黑黑的洗不掉，难道就是不讲卫生？

h2 style="text-align: left;"span style="font-size: 16px;"黑黑的洗不掉，难道就是不讲卫生？/spanbr//h2div style="text-align: left;"sectionsectionsectionsectionsectionsectionsectionsectionsectionsectionsectionsectionsectionsectionsectionspan style="font-size: 16px;"我的体重马上就要突破我的心理承受线了！而且还长痘了！/spanbr//section/section/section/section/sectionsectionsectionsectionsectionsection/section/sectionsectionsectionpspan style="font-size: 16px;"可怕的是，我现在，脖子上、大腿上都不知道什么时候开始变黑了。/spanbr//p/section/section/section/section/sectionsectionsectionsectionsectionsection/section/sectionsectionsectionpspan style="font-size: 16px;"洗不掉！洗不掉！洗不掉你要气死我吗/span/p/section/section/section/section/sectionsectionsectionsectionsectionsection/section/section/section/sectionsectionsectionsectionpbr//p/section/section/section/section/section/section/section/section/section/sectionsectionsectionsectionsectionsectionsectionsectionsectionsectionsection/section/section/sectionsectionsectionsection/section/section/section/section/section/section/section/section/section/sectionsectionsection/section/section/section/section/sectionsectionsectionspan style="font-size: 16px;"Cindy是我的一个患者，/spanspan style="font-size: 16px;"这是发生在她身上真实的故事。/spanspan style="font-size: 16px;"起初她以为是工作压力太大，/spanspan style="font-size: 16px;"慢慢开始长胖，被同事调侃“压力肥”，/spanspan style="font-size: 16px;"但她还月经经常推迟，脸上冒痘。/spanspan style="font-size: 16px;"看过皮肤科医生，/spanspan style="font-size: 16px;"可总是“野火烧不尽，春风吹又生”，/spanspan style="font-size: 16px;"和朋友吐槽后。/spanspan style="font-size: 16px;"她就带着疑惑，来到了医院。/spanspan style="font-size: 16px;"不过知道原因后/spanspan style="font-size: 16px;"她更疑惑了/spanspan style="font-size: 16px;"……/span/sectionsectionbr//sectionsectionspan style="font-size: 16px;"其实，Cindy患上了多囊卵巢综合征，这是很常见的妇科内分泌疾病，而脖子上和大腿内上方洗不掉的黑色，学名叫—— 黑棘皮征。/spanbr//section/sectionsectionsectionsectionsectionbr//section/sectionsectionsectionpspan style="font-size: 16px;"黑黑的，难道是我不讲卫生吗？/span/p/section/sectionsectionsectionspan style="font-size: 16px;"患上黑棘皮征的患者，尤其是胖MM们，在她们的后颈部、腋下、腹股沟、大腿内上方、阴阜、大阴唇等部位，尤其是皮肤皱纹和皱褶处可出现皮损。/spanspan style="font-size: 16px;"它经常表现为疣状、乳头样增生，角化过度和色素加深。这些皮损先为污黄色、灰色或棕黄色，随后黑素加深，似天鹅绒状，触之柔软，外观类似“老坑”。/spanspan style="font-size: 16px;"所以，黑黑的洗不掉，跟讲不讲卫生真的没得关系。/spanbr//section/section/section/sectionsectionsectionsectionsectionbr//section/sectionsectionsectionpspan style="font-size: 16px;"为啥会出现黑棘皮征？/span/p/section/sectionsectionsectionspan style="font-size: 16px;"黑棘皮征的发生与很多因素相关，受遗传因素影响的黑棘皮病有可能在生后或是幼年时期即发病。/spanspan style="font-size: 16px;"但是，常见的还是跟肥胖、糖耐量受损、糖尿病、代谢综合征，甚至多囊卵巢综合征这些与胰岛素抵抗状态有关的疾病相关。/spanspan style="font-size: 16px;"这些状态下，血液中升高的胰岛素作用于角质细胞或纤维母细胞上的类胰岛素生长因子受体上，促使细胞增生，会造成局部皮肤粗黑的状况。偶尔也会有胃腺癌或淋巴瘤患者出现黑棘皮征。/span/section/section/section/sectionsectionsectionbr//section/sectionsectionsectionsectionsectionpspan style="font-size: 16px;"黑棘皮征也分三六九等，/spanspan style="font-size: 16px;"黑棘皮征的严重程度，可以据它的分布和皮肤情况，分为以下几个级别：/span/p/section/section/section/sectionsectionsectionbr//section/sectionsectionsectionsectionsectionpspan style="font-size: 16px;"0级：无黑棘皮征；/spanbr//ppspan style="font-size: 16px;"1级：颈部和腋窝有细小的疣状斑块，伴有或不伴有受累皮肤色素沉着；/spanbr//ppspan style="font-size: 16px;"2级：颈部和腋窝有粗糙的疣状斑块，伴有或不伴有受累皮肤色素沉着；/spanbr//ppspan style="font-size: 16px;"3级：颈部、腋窝及躯干有粗糙的疣状斑块，伴有或不伴有受累皮肤色素沉着。/span/p/section/section/section/sectionsectionsectionbr//section/sectionsectionsectionsectionsectionpspan style="font-size: 16px;"出现黑棘皮征该怎么办？/spanbr//p/section/section/section/sectionsectionsectionspan style="font-size: 16px;"虽然可以理直气壮地面对“质疑”，但是黑棘皮征还是很影响美貌的。所以，面对黑棘皮征：/spanspan style="font-size: 16px;"由于黑棘皮征往往是胰岛素抵抗的外在表征，因此，对于体重超重BMI≥24的成年人必须检测血糖及胰岛素。/spanspan style="font-size: 16px;"而对年轻女性而言，会影响生育的多囊卵巢综合征往往存在胰岛素抵抗现象，所以月经失调的胖MM黑棘皮征发生率相对偏高，尤其要注意。/span/section/sectionsectionsectionbr//sectionsectionspan style="font-size: 16px;"首要任务是积极减重，调整生活方式，健康饮食，积极锻炼。/spanspan style="font-size: 16px;"另外，可以在医生指导下增加胰岛素敏感性的治疗，比如口服二甲双胍等药物，当体内胰岛素下降后，黑棘皮征也会自行好转。/spanspan style="font-size: 16px;"如果因肤色改变及皮赘有碍美容，可以做外科手术或电烧灼治疗。如需局部用药，请在医生指导下进行。br//span/sectionsectionspan style="font-size: 16px;"br//spanspan style="font-size: 16px;"所以啊！脖子上洗不掉的黑黑的不是脏东西，而可能是体内存在胰岛素抵抗或高胰岛素血症状态的信号。/spanbr//section/section/section/divpbr//p