Erythema is accompanied by an increase in capillaries, due to the intense flow of blood to them. Ring erythema (Erythema annulare) is considered one of the signs of rheumatism in the activity phase, for example with polyarthritis, as well as the manifestation of other disorders in the body. The disease affects mainly children and young people under 30 years old. In the last century, experts evaluated annular erythema as a disease with a poor prognosis. Nowadays, in the presence of new effective methods of treating rheumatic disorders, the prognosis in the fight against erythema is quite optimistic.
History of erythema
Symptoms of the disease were discovered by doctors at the beginning of the last century. The first to describe annular erythema and attributed it to skin diseases pediatricians from Austria G. Lendorff and H. Leiner in 1922. They described the disease as one of the symptoms of rheumatism. Therefore, the disease is also called rheumatic erythema of Lendorff-Leiner. A doctor from France, Benier, at that time called the ring-shaped erythema erytheme margine en plaques, so in foreign sources you can often find the name erythema marginatum.
In 1975, H. Stollerman revealed a form of annular erythema, which was not a manifestation of rheumatism. Numerous histological studies in the field of rashes allowed specialists to identify forms of the disease, the cause of which is not rheumatic disorders, but a violation of the autonomic regulation of the walls of blood vessels, as well as various infections and disorders in the functioning of the immune system.
Symptoms of annular erythema
Ring erythema manifests itself in the form of pink or red closed rings appearing on the skin. Most often, spots are round or oval in shape, with a pale center and often swollen. Affected areas are not flaky and painless. Patients may experience itching and burning sensation in the affected area.
Rings increase in size, the formation of new circles is often observed inside them. As the spots grow, erythema can merge with each other, forming shapes of various shapes. The disease proceeds in waves, and if some rings disappear, then after a while new redness appears instead of them. One attack replaces another after about three weeks. The appearance of rashes on the mucous membranes, skin of the palms and soles is not typical for a disease such as ring erythema. The photo clearly demonstrates the nature of skin lesions with erythema.
Ring-shaped erythema is localized on the chest, shoulders, face and neck, sometimes on the back, arms and legs. The intensity of the spots is often enhanced by certain factors. Among them, the influence of temperature, both low and high, emotional state, endocrine changes (menstruation, taking hormonal contraceptives or steroid drugs) and so on. In some cases, erythema appears atypical, accompanied by purple rashes and the formation of vesicles. If nodules appear on the skin along with rings, doctors see this as a symptom indicating an unfavorable development of rheumatism. At the same time, annular erythema is observed in patients at the recovery stage after the disappearance of the main manifestations of rheumatoid disease.
Causes of the disease
The cause of rheumatoid erythema is rheumatism in the activity phase, and the appearance of rings on the skin often acts as a harbinger of exacerbation of rheumatic heart disease and polyarthritis. For doctors, in most cases, ring erythema is a confirmation of the diagnosis of rheumatism.
Forms of non-rheumatoid annular erythema develop due to some other reasons. Among them:
- fungal infections such as foot mycosis and candidiasis;
- malfunctions of the endocrine system;
- immune system problems;
- intoxication;
- focal infections (osteomyelitis, tonsillitis, cholecystitis and others);
- dysproteinemia, or a violation of the protein composition of the blood;
- allergic reactions to drugs;
- leukemia, lymphoma, adenocarcinoma;
- sepsis;
- glomerulonephritis;
Treatment of annular erythema
As for the fight against a disease such as ring erythema, treatment is primarily aimed at eliminating the causes of skin lesions. If the disease is accompanied by the presence of infection in the body, antibiotics are prescribed. Also, in the fight against annular erythema, vitamin therapy, the use of immunostimulating, antihistamines, calcium preparations and sodium thiosulfate are widely used . The patient's diet provides for a diet in which there are no allergens in the food. The treatment of erythema, the cause of which is rheumatism, is primarily aimed at combating the underlying disease.
Erythema migrans
If single rings appear on the skin with bite marks in the center, then we are talking about such a lesion as a migratory ring erythema. It was established that this type of disease can appear due to bites of ixodid ticks and some other insects.
The cause of the development of migratory erythema is an infection, often viral or bacterial. The disease is quite complicated, often goes into a chronic form. It is worth noting that erythema migrans has the property of being transmitted from mother to fetus. Initial symptoms are flushing of the skin, swelling and peeling. The lesion focus gradually increases in size and forms a kind of border. Further stages are characterized by the development of exocytosis, which manifests itself as a protective function, while the cells of the affected tissues displace toxic substances through the membrane to the surface. In tissues, leukocyte infiltration is detected. Infiltrate undergoes a thorough analysis, which allows you to make the correct diagnosis.
It is characteristic that the bites of ticks, bees, hornets and other insects cause the development of acute migratory erythema. A more complex and insidious form of the disease is its chronic form, the origin of which in most cases remains unknown. And erythema itself is characterized by severe swelling, pain and constant itching and burning. For the diagnosis of chronic erythema, a comprehensive examination is carried out, which includes a complete analysis of blood and urine, a study of infiltrate and epidermis.
Treatment of migratory erythema
Therapy is carried out using broad-spectrum antibiotics. The doctor conducts the choice of drugs depending on the form and stage of the disease. For example, in the first stage, the use of the drug "Doxycycline" gives a good effect for one to two weeks. If the disease is severe, the doctor may prescribe the drugs “Cetriaxone” in tablets and “Benzylpenicillin” intramuscularly for 14-21 days. Complementary therapy includes vitamins. An optimally selected treatment option for such an ailment as migratory ring erythema, in most cases, contributes to a quick recovery.
Erythema toxic
This type of disease occurs in newborns and is manifested by rashes on the baby's body. The disease affects 20-40% of infants. By the severity of the course, toxic erythema is divided into unexpressed and pronounced (or generalized) forms. In the first case, the rashes are slight and localized on the back and internal bends of the limbs. The general condition of the baby is assessed as satisfactory.
With generalized toxic erythema, rashes are multiple, they often merge with each other, forming vesicles. The temperature is elevated, and the child becomes restless. An increased content of eosinophils is found in the baby’s blood. This is a type of white blood cells that perform a protective function when allergens enter the body, as well as helminthic invasions.
Among the risk factors for toxic erythema, the following are distinguished:
- hereditary burden;
- toxicosis of a pregnant woman, especially severe;
- employment of the future mother in hazardous work;
- intrauterine infection;
- the presence in the diet of a pregnant or lactating woman of food obligate allergens, such as citrus fruits, chicken eggs, chocolate, honey, currants, raspberries and others;
- diabetes, malfunctioning of the thyroid gland, or obesity of the mother.
If erythema of the newborn is a consequence of the presence of allergens in breast milk or a formula for feeding, then the disease goes away on its own 4-5 days after a review of nutrition. In severe forms of toxic erythema, special treatment is prescribed.
Therapy of erythema of the newborn
The toxic form of erythema requires treatment for its severe forms. The doctor prescribes the right antihistamines and special ointments or creams. It is important at the treatment stage to exclude the intake of allergens in the mother and child. As an adjunct treatment, Calcium Gluconate, vitamins, and Rutin are used. Rashes and vesicles should be treated several times a day with brilliant green or a weak 4-5% potassium permanganate solution, and after the procedure, a baby powder should be applied to the skin of the child.
Erythema multiforme
This is an inflammation of the skin and mucous membranes, which is based on an allergic reaction of the body. Erythema multiforme affects the limbs, mucous membranes of the mouth, genitals and nose. The disease occurs in both children and adults.
Certain medications and certain infections contribute to the development of exudative erythema multiforme. Penicillin antibiotics, barbiturates, sulfonamides and other drugs cause this type of disease. Of the infections, the most common causes of erythema multiforme are mycoplasmosis and herpes. Erythema disease, caused by a reaction to drugs, is considered the most severe. For example, Stevens-Johnson syndrome.
Treatment of erythema multiforme
To combat the disease, both general and local methods of therapy are used. The first include the use of antibiotics and antihistamines, taking immunostimulants. At the same time, chronic diseases of the patient are treated. Local treatment is expressed in the use of painkillers and antiseptics, such as Chlorhexidine or Furacilin, ointments containing prednisolone and hydrocortisone. Important is the thorough hygiene of the oral cavity and other mucous membranes.