Erythema - abnormal redness of the skin is or rash caused by excessive rush of blood to the capillary vessels. There are several types of erythema, including infrared, infectious erythema nodosum, sudden and exudative erythema multiforme. Infrared erythema occurs after prolonged infrared (heat), irradiation of the skin, often resulting in that the increased sensitivity of the skin due to infection or taking certain medications.

Erythema multiforme is characterized by rash, which are located mainly in the skin of hands and feet, legs, hands, arms, genitals, oral mucosa. They are a pinkish-red spots with sharp edges or flat papules. Usually, erythema multiforme exudative colds caused by a reaction to certain medications or infections. Erythema nodosum is characterized by inflammatory nodes in the lower extremities, sensitive to the touch. This form of erythema may also be a response to certain medications or disease.

Causes of erythema

In half the cases of erythema multiforme or nodosum exact cause of the disease is unknown. In other cases, erythema multiforme may be caused by the following reasons:

• the presence of infection, especially herpes simplex virus Herpes simplex - in fact, not so simple   (HSV), scarlet fever, measles Measles in children - may cause serious complications ;
• drug administration, in particular, penicillin and sulfa drugs, anticonvulsants, nonsteroidal antiinflammatory drugs (NSAIDs).

Erythema nodosum can be caused by the following reasons:

• the presence of infection, primarily mononucleosis;
• taking drugs, in particular, contraceptive pills and sulfonamides;
• connective tissue disorders such as systemic lupus erythematosus;
• pregnancy;
• ulcerative colitis;
• Crohn's disease.

Who is at risk

• Men are at greater risk of erythema mnoformnoy than women.
• Women are at greater risk of erythema nodosum than men.
• It increases the risk of erythema frequent and prolonged exposure to the sun.
• Increased risk of erythema nodosum affects people aged 20 - 30 years.
• Familial predisposition to skin disease increases the likelihood of both multiforme and erythema nodosum.

Signs and symptoms of erythema

Signs and symptoms of erythema multiforme exudative:

• fatigue, fever, itching (until rash);
• the sudden appearance of rashes, nodules and ulcers on the skin (usually on the knees, elbows, hands and feet);
• Education mishenevidnyh lesions (lesions surrounded by rings of normal and reddened skin like a target);
• Infectious erythema - an acute infectious disease that is characterized by maculopapular rash, also known as fifth disease. Stored in two weeks.

Signs and symptoms of erythema nodosum:

• fatigue, the clinical picture is reminiscent of colds (before the rash);
• focal nodules and ulcers in the leg, arms, thighs and buttocks;
• painful reddish lesions soften and take on a bluish at first, then yellow and brown color;
• joint pain Joint pain - how to understand what is going on? ;
• arthritis.

Stevens-Johnson syndrome and Lyell's syndrome (toxic epidermal necrolysis) represent the most severe form of erythema multiforme and have different symptoms. If Stevens-Johnson syndrome, there are bubbles in the mucosa of the mouth, throat, eyes, genitals and other areas of the skin and mucous membranes. After opening the bubbles formed erosion bleeding, which merge into a continuous bleeding sharply painful surface. When toxic epidermal necrolysis skin rash appears, which in a few hours it turns into a big flat bubbles with serous or hemorrhagic content serous. They quickly opened with the advent of extensive erosion of bright red color. In both cases, if left untreated may lead to death.

Prevention

For the prevention of erythema is necessary to cure the underlying disease and to avoid any known triggers (eg, certain medications). It is also important to visit less in the sun if you are taking certain medications.

Treatment program

After being diagnosed erythema, start treatment of major diseases. It should stop taking any medications that may contribute to the emergence or worsening of symptoms, as well as measures to control current symptoms. In some cases erythema not require treatment. In more severe cases, requires bed rest and medication.

Medication

• Antihistamines to eliminate itching;
• Antibiotics to fight infection;
• Antiviral drugs such as acyclovir Acyclovir - as it is safe?   and valaciclovir, to fight the virus;
• Aspirin and non-steroidal anti-inflammatory drugs (NSAIDs);
• Compresses with Burrow solution (help relieve skin irritation and reduce blisters);
• Corticosteroids: in the form of ointments (topical application) or tablets (oral administration).
• Intravenous immunoglobulin: used experimentally for the treatment of Stevens-Johnson syndrome and Lyell's syndrome.

Complementary and alternative therapy

Before the treatment of erythema, you must determine its cause. It is important to make the correct diagnosis before you apply any additional and alternative therapies, since they are not universal, in interaction with conventional drugs may cause complications. Use alternative methods of treatment can only be under the supervision of a physician. Complementary and alternative therapies are used to:

• reducing inflammation;
• strengthen the immune system;
• prevent infections.

Tuberculosis of the skin called a number of violations in which TB bacteria - those that usually cause pulmonary tuberculosis - affect the skin. TB skin - it's pretty rare variety of extrapulmonary tuberculosis Extrapulmonary tuberculosis - many forms . Even in countries such as China and India, where TB incidence is very high, cutaneous tuberculosis is rare - less than the 0.1% of patients.

Mycobacteria can get into the skin of lungs (via lymph or blood), or through small lesions in the skin; in most cases tuberculosis Tuberculosis - a full recovery is not guaranteed   Skin becomes secondary infection in patients suffering from pulmonary tuberculosis.

Symptoms of TB of the skin

Usually, the first symptoms of tuberculosis Symptoms of TB - how to recognize the disease   skin appear 2-4 weeks after mycobacterium penetrated into the skin. The manifestations of this disease is largely dependent on its type and the type and severity of tuberculosis, in turn - on the strength of the immune response and the virulence of mycobacteria.

Verrucose lupus is most common in adults, and in men. As a rule, the disease affects the skin on the back of the hand, fingers, feet, elbows, knees and buttocks. The first sign of warty tuberculosis is usually a convex skin tumors purple or brown-red. It increases gradually with time the skin may appear a few of these warty formations. Additionally, the affected skin can form abscesses. There are cases where these tumors persist for years, and then were on their own, without treatment. This, of course, does not mean that the disease can ride - on the contrary, in cases of suspected TB skin as soon as possible to seek medical help.

Lupus usually affects the skin around the mouth, in rarer cases - the neck, arms, legs, or torso. The skin produces small reddish-brown lumps with clear boundaries. Over time, these tumors can cause large scars and, sometimes, to skin cancer.

Strumoderma or skrofuloderma mostly develops in the skin in the neck or chest. Such lupus in children and young adults is more common than in middle-aged and elderly. Kollikvativny TB often develops in patients with tuberculosis of the lymph nodes Tuberculosis of the lymph nodes - the degree of complexity of the disease   or skeletal tuberculosis. The first sign of the disease - a small convex nodule, which usually does not cause pain. He gradually increases and can reach the size of a hen's egg. In the later stages the disease affects the lymph nodes.

Acnitis. Patients with this disease may appear pustules resembling acne; usually they are located on the face and chest. Over time, the spot may be formed pustules ulcers, and then - scars. Deep pustules, or follicles, usually appear on the trunk and legs; after them on the skin can also be scars. Patients with very weak immune papulonekrotichesky tuberculosis may lead to the formation of deep ulcers of various areas of the skin. Low immunity in these patients may also lead to the fact that the Mantoux test will show a negative result, due to which the diagnosing lupus is difficult.

Diagnosis of tuberculosis of the skin

Mycobacterium Infections in patients with any form of TB is set by the tuberculin skin test, analysis of the secretion of interferon-gamma and / or sputum. To diagnose TB of the skin, after examining the patient's doctor may prescribe a skin biopsy. The procedure is performed under local anesthesia, and usually it takes about half an hour. The patient can go home shortly after the procedure. In whichever performed incisional biopsy or puncture, the patient may only sutures or bandages. As a rule, the bandage should be worn for one day after the biopsy. Biopsy results will be known three to five days later. In place of the deleted fragments of the skin may be small scars, but as a rule, they are virtually invisible and are not a serious aesthetic problem.

Treatment of tuberculosis of the skin

Patients who have been diagnosed as pulmonary and extrapulmonary tuberculosis, prescribe anti-TB drugs. Typically, the most effective is a combination of medicines, as isoniazid, rifampicin, pyrazinamide and ethambutol. Cutaneous tuberculosis may only use rifampicin and isoniazid, and, if necessary, in addition to other drugs can be administered. The course of treatment usually lasts from nine months to one year. In addition, patients should follow the principles of a healthy diet and taking vitamins - these measures help strengthen the immune system. In some forms of cutaneous tuberculosis are also required to wash the affected skin disinfectant.