackheads are called pimplic acne.

3. Pustular acne: Those with pustules and inflammatory papules are called pustular acne.

4. Abscessive acne: Sebaceous cysts of varying sizes contain bloody thick pus, which can form sinuses and scars after rupture, called cystic acne

5. Atrophic acne: Papules or pustular acne destroy the glands and form pit-like atrophic scars, which are called atrophic acne.

6. Acne conglobata: Several acne nodules gather and merge in the deep part, with redness and swelling, bruising in color, called conglomerate acne or acne conglomerate.

7. Cachexia acne: Super-heavy acne, although rare, it is also quite serious. The damage is purple-red papules, pustules or nodules from millet to soybeans. Blackheads are not many and do not heal for a long time; and they often occur in anemia, tuberculosis or other systemic diseases.

不是被蟲咬，反而紅疹更厲害!?

[騎車騎到一半，突然覺得脖子刺刺癢癢的，回家一看，才發現起紅疹了!]
昨天一位患者這樣描述著。

等他抬起脖子一看，看不到被蟲咬後一顆一顆丘疹，反而是廣泛性的泛紅，同時還有白色的膿皰出現(照片一)。

這是隱翅蟲皮膚炎(Paederus dermatiits)，原因並不是被隱翅蟲咬到，而是被牠的體液沾染到，隱翅蟲的身體裡有一種毒素(pederin)，會引發接觸性皮膚炎，發炎厲害的皮膚，因而呈現出紅、腫、甚至形成膿皰、膿皰池(pustular lake)。

患者除了癢之外，更常有的症狀是:刺痛感。

治療隱翅蟲皮膚炎，可以用局部用藥搭配口服藥，一般3~5天的治療後，膿皰的病灶會慢慢乾掉，以脫皮來表現，紅疹的顏色也會慢慢變得暗沉，大約一週即可痊癒。由於發炎厲害，通常會留下色素沉積，色素沉積也會自行消退，但通常需要二到三個月的時間。

隱翅蟲小小的，大約一公分大小(照片二)，會飛，喜歡在夏天出沒，如果看到隱翅蟲飛到身上，千萬不要反射性的用手掌拍死牠，可以用小紙片、衛生紙撥掉牠，避免牠的體液沾到皮膚表面，引發隱翅蟲皮膚炎；如果真的不甚接觸到，則趕快用大量清水沖皮膚表面，如果紅疹還是出現，建議就醫治療。