Facial disseminated miliary lupus
Introduction
Introduction to facial disseminated miliary lupus In the past, facial disseminated miliary lupus was considered to be a type of skin tuberculosis disseminated by blood. It is a variant of lupus vulgaris or tuberculosis, but there is no evidence of tuberculosis. Although histology has tuberculosis changes, tuberculin The test is often negative. basic knowledge The proportion of illness: 0.003% Susceptible people: no special people Mode of infection: non-infectious Complications: pustules, erysipelas
Cause
Facial disseminated miliary lupus
(1) Causes of the disease
The cause has not been determined. In the past, this disease was considered to be a type of skin tuberculosis disseminated by blood. It is a variant of lupus vulgaris or tuberculosis, but there is no evidence of tuberculosis. Although histology has tuberculosis changes, tuberculin test Frequently negative, the course of the disease is self-limiting, there is a tendency to heal naturally, and there are often other areas of tuberculosis, tuberculosis can not be found in the skin lesions, anti-tuberculosis treatment is invalid, so recently this disease is not related to tuberculosis, a certain Some cellular immune tests showed abnormalities.
(two) pathogenesis
The pathogenesis is still inaccurate. It used to be a variant of lupus or tuberculosis, but there is no evidence of tuberculosis. Although histology has tuberculosis changes, the tuberculin test is often negative.
Prevention
Facial disseminated miliary lupus prevention
Precautionary principle: It is mainly to mobilize the masses, vigorously publicize the prevention and treatment knowledge of tuberculosis, conduct regular health checkups, early diagnosis, early treatment, eliminate infection sources, eliminate infection routes, carry out BCG vaccination, and enhance the body's resistance.
Complication
Facial disseminated miliary lupus complications Complications
1, often complicated by pyogenic infections, such as impetigo, sputum and erysipelas.
2, can be complicated by lymphangitis or lymphadenitis, lymphatic drainage disorder, and complicated limbs like skin swelling.
3, can be concurrent with other organs of tuberculosis, such as tuberculosis, bone tuberculosis and so on.
4, the disease often prolonged decades of unhealed, and some are likely to cause squamous cell carcinoma, squamous cell carcinoma and other skin cancer on atrophic scars.
Symptom
Facial disseminated miliary lupus symptoms Common symptoms constipation papules bloating scaly mouth dry tongue tongue red
The original rash is a miliary-sized round papule with a flat top and a clear boundary. The new rash has a bright red or reddish color. The old rash is brown or yellow. The surface is covered with grayish scales. Most of the clusters are clustered but not fused. The surface is soft. Gloss, central purulent, lack of self-conscious symptoms, slides are brownish red, probe penetration method, sometimes positive, symmetry occurs in the face, especially around the eyelids, eyebrows, nasolabial folds, upper and lower lips, The cheeks are more common, the incidence is sharp, after the slowness, it occurs in young and middle-aged; after the self-healing, the left scar can be left behind, and the tuberculin low-diluted dilution (1:1000) test is positive or Weakly positive.
Examine
Examination of facial disseminated miliary lupus
Histopathology: The middle and lower layers of the dermis showed tuberculous infiltration, with epithelial-like cells, Langhans giant cells and lymphocytes, and occasionally there was caseous necrosis in the center.
Diagnosis
Diagnosis and differentiation of facial disseminated miliary lupus
diagnosis
TCM pathogenesis and syndrome differentiation:
1. Pathogenesis Chinese medicine believes that this disease is caused by the poisonous internal stagnation, phlegm and blood stasis or lung and stomach heat and toxic evil.
2. Syndrome differentiation
(1) wet poisonous depression type: face, eyebrows, eyelids have deep red, corn to sorghum hard pimples, with dry mouth and bitterness, full abdominal distension, yellow urine, dry tongue, red tongue, greasy fur, pulse Shen slow.
(2) Internal heat susceptibility type: facial mouth week, red hard pimples on the nasal side, pressure does not fade, with dry mouth, anxious, constipation, red tongue, yellow fur, pulse string slip or slip .
Differential diagnosis
1. The acne vulgaris is conical, consistent with the pores, and there are pustules at the top, and the surrounding infiltration is obvious, accompanied by acne, which occurs in the face and chest.
2. The rosacea lesions invade the cheeks, the tip of the nose, the forehead, and the lower jaw. It is extensively flushed with telangiectasia.
