Lupus erythematosus tuberculosis is a rare form of skin tuberculosis. The disease is severe, lasts a long time, and lends itself poorly to treatment. And usually begins with a small subtle ulcer. Now we will talk about what are the prerequisites for this disease, what symptoms are alarming, and how diagnostics and treatment are carried out.
In brief about the disease
Lupus erythematosus is usually found in childhood. If it is diagnosed early, then it will be possible to exclude a negative effect on the skin of the face (this area is most often affected).
This nuance is very important, because it is about maintaining aesthetics and attractiveness. The later stages are accompanied not only by physiological changes, but also by cosmetic ones. Not only the patient's health is deteriorating, but also his appearance.
The final stage of this disease is manifested by a gradual melting of tissues. The structure of cells changes, their nutrition is disrupted. Since the disease is chronic, it is impossible to cure it. But to suspend the pathological process is real.
That is why regular examination by a dermatologist is so important. Early diagnosis is the key to successful treatment.
Classification
In modern medicine, you can quickly determine the type of lupus tuberculosis. Thanks to this, the speedy start of treatment has become real, which can inhibit the development of the disease. Its varieties are determined by localization, symptoms and appearance. Allocate such a list:
- Manifestations on the skin of the face. As a rule, ulcers are localized on the forehead, nose and cheeks.
- On the mucous membrane. Symptoms are found in the nasal and oral cavity.
- Pitiarezoform variety. Accompanied by peeling of damaged surfaces.
- Psoriasis lupus erythematosus. Silver-gray particles form on the damaged surface.
- Serpiginous form. In place of ulcers after their passage, scars form.
It is worth noting that two types of lupus are also distinguished - flat and tuberous. In the first case, neoplasms do not protrude above the surface of the epidermis. In the second, on the contrary, ulcers “bulge” and differ in color from healthy skin.
Infection
According to the World Health Organization, every third person on the planet in the body has tuberculous mycobacteria. As a rule, they do not manifest themselves in any way, being at rest. Propagate only when the body "gives slack." Microorganisms divide within 24 hours - in a short time period, the inflammatory process occupies a large territory.
Koch's wand, which is the causative agent, is transmitted in the following ways:
- Airborne. If the patient coughs next to a healthy person, then he can easily become infected.
- Contact. In this case, a healthy person must take advantage of some thing belonging to the carrier of the Koch wand. This also includes infection with a kiss or unprotected intercourse.
- Food. If a person eats the meat of an infected animal, he will become infected. However, in the age of modern technology, this is rare. But in rural areas is common.
Koch's wand is also transmitted from mother to child. The risk is very high, but not one hundred percent.
Causes
The clinical varieties of lupus erythematosus have been listed above. It is necessary to briefly talk about what provoking factors cause the pathogen to “activate” and the disease begins to form.
The cause is always an injury to the skin. However, for bacteria to start to multiply and grow, favorable conditions are needed. They are caused by the following violations:
- Weakened immunity. The body may lose some of its defenses due to frequent illnesses, stress or pregnancy.
- Hormonal disbalance. It arises as a result of pathologies related to the endocrine system.
- Chemotherapy. Those drugs that are used to treat cancer just kill the immune system.
- Corticosteroid use. Long-term use of these drugs weakens the body, making it vulnerable.
Also, the conditions in which a person lives, as well as his daily regimen, diet and habits, influence the development of lupus erythematosus.
Groups and risk factors
It is important to make a reservation that some carriers of Koch's stick have such strong immunity that lupus erythematosus does not threaten them. There are also certain groups of people who are more likely than others to become infected. These include:
- Persons in contact with the carrier of the Koch stick.
- Alcohol abusers.
- Drug addicts.
- Medical staff working in TB dispensaries.
- People who lead an unhealthy lifestyle.
- Prison attendants and prisoners themselves.
People from these groups are more likely than others to become infected. If an open wound appears on the skin, lupus erythematosus of the face and hands can occur with high probability. Particularly at risk are people suffering from any of the following:
- Thyroid disease.
- Obesity or overweight.
- HIV and other infectious diseases.
- Oncological formations.
- Skin pathologies of an infectious or allergic nature.
Another important factor to consider is the presence of a person who has had tuberculosis in the family.
Symptoms
The following physiological manifestations are characteristic of lupus erythematosus:
- Localization of the lesion on the face. Less commonly, ulcers form on the limbs, sometimes spreading throughout the body.
- The appearance of small pimples that look like prickly heat. They are replaced by tubercles, their number is gradually increasing.
- Drying of the skin at the site of the focus, the appearance of further scars and ulcers.
- General condition worsening. A person quickly gets tired, sleeps very badly, suffers from headaches.
- The appearance of pus on the tubercles. As disease progresses, wounds grow. They ooz, healing does not occur. In all affected areas, severe itching is felt.
- Wounds gradually increase in size. After some time they merge into one. The pain does not pass, only intensify.
Further worse. Ulcers that have matured begin to cornea and peel off. The epidermis can literally “fall off” in pieces. This gives rise to a necrotic process - tissues rot, whole holes form in the place of ulcers.
The disease, if left untreated, actually destroys the person - with a neglected form, there is a risk of loss of the nose, part of the ear. And the cheeks quite often completely rot through.
Diagnostics
Once again, you need to make a reservation that if you find suspicious pimples, you should immediately make an appointment with a dermatologist or infectious disease specialist. However, the diagnosis of lupus erythematosus is usually carried out by two specialists together.
First, an external examination is performed, then the subjective sensations of the patient are analyzed. A laboratory study of skin tests is also prescribed.
It is very important to carry out differential diagnostics. This will eliminate the likelihood of the patient having leprosy of the tuberculoid form, DKV, lupus erythematosus, actinomycosis.
Baby therapy
Having examined the causes and symptoms of lupus erythematosus, attention should be paid to the topic of treatment. The doctor prescribes at least three drugs, the intake of which must be alternated. Usually, the following medicines are prescribed for children:
- Tableted "Rifampicin" 2 times a day. The dose for children under 12 years of age is calculated based on the norm of 10-20 mg per 1 kg of body weight. For babies from 1 to 3 years old - 10-30 mg per 1 weight. Adolescents aged 12 to 15 - 2-3 times a day, 15-20 mg per 1 kg.
- "Ftivazidum" three times a day. It is indicated for infants. The dose should correspond to the norm of 0.02-0.3 g per 1 kg of weight. Older children are also allowed to give it. In this case, the dosage is increased by 0.2 grams with each dose. Preschoolers aged 3 to 7 years are shown approximately 0.6-0.7 grams of the drug.
- "Streptomycin" in the form of injections that are given intramuscularly. Daily dosages are calculated on the basis of the following norms per 1 kg of weight: 0.01-0.02 g (up to 5 years), 0.25-0.3 g (preschoolers), 0.3-0.5 g (older age) .
The last drug is prescribed with great care, since there is a high probability of side effects.
Adult Therapy
Continuing to talk about the treatment of lupus tuberculosis, it is necessary to discuss what it is based on in the case of older patients. This disease in adults lends itself to therapy a little more complicated. Especially if the patient suffers from childhood.
Specific agents are used in the treatment. In particular, Ortivazide, taken in parallel with vitamin D2 in large quantities (30,000, 50,000, and 100,000 units per day). The notorious Streptomycin is also prescribed. Adult daily allowance is 0.5-1 grams.
If a person is diagnosed with ulcerative, warty, tumor-like tuberculous lupus, the photo of which is far from the most pleasant experience, then exposure to x-rays is indicated. Experts also believe that light therapy is effective, but it is carried out in cases where there is no active infectious process in the lungs.
Local treatment
It is prescribed in order to destroy the diseased tissue. Effective remedies are such medicines:
- Pyrogallic ointment. A good drug, but in no case can it be used to eliminate the effects of lupus erythematosus in the oral cavity. If part of it gets inside, you will have to do a gastric lavage, and then rehabilitate animal charcoal, oil, inhalation of oxygen. With severe poisoning, a blood transfusion may be needed.
- Resorcinol paste. Suitable for removing tissue caused by lupus erythematosus in the oral cavity. However, in the field of dentistry, this drug is now considered obsolete, even dangerous. Although once this tool was one of the best.
- A liquid nitrogen. This tool in our time is very popular in the treatment of atopic dermatitis, psoriasis, lupus erythematosus, warts, age spots, etc.
If the foci on the human body are difficult to treat, an operation to remove them can be prescribed, after which the passage of x-ray therapy is mandatory.
Complications
They cannot be avoided if timely, rational treatment is not provided. Serious complications, among them:
- Erysipelas. This infectious pathology is fraught with phlegmon, abscesses, necrotic lesions. Perhaps the development of secondary pneumonia, sepsis. Due to prolonged stagnation of lymph, elephantiasis and lymphedema occur.
- Elephantiasis, manifested in a persistent increase in the size of a particular part of the body.
- Impetiginization. For this consequence, spread of purulent lesions throughout the skin is characteristic.
- Lymphangitis. Often, due to lupus, lymphatic capillaries or trunks become inflamed. Such processes are accompanied by painful swelling and hyperemia along the course of inflammation, as well as weakness, chills, swelling, etc.
But the most serious complication is lupus carcinoma. It occurs due to the malignancy of the process, which leads to a long torpid lupus erythematosus.
Forecast
The disease in question is typically chronic, prolonged. And not all patients have the same course. In some people, lupus may not progress for years, even if they are not treated. And for others, it will develop with the passage of therapy.
The outcome depends on how strong the immune system is. And also from the presence or absence of other diseases, from living conditions, environmental conditions, from work. The prognosis can be favorable if a person will strictly follow medical recommendations, eat well, and also constantly strengthen his immunity. Under such conditions, the restoration of performance is likely.