Exudative erythema ICD 10. Exudative erythema multiforme - description, symptoms (signs), diagnosis, treatment

Infectious:

Trichophytosis;
Inguinal lymphogranulomatosis;
Cat scratch disease;
Leprosy;
Blastomycosis;
Histoplasmosis;
Coccidioidomycosis;
Yersiniosis;
Psittacosis.

Etiology unknown.

Pathogenesis: sensitization of blood vessels of the skin and subcutaneous tissue by pathogens of various infectious diseases. Typically, erythema nodosum develops after or against the background of common infections (streptococcal tonsillitis, tuberculosis, leprosy, syphilis, mycoses).

Less commonly, the sensitizing agent is classified as a medication. Erythema nodosum is often a skin syndrome of sarcoidosis.

Sometimes it can act as a paraneoplastic symptom. Predisposing factors: colds, congestion in the lower extremities, hypertension.

Genetic aspects

Inherited form (

knotty familial).

Risk factors

Infectious diseases Deep mycoses Sarcoidosis Taking drugs (sulfonamides, oral contraceptives, bromides) Ulcerative colitis Crohn's disease.

Etiology

unknown.

Pathogenesis

sensitization of blood vessels of the skin and subcutaneous tissue by pathogens of various infectious diseases. Usually nodular

develops after or against the background of common infections (streptococcal tonsillitis, tuberculosis, leprosy, syphilis, mycoses). Less commonly, the sensitizing agent is classified as a medication. Often nodular

is a cutaneous syndrome of sarcoidosis. Sometimes it can act as a paraneoplastic symptom. Predisposing factors: colds, congestion in the lower extremities, hypertension.

Normally, redness of the skin is a temporary phenomenon, quickly passing after the irritating factor is eliminated (for example, caused by an emotional outburst). Pathological forms are characterized by persistence and duration; their main causes are:

inflammatory and infectious diseases of viral or bacterial origin;
skin burns (sun, radiation, chemical);
allergic erythema is a consequence of exposure to allergens;
autoimmune diseases (systemic lupus erythematosus).

Physiological factors for redness include ingestion or topical use of certain medications (for example, warming ointments), physical impact such as spanking or massage, and UV irradiation in the sun preceding tanning. A reflex change in skin color is caused by strong emotions (shame, anger), orgasm, and sometimes by hypnotic suggestion.

The mechanism of development of the pathological process is determined by the action of the irritating agent. Viruses or bacteria provoke inflammation and general intoxication, accompanied by fever and a rush of blood to small vessels. With burns and allergies, redness appears due to the release of histamine into the bloodstream, which dilates the capillaries and promotes stagnation of blood in them.

Erythema nodosum: Signs, Symptoms

Clinical picture

There are acute and chronic forms. Acute nodular

manifests itself as a rapid rash on the legs of painful, bright red, swollen nodules the size of a child’s palm. Fever up to 38 - 39 degrees is noted.

C, general weakness, headache, sometimes arthralgia. The nodes disappear without a trace after 2 - 3 weeks, successively changing their color to bluish, greenish, yellow (bruise bloom).

There is no ulceration of the nodes. The disease is more common in young women and children, usually after a sore throat, and does not recur.

Chronic nodular

Symptoms of erythema nodosum

There are more than two dozen varieties of this disease, and each of them has its own causes and external clinical signs. The type of redness and accompanying symptoms allow the dermatologist to fairly reliably diagnose one or another type of erythema during the initial examination.

The following forms are distinguished:

Symptomatic (emotive)
Persistent
Ramirez's persistent ashy dermatosis (dyschromic erythema)
Palmar - erythema of the palms (palmar congenital, “liver palms”)
Polymorphic
Exudative erythema multiforme (Stevens-Johnson erythema)
Physiological
Viral
Infectious
Erythema Chamera
Centrifugal erythema of Biette
Centrifugal erythema of Daria
Solar (ultraviolet)
Ultraviolet
Fixed
Ring rheumatic
Erythema toxicum of the newborn
Knotty
Nodose
Cold
Thermal
Scarlatiniform desquamative erythema
Erythema Miliana
Radial
Hammel's tortuous erythema
Bordered
Afzelius-Lipschutz migratory erythema
Congenital telangiectatic erythema of Bloom

Redness of the skin in medical terminology is referred to as erythema. It can be caused by natural harmless factors - increased air temperature, bathing in hot water or physical impact. But a change in the color of the skin to red for no obvious reason is a signal of pathological processes in the body that require seeking qualified medical care.

This term of Greek origin (“erythros” - red) refers to pronounced redness of the skin due to dilation of capillaries. These small vessels are located directly in the skin, so the rush of blood to them is clearly visible externally. It can be one of the symptoms of an infectious-inflammatory process in the body, but often has purely physiological causes, not related to any diseases.

Erythema should be divided into active, caused by an acute inflammatory process, and passive, associated with blood stagnation (venous stasis).

Causes

inflammatory and infectious diseases of viral or bacterial origin;
skin burns (sun, radiation, chemical);
allergic erythema is a consequence of exposure to allergens;
autoimmune diseases (systemic lupus erythematosus).

Diagnostics

Diagnosing one of the many types of erythema is quite difficult, since the characteristic redness of the skin and accompanying symptoms are characteristic of many diseases. For example, when , or . After making a preliminary, primary diagnosis, the dermatologist prescribes specific tests:

a serological test to detect the presence of antibodies to the virus that causes the disease;
general blood test to determine the number of formed elements;
allergy tests;
taking exudate from pustules, if any.

It is also necessary to first exclude physiological causes of erythema and perform a differential diagnosis.

Erythema - photos, symptoms and treatment

The following forms are distinguished:

Symptomatic (emotive)
Persistent
Ramirez's persistent ashy dermatosis (dyschromic erythema)
Palmar - erythema of the palms (palmar congenital, “liver palms”)
Polymorphic
Erythema multiforme exudative (+ Stevens-Johnson erythema)
Physiological
Viral
Infectious
Erythema Chamera
Centrifugal erythema of Biette
Centrifugal erythema of Daria
Solar (ultraviolet)
Ultraviolet
Fixed
Ring rheumatic
Knotty
Nodose
Cold
Thermal
Erythema Miliana
Radial
Hammel's tortuous erythema
Bordered

The principles of treatment for a particular type of disease depend on the causes that caused it, the severity of the disease, the age of the patient and some other factors. In addition, physiological forms go away independently and quickly; they do not require therapy.

The second name is emotive, which indicates its origin. Redness of the skin is caused by strong emotions such as anger, shame or stressful situations. It manifests itself as a transient change in the color of the skin of the face, chest and neck to a pronounced red or crimson color. In this case, the vessels dilate briefly due to a chemical reaction stimulating cholinergic receptors.

Photo of symptomatic erythema

Persistent erythema

ICD-10 code L95.1. It is also known as Crocker-Williams erythema or Crocker-Williams erythema. A rather rare type of unclear etiology: the causes can be vasculitis, infections, or heredity. The disease begins with the appearance of small papules, which subsequently merge into large (up to 7 cm in diameter) foci of uneven outline with ridges along the edges. The color varies from pinkish to deep red, the surface is initially soft, then thickens and may peel off. NSAIDs, heparins, vitamins, antiplatelet agents, and angioprotectors are prescribed. Large lesions are removed using cryotherapy.

Photo of a persistent towering era.

Ramirez's persistent ashy dermatosis (dyschromic erythema)

A rare variant of lichen planus, accompanied by the appearance of ash-gray spotted rashes.

No treatment has been developed. Independent spontaneous regression of the rash is possible.

Photo of dischromatic era.

ICD-10 code L53.8. A characteristic symptom is severe redness of the palms. The pathological variety of this phenomenon is most often caused by liver diseases, leukemia, rheumatoid arthritis, bacterial endocarditis and other pathologies. Acquired palmar erythema is also called the liver palm sign.

It is sometimes observed in pregnant women, usually in the second trimester. The photo of palmar erythema shows that predominantly the palmar eminences and fingertips turn red. Subsequently, hyperemia covers the entire palm.

Subjectively, sensations of itching and pulsation are likely; when pressed, the skin turns pale for a short time, then returns to a state of hyperemia. Treatment is prescribed in accordance with the cause of palmar erythema - cirrhosis, jaundice, arthritis.

Liver palms

Erythema of the palms (palmar)

Congenital palmar erythema is hereditary in nature and is caused by the expansion of capillary palmar anastomoses. The disease is not accompanied by other symptoms and does not require treatment.

ICD-10 code L51. An acute disease that often recurs or takes on a chronic form. The causes can be both infections and toxic-allergic reactions of the body. It manifests itself as polymorphic rashes on the mucous membranes and skin, and they begin to appear strictly symmetrically on the extremities (the dorsum of the feet, legs and forearms). Blue spots with a pink border up to 3 cm in diameter and small papules form. Soreness and itching appear, and sometimes general health worsens. The border of the lips is also involved in the process, with the formation of bloody crusts subsequently. The rash lasts for about a week, after which the blisters dry out and the spots disappear.

Multiform exudative era. on the elbows

In some cases, the disease occurs in a vesiculobullous form (Stevens-Jones erythema), characterized by a severe course and a high risk of death.

Stevens-Johnson erythema

Er. Stevens-Johnson on the face

Erythema multiforme

Synonymous with erythema multiforme. It is characterized by multiple rashes of different types: papules (nodular rash), vesicles (small fluid-filled blisters), hemorrhages - pinpoint intradermal hemorrhages and others. Their appearance is accompanied by symptoms of general intoxication.

The cause is usually a negative reaction of the body to the drug due to its intolerance. The progression of the disease leads to spread to the mucous membranes and fusion of rashes with the formation of large blisters. Treatment involves discontinuation of the allergen drug, administration of antihistamines, glucocorticoids, wound-healing drugs, and vitamins. Cardiovascular syndrome is treated if it is present.

Physiological erythema

ICD-10 code P83.1. From the name it is clear that this phenomenon does not mean a painful condition, passes quickly and does not require treatment. In adults, it appears due to physical impact on the skin or reflex nervous reactions. There is also physiological erythema that appears in infants a few hours or days after birth (sometimes with minor gray-yellow rashes). It is explained by the peculiarities of adaptation of the child’s body in the postpartum period.

The cause of physiological erythema in newborns is, first of all, the difference in temperature: in the womb it is higher and constant, so its decrease leads to increased peripheral blood circulation and, accordingly, temporary redness. It does not require treatment because it goes away within a day. The second factor causing erythema on days 2 or 3 may be addiction to nutrition through the gastrointestinal tract and the entry of allergens into the body through this route. It also usually does not require therapy unless infection is detected. Antihistamine drops are sometimes prescribed to relieve itching.

Physiological era. newborns

ICD-10 code L51.8. The cause of the disease is infection of the body by a virus. Mostly children aged 4-2 years get sick, especially in spring and autumn. Viral erythema is quite easy to confuse with other infectious colds at the initial stage, since the symptoms are almost the same. The main symptoms of viral erythema in children include:

temperature increase;
sore throat, itchy nose;
runny nose;
headache;
the appearance of rashes (spots) on the body and oral mucosa after 2 or 3 days.

After a few days, the rash disappears, but the internal organs become infected. Viral erythema in children, if not recognized in time, leads to hematopoietic disorders, damage to joints and bone marrow, and anemia. Treatment is carried out with antiviral drugs and analgesics. Lorinden ® and Advantan ® ointments are used externally.

Erythema infectiosum

ICD-10 code B08.3. The second name is “fifth childhood infection”, caused by parvovirus B19. It occurs very often in children, and in most cases it is asymptomatic or mild. The incubation period is up to 2 weeks, after which the first and main symptom appears - severe redness of the cheeks. Then a characteristic “lace” rash appears all over the body, which disappears no later than after 2 weeks. Treatment is primarily symptomatic and immune supportive. In adults, the disease is more severe; parvovirus is especially dangerous for pregnant women.

Erythema Chamera

ICD-10 code L53. A type of infectious form of the disease that occurs in children and adults. It is characterized by a fairly mild course with minor symptoms of intoxication and fever. The photo of Chamera's erythema in children shows that the rashes that appear on the very first day from the onset of the disease merge into a large spot of a specific shape on the second day.

The reddened areas have a butterfly outline. Chamera's erythema in children completely disappears within 2 weeks, and is treated exclusively symptomatically if necessary. It is easily tolerated by adults, and usually occurs in an erased form, sometimes with slight swelling of the joints.

Centrifugal erythema of Biette

ICD-10 code L93. This is the name of a rare superficial type of lupus erythematosus. In this case, this autoimmune disease manifests itself in the form of redness diverging from the center of the face to the edges (the “butterfly” symptom), which is not accompanied by subjective unpleasant sensations. It is classified as a separate disease, but can be one of the signs of systemic damage to the body. It is treated with antimalarial drugs, B vitamins, and antioxidants.

Centrifugal erythema of Daria

The disease is also called arcuate persistent erythema. The exact reason for its development has not been established. Viral, fungal and bacterial theories cannot be ruled out.

Erythema is characterized by the appearance on the skin of the body (less commonly of the face) of small pinkish nodules due to depression in the center, similar to rings.

Treatment includes therapy for the underlying disease, taking antihistamines and glucocorticosteroids.

ICD-10 code L55. This diagnosis is a consequence of prolonged exposure to the sun and exposure to UV rays of exposed areas of the body. As a result, the skin turns red for several hours, touching causes pain, slight swelling and an increase in overall body temperature are possible. Treatment of solar erythema comes down to the following measures:

cessation of exposure to radiation;
cool shower and cold lotions on the affected area;
sprays based on dexpanthenol.

With extensive lesions of a more severe degree (with the formation of blisters), it is advisable to consult a dermatologist. He will prescribe anti-inflammatory and antihistamines, ointments with glucocorticoids.

Patients with increased sensitivity to ultraviolet radiation and a tendency to develop solar erythema are recommended to always use a cream with a high SPF filter, regardless of the time of year.

Ultraviolet erythema

ICD-10 code L56. When exposed to the sun, it is considered synonymous with solar erythema, but can also be caused by artificial sources (special devices, solariums, etc.). the symptoms are the same: skin hyperemia, soreness, general deterioration in well-being. Treatment consists of cooling the irradiated areas and using dexpanthenol in the form of an aerosol.

ICD-10 code L53. It is the body’s response to the entry into the bloodstream of a certain substance to which there is hypersensitivity. The peculiarity of this disease is that redness always appears in the same area of the skin or mucous membrane. The areas most often affected are the natural folds, genitals, and face. The photo of fixed erythema shows that the spot is extensive, red or bluish in color, sometimes with blisters and accompanying erosions.

Therapy for the disease always begins with the detection and abolition of the provoking factor (most often these are NSAIDs, antibiotics, hormonal agents). Further treatment of fixed erythema involves infusion therapy, enterosorbents and external use of steroids. Extensive erosive lesions require the use of combined antimicrobial and wound healing ointments and systemic corticosteroids.

Ring-shaped erythema

ICD-10 code L53.1. This concept combines a group of dermatological diseases with similar external manifestations. A characteristic general symptom is ring-shaped or closed shapeless redness on the body, with or without peeling, vesicles. Depending on the specific form of the disease, the cause may be infections, helminthiases, weakened immunity, tonsillitis, mycoses, hormonal imbalances and cancer.

Most often, ring-shaped erythema is rheumatic in nature.

Treatment is prescribed in accordance with the main diagnosis.

Photo of the ring-shaped era.

Erythema toxicum

ICD-10 code L53.0. It is a consequence of the introduction of an allergen into the body and manifests itself in the form of hyperemic areas of the skin with an increase in their temperature. It is usually observed in newborns, full-term and breastfed infants. In adults, incidence statistics are unknown; the cause may be exogenous (external) or endogenous (heredity, medications, food) factors. Treated by taking antihistamines.

ICD-10 code L52. The disease received its name in accordance with the main clinical symptom - the formation of multiple or single nodes in the skin of the legs. In the acute form, they are about 2 or 3 cm in diameter, pink or bluish in color, and are characterized by pain (up to the inability to walk). Causes: infections (most often streptococcal, toxoplasmosis, tuberculosis) or allergies to medications. Treatment is carried out in a hospital according to indications depending on the provoking factor.

Photo of knotty era.

Erythema nodosum

ICD-10 code L52. It is synonymous with erythema nodosum, so the symptoms and etiology (causes of the disease) are the same. Treatment is also carried out in the same way - in a hospital according to the factor that caused the disease.

ICD-10 code L50.2. In response to lower ambient temperatures, persistent painful redness and rashes may appear on the skin. The reasons for this phenomenon have not been identified; the process is presumably triggered by special proteins that, in the cold, release histamine and cause an allergic reaction. Chronic infections and weakened immunity can also be trigger factors. There is no etiotropic treatment; antihistamines are prescribed, infectious diseases are identified and treated.

The disease is also called reticulate telangiectatic dermatosis pigmentosa. Thermal erythema develops with prolonged exposure to infrared radiation (fireplace, electric heating pads, etc.).

Treatment boils down to eliminating the cause of erythema.

With this type of erythema, the distinctive feature is erythematous-desquamative rashes. The disease is characterized by a benign course and a favorable prognosis.

The cause of erythema is bacteria (staphylo- and streptococcal flora).

The onset of the disease is always acute. There is a high fever, intoxication syndrome and a bright spotty rash. After the erythema disappears, profuse peeling begins (especially on the palms and soles).

Differential diagnosis is carried out with scarlet fever.

Treatment includes antibacterial and anti-inflammatory therapy, and antihistamines are also indicated.

Erythema Miliana

ICD-10 code L53. The disease is an allergic reaction to parenteral administration of salvarsan, an outdated medicine for syphilis. It manifests itself as a characteristic pinpoint scarlet fever or measles-like rash throughout the body. Due to the fact that salvarsan has been replaced by more modern and safe drugs, this erythema does not occur.

ICD-10 code L58. This is the name given to redness of the skin in response to radiation in radiobiology. The causes may be natural or artificial (used for the treatment of cancer and diagnosis) radioactive radiation. Early erythema occurs within 24 hours after irradiation, is characterized by slight hyperemia and resolves quickly. True radiation erythema develops after a few days, is persistent, and is accompanied by pain, swelling and itching.

Hammel's tortuous erythema

ICD-10 code L53.3. Belongs to the group of patterned erythemas, manifests itself in the form of winding stripes, reminiscent of a cut of wood and localized mainly in the area of the face, neck, and chest. It is a tumor marker, that is, it indicates the formation of a malignant tumor and requires appropriate treatment of the underlying disease. Erythema is observed in adenocarcinomas of the mammary glands, myelomas, pulmonary tumors, etc.

Fringed erythema

ICD-10 code L51.8. Another name is serum toxidermia, which occurs as a response to the introduction of serums into the body. The external manifestation consists of serous rashes or urticaria: a rash appears, blisters filled with serous fluid on the skin. Treatment is symptomatic.

ICD-10 code A69.2. An infectious skin disease that develops after a tick bite and the bacterium Borrellia burgdorferi entering the body. The incubation period, which lasts from 1 to 3 weeks, is replaced by the appearance of a ring-shaped erythematous spot, the boundaries of which are rapidly expanding.

Also called chronic migratory erythema or Lyme disease. A course of antibiotics is indicated to destroy the pathogen and symptomatic treatment. In case of complications, Stevens-Johnson syndrome develops (ICD-10 code L51.1) or necrolytic migratory erythema, which is fraught with severe damage to the mucous membranes of the mouth, esophagus, genitals and eyes. It is difficult to treat.

The disease is hereditary and has an autosomal recessive mode of inheritance. As a rule, males are affected. Bloom's erythema is extremely rare in women.

Characteristic is the appearance of butterfly erythema (as with systemic lupus erythematosus) on the face, as well as red spots on the skin of the eyelids, ears, and hands. In addition to facial erythema, patients have dwarf stature and signs of a dolichocephalic skull.

No treatment has been developed.

Congenital telangiectatic era. Bloom

Consequences and forecasts

The outcome is different for each type of disease. Erythema infectiosum, for example, goes away quickly and without any consequences. Toxic and migratory forms pose a danger to life. Skin lesions heal, depending on the depth of the lesion, without leaving a trace or with scarring. The prognosis also depends on the timeliness and correctness of medical care.

Prevention

It does not seem possible to completely exclude the development of erythema, but it is quite possible to significantly reduce the likelihood. Almost all types of this disease develop against the background of reduced immunity and chronic infections. That is, it is necessary to promptly improve health and treat diseases. Caution and protective measures in tick habitats will protect you from erythema migrans.

For normal healthy people, normal home treatment (including rest, fluids, and pain medications) is sufficient for erythema infectiosum. The reappearance of the rash does not mean that the disease has progressed or that the condition has worsened. Often the rash can reappear due to exposure to sunlight, high temperatures or stressful situations.
Antibiotics are not used to treat erythema infectiosum because the disease is caused by a virus, not a bacterium.
Treatment for people at increased risk.
However, pregnant women and people with weakened immune systems or blood problems such as sickle cell disease or thalassemia are at increased risk of developing complications from fifth disease. Such people need to be under the supervision of specialists, and if they come into contact with a sick person, they should see a doctor. Sometimes, hospitalization may be necessary to eliminate complications.
If you are pregnant and have been exposed to the virus that causes fifth disease, your doctor may recommend a blood test to see if you have become infected or have developed immunity. If you have been infected, your doctor may recommend frequent fetal sound testing throughout your pregnancy.
Preventing the spread of erythema infectiosum.
By the time the rash appears, you will no longer be a carrier of the disease. Once a child develops a rash, he or she can return to school or daycare.
People who get erythema infectiosum, including those who develop complications, should take precautions to stop the spread of the virus. You should wash your hands frequently. If people with erythema infectiosum are hospitalized, they may be isolated from other patients.
A vaccine against parvovirus B19 is currently being tested and may become available in the very near future.
Treatment for complications from erythema infectiosum.
Pregnant women and people with weakened immune systems or blood problems such as sickle cell disease or thalassemia are at increased risk of developing complications from fifth disease.
Treatment for pregnant women In very rare cases, a fetus who has been infected with parvovirus B19 may develop severe anemia and swelling, or a condition called polyhydramnios. To detect such problems, the fetus and mother must be closely monitored and regular ultrasound examinations performed. When a fetus is found to have edema, the fetus may be treated with a blood transfusion while the baby is still in the womb, although this is usually not necessary. Some babies born to mothers who contracted erythema infectiosum during pregnancy may also receive blood transfusions.
Treatment for people who have blood disorders or a weakened immune system.
People who have blood disorders that cause anemia (such as sickle cell disease or thalassemia) may need a blood transfusion if the condition gets worse rapidly (short-term aplastic anemia). To prevent the development of chronic parvovirus B19 infection and profound anemia, people with weakened immune systems may be given immunoglobulin intravenously.

Erythema nodosum ICD-10 is a skin disease from the group of deep cutaneous angiitis, which has a unique number after the 10th revision. Simply put, this is an inflammation of adipose tissue in the skin and its remaining layers, which occurs both as an independent disease and as one of the symptoms of more serious internal pathologies. Erythema nodosum ICD-10 should be treated exclusively as prescribed by the doctor.

In accordance with the International Classification of Diseases, 10th revision, a unique code has been assigned to this disease: L52. Erythema nodosum is included in the subclass “Urticaria and erythema” (code L50-54), as well as the class “Diseases of the skin and subcutaneous tissue” (code L00-L99).

Symptoms

The disease occurs in acute and chronic forms. General weakness, muscle aches and joint pain are mainly observed.

The acute form of erythema is characterized by:

severe rash on the legs, appearing as soon as possible;
the rash nodules look like large red swellings;
body temperature rises to 38-39 degrees;
general weakness and attacks of headache are felt;
during the course of the disease, the redness changes to bluish, greenish, and eventually acquires a yellow tint;
disappearance of edematous spots after 2-3 weeks.

This form of pathology is more typical for young women and children after severe tonsillitis. Doesn't happen again.

The chronic form is divided into several more varieties: migratory (long-term developing) and superficial-infiltrative. Manifests:

periodic relapse;
seasonal appearance (spring-autumn);
combined with existing diseases: allergies, vascular problems, chronic infection;
outwardly it looks like several nodes of a natural skin or light blue-pink shade with a diameter of 2-4 cm;
mild pain is felt;
locations of the lower leg and thigh;
may be accompanied by swelling of the feet;
in rare cases, nodes break through;
exacerbation lasts several months.

This type occurs in females of middle and elderly age.

Causes

Erythema nodosum (or nodosum) is considered an adolescent disease. It is more common in girls, less common in boys.

Basically, erythema is expressed as a sign of one of the following diseases:

tuberculosis, syphilis;
infectious diseases caused by streptococci;
lupus erythematosus;
rheumatoid arthritis;
colitis accompanied by peptic ulcer;
Crohn's disease;
oncology;
In rare cases, the causative agent is a substance produced by the body after taking certain medications.

In rare cases, nodules appear during pregnancy. In this condition, you should consult a doctor for an examination.

People with hypertension are at risk.

Diagnostics

The definition of the disease consists of examining the affected areas of the body and the results of histopathology: the condition of small skin vessels, the accumulation around them of certain substances produced by the body, the study of the reticular layer of the dermis for density and proliferation.

Treatment

First of all, the likelihood of tuberculosis infection is studied. If the diagnosis is confirmed, appropriate therapy is prescribed.

Young children are prescribed aminocaproic acid. For different ages, the drug is selected in the form of a solution, syrup or tablets.

In the case of a severe stage of the disease, hormonal drugs may be prescribed along with antibiotics.

To strengthen the body and fight inflammation from the inside, vitamins are prescribed: ascorbic acid, aevit, autohemotherapy, and others.

Physiotherapy can include irradiation with a mercury-quartz lamp, UHF, or diathermy.

For external use, decongestant compresses are prescribed.

Multiform exudative erythema(multiform erythema) - an acutely developing disease characterized by the appearance of erythematous spots, bullous lesions of the skin, mucous membranes, and a cyclic relapsing course.

Code according to the international classification of diseases ICD-10:

L51- Erythema multiforme

Statistical data

The incidence is 0.3-0.5: 100,000 population, severe forms are noted 2-3 times more often in men.

Classification

The infectious-allergic (idiopathic) form is associated with hyperreactivity to allergens and infectious agents. The toxic-allergic (symptomatic) form is associated with hypersensitivity to drugs. Exudative malignant form (see Stevens-Johnson syndrome). Rheumatic erythema- round or arched foci of erythema on the trunk and limbs, sometimes observed during a rheumatic attack.

Erythema multiforme exudative: Signs, Symptoms

Clinical manifestations

Local symptoms. Symmetrical rashes appear acutely on the skin of the extensor surfaces of the forearms, legs, dorsum of the hands and feet, face, genitals, and mucous membranes. Edema, clearly demarcated, flattened papules of pink-red color, round in shape, with a diameter of several millimeters to 2-5 cm, appear, having two zones: internal (grayish-bluish in color, sometimes with a bubble in the center filled with serous or hemorrhagic contents) and external (red [cockade-shaped rashes]). Spillage appears on the lips, cheeks, and palate. erythema, blisters, erosive areas covered with a yellowish-gray coating. General symptoms. Burning and itching in the area of the rash, soreness and hyperemia of the mucous membranes, especially the mouth and genitals. Fever. Headache and joint pain. The most severe manifestation is Stevens-Johnson syndrome. In the toxic-allergic form, unlike the idiopathic form, there is no seasonality of relapses of rashes.

Erythema multiforme exudative: Diagnosis

Research methods

Laboratory tests are carried out to exclude syphilis - serological tests, tests for Treponema pallidum. Nikolsky's and Asbo-Hansen's symptoms are negative; there are no acantholytic cells in the fingerprint smears. During histopathological examination, intracellular and intercellular edema, hydropic degeneration of basal cells are noted in the epidermis, and edema of the papillary layer and perivascular infiltrates are noted in the dermis.

Differential diagnosis

Chicken pox. Bullous pemphigoid. Dühring's dermatitis herpetiformis. Herpes zoster. Syphilitic papular eruptions.

Erythema multiforme exudative: Treatment methods

Treatment

For mild cases, use antihistamines and desensitizing agents. For blisters and erosions on the skin - ointments with HA and antibiotics (for example, oxytetracycline + hydrocortisone). If the oral mucosa is affected, warm rinses with 10% sodium bicarbonate solution, local anesthetics (2% lidocaine solution), as well as glucocorticosteroids: dexamethasone (elixir, 0.5 mg per 5 ml of water) 4 times a day, followed by ingestion. In more severe cases and with widespread bullous forms - antibiotics (orally or parenterally), GCs (for example, prednisolone 1-2 mg/kg/day with subsequent dose reduction), proteolytic enzyme inhibitors (aprotinin). For Stevens-Johnson syndrome - see Stevens-Johnson syndrome.

Forecast

The outcome of the disease in uncomplicated cases is favorable. With Stevens-Johnson syndrome, mortality is 10-30%.

ICD-10. L51 Erythema multiform