Redness in the form of a ring. Causes and treatment of erythema annulare: available information about a rare disease

Ring-shaped erythema refers to skin pathologies of the erythematous type. The range of such diseases is very extensive and includes changes in skin color with the manifestation of additional symptoms due to infection or disruption of internal processes in the body. It is believed that erythema is equally common in people of any gender and age.

Characteristic

The disease is classified into several types depending on clinical manifestations, treatment methods and the nature of its occurrence. In medical practice, it is customary to divide diseases into two large groups: infectious and non-infectious.

There are several types of erythema annulare:

Rheumatic - manifested by the formation of light pink rings on the skin (age category of patients - up to 18 years).
Migratory - spreads due to infection with a viral or bacterial infection. Clinical signs resemble those of dermatosis.
Centrifugal erythema of Daria - is characterized by the appearance of voluminous foci of pathology in large numbers. Spots can change location and shape.

In addition to classification according to general characteristics, several categories of the disease are distinguished depending on the symptoms.

Clinical forms:

Depending on the speed of development of the disease, the following forms occur:

paroxysmal;
acute;
chronic;
recurrent.

Causes

The causes of ring-shaped erythema include:

the presence of intoxication (penetration and accumulation of toxins in the body);
diseases associated with hereditary changes;
infection with bacteria, viruses, fungi, helminths;
focal infections (osteomyelitis, tonsillitis, dental granuloma);
chronic form of sinusitis;
chronic cholecystitis;
candidiasis;
development of rheumatism;
disruption of the endocrine glands;
gastrointestinal diseases;
decreased immune defense;
side effects after or during a course of medications;
Lyme disease;
acute allergic reaction;
tuberculosis infection;
development of neoplasms.

In the case of Darier's erythema, the cause of the disease remains in question.

It is known that erythema in childhood most often coincides with rheumatic diseases, disorders of the immune system, or infection with helminths.

Symptoms

General signs of the onset of the disease:

formation of red spots on the surface of the skin;
localization of the lesion in the cheeks, abdomen, shoulders, on the sides of the chest;
spots quickly increase in size (sometimes up to 20 cm in diameter);
redness located close to each other merges;
the skin in the area of the rash is above the level of healthy epithelium;
formation of a “lace pattern” on the body;
itching and burning sensation;
in children, the skin inside the reddened spots turns pale or has a natural color;
rashes appear and disappear.

Symptoms of the disease depend on the cause of occurrence and the general condition of the body at the time of the manifestation of the pathology.

Treatment

In most cases, treatment for erythema depends on the cause and severity of the symptoms of the disease.

To cure a pathology, it is necessary to eliminate the factors that provoke it. During therapy, the patient is under the supervision of a dermatologist and a doctor whose specialization is related to the underlying disease. Sometimes hospitalization and treatment in a hospital are required.

External means

Local preparations include gels and ointments for external use.

The following remedies are effective:

To avoid serious complications, the form and dosage of the medications used should be selected by a doctor.

Systemic drugs

In addition to local remedies, a dermatologist may prescribe medications in a different form of release. These include:

The choice of drugs is determined by clinical indicators and the cause of the disease. When self-medicating, a person can make a mistake and use drugs that are not effective in a particular case..

Unconventional methods

Folk remedies help relieve mild manifestations of the disease and complement the main therapy.

Ring-shaped erythema is only a sign of pathology developing in the human body.

For treatment it is necessary to conduct appropriate medical research. After identifying the cause of the erythema, the dermatologist prescribes a course of therapy aimed at eliminating the symptoms and the provoking factor.

Erythema annulare is a polyetiological disease of the skin that is erythematous in nature and prone to recurrence. As a result of its progression, specific ring-shaped spots are formed on human skin. Also in the medical literature, this disease is called centrifugal annular erythema of Daria (after the name of the scientist who diagnosed the pathology). The development of the disease is based on toxic-allergic and immune mechanisms.

Darier's annular erythema was first diagnosed and described in 1916. The disease occurs in a chronic form. Young and middle-aged men are more susceptible to it. Less commonly, the disease affects children and women.

Causes

Until now, scientists have not been able to find out the true reasons for the progression of Darier's annular erythema in people. Some doctors view the disease as a reactive process that may be associated with an allergic reaction to certain groups of medications, as well as bacterial or fungal infections that have a chronic course.

It is also worth noting the fact that sometimes Darier's annular erythema begins to progress in patients who have a history of ordinary or. Also, doctors do not rule out a connection between the pathology and helminthiasis.

The main reasons that can trigger the progression of Darier's annular erythema:

heredity;
intoxication of the body;
gastrointestinal diseases;
bacterial infections;
chronic;
viral infections;
dysproteinemia;
endocrine pathologies;
chronic;
focal infections;
decreased general and local immunity;
also a common reason that contributes to the progression of Darier’s annular erythema is taking medications to which a person becomes allergic;
neoplasms of benign and malignant nature.

Kinds

There are three types of ring-shaped erythema:

erythema migrans. This is a chronic disease that is very similar to dermatosis. Doctors consider viral and bacterial infections to be the cause of erythema migrans. This form is diagnosed most often. Middle-aged men are susceptible to it. It is also worth noting that erythema migrans is easier to treat than other forms;
ring-shaped rheumatic erythema. This form is a specific symptom of rheumatism. On the human body it appears in the form of ring-shaped spots that are pale pink in color. Unlike the migratory form, the rheumatic one is diagnosed mainly in children and adolescents;
Annular centrifugal erythema of Darier. In this case, the etiology is unknown. The symptoms of the pathology are quite specific. Ring-shaped erythemas form on the skin, which gradually take the shape of a roller and begin to rise above the surface of the skin. Formations with centrifugal erythema Daria tend to grow or change their basic shape.

Clinical forms of the disease:

simple garland-shaped annular erythema. In this case, spots form on the skin, which disappear very quickly. Time range – from a couple of hours to two days;
scaly ring-shaped erythema. The skin at the edges of the formed spots constantly peels off;
persistent ring-shaped microgarland-shaped erythema. Spots are formed on the surface of the skin, the diameter of which does not exceed one centimeter;
vesicular annular erythema. A characteristic feature is that vesicles form along the edges of the spots. These are pathological formations that are filled with exudate inside. They appear quickly and disappear just as quickly.

Appearance

Formations with annular erythema have a characteristic appearance:

have the shape of a ring;
elements tend to grow peripherally;
the center of the formation is always pale, the edges are urticarial;
the surface in the center of the formation is smooth and flat;
with this pathology, ring-shaped formations tend to merge with the subsequent formation of arcs or garlands;
scalloped elements exist on the skin for no more than 2–3 weeks. After this, they disappear, and pigmentation forms on the skin. After a certain period of time, new elements begin to form;
arrangement of elements - limbs, torso, stomach, back. In more rare clinical situations, pathological elements are localized on the buttocks, face, neck or lips.

Symptoms

the first symptom is the appearance of red spots on the skin;
growth of formations is very fast. They can reach 20 cm in diameter;
spots rise above the skin;
New ones may form near formed old lesions;
a lace pattern is created on the body;
burning;
mild itching;
rashes occur in paroxysms;
new formations have an interesting feature - they can appear more actively if a person’s body temperature rises or he stays in the sun for a long time.

Diagnostics

At the first symptoms that indicate the progression of the disease, you must contact a medical facility. Diagnosis of the disease is carried out by a dermatologist or venereologist. The doctor will be able to accurately determine the form of the disease, as well as the cause that could provoke its progression.

The standard diagnostic program includes:

skin biopsy;
serological study;
histopathological examination;
mycological research;
examination for the presence of oncology;
hematological study.

Treatment

The main goal of treating this type of erythema is to eliminate the cause that led to the progression of the pathology, as well as to sanitize foci of infection in the body. If there are concomitant pathologies, their treatment is also carried out.

Drugs prescribed for the treatment of erythema annulare:

anabolic compounds;
calcium and sodium thiosulfate preparations;
antihistamine gels for treating pathological elements;
broad-spectrum antibiotics. Antibacterial treatment is prescribed if there is a suspicion that the cause of disease progression is a bacterial infection;
corticosteroid drugs;
special compresses are applied to the locations of pathological elements;
antihistamines for systemic use;
products with antiseptic and disinfectant properties;
vitamin therapy;
ointments containing substances that have a beneficial effect on the epithelization process;
homeopathic remedies;
the lesions are treated with aerosol preparations that contain sodium thiosulfate.

Erythema in children

Ring-shaped erythema in children is quite rare. As a rule, purple, bluish or pink rings appear on the child’s skin, which are intricately intertwined with each other, forming a specific pattern. Treatment of pathology in children is carried out according to the same principle as in adults - first, the cause of the development of the pathology is identified and eliminated, then the foci of infection in the body are sanitized, as well as the underlying pathologies of the gastrointestinal tract and endocrine system are treated.

Prevention

Prevention of ring-shaped erythema is quite simple and includes the following measures:

moisturizing the skin;
compliance with personal hygiene rules;
timely and correct treatment of diseases of the gastrointestinal tract and endocrine system;
change underwear in a timely manner;
if damage occurs on the skin, it must be immediately treated with antiseptic drugs;
undergo regular preventive examinations by specialists.

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Diseases with similar symptoms:

Vitamin deficiency is a painful human condition that occurs as a result of an acute lack of vitamins in the human body. There are spring and winter vitamin deficiency. There are no restrictions regarding gender and age group in this case.

Ring-shaped erythema is, by its nature, a skin disease. As a rule, it has a polyetiological erymatous character with the ability to recur, as a result of which elements that look like ring-shaped spots and polymorphisms are formed on the skin. It may be called persistent erythema, long-lasting figured erythema and erythema annular centrifugal Darier.

This type of disease primarily affects children, adolescents and young men. Since ring-shaped erythema is a chronic disease, basically infectious-toxic, the rash on the body can be accompanied by general malaise, headaches and swelling in the affected areas.

Ring-shaped erythema can be represented by the following types:

ring-shaped rheumatic - inherent in the symptoms of rheumatism. Its manifestation is characterized by faint pinkish ring-shaped spots. The disease is most common in young children and teenagers;
Darier's erythema - there is still no clear idea of the etiology of the disease. A distinctive feature of Daria is multiple ring-shaped neoplasms, shaped like a pinkish roller. Rising above the skin, such a roller tends to grow and change shape;
migratory - this type of erythema has a chronic form, the nature of the course resembles dermatosis. Provoking factors that influence the manifestation of the disease are bacterial infections or viral ones.

To date, scientists have not fully figured out the reason that leads to the appearance of erythema. Basically, experts are inclined to believe that this disease is the result of a reactive process, which is facilitated by various infections, as well as the patient’s intolerance to certain medications.

Often in medical practice, cases of erythema in patients with fungal skin lesions have been recorded. Also for those who were carriers of acute leukemia, lupus erythematosus, measles and other similar diseases.

Ring-shaped erythema has several clinical forms, which differ in different symptoms and the nature of the disease. The most typical clinical forms of erythema should be given:

flaky ring-shaped - this form of the disease is characterized by peeling of the skin, this is mainly visible along the edges of the tumors;
vesicular ring-shaped - differs in that vesicles filled with liquid and rising above the skin have the peculiarity of both quickly appearing and disappearing along the edges of the spots;
garland-shaped ring-shaped - this form of the disease is characterized by the fact that the neoplasms remain on the surface of the skin for a short period of time - usually from several hours to days;
persistent microgarland-shaped ring-shaped - has small spots on the skin in diameter, not exceeding a centimeter.

Causes of pathology

The disease has many factors that influence the manifestation of the disease. Scientists have reason to believe that the disease may have a genetic component. Recently, there has been an increase in the appearance of this pathology in the patient’s blood relatives.

Among the factors influencing the occurrence of the disease are the following:

the body has been severely intoxicated;
there have been disruptions in the functioning of the endocrine system;
disturbance of blood protein balance;
disruptions in the functioning of the nervous system;
the result of the body’s intolerance to drugs;
pathologies of the body's immune systems;
malignant neoplasms;
problems with the nervous system;
tonsillitis, cholecystitis and other focal infections;
bacterial and viral infection of the body;
genetic predisposition, hereditary factors;
the patient has chronic sinusitis;
weakened immunity and other factors.

Symptoms of erythema

When the first rashes appear, you should immediately go to the clinic and undergo an examination by a dermatologist; he, as a rule, has a specialization in venereology. At the appointment, it will be possible to find out what disease is occurring in this case and the possible cause of its manifestation.

In medical practice, erythema annulare is not a widespread disease, so making a correct diagnosis requires a detailed approach. If there are skin rashes on the patient’s body, you must first compare the erythema with possible similar symptoms of other skin diseases.

Such diseases, similar in external manifestations, include lupus erythematosus, leprosy, and other types of erythema - granuloma annulare, pityriasis rosea. As well as some fungal skin diseases, toxicoderma.

Some sexually transmitted diseases also manifest themselves in symptoms similar to erythema. For example, with syphilis, reddish spots appear on the skin, reminiscent of erythema rashes. To exclude syphilis from the list of possible diseases, the patient will have to undergo additional tests for the presence of a sexually transmitted disease.

He will be prescribed the necessary tests. To detect and take measures to treat possible disorders in the internal organ system, special clinical and laboratory tests will also be carried out, as well as a number of other diagnostic procedures. Below are some of the tests that the patient will have to undergo:

serological;
mycological;
histopathological;
hematological;
oncological;
skin biopsy.

Patients who have this disease will be registered at the skin clinic and at the appointed time will come for an appointment with a dermatologist.

Symptoms can be highlighted in separate points:

red spots form on the skin, which cause itching and a slight burning sensation in the patient;
the main localization of formations is the abdomen, surfaces of the shoulders (front), chest (sides);
spots are characterized by intensive growth (their size can be up to 10-20 centimeters or more);
the property of formations merging with each other, forming peculiar arcs;
a characteristic feature is an elevation above the skin; formation of a lace pattern;
new foci of redness may form next to old ones;

As a rule, the typical erythema is ring-shaped with a flat and smooth center that has a dull hue. The formations are distinguished by their ability to grow along the edges of the circle. As the erythema grows together, they sometimes form arched shapes or take on a garland-like appearance.

The duration of inflammation on the patient’s skin usually does not exceed three weeks. After which they disappear, but not without a trace - they leave pigmentation on the affected areas, which is quite stable.

After some time, the patient discovers new formations on his body. Basically, ring erythema is localized on the back and abdomen of the patient, and can also affect the limbs. It rarely chooses places for its manifestation such as lips, cheeks, buttocks and neck.

We must not let the disease take its course. At the first signs, seek medical help. If erythema is not treated, it will certainly take a chronic form. In spring and summer, the patient will be distressed by the exacerbations that occur. The course of the disease can be very long, practically continuous throughout life. Even after successful removal of ring erythema, persistent traces of erosion may remain.

Treatment methods

As with many other skin diseases, the principle of treating erythema annulare is to first eliminate the causes that caused its appearance. Complex therapy is used - measures include suppression and sanitation of foci of developed infection. At the same time, prevention and treatment of pathologies of the endocrine system and gastrointestinal tract is carried out.

The following medications and drugs are used for treatment:

in certain situations, broad-spectrum antibiotics are prescribed, and various anabolic compounds are also used to eliminate the disease;
help in the fight against the disease penicillin, erythromycin, as well as other means;
the patient may be prescribed antihistamine gels; drugs that contain corticosteroids;
for processing purposes, aerosol preparations and preparations for disinfection are used;
antimalarial drugs can be used to treat the patient;
Vitamin therapy is widely used in the treatment of this disease. Particular attention is paid to vitamins of groups A, B and C;
Compresses are applied to the affected areas.

Folk recipes

Traditional recipes for getting rid of erythema have been preserved, which can be used along with medications:

Place two tablespoons of arnica (dry) in a thermos, preheated, pour two glasses of boiled water. Infuse in a thermos, previously covered with warm things (blanket, padded jacket) for 24 hours. Then strain the infusion and drink the drink at least five times a day, one teaspoon at a time. Be sure to store in the refrigerator during the warm season;

For treatment to take place quickly and effectively, the gastric system must function normally. This can be facilitated by regular intake of mint tea or lingonberry tea. You can drink a glass of this drink a day, preferably before meals;

You need to take ten grams of white mistletoe (dry) and pour half a liter of alcohol. After settling for a month with periodic shaking of the contents, the prepared infusion must be filtered. Drink for a month, after a month's break you can resume taking the drug. Drink once a day - before dinner, no more than thirty drops. Drink with water. Since the plant is poisonous, the dosage must be strictly maintained.

Prevention

To avoid such an unpleasant and long-lasting disease as erythema, you need to try to take at least basic preventive measures. What are they? These are, first of all:

maintaining personal hygiene;
changing dirty linen to clean linen on a regular basis, as well as when necessary;
timely care of damaged skin with antibacterial agents;
prevention of gastrointestinal diseases and endocrine disorders, their timely treatment;
constant monitoring to ensure that the skin always remains moisturized; drinking at least 2 liters of clean water per day;
constant and timely examination by specialists for preventive purposes.

Ring-shaped erythema is redness and swelling of the skin, which is associated with dilation of blood vessels and stagnation of blood in them. It can often occur as a reaction to insect bites, as well as against the background of autoimmune processes and helminthic infestations. The pathology is so called because of its characteristic appearance: a red ring with raised edges that limit the area of damaged skin. Depending on the factors that caused the disease, the disease occurs in acute or chronic form.

Causes of ring-shaped erythema

The skin is connected to absolutely all systems and organs, therefore it reacts sharply to changes occurring in the human body. The appearance of ring-shaped spots on it is not an independent disease, but a signal of a disorder. The reasons for the violations should be clarified. Typically, causes of erythema may include:

The presence of defects in the immune system.
The appearance of malignant tumors.
The appearance of intoxications of various origins.
The occurrence of Lyme disease.
The presence of rheumatic and other autoimmune diseases.
Development of helminthic infestations.
The appearance of allergic reactions in the body.
Development of chronic local foci of infection in the form of sinusitis or osteomyelitis.
The appearance of tuberculosis.
The presence of certain hormonal disorders in the body.
The appearance of fungal infections.
Failure of the normal functioning of the digestive tract.

What disease can ring-shaped erythema be a sign of? As you can see, the list is quite large.

How does this pathology occur?

The appearance of ring-shaped erythema in humans is primarily associated with the pathology of vascular reactions. At the same time, the capillaries that are located in the skin expand, and the blood flow directly into them slows down significantly. As a result, part of the plasma enters the tissues, which leads to the appearance of local edema. T-lymphocytes, which are cells of the immune system that are responsible for recognizing a foreign agent, also follow the fluid. Their role in the formation of erythema is not yet clear, but they report a close connection between the pathology and the functioning of the immune system.

Peripheral increase

Ring-shaped erythema is capable of peripheral enlargement. In the center of the formed ring, pathological processes subside, so the skin acquires a standard color and thickness. But directly along the periphery there remains a certain shaft of dilated capillaries and cellular edema. The ring usually increases in size from the center to the edges. This type is called centrifugal erythema Daria.

Often has an acute development, protracted course and treatment. First there is peeling and swollen pinkish-yellow or red spots. Further, the process progresses, numerous erythematous elements appear, which have a ring-shaped shape with an urticarial edge and a pale center. In the central part of the lesion there is a flat, smooth surface, reaching a size of up to two cm. The color of the central part of the formation gradually changes to almost a brownish color. The peripheral growth of the elements leads to the fact that they reach a diameter of 15 cm. Some rings can unite and form scalloped elements, garlands, and also arcs. The scalloped elements last for 2-3 weeks, then they go away, but after them there remains a violent and stagnant pigmentation. Then new ring-shaped elements are formed.

The most favorite location of the pathology is the torso and limbs, somewhat less frequently the face, neck, lips and buttocks. There is itching and burning. Clinically, there are varieties of Darier's erythema, differing in the following forms:

Peeling (a thin white border peels off along the outer edge of the lesions).
Vesicular form of Darier's erythema (vesicles located at the edges of the elements quickly disappear).
Simple garland-shaped (short periods of existence of spots, from several hours to several days).
Persistent micro-garland-shaped form, including small elements up to 1 cm in diameter. A histological examination of the epidermis reveals dyskeratosis with elements of round bodies, and in addition also grains. Rarely, vesicles are found in the epidermis, which are filled with wrinkled cells with grains.

Symptoms of this pathology

How does the disease manifest itself? Let's take a closer look at this issue. Initially, a rounded red spot appears on a person’s skin, which is slightly raised above the surface and looks like a coin. During pressure, the erythema usually turns pale or disappears entirely. Over time, a focus of enlightenment forms in the center. The skin turns pink. Sometimes, in the center of the erythema, several round-shaped foci of clearing can form simultaneously. In such situations, several ring-shaped spots form on the skin.

Peeling skin

Peeling with bubbles often occurs on the surface. The boundaries of the erythema remain red and gradually creep further, which leads to an increase in the annular diameter. The edge of the ring may rise slightly above the skin.

In the same place there can be ring-shaped erythemas of varying degrees of maturity, and the rings often merge with each other. This is how arched contours with wavy edges near the spots are formed. Skin lesions are occasionally accompanied by pain, which directly depends on the main cause of the disease.

Other signs of pathology

Symptoms of annular erythema are formed against the background of other signs of pathology:

The infectious origin of erythema is indicated by signs of intoxication in the form of fever, weakness and muscle aches with lack of appetite. Erythema migrans often occurs against the background of Borrelia infection due to a tick bite. In the center of the redness, you can see the bite site in the form of a rounded crust or erosion. Often, target-like erythema may form. Against this background, the smaller ring is located inside the larger one.
With the development of rheumatism, damage to the connective tissue structure occurs, which is manifested by pain in the joints and muscles along with limited mobility, changes in skin quality, increased bleeding of blood vessels, a prolonged rise in temperature above thirty-eight degrees and impaired cardiac activity. In this case, the borders of the rings are usually pink, and their localization can be absolutely any.
Allergic erythema, as a rule, is quite bright, and the swelling is well pronounced and can be accompanied by a rash on various parts of the body. Conjunctivitis and rhinitis are also possible. Skin itching of varying intensity can often be observed.
The presence of a malignant neoplasm is indicated by prolonged weakness along with weight loss, bursting pain in the tubular bones, enlarged lymph nodes and a prolonged increase in temperature.

Ring-shaped erythema in children is often associated with rheumatic pathologies, immune disorders and helminthic infestation.

Course of the disease

The course of the disease directly depends on a number of reasons and can take place in various forms:

Paroxysmal type. In this case, skin changes occur suddenly, passing without a trace within a couple of hours or days.
Acute form. The spotted rings gradually disappear over two months.
Chronic type. Changes in the skin persist for a long time.
Recurrent type. After clinical cure, erythema migrans may reappear in the same or new area.

Diagnosis of pathology

Diagnosing erythema usually does not cause any difficulties. If it is necessary to distinguish the disease from a granuloma with similar symptoms, dermatologists take an area of damaged tissue for histological examination. In the laboratory, microscopic sections are prepared from the samples.

Skin changes due to erythema

Typically, changes in the skin as erythema develops include:

Expansion of capillaries.
Accumulation of lymphocytes near blood vessels.
The presence of slight swelling of cells, as well as intercellular spaces of the epidermis.
The presence of moderate edema of the dermis.

To determine the causes of erythema annulare, the doctor performs additional tests. For example, a general clinical blood test with plasma biochemistry is examined. Changes in these analyzes provide clues in which direction to move forward. For example, helminthic infestations are characterized by slight anemia along with eosinophilia and accelerated ESR. Against the background of an allergic reaction, the content of immunoglobulin E protein in the plasma increases. The presence of malignant neoplasms is manifested by a decrease in hemoglobin, as well as red blood cells, along with changes in the leukocyte formula.

Instrumental studies in the form of X-rays, electrocardiograms, computed tomography and the like are carried out if, after examining the patient or in laboratory tests, certain changes were detected.

Treatment of the disease

Effective therapy is possible once the cause of the pathology is established. Therapy is prescribed by a dermatologist together with a specialist who deals with the underlying disease. This could be a neurologist, rheumatologist, endocrinologist, immunologist, infectious disease specialist, and so on. The patient's need for hospitalization is determined based on the general well-being of the patient and concomitant diseases. Patients usually receive treatment on an outpatient basis.

Carrying out local treatment

Local treatment usually includes:

The use of antihistamine ointments, creams and gels that eliminate swelling, redness and itching associated with the release of histamine.
Using ointments that contain zinc compounds, such as Desitin. The mechanism of their action is not yet fully understood, but they can effectively eliminate inflammation in the epidermis along with itching and flaking. Moreover, unlike hormonal drugs, they are almost safe.
Treatment with glucocorticoid ointments and creams, for example, Akriderm or Sinaflan. These drugs slow down the active proliferation of t-lymphocytes, thereby eliminating the main causes of local changes in the skin. They should be used only as prescribed by a doctor, otherwise serious side effects may occur in the form of a severe bacterial or fungal infection.

Treatment of ring-shaped erythema is not limited to this.

Systemic drug therapy

Along with local treatment, systemic drugs are prescribed:

The use of desensitizing agents that remove toxins and allergens from the bloodstream, reducing the permeability of vascular walls and stabilizing the membranes of immune cells. Thanks to all this, the release of histamine into the tissues is reduced.
Use of glucocorticoids. These drugs are used in the form of tablets or injections. It is advisable to use them against the background of severe erythema.
Use of antibiotics. Such medications are necessary in the presence of an infectious disease. Typically, patients in these cases are prescribed penicillins or cephalosporins.
The use of antihelminthic drugs is prescribed when worm eggs are found in the stool, and, in addition, against the background of the detection of specific immunoglobulins in the blood.

Finally

Thus, annular erythema is not an independent disease, but rather a symptom of other pathologies. Therefore, it requires complex treatment and an accurate determination of the cause that caused it. If pathology occurs, you should not self-medicate, but you should definitely consult a doctor.

We looked at what kind of disease this is - annular erythema.

Basically, erythema in children is a manifestation of the body's reactions to irritants. Erythema infectiosum includes infectious diseases of childhood such as measles, rubella, scarlet fever, and infectious mononucleosis. So, we can highlight the following:

poisoning of the body by taking certain medications;
reaction to prolonged exposure to ultraviolet rays;
manifestation of a reaction to a food allergen;
formation of malignant tumors;
changes in the protein-leukocyte blood formula;
focal infections, under the influence of which many toxins enter the body.

The cause of erythema may be an imbalance of proteins and leukocytes in the blood

This term combines physiological and pathological modifications of the dermis. Causes.

Physiological. Redness of skin areas due to a psycho-emotional reaction of the body (shame, irritation, menopausal hot flashes, excitement). Under the influence of temperature or physical contact. When exposed to externally used drugs with a warming effect or taken internally to drugs with a vasodilating effect.
Pathological includes infectious diseases, dermatitis, dermatoses, autoimmune diseases, allergic reactions, including to drugs. May be on antibiotics, penicillin group. Also somatic pathologies and pregnancy, therapeutic electrical procedures, sunburn.

As mentioned earlier, erythema can occur in acute and chronic form. The chronic form of the disease implies a long period of the disease, during which remissions and exacerbations occur.

These include many skin diseases, Hammel's erythema, erythema rheumatica, centrifugal erythema of Biette and many other skin diseases. Let's look at what characterizes these diseases.

Translated from Greek, “erythema” means redness. Color changes are caused by internal and external factors. Erythema has a wide variety:

Ring-shaped erythema - another name for centrifugal annular erythema of Darier is a chronic toxic-allergic or infectious-allergic disease.

A distinctive feature is the formation of non-flaky spots on the skin, which tend to form lesions in the form of rings. The absence of itching or other subjective sensations can lead to the patient not noticing the appearance of centrifugal erythema.

Ring erythema is extremely dynamic and can appear and disappear within two hours.

The cause of the disease is foci of chronic infection (sinusitis, tonsillitis), candidiasis, mycosis, diseases of the gastrointestinal tract, endocrine disorders.

Erythema annulare appears in the form of small, non-flaky, ring-shaped spots. The color of the spot is pale pink.

As they increase in size, the erythema retains its shape. New formations may appear inside the rings.

In this case, the spot is slightly concave in the center and raised at the edges. The diameter of the rash ranges from a few millimeters to 10 cm.

The rashes are located on the patient’s shoulders, torso, and rarely on the forearms, legs, thighs, neck, and face. A characteristic feature is the absence of spots on the palms, soles of the feet, and mucous membranes.

Reasons for the development of ring-shaped erythema:

intoxication of the body;
heredity;
bacterial infections;
viral infections;
focal infections (osteomyelitis, tonsillitis, dental granuloma and others);
chronic sinusitis;
chronic cholecystitis;
osteomelitis;
candidiasis;
rheumatism;
mycoses of the feet;
endocrine disorders;
diseases of the gastrointestinal tract;
decreased immunity;
dysprooteinemia;
side effect when taking medications;
various neoplasms (lymphomas, adenocarcinomas, acute leukemia).

Types of disease

Ring-shaped erythema occurs:

Rheumatic – acts as a sign of the presence of rheumatism. It is characterized by barely visible spots of pale pink color. Often found in children and adolescents.
Migratory annular erythema is a chronic form, the inflammatory process has signs similar to dermatosis. May be a consequence of infections caused by viruses or bacteria.
Centrifugal - manifests itself in a large number of erythemas in the form of a roller, rising above the surface of the skin. The formation grows and changes shape.

Symptoms (signs)

The main symptoms of Darier's annular erythema in most cases are acute. The disease itself is chronic and long-lasting.

At the beginning of development, red or pink-yellow spots appear that peel off. As it progresses, erythema begins to appear as spots in the form of rings that rise slightly above the surface of the skin.

The diameter of the rash can reach 15 cm. The shade varies from rich red to purple.

The area of the rash may be itchy and a little itchy.

Typical appearance of erythema:

ring-shaped;
faded shade in the center;
the center of formation is flat and smooth;
the tendency of elements to grow along the periphery;
some erythemas can grow together, forming arcs or garlands;
The duration of manifestation of rashes is 2-3 weeks. Subsequently, they disappear, leaving persistent pigmentation on the skin. Over time, new erythemal rings appear.

Clinical picture The appearance on the skin of the torso and limbs of numerous coin-shaped, non-flaky, edematous spots of a pinkish-reddish color, prone to eccentric growth, merging to form bizarre polycyclic figures, rings, garlands, bordered by a roller-shaped edematous dense edge in the form of a cord embedded in the thickness of the skin.

Similar ring-shaped spots (rings within rings) may appear inside the rings. The central zone of the skin is somewhat sunken, slightly cyanotic. In some patients, atypical varieties are observed - vesicular, purpuric rashes, telangiectasia, etc.

Subjective disorders are not expressed, slight itching and burning are noted. The course of the disease is paroxysmal: one rash that disappears without a trace is replaced by others after 2-3 weeks.

Spontaneous remission may occur after a few months or years. Erythema often recurs.

Signs and symptoms

In addition to distinguishing the above forms of annular erythema (rheumatic, migratory, Darier), in practical dermatology there is a classification compiled taking into account the characteristics of the clinical course, which, in general terms, differs in the nature of the rash, duration and other characteristics.

Currently, there are four clinical forms of erythema annulare. The first symptom of all forms is the formation of red spots on the surface of the skin, sometimes with itching.

Subsequently, the course of each form acquires its own characteristic features.

Diagnostics

The diagnosis of erythema annulare is based on medical history and the results of a dermatological examination. In controversial cases, a skin biopsy is performed in the area of pathological lesions. When examined by a dermatologist, erythematous rashes of various shapes and sizes are determined, often in the form of bizarre closed lines and stripes. Depending on the form of the ring-shaped erythema, along with redness of the skin, peeling, formation of papules or vesicles may be observed.

When studying a patient's medical history, diseases that provoke the development of this form of reactive dermatosis are often revealed. Possible helminthic infestations, skin mycoses, malignant neoplasms, inflammation of the elements of the oral cavity and upper respiratory tract. In the absence of the listed diseases, the patient may be prescribed laboratory and instrumental tests to assess the condition of various organs and systems and determine the causes of the development of annular erythema. Particular attention should be paid to the possibility of cancer, since annular erythema is sometimes a manifestation of paraneoplastic syndrome.

Changes in the general blood test with annular erythema are nonspecific and mainly help to establish the nature of the provoking factor.

For example, eosinophilia may indicate helminthic infestation or allergies, leukocytosis may indicate acute or chronic inflammation. Quite often, with annular erythema, dysproteinemia is detected - a violation of the ratio between individual fractions of plasma proteins.

Histological examination of the skin usually reveals an unchanged epidermis with edema and pronounced leukocyte infiltration of the dermis. Histoimmunofluorescence analysis confirms the accumulation of class G immunoglobulins at the basement membrane of the epidermis.

Differential diagnosis of erythema annulare is carried out with seborrheic eczema, granuloma annulare and syphilitic roseola.

When the first rash appears, you must make an appointment with a dermatologist or venereologist. Consulting a doctor will help determine the disease and its causes. Specialists prescribe the following diagnostic tests:

serological study;
mycological research;
oncology research;
histopathological examination;
hematological examination;
skin biopsy.

Treatment

Treatment is selected by a dermatologist, in accordance with the reasons for its appearance. In addition to the dermatologist, treatment is discussed with a neurologist, infectious disease specialist, immunologist, rheumatologist and endocrinologist. The appearance of erythema may indicate the presence of infectious processes in the body, such as:

cystitis;
scarlet fever;
angina;
candidiasis;
tuberculosis;
otitis;
rheumatism;
inflammation of the inguinal lymph nodes.

Scarlet fever is a disease that sometimes accompanies erythema

A complex of drugs with the following action is selected:

antihistamines: ointments, creams, gels, tablets that will help eliminate tissue swelling;
antiviral: drugs aimed at destroying viruses, if any are present in the body, or preventing their appearance, since the body is in a weakened state and the risk of catching the virus is very high;
anti-infective;
antiseptics, glucocorticosteroids: drugs and ointments that block further proliferation of T-lymphocytes, which will help cope with external manifestations;
drugs that will remove toxins from the body;
anthelmintic drugs, if there are worms in the body: often several courses of treatment are required, and then also prevention;
antibiotics are prescribed if there is an infection in the body, and with a prolonged increase in body temperature;
cytostatics: drugs that will suppress the proliferation of genetically modified immune cells, thereby suppressing the manifestation of signs of autoimmune diseases.

Ointment is prescribed to relieve swelling

Therapy of erythema is associated with eliminating the cause that led to its appearance. It is necessary to normalize the functioning of the gastrointestinal tract, endocrine and nervous systems, and suppress foci of infection.

Effective treatment of ring-shaped erythema is possible by identifying the cause of the disease and eliminating it. Therapy is prescribed by a dermatologist together with a specialist who deals with the underlying disease: neurologist, rheumatologist, endocrinologist, immunologist, infectious disease specialist.

The need for hospitalization is determined based on the person’s general condition and concomitant pathology. As a rule, patients receive therapy on an outpatient basis.

Local treatment includes

There is no etiotropic treatment for annular erythema, however, successful therapy of the provoking disease can significantly reduce the manifestations of this condition. Depending on the identified pathology, treatment is carried out for mycoses of the skin, tonsillitis and diseases of the gastrointestinal tract. If necessary, the oral cavity is sanitized. In the process of treating the underlying disease, antibiotics, anthelmintics and other drugs are used. In the presence of a malignant neoplasm, the treatment plan is determined depending on the location, prevalence and type of neoplasia.

Along with treatment of the underlying disease, desensitizing therapy is carried out for annular erythema. Antihistamines (cetirizine, chloropyramine), calcium chloride and sodium thiosulfate are used.

To normalize metabolism, patients are prescribed vitamin therapy, especially vitamins C, A and E. Patients are prescribed a hypoallergenic diet with an increase in the amount of carbohydrates in the diet.

In severe cases, corticosteroids (prednisolone) are used to reduce inflammation. Antipruritic ointments are applied topically; if vesicles are present, antiseptics are used to prevent secondary infection.

Treatment Antibiotic therapy Vitamins A, E, group B Ketotifen Pentoxifylline In persistent cases - GK.

The prognosis is favorable.

ICD-10 L53.1 Erythema annular centrifugal

A rather rare dermatosis, granuloma annulare, occurs mainly in children and adolescents, more often in females.

Granuloma annulare is a benign idiopathic granulomatous dermatosis.

The origin of this pathology has not yet been determined. In earlier times, granuloma annulare was considered a tuberculosis disease, but then this theory was not confirmed.

A number of researchers classify the disease as a skin disease such as sarcoidosis. It is not completely ruled out that granuloma annulare can develop in a number of patients due to impaired carbohydrate metabolism, in particular disseminated forms.

A good therapeutic effect was obtained with the use of antidiabetic drugs and an appropriate diet. It is known that granuloma annulare rashes mainly develop on areas of the skin that are not covered by clothing, so some influence of solar radiation cannot be ruled out.

Symptoms of granuloma annulare

Antibiotic therapy

Vitamins A, E, group B

Ketotifen

Pentoxifylline

In persistent cases - glucocorticoids.

Synonym. Persistent erythema

ICD. L53.1 Erythema annular centrifugal

Treatment of annular erythema is aimed mainly at eliminating the causes that caused it, and consists of sanitizing foci of infection, treating diseases of the endocrine system and gastrointestinal tract. For this purpose they prescribe:

calcium and sodium thiosulfate preparations;
general antibiotics (in rare cases);
antihistamines;
drugs of the penicillin, erythromycin and others group;
vitamin therapy (especially vitamins A, B, E);
corticosteroid drugs;
anabolic compounds;
antimalarial drugs (sometimes);
disinfectants and antiseptics;
compresses on the lesions;
treatment of lesions with aerosol preparations with sodium thiosulfate;
antihistamine gels;
ointments promoting epithelization;
creams with low concentrations of corticosteroids;
homeopathic remedies (for treating children).

Patients with annular erythema should be registered at the dispensary and regularly visit a dermatologist.

Without treatment, ring-shaped erythema can become chronic with spring and summer exacerbations. The disease can last throughout life, and its treatment is ineffective.

Sometimes, after successful treatment of ring-shaped erythema, erosions with persistent pigmentation remain in certain areas of the skin.

Prevention and prognosis

Ring-shaped erythema is a chronic pathology with a positive prognosis. Treatment will produce more effective results if started as early as possible.

Erythema does not degenerate into malignant, but it must be treated. In advanced cases, surface erosions may appear at the sites of formations, which, when healing, leave pigment spots.

Preventive measures:

Prevention of annular erythema consists of observing the following rules:

follow the rules of personal hygiene;
carry out timely change of linen;
treat skin damage with antibacterial agents;
timely treatment of diseases of the endocrine system and gastrointestinal tract;
moisturize the skin surface;
preventive examination by specialists.

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