persistent limb dermatitis
Introduction
Introduction to persistent limb dermatitis Acrodermatitis continua, also known as acrodermatitis perstans or dermatitis repitis, is a chronic inflammatory, recurrent, aseptic pustular skin disease in the hands and feet. After the trauma, the cause is unknown. basic knowledge The proportion of illness: 0.005% - 0.008% Susceptible people: no specific people Mode of infection: non-infectious Complications: erythroderma
Cause
Causes of persistent limb dermatitis
(1) Causes of the disease
The cause is unknown. Some authors believe that this disease is a type of pustular psoriasis. In the past, the cause may be related to the following factors:
1. Infection theory, considered to be associated with staphylococcal infection.
2. The theory of endocrine disorders, the disease is exacerbated by menstruation and reduced during pregnancy.
3. Autonomic dysfunction theory, some cases have obvious autonomic dysfunction, such as skin temperature reduction, radioactive pain, electric shock convulsions, hibernation drugs improved after treatment.
4. Some people think that this disease is an autoimmune disease.
(two) pathogenesis
The pathogenesis is still unclear. Some people think that this disease is an autoimmune disease.
Prevention
Persistent dermatitis prevention
Because the cause of this disease is unknown, there is no effective prevention. But you can start by developing good habits.
Complication
Persistent dermatitis complications Complications
Individual patients with anatomia develop erythroderma and eventually die from complications.
Symptom
Persistent dermatitis symptoms Common symptoms Itching, herpes, herpes, pustules, mucous membranes, eczema
Occurs in middle-aged people, first on both sides of the finger (toe), most of the disease after trauma, the first and second fingers are most susceptible, the thumb is rarely involved, manifested as small pustules or paronychia, unilateral Limitations, visible surface exfoliation residual red surface, there is exudate (Figure 1), scarring, eczema-like and psoriatic lesions can be seen, the patient consciously itching.
In addition to the hand and foot, the mucosa, especially the oral mucosa, can also spread, forming a painful ring white plaque, pseudomembrane formation and cleft palate. A disease often causes paronychia. As the disease progresses, the deck can be malnourished or desquamate. Skin damage can be Causes skin atrophy and hardening of the underlying soft tissue, so that the entire bone tissue and finger absorption.
Skin lesions are generally limited to local (toe), but can also gradually spread, invading the entire finger (toe), and even the back of the palm and the back of the foot, the experimental examination has no significant value, and the bacterial culture is negative.
Pan-hairy patients have local symptoms. After a long time, they can have symmetrical erythema on the limbs, trunk, genital area and neck. There are pustules on the surface, burning, burning and other symptoms. Pan-type rash and pustular psoriasis and Herpes-like impetigo is similar, with erythroderma in individual patients and eventually death due to complications.
Examine
Persistent dermatitis examination
Histopathology: Primary lesions are filled with a large number of neutrophils in the subcortical lacunar space of the epidermis. The leukocytes between the epidermal cells adjacent to the pustules form a so-called Kogoj spongy pustule, and lymphocytes infiltrate and focal edema in the upper part of the dermis. The old damage is seen in the dermal papilla atrophy and the epidermis thinning.
Diagnosis
Diagnosis and identification of persistent dermatitis
Diagnostic criteria
1. Incidence after trauma.
2. Repeated blisters, pustules, erosion, burning, burning, mild itching.
3. General violation of the finger (toe), back of the hand, back of the foot, sometimes spread to the whole body.
4. There may be mucosal damage.
5. Chronic course of disease, resistance to treatment.
Differential diagnosis
1. The disease should be differentiated from fungal and bacterial infections at an early stage. Cultivation and smear can help to eliminate infectious diseases.
2. It can be distinguished from palmoplantar pustulosis and pustular sweaty eczema. The latter does not cause nail atrophy and shedding. Contact dermatitis secondary infection has a slightly blurred border of pustules and lacks persistent damage.
3. Skin lesions should be differentiated from generalized pustular psoriasis and subarachnoid pustulosis. They have the following
Same characteristics:
(1) The basic damage is an inflammatory pustule with a septic superficial base with redness.
(2) In addition to the pustulosis under the cornea, there are mucosal damage (groove tongue, map tongue) with fever, chills and other systemic symptoms.
(3) Pathologically there are Kogoj spongy pustules.
(4) Recurrence of skin lesions, they have a certain relationship with each other, different parts of the same patient may have different disease damage, patients may have different performances and transformations at different times, there are reports of continuous acrodermatitis, psoriasis, Pelvic epilepsy is converted to pustular psoriasis. Many authors believe that continuous acral dermatitis is the same disease as pustular psoriasis, but due to its special nature, the treatment is different. Treated as an independent disease.
