subcutaneous tissue induration
Introduction
Introduction Subcutaneous tissue induration is a clinical manifestation caused by simple varicose veins of the lower extremities. It is generally not serious. It is mainly characterized by the expansion of the superficial venous fistula of the lower extremity. If the disease course continues to progress, it should be later, especially when the traffic vein valve is destroyed. Mild swelling and skin nutrient changes in the boot area, including skin atrophy, scaling, itching, hyperpigmentation, induration of the skin and subcutaneous tissue, and even eczema and ulceration.
Cause
Cause
(1) Causes of the disease
Congenital vein wall weakness and poor venous valve structure are the main causes of the disease. Heavy physical labor, prolonged standing, and increased abdominal pressure caused by various reasons can cause the valve to withstand excessive venous pressure. In the case of poor valve structure, the valve may be incompletely closed and blood reflux may occur. Due to the thin muscular layer of the superficial vein and the lack of connective tissue around it, blood reflux can cause the vein to grow thicker and varicose veins appear. Due to the increase in venous pressure in the lower extremities, a large amount of capillary proliferation and permeability increase in the foot-shoe area, resulting in pigmentation and lipid hardening. The accumulation of fibrinogen, which hinders the exchange between capillaries and surrounding tissues, can lead to nutritional changes in the skin and subcutaneous tissue.
(two) pathogenesis
The main hemodynamic changes of varicose veins occur during the systolic phase of the calf muscle. Due to the destruction of the venous valve that protects the blood from one-way flow, the deep vein blood flows back into the superficial venous system, and the deep venous pressure formed during muscle contraction is as high as 20 ~26.7kPa, due to the lack of support for muscle fascia around the superficial vein, but only the loose connective tissue under the skin, coupled with the weak vein wall itself, resulting in the growth of the vein, thickening, varicose veins.
Barnandl and Browse have shown that there is a large amount of capillary proliferation in the pigmentation and lipid-hardening areas of varicose veins of the lower extremities. Moreover, due to the increase in pore size between capillary endothelial cells, a large amount of osmotically active particles, especially fibrinogen, leaks out, and at this time, the fibrinolytic ability of the vein decreases, so that a large amount of fibrin is deposited around the capillary. The exchange of oxygen and nutrients between the capillaries and the surrounding normal tissues is impeded, and nutritional changes occur in the skin and subcutaneous tissues.
Examine
an examination
Related inspection
Anti-saline extractable nuclear antigen (ENA) antibody
As the blood can not be renewed, skin dystrophy occurs here, manifested as skin atrophy, desquamation, itching, pigmentation, induration of the skin and subcutaneous tissue, and may also cause inflammation, ulceration, bleeding and other consequences.
Diagnosis
Differential diagnosis
Differential diagnosis of subcutaneous tissue induration:
1. Subcutaneous fat granules: Fat granules are small white mites that grow on the skin. They are about the size of a needle. They look like a small white sesame, usually on the face, especially in the eyes of women. The fat granules are caused by tiny wounds on the skin, and in the process of self-repair of the skin, a small white cyst is formed. It is also possible that sebum is covered by keratin and cannot be properly discharged to the epidermis, thereby accumulating white particles formed in the skin.
2, the subcutaneous finger to the big egg nodule nodules: the clinical manifestations of the split head rickets are located in the trunk or lower limbs of the finger to the pigeon's egg inflammatory mass nodules, the number is 1-2, the affected area has more edema and Itching.
3. Miliary nodules in subcutaneous deposition: oxalate crystal arthritis The deposition of oxalate crystals in the joints can lead to acute and chronic lesions of various joints, the most common of which are the knee joint and the hand joint. Other joints, such as wrist, ankle, foot and tendon sheath, and joint capsule lesions have also been reported. Patients treated with hemodialysis or peritoneal dialysis for renal failure can also develop oxalate deposits in the intervertebral disc, which often lead to disruption and degeneration of the intervertebral disc. Deposition of oxalate crystals in other tissues can also lead to the following consequences: local necrosis, myocardial lesions or heart block due to insufficient blood supply, miliary nodules, peripheral neuropathy and aplastic disorders in subcutaneous deposition Anemia.
4, subcutaneous nodules: subcutaneous nodules (subcutaneous nodules) is a hard, round or oval, painless nodules. The diameter is 0.2 to 10 cm. Often located in more parts of the friction, such as the elbow extension, the Achilles tendon, the scalp, the ischial tuberosity or around the joint. Unusual parts have ears and bridge of the nose. Subcutaneous nodules rarely cause symptoms, occasionally rupture or complicated infection. Typical subcutaneous nodules grow slowly, persist or disappear when the disease is relieved. The appearance of subcutaneous nodules is closely related to high titer serum rheumatoid factor, severe joint destruction and rheumatoid active lesions.
