Erythema is accompanied by an increase in capillaries, due to the intensive flow of blood to them. Ring erythema (Erythema annulare) is considered one of the signs of rheumatism in the active phase, for example, with polyarthritis, as well as a manifestation of other disorders in the body. The disease affects mainly children and young people under 30 years of age. In the last century, experts have assessed erythema annulare as a disease with a poor prognosis. Nowadays, with the availability of new effective methods for the treatment of rheumatic disorders, the prognosis in the fight against erythema is quite optimistic.
Erythema history
Symptoms of the disease were discovered by doctors at the beginning of the last century. The first to describe erythema annulare and attributed it to skin diseases were pediatricians from Austria G. Lendorff and H. Leiner in 1922. It was they who characterized the disease as one of the symptoms of rheumatism. Therefore, the disease is also called Lendorff-Leiner rheumatic erythema. A doctor from France Besnier at that time called erythema annulare erytheme margine en plaques, so in foreign sources you can often find the name erythema marginatum.
In 1975, H. Stollerman identified a form of erythema annulare thatwas not a manifestation of rheumatism. Numerous histological studies in the field of rashes have allowed specialists to identify forms of the disease caused not by rheumatic disorders, but by a violation of the autonomic regulation of the walls of blood vessels, as well as various infections and disorders in the immune system.
Erythema annulare symptoms
Erythema annulus manifests itself in the form of pink or red closed rings that appear on the skin. Most often, the spots are round or oval in shape, with a pale center and often edematous. The affected areas are not flaky and painless. Patients may experience itching and a burning sensation in the affected area.
Rings increase in size, the formation of new circles is often observed inside them. As the spots of erythema grow, they can merge with each other, forming figures of various shapes. The disease proceeds in waves, and if some rings disappear, then after a while new reddenings appear instead of them. One attack follows another in about three weeks. The appearance of rashes on the mucous membranes, the skin of the palms and soles is not typical for a disease such as erythema ring. The photo clearly demonstrates the nature of skin lesions in erythema.
Erythema annulare is localized on the chest, shoulders, face and neck, sometimes on the back, arms and legs. The intensity of the spots often increases under the influence of some factors. Among them, the influence of temperature, both low and high,emotional state, endocrine changes (menstruation, taking hormonal contraceptives or steroid drugs), and so on. In some cases, erythema manifests itself atypically, accompanied by purple rashes and the formation of vesicles. If, along with rings, nodules appear on the skin, doctors consider this as a symptom indicating an unfavorable development of rheumatism. At the same time, erythema annulare is also observed in patients at the stage of recovery after the disappearance of the main manifestations of rheumatoid disease.
Causes of disease development
The cause of rheumatoid erythema is rheumatism in the active phase, and the appearance of rings on the skin is often a harbinger of exacerbation of rheumatic heart disease and polyarthritis. For doctors, in most cases, erythema annulare is a confirmation of the diagnosis of rheumatism.
Forms of non-rheumatoid annular erythema develop due to some other reasons. Among them:
- fungal infections such as athlete's foot and candidiasis;
- malfunctions of the endocrine system;
- immune system problems;
- intoxication;
- focal infections (osteomyelitis, tonsillitis, cholecystitis and others);
- dysproteinemia, or a violation of the protein composition of the blood;
- allergic drug reactions;
- leukemia, lymphoma, adenocarcinoma;
- sepsis;
- glomerulonephritis;
Erythema annulare treatment
With regard to the fight against such a disease as annular erythema, treatment is primarily aimed at eliminating the causes,causing skin lesions. If the disease is accompanied by the presence of infection in the body, antibiotics are prescribed. Also, in the fight against erythema annulare, vitamin therapy, the use of immunostimulating, antihistamines, calcium preparations and sodium thiosulfate are widely used. The nutrition of the patient provides for a diet in which there are no allergens in the food. The treatment of erythema caused by rheumatism is primarily aimed at combating the underlying disease.
Erythema migrans
If single rings appear on the skin with bite marks in the center, then we are talking about such a lesion as migrating annular erythema. It has been established that this type of disease can appear due to the bites of ixodid ticks and some other insects.
Erythema migrans is caused by an infection, usually viral or bacterial. The disease is quite difficult, often becomes chronic. It is worth noting that erythema migrans tends to be transmitted from mother to fetus. The initial symptoms are skin hyperemia, swelling and peeling. The lesion gradually increases in size and forms a kind of border. Further stages are characterized by the development of exocytosis, which manifests itself as a protective function, while the cells of the affected tissues displace toxic substances through the membrane to the surface. Leukocyte infiltration is found in the tissues. The infiltrate is subjected to a thorough analysis, which allows a correct diagnosis.
Characteristically,that the bites of ticks, bees, hornets and other insects cause the development of acute erythema migrans. A more complex and insidious type of disease is its chronic form, the origin of which in most cases remains unknown. And erythema itself is characterized by severe swelling, pain and constant itching and burning. To diagnose chronic erythema, a comprehensive examination is performed, including a complete blood and urine test, an examination of the infiltrate and epidermis.
Erythema migrans treatment
Therapy is done with broad-spectrum antibiotics. The choice of drugs the doctor conducts depending on the form and stage of the disease. For example, at the first stage, the use of the drug "Doxycycline" for one to two weeks gives a good effect. If the disease is severe, the doctor may prescribe Cetriaxone tablets and Benzylpenicillin intramuscularly for 14-21 days. Additional therapy includes taking vitamins. The optimally selected treatment option for such an ailment as erythema migrans, in most cases, contributes to a quick recovery.
Erythema toxic
This type of disease occurs in newborns and is manifested by rashes on the child's body. The disease affects 20-40% of infants. According to the severity of the course, toxic erythema is divided into unexpressed and expressed (or generalized) forms. In the first case, the rashes are minor and are localized on the back and inner folds of the limbs. The general condition of the baby is assessed assatisfactory.
In generalized toxic erythema, the rashes are multiple, they often merge with each other, forming vesicles. The temperature is elevated, and the child becomes restless. In the blood of an infant, an increased content of eosinophils is found. This is a kind of leukocytes that perform a protective function when allergens enter the body, as well as helminthic invasions.
Among the risk factors for toxic erythema are the following:
- hereditary burden;
- pregnancy toxicosis, especially severe;
- employment of a future mother in hazardous work;
- intrauterine infection;
- presence in the diet of a pregnant or lactating woman of obligate food allergens, such as citrus fruits, chicken eggs, chocolate, honey, currants, raspberries and others;
- diabetes, thyroid disorders or maternal obesity.
If the erythema of the newborn is a consequence of the presence of allergens in breast milk or formula for feeding, then the disease disappears on its own 4-5 days after the revision of nutrition. In severe forms of toxic erythema, special treatment is prescribed.
Therapy for neonatal erythema
The toxic form of erythema requires treatment in its severe forms. The doctor prescribes properly selected antihistamines and special ointments or creams. It is important at the stage of treatment to excludeintake of allergens in the body of mother and child. As an auxiliary treatment, calcium gluconate, vitamins, Rutin are used. Rashes and vesicles should be treated several times a day with brilliant green or a weak 4-5% solution of potassium permanganate, and after the procedure, apply baby powder to the skin of the child.
Erythema multiforme
This is an inflammation of the skin and mucous membranes, which is based on an allergic reaction of the body. Erythema multiforme affects the extremities, mucous membranes of the mouth, genitals and nose. The disease occurs in both children and adults.
Certain drugs and some infections contribute to the development of exudative erythema multiforme. This type of disease is caused by antibiotics of the penicillin series, barbiturates, sulfonamides and other drugs. Of the infections, the most common causes of erythema multiforme are mycoplasmosis and herpes. The most severe disease is erythema, caused by a reaction to drugs. For example, Stevens-Johnson syndrome.
Erythema multiforme treatment
To combat the disease, both general and local methods of therapy are used. The former include the use of antibiotics and antihistamines, the use of immunostimulants. At the same time, the patient's chronic diseases are treated. Local treatment is expressed in the use of painkillers and antiseptics, such as "Chlorhexidine" or "Furacilin", ointments containing prednisolone and hydrocortisone. Good oral hygiene and othermucous membranes.
