Ring-shaped eritema – the damage of skin of various etiology which is shown eritematozny rashes various (most often ring-shaped) forms on integuments of a trunk, the lower and top extremities. It is characterized by a long current, will hard respond to treatment. Diagnostics of a ring-shaped eritema is based on studying of the anamnesis, data of survey and results of various serological researches conducted for an exception of infectious diseases. Etiotropny treatment is absent, usually perform the desensibilizing therapy, apply antibiotics and vitamin medicines. In some cases rashes disappear at elimination of provocative pathology.
Ring-shaped eritema (a resistant ring-shaped eritema, an eritema to Darya, it is long the proceeding eritema) – group of skin diseases with similar manifestations – formation of ring-shaped and shapeless eritematozny rashes. One of forms of this state in 1916 was described by the French dermatologist to Zh. Darya, at the moment it carries the name of a ring-shaped centrifugal eritema to Darya. In addition like a disease exists some more kinds of pathology differing among themselves on age of development, an etiology and clinical manifestations. Various types of a ring-shaped eritema can arise at children, teenagers or elderly people. The majority of kinds of an eritema are equally often diagnosed for men and women, the eritema to Darya several times meets at males more often.
Reasons of a ring-shaped eritema
The etiology and pathogenesis of a ring-shaped eritema in many cases remain not clear, are available only the assumption of influence of these or those factors. The rheumatic form of pathology is caused by rheumatic damage of joints, however the cause of skin manifestations is not established yet. The migrating ring-shaped eritema more often revealed at children and teenagers probably is connected with various viral and bacterial infections.
The greatest number of questions is caused by an etiology of a ring-shaped eritema to Darya. Development of this form of a disease, presumably, can be caused by a fungal infection of skin, autoimmune processes and reception of some medicines. Besides, the eritema to Darya quite often arises against the background of various helminthoses that also testifies in favor of the autoimmune nature of a disease. The set of cases of emergence of a ring-shaped eritema against the background of tonsillitis, other inflammatory processes, endocrine frustration and violations of a hormonal background is described. Oncologists note that sometimes the ring-shaped eritema is a part of a paraneoplastic syndrome. Thus, this state represents a special form of a jet dermatosis of various etiology.
Symptoms of a ring-shaped dermatosis
Besides allocation of the listed above forms of a ring-shaped eritema (rheumatic, migrating, Darya), in practical dermatology there is a classification made taking into account features of a clinical current which at common features differs on the nature of rashes, duration and other characteristics. At the moment allocate four clinical forms of a ring-shaped eritema. The first symptom of all forms is education on the surface of skin of spots of red color, sometimes with a skin itch. In the subsequent the current of each form gains the characteristic features.
The shelled ring-shaped eritema develops at helminthoses and a paraneoplastic syndrome more often. The site of reddening begins to be shelled over time, in the center insignificant pigmentation of skin comes to light, reddening becomes less expressed. Growth of education continues on the periphery, the size of the pathological centers reaches 15-20 centimeters. Changes of the central part are expressed poorly that in combination with peripheral growth leads to emergence of characteristic formations of a bizzare shape. Duration of existence of the center can make several months, after permission of rashes skin remains pigmented. New spots and sites of a ring-shaped eritema are often formed, at the long-term recidivous course of a disease on a body of the patient fancy patterns from sites of an eritema and zones of a hyperpegmentation come to light.
The vesicular ring-shaped eritema has not clear etiology, usually arises against the background of the reduced immunity and endocrine frustration. At a stage of a red spot at the edges of the center there are small bubbles filled with serous liquid. Further, as well as at the shelled ring-shaped eritema, the peripheral growth of the pathological center with formation of the site of a hyperpegmentation in the center is observed. In the course of growth at the edges of the center small vesicles constantly are formed and disappear. A current of this form of a ring-shaped eritema chronic recuring, rashes can disappear in several weeks or months, being replaced by development of the new centers.
The simple ring-shaped eritema arises at an allergy to food or medicines. Is the easiest option of a disease, it is characterized by rather bystry transformation of spots in ring-shaped structures. The peeling of skin or formation of vesicles does not occur, reddening becomes the only display of a disease. Ring-shaped structures are completely resolved in several days or even hours after education.
The resistant ring-shaped eritema has not clear etiology, is followed by formation of small spots and rings with a diameter up to 1 centimeter. Sometimes in a zone of defeat there are vesicles or sites of a peeling. The long current is characteristic.
In literature such forms of a ring-shaped eritema as teleangiektatichesky, condensed and purpurozny are also described. Because of insignificant prevalence (less than one hundred cases) some dermatologists believe that the specified forms of a ring-shaped eritema do not exist, and the described changes are other skin diseases with formation of ring-shaped structures. The question concerning justice of such opinion remains debatable today.
Diagnostics of a ring-shaped eritema
The diagnosis "a ring-shaped eritema" is based on data of the anamnesis and results of dermatological survey. In disputable cases make a skin biopsy in the field of the pathological centers. At survey of the dermatologist eritematozny rashes of various forms and the sizes are defined, it is frequent in the form of the fancy closed lines and strips. Depending on a form of a ring-shaped eritema along with reddening of skin the peeling, formation of papules or vesicles can be observed.
When studying the anamnesis of the patient the diseases which provoked development of this form of a jet dermatosis quite often come to light. The helminthic invasion, skin mycoses, malignant new growths, an inflammation of elements of an oral cavity and the top airways are possible. In the absence of the listed diseases to the patient laboratory and tool researches for assessment of a condition of various bodies and systems and definition of the reasons of development of a ring-shaped eritema can be appointed. Especially attentively it is necessary to treat a possibility of oncological defeat as the ring-shaped eritema sometimes is manifestation of a paraneoplastic syndrome.
Changes in the general blood test at a ring-shaped eritema have nonspecific character and, generally promote establishment of the nature of a provocative factor. For example, the eozinofiliya can testify to a helminthic invasion or an allergy, – to an acute or chronic inflammation. Rather often at a ring-shaped eritema the disproteinemiya – violation of a ratio between separate fractions of proteins of plasma is found. At a histologic research of skin invariable epidermis with hypostasis and the expressed leykotsitarny infiltration terms usually comes to light. The Gistoimmunofluorestsentny analysis confirms accumulation of immunoglobulins of a class G at a basal membrane of epidermis. The differential diagnosis of a ring-shaped eritema is carried out with seboreyny eczema, a ring-shaped granuloma and syphilitic rozeoly.
Treatment of a ring-shaped eritema
Etiotropny treatment of a ring-shaped eritema is absent, however successful therapy of a provocative disease can reduce manifestations of this state considerably. Depending on the revealed pathology carry out treatment of mycoses of skin, tonsillitis and diseases of digestive tract. If necessary carry out sanitation of an oral cavity. In the course of treatment of the main disease use antibiotics, antivermicular means and other medicines. In the presence of a malignant new growth the plan of therapy is defined depending on localization, prevalence and a type of a neoplasia.
Along with treatment of the main disease at a ring-shaped eritema carry out the desensibilizing therapy. Use antihistamines (, ), chloride of calcium and thiosulphate of sodium. For normalization of a metabolism to patients appoint vitamin therapy, especially vitamins C, And yes E. The hypoallergenic diet with increase in amount of carbohydrates in a diet is shown to patients. In hard cases apply corticosteroids (Prednisolonum) to reduction of the inflammatory phenomena. Locally apply protivozudny ointments, in the presence of vesicles use antiseptics for prevention of a secondary infection.
Forecast and prevention of a ring-shaped eritema
In general forecast favorable. This state does not threaten life of the patient and at establishment of the reason of development in some cases gives in to full treatment. At a ring-shaped eritema of the obscure etiology the forecast worsens as experts can only carry out symptomatic therapy and perform treatment of the revealed diseases, perhaps in any way not connected with damage of skin. Sometimes after the intensive desensibilizing therapy the ring-shaped eritema gradually disappears, but after a while arises again. In similar cases it is recommended to keep constantly to a hypoallergenic diet, to periodically accept vitamins and antihistamines.
Prevention consists in timely treatment of inflammatory respiratory diseases, regular sanitation of an oral cavity and prevention of a helminthic invasion. Patients of ring-shaped eritemy have to visit regularly the dermatologist even during remission. In especially hard cases statement on the dispensary account is required.