Shamberg disease (chronic pigmented purpura, skin hemosiderosis) is a chronic pathology that occurs due to destruction of skin capillaries.
As a result the skin appear the point petechiae (bleeding as by injection needle) which pass into brown or brown spots.
Symptoms of the disease Shamberg
The disease has a fairly typical symptoms: rash symmetrical, but have external diversity.
This is because the skin at the same time may be new and chronic hemorrhage.
When disease Shamberg no general health disorders, since in addition to the cutaneous vessels anywhere hemorrhage is not formed. Benign course of the disease, no complications and does not violate the general well-being.
There are four types of disease Shamberg:
1. petechial type
Mostly men. Rashes appear on the skin of the thighs and legs - this is a different spot size with a rough outline.
Spots consist of a plurality of small clustered dot hemorrhages. With the development, they become brownish-yellow or brown-brown. On the skin, there is no swelling and discomfort.
2. Teleangioektatichny type.
Eruptions are located throughout the body, manifested pyatnami- "medallions" centered arranged telangiectasia (deformed and expanded subcutaneous blood vessels), and the edges - spot hemorrhage. The rash does not hurt and does not itch, do not cause discomfort.
3. Lichenoid type Schamberg disease.
Eruptions are located throughout the body loose. There may be nodules on the skin, they are abundant and multiple. There are petechial hemorrhages. There are spots with the deposition of pigment and skin nodules with a brilliant surface intact.
4. Eczematous type.
This type of disease manifestations petechial Shamberg that they exhibit also features eczema.
Unlike the symptoms Shamberg the first type, the affected places are swollen, with bubbles, knots and even the crusts. They itch like typical eczema.
Photo: site of the Department of dermatology Tomsk Military Medical Institute
Diagnostics
In order to establish an accurate diagnosis, consultation and then treatment by a dermatologist.
Sometimes it takes an optional visit to the allergist-immunologist.
The initial diagnosis is established on the basis of the typical manifestations of skin lesions and the description of the dynamics by the patient.
One of the main diagnostic methods for determining the disease is Shamberg dermoscopy affected area - the study of the upper layers of the skin under the microscope.
When illness Shamberg doctor finds:
- changes in the capillaries with their swelling,
- special expansion vessel for traverse (allergens are accumulated in them),
- red blood cells outside the blood vessels,
- vascular ulcerations portions,
- vessels are narrowed due to the proliferation of blood vessels intact plots (to try to close the defects).
Treatment Schamberg disease
The basis of treatment are:
- diet therapy with the exception of potentially allergenic and irritating foods (chocolate excluded, citrus fruits, spirits in the form of coffee and tea, fried food with a crust, meats, alcohol and citrus)
- It recommended the exclusion of skin injuries,
- necessary to exclude hypothermia feet and hands,
- show only moderate load,
- need rehabilitation (thorough prolechivanie) chronic foci of infection - caries, tonsillitis, Endocrine diseases, chronic diseases,
- requires careful and delicate skin care using only hypoallergenic cosmetics.
Of drug therapy used:
- since Schamberg disease is immune nature, corticoid hormones are used (prednisolone and its analogs),
- apply means which suppress inflammation of the vessel walls,
- shown vascular drugs that stimulate regeneration and drugs that do not allow blood to clot within the capillaries (disaggregants).
In severe cases of illness Shamberg used methods of removing from the blood of immune complexes - hemosorption, plasmapheresis and cryoprecipitation.
The prognosis of the disease is favorable, since on the overall well-being and development of the organism is not affected. But quality of life Schamberg disease breaks - patients are embarrassed of their appearance, can not wear revealing clothes.
Causes
Mechanisms of disease is not well established, but one version is more preferable. It is believed that the damage to the vessel walls has under an autoimmune nature, i.e. own vascular cells perceived as an allergen, and their immune system attack.
As a result of damaged blood vessels, are formed in them holes through which leaves a little blood under the skin. Visually, it looks like petechial hemorrhages. Gradually iron from erythrocytes which have got into the skin, it begins to transform into a special pigment - hemosiderin. It has a brown color and gives a specific color of the skin.
