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4 курс / Дерматовенерология / Dermatologia_i_venerologia_KGMU_g_Simferopol_2012_g

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ce6opei1.m.rn,

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67

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npH ncoplia3e

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.lJAH IlOJJ,TBe p:iKJJ.eHHH AHaI' 03a Heo 6xo,U:HMO npoBe p HTb HaAH-

'iHencopuamul.{ecx:oil mpuaabl -

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1.

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2.

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68

Aa;a.OHHO-IlOAOWBCHHLIH

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1. Hosbre rranyrrhI He no~JUIIOTOJ.

2. OrcyTCTBHe rrepttcpepwiecKoro pocra y)l(e cyrn.eCTBymm;Mx nanyn.

3. YMepettHoe IUeJiyllleHl1e no BCelii noBepxnocrH nanyn . 11pH3HaKH perpeccHpyro~e:H CTa)J.HH:

1. Y MeHT>IIIem1e l1Jll1 Ht'le3HoneHl1eme;iyrueHMM.

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3 . H e)l(r·ra51 CKJrap;qaTCCTb

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c 11051 BoKpyr nanyn, ttanOMf,1Haroma51

n arr111poctty10 6yMary -

n ceB1J,OaTpocpw1ecKJ1H 060)].0K Bopottona.

Kn.uHU1lecKue cpopM&L ncopua3a.

Ce6opeiiHhlH ncopHa3 -

pa3BHBaeTCSI y 6oAbHbIX ce6opee:H

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ncopHa3 MO:li(eT HMeTb ABa sapH-

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69

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3Kccy.zr.aTHBH:&IH ncopHa3 o6ycAOBAeH "ip e3MepH OH

Bbipa-

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o6pa-

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pyUieHiffiMll.

 

 

 

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o cTpo,

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)J.11cceMHHttpoBam-1b1'11 rrycryne'.lHbIM rrco p uaJ ('nm UyM6y m a) -

 

MHO)KeCTBeI·IHhie 3pMTeMaT03HbJe n.:;rrHa, Ha J)JX IlOBepxHOCT11 pacno -

 

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Ha 3pM-

 

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8.napaJIJieJH13M Te'leH115£KO.lKHoro « c ycrasHoro CHHAPOMOB,

70