Tuberculosis lupus is a rare form of skin tuberculosis. The disease is severe, proceeds for a long time, and is difficult to treat. And it usually starts with a small inconspicuous sore. Now we will talk about what are the prerequisites for this disease, what symptoms are alarming, as well as how diagnosis is carried out and treatment is carried out.
About the disease in brief
Tuberculosis lupus is usually detected in childhood. If it is diagnosed early, then it will be possible to exclude a negative effect on the skin of the face (this is the area that is most often affected).
This nuance is very important, because we are talking about maintaining aesthetics and attractiveness. Late stages are accompanied not only by physiological changes, but also by cosmetic ones. Not only the he alth of the patient is deteriorating, but also his appearance.
The final stage of this disease is manifested by the gradual melting of tissues. The structure of cells changes, their nutrition is disturbed. Since the disease is chronic, it cannot be cured. But it is real to suspend the pathological process.
This is why regular check-ups with a dermatologist are so important. Early diagnosis is the key to successful treatment.
Classification
In the conditions of modern medicine, you can quickly determine the type of lupus erythematosus. Thanks to this, it has become real to start treatment as soon as possible, which can slow down the development of the disease. Its varieties are determined by localization, symptoms and appearance. The following list is distinguished:
- Manifestations on the skin of the face. As a rule, ulcers are localized on the forehead, nose and cheeks.
- On the mucous membrane. Symptoms are found in the nose and mouth.
- Pityaresoform variety. Accompanied by peeling of damaged surfaces.
- Psoriasioform lupus. Silver-gray particles form on the damaged surface.
- Serpiginous form. Scars form at the site of ulcers after they pass.
It is worth noting that there are also two types of lupus - flat and tuberous. In the first case, neoplasms do not protrude above the surface of the epidermis. In the second, on the contrary, the ulcers "bulge" and differ in color from he althy skin.
Infection
According to the World He alth Organization, every third person on the planet in the body has tuberculosis mycobacteria. As a rule, they do not manifest themselves in any way, being at rest. They breed onlywhen the body "gives up slack." Microorganisms divide within 24 hours - in a short time period, the inflammatory process occupies a large area.
Koch's wand, which is the pathogen, is transmitted in the following ways:
- Airborne. If a sick person coughs next to a he althy person, they can easily become infected.
- Contact. In this case, a he althy person should use some thing belonging to the carrier of the Koch wand. This also includes situations with infection through a kiss or unprotected intercourse.
- Food. If a person eats the meat of an infected animal, he will become infected. However, in the age of modern technology, this is a rarity. But in rural areas it is common.
Also Koch's wand is passed from mother to child. The risk is very high, but not one hundred percent.
Reasons
The clinical varieties of lupus were listed above. It is necessary to briefly talk about what provoking factors cause the pathogen to “activate” and the disease begins to form.
The cause is always trauma to the skin. However, in order for bacteria to begin to multiply and grow, favorable conditions are needed. They are caused by the following violations:
- Weakened immunity. The body can lose some of its defenses due to frequent illness, stress or pregnancy.
- Hormonal failure. Occurs as a result of pathologies related to the endocrine system.
- Chemotherapy. Thosedrugs that are used to treat cancer simply kill the immune system.
- Use of corticosteroids. Long-term use of these drugs weakens the body, making it vulnerable.
Also, the development of lupus erythematosus of the face is influenced by the conditions in which a person lives, as well as his daily routine, diet and habits.
Groups and risk factors
It is important to note that some carriers of Koch's wand have such strong immunity that lupus erythematosus does not threaten them. There are also certain groups of people who are more susceptible to infection than others. These include:
- Persons in contact with a Koch wand carrier.
- People who abuse alcohol.
- Drugs.
- Medical staff working in TB dispensaries.
- People who lead unhe althy lifestyles.
- Prison staff and prisoners themselves.
People from these groups are more susceptible to infection than others. If an open wound occurs on the skin, lupus erythematosus of the face and hands can occur with a high probability. People who suffer from any of the following are especially at risk:
- Thyroid disease.
- Obesity or overweight.
- HIV and other infectious diseases.
- Oncological education.
- Skin pathologies of an infectious or allergic nature.
Another weighty factor must always be taken into account - the presence of a person who has had tuberculosis in the family.
Symptoms
The following physiological manifestations are characteristic of lupus erythematosus:
- Localization of the focus on the face. Slightly less often, ulcers form on the limbs, sometimes spread throughout the body.
- The appearance of small pimples that look like prickly heat. They are replaced by tubercles, their number gradually increases.
- Drying of the skin at the site of the outbreak, the appearance of scars and ulcers in the future.
- Deterioration of the general condition. A person gets tired quickly, sleeps very badly, suffers from headaches.
- The appearance of pus on the tubercles. As the disease progresses, the wounds grow larger. They ooze, healing does not occur. There is intense itching in all affected areas.
- The wounds are gradually increasing in size. After a while they merge into one. The pain does not go away, only intensifies.
It gets worse. Ulcers that have matured begin to horn and peel off. The epidermis can literally “fall off” in pieces. This gives rise to a necrotic process - tissues rot, whole holes form in place of ulcers.
The disease, if left untreated, actually destroys a person - when the form is running, there is a risk of losing the nose, part of the ear. And cheeks often rot through and through.
Diagnosis
Once again, you need to make a reservation that if suspicious pimples are found, you should immediately sign up for an examination with a dermatologist or infectious disease specialist. However, the diagnosis of lupus erythematosus is usually done jointly by two specialists.
Firstan external examination is carried out, then subjective sensations of the patient are analyzed. A laboratory study of skin tests is also prescribed.
It is very important to conduct a differential diagnosis. This will exclude the possibility of a patient having tuberculoid leprosy, DLE, lupus erythematosus, actinomycosis.
Child Therapy
Having considered the causes and symptoms of lupus erythematosus, it is necessary to pay attention to the topic of treatment. The doctor prescribes at least three drugs, the intake of which must be alternated. The following medications are commonly prescribed for children:
- Tableted "Rifampicin" 2 times a day. The dose for children under 12 years of age is calculated based on the norm of 10-20 mg per 1 kg of body weight. For babies from 1 to 3 years old - 10-30 mg per 1 weight. Adolescents aged 12 to 15 - 2-3 times a day, 15-20 mg per 1 kg.
- "Ftivazid" three times a day. It is shown to babies. The dose should correspond to the norm of 0.02-0.3 g per 1 kg of weight. Older children are also allowed to give it. The dosage in this case is increased by 0.2 grams with each dose. Preschoolers aged 3 to 7 years are shown approximately 0.6-0.7 grams of the drug.
- "Streptomycin" in the form of injections that are placed intramuscularly. Daily dosages are calculated based on the following norms per 1 kg of weight: 0.01-0.02 g (up to 5 years), 0.25-0.3 g (preschoolers), 0.3-0.5 g (older age).
The last drug is prescribed with great care as side effects are likely to occur.
Adult Therapy
Continuing to talk about the treatment of lupus erythematosus, it is necessary to discuss what it is based on in the case of older patients. This disease in adults is amenable to therapy a little more difficult. Especially if the patient has been suffering since childhood.
Special means are used in the treatment. In particular, "Ortivazid", taken in parallel with vitamin D2 in large quantities (30,000, 50,000, and 100,000 IU per day). The notorious "Streptomycin" is also prescribed. The adult daily allowance is 0.5-1 grams.
If a person is diagnosed with ulcerative, warty, tumor-like tuberculous lupus, the photos of which are far from the most pleasant impression, then X-ray irradiation is indicated. Experts also consider phototherapy effective, but it is carried out in cases where there is no active infectious process in the lungs.
Topical treatment
It is prescribed to destroy diseased tissue. Effective remedies are such medicines:
- Pyrogallic ointment. A good drug, but in no case should it be used to eliminate the effects of lupus erythematosus in the oral cavity. If part of it gets inside, you will have to do a gastric lavage, and then rehabilitate with animal charcoal, oil, inhalation of oxygen. Severe poisoning may require a blood transfusion.
- Resorcinol paste. Suitable for removing tissues caused by lupus erythematosus in the oral cavity. However, in the field of dentistry, this drug is now considered obsolete, even dangerous. Although once this tool was one of the best.
- Liquid nitrogen. This remedy is now very popular in the treatment of atopic dermatitis, psoriasis, lupus erythematosus, warts, age spots, etc.
If the lesions on the human body are difficult to treat, they may prescribe an operation to remove them, after which X-ray therapy is mandatory.
Complications
They cannot be avoided if timely, rational treatment is not provided. Complications are serious, among them:
- Erysipelas. This infectious pathology is fraught with phlegmon, abscesses, necrotic lesions. Development of secondary pneumonia, sepsis is possible. Due to prolonged stagnation of lymph, elephantiasis, lymphedema occurs.
- Elephantiasis, manifested in a persistent increase in the size of a particular part of the body.
- Impetiginization. This consequence is characterized by the spread of purulent lesions throughout the skin.
- Lymphangitis. Often, due to lupus, the lymphatic capillaries or trunks become inflamed. Such processes are accompanied by painful swelling and hyperemia in the course of inflammation, as well as weakness, chills, edema, etc.
But the most serious complication is lupus carcinoma. It occurs due to the malignancy of the process, which leads to a long torpid course of lupus.
Forecast
For the disease in question, a chronic, long-term course is typical. And not all patients experience it the same way. In some people, lupus may not progress for years, even if they are not treated. And for others, it will develop during therapy.
The outcome depends on how strong the immune system is. And also from the presence or absence of other diseases, from living conditions, environmental conditions, from work. The prognosis can be favorable if a person strictly follows medical recommendations, eats well, and constantly strengthens his immunity. Under such conditions, recovery is quite likely.
