rheumatic marginal erythema
Introduction
Introduction to rheumatic marginal erythema Rheumatoid marginal erythema (erythemamarginatumrheumatieum) is the main symptom of rheumatic fever. There are two forms of skin lesions: one is flat, that is, annular rheumatoid erythema; the other is bulging type, that is, marginal erythema, and the lesion is ring-shaped. ,arc. It can be expanded into a multi-ring or mesh shape, and the damage spreads rapidly. It can disappear in a few hours or days, but it can be repeated in batches. The treatment can be performed with non-steroidal anti-inflammatory drugs and salicylate preparations. And at the same time apply antibiotics such as penicillin. basic knowledge The proportion of illness: 0.003% Susceptible people: no special people Mode of infection: non-infectious Complications: myocarditis
Cause
Rheumatic marginal erythema
(1) Causes of the disease
Rheumatic erythema marginatum is associated with group A hemolytic streptococcal infection.
(two) pathogenesis
The mechanism of the occurrence of rheumatic fever caused by group A streptococcus has not yet been fully understood, but it is not caused by the direct infection of streptococcus. In recent years, it has been found that the group A streptococcus cell wall contains a layer of protein consisting of three proteins, M, T and R. Among them, M protein is the most important, it can block phagocytosis, and it is the basis of bacterial typing, also known as "cross-reactive antigen". When the body produces "cross-reactive antigen", rheumatic erythema or marginal erythema can occur. .
Prevention
Rheumatic marginal erythema prevention
Prospective long-term follow-up study found that recurrence of rheumatic fever occurred only after re-infection of streptococcus; timely antibacterial therapy and prevention of streptococcal infection can prevent the initial and recurrence of this disease. Prevention of streptococcal infection in bed in the acute phase, giving digestible food, if necessary, infusion therapy such as infusion. The most important thing is to give enough antibacterial drugs immediately.
Complication
Rheumatic marginal erythema complications Complications
May be associated with myocarditis, arthritis, etc. Myocarditis can occur in people of all ages, with more incidence in young adults. For myocarditis caused by infectious causes, there are often primary infections. For example, viral patients often have fever, sore throat, cough, vomiting, diarrhea, muscle soreness, etc. Most of them develop myocarditis after 1 to 3 weeks of viral infection. symptom. Regardless of the cause of myocarditis, the clinical symptoms of myocarditis are related to the characteristics of myocardial damage.
Symptom
Rheumatic marginal erythema symptoms common symptoms discoid erythema fever subcutaneous nodules loss of appetite irritability fatigue
Most patients have a history of upper respiratory tract infections such as pharyngitis or tonsillitis 1 to 5 weeks before onset. The onset is fatigued, loss of appetite, irritability, and the main clinical manifestations are fever, arthritis, carditis, subcutaneous nodules, ring erythema and dance. Disease, etc., the skin is good for the trunk, especially the abdomen, followed by the limbs, the face and hands are rare.
Examine
Rheumatoid marginal erythema examination
Laboratory tests revealed an increase in anti-O and ESR.
Diagnosis
Diagnosis and diagnosis of rheumatic marginal erythema
According to the lesion, the bulge type can be diagnosed.
It should be differentiated from annular rheumatoid erythema, which is flat and has no bulge. It should be differentiated from annular rheumatoid erythema. The annular rheumatoid erythema is flat and has no bulge. Light red or dark red spots, the edges are not raised or slightly raised, palpation has a sense of infiltration. The erythema is migratory and multiple, and can form a ring or merge into a map. The erythema disappears within a few hours and as much as 2 to 3 days, but it can recur in different parts. Occurs in the trunk, especially in the abdomen, also seen in the upper arm, no symptoms.
