progressive pigmented purpuric dermatosis
Introduction
Introduction to progressive pigmented purpuric skin disease This disease is also known as Schamberg disease, specific peguliar progressive progressive pigmentation disease of the skin, the disease often occurs asymmetrically on the calf extension surface, which is a patch of different size and shape composed of needle tip to needle big sputum. unknown. There are reports of familial morbidity. The clinical manifestations are initially clustered, and the reddish enamel spots or ecchymoses from the miliary to the needle cap gradually increase and then merge into pieces to form irregularly shaped orange-red or brown-red patches. basic knowledge The proportion of illness: 0.002% Susceptible people: no specific population Mode of infection: non-infectious Complications: pruritus
Cause
Causes of progressive pigmented purpuric dermatosis
(1) Causes of the disease
The etiology of this disease is unknown, there are reports of familial morbidity, patients with more local venous pressure factors, that is, varicose veins of the lower extremities or long-term standing, resulting in poor venous return of the lower extremities, it is speculated that the peripheral blood vessels, especially the capillary wall The lesion.
(two) pathogenesis
Due to increased vascular permeability, red blood cell overflow and collapse, and hemosiderin deposition, the mechanism of increased vascular permeability is different. Schamberg et al originally thought it was related to hypercholesterolemia, but in many cases, blood cholesterol levels were It is not high, so it is difficult to explain. It is also believed that this disease and telangiectasia can cause vasomotor dysfunction.
Pathology: slight thickening or parakeratosis of the horn layer, thinning of the spinous layer, disordered arrangement, basic lesions are vascular lesions in the upper part of the dermis, early detection of capillaries, including swelling of the vascular endothelial cells of the papillary layer, vascular proliferation, red blood cell spillover and capillary Perivascular dense lymphocytes and a small number of tissue cells, eosinophil infiltration, capillary expansion in the old lesions, with vascular endothelial cell proliferation, often found in varying amounts of hemosiderosis and hemosiderin cells.
Prevention
Progressive pigmented purpuric skin disease prevention
Prevent possible incentives and avoid standing for too long. The room should not be too cold and humid, and the temperature should be appropriate.
In recent years, Chinese herbal medicines for promoting blood circulation and removing blood stasis, such as Danshen tablets or injections, Danggui pills, compound angelica injections, and Liangxueyu supplemented with heat-clearing and dehumidifying traditional Chinese medicines, have also received good results.
Complication
Progressive pigmented purpuric skin disease complications Complications pruritus
Many patients may be associated with other pigmented purpuric skin lesions, such as ring lesions and mossy papules.
Symptom
Progressive pigmented purpuric dermatosis symptoms common symptoms itching papules freckle
This disease occurs in the calf extension, especially in the lower part of the lower jaw, the ankle and the back of the foot, sometimes in the knees and thighs, occasionally involving the forearm, often asymmetrical, no or only a slight itching, although self-healing The tendency, but most tend to slowly expand, lasting 3 to 4 months, the elderly for several years, decades, many patients can be combined with other pigmented purpuric skin disease manifestations, such as ring lesions and canola-like papules.
At the beginning of the cluster, the reddish enamel or freckle of the miliary to the needle cap gradually increases and then merges into a piece of orange-red or brown-red patch with irregular shape. The edges are mostly jagged, and the spots are dense and dense. Bright, irregularly connected to each other into a network, island-like, slide compression does not fade, the damage gradually expands outward, at the edge of each rash, new damage appears one after another, scattered in the old skin lesions or edges, presented Pepper powder-like spots, after a few months, the color of the damage begins to fade and turns into a light brown or light yellow patch. The primary damage is not necessarily hair follicle, it is as high as healthy skin, and the surface is covered with a very fine peel. Chips, while the central old damage is thinned like parchment-like small wrinkles, where there are bristles, no telangiectasia and varicose veins.
Examine
Examination of progressive pigmented purpuric skin disease
Blood, urine routine may be normal, blood biochemical cholesterol can be increased.
Histopathology: The upper part of the dermis and the dermal papillary endothelial cells are swollen, lymphocytes around the capillaries, tissue cell infiltration and varying degrees of edema, showing hemosiderin deposition.
Diagnosis
Diagnosis and differentiation of progressive pigmentary purpuric dermatosis
According to the calf stretch, the border is bright brownish yellow spots, the outer edge is pepper-like spots, the pressure does not fade, slowly expand, the diagnosis is not difficult.
Differential diagnosis
It needs to be differentiated from pigmented purpuric dermatitis, telangiectasia, purpura, and hemangioma.
Pigmented purpuric mossy dermatitis
The skin lesions are symmetrically distributed, showing mossy pigment spots and consciously itching.
2. Capillary dilatation
It can be seen that the vascular capillaries that are in a ring-like arrangement are dilated and have hair loss and rheumatoid pain.
3. Claudication hemangioma
There is no need for a good site, the skin lesions are brown to bright red hemangioma, and there is no new rash around, no symptoms.
