Lupus is a disease resulting from limfogematogennym tuberculosis infection, with lesions also subcutaneous fat.
Causes of tuberculosis of the skin
The disease is caused by Mycobacterium tuberculosis both human and bovine type. Infection often occurs in childhood, both with external and via the internal environment (from other bodies). Currently the lupus is very rare.
Since skin is the environment favorable for growth and reproduction of the pathogen, the infection from the environment is possible only in case of massive infection via broken skin. In such cases, at the site of entry of the pathogen occurs primary affect.
Secondary forms occur in humans due to low immunity in people who have had tuberculosis at other sites.
To get TB skin from a patient with tuberculosis of any localization.
Symptoms of lupus
1. Primary tuberculosis.
the A. Acute primary disease:
– primary tuberculosis affect;
acute tuberculosis milliary;
– scrofuloderma primary (hematogenous).
the current B. Chronic primary TB:
– scrofuloderma secondary;
– fungusy tuberculosis;
– scattered TB of the skin ( erythema compacted; papulonecrotic tuberculosis – disseminated tuberculosis miliary persons rosariopatsy Lewandowski tuberculosis; scrofulous versicolor).
to 2. Secondary tuberculosis.
– exogenous forms of tuberculosis of the skin:
a) warty tuberculosis;
b) milliardo – ulcerative tuberculosis.
Primary tuberculosis affect is more common for children. The skin appear isolated nodules, pustules, erosions or ulcers with inflammatory reaction of the surrounding tissue, accompanied by an increase of nearby lymph nodes.
Acute miliary tuberculosis skin is difficult flowing form, often with fatal outcome. Currently almost never occurs. Characterized by a rash on the skin of the trunk and limbs pinkish papules with a bluish tint in the center of which are the sores.
Scrofuloderma primary often appears in children, in recent years the elderly and persons receiving long-term corticosteroid therapy. In the deeper layers of the skin appear one or more painful sites, further increasing, the skin over them becomes cyanotic hue. The formation of a cold abscess, which may become evident with the formation of a fistula. When healing deep scars are formed.
Scrofuloderma secondary is different from the primary that is associated with the lymph nodes, deep ulcers and more rough scars.
Fungusy TB typically occurs in the field of fistulas and ulcers in patients with bone tuberculosis. Formed cyanotic, painful, dense infiltrates. Is the addition of a secondary infection and they acquire a mushroom shape. Is extremely rare.
Condensed erythema is found in the form of two types: knotted and ulcer Bazin of Hutchinson, is the most common form of tuberculosis of the skin. On the flexor surfaces of the femora, often symmetrically located painful knots, dense. As enlarged lymph nodes, the skin over them becomes pinkish-bluish tint. Further, in the center of their ulcers with granulation tissue on the bottom.
Papulonecrotic TB appears symmetrically positioned on the face, ears, chest, belly, the extensor surfaces of the extremities, buttocks painless, dense knots. Characterized by hyperemia, presence of teleangiectasia (spider webs and spiders), pinkish papules with pustules in the center, dries into a crust, after the rejection of which forms a scar.
Versicolor scrofulous is more common in children and adolescents, currently is not common. Characterized by the appearance on the skin side surfaces of the chest and abdomen, upper and lower extremities symmetrically arranged dense nodules with scales on the surface.
Erythematosus is localized primarily on the face. The primary element is the tubercle of lipoma – spherical, pinkish color, soft, painless.
Warty tuberculosis skin occurs as a result of contact of skin with infected sputum mostly surgeons, veterinarians, pathologists when damage to the skin of the hands when working with the contaminated material. Rare.
Milliardo-ulcerative tuberculosis occurs MBT on mucous membranes or in places of transition of the skin to the mucous membrane, around the orifices. Begins with the appearance of firm, pink nodules, suppurating, ulcerated. Painful ulcers may increase in a depth of 1.5 cm. ulcer On the bottom of the yellow grains found Trill – the smallest abscesses. Sometimes there is an increase nearby lymph nodes.
Tests for suspected tuberculosis skin
Produce tuberculin diagnosis, since the cutaneous samples pirok, a negative reaction set the Mantoux test. During the chronic process, the test may be negative.
Bacteriological diagnosis is carried out in patients with scrofuloderma, ulcerative compacted forms of erythema and lupus. Study take the pus from sores, a punctate sites. Biopsy is best done after 1.5 months from the onset of the disease, because at this time, formed the tubercular structure.
Also conduct x-ray examination of the lungs to prevent their defeat.
When tuberculosis erythematosus has two characteristic symptom of “Apple jelly” – when pressed with the translucence of glass on a yellow background brighter brownish infiltrates and symptom Pospelova – when pressed bellied probe indentation is formed.
At detection at itself the above symptoms should consult a dermatologist for a complete examination. Then, if the diagnosis is confirmed, the pain will be referred to a TB specialist for further evaluation and treatment.
Treatment of lupus
Treatment of tuberculosis of the skin is carried out according to the same scheme as the treatment of pulmonary tuberculosis. The main drugs are: isoniazid, rifampicin, ethambutol, pyrazinamide and streptomycin. Local having isolated pockets of streptomycin. The use of medications, as antibiotics affect liver function.
Tuberculosis skin responds well to treatment if the pills are not to miss. The duration of treatment from 6 months to two years, depending on the severity of the process and the resistance of mycobacteria to antibiotics. In the initial stages it is better to undergo inpatient treatment at least two months, with a subsequent transition to outpatient monitoring.
Self treatment of tuberculosis of the skin
In tuberculosis it is useful to take in the form of infusions and decoctions: quince, eucalyptus, elderberry, aloe, cranberry, knotweed, spruce, strawberry, walnut, lilac, pine, licorice, plantain. The use of Mare’s milk has always been acceptable in tuberculosis (complete protein and vitamins). Before taking any folk remedy, it is better to consult a doctor.
Diet for lupus
During treatment requires a high protein diet – fish, meat, dairy products, milk. We need to increase the caloric content of food using sugar, honey, bakery products etc. Supply must be increased, but not excessive. You need to eat more vegetables and fruits. The liquid limit.
Rehabilitation after suffering tuberculosis of the skin
Rehabilitation includes possible treatment at the beautician or surgeon in connection with the formation of rough scars on the skin.
Complications of tuberculosis of the skin
Complications include: formation of cold abscess, slowly healing ulcers, fistula.
Effectiveness of treatment of tuberculosis of the skin
With proper treatment recovery always occurs.
Death in tuberculosis of the skin almost never occurs, is possible with generalized lesions of tuberculosis, for example, bones and lungs.
Prevention of tuberculosis of the skin
Prevention includes avoiding contact with anyone who has tuberculosis, if there is one. For children, it is BCG vaccination for the formation of immunity to tuberculosis. Adult annual chest x-rays.