erythema multiforme exudative
Introduction
Introduction of exudative polymorphic erythema Exudative polymorphic erythema (erythemamultiformeexudativum), also known as erythema multiforme, severely known as history-synthesis syndrome, is an acute inflammatory skin disease of unknown cause, clinical features of polymorphic rash, symmetry Occurs in the back of the hands, forearms and calves, more common in spring and autumn. basic knowledge The proportion of illness: the incidence rate is about 0.004%-0.008% Susceptible people: no special people Mode of infection: non-infectious Complications: nodular erythema
Cause
Exudative polymorphic erythema
(1) Causes of the disease
It is not entirely clear that the occurrence of this disease is related to many factors.
(two) pathogenesis
It is currently considered to be an allergic disease, which may be an allergic reaction caused by small blood vessels in the skin to certain sensitizing substances. The allergen may be bacteria, viruses, fungi, protozoa, mycoplasma or certain drugs such as sulfonamides. Salicylic acid, penicillin, arsenic, etc., may also be due to spoilage foods such as fish and shrimp, other such as X-ray irradiation, menstrual disorders, pregnancy, etc. may also be associated with physical factors such as cold and climate change, Chinese medicine believes The cause of this disease is blood heat or spleen deficiency and dampness, re-feeling the wind or the cold and the cold, so that the camp is not harmonious, the blood stasis is stagnation in the skin; or due to eating disorders, eating into taboos.
Prevention
Exudative polymorphic erythema prevention
More rich in vitamins and fruits, fresh vegetables, limiting animal protein and irritating foods, keeping the stool smooth.
Complication
Exudative polymorphic erythema complications Complications nodular erythema
Can be infected concurrently.
Symptom
Exudative polymorphous erythema symptoms Common symptoms Nodules, loss of appetite, rash, spleen, qi and blood stasis
The clinical features are more common in the spring and autumn, symmetry occurs in the back of the hand, the forearm and calf and other parts of the pleomorphic rash, is an acute inflammatory skin disease.
1. The rash is polymorphous: it starts with erythema. Later, there may be rubella, papules, blisters or blisters, purpura, etc. The erythema is about the size of a lentils or a fingernail. The color is bright red, and the center is dark red or purple. Some erythema centers can form a ring, or overlap blister, shaped like an iris, called rainbow-like erythema, which is characteristic damage of the disease. Blisters also have hemorrhagic content. If the number of bloody skin lesions is large, it is called hemorrhagic. Polymorphic erythema.
2. Frequent symmetry occurs in the fingertips, palms, followed by the forearms, the back of the foot, the calf, the face, the neck, the neck, and the severe ones are also seen in the mucosa.
3. The onset of acute, acute, pre-existing limbs are burnout, headache, loss of appetite, joint pain, micro-heat and other minor prodromal symptoms; after about 2 to 4 weeks, the temporary pigmentation remains.
4. More common in young people, more women, spring and autumn.
5. Self-conscious itching.
Examine
Examination of exudative polymorphic erythema
Laboratory examination: white blood cells are slightly increased, eosinophils are increased in most cases, erythrocyte sedimentation rate is accelerated, and proteinuria may also occur.
Histopathology: There are various types of tissue changes, mainly three types of changes: 1 epidermal type: epidermal keratinocytes appear different degrees of necrosis, severe basal cell liquefaction degeneration, true epidermal separation, the upper surface of the large piece of necrosis, This type is seen in target lesions and severe polymorphic erythema. 2 dermal type: dermal papillary edema, epidermis blister formation, perivascular infiltration of the upper part of the dermis, mainly mononuclear cells, mixed with eosinophils, this type is seen in macules, papular lesions. 3 dermal epidermis mixed type: common, along the edge of the dermis and superficial blood vessels around a mononuclear cell infiltration, with basal cell liquefaction and degeneration, the formation of subepidermal blisters, part of the epidermal keratinocyte necrosis, intracellular edema and sponge formation, dermis The upper part often has extravasation of red blood cells.
Diagnosis
Diagnostic identification of exudative polymorphic erythema
diagnosis
Diagnosis based on symptoms and findings.
1. The rash is pleomorphic and begins with erythema. Later, there may be rubella, papules, nodules or blisters, purpura, etc. The erythema is about the size of a lentils or a fingernail, the color is bright red, and the center is dark red or purple. .
2. Frequent symmetry occurs in the fingertips, palms, followed by forearm foot, calf, face, neck, neck, and severe cases can also be seen in the mucosa.
3. The onset of acute, acute, pre-existing limbs are burnout, headache, loss of appetite, joint pain, micro-heat and other minor prodromal symptoms; after about 2 to 4 weeks, the temporary pigmentation remains.
4. More common in young people, more women, spring and autumn.
5. Self-conscious itching.
Differential diagnosis
1. Frostbite: more common in winter and skin exposed parts, not seen in the mucous membrane, itching, especially in heat, local edema infiltration, and venous congestion.
2. Herpes-like dermatitis: Although it is a polymorphic rash, it is mostly in a ring or semi-annular arrangement, chronically passing, prone to recurrence, severe itching, more common torso, limbs, blood and vesicles, and eosinophils are significantly increased, potassium iodide The test was positive, and the histopathology showed subepithelial tonic bullae, which contained neutral and eosinophils.
3. Urticaria: no rash, no occurrence, rapid regression, rash is a single wind group, generally no blister, consciously itchy.
4. Drug rash (polymorphic erythema type): There is a history of taking medicine. After stopping the drug, it is treated properly, and it has nothing to do with the season.
