Diseases of the inflammatory nature of the vessels of the skin and fatty tissue are diagnosed in medicine quite often. Usually this phenomenon is observed with the complication of certain diseases. One of the pathologies of the connective tissue, in which the skin and subcutaneous fat is affected, is erythema nodosum. The disease manifests itself in the form of seals or nodules up to five centimeters in diameter on the lower extremities, in the thighs and buttocks. Usually, the pathology develops on two legs at once, it causes pain and can occur in an acute or chronic form.
Characteristic of the disease
Erythema nodosum is a disease of the skin and subcutaneous vessels, which manifests itself in the form of dense inflammatory nodes of various sizes. In medicine, this disease is considered to be one of the varieties of allergic vasculitis, which affects only the lower extremities. This disease is diagnosed in people of different age groups, but most often occurs between the ages of 20 and 30 years. Before adolescence, pathology is observed in the maleand female in the same ratio, but after puberty it usually affects women, especially in autumn or winter.
In a third of patients, erythema nodosum (the photo of which is shown below) develops as an independent disease. In other cases, it is a consequence of the progression of other pathologies in the body, such as tuberculosis, sarcoidosis or streptococcus. As erythema develops, complete damage to the vessels in the legs occurs. Red or purple seals appear on the limbs. The ICD-10 code for this disease is L52.
Causes of erythema
Most often, doctors fail to establish the reasons why erythema nodosum develops on the legs. In some cases, this pathology is preceded by various infectious diseases, in particular streptococcus, tonsillitis, pharyngitis, cystitis, arthritis, tuberculosis, inguinal lymphogranulomatosis and others. The main reasons for the development of the disease include:
- Sensitivity of the body to certain medications, the development of allergic reactions. Of particular danger in this case are preparations of the salicylates, bromides, iodides group, as well as antibacterial agents and vaccines.
- Hereditary predisposition to hypersensitivity to certain stimuli.
- Disorders of the vascular system. Often the pathology develops with varicose veins, atherosclerosis.
- Chronic infections in the body: tonsillitis, pyelonephritis and others.
- Pathologies of allergic genesis, in particularasthma, dermatitis, hay fever.
- Noncommunicable diseases: sarcoidosis, Begchet's syndrome, colitis.
- Diseases of the gastrointestinal tract of an inflammatory nature.
- Pregnancy.
- Benign and malignant neoplasms.
- STD.
Medics tend to argue that erythema nodosum, the photo, the symptoms and treatment of which are detailed in this article, develops when chemicals or infectious agents enter the body, as a result of which antigens are formed in the body. With a genetic predisposition to the disease, these antigens begin to form specific antibodies, which provoke the development of pathology. In 40% of cases, doctors fail to identify the causes of the disease.
Erythema during pregnancy
Erythema nodosum is most often diagnosed in pregnant women. Doctors have found that those women who have previously taken hormonal contraceptives are most susceptible to pathology. When the hormonal background is distorted in the body of a pregnant woman, antibodies are formed that provoke the development of the disease. Moreover, during the period of bearing a child, immunity is reduced, and the body is weakened, which causes the development of various diseases, including erythema.
Provoking factors include:
- changes in climatic and weather conditions;
- hypothermia;
- hypertension;
- congestion in the lower extremities.
Erythema nodosum in children
Oftenthis disease is diagnosed in children as a complication of viral infections, diseases of the oral cavity, chronic otitis, tuberculosis. If the doctor fails to identify the cause of the development of the disease, he diagnoses the idiopathic form of erythema, which develops as an independent pathology.
Most often the disease develops at the age of 6 years and older, girls are more susceptible to this disease. The first signs of erythema nodosum, the treatment of which will be described below, manifests 5 days after development. At the same time, the symptoms in children are pronounced, they have intoxication of the body, an increase in body temperature, pain in the abdomen and joints, the development of pain during physical contact with pathological areas, the appearance of nodes on the lower leg and thigh the size of a walnut. Pathological areas acquire a blue tint. When the first signs of pathology appear, it is necessary to urgently contact a medical institution to determine the cause of the disease and conduct effective treatment.
Symptoms and signs of erythema
Erythema nodosum usually begins to show symptoms on the fifth day. In a person, dense knots form in the subcutaneous fat, while the skin in these places becomes smooth and acquires a red tint. The nodes have fuzzy boundaries, as the edema goes beyond them. After 5 days, they begin to thicken, and the skin turns blue. In addition, a person experiences discomfort, he has chills, joint pain, swelling, and body temperature increases. Most often sealsare formed on the front of the shins, while they can also be located in places where there is fatty tissue, such as on the thighs, buttocks, calves, and even on the face.
After 2 or 3 weeks, the seals begin to disappear, the skin begins to peel off, age spots appear on it, the joints no longer bother a person. Usually, erythema nodosum (the photo and symptoms of which are presented) resolves on its own after 30 days, but sometimes it has a chronic form, so it may return after a while.
Disease forms
In medicine, there are several forms of erythema:
- The acute form is characterized by all of the above symptoms. First, one small node is formed on the limb, which gradually increases to 5 centimeters, and then stops growing. After 30 days, the symptoms of the pathology disappear, there is no recurrence of the disease.
- Erythema nodosum migrans is caused by washed out symptoms. First, there are malaise and weakness, pain in the muscles and joints. Then the person's body temperature increases, flat and dense nodules appear on the front side of the lower leg, which have clear boundaries, the skin at the site of their occurrence acquires a blue tint. The number of nodes can vary from one to eight, they are placed asymmetrically. As the nodules grow, they begin to migrate, in their place a plaque with a depression in the center is formed. The provoking factors in this case are pregnancy, streptococci andsarcoidosis. The disease can last for five months, after which it disappears without a trace.
- The chronic form usually develops in the presence of chronic infectious diseases in humans. At the same time, there are no symptoms of intoxication of the body, the nodules are small in size, so it is difficult to see them. Periodically, the symptoms get worse and then subside again.
Complications and consequences
Sometimes erythema nodosum on the legs, the treatment of which was untimely or ineffective, can transform into a chronic form that is difficult to cure. Usually this disease does not pose a danger to life and he alth. But often the pathology is accompanied by various diseases that can cause the development of negative consequences, so it is important to correctly establish the causes of erythema. The prognosis is usually favorable, modern medicine has many ways to successfully treat erythema.
Diagnosis
To make an accurate diagnosis, a comprehensive examination is required, during which it is necessary to examine other organs and systems. After studying the anamnesis and visual examination, the doctor prescribes laboratory blood tests. In the presence of erythema in the blood, leukocytosis and high ESR will be detected. A bacteriological culture is also prescribed from the mucous membrane of the nasopharynx in order to detect streptococcal infection, as well as feces to exclude tuberculosis.
In case of joint pathology, it is necessary to undergo an examination by a rheumatologist and donate blood forrheumatoid factor. If tuberculosis is suspected, tuberculin diagnostics is prescribed. If it is not possible to diagnose the disease, the doctor performs a biopsy of the pathological nodes on the lower extremities, followed by a histological examination of the biopsy, during which the presence of an inflammatory process in the walls of the veins and arteries is determined. Diagnostic methods such as ultrasound, pharyngoscopy, rhinoscopy, CT and MRI, radiography, rheovasography are also often used.
The doctor in each individual case selects the necessary diagnostic methods, it all depends on the course of the disease, its form, age and general condition of the patient.
The doctor differentiates the pathology from such diseases as skin tuberculosis, thrombophlebitis, vasculitis, panniculitis, erysipelas, Bazin's erythema, Weber-Christian syndrome.
Cure disease
Treatment of erythema nodosum involves such that it is aimed at eliminating, first of all, comorbidities. The doctor conducts sanitation of pathological foci, prescribes antibacterial and desensitizing drugs. NSAIDs, such as Ibuprofen, are prescribed to eliminate inflammation and relieve pain.
As a local therapy, anti-inflammatory ointments are used, which are applied to the affected areas and joints. The doctor often prescribes ultraviolet radiation, magnetotherapy, laser therapy, phonophoresis and plasmaphoresis, hemosorption. Also, erythema nodosum, the symptoms and treatment of which are being considered today, requires the use of antihistamines and aminocholinergics.funds, corticosteroids.
Children must be prescribed bed rest, warming compresses with anti-inflammatory ointment, antihistamines, such as Suprastin.
Efficiency of treatment is determined by the reverse development of the symptoms of pathology and the reduction or complete disappearance of signs of the inflammatory process of blood vessels and subcutaneous tissue.
Pregnancy Therapy
Difficulties in therapy most often occur with the development of pathology in a pregnant woman. In this case, the doctor prescribes drugs that will not harm the unborn child and his mother. The woman takes all medications under the supervision of the attending physician.
The goal of therapy in this case is to reduce the manifestations of skin pathologies and eliminate serious infections. A pregnant woman should adhere to bed rest, she is prescribed antibacterial drugs of the penicillin series or macrolides, NSAIDs. The doctor also sanitizes foci of infection, treats concomitant diseases.
Traditional medicine
Doctors do not recommend using traditional medicine to treat the disease, as they will not give a positive result, and the person will waste time. But despite this, many patients prefer to use folk recipes to fight the disease. Alternative therapy is possible only in the case of an additional method and only after consultation with your doctor, as some medicinal herbs can provoke the development of side effects.
Forecast and prevention
Usually erythema nodosum (photo and treatment is presented in the article) does not pose a danger to human life and he alth, it is only necessary to treat concomitant diseases in a timely manner that can provoke the development of negative consequences. The prognosis of this pathology is favorable. In the chronic course of the disease, relapses are possible, but they do not pose a danger to human he alth.
Prevention of the disease should be aimed at the timely treatment of infectious and inflammatory diseases, and also consists in the mandatory sanitation of the body from foci of infection. Doctors recommend monitoring the state of the vascular system, at the first sign of varicose veins, you should consult a specialist. It is also important not to come into contact with allergens, periodically undergo scheduled medical examinations and treat chronic pathologies. By following these recommendations and instructions, you can avoid the development of the disease or start timely treatment if it is present.
