Otrubevidny deprive — the proceeding fungal disease with damage of epidermis which is shown by emergence on skin of the pigmented spots of various shade is long: yellow, pink, brown, brown and characteristic otrubevidny peeling. Signs of an inflammation are absent. It is diagnosed otrubevidny deprive by means of iodic test of Baltser, a luminescent research and microscopy of the peeling scales. Treatment is carried out by antifungal ointments and solutions. Otrubevidny deprive of a common form demand the general antimikotichesky therapy.
Otrubevidny deprive received such name in connection with a peeling, typical for it. The second name — multi-colored deprive — arose thanks to various coloring of the spots appearing at a disease. The name "solar fungus" which is found in the people is also related to otrubevidny I deprive. It is connected with the fact that under the influence of sunshine affected areas of skin become brighter and noticeable. Most often to a disease of otrubevidny it is deprived men and women of young age are subject, it is the most rare - children up to 7 years.
Otrubevidny depriving of the cause
Otrubevidny deprive treats group of keratomikoz — the fungal diseases of skin affecting only a horn layer of epidermis and a hair cuticle. Its activators are mushrooms of Malassezia furfur, Pityrpsporum orbiculare and Pityrosporum ovale, and these types differ in ability passes one into another. Usually otrubevidny deprive it is characterized by small contageousness, that is infection occurs only in some cases at close and long contact with the patient. At the same time the probability to ache with otrubevidny is deprived more it is caused by the contributing factors.
The factors forming in an organism a favorable background for development otrubevidny depriving, are: weakening of immune system, the increased perspiration, endocrine violations (diabetes, Itsenko-Cushing's syndrome, obesity), changes in the chemical composition of sweat, vegeto-vascular dystonia, violation of barrier function of skin at frequent use of antibacterial gels and soaps, stressful impacts on skin (excessive suntan, a sunbed, etc.). Authors of some researches conducted in dermatology point to what in some cases otrubevidny deprive is connected with limfogranulematozy and tuberculosis of lungs.
Otrubevidny depriving symptoms
Otrubevidny deprive it is caused by reproduction of activators in skin blankets that leads to violation of functioning of melanotsit — the cages developing a pigment the melanin giving to skin this or that coloring. As a result the affected area of skin gains the color different from other integument. Process begins in the mouth of a hair follicle, then the spot of gradual increases in sizes.
At otrubevidny herpes formation of multiple roundish spots up to 1 cm is typical. In process of growth of a spot merge with each other, forming the sites, considerable in size, reaching the sizes more palm of the adult. Such spots do not act over the surface of skin and have no inflammation signs (hypostasis, redness, morbidity). Their color can be yellow, coffee, pinkish-brown, dark-brown. Otrubevidny depriving of edge of spots accurately delimited, uneven, scalloped. The peeling of spots caused by a loosening of a horn layer of epidermis which is easily found at a skin poskablivaniye is characteristic.
Most often otrubevidny deprive appears on skin of a back and a breast. Less often the neck, side parts of a trunk and a stomach is surprised. At children and teenagers of a spot can be localized on skin of extremities, in axillary areas and on a hairy part of the head. Symmetry is absent.
The patient with otrubevidny is deprived, as a rule, does not note any subjective feelings. In certain cases on sites of damage of skin the small itch is observed. Emergence morbidity, burnings or other unpleasant feelings demonstrates secondary infection of skin with bacterial flora.
Otrubevidny deprive differs long (within several years) in a current. In the absence of systematic therapy after treatment emergence of a recurrence of a disease is possible. Otrubevidny deprive often recovers under the influence of sunshine. We deprive the sites which are earlier struck, do not sunbathe and remain white against the background of suntanned skin (psevdoleykoderm).
Diagnostics otrubevidny depriving
Otrubevidny deprive often at once it is diagnosed on consultation of the dermatologist at survey and Dermoscopy of sites of skin with the changed coloring. For confirmation of the diagnosis the iodic test of Baltser consisting in drawing on skin of 5% of spirit solution of iodine is carried out. Because of a razrykhlennost of affected areas of epidermis, skin in these parts absorbs iodine better and is painted more intensively, than on healthy sites. Equally well for conducting test it is possible to use solutions of aniline dyes: brilliant green, iodine, . Also existence of a symptom of Benye or "a shaving phenomenon" is defined: otrubevidny depriving a skin peeling at its easy scraping on a surface of spots.
The luminescent diagnostics which is carried out in the special darkened room reveals red-yellow or dark brown fluorescence of spots. The microscopic research of scrape at otrubevidny herpes allows to find mushroom elements in epidermis scales.
Differentiate otrubevidny deprive from pink on the basis of a clinical picture. Pink deprive it is characterized by an oblong and diamond-shaped shape of the centers of defeat, localization of spots along lines of a tension of skin. The psevdoleykoderma centers remaining after it is allowed otrubevidny deprive, differentiate from vitiligo, secondary gipopigmentation, a leprosy.
It is also necessary to distinguish otrubevidny deprive from a syphilitic rozeola, and sites of a psevdoleykoderma — from a syphilitic leykoderma. The syphilitic rozeola not to be shelled, has pink color, vanishes when pressing. The syphilitic leykoderma the appearance reminds a lacy network, but not drain spots of the lowered pigmentation. To differentiate otrubevidny deprive from syphilitic manifestations, to the patient can appoint the following analyses: scrape microscopy on a pale treponema, PTsR-diagnosis of syphilis or the RPR test.
Otrubevidny depriving treatment should be carried out only under the supervision of a doctor. Self-treatment is unacceptable!!!
Treatment is carried out on an outpatient basis before total disappearance of manifestations otrubevidny depriving. Apply local antifungal means: 5% salicylic ointment, 3-5% salicylic alcohol, 5-10% sulfuric ointment, 3-5% rezortsinovy alcohol, , , , , , , etc. Widespread otrubevidny deprive or its recidivous current are the indication to the general antifungal treatment. It is carried out by intake of such antifungal medicines as , .
Prevention of a recurrence otrubevidny depriving includes a repeated course of anti-fungal treatment, regular water procedures and therapy of a gipergidroz. Make disinfection of clothes and patient's linen for the prevention of infection of relatives of the patient. The people who are in continuous contact with the patient are examined with application of a luminescent lamp.