What Is Erythema?
It is a local or systemic red spotted rash caused by localized or systemic expansion of the dermal papillary capillary network. Also called lupus erythematosus.
erythema
Basic overview of erythema
- It is a local or systemic red spotted rash caused by localized or systemic expansion of the dermal papillary capillary network. Also called lupus erythematosus.
Erythema considerations
- (1) Strictly control the number of accompany and visits. Use chlorine-containing disinfectant to moisten the floor of the ward 1 or 2 times / d and wipe the bedside tables, chairs, doors and windows 1 / d. The sheets, quilts and quilts are all autoclaved and used in time. It is advisable to use cotton products. Before and after all treatments, inspections, and nursing care, medical staff wash their hands in time and disinfect them with a new spray. Thermometers, sphygmomanometers, and other items are fixed for use, and related education is provided to family members.
- (2) Encourage patients to drink more water and urinate frequently to flush the urethra naturally to prevent urinary tract infections. Hot compressing, listening to the sound of running water, or light pressure on the bladder area can help the urination disorder to relieve the stool. Wash your eyes with a cotton swab dipped in physiological saline, pay attention to remove secretions, scalp peels, and eyelashes, and then use rifampicin, tobes or ciclovir eye drops, alternately, 2 to 3 times / d , The two collaborated.
Erythema care
- Oral care. Most patients develop erosion of the lips and mucous membranes. Patients are encouraged to gargle with 5% sodium bicarbonate by themselves, and if necessary, gargle 2 to 3 times per day.
- Diet care. Give a high-calorie, nutritious, digestible liquid or semi-liquid diet, fasting foods to avoid irritation of oral ulcers; disable allergic foods such as fish, shrimp, and milk to prevent re-allergies and induce skin rashes. Intravenous supplementation should be given to those who have difficulty eating to ensure adequate nutrition and heat, and promote skin repair.
Clinical manifestations of erythema
- Discoid lupus erythematosus: It mainly attacks the skin and is the lightest type of lupus erythematosus. A few may have mild visceral damage, a few cases (about 5%)
- erythema
- Subacute cutaneous lupus erythematosus, which is rarely seen clinically, is a special intermediate type. There are two types of skin damage. One is ring-shaped erythema, which is a single or multiple scattered erythema, which is ring-shaped, semi-ring-shaped, or multi-ring-shaped. The dark red edge is slightly edema and bulging, and the outer edge has redness. It has pigmentation and telangiectasias, and it occurs in the face and trunk. The other type is pimples and scaly types. The skin lesions are similar to psoriasis, including erythema, pimples, and patches. There are obvious scales on the surface, which are mainly distributed in the upper limbs and face of the trunk. Most of the two skin lesions exist alone, and a few can exist at the same time. Skin lesions often recur, and most patients have visceral damage, but severe ones are rare. The main symptoms are joint pain, muscle pain, repeated low fever, and a few have nephritis and changes in the blood system.
- Deep lupus erythematosus, also known as lupus panniculitis, is also an intermediate type of lupus erythematosus. Skin lesions are nodules or plaques, located in deep or subcutaneous fatty tissue of the dermis, of varying size and number, with a normal or pale red skin color, solid texture, and no mobility. Damage can occur anywhere, most commonly on the cheeks, hips, arms, followed by the calf and chest. After chronic, which can last for months to years, skin atrophy and depression remain after healing. Deep lupus erythematosus is unstable in nature and can exist alone. It can later be transformed into discoid lupus erythematosus, systemic lupus erythematosus, or both.
- Systemic lupus erythematosus is the most severe type of lupus erythematosus. The majority of patients have multiple systemic damage at the time of onset, and a few patients develop from other types of lupus erythematosus. Some patients are also accompanied by other connective tissue diseases, such as scleroderma, dermatomyositis, Sjogren's syndrome, etc., forming various overlapping syndromes. Systemic lupus erythematosus has various clinical manifestations, is intricate and complicated, and is more serious. It can endanger patients' lives due to the side effects of lupus nephritis, lupus encephalopathy, and long-term heavy use of drugs.
Pathological features of erythema
- The pathological morphology of lupus erythematosus varies greatly depending on the condition and the lesion. The following are common:
- (1) Angiopathy Necrotizing vasculitis manifested by small blood vessels (small arteries or arterioles). Immunofluorescence showed DNA, C 3 and immunoglobulin deposition in the vessel wall.
- (2) Skin pathological changes Skin pathological changes are epidermal atrophy, liquefaction or necrosis of basal cells or dermis, and edema at the junction of the dermis and epidermis. Immunofluorescence examination at the junction of epidermis and dermis has immunoglobulin, (IgG), (IgM), (IgA) and complements C3, C4, C1q and other deposits.
- (3) Renal lesions . Patients with systemic lupus erythematosus who have abnormal kidney and urine tests have 100% renal lesions during electron microscopy and immunofluorescence examination of the biopsy, which affects the glomeruli, tubules, interstitial and blood vessels. Its characteristic changes are coil-like changes in hematoxylin bodies and glomerular basement membranes. Immunofluorescence examination showed a "full house red" phenomenon (a variety of immunoglobulins and complement deposits can be seen in the glomerular tubules and stroma).
- (4) Changes in the heart. Half of patients with systemic lupus erythematosus involve the heart, including pericarditis, myocarditis, heart valves, and endocardial lesions. Mainly manifested by nonbacterial verrucous endocarditis or Libran-Sacks endocarditis.
- (5) Other Fibrin-like substances are deposited in the synovium and serosa, with cell proliferation and necrosis of small blood vessels. Neurological lesions include diffuse neurocytopenia, small vasculitis, micro-infarction, necrosis, and bleeding. The pathological changes of the lung are more common in interstitial pneumonia and diffuse pulmonary fibrosis, and coil-like lesions in the pulmonary capillaries.
Erythema erythema is easily confused with which diseases
- First, Lichen planus
- Lichen planus variability, often with white streaks or reticular damage around the reddish area, often symmetrical, and can occur in multiple places. The mucosa in the lesion area is flat, the white lines are slightly higher, and the erosion can heal. Pathological examination showed that the basal layer was liquefied and degenerated, and there was a lymphocyte infiltration zone in the lamina propria. The erythema has clear edges and a fixed range. Lesions are higher than the mucosa, or they are flat or eroded. Velvet-like surface, granules, nodules, granulation. The matte surface does not heal. Pathological examination of epithelial atrophy, abnormal epithelial hyperplasia, carcinoma in situ, invasive carcinoma. There are keratinocytes in the epithelium, and sometimes horn beads are formed.
- White spots
- Generally slightly higher than the surface of the mucosa, removing possible irritants and reducing symptoms. It can be plaque-like, granular, wrinkled, or wart-like. Generally no conscious symptoms, conscious local rough. Spontaneous pain and irritation when ulceration occurs. Pathological examination showed epithelial hyperplasia, obvious granular layer, thickened spinous layer, enlarged epithelial studs, and infiltration of inflammatory cells in connective tissue. Epithelial hyperplasia was seen. Erythema is white spots or white frosted surface on the basis of red lesions, and the lesions do not heal. Except for abnormal epithelial hyperplasia, pathological examinations also showed carcinoma in situ or invasive carcinoma.