Erythroderma - a generic name of various skin lesions, severe joint generalized redness of the skin with a characteristic krupnoplastinchatym peeling.Erythrosis increasingly common in males (2: 1 ratio with respect to women) after forty years.The incidence of the disease - about 1% of all seating hospitalizations for skin diseases.
Erythroderma has the following features: a significant prevalence, reaching sometimes up to almost absolute destruction of the skin;constant peeling skin, both at the initial and at a later stage of development, from pityriasis and mukovidnogo to the sheet-like or plate-like;resistance to treatment.
Distinguish primary and secondary erythroderma.And if the primary appear as if out of nowhere, with no apparent prior predisposing factors, the secondary as if superimposed on the already present in human skin diseases.The development of erythroderma may cause the following fairly common diseases: toxic epidermal necrolysis, Stasis dermatitis, Lyme diseas
Erythroderma can occur acute, subacute, chronic.The acute form of erythroderma is usually caused by hypersensitivity (any allergic) patients to different drugs (antibiotics, sulfonamides, mercury, arsenic and so on.).Chronic erythroderma is a consequence of the presence of a person of common diseases (mycosis fungoides, Hodgkin's disease, reticulosis, leukemia, etc.).
For one of the most important symptoms of erythroderma include: a significant increase in body temperature, general grave condition of the patient, hair loss, lymphadenopathy, serious defeat nail plates, sometimes until they peel.Because sweating and a significant expansion of superficial skin vessels, there is high heat, which manifests the constant feeling of cold, chill, which is further enhanced on the background of chills and fever.
Other subjective feelings include feeling of constriction and dryness of the skin, paresthesia, burning and itching.In severe cases, there may be swelling, causes of which can be a heart failure and hypoproteinemia.
Erythroderma in the early stages usually has the following symptoms:
- In the event of acute onset or development against the backdrop exudative dermatitis observed such phenomena: a significant thinning of the epidermis, exudation to form crusts, erythema
- Mandatory exacerbation of concomitant diseases
- Generalizedmelkoplastinchatoe peeling with lihenifikatsiya skin and nekordinalnoy erythema
- in the absence of concomitant diseases commonly observed lesion of the scalp, perineum and the trunk, and then - generalization areas defeat
Erythroderma in later stages of development, has the following symptoms:
- Hair Loss, atrophicnail infections, dryness of mucous membranes
- An increase in body temperature, chills, tachycardia
- Enlargement of the spleen, liver enlargement, lymphadenopathy
- In the case of related leukemia or lymphomas observed steatorrhea and gynecomastia
This type of erythroderma develops due to the impact of such precipitating factors as excessive sun exposure, neuro-psychological overload, poorly chosen therapy with Tsingoderma, Tsingolina, Hrizorabina, psoriasin, antibiotics and other irritants.Psoriatic erythroderma within the context of this disease events (lymphadenopathy, fever and so on.) Manifests persistent generalized compacted redness, feeling of chill, burning and tightening of the skin and severe scaling.
erythrodermic psoriasis treatment at an early stage based on the use of the drug mixture of alternating components such as sodium thiosulfate and neogemodez.In some cases, treatment erythrodermic psoriasis based on the use of cytostatics (methotrexate, etc.).However, they should be used very carefully, because there are quite likely to develop serious complications.
treatment of all types of erythroderma is usually conducted on similar principles.The first shows the therapy of the underlying disease that caused the development of erythroderma.At the same time shows the absolute abolition of all of drugs that were taken before the development of skin process (this does not apply to the reception of essential drugs).
The patient should be placed in a separate room in which the possibility of regulation of humidity and temperature (infectious or kombustiologichesky hospital).Using conventional chambers is also acceptable, but they should be repeatedly daily wet cleaning, bed linen and kvartsevanie.
If the primary process, against which there erythrosis has not been established, the application shows a standard therapeutic complex, a major role in the introduction of which is withdrawn detoxicants (Reamberin, Sorbilakt, Polidez, Neogemodez, Reosorbilakt) together with 5% prum albumin.In some cases, it shows the use of amino acids and fat emulsions (Lipofundin etc.) For parenteral nutrition, in / prescribe sodium thiosulfate.If erythroderma was caused by exposure to heavy metal poisoning, or on the soil, to use Unithiol shown.Also, according to indications shown holding the correction fluid and electrolyte disturbances.In addition, it is necessary to strictly control the volume of fluid injected and released.
Due to the fact that some types of erythrodermic develop against any malignant processes are immune or nature shows the assignment of selective immunosuppressants, cytostatics and corticosteroids.However, systemic treatment with these agents can be carried out only in case of a well established type of erythroderma.
Because most erythrosis accompanies the violation of differentiation and keratinization cells, and abnormal keratinization, shown to the appointment of aromatic retinoids.However, the appointment of these drugs should exercise extreme caution, as they are able to cause erythroderma, having also quite a wide range of side effects.
occurring in severe widespread erythrodermic shown holding hemosorption, limfotsitofereza, lazmafereza and others. Treatment of erythroderma, eczematous manifestations, and is accompanied by itching, it is to appoint antimediatornyh funds antagonize histamine and other biogenic amines.Also shown is the appointment of vitamins E, A, C, B.
erythroderma Local treatment is purely symptomatic and consists in the application of topical corticosteroids, emollients, 0.1-1% salicylic ointment, as well as taking baths with the addition of potassium permanganate (manganese)and infusions of herbs.