Diseases of the inflammatory nature of the vessels of the skin and fatty tissue are diagnosed in medicine quite often. Typically, this phenomenon is observed with complications of certain diseases. One of the pathologies of connective tissue, in which the skin and subcutaneous fat are affected, is erythema nodosum. The disease manifests itself in the form of seals or nodules up to five centimeters in diameter on the lower extremities, in the thighs and buttocks. Usually, the pathology develops on two legs at once, it causes pain and can occur in acute or chronic form.
Disease characteristic
Erythema nodosum is a disease of the skin and subcutaneous vessels, manifested in the form of dense inflammatory nodes of different sizes. In medicine, this disease is considered to be one of the varieties of allergic vasculitis, which affects only the lower extremities. This disease is diagnosed in people of different age groups, but most often occurs between the ages of 20 and 30 years. Before adolescence, pathology is observed in males and females in the same ratio, but after puberty it usually affects women, especially in the autumn or winter.
In a third of patients, erythema nodosum (photo of which is given below) develops as an independent disease. In other cases, it acts as a consequence of the progression of other pathologies in the body, such as tuberculosis, sarcoidosis or streptococcus. As erythema develops, complete damage to the vessels on the legs occurs. Red or purple seals appear on the limbs. According to ICD-10, this disease has the code L52.
Causes of erythema
Most often, doctors are unable to establish the reasons why erythema nodosum develops on the legs. In some cases, this pathology is preceded by various infectious diseases, in particular streptococcus, tonsillitis, pharyngitis, cystitis, arthritis, tuberculosis, inguinal lymphogranulomatosis and others. The main causes of the development of the disease include:
- The sensitivity of the body to certain medications, the development of allergic reactions. Of particular danger in this case are drugs of the salicylate group, bromides, iodides, as well as antibacterial agents and vaccines.
- Hereditary predisposition to hypersensitivity to certain irritants.
- Violations of the vascular system. Often, the pathology develops with varicose veins, atherosclerosis.
- Chronic infections in the body: tonsillitis, pyelonephritis and others.
- Pathologies of allergic genesis, in particular asthma, dermatitis, hay fever.
- Noncommunicable diseases: sarcoidosis, Begcet's syndrome, colitis.
- Gastrointestinal diseases of an inflammatory nature.
- Pregnancy.
- Benign and malignant neoplasms.
- STDs.
Doctors tend to claim that erythema nodosum, a photo, the symptoms and treatment of which are detailed in this article, develops when chemicals or infectious agents enter the body, resulting in the formation of antigens in the body. With a genetic predisposition to the disease, these antigens begin to form specific antibodies, which provoke the development of pathology. In 40% of cases, doctors are unable to identify the causes of the development of the disease.
Erythema during pregnancy
Most often, erythema nodosum is diagnosed in pregnant women. Doctors have found that the representatives of the weaker sex who previously took hormonal contraceptives are most affected by pathology. With a distortion of the hormonal background in the body of a pregnant woman, antibodies are formed that provoke the development of the disease. Moreover, during the period of bearing a child, immunity is reduced, and the body is weakened, which causes the development of various diseases, including erythema.
Provoking factors include:
- changes in climatic and weather conditions;
- hypothermia;
- hypertension;
- congestion in the lower extremities.
Erythema nodosum in children
Often this disease is diagnosed in children as a complication of viral infections, diseases of the oral cavity, chronic otitis media, and tuberculosis. If the doctor is unable to identify the cause of the disease, he diagnoses the idiopathic form of erythema, which develops as an independent pathology.
Most often, the disease develops at the age of 6 years and older, girls are more susceptible to this disease. The first signs of erythema nodosum, the treatment of which will be described below, manifests itself after 5 days from the moment of development. In this case, the symptoms in children are pronounced, they have intoxication of the body, an increase in body temperature, pain in the abdomen and joints, the development of pain during physical contact with pathological areas, the appearance of nodes on the lower leg and thigh the size of a walnut. Pathological areas acquire a blue tint. When the first signs of pathology are manifested, it is urgent to contact a medical institution to establish the cause of the disease and conduct effective treatment.
Symptoms and signs of erythema
Usually erythema nodosum begins to manifest symptoms on the fifth day. In humans, dense nodes form in the subcutaneous fat, while the skin in these places becomes smooth and acquires a red tint. The nodes have fuzzy borders, since the edema goes beyond them. After 5 days, they begin to condense, and the skin turns blue. In addition, a person experiences discomfort, he develops chills, joint pain, swelling, and body temperature rises. Most often, seals are formed on the front of the legs, while they can also be located in places where there is fatty tissue, for example on the hips, buttocks, calves and even on the face.
After 2 or 3 weeks, the seals begin to disappear, the skin begins to peel off, age spots appear on it, joints no longer bother a person. Usually erythema nodosum (photo and symptoms of which are presented) disappears on its own after 30 days, but sometimes it has a chronic form, so it can return after some time.
Forms of the disease
In medicine, several forms of erythema are distinguished:
- The acute form is characterized by all of the above symptoms. First, one small knot is formed on the limb, which gradually increases to 5 centimeters, and then stops growing. After 30 days, the symptoms of the pathology disappear, relapse of the disease does not occur.
- Migratory erythema nodosum is caused by washed out symptoms. At first, malaise and weakness, pain in muscles and joints appear. Then the person’s body temperature rises, flat and dense nodules appear on the front side of the lower leg, which have clear boundaries, the skin at the place of their appearance acquires a blue tint. The number of nodes can vary from one to eight, they are placed asymmetrically. As they grow, the nodules begin to migrate; in their place, a plaque forms with a depression in the center. The provoking factors in this case are pregnancy, streptococci and sarcoidosis. The disease can last for five months, after which it disappears without a trace.
- The chronic form usually develops in the presence of chronic infectious diseases in humans. In this case, the symptoms of intoxication are absent, the nodules are small, so it is difficult to see them. Symptoms intensify periodically, and then subside again.
Complications and consequences
Sometimes erythema nodosum on the legs, the treatment of which was untimely or ineffective, can transform into a chronic form that is difficult to cure. Usually this disease does not pose a danger to life and health. But often the pathology is accompanied by various diseases that can cause the development of negative consequences, so it is important to correctly establish the causes of erythema. The prognosis is usually favorable; modern medicine has many ways to successfully treat erythema.
Diagnostics
An accurate diagnosis requires a comprehensive examination, during which it is necessary to examine other organs and systems. After studying the history and visual examination, the doctor prescribes laboratory blood tests. In the presence of erythema in the blood, leukocytosis and high ESR will be detected. Bacteriological culture from the mucous membrane of the nasopharynx is also prescribed in order to detect streptococcal infection, as well as feces to exclude tuberculosis.
In case of joint pathology, it is necessary to undergo examination by a rheumatologist and donate blood to the rheumatoid factor. If tuberculosis is suspected, tuberculin diagnostics are prescribed. If the disease cannot be diagnosed, the doctor conducts a biopsy of the pathological nodes on the lower extremities followed by a histological examination of the biopsy, during which the presence of an inflammatory process in the walls of the veins and arteries is determined. Also, such diagnostic methods as ultrasound scan, pharyngoscopy, rhinoscopy, CT and MRI, radiography, rheovasography are often used.
The doctor in each individual case selects the necessary diagnostic methods, it all depends on the course of the disease, its form, age and general condition of the patient.
The doctor differentiates the pathology with diseases such as skin tuberculosis, thrombophlebitis, vasculitis, panniculitis, erysipelas, Bazin erythema, Weber-Christian syndrome.
Disease treatment
Treatment of erythema nodosum suggests that it is aimed at eliminating, first of all, concomitant pathologies. The doctor reorganizes the pathological foci, prescribes antibacterial and desensitizing drugs. To eliminate inflammation and relieve pain, NSAIDs, such as Ibuprofen, are prescribed.
As local therapy, anti-inflammatory ointments are used that are applied to the affected areas and joints. The doctor often prescribes ultraviolet radiation, magnetotherapy, laser therapy, phonophoresis and plasmapheresis, hemosorption. Also, erythema nodosum, the symptoms and treatment of which are being considered today, requires the use of antihistamines and aminocholinolines, corticosteroids.
Children are prescribed bed rest, warming compresses with anti-inflammatory ointment, antihistamines, for example, Suprastin.
The effectiveness of treatment is determined by the reverse development of the symptoms of pathology and a decrease or complete disappearance of signs of the inflammatory process of blood vessels and subcutaneous tissue.
Pregnancy therapy
Difficulties in therapy most often arise with the development of pathology in a pregnant woman. In this case, the doctor prescribes such drugs that will not harm the unborn child and his mother. A woman takes all medicines under the supervision of a doctor.
The goal of therapy in this case is to reduce the manifestations of skin pathologies and eliminate serious infections. A pregnant woman should adhere to bed rest, she is prescribed antibacterial drugs of the penicillin series or macrolides, NSAIDs. The doctor also carries out sanitation of foci of infection, therapy of concomitant diseases.
ethnoscience
Doctors do not recommend using traditional medicine to treat the disease, since they will not give a positive result, and the person will spend time. But, despite this, many patients prefer to use alternative recipes to combat the disease. Alternative therapy is possible only in the case of an additional method and only after consultation with the attending physician, as some medicinal herbs can provoke the development of side effects.
Forecast and Prevention
Usually erythema nodosum (photo and treatment is presented in the article) does not pose a threat to human life and health, it is only necessary to treat concomitant diseases in a timely manner that can provoke the development of negative consequences. The prognosis of this pathology is favorable. In the chronic course of the disease, relapses may occur, but they do not pose a danger to human health.
Prevention of the disease should be aimed at timely treatment of infectious and inflammatory diseases, and also consists in the mandatory sanitation of the body from foci of infection. Doctors recommend monitoring the state of the vascular system, at the first signs of varicose veins, you should consult a specialist. It is also important not to contact with allergens, periodically undergo scheduled medical examinations and treat chronic pathologies. By following these recommendations and instructions, you can avoid the development of the disease or start timely treatment if it is available.