Unit 4
I Got a Rash
WARM-UP
Share your opinions and experiences of the following subjects with
your friends.
1. What is the irritant or allergic contact dermatitis?
2. What are the most common symptoms of the irritant or allergic
contact dermatitis?
3. What will you do when you get an irritant or allergic contact
dermatitis?
SECTION I: READING HEALTH RELATED ISSUES
1. READING
There are many medical conditions that can cause skin rashes
on the extremities. The red rash confined to the arm or leg
usually indicates a local process as opposed to a systemic
condition. The relative factors are connected with irritating
chemicals, such as general household cleaning agents of the
kitchen, bathroom, glass and strong detergents, such as paint
thinners and other solvents, drain cleaners and certain glues.
For example, an irritant contact dermatitis is often found on
the hands of healthcare workers and is generally caused by
frequent hand washing, gloves, aggressive disinfectants or
detergents. In fact, the irritant reaction is caused by the
direct contact of an irritant substance with the skin and does
not involve the disorders or diseases of the immune system.
The commonly allergy diseases include atopic dermatitis,
allergic dermatitis (eczema) and urticaria. Atopic dermatitis
is a chronic skin condition in which the skin is extremely
sensitive to many substances. Allergic dermatitis indicates
that the patient’s contacting with substances containing
nickel may trigger allergic dermatitis. It may develop the red
and itchy rash at the contact site. When some people also may
affect the arm or any other site that comes into contact with
the perfume, plants of poison sumac, ivy or oak, they may get
another form of allergic dermatitis. Hives are also called
uticaria. Urticaria causes an itchy skin eruption, and red and
wheal’s bumps formed on the skin. It is usually the result of
an allergic response to food or drugs or insect bites and
stings.
Cellulitis is a localized infection or diffuse inflammation of
connective tissue. The severe inflammation may cause strong
skin reactions, which lead to red rashes on the limbs. The skin
reactions
can
involve
swelling,
itching,
scratching,
inflammation, burning, redness or small blisters on the skin.
Patch testing can help to differentiate between the irritant
contact dermatitis and allergic contact dermatitis. The
allergens are mixed with a non-allergic material base to a
suitable concentration ratio. Skin patch test involves the
application of various test substances to the skin under
adhesive tape and they are left in place for 48 hours. Moreover,
the doctor has to further observe the responses for 48 hours.
Then he can decide which allergens should be avoided in order
to stop aggravating the dermatitis. Healthcare workers usually
advise patients to take fewer and shorter baths and try a
soapless cleanser instead of the excessive use of soap. They
also suggest patients within irritant contact dermatitis not
to overheat the house or/and use a humidifier if he or she lives
in a dry climate.
2.READING COMPREHENSION
Please select the best answer for each question.
1. Which of the followings is not the causes of the irritant
contact dermatitis?
(A)
Toys and Books.
(B)
General household cleaning agents.
(C)
Strong detergents.
(D)
Paint thinners and other solvents, drain cleaners and
certain glues.
2. How long will it probably take to check the responses of the
skin patch test?
(A)
6 hours.
(B)
12 hours.
(C)
24 hours.
(D)
48 hours.
WORD BANK
3.VOCABULARY
1. rash KK [ræʃ] DJ [ræʃ] a./ 草率從事的, 輕率的
2.substance KK [ˋsʌbstəns] DJ [ˋsʌbstəns] n./ 物質
3. chemical KK [ˋkɛmɪk!] DJ [ˋkemikəl] a./化學的,化學上的,
化學用的
4. detergent KK [dɪˋtɝdʒənt] DJ [diˋtə:dʒənt] a./n./去垢的,
使潔淨的
5. solvent KK [ˋsɑlvənt] DJ [ˋsɔlvənt] a./n./有償付能力
的/溶媒,溶劑
6. glue KK [glu] DJ [glu:] n./ Vt./ 膠,膠水;黏著劑/膠合;黏
牢
7. sumac KK [ˋʃumæk] DJ [ˋʃu:mæk] n./ 漆樹
8. nickel KK [ˋnɪk!] DJ [ˋnikl] n./ Vt./ 鎳/鍍鎳於
9. insect KK [ˋɪnsɛkt] DJ [ˋinsekt]
n./ 昆蟲
10. concentration KK [͵kɑnsɛnˋtreʃən] DJ [͵kɔnsenˋtreiʃən]
n./集中, 專注, 濃縮; 濃度
11. humidifier KK [hjuˋmɪdə͵faɪɚ] DJ [hju:ˋmidifaiə] n./ 增濕器; 濕潤
器
4.ESP WORDS
1. extremity KK [ɪkˋstrɛmətɪ] DJ [iksˋtremiti] n./末端; 盡
頭
2. allergic KK [əˋlɝdʒɪk] DJ [əˋlə:dʒik] a./ 過敏的
3. dermatitis KK [͵dɝməˋtaɪtɪs] DJ [͵də:məˋtaitis] n./ 皮
膚炎
4. eczema KK [ˋɛksɪmə] DJ [ˋeksimə] n./ 濕疹
5. urticaria KK [͵ɝtɪˋkɛrɪə] DJ [ˋə:tiˋkɛəriə] n./ 蕁麻疹,
風疹塊
6. cellulitis KK [͵sɛljʊˋlaɪtɪs] DJ [͵seljuˋlaitis] n./ 蜂
窩組織炎
7. itching KK [ˋɪtʃɪŋ] DJ [ˋitʃiŋ] n./ a./ 癢, 渴望的
8. scratching KK [skrætʃ] DJ [skrætʃ] Vt./ n./抓; 搔/抓痕;
擦傷
9. blister KK [ˋblɪstɚ] DJ [ˋblistə] n./ Vt./ (皮膚上的)
水泡/起水泡(或氣泡)
10. eruption KK [ɪˋrʌpʃən] DJ [iˋrʌpʃən] n./(火山)爆發; (熔
岩的)噴出,發疹
11. irritant [ˋɪrətənt] KK [ˋɪrətənt] DJ [ˋiritənt]a./ n./
刺激的,刺激物
5.PHRASES
contact with 接觸/聯繫
This medication is for external use only. Avoid contact with
the eyes.
這是僅限外用的藥物，需避免接觸到眼睛。
6.THE GRAMMAR ATM
Conditional Clause (條件子句):
If + S + V + (O)…, S + will + V…
If you invite him to your party, he will come. (如果你邀他
去你的聚會，他會去的。)
7.READING APPLICATION
In groups, discuss the following questions.
1. How do you assess a patient with the irritant contact
dermatitis?
2. How do you assess a patient with the allergic contact
dermatitis?
Please make comparisons between the irritant contact
dermatitis and allergic contact dermatitis.
8.SENTENCE COMPLETION
A word or phrase is missing in each of the question. Please select the best
answer to complete the sentence.
1. ______ small quantities of allergens are necessary to induce the
reactions.
(A) Overall
(B) Only
(C) Finally
(D) Fortunately
2. ______patch testing, the history identifies potential causes of allergic contact
dermatitis, and the materials to which individuals are exposed should be included in
patch testing.
(A) After
(B) Before
(C) Begin
(D) During
9. TEXT COMPLETION
A word or phrase is missing in each text or sentence listed below. Please
select the best answer to complete the text or sentence.
1. Allergic contact dermatitis is an itchy skin condition ______by an
allergic reaction to material in contact with the skin.
(A) neared
(B) caused
(C) stood
(D) sorted
2. Dermatitis is unlikely to occur due to a specific allergen if the area of
skin most in _______with that allergen.
(A) cover
(B) often
(C) contact
(D) supply
10. WRITING PRACTICE
Please restructure following sentences to form a correct expression.
1. allergic reactions may occur, suddenly, or only after months of being
exposed to a substance.
2. allergic reaction is often delayed, with the rash, appearing 24 - 48
hours after exposure.
SECTION II: COMMUNICATING HEALTH ISSUES
11. DIALOGUE
Scenario
Mary Wang, a 50-year-old woman, has suffered from an irritant
contact dermatitis for two years. Last month her family moved
in a new apartment, and she spent much time cleaning and washing
without wearing the gloves. Then she found her both hands were
covered with severe rashes and blisters after her contacting
with the strong detergent, so she made an appointment with a
dermatologist at Preston Hospital this morning.
Dialogue
Nurse: Hello, Mrs. Mary Wang?
Mary: Yes, I am.
Nurse: Please come in.
Mary: Thank you.
Doctor: Hello, Mrs. Wang. What can I do for you?
Mary: My both hands are shown with severe rashes and blisters.
Doctor: How long have you had this problem?
Mary: I think it’s been more than two years.
Doctor: What are the symptoms of the skin disease like?
Mary: Sometimes the skin becomes sore, and painful cracks can develop
over the backs of the fingers on both hands.
Doctor: Which condition could make it worse?
Mary: I realized the problem was getting worse after contacting
with the household cleaning agents.
Doctor: What did you do then?
Mary: I tried to decrease the amount of household cleaning
agents, or I wear gloves.
Doctor: Have you had any prescription to improve the symptoms
of skin?
Mary: Last year, my family’s doctor suggested my applying a
thin film of DERMATOP Ointment 0.1% to the affected skin areas
twice daily.
Doctor: Did it work?
Mary: Yes, it did. It could improve the redness, swelling, heat
and pain on my hands in the first week.
Doctor: All right, please continue to use DERMATOP Ointment
0.1% to the affected skin areas every morning and night for two
weeks. It is for external use only. Be careful and avoid
contacting with the eyes.
Mary: I will. Thank you very much.
12. CONVERSATION COMPREHENSION
1. Why did Mrs. Wang go to hospital this morning?
(A)
Itching, scratching on the legs
(B)
Redness and blisters on the hands
(C)
Burning and inflammation on the abdomen
(D)
Redness and blisters on the neck
2. Which of the followings is not the Mrs. Wang’s problem?
WORD BANK
(A)
Non-allergic material.
(B)
Worse skin reactions before wearing the gloves.
(C)
Soapless cleaners.
(D)
Aggressive disinfectants.
13.VOCABULARY
1. household KK [ˋhaʊs͵hold] DJ [ˋhaushəuld] n./ 一家人; 家
眷; 家庭,戶
2. apply KK [əˋplaɪ] DJ [əˋplai] Vt./Vi/ 塗, 敷; 將...鋪
在表面/申請, 請求
3. swelling KK [ˋswɛlɪŋ] DJ [ˋsweliŋ] n./增大; 膨脹, 隆起
物; 疙瘩; 腫瘤
14.ESP WORDS
1. dermatologist KK [͵dɝməˋtɑlədʒɪst] DJ [͵də:məˋtɔlədʒist] n./皮膚學
者; 皮膚科醫生
2. prescription
KK [prɪˋskrɪpʃən] DJ [prisˋkripʃən] n./
命令,指示;規
定,法規
3. external
KK [ɪkˋstɝnəl] DJ [eksˋtə:nl] a./
15.PHRASES
be careful
be careful of + 人
外面的, 外部的
Please be careful of your health.
be careful with ＋ 物
Be careful with the wet paint chair.
16.THE GRAMMAR ATM
Present Perfect Tense (has/have + p.p.) is used to express
experience. (現在完成式表經驗)
Have you ever been to Taipei? 你曾經去日本嗎?\
★ If it is a regular verb, the past participle is formed by
adding “-ed” to the end of the verb. If not, the past
participle form of the verb needs memorizing.
Ex: The past participle of “be” verb is “been” ande the
past participle of “has and have” is “had”.
17. Useful Expressions
1. How long have you had this problem?
When did you have this problem?
18. Role Plays
John Smith, a 35-year-old man, has suffered from an allergic
contact dermatitis since last week. He bought two bracelets for
his girlfriend and himself as the Valentine's gift from a
jewelry shop. Then he found that the skin from his neck to his
front chest was shown with the red and itchy rashes at the
contact sites of the bracelet. So he made an appointment with
a dermatologist at Preston Hospital this morning.
19. GRAPHIC COMPREHENSION
1. Which one can be the skin reaction of a patient’s leg
touching the plant of poison sumac?
(A) Allergic contact dermatitis.
(B) Eczema.
(C) Urticaria.
(D) Cellulitis.
20. LISTENING COMPREHENSION
Dialogue (Script)
Ann: How do you feel, Chloe?
Chloe: I don’t feel well. I cannot stop scratching my forearm.
Ann: What did you touch? There are rashes and swellings all over
your forearms and wrists.
Chloe: I tried the new award winning perfume and fragrance on
both wrists at the department store about one hour ago.
Ann: Are you allergic to the perfume before?
Chloe: No, this is the first time for me to experience that.
Ann: I think you should go to see a dermatologist as soon as
possible.
Chloe: You are right. Can you make a call to Dr. Kim for me?
Ann: No problem. Give me a second.
After 5 minutes~
Ann: I am going to send you to see Dr. Kim in 10 minutes. One
of his patients cancels the appointment at 2 p.m. today.
Chloe: Thanks God! I don't need to wait for a long time.
Ann: OK. Let’s go!
Questions:
Are the following statements true?
1. Chloe is going to see her doctor because of the skin allergy.
(A) True
(B) False
2. The new award winning perfume and fragrance causes the
uncomfortable symptom.
(A) True
(B) False
3.
Chloe will go to visit Dr. Kim’s clinical setting tomorrow afternoon.
(A) True
(B) False
21.Question-Response
Match following questions and responses.
1. How long have you had these
symptoms?
A. I feel slight pain around a bit of
scratching marks.
2. What have you touched?
B. Perfume and fragrance.
3. How is your skin breakdown on the
wrist?
C. About 60 minutes.