Erythema - photos, symptoms and treatment, what is it, types, mcb code 10

Symptomatic erythema belongs to the group of the most common erythema. The main manifestation of erythema is a pronounced reddening of the skin (most often the skin of the face, neck and upper chest) against the background of the influence of vivid emotions, stress, anger, etc.

Redness of the skin is caused by the temporary expansion of the skin vessels.

Erythema ultraviolet

This type of erythema is a vascular reaction of the skin to ultraviolet radiation.

Immediate ultraviolet erythema occurs immediately after irradiation with ultraviolet light and disappears within half an hour after the cessation of the provoking factor.

Immediate erythema occurs as a result of thermal exposure to the skin.

Late erythema develops within 3-7 hours after exposure to ultraviolet radiation. The maximum severity of erythema is recorded within a day after exposure to a provoking factor.

Late erythema develop as a result of exposure to ultraviolet radiation on the skin vessels.

With intense irradiation at the site of erythema, edema, peeling, skin soreness, blisters filled with serous contents, etc. can be noted.

Cold erythema Edit

This type of erythema develops as a result of exposure to low temperatures on the body.

Congenital defects of serotonin metabolism are considered the cause of the development of cold erythema.

Symptoms of cold erythema are manifested by an erythematous rash (without urticarial components), swelling, sometimes itching.

Acquired Palmar Erythema Edit

The main reason for the development of acquired palmar erythema is severe liver disease. In this regard, this type of erythema is also called "hepatic palms."

Also, palmar erythema can develop against the background of polyarthritis, lung diseases, subacute bacterial endocarditis, pregnancy, etc.

Symptoms of erythema are the appearance of a motley finely spotted palm color, a sharp restriction of hyperemia in the hypotenar region and the subsequent spread of erythema to the entire palmar surface.

Erythema can also occur around the nail bed and on the lateral surfaces of the fingers.

Toxic erythema of the newborn

Moderately expressed neonatal erythema occurs in approximately 50% of newborns. The nature of the disease is unknown. Patients have marked eosinophilia, however, at the moment, it has not been possible to detect allergens or an infectious agent.

Most often, symptoms of erythema appear 1-2 days after birth. The disease is accompanied by the appearance of multiple spots on the skin of the chest and abdomen. To a lesser extent, the skin of the face, shoulders and hips is affected.

After 1-2 days, the spots spontaneously disappear.

In rare cases, the development of periorbital edema, urticarial, papular or pustular rash is noted.

Scarlet fever desquamative erythema Edit

This disease is accompanied by the development of erythematous-desquamative rashes against the background of the effect on the body of staphylococcal and streptococcal toxins (less commonly, drugs).

The course of the disease is benign, the prognosis is favorable.

The onset of the disease is acute. The appearance of headaches, nausea, febrile and intoxication symptoms. The rash with scarlet fever desquamative erythema is bright red, generalized. Rashes are accompanied by burning and itching.

After a few days, the rash disappears, but there remains a pronounced pityriasis peeling, most noticeable on the feet and palms.

In rare cases, the development of alopecia, bronchitis, enteritis, arthritis, etc. is noted.

Bloom's Congenital Telangiectatic Erythema

This type of erythema is hereditary (autosomal recessive inheritance). Men get sick more often than women.

The disease is manifested by dwarf growth and specific erythema of the face. The first signs of Bloom erythema are observed in infancy or early childhood and clinically resemble the debut of lupus erythematosus.

Erythematous spots and plaques affect the skin of the nose and cheeks, resembling a butterfly. In rare cases, the skin of the eyelids, forehead, ears, hands, etc. is affected.

Affected skin peels off, under the influence of insolation, the formation of blisters and crusts is noted.

Ring-shaped centrifugal erythema Daria

This type of erythema is also called "persistent erythema", "curly persistent erythema", "arched persistent erythema", etc.

The exact cause of the disease is unknown. The connection between erythema and fungal infection of the feet, carcinomas, candidiasis, dysproteinemia, allergies to drugs, immune disorders, etc. is noted.

The course of the disease is chronic. The debut is most often celebrated at a young age.

The first symptom of Daria erythema is the appearance of small pinkish nodules, which slowly increase and lead to the formation of a ring-shaped depression in the center.

Due to the uneven increase in the nodule, it often acquires an arched shape.

The foci are multiple and itchy. The edges of erythema are smooth or slightly flaky. In rare cases, small vesicles are noted along the edge of erythema.

Most often, the skin of the trunk and legs is affected. The skin of the hands and face is less commonly affected.

Treatment depends on the underlying disease.

Treatment of cold, thermal, ultraviolet, etc. erythema is symptomatic. It is also mandatory to exclude the effects of a provoking factor.

Classification

In medicine, there are a fairly large number of clinical forms of skin erythema, but it is worth highlighting such:

  • knotty (nodose) skin erythema,
  • annular erythema or centrifugal erythema darya,
  • migratory
  • sunburn,
  • infectious (viral)
  • toxic or erythema in newborns,
  • erythema multiforme or erythema polymorphic,
  • exudative erythema,
  • palmar erythema or erythema of the palms.

Knotty shape

In this case, red spots are localized on the surface of the skin. When feeling, you can find that their structure is dense. They cause discomfort to the patient. Pathological formations can disappear spontaneously, and can last for several days. With such skin erythema, the inflammatory process is localized in the subcutaneous fatty tissue, as well as in the thickness of the skin itself. The sizes of the nodes are different - from 1 cm to 10 cm. Usually, the nodes are localized on the lower leg and on the inner side of the thigh.

Sometimes the progression of the disease contributes to viral pathology. In this case, the main clinic is supplemented with the following symptoms - overall health worsens, the temperature rises, joint pain, possibly inflammation of the eye mucosa.

Ring shape

Pathology begins to progress due to infectious ailments, poisoning of the body, an allergic reaction. In this case, round spots appear on the human skin, which tend to merge. They may protrude somewhat above the skin. The periphery of the ring is colored red. The central part of the formation of normal color. Size - from 2 to 8 cm in diameter.

Migratory form

This is a chronic ailment. Usually it develops after a bite of a forest tick. Outwardly, it appears first in the form of a red speck, which begins to grow rapidly as the pathology progresses. Peeling is not observed. Symptoms of pathology can independently disappear after a couple of months. But it is also possible the development of complications (damage to the central nervous system).

Solar form

Solar erythema is a pathology that develops as a result of prolonged exposure to ultraviolet skin. It is worth noting that for the life of the patient, the disease does not carry any danger. Symptoms of solar erythema:

  • the skin turns red after a long stay in direct sunlight,
  • the affected areas begin to itch,
  • in the place of localization of erythema, bubbles form that can spontaneously open with the release of exudate,
  • after a few days, the affected areas begin to peel off.

Infectious erythema

The causes of its progression are pathogenic microorganisms.

  • temperature rise,
  • chills,
  • signs of intoxication,
  • pathological spots form on the body, which tend to merge (the formation of large foci is possible).

Toxic form

This form is also called erythema of the newborn, as it manifests itself in babies in the first few days of their life. On the skin of the child, rashes appear that spontaneously disappear, so no specific treatment is required. With erythema of the newborn, a slight increase in temperature is possible.

Erythema in children in the first days of life is a peculiar symptom of the adaptation of their body to the outside world. Red spots form on the body, which have a denser structure than other tissues. Sometimes small vesicles may appear on them, inside filled with serous exudate. Typically, the lesions are localized on the head, on the bends of the legs and arms, on the buttocks.

Erythema multiforme

Polymorphic exudative erythema can affect both the mucous membranes and the skin. She is more susceptible to young men. This form of pathology is much harder than the rest - the symptoms are very pronounced:

  • fever
  • muscle and joint pain
  • first, pathological spots form, which later degenerate into blisters filled with serous or hemorrhagic fluid,
  • the rashes are painful and itchy,
  • possible development of keratitis or conjunctivitis.

It is worth noting that if the pathology proceeds in a severe form, then even a fatal outcome is possible.

Exudative form

Exudative erythema is an inflammatory disease that affects the mucous membrane and skin. As a result of its development, red spots, blisters and other elements of the rash form on the affected areas of the skin. Exudative erythema occurs in acute form, but there is the possibility of its transition to chronic.

The causative agents of exudative erythema:

Palmar form

Palmar erythema is a pathology in which there is a symmetrical redness of the palms of the hands. Most often this is observed in chronic liver ailments, pregnancy, rheumatoid arthritis, leukemia and so on. It is worth noting that palmar erythema can occur on the body even in healthy people.

Treatment of erythema should only be comprehensive. The first stage is to identify and eliminate the true cause that provoked the progression of the pathology. For example, to cure infectious diseases, abandon procedures that can irritate the skin and so on.

The second stage is drug treatment. Assign to take antibiotics, corticosteroids, angioprotectors and more. Sometimes doctors prescribe drugs containing substances that strengthen the walls of blood vessels.

Treatment recommendations:

  • bed rest
  • to perform physical exercises
  • dieting
  • rejection of allergens - alcohol, chocolate, citrus fruits, coffee and more.

Erythema - what is it?

This term of Greek origin ("erythros" - red) refers to the pronounced redness of the skin due to the expansion of capillaries. These small vessels are located directly in the skin, so a rush of blood to them is clearly visible externally. It may be one of the symptoms of an infectious and inflammatory process in the body, but it often has purely physiological reasons not associated with any diseases.

Erythema should be divided into active, due to acute inflammatory process and passive, associated with stagnation of blood (venous stasis).

Causes of occurrence

Normally, redness of the skin is a temporary phenomenon that quickly disappears after elimination of an irritating factor (for example, caused by an emotional outburst). Pathological forms are characterized by durability and duration, their main reasons are:

  • inflammatory infections of a viral or bacterial origin,
  • burns of the skin (solar, radiation, chemical),
  • allergic erythema - a consequence of exposure to the body of allergens,
  • autoimmune diseases (systemic lupus erythematosus).

Among the physiological factors of redness, one can single out the ingestion or local use of certain medications (for example, warming ointments), physical effects such as flogging or massage, UV irradiation in the sun, preceding tanning. Reflex skin color change is caused by strong emotions (shame, anger), orgasm, sometimes hypnotic suggestion.

The mechanism of development of the pathological process is determined by the action of the irritating agent. Viruses or bacteria provoke inflammation and general intoxication, accompanied by fever and a rush of blood to small vessels. With burns and allergies, redness appears due to the release of histamine into the bloodstream, expanding the capillaries and contributing to stagnation of blood in them.

Diagnostics

It is quite difficult to diagnose one of the many varieties of erythema, since the characteristic redness of the skin and the accompanying symptoms are characteristic of many diseases. For example, with scarlet fever, rubella, or measles. After a preliminary, initial diagnosis, the dermatologist prescribes specific tests:

  • a serological test to detect the presence of antibodies to the virus that caused the disease,
  • general blood test to determine the number of shaped elements,
  • allergological tests,
  • taking exudate from pustules, if any.

It is also necessary to first exclude the physiological causes of erythema and go through a differential diagnosis.

Erythema - photos, symptoms and treatment

There are more than two dozen varieties of this disease, and each of them has its own causes and external clinical signs. The type of redness and concomitant symptoms allow the dermatologist even at the initial examination to reliably diagnose one or another type of erythema.

The following forms are distinguished:

  1. Symptomatic (emotional)
  2. Persistent
  3. Persistent ashy dermatosis of Ramirez (dyschromic erythema)
  4. Palmar - palmar erythema (congenital palmar, “hepatic palms”)
  5. Polymorphic
  6. Exudative erythema multiforme (+ Stevens-Johnson erythema)
  7. Physiological
  8. Viral
  9. Infectious
  10. Erythema chamera
  11. Centrifugal erythema bietta
  12. Centrifugal erythema darya
  13. Solar (UV)
  14. Ultraviolet
  15. Fixed
  16. Ring-shaped rheumatic
  17. Toxic erythema of the newborn
  18. Knotty
  19. Nodose
  20. Cold
  21. Thermal
  22. Scarlet fever desquamative erythema
  23. Erythema miliana
  24. Beam
  25. Winding Erythema Gummel
  26. Fringed
  27. Migratory erythema of Aphselius-Lipschutz
  28. Bloom congenital telangiectatic erythema

The principles of treatment of a particular kind of disease depend on the causes that caused it, the severity of the course, the age of the patient, and some other factors. In addition, physiological forms pass independently and quickly; therapy is not required.

Symptomatic erythema

The second name is emotive, which indicates its origin. Redness of the skin is caused by strong emotions such as anger, shame, or stressful situations. It manifests itself in the form of a transient change in the color of the skin of the face, chest and neck to a pronounced red or crimson color.The vessels in this case expand for a short time due to the chemical reaction of stimulating cholinergic receptors.

Symptomatic erythema photo

Persistent erythema

Code for ICD-10 L95.1. She is a towering erythema or Crocker-Williams. Quite a rare variety of unclear etiology: the causes can be both vasculitis, infections, and heredity. The disease begins with the appearance of small papules, which subsequently merge into large (up to 7 cm in diameter) foci of uneven outlines with ridges along the edges. Color varies from pinkish to deep red, the surface is initially soft, then hardens and can peel off. NSAIDs, heparins, vitamins, antiplatelet agents, angioprotectors are prescribed. Large foci are removed using cryotherapy.

Photo of a persistent towering era.

Persistent ashy dermatosis of Ramirez (dyschromic erythema)

A rare variant of lichen planus, accompanied by the appearance of ash-gray spotted rashes.

The treatment has not been developed. An independent spontaneous regression of rashes is possible.

Photo dyschromatic er. Ash dermatosis of Ramirez on the hands

Palmar erythema

Code for ICD-10 L53.8. A characteristic symptom is pronounced redness of the palms. The pathological variety of this phenomenon is most often caused by liver diseases, leukemia, rheumatoid arthritis, bacterial endocarditis and other pathologies. Acquired palmar erythema is also called a symptom of "hepatic palms."

Sometimes it is observed in pregnant women, usually in the second trimester. In the photo of palmar erythema, it is seen that mainly palmar elevations and fingertips are red. In the future, hyperemia covers the entire palm.

Subjectively, sensations of itching and pulsation are possible, when pressed, the skin turns pale for a while, then returns to a state of hyperemia. Treatment is prescribed in accordance with the cause of palmar erythema - cirrhosis, jaundice, arthritis.

Hepatic palms Erythema of the palms (palmar)

Congenital palmar erythema is hereditary and is caused by the expansion of capillary palmar anastomoses. The disease is not accompanied by other symptoms and does not require treatment.

Exudative erythema multiforme

Code for ICD-10 L51. An acute disease that often recurs or takes on a chronic form. The causes can be both infections and toxic-allergic reactions of the body. It manifests itself as polymorphic rashes on the mucous membranes and skin, and they begin to appear strictly symmetrically on the extremities (the back surfaces of the feet, lower legs and forearms). Blue spots are formed with a pink border with a diameter of up to 3 cm and small papules. Pain and itching appear, sometimes general health worsens. The border of the lips is also involved in the process with the formation of blood crusts subsequently. Rashes exist for about a week, after which the bubbles dry out, and the spots disappear.

Multiforme exudative er. on the elbows

In some cases, the disease proceeds in a vesiculobullous form (Stevens-Jones erythema), which is characterized by a severe course and a high risk of death.

Erythema stevens-johnson Er. Stevens-Johnson on the face

Polymorphic erythema

A synonym for erythema multiforme. It is characterized by multiple rashes of different types: papules (nodular rash), vesicles (medium-sized fluid-filled blisters), hemorrhages - pinpoint intradermal hemorrhages and others. Their appearance is accompanied by symptoms of general intoxication.

The reason usually becomes a negative reaction of the body to a drug if it is intolerant. The progression of the disease leads to spread to the mucous membranes and the fusion of rashes with the formation of large blisters. Treatment involves the abolition of an allergen drug, the introduction of antihistamines, glucocorticoids, wound healing drugs, vitamins. Cardiovascular syndrome is being treated if available.

Physiological erythema

Code for ICD-10 P83.1. From the name it is clear that this phenomenon does not mean a painful condition, passes quickly and does not require treatment. In adults, it appears due to physical effects on the skin or reflex nervous reactions. Physiological erythema also appears, which appears in infants several hours or days after birth (sometimes with minor rashes of gray-yellow color). It is explained by the peculiarities of the adaptation of the child's body in the postpartum period.

The cause of physiological erythema of newborns is, first of all, the temperature difference: in the womb it is higher and more constant, therefore its decrease leads to increased peripheral blood circulation and, accordingly, temporary redness. It does not require treatment, because it passes in a day. The second factor causing erythema on the 2nd or 3rd day may be addiction to nutrition through the digestive tract and the ingestion of allergens in the body through this route. Also usually does not require therapy if no infection is detected. Antihistamines in drops are sometimes prescribed to reduce itching.

Physiological er. newborns

Viral erythema

Code for ICD-10 L51.8. The cause of the development of the disease is the defeat of the body by the virus. Mostly children aged 4-2 years fall ill, especially in the spring and autumn. Viral erythema is quite easy to confuse with other infectious colds at the initial stage, since the symptoms are almost the same. The main symptoms of viral erythema in children include:

  • temperature rise,
  • sore throat, itchy nose
  • runny nose
  • headache,
  • the appearance of rashes (spots) on the body and oral mucosa after 2 or 3 days.

After a few days, the rash disappears, but internal organs are already infected. Viral erythema in children, if you do not recognize it in time, leads to impaired blood formation, damage to joints and bone marrow, and anemia. Treatment is carried out with antiviral drugs, analgesics. Topically applied ointments Lorinden ®, Advantan ®.

Erythema chamera

Code for ICD-10 L53. A kind of infectious form of the disease that occurs in children and adults. It is characterized by a fairly mild course with minor symptoms of intoxication and fever. In the photo of Chamera erythema in children, it can be seen that the rashes that appear on the first day from the onset of the disease, on the second day merge into an extensive spot of a specific form.

The reddened areas have a butterfly outline. Erythema Chamera in children completely disappears within 2 weeks, while being treated only symptomatically if necessary. It is easily tolerated by adults, and usually occurs in a worn-out form, sometimes with slight swelling of the joints.

Centrifugal erythema bietta

Code for ICD-10 L93. This is the name of a rare superficial variety of lupus erythematosus. In this case, this autoimmune disease manifests itself in the form of a diverging from the center of the face to the edges of the redness (a symptom of a "butterfly"), not accompanied by subjective unpleasant sensations. It stands out as a separate disease, but may be one of the signs of a systemic lesion of the body. It is treated with antimalarial drugs, B-group vitamins, antioxidants.

Centrifugal erythema darya

The disease is also called arched persistent erythema. The exact reason for its development has not been established. Viral, fungal and bacterial theories are not excluded.

Erythema is characterized by the appearance on the skin of the body (less often the face) of small pinkish nodules due to retention in the center, similar to rings.

Treatment includes the treatment of the underlying disease, the use of antihistamines and glucocorticosteroid drugs.

Sunburn

Code for ICD-10 L55. This diagnosis is a consequence of prolonged exposure to the sun and UV exposure of exposed areas of the body. As a result, the skin turns red within a few hours, touches cause pain, slight swelling and an increase in general body temperature are possible. Treatment of solar erythema is reduced to the following activities:

  • termination of exposure to radiation,
  • cool showers and cold lotions on the affected area,
  • dexpanthenol sprays.

With an extensive lesion of a more severe degree (with the formation of blisters), it is advisable to consult a dermatologist. He will prescribe anti-inflammatory and antihistamines, ointments with glucocorticoids.

It is recommended that patients with increased sensitivity to ultraviolet and a tendency to form solar erythema always use a cream with a high SPF filter, regardless of the time of year.

Erythema ultraviolet

Code for ICD-10 L56. When exposed to the sun, it is considered a synonym for solar erythema, but it can also be caused by artificial sources (special devices, tanning salons, etc.). the symptoms are the same: flushing of the skin, soreness, general deterioration of well-being. treatment consists in cooling the irradiated areas, the use of dexpanthenol in the form of an aerosol.

Fixed erythema

Code for ICD-10 L53. It is the body's response to the ingestion of a certain substance into the bloodstream, in relation to which there is hypersensitivity. A feature of this disease is the appearance of redness always on the same area of ​​the skin or mucous membrane. Most often, areas of natural folds, genitals, and face are affected. In the photo of fixed erythema, it is seen that the stain forms an extensive, red or cyanotic shade, sometimes with blisters and associated erosions.

Therapy of the disease always begins with the detection and cancellation of the provoking factor (most often these are NSAIDs, antibiotics, hormones). Further treatment of fixed erythema involves infusion therapy, administration of enterosorbents and external use of steroids. Extensive erosive lesions require the use of combined antimicrobial wound healing ointments, systemic corticosteroids.

Annular erythema

Code for ICD-10 L53.1. Under this concept, a group of dermatological diseases similar in appearance is united. A characteristic common feature is ring-shaped or closed shapeless redness on the body, with peeling, or without vesicles. Depending on the specific form of the disease, the cause can be infections, helminth infections, weakened immunity, tonsillitis, mycoses, hormonal disruptions and cancer.

Most often, ring-shaped erythema is rheumatic in nature.

Treatment is prescribed in accordance with the main diagnosis.

Photo of the ring-shaped era.

Toxic erythema

Code for ICD-10 L53.0. It is a consequence of the introduction of an allergen into the body, manifests itself in the form of hyperemic areas of the skin with an increase in their temperature. It is usually observed in newborns, full-term and being breastfed. In adults, the incidence statistics are unknown; the cause may be exogenous (external) or endogenous (heredity, drugs, food) factors. It is stopped by taking antihistamines.

Erythema nodosum

ICD-10 code L52. The disease was named in accordance with the main clinical symptom - the formation of multiple or single nodes in the skin of the lower legs. In the acute form, they are about 2 or 3 cm in diameter, pink or bluish in color, characterized by soreness (up to the inability to walk). The causes are infections (most often streptococcal, toxoplasmosis, tuberculosis) or an allergy to medications. Treatment is carried out in a hospital according to indications, depending on the provoking factor.

Photo knotted er.

Thermal erythema

The disease is also called reticular telangiectatic pigmented dermatosis. Thermal erythema develops with prolonged exposure to infrared radiation (fireplace, electric heaters, etc.).

Treatment comes down to eliminating the cause of erythema.

Erythema miliana

Code for ICD-10 L53. The disease is an allergic reaction to the parenteral administration of salvarsan, an obsolete drug for syphilis. It manifests itself as a characteristic small-pointed scarlet fever or measles-like rash throughout the body. Due to the fact that salvarsan was replaced by more modern and safer drugs, this erythema does not occur.

Radiation erythema

Code for ICD-10 L58. This is the name for reddening of the skin in response to radiation in radiobiology. The reasons may be natural or artificial (used for the treatment of cancer and diagnosis) radioactive radiation. Early erythema occurs within 24 hours after irradiation, is characterized by slight hyperemia and passes quickly. True radiation erythema develops after a few days, has a persistent character, accompanied by soreness, swelling and itching.

Winding Erythema Gummel

Code for ICD-10 L53.3. It belongs to the group of patterned erythema, manifests itself in the form of twisting stripes resembling a section of a tree and localized mainly in the face, neck, chest. It is a tumor marker, that is, indicates the formation of a malignant tumor and requires appropriate treatment of the underlying disease. Erythema is noted in mammary adenocarcinomas, myelomas, pulmonary tumors, etc.

Rounded erythema

Code for ICD-10 L51.8. Another name - serum toxidermia, occurs as a response to the introduction of serum into the body. The external manifestation is serous rashes or hives: a rash appears, filled with serous fluid, vesicles on the skin. Treatment is symptomatic.

Migratory erythema of Aphselius-Lipschutz

Code for ICD-10 A69.2. An infectious skin disease that develops after a tick bite and the bacteria Borrellia burgdorferi enter the body in this way. The incubation period, which lasts from 1 to 3 weeks, is replaced by the appearance of a ring-shaped erythematous spot, the boundaries of which are rapidly expanding.

Also called chronic migratory erythema or Lyme disease. A course of antibiotics for the destruction of the pathogen and symptomatic treatment are indicated. In case of complications, Stevens-Johnson syndrome (code for ICD-10 L51.1) develops or necrolytic migratory erythema, fraught with severe damage to the mucous membranes of the mouth, esophagus, genitals and eyes. Treats poorly.

Consequences and forecasts

The outcome for each kind of disease is different. Infectious erythema, for example, is fast and without any consequences. Toxic and migratory forms are life threatening. Skin lesions heal depending on the depth of the lesion without a trace or with scarring. The prognosis also depends on the timeliness and accuracy of the provision of medical care.

Prevention

It is not entirely possible to exclude the development of erythema, however, it is completely possible to significantly reduce the probability. Almost all types of this disease develop against a background of reduced immunity and chronic infections. That is, you need to improve health and treat diseases in a timely manner. Caution and protective measures in tick habitats will protect against erythema migrans.

Erythema - what is it?

This term combines some physiological and very many pathological conditions of the skin and mucous membranes. They are caused by the expansion of capillaries of the skin and appear single or multiple, often merging with each other into fields of significant area, red, red-cyanotic or pink spots of various sizes. Depending on the cause of the occurrence, physiological spots and those resulting from pathological conditions are distinguished.

Pathological erythema

The main causes of pathological erythema, provoking it as a disease, are as follows:

  • general infectious diseases
  • infectious and non-infectious skin diseases (dermatitis and dermatoses),
  • autoimmune connective tissue diseases and allergic reactions, especially to certain drugs - penicillin antibiotics and sulfonamides, non-steroidal anti-inflammatory drugs, combined oral contraceptives, antidepressants and anticonvulsants,
  • somatic pathology (circulatory disturbance, Crohn's disease, pulmonary sarcoidosis) and pregnancy,
  • solar radiation, physiotherapeutic thermal and other electrical procedures.

Erythema of the skin and mucous membranes occurs mainly in genetically predisposed young people (20-30 years old), regardless of gender, who are exposed to excessive solar radiation. It can be multifactorial in nature, that is, to be provoked not by one of the factors, but by several at the same time.

Noncommunicable erythema

This group includes mainly diseases, which are a response of the body to the effects of an external stimulus or allergenic factor. These include the following types of erythema:

  1. Infrared, or thermal, resulting from prolonged or often repeated infrared radiation, which, due to insufficient intensity, is unable to lead to a complete burn. Dermatosis is manifested by reticular or age spots. The treatment of erythema of this type is only to eliminate the effects of infrared rays.
  2. X-ray, which is a consequence of the multiple or long-term influence of electromagnetic waves and x-rays on the skin area. It is characterized by the development of a skin inflammatory process at the site of irradiation, which manifests itself as a distinct red spot. The latter occurs on average 1 week after irradiation and lasts about 10 days, then gradually darkens, and acquires a brown color. In the area of ​​the spot, small-plate peeling of the epidermis sometimes occurs.
  3. Persistent towering idiopathic and symptomatic. It is a manifestation of cutaneous vasculitis in the form of edematous bright pink nodules with a cyanotic hue, grouped into plaques, which may have a sunken center. This gives them an arched shape towering above the surface of the skin.
    The idiopathic form is hereditary, symptomatic - it occurs with any chronic infections, an allergic reaction to taking certain medications, or developing in the area of ​​the knee and / or elbow joints in autoimmune diseases (ulcerative colitis, rheumatism, rheumatoid arthritis, etc.).

Persistent elevated erythema
Photo is the property of skinmaster.ru

Infectious erythema

Various forms of erythema, among the entire dermatological pathology, occupy a significant place. The selection of those species that are found precisely in infectious diseases is very important in order to conduct differential diagnosis of the latter.

The number of such infectious diseases is small, and almost all of them are accompanied by high body temperature and severe symptoms of intoxication. An exception is only some chronically occurring infections (cutaneous leishmaniasis, tuberculoid leprosy, helminth infections with skin changes caused by filarias, and others), in which the appearance of skin erythematous rashes occurs without these symptoms.

Infectious diseases that occur with an erythematous rash, respectively, are called "infectious erythema." Depending on the cause, all infectious diseases with focal reddening of the skin are combined in two main groups:

  1. In fact, erythema, that is, skin redness, formed by the fusion of large spots into erythematous fields.
  2. Spots for skin diseases, including anthrax, erysipelas, erysipeloid (acute infectious bacterial disease) and some others, which are redness in the area of ​​local inflammatory skin changes.

The main types of erythema of infectious etiology are not dangerous in terms of the possibility of infection of surrounding people.

Rosenberg's Spotted Infectious Erythema

The causative agent, presumably, is a virus. The disease occurs sporadically in autumn and winter among high school children and young people under 25 years old. The onset is acute, the temperature in the first two days rises to 39 ° and higher and lasts 1-2 weeks. The disease is manifested by symptoms of severe general intoxication - general weakness and malaise, increased emotional irritability, headache, pain in the muscles and joints, sleep disturbance.

Sometimes there may be an increase in the liver and spleen, the appearance of dry wheezing in the lungs, polyadenitis (the reaction of multiple lymph nodes), redness of the mucous membranes of the eyes and oral cavity, spotty rash on the soft palate, meningeal symptoms, etc.

After 4-6 days, an asymmetric rash appears in the form of copious isolated spotted-papular elements with clear boundaries with a diameter of up to 0.5 cm. They gradually increase in diameter to 1.5 cm or more, lose their regular shape and clarity. Soon, as they increase numerically, in the places of condensation, individual elements merge into large spots with irregular outlines or form continuous erythematous fields.

The elements of the rash at the time of the appearance have a bright pink color, then they turn purple-red, brown, gradually turn pale and one week after their appearance completely disappear. In their place, peeling of the horny epithelium of a pityripe nature occurs.

Typical areas of erythema localization are the buttocks, where the rashes look like solid reddish spots, the extensor surface of the elbow, wrist, knee and ankle joints. In a smaller amount, elements appear on the chest, and sometimes isolated on the skin of the face. In even more rare cases, erythema of the palms and feet is possible, which is allowed by large-plate peeling.

The duration of the disease is from 8 days to 2 weeks. After lowering the temperature, the patient's condition quickly recovers. For treatment, mainly infusion detoxification therapy and vitamin therapy are used. Antibiotic treatment is usually ineffective, but they are used in severe conditions to prevent complications.

Erythema multiforme or polyform exudative

In half the cases, the disease is caused by the herpes simplex virus, microorganisms that cause such infectious diseases as measles, scarlet fever and others, as well as the use of penicillin antibiotics, sulfonamides, anticonvulsants, contraceptives and some other drugs. In other cases, it is not possible to establish the exact cause of the disease. It proceeds with severe symptoms of general intoxication and high (up to 39-40 °) body temperature.

A rash in the form of spots with a diameter of up to 1.5 cm appears on the 4th - 5th day from the onset of the disease, and with repeated illnesses - already on the 1st - 2nd day. The spots, gradually increasing, merge, sometimes forming annular erythema due to less intense color in the central departments. The most dense localization of rashes is the extensor surface of the limbs.

A feature of this species is the polymorphism (variety) of elements - spots merging with each other, papules, blisters with serous contents and painful erosion that remain after opening the blisters. In severe forms of multiforme exudative erythema, which sometimes are fatal if untreated, blisters and ulcers can appear on the mucous membranes of the mouth and pharynx, eyes, genitals, and in the perineum, etc.

This polymorphism of the elements led to the name of the pathology and is of primary importance in the differential diagnosis.

Exudative erythema multiforme

Sudden erythema

Presumably, the disease is caused by an adenovirus infection and affects mainly children. It begins acutely (with chills) with mild symptoms of general intoxication of the body. The temperature rises to 40 ° and lasts 3-4 days, after which it quickly (within a few hours) without severe sweating decreases to normal levels. At high temperatures, a child may experience symptoms of serous meningitis or meningoencephalitis.

Simultaneously with a decrease in temperature or 1-2 days after that, a pale pink spotty-papular rash appears with a jagged outline and a diameter of 0, 2 to 0.5 cm, often surrounded by a pale halo. When elements merge, erythematous fields form, which are very similar to rashes with measles or measles rubella, but less bright.

The rash appears primarily on the back. For several hours, it spreads to the front surface of the chest and abdomen, then to the neck, neck, face (as separate elements) and the scalp, as well as to the limb. The maximum number of elements is localized on the chest. Rashes in 2-3 days disappear without a trace - without peeling and pigmentation.

For more information on the manifestations of infectious erythema, see the link.

Erythema infectious undifferentiated

It is assumed that it is not a separate species, but a group of infectious diseases with an unspecified and / or unclear cause. The cyclical course is characteristic of these forms, which indicates their infectious nature, high fever and pronounced general intoxication. Against the background of this symptomatology, rashes appear, varying in the variability of localizations and the intensity of the color. The picture of the disease clinically does not correspond to any of the above types.

All of these types of erythema, due to the acute course with fever and general intoxication, are relatively easy to differentiate with rashes that accompany skin pathology and occur without such symptoms in a satisfactory general condition.

Chronic erythema

Dermatological diseases occur for a long time with periods of relapse and remission, and the elements of the erythematous rash are often ring-shaped and are often accompanied by peeling on their background.

This type includes a large number of diseases - garland-like migratory erythema of Hamel, fixed sulfanilamide and ring-shaped rheumatic erythema, persistent curly erythema Wende, and many other dermatological diseases with cutaneous erythema.

An example of a chronic course is the Afselius-Lipschütz chronic migratory erythema. Infectious pathogen - Borrelia (a type of treponema) of Burgsdorfer, which are transmitted by ordinary forest ixodid ticks.

After 1-3 weeks, a red rounded spot appears at the site of the tick bite, which gradually increases due to peripheral sections to 20 cm or more. As it increases, its central departments undergo reverse development and become cyanotic and then light brownish due to weak pigmentation, as a result of which the spot transforms into a ring.

In the center of the spot you can see the trace of a tick bite, and on the periphery it is surrounded by a solid red-pink border up to 20 mm wide. Sometimes the stain does not take the form of a ring, but of a continuous tape that can pass through the face, neck and chest.

The general condition remains satisfactory, and subjective sensations during the illness are absent. The latter has a tendency to self-resolution within a few weeks or even months, but adequate treatment significantly reduces these periods.

How to get rid of erythema

This largely depends on the type of disease, the nature of its course and the complications that have arisen. The principles of treatment consist in the rehabilitation of chronic foci of infection in the body, in the exclusion of the use of certain medications. The physiotherapeutic effect is also excluded, except for using it at a certain stage of development of nodes in erythema nodosum, when magnetotherapy, phonophoresis with corticosteroids, laser therapy, and erythemic doses of ultraviolet radiation are prescribed for faster resorption of nodes

In mild forms of the disease, only symptomatic therapy is performed. Be sure to use antihistamines, angioprotective, iodine drugs, as well as drugs that improve the rheological properties of blood.

In severe cases, intravenous detoxification therapy is carried out, glucocorticosteroids are prescribed inside, and in the absence of contraindications - antibiotics. For example, the use of penicillin antibiotics, as well as macrolides, interferon inducers (Neovir, Cycloferon, Amixin) and vitamins can significantly reduce the duration of the course of chronic erythema.

When erosion is formed on the skin or mucous membranes, antiseptic solutions, an ointment or an emulsion with antibiotics and corticosteroids are used, including also local anesthetic ingredients, and in the presence of necrotic areas on the skin or mucous membranes, an ointment with proteolytic enzymes is used.

In addition, for many types of this pathology, it is necessary to exclude spicy, smoked and canned foods, as well as fried foods, coffee and alcohol from the diet.

Watch the video: June 15 2010 Lupus Vlog - Redness and Pictures (January 2020).