Tu-ber-ku-lez skin - this is a very wide and different-but-about-ny on its own manifestation lem-ni-yam group of derma-to-go, which appeared the development of and the development of co-rye woo-lo-in-le-but-pro-nik-no-ve-ni-n into the skin and the sub-skin-cell-chat-ku tu -ber-ku-lez-mi-ko-bak-te-rii.
Focal (lupus erythematosus, scrofuloderma, warty and ulcerative tuberculosis) and disseminated (papulonecrotic tuberculosis and inductive erythema) forms of tuberculosis of the skin are distinguished.
Almost all cases of tuberku-ku-n-oe skin lesion is secondary and en-gogen. The airbag-di-tel is usually in the skin and sub-skin cell lymphohema-chatto-lymphoid cell from the foci of tuberblu in other organs, sometimes infection of the prostate into the skin by pro-severity - from parasitic co-organs; Very rarely, an ekso-gene infection of the skin is encountered — through its response.
Certain factors that can increase the risk of infection with skin tuberculosis can significantly reduce the protective functions of the body. These factors include:
- pathology of the nervous system;
- hormonal dysfunction;
- disorder of mineral and water metabolism;
- vitamin imbalance;
- certain vascular disorders;
- unsatisfactory climatic and living conditions;
- the presence of various infectious diseases;
- HIV can also provoke a sharp decline in immunity.
Social factors also play an important role: living conditions, environmental factors and nutrition. No less important are the climatic conditions - the lack of sunlight and dampness can be provoking factors in the development of the disease.
Symptoms of Skin Tuberculosis
Tuberculosis of the skin has numerous symptoms that vary in the form of infection, the course of the disease and how the skin tuberculosis looks.
The entire group of diseases can be divided into localized (focal) and disseminated (common) tuberculosis of the skin.
The focal forms of the disease include:
- Scrofuloderma In the submandibular region, on the neck, chest, limbs, single or multiple bluish-red nodes occur, followed by central softening and the formation of deep, soft, almost painless ulcers with overhanging edges, interconnected in depth by fistulous passages. The course of the process is chronic with a tendency to spontaneous healing. After healing of the ulcers, abnormal bridges remain. It is observed mainly in children and adolescents suffering from tuberculosis of the subcutaneous lymph nodes, from which the process moves to the subcutaneous fatty tissue.
- Vulgar (ordinary) lupus is the most common form of the disease. A characteristic feature is a chronic course with a slow progression. In most cases, the lesions are located on the face: nose, cheeks, lips. The first signs of lupoid tuberculosis of the skin are small brownish-red rashes. To the touch they are soft and smooth and only later begin to peel off. Lupom often localized groups in the distance from each other and only with the course of the disease can merge. In the case of pressure on the group with the lyupom, blood oozes out, and the empty holes have a yellowish tint. Often there are cases when the disease began in childhood and continued throughout life.
- Warty tuberculosis of the skin. Localized point, in the field of penetration of tuberculosis infection. This type of disease can be attributed to the disadvantages of such professions as a veterinarian, a pathologist, a butcher, which imply physical contact with the pathogen. As a rule, warty tuberculosis of the skin develops on the hands and feet.
- Ulcerative tuberculosis. Most often occurs in people with an open form of pulmonary tuberculosis, kidney or intestine. It manifests itself in the form of bleeding ulcers. The wounds have an uneven surface and are covered with nodules of a yellow shade.
Among the disseminated forms are distinguished:
- Papulonecrotic tuberculosis of the skin. It appears at a young age in the form of small bluish-red nodules with a necrotic scab in the center, after the falling off of which the “stamped scars” remain. Rashes are arranged symmetrically, mainly on the limbs and buttocks. Subjective feelings are absent. The process is recurrent.
- Lichenoid tuberculosis of the skin (aka lichenvilus). Characteristic is the appearance of nodules in size from a pinhead to millet grain, pinkish-brown in color, and a softish consistency. Nodules are often associated with skin follicles, with small scales on their surface. Rashes are located on the body symmetrically, often on the lateral surfaces of the chest. Develops in debilitated children on the background of active pulmonary tuberculosis, lymph nodes or bone and joint tuberculosis.
The diagnosis of tuberculosis of the skin is based on the history, clinical features, the presence of lesions of other organs, positive tuberculin tests, the isolation of tuberculosis mycobacteria from ulcerative foci. In difficult cases, histopathological examination of the skin, inoculation of experimental animals and trial treatment are performed.
Skin tuberculosis: photo
What is the disease, we offer to view some photos.
Treatment of skin tuberculosis
With skin tuberculosis, treatment should be comprehensive, taking into account the age of the patient and the accompanying pathology:
- exposure to infection;
- impact on the sick body as a whole (immune status) and on the pathological
- processes (pathogenetic treatment);
- reduction and elimination of symptoms of the disease;
- local treatment.
The tuberculous process is difficult to treat. From the patient requires a lot of patience and self-discipline. In case of illness, not only the affected organ suffers, but the entire body as a whole. The treatment is carried out in anti-tuberculosis facilities.
The most effective means include rifampicin, isoniazid. At the second stage, in 3-4 months, pyrazinamide, streptomycin, and ethambutol are prescribed. For ulcerative lesions, topical external agents based on PASK or isoniazid are used topically.
The basic course of treatment lasts about a year, but even in the case of a recovery, the patient is in the focus of attention of phthysatros. For the next three years, twice a year, medical procedures are carried out aimed at preventing the recurrence of the disease.
The prognosis depends on the form of skin tuberculosis, the severity of the symptoms and the effectiveness of the treatment.
- Tubercular lupus is a long-term current disease. In some cases, the lesion may not show a tendency to progression over the years even without treatment, in others, the process slowly spreads, covering all new areas of the skin. This is facilitated by intercurrent diseases, unfavorable living conditions and other factors that weaken the body's defenses and reduce its reactivity.
- Scrofuloderma The disease is chronic, lasts for months and years with remission. Mild cases are successfully cured by modern methods. In cases of advanced ulcerative prognosis is less favorable.
- Warty tuberculosis of the skin. The prognosis is often favorable, although the course of the disease is long, chronic.
- Ulcerative tuberculosis of the skin. The prognosis depends on the course of tuberculosis of the internal organs. At present, due to advances in the treatment of general tuberculosis, the prognosis of ulcerative tuberculosis of the skin and mucous membranes has improved, and the incidence of this disease has sharply decreased.