erythema multiforme - a disease which is the inflammation spreads to the skin and mucous membranes.In essence this is the same multiforme or erythema multiforme characterized by a variety of painful symptoms.
exudative erythema occurs in two forms: idiopathic and symptomatic.Idiopathic exudative erythema in its origin is infectious and allergic genesis.A significant proportion of patients have chronic infectious foci: tonsillitis, carious teeth, periodontal disease, granulomas.Taps and the likelihood of viral origin of the disease.
Symptomatic form of exudative erythema occurs immediately after the drug therapy and has a toxic-allergenic nature of origin.Characterized by recurrent moments for the disease, including an explosion in the autumn and spring seasons.Exacerbations are observed in most of the 50% of patients.
exudative erythema able to have long-term for long.Often ill persons young and middle age.The children under five years are not subject to erythema multi
exudative erythema able to rapidly spread on the skin or mucous membranes.But maybe that is just and spread over the skin and mucous membranes.The first manifestations of the disease are in an acute form.Next exudative erythema becomes chronic.
exudative erythema reasons
Causes of exudative erythema, as well as mechanisms for its development remain unclear, but erythema conditionally divided into the true and idiopathic.When idiopathic form of the disease for the descent is an infection or an allergy.And the major pathogens Streptococcus or Staphylococcus believe.
But there is evidence of erythema due to herpes infection.In this case, once every three months, the following occurs: the mucous membranes of the mouth and eyelids are covered ulcers.With this treatment with antifungal drugs ineffective.Causes of exudative erythema acts vitamin deficiency, weakened immunity.
first signs of erythema multiforme is a fever, aches, and malaise.Two days later, the body having on the red and blue spots having a slightly convex shape.
Symptoms of toxic-allergic form of erythema multiforme have allergic genesis and associated with the occurrence of allergic reactions to medications: sulfa drugs, antibiotics, barbiturates, Amidopyrine, serum Antipyrin vaccines.For the clinical picture is characterized by acute onset and severe course of the disease.Idiopathic exudative erythema characterized by prodromal events (low-grade fever, muscle aches, sore throat, joint pain, malaise).All symptoms arise due to hypothermia or acute respiratory disease and angina.
erythema multiforme is characterized by symmetrical common skin lesions.Places concentration are located mainly on the extensor surfaces of the extremities: the face, forearms, hands, neck, lower leg, back of the feet.
often joins the process and mucosa, located in the mouth.Primary morphological elements rashes appear swollen papules (inflammation spots), with sharp edges, rounded shapes, reaching a diameter of 3 to 15 mm.Wherein the color varies from red-pink to bright red.
edges eruption characterized by a roller, and the central part of the element, the West, becomes cyanotic shade.These spots are able to merge and form a figure with polycyclic contours (arc garlands).At the same time inflammation spots appear blisters, sometimes bubbles, and even less bubbles (bullous form).
There are papular, blotchy, maculopapular, bullous, vesicular and vezikobulleznuyu form of the disease.This inflamed oral mucosa in 60% of patients.Rash is able to occur on the genitals, in the folds of the skin, conjunctiva, which later takes its transformation into a moist erosion, which are covered or purulent bloody crusts.New rash occurs in the first days after the illness.She is accompanied by fever, malaise, headache.This process is delayed up to 15 days and then begins recovery.Rarely observed hyperpigmentation local lesions.
Clinic symptomatic erythema multiforme is the same in the absence of the disease due to the seasonality of infections and relapses.Symptomatic form and is caused due to the re-admission of the drug - an allergen.
notes that this form of skin rash is spreading in nature, and mucous membranes of the mouth in most of the infected patients.Relapses rashes occur on repeated areas of skin and mucous membranes.Disturb blotchy rash and painful blisters with erosions that prevent ingestion.
maculopapular form of the disease is characterized by intracellular edema in the epidermis, the patient worried spongiosis, perivascular infiltration and edema papillary dermis.There are multi-chambered subepidermal and intraepidermal vesicle that goes directly to necrobiotic changes, the introduction of infiltration into the epidermis, and the subsequent development of necrosis.
erythema multiforme is diagnosed after the acute onset of the disease (respiratory disease or after taking drugs) with a bright pronounced symptoms: symmetrical rash located on the extensor limbs with lesions of the mucosa of the lips and mouth.
When diagnosing pay attention to the specific primary cells - inflammatory patches (edematous papules) red, juicy colors, with the growth in the middle and forming annular elements.
height of the disease is usually accompanied by polymorphism rash (papules, patches, blisters, bubbles, rarely vesicles).
Polymorphic erythema multiforme is diagnosed by immunological tests (blast transformation of lymphocytes, Shelley).
exudative erythema multiforme stands symptoms (rashes character), and it differs from other forms of diseases.
Depending on the predominance of elements of rash and severity of symptoms are three forms of the clinic exudative erythema:
- Papular simple form, which flows easily with the elements of the rash: papules, plaques, erythematous spots and lesions of the mucous membranes
- bullous form usually causes erythematous plaqueshaving a bubble in the center of the ring and the periphery of the bubbles.Often, always accompanied by the pathological process of the mucous membranes in the small number of lesions
- Severe bullous form (Stevens Johnson syndrome), including skin lesions and mucous membranes of the eyes, mouth, vulvovaginal and anogenital areas, sometimes turning into Lyell's syndrome
duration of illnessfrom three to six weeks.
erythema multiforme treatment
Effective treatment of exudative erythema implies total and topical therapy.Acute period of the disease is treated by corticosteroids (20 to 60 mg per day to three weeks, severe treated parenterally to 150 mg).To avoid patient detoxification prescribed excessive drinking, diuretics, plasmapheresis, as recommended intravenous drip the introduction gemodeza, 10% albumin solution, saline, 5% glucose solution.
Patients must take chelators (activated carbon, enterosgel), antihistamines (pipolfen, diphenhydramine, Diazolin, Suprastin), as well as desensitizing agents (Sodium thiosulfate, calcium gluconate).
exudative erythema with recurrent induced foci of chronic infection treated with broad-spectrum antibiotics.In the case of suspected viral origin of the disease designate receiving antivirals (Famvir, Acyclovir).
shown immunomodulation (gistoglobulin, autohemotherapy, staphylococcal toxoid timalin, pirogenal, taktivin).Good effect antiviral and immunomodulatory gives appointment Panavir intravenously.
processing elements bullous rash needs aniline dye (solution of brilliant green, fukortsin, methylene blue).After calming down ostrovospalitelnyh phenomena ointments regenerating action (kseroformnaya, dermatolovaya "Solkoseril" methyluracyl "Aktovegin").Papules and patches treated with corticosteroid ointments and creams nourishing anti-inflammatory action.
Relapse prevention exudative erythema includes a comprehensive examination of patients, which is defined as the study of immune status, as well as a selection of more optimal method of chemiluminescence immunomodulators and the subsequent reorganization of the identified lesions.