What is parapsoriasis? Basic forms and symptoms. Therapeutic measures for parapsoriasis

The term parapsoriasis dermatologists designate a group of dermatoses, which is united by damage to the skin tissue.

Data about pathological condition were first published in 1902 by a scientist named Brocq. The researcher put in one row several chronic abnormalities, manifested by a spotted-scaly rash without internal defeat organism.

Plaque parapsoriasis (Broca's disease) dominates among them.

Causes of parapsoriasis

Doctors do not name the exact reasons provoking the development of parapsoriasis. Doctors have long been inclined to think that the disease is infectious nature. But then their opinion changed, and the provoking factors were called allergic reactions of the body.

In some patients, skin rashes are similar to signs of tuberculous meningitis, syphilis, disseminated tuberculosis. But by origin, parapsoriasis and these diseases do not have a common pathogen.

In the study of another group of patients revealed structural disturbances vascular walls. Their body suffers from increased capillary permeability and reduced strength. Such deviations are inherent in many infectious diseases:

measles;
flu;
angina;
chicken pox;
typhus;
meningococcal brain injury.

Thus, plaque parapsoriasis and its other varieties are dependent on the foci of infection. Vascular disorders take a back seat.

As for the skin itself, its inflammatory autoimmune reaction is explained by antigens formed by infectious-toxic agents - viruses, allergens, intoxications. They contribute to damage to DNA cells and the formation of defects that distort the activity of T-lymphocytes. Due to the stimulation of the body by antigens, any skin ailments become inflammatory.

Exacerbation of the symptoms of parapsoriasis contribute to frequent colds, bowel injury helminthic infestations, dysfunction endocrine system and weakening of the immune system.

How the disease progresses

Parapsoriasis - chronic pathology, periods of exacerbation of which occur in the autumn and spring months. Dermatologists distinguish several main forms of skin problems:

acute;
lichenoid;
drop-shaped.

Acute parapsoriasis

This type of disease is known as varioliform parapsoriasis.

Its symptoms are various elements scattered all over the body or concentrated on the palms, soles or skin of the face. The disease develops acutely without deterioration in general well-being. After the appearance of a specific rash, an increase in body temperature and an increase in lymph nodes are possible, but this rarely happens.

Acute parapsoriasis ends with the subsidence of the process with the formation of small scars or the transition to the form of psoriasis.

Guttate type of parapsoriasis

Cutaneous guttate parapsoriasis often affects young women. Rashes a few millimeters in size resemble nodules, the center of which is crowned with a dense grayish scale. The color of the "droplets" varies from pink to brown, they are localized on the body and limbs.

3 phenomena help doctors confirm the diagnosis of guttate parapsoriasis

hidden peeling. Careful scraping of the nodule leads to peeling of the element according to the pityriasis type.
Purpura. Intense scraping exposes bleeding tissue (fragile vessels give pinpoint hemorrhages).
Wafer. Attempts to remove the central scale end with its separation as a whole layer.

During the period of remission, drop-shaped rashes either disappear without a trace, or leave behind leukodermic spots. Pathology does not cause subjective sensations.

Plaque form, or Broca's disease

Plaque parapsoriasis occurs in two varieties:

The classic signs of pathology are pale pink spots or plaques with a small accumulation of infiltrate. The shape of the elements is oval or irregular, the diameter is from 3 to 5 cm. The foci appear on the trunk, arms,. They do not rise above the skin.

Rash plaque parapsoriasis gives scaly. The affected areas of the skin look hyperpigmented or lifeless, do not merge with each other. In the cold season, Broca's disease worsens, but on general well-being the person is not affected. The appearance of itching may indicate its transition to fungal mycosis.

Lichenoid form

Parapsoriasis with rounded or cone-shaped papules is uncommon. Lichenoid elements stand out on the lateral parts of the body as yellowish-red or brown neoplasms.

Their surface is smooth and shiny, sometimes covered with small scales. Rashes may appear on the eyelids. The process of formation of a reticular rash is painless.

The photo in the article shows different forms parapsoriasis. Despite visible differences, only a dermatologist should deal with the diagnosis. For appointment adequate therapy it is important to differentiate parapsoriasis from true psoriasis and lichen planus.

Video: what is parapsoriasis, types and symptoms.

Therapeutic measures for parapsoriasis

Together with the doctor, the patient must detect and eliminate all factors predisposing to the appearance of a rash. When Broca's disease is diagnosed special attention deserve the organs of the gastrointestinal tract, because their wrong job affects the condition of the skin. Deviations are corrected by appropriate therapy.

Patients with acute parapsoriasis are prescribed antibacterial treatment. Drugs are used penicillin series, macrolides, Erythromycin, Tetracycline. As indicated, antimalarial drugs are prescribed.

Corticosteroids are prescribed for severe course any form of illness. Prednisolone at the beginning of therapy is allowed to take a dosage of about 35 mg / day. Subsequently, the rate is gradually lowered. Considering pernicious influence hormonal agents and antibiotics on the liver, hepatoprotectors are prescribed to support the organ. Antihistamines are used to relieve itching.

Fortifying therapy is carried out with preparations containing aloe and vitamins:

Aevit;
B vitamins;
ascorbic acid.

Vitamin therapy is given for 2-3 months. Then they arrange a break of the same duration and take the substances again.

Physiotherapy sessions provide high efficiency in the fight against parapsoriasis: phonophoresis with solcoseryl ointment and retinol, selective UV, iodine-bromine baths.

Broca's pseudopelade (atrophic alopecia) is a fairly rare disease characterized by hair loss. The term "pelada" refers to alopecia areata, and "pseudo-pelada", respectively, will mean "something similar to, but not this disease."

The description of this disease was given by the researcher Brock, which is why it was named after the scientist. Broca's pseudo-pelade may appear as individual disease and as a complication of other diseases. Most commonly, Broca's pseudopelade accompanies .

Reasons for the development of the disease

Broca's pseudopelade is classified as an idiopathic disease, the causes of which have not yet been identified. Most often, Broca's pseudopelade occurs in people over 35 years old, and women are about three times more likely than men. However, there are cases when pseudo-pelade developed in children.

It must be admitted that the effect of the disease is irreversible, it is not possible to restore lost hair. However, it is usually possible to stop the process of their loss.

Manifestations and symptoms

Broca's pseudopelade develops gradually, often completely invisible to the patient. Initial symptom pseudo-pelades - the appearance of foci of baldness. They are localized, as a rule, in the upper part of the occiput and on the crown of the head. Since the hair falls out gradually, the patient does not immediately notice something was wrong.

Gradually, the foci of alopecia merge, forming rather extensive areas of baldness. The shape of the foci can be quite bizarre, the boundaries are quite clearly expressed.

With Broca's pseudopelade in the area of baldness, the skin looks quite healthy. Skin pale pink, smooth, no rash peeling. At the borders of the foci, the skin and hair do not have notable changes. However, upon closer examination, one can see characteristic symptom pseudo-pelades - the growth of two hairs from one hair follicle.

Broca's pseudopelade has chronic course development is slow. Gradually, everyone is involved in the process large quantity hair follicles. Around hair bulb, affected by the disease, you can see a pale pink border, and keratosis is observed at the mouth of the follicle.

If you pull out the hair from the affected pseudo-pelade of the bulb, you will notice that it looks like a burnt match (as described by Yu.V. Sergeev). The root of the hair shows signs of atrophy, and is similar in color and appearance to a burnt match.

In areas of the scalp that are not covered by alopecia, foci of peeling and the formation of hard crusts can be found. The presence of these foci is easy to determine by palpation.

As Broca's pseudo-pelade develops, scars form at the site of the fallen hair, which can be located randomly or in groups. No discomfort physical sensations the pseudo-pelade is not called. Over time, the process may spontaneously stop.

So, the main symptoms of Broca's pseudopelade:

In the first stage, the lesions are very small, but they grow slowly but steadily.
In most cases, foci of baldness have round shape.
The boundary between the lesion and healthy skin with pseudopelade very clear.
The skin in the area affected by leanness is devoid of hair, has a pinkish or White color. Sometimes in the area of position you can see a few single thickened hairs.
Individual lesions in pseudopelade are usually small, however, they are prone to confluence, resulting in a fairly large focus of alopecia.

Forms of the disease

There are several forms of pseudopelade that differ external manifestations:

pure atrophy. In this case, there is no hair in the lesion, the skin is completely clean and has a white or pinkish color.
Atrophy with redness. With this form of pseudopelade in the area of baldness, the skin becomes red.
atrophy with . This form pseudopelade is distinguished by a significant thickening of the stratum corneum in the area of hair that has fallen out.

Diagnostic methods

Diagnosis of Broca's pseudopelade is not particularly challenging task, however, the dermatologist must exclude the presence in the patient of diseases that have similar symptoms.

When examining a skin biopsy taken from a patient with pseudopelade, the following picture can be observed: no signs inflammatory process() and there are no significant changes in the hair follicles. Absence of fibrous streamers in the dermis histological examination signs of cicatricial alopecia are revealed in the absence of an inflammatory process.

Currently, certain diagnostic criteria have been adopted to determine Broca's pseudopelade.

Grade clinical criteria:

Foci of hair loss tend to coalesce.
long current disease with slow progress.
On late stage moderate atrophy of the skin in the lesions can be observed.
On early stage pseudo-pelades near the hair follicles, you can notice redness in the form of a border.

Required differential diagnosis co the following diseases:

. With pseudopelade, only the scalp is affected, in addition, there is no erythema, scutes and scales on the skin are not formed.
infectious diseases – erysipelas, etc.
Malignant tumors skin.

Treatment

There is no treatment that can reverse the process of pseudopelade and restore lost hair. However, with the help of therapeutic agents, it is possible to suspend the process and improve Current state skin.

It is best to start treatment of pseudopelades at an early stage of the disease, until the process of alopecia has gone far.

Treatment of Broca's pseudopelade is prescribed by a dermatologist and endocrinologist. As a rule, patients are advised to:

Rubbing mercury, tar and sulfur ointments into the lesion. Moreover, in the treatment of pseudopelades, as a rule, it is recommended to alternate ointments.
Vitamin therapy. Patients with pseudopelade are prescribed vitamins A, B6.E, B1.
Physiotherapy procedures. With pseudo-pelade, moderate UVI is shown, paraffin applications massage with rubbing medicines.
Antibiotics may be prescribed if needed hormonal agents. As a rule, benzyl penicillin, ampicillin, oxacillin are prescribed for pseudopelade. sodium salt. In addition, the reception of lidase, ascorutin, nikospan, teonicol, aloe preparations is indicated. The place is assigned to electrophoresis using Ronidase, butadione ointment. Treatment of pseudopelades is carried out in 3-4 week courses. Then you need to take a break for 6 weeks. In total, for the treatment of the disease, it is necessary to conduct from 3 to 6 courses.
Patients with pseudo-pelade are recommended to use only for washing their hair. boiled water and neutral detergents. You can use baby shampoo.

Treatment with herbal medicine methods

IN folk medicine There are recipes that can help effective help with Broca's pseudopelade. These prescriptions can be used as an addition to the therapy prescribed by the doctor.

Walnut oil is used to treat Broca's pseudopelade.

Walnut oil is used to lubricate the lesions in pseudopelade. To prepare this remedy, you need to take 100 ml of burdock or other vegetable oil and hazelnuts - 20 pcs. Nuts need to be crushed and mixed with oil, insist in the dark for 2 weeks. After straining, use to lubricate the affected skin.

In a similar way, you can prepare garlic oil for the treatment of pseudopelades. For 100 ml of oil, take 5 large cloves of garlic. Wild garlic can be used instead of garlic.

To prepare lotions and wash your hair, you can use infusions and decoctions. medicinal herbs. Burdock and willow roots are effective for the treatment of pseudopelades. It is necessary to mix this medicinal raw material in equal proportions. A liter of boiling water will require 4 full tablespoons of this mixture. Leave for at least half an hour.

For rubbing into the lesions with Broca's pseudopelade, you can use the following composition: a mixture of wormwood grass, sage, lungwort, plantain, centaury (all raw materials are taken in equal proportions). A spoonful of the mixture is brewed with a glass of boiling water, after cooling, a spoonful of honey is added and filtered. Use for daily rubbing, the duration of the procedure is 15 minutes, the course of treatment is two weeks.

For patients with pseudopelade, it is recommended to use decoctions prepared from nettle, celandine, chamomile, plantain for rinsing hair after washing.

Forecast and prevention

Since to date it has not been possible to identify the causes that lead to the development of Broca's pseudopelade, the prevention of this disease is impossible. Only possible recommendation is to take care of your health. When the first signs of hair loss appear, you should consult a doctor.

The prognosis for recovery with Broca's pseudopelade is unfavorable. The disease is chronic and runs throughout the life of the patient. Hair in the lesions will never grow back. Therefore, despite proper treatment hope for full recovery patients with Broca's pseudopelade do not have to.

However timely treatment allows you to limit the process and greatly slow down its spread. Therefore, patients who have a pseudopelade are advised to carefully follow the doctor's instructions.

Doctors brought to the consultation a girl who had visited a number of clinics, but all the diagnoses turned out to be wrong. Once they even did a biopsy, but they did not describe the characteristics of the hair follicles and did not comment on the diagnosis. At microbiological research epidermal staphylococcus was sown. However, the diagnosis is typical and simple - Broca's pseudopelade. At the end of the consultation, the patient confessed that yesterday she had a consultation with Academician Yu.K. Skripkin, he made the same diagnosis.

The patient has been ill for about 2 years. The ongoing therapy has no effect.

There is a focus of alopecia on the scalp, a scarring focus in the center, hair follicles are not preserved. On the periphery of the focus, an inflammatory reaction, yellowish crusts, hair with a muff gray color at the base, a sign described in the literature is revealed - the growth of several hairs from one follicle. In addition, foci of peeling and hard crusts (resembling a “grater”) were found on other parts of the head, which are well detected by palpation of the scalp.

Clinical diagnosis

Broca's pseudopelade (atrophic alopecia)

Comments.

Cicatricial atrophy is a collective term that characterizes the irreversible loss of hair due to the death of hair follicles as a result of inflammation, which ends in scarring. Along the periphery of the foci of alopecia, one can detect signs of the disease that caused alopecia (discoid lupus, dermatophytosis, red lichen planus). But more often than not, the cause is not known.

Broca's pseudopelade is described as feature the growth of several hairs at once from one follicle.

I can immediately supplement the diagnostic panel with Broca's pseudopelade, I have already met and examined this symptom more than once - with a video dermatoscopy examination of a removed hair from the edge of the alopecia focus, a characteristic symptom is revealed at its root, which I described as a symptom of a "burnt match". Atrophy of the hair root is revealed, the hair follicle is bordered by a furrow and resembles a burnt black match (see photo of a video dermatoscopy study in this patient). In addition, note the formation of gray muffs at the base of some of the affected hairs.

The disease is extremely difficult to treat. The main effort must be spent on removing inflammatory response leading to atrophy.

Atrophic alopecia - Broca's pseudopelade is quite rare. This is a disease for which characteristic feature is .

If the term means "pelada" alopecia areata, then, accordingly, "pseudo-pelada" is a condition that resembles alopecia areata, but is not.

Broca's pseudopelade can exist as individual disease and be a complication of other diseases. Mostly, Broca's pseudo-pelade appears at.

Causes

Broca's pseudopelade is an idiopathic disease with still unknown causes, which develops mainly after the age of thirty-five, and is three times more common in women than in men. Registered rare cases children's pseudo-pelade. The effect of this disease is irreversible and there is no way to restore lost hair. It is only possible to stop the process of their loss.

Symptoms

Broca's pseudopelade characterized by gradual development initial stages for the patient are almost imperceptible, until there are foci of alopecia, which are concentrated on the crown and in the upper part of the nape. Over time, the foci of alopecia merge and there are very extensive areas of baldness with clear boundaries and often a bizarre shape. The area of baldness is characteristic looking healthy skin, smooth, pale pink in color, without peeling and rash.

Careful examination may reveal the characteristic symptom of pseudopelade, when two hairs grow from one hair follicle. In the process of development, an increasing number of hair follicles are affected by the disease, and a pale pink border is found around the affected hair follicle, and keratosis is noticeable at the mouth of the follicle. A hair plucked from a bulb affected by a pseudopelade looks like a burnt match, and there are signs of atrophy on its root.

On areas of the scalp not covered by alopecia, foci of peeling appear, and hard crusts also appear there. In place of the fallen hair, chaotic or group scars appear.

No physical discomfort is felt with pseudopelade. Cases of spontaneous stop of the process have been registered. Most often, foci of baldness are rounded.

Forms of the disease

There are several forms of pseudopelade.

With pure atrophy, there are no hairs in the lesion, the skin is white or pinkish in color, completely clean.

Another form is atrophy with redness, where the skin in the area of alopecia becomes reddish. With atrophy with hyperkeratosis, the stratum corneum noticeably thickens in the area of hair loss.

Examination of the affected areas shows no manifestations of folliculitis (inflammatory process) and no noticeable changes in the hair follicles.

Treatment of Broca's Pseudopelade

Medications can only stop the process, but the condition of the affected skin improves. As always, it is preferable to start the treatment of pseudopelade at an early stage of the disease, without starting the process of alopecia. You should contact a dermatologist and an endocrinologist here. Usually, doctors recommend rubbing tar, mercury and sulfur ointments which are recommended to be alternated.

Vitamin therapy is also used, in which vitamins A, B 1, B 6, E are prescribed. Physiotherapeutic procedures are recommended, such as paraffin applications, moderate UV radiation, massage with rubbing medicines. In some cases, antibiotics are prescribed and. Usually, with pseudopelade, benzyl ampicillin, penicillin, oxacillin sodium salt are used. Theonikol, lidase, nikospan, ascorutin, aloe preparations are shown. Often, the use of local electrophoresis with the use of butadione ointment and Ronidase.

Treatment of pseudopelade carried out in courses of three to four weeks, after which a break of one and a half months is taken. The total duration of treatment includes three to six courses. With a pseudo-pelade for washing your hair, you should use only boiled water and neutral detergents, children's shampoos are good. In addition, you should regularly sanitize the mouth and pharynx, nasal cavity. Here you will need to visit an otolaryngologist and a dentist.

Traditional medicine for the treatment of Pseudopelades

In folk medicine, there are recipes that should be used in addition to the treatment prescribed by the doctor.

These include peanut butter. To prepare it, half a glass of burdock or other vegetable oil is mixed with twenty crushed hazelnuts and half a month insist. After straining, the agent lubricates the affected skin.

It is also prepared garlic oil- five large cloves and half a glass of butter. Garlic can be substituted .

Effective and lotions, as well as hair washing in which decoctions and infusions of medicinal herbs are used, for example, willow roots and burdock, taken equally. Four full spoons are taken and brewed with a liter of boiling water, after which they insist for half an hour or more. A composition of a mixture of sage, wormwood, lungwort, centaury and plantain, taken equally, is rubbed into the lesions. A spoonful of this mixture is brewed with a glass of boiling water, cooled, a spoonful of honey is added and filtered. Rub should be every day for a quarter of an hour, a two-week course.

Causes this disease remain unknown to this day. This pathology manifests itself in the form of hair loss, but this, unlike alopecia areata, does not occur immediately and simultaneously, but imperceptibly for the patient himself. Mainly affected hairy part heads. At the beginning, the lesions are very small, but gradually and steadily grow, reaching first the size of a grain of lentils, then a dime, becoming more and more pronounced and noticeable. Most often they have the shape of a circle or oval. Such bald spots are immediately noticeable during an external examination of the patient, since the border between them and the healthy scalp is very clear. The skin in the area of the foci is completely “bald”, but sometimes single thickened hair can be found on it. The skin in the area of the lesions takes on a pinkish or white color. As a rule, individual bald patches do not reach large sizes. On the head, they are located in several groups, which later merge with each other, and even then a truly large focus is formed. According to one of the largest researchers in this field, Rabu, there are several different varieties of pseudopelade.
1. Pure spotted atrophy, when hair is completely absent in the area of \u200b\u200bthe foci, the skin has a white color.
2. Spotted atrophy with redness, when the skin becomes red in the area of bald patches.
3. Spotted atrophy with hyperkeratosis, when in the area of lesions, in addition to hair loss, there is also a significant thickening of the stratum corneum of the skin.
When examining the material taken from the patient under a microscope, it is possible to reveal some changes characteristic of allergic reactions.
It is quite easy to make a diagnosis for such a patient if all other skin diseases, in which scars remain at the site of the lesions.
Treatment. Full reverse development manifestations and recovery cannot be achieved, however pathological process it is possible to suspend, which is the main goal of therapy for pseudopelade. First of all, they are appointed vitamin preparations, especially A and E. Hormone preparations should certainly be used, but this should be done only after consulting the patient with an endocrinologist. Of the non-drug methods of treatment, massage of the lesions, various physiotherapeutic procedures are used.
Forecast. This type atrophic alopecia is chronic disease, flowing all life and not giving in therapeutic activities. From the very beginning, reddening of the skin appears in the area of bald patches, which then disappears, and a slightly pronounced atrophy of the skin appears in this place. Hair in the places of the former lesions almost never grows. Hopes for recovery, even with proper therapy, are essentially zero.