서면피부과
Subcutaneous tissue, also called superficial fascia and the deep fascia, stores fat, protects organs, pads and cushions the body, and helps the body adjust to temperature changes. Some health conditions start in this layer and it’s where many medications are given.
서면피부과Mild edema shows US as hypoanechoic accumulation of fluid related to distension of the hyperechoic connective septa between fat lobules (Fig. 4a,b).
Tumors
Several types of benign and malignant soft tissue masses occur in the subcutaneous tissue. Generally, these lesions are painless unless they are irritating a nerve in close proximity and can go undetected for some time until they have grown considerably. This makes prompt and accurate diagnosis essential to prevent potentially debilitating complications, such as a tumor on a patient’s foot impairing mobility or blocking a nerve requiring surgical removal.
Benign soft tissue tumors are noncancerous lumps that develop anywhere you have soft tissue, such as muscles and tendons. They may form anywhere under the skin, including your arms, legs and trunk. They can also develop in the spaces that surround and support your nerves, including schwannomas (nerve sheath tumors) and neurofibromas. These tumors can be formed from a variety of materials, such as fat cells (lipomas), blood vessels (hemangiomas) or fibrous connective tissue (fibromas).
A biopsy is required to determine the nature of any abnormal lumps and bumps. MRIs are used to accurately pinpoint the location of a suspected benign or malignant soft-tissue mass and can provide a more detailed image of its structure than conventional imaging methods.
Panniculitis
Panniculitis is a general term for inflammation of subcutaneous fat, and there are many different types. It can result from infections, injuries, external insults or underlying conditions and diseases (table 1). It usually presents as a series of painful inflammatory nodules and occasionally ulcers or patches of broken skin called plaques. Most of these are located over the extremities, but they can also be found on the breasts, face and buttocks. The condition can occur in all ages and is more common in women than men.
The most 서면피부과 common form of panniculitis is erythema nodosum, or EN. It shows up as a sudden occurrence of painful, hard lumps that are red or purple and typically over the front of your shins. It happens three to six times more often in women than in men and recurs frequently. It is not a disease, but a reaction pattern to an infection, injury or drug.
Another type of panniculitis is lipodermatosclerosis, which causes a buildup of fat within the subcutaneous tissue and leads to painful swelling and thickening of the skin. It is often mistaken for cellulitis. It may also happen as a side effect of some medications, including chemotherapeutic agents like the BRAF inhibitors dabrafenib and vemurafenib. It also occurs in people with tuberculosis, or as a part of the condition sarcoidosis.
Abscess
An abscess is caused by bacteria that get into the skin through a cut or abrasion. The infection triggers the body to form a pocket of pus to fight the bacteria. The pus contains the bacteria, white blood cells that attack the bacteria and dead tissue. When the abscess reaches a certain size, it “points” and spontaneously ruptures. This releases the pus and usually relieves the pain.
You can’t prevent abscesses, but good hygiene can help. Keep cuts and scrapes clean, and apply over-the-counter antibacterial ointment. Do not try to break or drain a boil or an abscess yourself by pressing on it or sticking something into it, because you may injure an underlying blood vessel and cause the infection to spread.
The healthcare provider will numb the area around the abscess and make a small incision to drain it. This is called an incision and drainage (I&D). The doctor will also prescribe antibiotics to treat the infection.
Ultrasound imaging may be used to detect a subcutaneous abscess. The abscess appears as an echogenic hypoechoic lesion in the affected skin with a surrounding area of hyperemic tissue. Typically, the abscess will have a thick wall and a fluid-fluid level within its center, with dependent layering of more echogenic debris (pus). A needle or other sharp instrument is then inserted into the abscess to drain it. Afterward, the healthcare provider will pack the wound with surgical material to help it heal and to avoid the abscess from recurring.
Pressure ulcers
Pressure ulcers are areas of necrosis of soft tissues (usually skin) due to unrelieved pressure over an extended period. They develop as a result of the combination of external and internal risk factors such as age, impaired circulation and tissue perfusion, immobility, friction and shear forces, decreased sensation, and poor nutrition.
When a pressure ulcer develops, it must be identified and treated. It is recommended that bedsores be checked daily if possible, and especially when patients are bedridden. Ideally, bedsores should be prevented by promoting movement, relieving pressure and using mattresses that distribute pressure. Individual patient positioning plans and regular re-positioning are important in community settings such as residential aged care facilities.
It is also essential to have a pressure ulcer management plan in place and to document the location of each pressure ulcer as this allows reassessment when patients are moved between beds or services. Medical devices that cause pressure ulcers should be noted, as they are often difficult to remove and can lead to serious infection. Temperature sensing technologies can aid early diagnosis of pressure ulcers, as they can show changes to subcutaneous fat tissue as early as 5-18 days before the appearance of a visible wound.
The stages of pressure injuries are defined as nonblanchable erythema, partial-thickness skin loss that does not reach the fascia, full-thickness skin loss with exposed bone, muscle and/or tendon and blackened dead tissue (eschar). Treatment includes reversing the damage by removing all pressure from the area, ensuring good moisture in the wound bed, dressings to control bacterial growth and debridement when needed.