Kaltsinoz of skin
Kaltsinoz of skin – a chronic state at which in fabrics of integuments there are deposits of solid salts of calcium, sometimes with development of an inflammation and restriction of mobility of joints. Symptoms of this disease are small knots on various parts of the body, generally on the top extremities, a firm and dense consistence, sometimes painful. Diagnostics is performed by survey of integuments of the patient and carrying out radiological researches. Treatment of a kaltsinoz of skin depends on the reason of development of this state, generally apply the means normalizing mineral exchange at the centers, considerable by the size, resort to electrothermic coagulation and surgical intervention.
Kaltsinoz of skin
Kaltsinoz of skin (Profishe's syndrome) – a dermatological disease of various etiology at which in fabrics of integuments conditions for adjournment of salts of calcium in a firm look are created. For the first time such state was professionally described by the French doctor Zh. Profishe therefore in some sources the syndrome at which adjournment of kaltsinat in skin is observed bears his name. This polietiologichesky disease which can act both as the only manifestation of various violations of metabolism, and a symptom of some serious internal pathologies. Kaltsinoz of skin has several versions which differ among themselves in clinical shows and the mechanism of adjournment of salts in fabrics.
Reasons of a kaltsinoz of skin
Usually in the majority of body tissues (except for teeth and bones) salts of calcium are in the dissolved look – it allows to transfer them with blood current to those bodies where they are necessary. However in some cases conditions for their loss in a deposit can be created that leads to formation of the pathological centers including a kaltsinoza of skin. Metastatic it is characterized by a giperkaltsiyemiya because of which the increased quantities of ions of calcium are carried on all organism. At the same time deposits of salts are usually formed in many bodies, but can sometimes arise also in integuments. Such skin usually proceeds against the background of malignant tumors of bones, metabolic violations, the increased intake of calcium with drinking water or food. Option of this state is also D at which there can also be deposits of salts of calcium in various fabrics including to skin.
More often meeting metabolic skin it is caused by violations in integuments and hypodermic fatty cellulose. At the same time it is optional that in an organism there was a large amount of these salts – because of various reasons (features of blood circulation, level ) at normal concentration of calcium in blood he all the same is late in fabrics, leading to development of a disease. Presumably, the delay of this element is made by the changed collagenic fibers that happens at different collagenases of autoimmune and hereditary character. One more type of such disease is so-called secondary skin which arises on the place of hems, the centers of various dermatological diseases (a system sklerodermiya, a dermatomiozit, new growths of integuments).
Symptoms of a kaltsinoz of skin
Allocate two main groups of a kaltsinoz of skin – metastatic and metabolic. Metastatic as it is possible to understand from the name, arises because of transfer of salts of calcium from one part of an organism in another. The malignant tumor, the osteolysis center, the affected kidneys and other bodies can be their source. At the same time there is a giperkaltsiyemiya, and in those bodies where concentration of ions of calcium exceeds their solubility in these conditions, the centers of adjournment of salts are formed. Usually it is internals, sinews and vaginas of muscles, sometimes - hypodermic fatty cellulose and skin. At this type of a kaltsinoz of skin the symptomatology which is very erased is also quite often hidden by displays of the main disease. Separate small knots and consolidations on skin and in hypodermic cellulose can be defined, inflammatory manifestations and other pathological changes, as a rule, are not observed.
Metabolic skin meets much more more often and has several versions which are characterized by different symptoms and manifestations. At the same time giperkaltsiyemiya it can not be observed, there can not be also no deposits of salts in other fabrics and bodies as formation of the centers on skin happens for a cause of infringement of a local metabolism in integuments. Dermatologists allocate the following forms of a metabolic kaltsinoz of skin: limited, universal, opukholevidny.
The pathogenesis of a limited metabolic kaltsinoz of skin is authentically unknown, as well as the reasons of formation of deposits of salts in this case. At first this pathology proceeds completely asymptomatically – only sometimes the person can find sites of consolidation under not changed skin. Such type of a kaltsinoz of skin mainly strikes the top extremities, favourite localization of the pathological centers – sites over projections of joints (elbow, luchezapyastny, interphalanx). Over time the centers grow and become noticeable in the form of the small small knots towering over the surface of skin. Under the influence of injuries or spontaneously they inflame, integuments over them gain red color, their palpation becomes painful. Women of middle and advanced age suffer from such form of a kaltsinoz of skin mainly.
Universal skin – more severe form of a disease caused by violations of exchange of calcium and phosphorus. At this state the pathological centers are formed on extremities (also within a projection of large joints) and on buttocks, other localization occasionally can be observed. Quickly enough deposits of salts gain character of dense small knots, but over time begin to be softened and turn into painless erosion and ulcers which bottom is covered to the white, easily crumbling contents. Healing of such damages caused kaltsinozy skin happens very slowly to formation of noticeable hems and scars. Such state is most often diagnosed for children and young people aged up to 20 years.
Opukholevidny skin – a rare form of a disease at which there is an adjournment of salts in soft tissues of joints and on head integuments. As a rule, the centers single, can reach the considerable sizes (to 10-12 centimeters), slowly grow and can externally remind oleogranulema. Such form of a kaltsinoz of skin occurs practically only at children.
Secondary skin, caused by pathological changes at some dermatological states, a part of experts treats metabolic type whereas others – in a separate form of this disease. It is separately allocated also idiopathic , having not clear etiology – it is supposed that it possesses symptoms of a hereditary disease. Authentically it was succeeded to prove the genetic nature of a kaltsinoz of skin concerning a syndrome of Teychlender which is inherited autosomno-retsessivno. At this state young people have kaltsinata in hypodermic cellulose and soft tissues of joints, all this is followed by fever and muscular dystrophy.
Diagnostics of a kaltsinoz of skin
Diagnostics of a kaltsinoz of skin in dermatology is made on the basis of the present status of the patient, radiological researches, histologic studying of fabrics in the place of the pathological centers. A supporting role in diagnostics plays biochemical blood tests and urine, various inspections for search of the main pathology which could lead to violation of mineral exchange with such manifestations. At survey reveal the centers of various localization and the sizes depending on type of a kaltsinoz of skin and a stage of its current, most often it is the small knots of the stony hardness in projections of joints covered not changed or inflamed by skin. Morbidity arises at accession of an inflammation or a trauma of a pathological small knot, mobility of joints because of the considerable sizes of a kaltsinat can sometimes be broken. At a universal metabolic kaltsinoz of skin in a stage of permission to surfaces of integuments of legs and buttocks painless ulcers with white contents at the bottom can be observed.
When carrying out radiological inspection of the patient with kaltsinozy skin on the place of the pathological centers are defined dense (sometimes more dense than a bone) shadows of irregular shape and consisting as though of separate small balls. In case of old kaltsinat the thin structure is not visible any more, only the dense center comes to light. Sometimes on X-ray it is possible to see existence of the centers with calcium not only in skin and hypodermic cellulose, but also in other fabrics – around joints, sinews, some internals. Carrying out a biopsy of such centers can be sometimes complicated, however if all this managed to be made, then perivaskulyarny deposits of calcic salts with a degeneration of soyedinitelnotkanny fibers will be observed most often.
At a metastatic kaltsinoz of skin in results of biochemical blood test the expressed giperkaltsiyemiya will be defined, in case of metabolic option of a disease it is not obligatory manifestation. Idiopathic , having symptoms of a hereditary disease, it is often shown by a fosfatemiya. Also the dermatologist can direct the patient to experts of other profiles for search of pathology which could lead to development of a kaltsinoz of skin or to appoint additional analyses. Quite often careful poll and studying of the anamnesis of the patient as at the same time it is possible to reveal the factors promoting violations of mineral exchange can help with diagnostics of this state. Differential diagnostics of a kaltsinoz of skin should be carried out with some forms of tubercular and syphilitic defeats, skin new growths, gout and sarkoidozy.
Treatment of a kaltsinoz of skin
At rather small sizes of kaltsinat it is possible to try to eliminate them in the conservative way – for this purpose use the chloride of ammonium and iodide of potassium capable to normalize mineral exchange and to bring surplus of calcium out of fabrics. However effective treatment by these medicines requires use of high dosages that sharply increases risk of development of by-effects and increases toxicity of these drugs. Therefore it is necessary to count a course of treatment of a kaltsinoz of skin very carefully and strictly individually, proceeding from a number of indicators of an organism – functioning of secretory system, quantity and the sizes of kaltsinat, existence or absence of associated diseases. Also for therapy of this state use .
At the considerable sizes of kaltsinat or in the presence of restriction of mobility of joints use surgical removal of the pathological centers. However it often does not remove the cause of a kaltsinoz of skin therefore it is very probable that on the place of remote deposits of salts or on other parts of the body there will be new small knots again. Therefore surgical intervention, laser removal or electrothermic coagulation have to be made surely against the background of conservative treatment. It is also important to limit intake of calcium in an organism – the doctor develops a special diet with inclusion of products in it with the lowered maintenance of this element. According to indications treatment of the main disease which provoked development of a kaltsinoz of skin is made.
Forecast and prevention of a kaltsinoz of skin
Kaltsinoz of skin very seldom threatens the patient's life therefore the forecast of a disease in this regard rather favorable. However this indicator is in strong dependence on the factors which became the reason of disorder of mineral exchange. So, at a metastatic kaltsinoz of skin it can be a malignant tumor, at secondary – a system sklerodermiya and other serious and dangerous diseases. For prevention of development of such state it is necessary to undergo in due time preventive medical examination (for earlier detection of dangerous diseases), not to self-medicate with use of medicines of calcium and vitamin D. To the persons inclined to adjournment of salts in fabrics, it is important to reduce quantity accepted with food and water of calcium, to periodically undergo inspections at the dermatologist and experts of other profiles.