Annular granuloma (or anulyarnaya) refers to chronic and gradually relapsing, progressive dermatosis of unknown origin.For this disease is characterized by the occurrence of annular knots with the destruction of collagen, as well as granulomatous inflammatory reaction.Lesions can persist for years and then regress on their own.
Annular granuloma is able to proceed without subjective feelings at any age.Localization is often subject to the dorsum of the hands, elbows, feet and knees.Women are more likely than men disease.Some patients with annular granuloma is capable of receiving recurrent nature.
Annular granuloma causes
still causes of the disease remain unknown.A role in causing the disease is removed chronic infections such as sarcoidosis, tuberculosis, rheumatism.In this case, granulomatous process seen as a consequence of altered reactivity tissue.It is believed that allergic diseases are also prerequisites.Initially, the disease is on the type of phenomenon Arty
were found conflicting data on the relationship with endocrinopathies annular granuloma, which is associated with changes in carbohydrate metabolism.In this case, it is developing "hyperglycemia skin."There was a link between the disseminated annular granuloma and diabetes.
annular granuloma classification includes the following forms:
- typical, limited form of annular granuloma;
- atypical forms of annular granuloma consisting of subforms: papular (papule are isolated), disseminated, deep (subcutaneous nodule location), erythematous, perforating (leaving scars), lichenoid.
Annular granuloma symptoms
The disease starts with the appearance of smooth, dense, shiny papules purple, red and pink, flesh color without subjective sensations.A few months later papules can form annular plaques.The diameter of the plaque gradually increased, reaching a size of 0.5-10 cm. The center part becomes normal color or becomes slightly bluish.Lesions can occur simultaneously and can not be observed evolutionary polymorphism.This ulcerated lesions occur rarely.Localization of plaques is skin dorsum of the hands, elbows, feet, knees;rarely rash move on the neck, buttocks, upper arm.
Annular granuloma in children worried foot joints.The disease progresses in older people with diabetes mellitus.
Annular granuloma is differentiated from the following diseases: lipoid necrobiosis, melkouzelkovy sarcoidosis, tinea, rheumatoid nodules, lichen planus, erythema annular centrifugal Darya, tuberculoid type of leprosy, eczema nummulyarnaya.
Annular granuloma has a characteristic clinical picture and often does not need to conduct any additional methods of examination.Only in cases of doubt, carry out histological examination of biopsy of the skin.
Annular granuloma in children
disease in children is idiopathic, benign granulomatous dermatoses.The cause of the disease remains unknown.Presumably believe that the cause granuloma annulare act on the immune system.
Annular granuloma in children often occurs without symptoms and which expressed themselves.
Children granuloma annulare appears in place of scars and tattoos, as well as after such diseases as herpes zoster and warts.
The disease is divided into such forms: subcutaneous localized, disseminated, perforating.
Annular granuloma in children is often a localized form, in which there is a limited number or a single lesion.Dense papules are arranged in the form of rings or arcs, leaving the central region unaffected.Outbreaks can be distributed along the periphery, recurring at the same place.This epidermis is not affected.Often, the children found a form of annular lesions reach a value of 2-5 cm.
Annular granuloma is a localized form of children prefer to focus on the back of the hands and feet.Much less is rash in areas of large joints and other parts of the skin.
Annular granuloma is observed at the subcutaneous form olds in the form of single and multiple subcutaneous sites on the forearms, scalp, back of the hands, shins, elbows, fingers.
Annular granuloma in children treated
in disease outbreaks prescribe topical corticosteroids.Recommended local therapy with vitamin E, C, D2, obkalyvanie defeats hydrocortisone emulsion.In rare cases, a biopsy helps to come to a resolution of the hearth.Practice has a method such as surface scarification (notching).Kids still appoint Psoriderm applied on the lesion once a day, using an occlusive dressing length of two weeks.
Annular granuloma treatment
for the successful treatment of the correction of carbohydrate metabolism, being treated comorbidities (tuberculosis, chronic infections, diabetes mellitus).It recommends taking drugs that improve the microcirculation.These include Retinol, vitamins, tocopherol acetate, ergocalciferol, ascorbic acid, iron preparations.
The efficiency of the treatment at the centers of injecting Triamtsenolonom acetonide in a dose of 2.5-5 mg / ml.This technique contributes to long periods of remission.There is evidence of successful treatment with drugs such as the Diapson 100-200 mg / day, hydroxychloroquine, Niacinamide, isotretinoin at a dose of 1.5 g / day.
granuloma annular How to treat?
shown topically applied topical steroids, which are the alternative to hormone replacement therapy.At the same time the lesion irrigate chloroethylene.Applied also snow carbonic acid, liquid nitrogen.Common forms of dermatosis treated with PUVA therapy.
limited pockets of granuloma annular are eliminated using Phonophoresis 2.5% hydrocortisone with ihtiola and a combination of physical therapy techniques, which include a local vacuum decompression and Phonophoresis, local vacuum decompression and systemic enzyme therapy.It is established that this combination is capable of normalizing the immunological reactivity of the organism and to reduce the concentration of pathogenic immune complexes, C-reactive protein, blocking the formation of antibodies to DNA and rheumatoid factor.