Erythema annulare is redness and swelling of the skin, which is associated with vasodilation and stagnation of blood in them. It can often occur as a reaction to insect bites, as well as against the background of autoimmune processes and helminthic invasions. Pathology is so called because of the characteristic appearance: a red ring with raised edges that limit the area of \u200b\u200bdamaged skin. Depending on the factors that caused the disease, the disease takes place in an acute or chronic form.
Causes of erythema annulare
The skin is connected with absolutely all systems and organs, therefore it reacts sharply to the changes taking place in the human body. The appearance of spots in the form of rings on it is not an independent disease, but a signal of a violation. The reasons for the violations should be investigated. Typically, causes of erythema may include:
- The presence of defects in the immune system.
- The appearance of malignant tumors.
- The appearance of intoxications of various origins.
- The occurrence of Lyme disease.
- Presence of rheumatic and other autoimmune diseases.
- Development of helminthic invasions.
- Appearance of allergic reactions in the body.
- Development of chronic local foci of infection in the form of sinusitis or osteomyelitis.
- The emergence of tuberculosis.
- The presence of certain hormonal disorders in the body.
- The appearance of fungal infections.
- Failure of the normal functioning of the digestive tract.
Erythema annulare can be a sign of what disease? As you can see, the list is quite long.
How does this pathology occur?
The appearance of annular erythema in humans is primarily associated with the pathology of vascular reactions. At the same time, the capillaries that are located in the skin expand, and the direct blood flow in them slows down significantly. As a result, part of the plasma enters the tissues, which leads to the appearance of local edema. T-lymphocytes, which are cells of the immune system that are responsible for recognizing a foreign agent, also come out of the liquid. Their role in the formation of erythema is not yet clear, but they report a close relationship between the pathology and the immune system.
Peripheral zoom
Erythema annulus is capable of peripheral enlargement. In the center of the formed ring, pathological processes subside, so the skin acquires a standard color and thickness. But directly on the peripherythere remains a certain shaft of dilated capillaries and cellular edema. The ring, as a rule, increases in size from the center to the edges. This type is called Darier centrifugal erythema.
Often has acute development, protracted course and treatment. First there is peeling and swollen pinkish-yellow or red spots. Further, the process progresses, numerous erythematous elements appear, which have an annular shape with an urticarial edge and a pale center. In the central part of the focus there is a flat, smooth surface, reaching a size of up to two cm. The color of the central part of the formation gradually changes almost to a brownish color. The peripheral growth of the elements leads to the fact that they reach a diameter of 15 cm. Some rings can be combined and form scalloped elements, garlands, and also arcs. Scalloped elements exist for 2-3 weeks, then they pass, but after them violently stagnant pigmentation remains. Then new annular elements are formed.
The most favorite location of the pathology is the torso and limbs, somewhat less often the face, neck, lips and buttocks. There is itching and burning. Varieties of Darier erythema are clinically distinguished, differing in the following forms:
- Scaly (a thin white border peels off along the outer edge of the lesions).
- Vesicular form of Darier's erythema (vesicles located at the edges of the elements quickly disappear).
- Simple garland-shaped (short duration of spots, from several hours to several days).
- Resistant microgarland-shaped form, including small elements up to 1 cm in diameter. When conducting a histological examination of the epidermis, dyskeratosis with elements of round bodies, and also grains, is detected. Rarely, vesicles are found in the epidermis, which are filled with shriveled cells that have grains.
Symptoms of this pathology
How does the disease manifest itself? Let's take a closer look at this issue. Initially, a rounded red spot appears on the skin of a person, which is slightly raised above the surface and looks like a coin. During pressure, the erythema usually fades or disappears completely. In the center, over time, a focus of enlightenment is formed. The skin turns pink. Sometimes in the center of erythema, several foci of enlightenment of a round shape can simultaneously form. In such situations, several ring-shaped spots form on the skin.
Skin peeling
Often peeling with bubbles occurs on the surface. At the same time, the erythema borders remain red and gradually creep further, which leads to an increase in the annular diameter. The edge of the ring may rise slightly above the skin.
Erythema annulare of varying maturity can be found in the same place, and the rings often merge with each other. This is how arched contours are formed with wavy edges at the spots. Skin lesions are occasionally accompanied by soreness, which directly depends on the main cause of the disease.
Other signs of pathology
Symptoms of annularerythema is formed against the background of other signs of pathology:
- The infectious origin of erythema is reported by signs of intoxication in the form of fever, weakness and aching muscles with lack of appetite. Migrating erythema often occurs against the background of infection with Borrelia due to a tick bite. In the center of redness, you can see the bite in the form of a rounded crust or erosion. Often, target-shaped erythema can form. Against this background, the smaller ring is located inside the larger one.
- With the development of rheumatism, the connective tissue structure is damaged, which is manifested by pain in the joints and muscles, along with limited mobility, changes in skin quality, increased bleeding of blood vessels, a prolonged rise in temperature above thirty-eight degrees and a violation of cardiac activity. At the same time, the borders of the rings usually have a pink color, and their localization can be absolutely any.
- Allergic erythema, as a rule, is quite bright, and the edema with it is well expressed and may be accompanied by a rash on various parts of the body. Conjunctivitis and rhinitis are also not excluded. Itching of varying intensity can often be observed.
- The presence of a malignant neoplasm is indicated by prolonged weakness along with weight loss, arching pains in the tubular bones, with an increase in lymph nodes and a prolonged fever.
Erythema annulare in children is often associated with rheumatic disorders, immune disorders and helminthic invasion.
Course of disease
The course of the disease directly depends on a number of reasons and can take various forms:
- A paroxysmal type. In this case, skin changes occur suddenly, passing without a trace within a couple of hours or days.
- Sharp shape. Spotted rings will gradually disappear over two months.
- Chronic type. Skin changes persist for a long time.
- Recurrent type. After clinical cure, erythema migrans may reappear at the same site or at a new site.
Diagnosis of pathology
Diagnosis of erythema usually does not cause any difficulties. If it is necessary to distinguish the disease from a granuloma similar in symptoms, dermatologists take a section of damaged tissue for histological examination. In the laboratory, microscopic sections are prepared from the samples.
Skin changes in erythema
Typically, skin changes with erythema include:
- Expansion of capillaries.
- Accumulation of lymphocytes near vessels.
- The presence of slight edema of cells, as well as intercellular spaces of the epidermis.
- Presence of moderate edema of the dermis.
As part of finding out the causes of erythema annulare, the doctor conducts additional tests. For example, a general clinical blood test with plasma biochemistry is being investigated. Changes in these analyzes suggest in which direction to move forward. For example, helminthic invasions are characterizedslight anemia along with eosinophilia and accelerated ESR. Against the background of an allergic reaction in plasma, the content of immunoglobulin E protein increases. The presence of malignant neoplasms is manifested by a decrease in hemoglobin, as well as erythrocytes, along with changes in the leukocyte formula.
Instrumental studies in the form of x-rays, electrocardiograms, computed tomography and the like are carried out if certain changes were found after examining the patient or in laboratory tests.
Treatment of disease
Effective therapy is possible when the cause of the pathology is established. Therapy is prescribed by a dermatologist together with a specialist dealing with the underlying disease. They can be a neurologist, rheumatologist, endocrinologist, immunologist, infectious disease specialist, and so on. The patient's need for hospitalization is determined on the basis of the general well-being of the patient and concomitant disease. Patients are usually treated as outpatients.
Performing local treatment
Topical treatments typically include:
- Using antihistamine ointments, creams and gels to treat swelling, redness and itching associated with histamine release.
- Using ointments that contain zinc compounds, such as Desitin. The mechanism of their action is not yet fully understood, but they can effectively eliminate inflammation in the epidermis along with itching and flaking. In addition, unlike hormonal drugs, they are almost safe.
- Treatmentglucocorticoid ointments and creams, for example, Akriderm or Sinaflan. These drugs slow down the active reproduction of T-lymphocytes, thereby eliminating the main causes of local changes in the skin. They should be used only as directed by a doctor, otherwise serious side effects in the form of skin atrophy may occur. Severe bacterial and fungal infections are possible.
Treatment of erythema annulare is not limited to this.
Systemic drug therapy
Along with local treatment, systemic drugs are prescribed:
- The use of desensitizing agents that remove toxins with allergens from the bloodstream, reducing the permeability of the vascular walls and stabilizing the membranes of immune cells. Thanks to all this, the release of histamine in the tissue is reduced.
- The use of glucocorticoids. These drugs are used in the form of tablets or injections. It is advisable to use them against the background of severe erythema.
- The use of antibiotics. Such medicines are necessary in the presence of an infectious disease. Typically, patients in these cases are prescribed penicillins or cephalosporins.
- The use of antihelminthic drugs is prescribed when there are worm eggs in the feces, and, in addition, against the background of the detection of specific immunoglobulins in the blood.
In closing
Thus, erythema annulare is not an independent disease, but rather a symptom of other pathologies. Therefore, it requires complex treatment andexact definition of the cause that caused it. In the event of a pathology, you cannot self-medicate, but you should definitely consult a doctor.
We looked at what kind of disease it is - erythema annulare.
