Ring-shaped erythema is redness and swelling of the skin, which is associated with vasodilation and blood stasis in them. It can often occur as a reaction to insect bites, as well as against the background of autoimmune processes and helminthic invasions. Pathology is so called because of its characteristic appearance: a red ring with raised edges that limit the area of damaged skin. Depending on the factors that caused the disease, the disease is acute or chronic.
Causes of annular erythema
The skin is connected with absolutely all systems and organs, therefore, it reacts sharply to changes in the human body. The appearance of spots in the form of rings on it is not an independent disease, but a signal of a violation. The causes of violations should be clarified. As a rule, the causes of erythema may include:
- The presence of defects in the immune system.
- The appearance of malignant tumors.
- The appearance of intoxication of various origins.
- The onset of Lyme disease.
- The presence of rheumatic and other autoimmune diseases.
- The development of helminthic infestations.
- The appearance in the body of allergic reactions.
- The development of chronic local foci of infection in the form of sinusitis or osteomyelitis.
- The appearance of tuberculosis.
- The presence of certain hormonal disorders in the body.
- The appearance of fungal infections.
- Failure of the normal functioning of the digestive tract.
A sign of what disease can be ring-shaped erythema? As you can see, the list is quite large.
How does this pathology arise?
The appearance of annular erythema in humans is primarily associated with the pathology of vascular reactions. In this case, the capillaries that are located in the skin expand, and directly the blood flow in them significantly slows down. As a result, part of the plasma enters the tissue, which leads to the appearance of local edema. T-lymphocytes, which are cells of the immune system that are responsible for the recognition of a foreign agent, also go beyond the fluid. Their role in the formation of erythema is not yet clear, but they report a close relationship between pathology and the work of immunity.
Peripheral enlargement
Ring-shaped erythema is capable of peripheral enlargement. In the center of the formed ring, pathological processes subside, so the skin acquires a standard color and thickness. But directly on the periphery there remains a certain shaft of dilated capillaries and cell edema. The ring, as a rule, increases in size from the center to the edges. This type is called centrifugal erythema Daria.
Often has acute development, prolonged course and treatment. At first there is a peeling and edematous pinkish-yellow or red spots. Further, the process progresses, numerous erythematous elements arise, in which a ring-shaped with an urtikarny edge and a pale center. In the central part of the focus there is a flat, smooth surface, reaching a size of up to two cm. The color of the central part of the formation gradually changes to almost a brownish color. The peripheral growth of the elements leads to the fact that they reach a diameter of 15 cm. Some rings can combine and form scalloped elements, garlands, and also arcs. Scalloped elements exist for 2-3 weeks, then they pass, but after them remains lushly stagnant pigmentation. Then new ring-shaped elements are formed.
The most favorite location of the pathology is the trunk and limbs, a little less often the face, neck, lips and buttocks. In this case, itching and burning are present. Varieties of Daria erythema are clinically distinguished, differing in the following forms:
- Flaky (flaky thin white border along the outer edge of the foci).
- The vesicular form of Daria erythema (vesicles located at the edges of the elements quickly disappear).
- Simple garland-like (short periods of the existence of spots, from several hours to several days).
- Persistent micro-garland-like form, including small elements up to 1 cm in diameter. When conducting a histological examination of the epidermis, dyskeratosis with elements of round bodies, and also grains, is detected. Rarely, vesicles are found in the epidermis that are filled with shriveled cells that have grains.
Symptoms of this pathology
How does the disease manifest itself? We will examine in more detail in this matter. Initially, a rounded red spot appears on the skin of a person, which is slightly elevated above the surface and looks like a coin. During pressure, erythema usually turns pale or completely disappears. In the center, a center of enlightenment forms over time. The skin turns pink. Sometimes in the center of erythema several centers of enlightenment of a round shape can be formed simultaneously. In such situations, the formation of several annular spots on the skin.
Skin peeling
Often on the surface there is peeling with bubbles. At the same time, the boundaries of erythema remain red and gradually creep further, which leads to an increase in the annular diameter. The edge of the ring may rise slightly above the skin.
In the same place can be ring-shaped erythema of varying degrees of maturity, and the rings often merge with each other. So arched contours are formed with wavy edges at the spots. Skin lesions are rarely accompanied by soreness, which directly depends on the main cause of the disease.
Other signs of pathology
Symptoms of annular erythema are formed against the background of other signs of pathology:
- The signs of intoxication in the form of fever, weakness and muscle aches in the absence of appetite report an infectious origin of erythema. Migratory erythema often occurs against the background of infection with borrelia due to a tick bite. In the center of redness, you can see the bite in the form of a round crust or erosion. Often, target erythema can form. Against this background, a smaller ring is located inside the larger one.
- With the development of rheumatism, a connective tissue structure is damaged, which is manifested by pain in the joints and muscles along with limited mobility, a change in skin quality, increased bleeding of blood vessels, a prolonged rise in temperature of more than thirty-eight degrees and a violation of cardiac activity. At the same time, the boundaries of the rings are usually pink, and their localization can be absolutely any.
- Allergic erythema, as a rule, is quite bright, and edema with it is well defined and may be accompanied by a rash on various parts of the body. Also conjunctivitis and rhinitis are not excluded. Often, itchy skin can be observed, which has different intensities.
- The presence of a malignant neoplasm is evidenced by prolonged weakness along with weight loss, pains of a bursting type in the tubular bones, with an increase in lymph nodes and a prolonged increase in temperature.
Ring-shaped erythema in children is often associated with rheumatic pathologies, immune disorder and helminthic invasion.
Course of the disease
The course of the disease directly depends on a number of reasons and can take place in various forms:
- Paroxysmal type. In this case, skin changes occur suddenly, without leaving a trace for a couple of hours or days.
- Acute form. Rings with spots gradually disappear within two months.
- Chronic type. Changes on the skin persist for a long time.
- Recurrent type. After a clinical cure, erythema migrans may reappear in the same or in a new area.
Pathology diagnostics
Diagnosis of erythema usually does not cause any difficulties. If necessary, to distinguish the disease from a granuloma similar in symptoms, dermatologists take a site of damaged tissue for histological examination. Microscopic sections are prepared from samples in the laboratory.
Skin changes with erythema
Typically, changes in the skin with the development of erythema include:
- Expansion of capillaries.
- Accumulation of lymphocytes near blood vessels.
- The presence of slight swelling of the cells, as well as the intercellular spaces of the epidermis.
- The presence of moderate edema of the dermis.
As part of identifying the causes of annular erythema, the doctor conducts additional tests. For example, a general clinical blood test with plasma biochemistry is being investigated. Changes in these analyzes suggest which direction to move on. For example, helminthic invasions are characterized by slight anemia along with eosinophilia and accelerated ESR. Against the background of an allergic reaction in the plasma, the content of immunoglobulin E protein increases. The presence of malignant neoplasms is manifested by a decrease in hemoglobin, as well as red blood cells, along with changes in the leukocyte formula.
Instrumental studies in the form of x-rays, electrocardiograms, computed tomography and the like are carried out if, after examination of the patient or in laboratory tests, one or another change was found.
Disease treatment
Effective therapy is possible when establishing the cause of the pathology. Therapy is prescribed by a dermatologist in conjunction with a specialist in the underlying disease. It can be a neurologist, rheumatologist, endocrinologist, immunologist, infectious disease specialist and so on. The patient's need for hospitalization is determined on the basis of the general well-being of the patient and the concomitant disease. Patients usually receive outpatient treatment.
Local treatment
Local treatment, as a rule, includes:
- The use of antihistamine ointments, creams and gels that eliminate swelling, redness and itching associated with the release of histamine.
- The use of ointments that contain zinc compounds, such as, for example, the drug Desitin. The mechanism of their effect is not yet fully understood, but they can effectively eliminate inflammation in the epidermis along with itching and peeling. In addition, unlike hormonal drugs, they are almost safe.
- Treatment with glucocorticoid ointments and creams, for example, “Acriderm” or “Sinaflan”. These drugs slow the active reproduction of t-lymphocytes, thereby eliminating the main causes of local changes in the skin. They should be used only as directed by the doctor, otherwise serious side effects in the form of skin atrophy may occur . The appearance of a severe bacterial and fungal infection is not excluded.
Treatment for annular erythema is not limited to this.
Systemic Drug Therapy
Along with local treatment, systemic drugs are prescribed:
- The use of desensitizing agents that remove toxins with allergens from the bloodstream, reducing the permeability of the vascular walls and stabilizing the membranes of immune cells. Thanks to all this, the release of histamine in the tissue is reduced.
- The use of glucocorticoids. These drugs are used in the form of tablets or injections. It is advisable to use them against the background of severe erythema.
- The use of antibiotics. Such medicines are necessary in the presence of an infectious disease. Typically, patients in these cases are prescribed penicillins or cephalosporins.
- The use of anthelmintic drugs is prescribed when there are worm eggs in the feces, and, in addition, against the background of the detection of specific immunoglobulins in the blood.
Finally
Thus, annular erythema is not an independent disease, but rather a symptom of other pathologies. Therefore, it requires comprehensive treatment and an accurate determination of the cause that caused it. In the event of a pathology, you should not self-medicate, but you should consult a doctor without fail.
We examined what kind of disease is ring-shaped erythema.