What Is a Subungual Hemorrhage?

Fingertip and fingernail (toenail) erythema are clinical symptoms of lupus erythematosus. Lupus erythematosus is one of autoimmune diseases and belongs to the scope of connective tissue disease. Lupus erythematosus is divided into discoid lupus erythematosus (DLE), systemic lupus erythematosus (SLE), subacute cutaneous lupus erythematosus, and deep lupus erythematosus. The onset of lupus erythematosus is slow, the insidious attack occurs, and the clinical manifestations are diverse and varied. About 40% of patients have a typical facial erythema called butterfly erythema. In the acute stage, there is edema, bright red, slightly dilated capillaries and scale-like desquamation. In severe cases, blisters, ulcers, skin atrophy, and pigmentation occur.

Fingertip and fingernail (toenail) erythema

Fingertip and fingernail (toenail) erythema are clinical symptoms of lupus erythematosus. Lupus erythematosus is one of autoimmune diseases and belongs to the scope of connective tissue disease. Lupus erythematosus is divided into discoid lupus erythematosus (DLE), systemic lupus erythematosus (SLE), subacute cutaneous lupus erythematosus, and deep lupus erythematosus. The onset of lupus erythematosus is slow, the insidious attack occurs, and the clinical manifestations are diverse and varied. About 40% of patients have a typical facial erythema called butterfly erythema. In the acute stage, there is edema, bright red, slightly dilated capillaries and scale-like desquamation. In severe cases, blisters, ulcers, skin atrophy, and pigmentation occur.

Affected area

Limbs

Related diseases

Lupus nephritis

Affiliated Department

Dermatology Dermatology

Related symptoms

Maculopapular

(I) Causes of Onset

The etiology is unknown. Recent studies have confirmed that the disease is currently characterized by various immune response abnormalities. As for the factors that cause immune disorders, there may be many aspects.

1. Genetic background

Drugs

3.Infection

4. Physical factors: Ultraviolet rays can induce skin lesions or exacerbate existing skin lesions. A few cases can induce or aggravate systemic lesions. About 1/3 of SLE patients are allergic to sunlight, Epstein ultraviolet irradiation of skin-type LE patients, about half of the cases are clinical And histological typical lesions.

5. Endocrine factors: In view of the fact that there are significantly more women than men in this disease, and most of them occur during fertility, it is believed that estrogen is related to the occurrence of this disease.

6. Immune abnormalities.

Clinical manifestations: About 40% of patients have a typical facial erythema called butterfly erythema. In the acute stage, there is edema, bright red, slightly dilated capillaries and scale-like desquamation. In severe cases, blisters, ulcers, skin atrophy, and pigmentation occur. Palm-sized erythema, fingertips, and fingernails (toenail) erythema, spotted papules, purple spots, etc. on exposed skin. People with various skin lesions account for about 80% of the total number of illnesses. Hair is easily broken and alopecia areata may be present.

Osler nodules appear on the fingertips: Vasculitis occurs in the subcutaneous arterioles, and purple-red, large rice grains, and nodules with obvious tenderness can be formed on the palm of the finger (toe) tip, called Osler nodules.

Small particles on nails: Small particles on nails are symptoms of small particles growing on the nails.

Nail bulge in the central part: The bulge in the middle part refers to the bulge in the middle part of the nail. It is a warning from the body that there is an abnormality in the respiratory system. If the protrusion is particularly obvious, it indicates that the liver is defective.

Peeling around fingernails: a manifestation of vitamin C deficiency. Vitamin C deficiency can also cause scurvy. Early symptoms are: irritability, pale skin, indigestion, weakened immunity, etc. In the later stage, bones and capillaries are significantly damaged. In bones, mainly subperiosteal hemorrhage.

prevention

1. Establish optimism, treat diseases properly, build confidence to overcome diseases, regularize life, pay attention to work and rest, take appropriate rest, and prevent infection.

2. Remove all incentives, including all possible internal medicines, chronic infections, etc., avoid irritating external medicines and all external stimulating factors.

3. Avoid sunlight and ultraviolet rays, especially during the active period, you can add anti-sun drugs such as 3% quinine ointment, compound titanium dioxide ointment, 15% paraben benzoic acid ointment, etc., others such as cold, X-ray Excessive exposure can also aggravate the disease and cannot be ignored.

4. Reasonable action on hydrazine, procaine, penicillamine, antibiotics and sulfa drugs.

5. Patients should be contraceptive, pregnancy should be avoided during the active period, and if there is damage to renal function or multiple system damage, early treatment for abortion should be sought.

1. Remove possible incentives. Use drugs that can induce SLE with caution and reasonable application; avoid exposure to sunlight, and use light-blocking agents such as 3% quinine ointment, 5% titanium dioxide cream, etc. if necessary.

2. Maintain optimism to treat the disease correctly, build confidence to overcome the disease, pay attention to the combination of work and rest, strengthen nutrition, and prevent infection.

3. Patients should avoid pregnancy during the period of birth control. If there is damage to renal function or multiple systems, it is advisable to seek early treatment abortion.

4. Early diagnosis refers to the main points of diagnosis.

5. Early treatment

(1) Discoid lupus erythematosus: antimalarial drugs such as chloroquine (0.25-0.5g / d), Chinese traditional medicine Liuwei Dihuang Pill, Dabuyin Pill, Kunming Mountain Begonia, Tripterygium wilfordii preparation, etc., can be used externally with appropriate corticosteroid preparation.

(2) Subacute cutaneous lupus erythematosus: see treatment of mild systemic lupus erythematosus.

(3) Systemic lupus erythematosus:

light type: available non-steroidal anti-inflammatory drugs such as salicylic acid, indomethacin (indomethacin) and so on. If the rash is obvious, chloroquine can be used, and low-dose corticosteroids such as prednisone 15-20mg / d and Liu Wei Di Huang Wan, Kunming Mountain Begonia or Tripterygium wilfordii can be used.

Heavy:

A. Corticosteroids: Drugs of choice for the treatment of severe autoimmune diseases. The dose is roughly equivalent to 1 mg per kg of body weight per day for prednisone. In the course of treatment, pay attention to sufficient dosage, sufficient course of treatment, and slow reduction.

B. Immunosuppressant: It has anti-inflammatory and immunosuppressive effects, and has a synergistic effect with corticosteroids, which can reduce the amount of corticosteroids and its side effects. Commonly used are cyclophosphamide and azathioprine, the dosage is 1 to 4 mg per kilogram of body weight per day.

C. Immune enhancer: It can reduce the formation of antibodies by improving the function of suppressor T lymphocytes and reducing the hyperfunction of B lymphocytes. Can be used during remission. Commonly used are levamisole, transfer factor, thymosin and so on.

D. Plasma exchange method: This method can be used for severe patients with progressive multiple organ damage, active nephritis, and central nervous system involvement to remove harmful components such as autoantibodies and immune complexes in the plasma to temporarily relieve the disease.

E. Traditional Chinese Medicine Law: The treatment is mainly based on traditional Chinese medicine syndromes.