toxicoderma - acute inflammatory toxic-allergic lesions of the skin that develops under the influence of penetrating into the skin kroverodnym by allergen.Toksikodermiya large variety of different elements of the rash (blisters, pustules, vesicles, papules, patches), and is often accompanied by lesions of the mucous membranes.
majority of recorded cases toxicoderma proceeds in the form of allergic reaction of immediate type organism that has developed in connection with congenital intolerance or after acquired sensitization.Thus, a causal factor toxicoderma unlike allergic contact dermatitis, is not in contact with the skin of the patient.Because of toxic allergen enters the body by other means, is absorbed into the blood, and the blood flow delivers it to the skin.The most severe form is toxicoderma Lyell's syndrome, Stevens-Johnson syndrome.
severity of clinical symptoms toxicoderma depends on the amount taken into the body of the allergen, its antigenic activity, frequency of
Modern Dermatology distinguishes four groups of etiological causes of toxicoderma: autotoksicheskaya, professional, alimentary and drug.
Autotoksicheskaya toksikodermiya develops as a result of exposure to toxins and allergens, self-produced in the human body under the influence of a variety of metabolic disorders.This condition can occur in the presence of various malignancies (cancer of the colon, adenocarcinoma of the kidney, lung cancer), chronic kidney disease (chronic renal insufficiency, glomerulonephritis, hydronephrosis, pyelonephritis), and gastrointestinal tract (peptic ulcer disease, pancreatitis, hepatitis, gastritis).Often autotoksicheskaya toksikodermiya flows into chronic.
Professional toksikodermiya caused by human activity, which is associated with a variety of chemical compounds.The most active antigens include substances that contain chlorine and a benzene ring with an amino group.
Alimentary toksikodermiya develops due to consumption of any food or in its composition various additives (preservatives, disintegrating agents, coloring agents).
Drug toksikodermiya occurs most often develops as a result of receiving a variety of medications.Usually its appearance provoke serum barbiturates, vitamins, antibiotics (streptomycin, neomycin, penicillin, biomitsin), sulfonamides (Norsulfazol, Sulfadimidine).
for clinical toxicoderma peculiar to a great variety of forms.Skin rashes can wear papullo-vesicular, urticarial, erythematous, vesicular and papullezny character.Mucosal lesions of the lips and mouth may be hemorrhagic, catarrhal or vesico-erosive character.Sometimes toxicoderma observed destruction not only of oral mucosa, anal mucosa and rectum, urethra and genitalia.Elements of the rash on the skin and mucous membranes are usually accompanied by subjective sensations such as an itchy skin in the places of defeat, pain, burning, tension.
toxicoderma often accompanied by general symptoms: recurrent arthralgia, fever, and malaise.In the rash is almost always a severe pruritus that due to the constant discomfort can cause a variety of disorders of the nervous system adequate, irritability, sleep disturbances, and emotional lability.It is also often joins symptoms, indicating toxic-allergic lesions of the liver and / or kidneys.The presence of hemorrhagic syndrome suggests the presence of lesions of the vessel wall.
Separately want to note that different people have the same provocative material can provoke different options toxicoderma.However, on the other hand, most substances causing toxicoderma with characteristic for the clinical picture of them.For example, develop a toxicoderma after taking iodine salt is always accompanied by the so-called "iodine acne", is a towering above the skin crusting juicy soft plaque.
Depending on the breadth of distribution of clinical manifestations, toxicoderma divided into common and fixed.Common
toksikodermiya multiple different eruptions often affects the mucous membranes and / or internal organs, with the subsequent development of renal failure, hepatitis, myocarditis.Also in this form is characterized by fairly severe general condition of the patient, vomiting, diarrhea, chills accompanied by fever.
Fixed toksikodermiya usually manifested on the skin a few rounded erythematous patches with a diameter of two to three centimeters.Over time, the data spots usually acquire a brownish color in the central part of some of them there is the formation of bubbles.In the case of the timely elimination of further intake of the patient provoking allergen fixed toksikodermiya usually disappear on their own within ten days.Repeated ingestion of a provoking factor, a rash may develop on the same field, and in front of these pristine areas of the skin.
Separation toxicoderma severity:
- First degree toxicoderma accompanied by a rash (nodules, urticaria, erythematous spots) and minor skin itch.Symptoms of the disease is expressed softly, after the exclusion of the allergen enters the body, recover within a few days
- Second degree toxicoderma accompanied by a low grade fever and mild pruritus.There may be individual blisters, nodules, vesicles, urticaria and erythema of light.Clinical blood tests show an accelerated erythrocyte sedimentation rate, and changes in the form of eosinophilia
- Third Degree toxicoderma appears quite serious violations of the general state of nausea, vomiting, a rise in temperature to 40 ° C.The elements have a generalized rash: Lyell's syndrome, angioedema, urticaria, erythroderma may develop this very dangerous condition as anaphylactic shock.Sometimes there are very severe forms of the disease and how yododerma bromoderma.There are cases when toksikodermiya develop absolutely all medicated preparations, except glucose and physical.solution
differential diagnosis toxicoderma should be carried out with such diseases dermatological nature as allergic vasculitis, erythema multiforme, systemic lupus erythematosus, urticaria, lichen planus, secondary syphilis, pink zoster Gibert, as well as infectious diseases such as measles, rubella and scarlet fever.
First toxicoderma treatment begins with a mandatory exclusion impacts caused her provoking substances.To do this, autotoksicheskom and elementary toxicoderma embodiment shows the use of cleansing enemas, diuretics and laxatives, antihistamines (Claritin, etc.) In / in a desensitizing solution of calcium chloride and sodium thiosulfate. toxicoderma If the development is due to the use of sulfonamides - in / in a sodium thiosulfate is strictly prohibited!
In severe forms toxicoderma shown holding of extracorporeal blood purification how krioaferez, cascade filtration plasma membrane plasmapheresis, hemosorption.Treatment of severe forms should be carried out only in a specialized hospital appointment or intravenous reopoliglyukina gemodeza, albumin, or plasma, taking corticosteroids, antibiotics, and preventive maintenance of adequate health liver and kidneys.
toxicoderma Local therapy is the use of local antipruritic and anti-inflammatory drugs, glucocorticosteroid ointments, aqueous suspensions or powders shaken with zinc oxide.Lots soak should be treated with disinfectant and astringent, and aniline dyes.
To reduce the incidence of dosage form toxicoderma avoid uncontrolled medication, to deal with self-treatment, in a timely manner to carry out sanitation of foci of infection, enhance their knowledge of this disease as a drug allergy.In addition, great importance should be given to the treatment of common diseases (alcoholism, diabetes, diseases of the nervous system and the digestive tract) that can create the preconditions for the development of toxicoderma.
The daily diet should strictly limit the use of salt (in some cases for several days shows general table salt-free), extractives, carbohydrates, smoked and canned.In the first three to five days shows the assignment of plant-dairy diet.Later in the diet gradually introduced into meat and boiled fish.Throughout the treatment period is recommended to drink plenty of liquids.