Sarcoidosis was until recently considered a rare disease. But nowadays, with the availability of the latest diagnostic methods, it has become diagnosed more often. For the first time this disease was described more than a century ago. Then it was considered one of the forms of tuberculosis. However, later this statement was refuted by official medicine.
Definition
Sarcoidosis is a systemic disease. It leads to damage to organic systems and tissues. The most frequently reported cases of sarcoidosis of the lungs and skin. Otherwise, this disease is called Besnier-Beck-Schaumann disease (in honor of those doctors who worked on the study of this pathology). Sarcoidosis is inflammatory in nature. Belongs to the group of granulomatosis. In the process of pathology development, clusters of inflammatory cells are formed, which are called granulomas.
Sarcoidosis has become the object of attention of internists, pulmonologists and general practitioners. The study of the causes of the disease, its diagnosis and treatment is relevant among physicians. Sarcoidosis can now be detected not only based on the resultsfluorographic studies, but also by skin signs.
Spread of disease
Most often, sarcoidosis of the skin, the symptoms of which will be discussed below, is diagnosed in middle-aged people. The disease is more common in women. It is extremely rare for this disease to develop in children. The most important symptom of the disease is the appearance of granulomas. They are nodules located in the form of limited foci. They may vary in size and shape. The disease does not apply to infectious diseases. Often, sarcoidosis occurs without any symptoms and is detected only during a physical examination of the patient.
Etymology of disease
The exact causes of this disease remain unknown. But most doctors believe that the development of this pathology is influenced by a whole range of reasons, including immunological, environmental and genetic factors. According to the current theory, pathogenic fungi, bacteria, parasites, plant pollen and toxic substances also affect. Officially, this disease is non-infectious. However, the possibility of the influence of microbial agents in the development of a disease such as skin sarcoidosis cannot be completely ruled out.
The reasons for its occurrence are still unknown. There are two theories about this. According to the first, sarcoidosis is inherited. Admirers of the second opinion argue that the appearance of the disease is associated with the individual immune response of the body to hormonal changes. The main cause is hereditaryfeatures of immunity, that is, its specific reaction to certain influences. As a rule, several causes are necessary for the occurrence of an ailment. It is worth noting that every third or sixth patient has a skin lesion with sarcoidosis.
Main types of sarcoidosis
As already mentioned, skin rashes are characteristic of the disease in the first place. These are certain pathological changes that are expressed in the formation of red nodules, spots and plaques. With this disease, the so-called erythema nodosum occurs. The most common is small-nodular sarcoidosis. It is characterized by the appearance of a large number of small red spots, which eventually transform into nodules of a dense consistency. Large nodular sarcoidosis is expressed in the appearance of single nodules and less often multiple. The skin lesion in this case is expressed in the presence of sufficiently large spherical nodes, characterized by sharp boundaries.
Other forms of illness
There are other varieties of the disease. Doctors allocate:
- Diffuse infiltrative sarcoidosis. Rashes on the skin are formed in the form of dense plaques. They are localized on the head or face. The boundaries of formations that are brown in color are blurred. They reach 15 cm in diameter.
- Angiolupoid Broca-Potrier. Neoplasms are observed on the nose and cheeks. As a rule, at first they are spots of red or violet color. Brown plaques then appear in their place.
- Besnier's lupus pernicitas-Tennesson. The place of distribution is the face and auricles. Lesions are red-violet and flat.
- Sarcoids Darier-Russy. This form of the disease is characterized by large nodes located under the skin and representing infiltrates. Localization - the area of the abdomen, thighs and armpits.
- Knodular subcutaneous type. Subcutaneous nodes appear on the legs or torso. There are few formations, they are painless and mobile. Sarcoids may coalesce to form infiltrated plaques with a rough surface.
In general, sarcoidosis of the skin, the treatment of which we will consider in this article, is periodic. At a time when the nodules disappear, in the foci the skin differs from he althy tissue. It is pigmented and flaky. An exception is Besnier-Tenneson's lupus. In this case, the foci after the disappearance of the rashes are no different from he althy tissue. Sarcoidosis of the skin, the photo of which is presented in the article, demonstrates large lesions on the patient's face. Next - about the symptoms.
Skin sarcoidosis: signs of the disease
Specific symptoms of the disease: plaques, nodes, cicatricial sarcoidosis, maculo-popular changes. Rare manifestations include: ulcers, psoriasis-like changes, ichthyosis, alopecia, nail damage. It is noted that most skin lesions are accompanied by moderate symptoms. However, there are also chronic skin lesions that lead to disfigurement of a person.
Sarcoidosis of the skin, the photo and symptoms of which are presented in the publication, has other distinctive features. Its feature isthe formation of dense bumps on the skin of the extremities, face and in some cases the trunk. The color of the seals changes from pinkish red to bluish and brown. Often there is a fusion of elements, there are small brown spots on the skin, in some cases the tubercles appear.
Scalp sarcoidosis may be one of the first manifestations of the disease. In this case, it is necessary to diagnose other organs and systems that can also be inflamed. The defeat of the scalp, as a rule, is combined with the presence of rashes on the skin of the forehead. In the center of the foci, there is a decrease in the density and diameter of the hair, which may be the beginning of the formation of foci of alopecia.
Small and large nodular sarcoidosis
Sarcoidosis can be small-nodular or large-nodular. In the first case, the nodules are most often located on the face, in the area of the elbow joints, decollete, shoulder blades. Their sizes are small - about 0.5 cm. They are hard and dense, in color - a brick shade or reddish-bluish. Sometimes nodules can spread throughout the body. Palpation is painless. With the course of the pathological process, skin areas in the lesions undergo pigmentation. Clear pigmented borders form around the affected areas.
If we consider the second option, then there are separate nodes. They are larger in size than in the previous case: they reach 2 cm. They do not differ in color from small ones. Most often appear in the face, neck, groin, sometimes on the outerside of the hands. Red or white pimples may form. Over time, the nodes often dissolve and leave behind a pigmented surface of the skin.
Medicated treatment
As a rule, patients with sarcoidosis are prescribed the following drugs: non-steroidal anti-inflammatory drugs, hormones. Complex treatment is provided. The best treatments for skin forms of this disease are glucocorticoids, methotrexate, and antimalarial drugs. Hormonal ointments are rubbed into the affected area, and drugs are also used orally. In addition to these drugs, the patient is prescribed sedatives and, in some cases, antidepressants.
Skin changes that spoil the appearance negatively affect the general condition. The patient in this case may become depressed, obsessed with his problem. Sarcoidosis of the facial skin especially has a negative impact on the psychological state of the patient. It turns out a vicious circle: a nervous breakdown further provokes the development of the disease, stimulating the emergence of new foci. Also, in addition to the above drugs, physiotherapeutic procedures are also connected: ultrasound, laser therapy and electrophoresis with hydrocortisone. At present, the disease is not fully understood. Therefore, in some cases, treatment is difficult. Doctors prescribe surgical techniques that eliminate symptoms.
Sarcoidosis of the skin: treatment of folk remedies
Sarcoidosis can also be treated with folk remedies. They contribute to the fact that the granulomas will resolve, in addition, the immune system as a whole will be strengthened. Propolis tincture is often used as a folk remedy for this disease. It can be purchased at the pharmacy, or you can make it yourself. To do this, 100 g of propolis must be infused in a bottle of vodka for a month. Application is as follows: dissolve 25-30 drops in boiled water or milk, drink once a day in the morning, on an empty stomach. Course - 28 days.
Sarcoidosis is often treated with herbs. For example, for this purpose, a tincture of radiola rosea is used. 15-20 drops of the medicine should be dissolved in boiled water. Take in the morning: before breakfast and lunch. The remedy must be drunk in two courses, each of which is equal to 25 days. The break between them is 2 weeks. Herbal tea, which includes marshmallow root, oregano and sage stalks, marigold flowers, bird mountaineer and plantain leaves, also gives good results. Welding ingredients must be mixed in equal parts. Then 1 tbsp. l. Pour boiling water over the mixture (1.5 cups). Insist for an hour wrapped up. Take 2 tbsp. l. four times a day. The course of treatment is 28 days. Break - a week. So it is necessary to repeat 4 times.
Very effective and a decoction of grape cuttings. It is necessary to boil 300 g of bunch branches in 1.5 liters of water. Cook for 15-20 minutes, cool and strain. Drink with honey, like tea, 100-200 g per day. Eucalyptus leaf tea has sedative properties, which is also used for this disease. In the morning you need to fall asleep 50 gcrushed leaves in a thermos and pour half a liter of water. In the evening, drink 100 g of infusion with honey.
It is worth noting that the considered decoctions in the treatment of sarcoidosis are used not only inside, but also in the form of lotions (except for eucalyptus tea). In the initial stage of the disease, it is also recommended to use onion ointment. It is prepared as follows: grated onion is mixed with sunflower oil and applied to the skin. Among other things, you can make baths with sage, chamomile, string and calendula.
Recommendations
There are a number of recommendations, the observance of which will contribute to a faster recovery. As such, there are no preventive measures against the recurrence of the disease. However, there are certain tips that will reduce the risk of sarcoidosis. Among them: maintaining a he althy lifestyle (refusal of nicotine), treatment of diseases that cause a weakening of the immune system, adherence to a non-strict diet and a rational diet. Food should be consumed 5-6 times a day in small portions. The ecology of the area is of no small importance, and it is also necessary to undergo a full medical examination in the clinic.
It is necessary to exclude dairy products from the diet, reduce the consumption of sweets and s alt. But the amount of fruits and vegetables, on the contrary, increase. You should choose fruits with the highest content of vitamin C. Avoid skin contact with aggressive substances that can cause irritation and allergies. If the patient is given adequate systemic treatment, the disease will quickly recede. For this lifetimeailment has no effect.
Biopsy
For early recognition of sarcoidosis, the most effective method is a biopsy. It is used for early diagnosis of the disease using a minimally invasive procedure. Sarcoidosis can affect various organs and systems of the body. Simultaneously with the skin, the disease can affect the lymph nodes, liver, spleen, heart and nervous system. If a patient is diagnosed with sarcoidosis of the skin, he should undergo a complete examination. Because often other organs are also affected with this disease.
Specific and non-specific lesions
Skin lesions are divided into specific and non-specific. Let's consider the first kind. Foci of erythema nodosum occur without the appearance of deformities, but are characterized by pain on palpation. May be accompanied by arthritis, fever. With an exacerbation of the disease, there is also fatigue and skin rashes that last about 3-6 weeks. At the beginning of the development of the disease, warm painful reddish nodes appear on the lower extremities. Bilateral formations, the size of which is from 1 to 5 cm, can change their color several times: from bright red and purple to yellow and green. Expressions are usually not observed. The nodes generally heal without scarring. Non-specific manifestations include skin calcification and lymphedema.
Sarcoidosis of the skin, the symptoms of which are expressed by specific lesions, is usually maculopapular type. There are foci of red-brown or lilac color, reaching less than 1 cm in size. They spread to the face, neck,lips, auricles, limbs and upper back. Typical granulomas do not show signs of infection. Old scars that are then damaged for some reason may become infiltrated with sarcoid granulomas.
Examination
For a condition called skin sarcoidosis, diagnosis usually includes a biopsy procedure and a complete blood count with leukocyte count and platelet count. With this disease, in some cases, leukopenia, thrombocytopenia, anemia are observed, most often - eosinophilia, decreased skin reactivity, hypergammaglobulinemia. In addition, patients are examined for calcium content in daily urine and blood serum. Half of the patients had hypercalciuria, 13% had hypercalcemia. An analysis of the level of AKF in the blood serum is carried out. In more than half of the cases, it is elevated in patients. A biochemical blood test is also provided. An increase in ESR and antinuclear bodies should also be taken into account.
For sarcoidosis, chest x-rays and computed tomography are performed, as this disease is often accompanied by damage to them. For more accurate diagnosis, a skin biopsy is performed, after which the material, including the dermis and subcutaneous fat, is sent for histological examination.
Dieting
For a speedy recovery, you need to follow a certain diet, which includes foods containing Omega-3 fatty acids. They stimulate the production of hormones that are aimed atreducing inflammation. In addition to fish oil and flax seeds, you need to eat fruits, vegetables and nuts. In this case, you need to exclude those foods that increase the risk of inflammation. For example, vinegar and other synthetic acid forms. It is necessary to minimize the consumption of sugar, flour products, fried, s alty foods, hot sauces and seasonings, sweet carbonated drinks, dairy products.
In this article, we examined a rather rare disease - skin sarcoidosis, the photos and symptoms of which clearly demonstrate the clinical manifestations of this disease. Treatment is carried out mainly with hormonal drugs. The prognosis in the presence of an acute form is usually favorable. Therapy is often given on an outpatient basis.
