Nodosum (nodes) erythema

March 11, 2013

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Erythema nodosum   - A disease in which there is loss of skin and subcutaneous vascular inflammatory. This disease is allergic in nature. In the course of its development the patient has dense hemispherical painful knots. They may have a different size and usually appear symmetrically on the lower extremities.

First, the term " nodular erythema "Dermatologist introduced in the UK Robert Villano   at 1807 . More recent studies have made it possible to conclude that the nodal erythema - is one embodiment and llergicheskogo vasculitis . If we compare symptoms with systemic vasculitis , Then the node is marked erythema localized vascular lesions, which appear mainly on the legs.

The disease can occur in patients of any age, but often the disease affects people in the age group from 20 to 30 years . If before puberty nodal erythema distributed equally among both sexes, after this period, erythema nodosum occurs in women 3-6 times   often. The number of cases increases in winter and spring.

Causes of erythema nodosum

Erythema nodosum develops in the human body due to the manifestation of infectious processes. First of all, we are talking about streptococcal infections . Consequently, when the disease develops sore throat . scarlet fever . pharyngitis . otitis   and other diseases. Also, the symptoms of erythema nodosum occur in patients Tuberculosis . Less disease develops when iersinioza . trihofitii . coccidioidomycosis . poradenitis . In addition, the cause of the disease and may be a result of taking medication sensitization sulfonamides . salicylates . iodides . bromides . antibiotics And as a consequence Vaccination .

Often severe erythema nodosum in children and adults is shown at sarcoidosis . Noncommunicable reasons for developing the disease, it is Behcet's disease . inflammatory bowel diseases . ulcerative colitis . oncological diseases . But in these cases the symptoms occur less frequently. Nodal erythema may also occur pregnancy , At a dose of foci of chronic infections. Sometimes nodular erythema is diagnosed in several canoes family, it is possible to speak about hereditary tendency to erythema nodosum. For chronic disease tend to people who have observed violations related to the vessels, the tendency to allergic diseases.

It is very important to diagnosis of the disease was carried out timely and accurately. In determining how to treat erythema nodosum, the doctor must find out exactly what was the root cause of it. But in any case the treatment of erythema nodosum is always carried out only under the supervision of a specialist.

Symptoms

The main manifestation of the disease is the presence of dense nodes, which are located in the lower dermis or subcutaneous tissue. Such nodes can have different diameters: it ranges from 5 mm to 5 cm. Above units and smooth skin red. Nodes slightly rise above the common skin, but clear boundaries are not observed, as the tissue around the swell. These nodes grow very quickly, but increased to a certain size, they stop growing.

In people with erythema nodosum pain can be different. It can manifest as during palpation, and from time to time occur spontaneously. Itching in the affected areas are not shown.

After about 3-5 days it occurs permit nodes. They are sealed and do not break. The characteristic symptom - the change in color of the skin in areas of the nodes. This process is similar to how gradually passes bruise . First, the skin is brownish, and then turn blue, and gradually turn yellow.

The most common sites with the erythema nodosum appear on the front of the leg. In most cases the damage is symmetrical, but sometimes there are one-sided or single eruption. In all parts of the body where the subcutaneous fat may appear elements of erythema nodosum. They appear on the calves, thighs, buttocks, face, and sometimes episclera eyeball.

Most often, erythema nodosum begins acutely. The man says fever, chills, fatigue, lack of appetite.

Most of the patients with nodular erythema observed arthropathy : Worried about joint pain, morning stiffness, pain on palpation. Approximately one third of patients have symptoms of inflammation in the joint ( Arthritis ). The skin in the joint becomes red and swells, there is intra-articular effusion. In the presence of articular syndrome in patients with erythema nodosum large joints are affected symmetrically. Can swell the small joints of the hands and feet. Common symptoms of arthropathy and sometimes lie for a few days before the elements on the skin.

Depending on the severity of the disease within two to three weeks nodes completely resolved. In the place where they were located, while there may be hyperpigmentation and peeling of the skin . When disappear cutaneous manifestations, also runs joint syndrome. The acute period of the disease lasts for about one month.

Chronic disease with periodic relapses observed more rarely. In exacerbations there is a small number of nodes. Typically, units are isolated, they are dense, bluish-pink, and may persist for several months. Sometimes the skin manifestations accompanied by chronic arthropathy, but the joints are not deformed.

Types of erythema

To the treatment of erythema was the most effective in diagnosing necessarily determined by the type of erythema. It identifies several different types of this disease. Toxic erythema   It appears in newborns and is the physiological norm. The child has a skin rash. Other symptoms are not observed. This is a natural manifestation that disappears on its own in about a week after the appearance.

Infectious erythema   It occurs in humans suffering from acute infectious illnesses of unknown etiology. It manifested in adults and children.

Erythema multiforme exudative Usually develops when colds. The characteristic symptom is a severe headache, general malaise and weakness, joint pain, rash and throat, which mainly occur on the skin of the hands and feet, as well as on the hands, legs, genitals, oral mucosa. Pronounced rashes can be discerned even in the photo. This reddish spots with clear boundaries that are sometimes bubbles with serous content, which opened on their own, and then left bleeding erosion. If the disease is left untreated, it may cause death.

Erythema migrans   - A characteristic symptom Lyme disease Which is transmitted in the course of a tick bite. Around the place where the stuck tick appears annular erythema, which is rapidly increasing and at the same pale in the center.

Annular erythema   - chronic illness. The reasons for its appearance - the body poisoning, infectious diseases, as well as allergic reactions. It is characterized by the appearance of spots that have a rounded shape. These spots merge into the rings. Most often the disease develops in young men.

There are also other types of erythema, which are manifested in certain pathologies and diseases.

Diagnostics

During the initial diagnosis the doctor examines the patient. Be sure to be appointed by laboratory tests. Note, however, that changes in the data of these studies are nonspecific. Still, they can be used to differentiate the disease, as well as to determine the cause and associated diseases. The results of clinical blood analysis in acute erythema nodosum or relapse of chronic disease indicated an increased ESR   and leukocytosis . To determine the presence of streptococcal infection in the body, made bakposev from the nasopharynx. If the doctor suspects yersiniosis, the doctor prescribes conduct fecal bacterial inoculation test. To eliminate tuberculosis, carried out tuberculin. In case of complaints of the patient on the severity of the articular syndrome should consult a specialist, rheumatologist and subsequent blood tests for rheumatoid factor.

If there are difficulties in the process of confirming the diagnosis, it is possible to conduct a biopsy of one of the nodes. During the histological study can detect inflammation.

To determine the origin of the disease, the presence of vascular disorders, foci of chronic infection, the patient should consult with infectious diseases, pulmonology, otolaryngology and other professionals. Also, if necessary, in the diagnostic process is carried out rhinoscopy . pharyngoscope . radiography   and CT of the lungs . Study veins . rheovasography lower extremities   and etc.

The study reveals the lungs tuberculosis . sarcoidosis   or other pathological processes in lungs.

Treatment

Will therapy erythema nodosum effective depends on whether adequate treatment of the underlying disease or diseases. It is necessary to reorganize chronic foci of infection, if necessary, treatment is prescribed antibiotics, desensitizing treatment. It is also recommended intake of vitamins C, P, calcium chloride. To stop the inflammatory process and prevent pain, patients with erythema nodosum appointed by nonsteroidal anti-inflammatory drugs. It Nurofen . diclofenac . Ibuprofen   and other medications. Also apply the methods of extracorporeal blood correction, practiced by laser irradiation of blood. All of these methods contribute to more rapid extinction of the symptoms of erythema nodosum.

It is also practiced by the local use of corticosteroids, anti-inflammatory ointments. If there is an inflammation in the joints, then they bandage with Dimexidum . Patients with erythema nodosum also prescribed physiotherapy treatments. Effective in the treatment of erythema nodosum UFO, magnetic therapy, phonophoresis with hydrocortisone in place inflamed nodes, laser therapy. But the most difficult to treat erythema nodosum during pregnancy, because at this time the reception of many drugs is contraindicated. In this case, it requires precise control specialist.