Ring erythema. Erythema - treatment

Erythema is accompanied by an increase in capillaries,which is due to the intensive flow of blood to them. Ring erythema (Erythema annulare) is considered one of the signs of rheumatism in the phase of activity, for example in polyarthritis, as well as the manifestation of other disorders in the body. The disease affects mainly children and young people under 30 years. In the last century, experts evaluated ring-shaped erythema as a disease with poor prognosis. Nowadays, in the presence of new effective methods of treating rheumatic disorders, the prognosis in the fight against erythema is quite optimistic.

History of the study of erythema

Symptoms of the disease were discovered by doctors inbeginning of the last century. The first to describe annular erythema and carried it to skin diseases pediatricians from Austria G. Lendorff and H. Leiner in 1922. It was they who characterized the disease as one of the symptoms of rheumatism. Therefore, the ailment is also called rheumatic erythema of Lendorff-Leiner. The doctor from France Bénier at that time called the ring-shaped erythema erytheme margine en plaques, therefore in foreign sources it is often possible to find the name erythema marginatum.

In 1975, H. Stollerman revealed a form of annular erythema, which was not a manifestation of rheumatism. Numerous histological studies in the field of rashes allowed specialists to identify the forms of the disease, which are caused not by rheumatic disorders, but by a violation of vegetative regulation of the walls of the vessels, as well as various infections and disorders in the functioning of the immune system.

Symptoms of annular erythema

The annular erythema manifests itself in the form of pinkor red closed rings appearing on the skin. Often the spots are round or oval in shape, with a pale center and often swollen. Affected areas are not flaky and painless. Patients may experience itching and burning sensation in the affected area.

Rings grow in size, inside them oftenthe formation of new circles is observed. As the spots grow, the erythema can merge with each other, forming figures of various shapes. The disease proceeds wavy, and if some rings disappear, after a while new reddening appears instead of them. One attack succeeds another in about three weeks. The appearance of rashes on the mucous membranes, the skin of the palms and soles is not typical for such a disease as ring erythema. The photo clearly demonstrates the nature of skin lesions with erythema.

Ring-shaped erythema is located on the chest,shoulders, face and neck, sometimes on the back, arms and legs. The intensity of the spots is often increased by the influence of several factors. Among them, the effect of temperature, both low and high, the emotional state, endocrine changes (menstruation, the intake of hormonal contraceptives or steroid drugs) and so on. In some cases, erythema manifests itself atypically, accompanied by purple rashes and the formation of vesicles. If nodules appear along with the rings on the skin, doctors consider this as a symptom that indicates the unfavorable development of rheumatism. At the same time annular erythema is observed in patients at the stage of recovery after the disappearance of the main manifestations of rheumatoid disease.

Causes of the disease

The cause of rheumatoid erythema is rheumatismin the phase of activity, and the appearance of rings on the skin often acts as a harbinger of exacerbation of rheumatic carditis and polyarthritis. For doctors, in most cases, ring erythema is a confirmation of the diagnosis of rheumatism.

Forms of non-rheumatoid annular erythema develop due to several other causes. Among them:

• Fungal lesions, such as foot mycosis and candidiasis;
• failures in the endocrine system;
• problems of the immune system;
• intoxication;
• focal infections (osteomyelitis, tonsillitis, cholecystitis and others);
• disproteinemia, or a violation of the protein composition of the blood;
• allergic reactions to medicines;
• leukemia, lymphoma, adenocarcinoma;
• sepsis;
• glomerulonephritis;

Treatment of annular erythema

With regard to the fight against such a disease asannular erythema, treatment is primarily aimed at eliminating the causes that caused skin lesions. If the disease is accompanied by the presence of infection in the body, prescribe antibiotics. Also in the fight against annular erythema, vitamin therapy is widely used, the use of immunostimulating, antihistamines, calcium and sodium thiosulfate. Nutrition requires compliance with a diet, in which allergens are absent from food. Therapy of erythema, the cause of which is rheumatism, is primarily aimed at combating the underlying disease.

Migrating erythema

If a single ring appears on the skintraces of a bite in the center, then we are talking about such a defeat as a migratory annular erythema. It is established that this type of disease can appear due to bites of ixodid ticks and some other insects.

The cause of migratory erythema developsinfection, more often viral or bacterial. The disease is quite difficult, often turning into a chronic form. It should be noted that migratory erythema has the property of being transmitted from mother to fetus. The initial symptoms are skin flushing, puffiness and peeling. The lesion focal point gradually increases in size and forms a peculiar fringe. Further stages are characterized by the development of exocytosis, which manifests itself as a protective function, with the cells of the affected tissues displacing toxic substances through the membrane to the surface. In the tissues, leukocyte infiltration is found. The infiltrate is subjected to careful analysis, which allows you to put the correct diagnosis.

It is characteristic that bites of ticks, bees, hornets andother insects cause the development of acute migratory erythema. A more complex and insidious kind of disease is considered to be its chronic form, the origin of which in most cases remains unknown. And erythema itself is characterized by severe swelling, pain and constant itching and burning. For the diagnosis of chronic erythema, a comprehensive examination is carried out, including a complete analysis of blood and urine, the study of infiltration and epidermis.

Treatment of migrating erythema

Therapy is carried out with the help of antibioticsbroad spectrum of action. The doctor selects the drugs depending on the form and stage of the disease. For example, in the first stage, a good effect is the use of the drug "Doxycycline" for one to two weeks. If the disease is severe, the doctor may prescribe Cetrioxone in tablets and Benzylpenicillin intramuscularly for 14-21 days. Additional therapy includes the intake of vitamins. The optimal choice of treatment for such a disease as migratory annular erythema, in most cases, promotes rapid recovery.

Erythema toxicum

This type of disease occurs innewborns and is manifested by rashes on the baby's body. The disease affects 20-40% of infants. According to the severity of the course, the toxic erythema is divided into a non-expressed and expressed (or generalized) form. In the first case, the rashes are minor and localized on the back and internal folds of the limbs. The general condition of the baby is assessed as satisfactory.

With generalized toxic erythemarashes multiple, they often merge with each other, forming vesicles. The temperature is increased, and the child becomes restless. In the blood of the infant, an increased content of eosinophils is found. This is a kind of leukocytes, performing a protective function when ingested allergens, as well as helminthic invasions.

Among the risk factors for the occurrence of toxic erythema are the following:

• hereditary burden;
• toxicosis of the pregnant, especially severe;
• employment of the future mother in harmful production;
• intrauterine infection with infection;
• presence in the diet of a pregnant or lactating woman of the food obligate allergens such as citrus, chicken egg, chocolate, honey, currant, raspberry and others;
• diabetes, thyroid disorders or obesity of the mother.

If the erythema of the newborn is a consequencepresence of allergens in breast milk or a mixture for feeding, the disease passes by itself on the 4-5th day after a review of nutrition. In severe forms of toxic erythema, special treatment is prescribed.

Erythema therapy of newborns

The toxic form of erythema requires treatment withits heavy forms. The doctor prescribes correctly selected antihistamines and special ointments or creams. It is important at the stage of treatment to exclude the receipt of allergens in the body of the mother and child. As an auxiliary treatment, "Calcium Gluconate", vitamins, "Rutin" are used. Rashes and vesicles must be treated several times a day with greenery or a weak 4-5% solution of potassium permanganate, and after the procedure, put on the baby's skin a baby powder.

Erythema multiforme

This inflammation of the skin and mucous membranes, at the basewhich is the allergic reaction of the body. The multiform erythema affects the limbs, the mucous membranes of the mouth, the genitals and the nose. The disease occurs in both children and adults.

Certain medications and some infectionspromote the development of exudative erythema multiforme. This type of disease is caused by penicillin antibiotics, barbiturates, sulfonamides and other drugs. Of infections, the most common causes of erythema multiforme are mycoplasmosis and herpes. The most severe is erythema, caused by a reaction to drugs. For example, Stevens-Johnson syndrome.

Treatment of erythema multiforme

To combat the disease are used as general,and local methods of therapy. The first is the use of antibiotics and antihistamines, the use of immunostimulants. At the same time, the patient's chronic illnesses are treated. Local treatment is expressed in the use of analgesics and antiseptics, such as "Chlorhexidine" or "Furacilin", ointments containing prenisolone and hydrocortisone. Important is the thorough hygiene of the oral cavity and other mucous membranes.