Ring-shaped skin rash in adults. Ring-shaped erythema: causes and treatment in children and adults. Characteristic symptoms and development of the disease

What is erythema nodosum

Many demotic diseases have similar external signs, so only a dermatologist can determine the type of pathology. Ring-shaped erythema is a disease that belongs to infectious-toxic diseases of a chronic nature.

Unlike other skin diseases, this can be recognized independently. A typical manifestation is ring-shaped spots on the skin of a bright red color, they do not peel off, and are accompanied by general malaise, headache, fever, and swelling.

The disease got its name due to its characteristic symptoms. On the affected areas, most often in the lower extremities, dense nodes with a diameter of 5 mm to 5 cm begin to appear.

In the medical literature you can also find the name erythema nodosum. Experts classify the pathology as a type of allergic vasculitis.

Inflammation of the walls of blood vessels develops as a reaction of the body to the effects of various toxic factors.

Most often, young people aged 20–30 years face pathology. Statistics show that women develop the disease more often. Exacerbation in most cases occurs in the winter-spring period.

Erythema nodosum is a systemic disease of connective tissue affecting the skin and subcutaneous fat, the most typical manifestation of which is painful on palpation, moderately dense nodules 0.5-5 cm or more in diameter.

Erythema nodosum, or as it is also called erythema nodosum, is an etiologically complex disease that affects the vessels mainly of the upper and lower extremities. In this case, inflammation and the formation of specific subcutaneous nodes are observed.

For a long time, the origin of the pathology was not studied. However, at the moment it has been possible to clarify the allergic etiology of the inflammatory process in the blood vessels.

Damage and inflammation of the vessels located under the skin is often provoked by the presence of so-called erythema nodosum. The origin of the disease may be different. Most often, it is believed that the main provocateur of the pathological process is the body’s increased sensitivity to various pathogens and irritants. Early diagnosis is the key to successful treatment.

Causes and mechanisms of development of erythema nodosum

The body's immune response

With regard to the mechanisms of disease development, most authors give primary importance to the hypothesis of an immediate or delayed immune reaction of the body in response to exposure to bacterial, viral or other provoking antigens.

The fairly frequent development of the disease after taking certain medications and the similarity of skin elements in erythema nodosum to rashes in allergic diseases confirms the assumption of the allergic nature of this pathology.

The skin is an area that quickly responds to the influence of a provoking agent. Under its influence, immune complexes are produced, which, circulating in the blood, settle and accumulate on the walls and around the walls of small vessels (venules) located in the connective tissue partitions of the subcutaneous tissue.

Causes

Skin problems develop:

Due to focal infections - cholecystitis, tonsillitis, dental granuloma, gastroduodenitis;
Due to candidiasis;
Due to mycosis of the foot;
Due to endocrine disorders;
Due to immune disorders;
Due to intolerance to certain medications;
Due to various neoplasms - acute leukemia, lymphoma, adenocarcinoma.

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.

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.

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).

The causes of ring-shaped erythema can be the following malfunctions of the body and pathology:

autoimmune disorders;
malignant and benign neoplasms;
intoxication;
Lyme disease developed as a result of a tick bite;
rheumatism;
helminthic infestations;
allergy;
tuberculosis;
disturbances in the functioning of the endocrine system;
focal infection;
fungus;
heredity;
violation of the protein ratio in the body;
mycosis of the skin;
disruptions in the functioning of the immune system;
disruptions in the functioning of the digestive system.

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 lupus erythematosus or leukemia. 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;
mycoses of the feet;
chronic cholecystitis ;
viral infections;
candidiasis;
dysproteinemia;
endocrine pathologies;
chronic sinusitis;
focal infections;
decreased general and local immunity;
rheumatism;
osteomyelitis;
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.

The ring erythema shown in the photo is not an independent phenomenon. It is a sign of some existing disorders in the body. For example, immunodeficiency, the presence of malignant tumors, tuberculosis, and gastrointestinal diseases can cause erythema to appear.

The photo shows erythema infectiosum, which can be caused by sinusitis or osteomyelitis. Also among the reasons are hormonal dysfunctions, rheumatic diseases, allergies.

This is also possible. If during the diagnosis it is not possible to establish the cause of the erythema, as in the photo, it is customary to talk about idiopathic annular erythema of Daria.

Separately, centrifugal erythema of Darier stands out - an idiopathic form of the disease, the cause of which cannot be identified through laboratory tests.

The skin is tightly connected to all organs of the body, so it often reacts to any changes that occur in the human body. The causes of annular erythema lie in the disruption of one of the systems; the pathology is not an independent disease. Below are some possible triggers for the disease:

tuberculosis;
malignant tumors;
intoxications of various types;
fungal infections;
allergic reactions;
defects of the immune system, usually of the lymphocytic level;
chronic local foci of infection;
autoimmune, rheumatic diseases;
disorders of the gastrointestinal tract;
helminthic infestations, tissue and intestinal forms (trichinosis, ascariasis, strongyloidiasis);
Lyme disease (transmitted through a tick bite);
hormonal disorders.

Ring-shaped erythema in children

Unlike adults, children exhibit pathology with a more pronounced clinical picture. Ring-shaped erythema in children looks like semi-closed or completely closed circles of red or purple color with a pink-blue tint.

The lesions can intertwine with each other and form lace patterns on the skin. The inside of the ring has a characteristic pale tint.

Ring-shaped erythema is observed in children, usually suffering from heart disease and rheumatism.

The disease can appear in a child quickly and disappear just as quickly. Treatment is aimed at combating chronic foci of infection. The pediatrician prescribes sulfonamides, complex vitamins, and antibacterial agents. The course of treatment may include homeopathic medicines:

Sepia 6 – you need to drink 1 granule in the evening;
Barium muriaticum 6 – between breakfast and lunch 3 granules per day.

Erythema annulare affects both men and women. If you study the statistics, the male gender is more susceptible to the disease.

To date, the exact causes of the appearance of ring-shaped erythema have not been identified. Most doctors consider this skin disease as a reactive process associated with intolerance to certain medications, fungal and bacterial infections that occur in a chronic form.

Sometimes a ring-shaped form of erythema appears in patients suffering from leukemia and lupus erythematosus. A connection between the disease and helmitosis cannot be ruled out.

So, ring-shaped erythema can be provoked by the following factors:

intoxication of the body;
focal (focal) infections. For example, tonsillitis, dental granuloma, cholecystitis, etc.;
mycoses of the skin;
endocrine system disorders;
disorders of the immune system;
dysproteinemia – disturbances in the quantitative ratio of blood proteins;
drug intolerance;
the appearance of malignant neoplasms.

An outbreak of annular erythema can be triggered by pathological conditions, external and internal factors:

acute poisoning with toxic substances;
hereditary predisposition;
viral or bacterial infection;
infectious processes localized at the site of the rash (inflammation and purulent bone lesions, tonsillitis, granulomas);
acute and protracted forms of sinusitis;
chronic inflammation of the gallbladder;
purulent-inflammatory processes in bone tissue and bone marrow;
fungal infection of the genitals, feet, mucous membranes of the mouth and nose;
rheumatoid diseases;
dysfunction of the thyroid gland and endocrine system;
gastrointestinal pathologies;
suppressed immunity;
benign and malignant tumors;
blood diseases;
heart attack;
collagenosis

In most cases, the appearance of ring-shaped erythema is recorded as a result of:

Diseases of the gastrointestinal tract;
Chronic tonsillitis;
Chronic sinusitis;
Chronic adnexitis;
Malfunctions of the immune system;
Dysprotenemia;
Chronic cholecystitis;
Osteomyelitis;
Candidiasis;
Mycosis of the feet;
Endocrine disorders;
Tooth granulomas;
Drug intolerance;
Lymphomas;
Acute leukemia.

The disease may be hereditary. Ring-shaped erythema in children is usually a reflection of an active rheumatic process in the body.

The appearance of ring-shaped erythema is promoted by:

intoxication of the body;
focal infections (tonsillitis, osteomyelitis, cholecystitis, gastroduodenitis, dental granuloma);
candidiasis;
mycosis of the foot;
endocrine disorders;
immune disorders;
dysproteinemia;
drug intolerance;
neoplasms (adenocarcinomas, lymphomas, acute leukemia).

According to research by modern scientists, erythema nodosum is one of the variations of allergic vasculitis.

The most common cause of erythema is an infection in the body, namely streptococcus.

Red nodules form in the following diseases:

erysipelas;
sore throat and otitis media;
acute pharyngitis;
streptoderma;
rheumatoid arthritis;
cystitis.

Damage to the vascular wall develops in the following conditions:

sarcoidosis;
during pregnancy;
with the development of various oncopathologies.

patients with vascular pathologies - varicose veins, the formation of atherosclerotic plaques in the vessels;
people prone to allergic reactions - hay fever, bronchial asthma, atopic dermatitis;
the presence of inflammatory processes in the gastrointestinal tract - Crohn's disease, colitis;
the presence of chronic infections - sinusitis, tonsillitis, pyelonephritis.

The use of certain medications can also lead to the development of this pathology. Such means include:

antibacterial drugs;
sulfonamides;
oral contraceptives.

For a long time they tried to detect the deep roots of erythema nodosum, but without success.

To be fair, it should be said that even today the cause of the disease is not yet fully understood.

We have only considered some of the factors that provoke the appearance of erythema nodosum.

Pregnant women and women taking contraceptive and hormonal medications are at risk.

European and American doctors have discovered a connection between erythema nodosum and:

yersiniosis;
histoplasmosis;
sarcoidosis;
tuberculosis;
streptococcal infection.

It is difficult to dispute the fact that erythema nodosum is a response to taking contraceptive medications.

Doctors have proven that erythema nodosum occurs most often in women susceptible to vascular diseases of the lower extremities:

thrombophlebitis;
varicose veins.

You can pay attention to a similar incidence among pregnant women.

A blood test shows an increased sedimentation rate of red blood cells - erythrocytes.

Typically, doctors examine for erythema nodosum:

gastrointestinal diseases;
lupus erythematosus;
tuberculosis.

Cultures from the uterine pharynx are required to detect streptococcus.

Sometimes, erythema nodosum is an independent disease.

In this case, searching for the cause of the disease becomes meaningless and even impossible.

Depending on the form of diagnosis, the manifestations of the disease are distinguished.

Acute erythema most often affects girls who are sensitive to the tuberculosis test.

The acute phase of erythema is manifested by red spots, and only then, the color of pigment spots may change depending on the shape and stage of attenuation.

Sick people experience:

chills;
joint pain;
in the shoulder area;
hips;

The development of the disease is based on infections, primarily streptococcal: scarlet fever, tonsillitis, streptoderma, acute pharyngitis, otitis media, erysipelas, cystitis, arthritis, etc.

, – and tuberculosis. Less commonly, the root cause is coccidioidomycosis, yersiniosis, inguinal lymphogranulomatosis, trichophytosis.

In addition, drug sensitization may be a cause.

The development of inflammation of blood vessels and subcutaneous fat is most often promoted by various infectious processes in the body. Unpleasant symptoms can develop as a result of diseases:

angina;
cystitis;
otitis media;
streptoderma;
tuberculosis;
rheumatoid arthritis;
scarlet fever, etc.

Skin nodules can develop as a side effect of drug therapy. Erythema nodosum often appears after vaccination or taking antibiotics.

People suffering from cancer pathologies also have to deal with inflammation of the vascular walls. People with lymphoma are most susceptible to erythema nodosum.

People with blood and vascular diseases (varicose veins, vascular atherosclerosis) are predisposed to the chronic course of the inflammatory process. Allergy sufferers, as well as women during pregnancy, are at risk.

In medical practice, there are familial cases of erythema nodosum. Hereditary predisposition to the development of the pathological process is of great importance. If parents suffer from the disease, there is a risk of developing inflammation in the child.

Prevalence

Erythema nodosum occurs in 5-45% of the population, especially often in young people. As a result of epidemiological studies, it has been established that in different regions the incidence rate differs significantly and largely depends on the predominance of a particular pathology characteristic of a particular area.

However, complete statistics on the prevalence of this disease are insufficient. It is only known that in the UK, 2-4 cases are registered per 1000 population every year.

The name of the disease was proposed at the end of the 18th century. , and its clinical symptoms were described in detail in the second half of the 19th century.

In subsequent years, some features of the clinical manifestations of erythema nodosum in many infectious processes with a chronic course were also described, various treatment regimens were proposed, but the specific etiological factor has not yet been established, and the frequency of chronic forms remains quite high.

There are no differences in the incidence of the disease between urban and rural populations, as well as between genders in adolescence. However, after puberty, girls and women are affected 3-6 times more often than boys and men.

It is generally accepted that pathology develops mainly against the background of other diseases, of which sarcoidosis is the most common. Although people of any age are at risk of developing erythema nodosum, young people 20-30 years of age are more often affected.

This is due to the fact that the maximum incidence of sarcoidosis occurs precisely in this age period. Often, after an X-ray examination of the chest organs, sarcoidosis was discovered in patients who presented with a clinical picture of erythema nodosum.

Often this pathology manifests itself during pregnancy. During pregnancy, the female body is weakened and loses its ability to resist negative influences.

There are many cases where the disease is a syndrome of the immune inflammatory process, but genetic disposition also plays an important role.

Infectious:

Trichophytosis;
Inguinal lymphogranulomatosis;
Cat scratch disease;
Leprosy;
Blastomycosis;
Histoplasmosis;
Coccidioidomycosis;
Yersiniosis;
Psittacosis.

1Clinical picture

Darier's erythema is a large number of pinkish (with yellowish) or red spots. The spots resemble coins, do not peel, and when touched there is slight swelling.

The spots can grow very quickly and even merge into large formations. Darier's erythema can form various shapes: rings, garlands, specific polycyclic formations, round spots with “rollers” inside. With large-sized formations, rings may appear not only at the base of the spot, but also inside.

Types of disease

Erythema migrans

Rheumatic erythema accompanies the disease rheumatism. With it, pale pink spots appear, they are almost invisible. Most often, rheumatic annular erythema is characteristic of childhood or adolescence.
Erythema migrans refers to a chronic inflammatory disease, somewhat reminiscent of dermatosis. The migratory species is caused by a viral or bacterial infection.
Erythema centrifugum is still being researched. When the disease occurs, a large number of ring-shaped erythemas appear on the skin, they rise above the skin.

Depending on the symptoms, the following types of annular erythema can be distinguished:

Scaly erythema, with peeling of the edges of spots on the skin.
Vesicular erythema. When the disease occurs, vesicles (fluid-filled elevations above the skin) suddenly appear along the edges of erythema spots.
Garland-shaped erythema is characterized by the fact that the spots exist for a short time.
Microgarland-shaped erythema is characterized by small spots.

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.

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.

Among the varieties of this phenomenon, it is important to distinguish nodular, multiforme, infectious, exudative or polymorphic erythema. The photo shows only one of the possible types.

Erythema migrans is infectious in nature and appears as a result of a tick bite. It is characterized by a rapid degree of spread, has no specific foci, and is capable of migrating throughout the body.

The incubation period lasts 32 days and includes 3 stages:

Early stage. It involves the appearance of a pinkish or bright red spot with a papule inside. The spot has a convex shape and is hot to the touch. Its borders expand instantly. Upon reaching 5 cm in diameter, the spot becomes ring-shaped. Along with this, the patient feels itching and burning. Sometimes the disease is accompanied by signs of anicteric hepatitis or the presence of inflammatory processes in the brain.
The duration of stain preservation is 3-30 days. Subsequently, it evaporates, leaving pigmentation behind. If treatment is ignored, erythema migrans moves into the second stage.
Disseminated stage. It is characterized by inflammation of the lymph nodes, multiple rashes and the appearance of secondary ring-shaped formations. Sometimes benign skin formations appear. In parallel with these symptoms, there is an increase in body temperature, headache, weakness and lack of sleep. The duration of the stage can vary from six months to a year. In the absence of proper treatment, the disease enters the third stage.
Late. This migratory erythema is characterized by the development of Lyme arthritis, which results in damage to the nerve endings of the musculoskeletal system, swelling, and limitation of motor functions. Migrating spots acquire a purple color, thinning of the skin occurs, resulting in translucent blood vessels. The stage can last for years and, as a rule, ends badly for the patient’s health.

This disease has several types and different clinical manifestations. The following types of ring-shaped erythema are distinguished:

Centrifugal - a characteristic feature is a large number of erythemas in the form of a roller, which rise above the skin. Over time, the shape of the lesion changes and it grows.
Erythema migrans is a chronic form of pathology, the signs of the inflammatory process are similar to dermatosis. The disease becomes a consequence of bacterial or viral infections.
Rheumatic - becomes a direct sign of the presence of rheumatism. A characteristic manifestation is pale pink, barely visible spots. Occurs in children and adolescence.

The cause of the disease lies in Borrelia, which is transmitted by the ixodid tick. Penetrating into the surface layer of the epidermis, the layers of the skin are damaged and become infected.

Due to a violation of the circulatory system, swelling appears at the site of the bite, which causes the spot to rise above the surface of the skin. The formation of erythema begins from the center.

Subsequently, it increases, and the spot acquires an edging characteristic of annular erythema. In order to early diagnose erythema migrans, it is necessary to be familiar with its symptoms, which are as follows.

The classification divides ring-shaped erythema into 3 types.

Like any other disease, erythema has its own classification. Depending on the etiological factor of dermatosis, the following are distinguished:

Migratory - a consequence of fungal, bacterial and viral infections.
Rheumatic annular erythema. Adolescents and children are mainly affected. It is a consequence of rheumatism.
Centrifugal erythema of Darier includes dermatoses of unknown etiology.

This classification in practical medicine does not quite correctly reflect the necessary division of types of disease. Therefore, several clinical forms have been identified:

The simple form is the most favorable. Round pink spots with a red rim appear and regress within a few hours or days.
Scaly ring-shaped erythema is accompanied by profuse desquamation. It goes away without a trace, because the deep layers of the skin are not damaged.
Vesicular: in addition to the characteristic spots, there are vesicles (superficial bubbles of small diameter filled with liquid).
Persistent microgarland-shaped - the most severe form.

The rash can develop in adults as an independent disease. In this case, the pathology is primary.

If vascular inflammation occurs against the background of another pathological process in the body, we are talking about secondary erythema nodosum. The disease can develop on the arms or legs.

Most often, unpleasant symptoms appear on the lower extremities.

Depending on the causes of the disease, the following types are distinguished:

Erythema infectiosum. The disease develops against the background of various infections in patients of any age.
Exudative erythema multiforme. The disease develops against the background of a cold and may be accompanied by pain in the throat and joints. Nodes form not only on the extremities, but also on the mucous membrane of the mouth and in the genital area.
Ring-shaped erythema. The disease is classified as chronic. The pathology can develop against the background of allergic reactions or a long-term infectious disease. Rounded nodules eventually merge into rings.
Erythema migrans. Pathology manifests itself as a result of a tick bite.

Toxic erythema is a disease that develops in a child in the first days of life. Small red lumps appear on the baby's body. After a few days, the rash goes away on its own. No special treatment is required.

The disease can manifest itself in acute form. But more often we have to deal with secondary chronic inflammation. To completely remove unpleasant symptoms, it is necessary to cure the underlying disease.

There are several types of erythema nodosum, the treatment of which is slightly different. From photographs of patients with various inflammatory formations, it is difficult for a non-specialist to determine what is the difference between one type of pathology and another.

Erythema nodosum comes in two forms:

acute erythema nodosum;
chronic erythema nodosum.

Acute erythema nodosum appears against the background of fever and malaise. It is expressed in the form of rapidly developing, multiple, very large dermohypodermal nodes of oval outline, hemispherical in shape, slightly raised above the surrounding skin and painful on palpation. These nodes are localized on the front surface of the legs, knee and ankle joints.

Chronic erythema nodosum, in turn, is divided into several subtypes, namely:

migrating erythema nodosum, which is characterized by a predominance of dense nodes with “blurred” boundaries, bluish-red or brownish-red in color;
superficial infiltrative erythema nodosum, which is characterized by large sizes, and the rashes themselves are formed accompanied by fever, pain, swelling of the joints and increased ESR.

Erythema nodosum can be an independent disease, or a symptom of another disease, or a sign of excessive sensitivity of the patient to a particular drug.

In children, erythema nodosum may appear after a cold or sore throat (especially streptococcal).

Signs and symptoms

The main indicator of the manifestation of the disease is noticeable rashes. Erythema is distributed on the patient's skin in rings that protrude significantly above its level.

Along the edges of the rash, the border has a rich red tint and forms chains; they can also form in the form of a semicircle. The spots are up to 9 centimeters long, which sometimes flake and are accompanied in some cases by itching.

The constant places where spots are concentrated are the face, shoulders, neck, stomach, and chest area. Sometimes rings appear on the buttocks and limbs. The disease progresses rapidly. At this time, the spots can increase to 23 centimeters in diameter within a few hours.

The pattern of rashes can be compared to weaving. The patient's temperature rises, general malaise, dizziness, drowsiness are felt, and swelling appears on the body.

Erythema is redness and swelling of the skin associated with dilation of the blood vessels of the dermis and stagnation of blood in them. It occurs as a reaction to the bites of blood-sucking insects, autoimmune processes, and helminthic infestations. Ring-shaped erythema gets its name due to its characteristic appearance: a red ring with raised edges limits an area of unchanged skin. Depending on the cause, the disease occurs in acute or chronic, recurrent forms.

What causes the disease?

The skin is closely connected with all organ systems, therefore it is sensitive to changes occurring in the body. The appearance of red spots in the form of rings on it is not an independent disease, but a signal of a disorder, the cause of which remains to be determined. Causes of erythema annulare include:

defect of the immune system, in particular the lymphocyte link;
malignant tumors;
intoxication of various origins;
Lyme disease (borreliosis, transmitted through a tick bite);
rheumatic and other autoimmune diseases;
helminthic infestations, intestinal and tissue forms (strongyloidiasis, ascariasis, trichinosis);
allergic reactions;
chronic local foci of infection (sinusitis, osteomyelitis);
tuberculosis;
hormonal disorders;
fungal infections;
disruption of the digestive tract.

Idiopathic annular erythema of Darier is often encountered - in this case, even a thorough examination does not reveal the possible cause of the disease.

How does it arise?

The appearance of erythema is associated with a pathological vascular reaction: the capillaries located in the skin expand, the blood flow in them slows down, and the fluid pressure in their lumen increases. As a result, part of the plasma escapes into the tissue, which leads to local edema - this is how raised edges or a platform appear in the annular erythema. Following the liquid, T-lymphocytes emerge - cells of the immune system responsible for recognizing foreign agents and destroying the body’s own infected cells and tumor cells. Their role in the occurrence of erythema is not completely clear, but they indicate a close connection of the disease with the functioning of the immune system.

Erythema annular centrifugal is capable of peripheral growth. In the center of the ring, the pathological process subsides, so the skin acquires its usual color and thickness, and along the periphery a shaft of dilated capillaries, T-lymphocytes and cellular edema remains. The ring grows in size from the center to the edges - this growth is called centrifugal.

How does it manifest?

Initially, nummular erythema appears on the skin - a rounded red spot, slightly raised above its surface, similar to a coin. When pressed, the erythema turns pale or disappears completely. A center of clearing gradually forms in the center, the skin becomes pink, then acquires a normal or paler color. Sometimes, in the center of nummular erythema, several round-shaped foci of clearing are simultaneously formed; in this case, several rings form.

In some cases, peeling or blisters appear on the surface of the changed skin. The boundaries of the formation remain red or pink and gradually “spread” wider and wider, which leads to an increase in the diameter of the ring. The edge of the ring can be flush with the skin or slightly raised above it.

Ring-shaped erythemas of varying degrees of maturity can be located in the same location; the rings often merge with each other. Thus, fancy arched contours and wavy edges of the spots are formed. Skin changes are occasionally accompanied by itching and soreness, which depends on the underlying cause of the disease. Symptoms of annular erythema occur against the background of other signs of the disease:

The infectious nature of erythema is indicated by signs of intoxication - fever, weakness, aching muscles and joints, and lack of appetite. Migratory annular erythema most often occurs when infected with Borrelia as a result of a tick bite (Lyme disease, Lyme borreliosis). In the center of the redness, the primary affect is visible - the site of the tick bite in the form of a rounded hemorrhagic crust or erosion. Often characteristic target-shaped erythema is formed when a smaller ring is located inside a larger one in diameter.
With rheumatism, damage to connective tissue structures comes to the fore - pain in joints, muscles, limited mobility, changes in skin quality, increased bleeding of blood vessels, prolonged rise in temperature above 38 degrees C°, impaired cardiac activity. As a rule, the borders of the rings in this case are pale pink and indistinct; their localization can be anywhere.
Allergic erythema is usually bright, the swelling is well expressed, and can be combined with a rash like urticaria on other parts of the body, with Quincke's edema, conjunctivitis, and rhinitis. It is also characterized by skin itching of varying intensity.
A malignant neoplasm is indicated by prolonged weakness, weight loss, bursting pain in the long tubular bones of the extremities, enlarged lymph nodes, and a prolonged increase in temperature to subfebrile levels (up to 38 degrees C°).

Ring-shaped erythema in children is most often associated with rheumatic diseases, immune disorders and helminthic infestations.

The course of the disease depends on the cause and may be:

paroxysmal - changes in the skin occur suddenly and disappear without a trace within several hours or days;
acute – rings and spots gradually disappear within up to 8 weeks;
chronic – skin changes persist for a long time;
recurrent - after complete clinical cure, erythema reappears on the same or new areas of the skin.

Ring-shaped erythema in children (Lyme disease)

How to make a diagnosis?

Diagnosis of ring-shaped erythema is not difficult due to the characteristic appearance of the spots on the skin. If it is necessary to distinguish the disease from granuloma annulare, which has similar symptoms, a dermatologist takes a section of altered tissue (biopsy) for histological examination. In the laboratory, microscopic sections are prepared from the sample, stained, and a pathologist examines the resulting preparations under a microscope. Skin changes with erythema include:

expansion of capillaries of the dermis;
accumulations of lymphocytes around blood vessels;
slight swelling of cells and intercellular space of the epidermis;
moderate swelling of the dermis.

To find out the cause of annular erythema, the doctor conducts a number of additional tests, starting with the simplest ones - a general clinical analysis of blood, urine and biochemical analysis of plasma. Changes in them suggest which direction to move next. Thus, helminthic infestation is characterized by slight anemia, eosinophilia, and accelerated ESR. During allergic reactions, the protein content in the plasma increases, in particular immunoglobulin E. Malignant neoplasms manifest themselves by a decrease in hemoglobin, red blood cells in the blood, a change in the leukocyte formula, and an acceleration of ESR. The diagnosis of Lyme borreliosis is confirmed by a serological test - immunoglobulins M and G to borrelia are detected in the blood serum.

The doctor uses instrumental studies (ultrasound, CT, MRI, X-ray, ECG, ECHO-CG) if any changes were detected as a result of examination of the patient or laboratory tests.

How to cure?

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.

Video: Removing erythema using the Ellipse device

Local treatment includes

Antihistamine ointments, creams, gels (Fenistil-gel) - they eliminate swelling, redness, itching associated with the release of histamine. Effective in cases of allergic nature of the disease, since histamine plays a key role in the development of a hypersensitivity reaction.
Ointments containing zinc compounds (Skin-cap, Desitin) - their mechanism of action is not fully understood, but they effectively eliminate inflammation in the dermis and epidermis, itching, and flaking. Unlike hormonal and antihistamines, they are practically safe.
Glucocorticoid ointments, creams (Akriderm, Sinaflan) - reduce the activity and slow down the proliferation of T-lymphocytes, thereby eliminating the main cause of local changes in the skin. They can only be used as prescribed by a doctor, strictly following the instructions. Otherwise, serious adverse reactions occur in the form of skin atrophy, severe bacterial and fungal infections.

Video: How to treat granuloma annulare

Systemic drugs

Along with local therapy, systemic drugs are prescribed:

Desensitizing agents (sodium thiosulfate, calcium chloride) - remove toxins and allergens from the bloodstream, reduce the permeability of the vascular wall, stabilize the membranes of immune cells, thereby reducing the release of histamine into the tissue.
Glucocorticoids - used in the form of tablets and injections for persistent severe erythema and rheumatic diseases.
Antibiotics are necessary if the disease is infectious, for example, Lyme borreliosis is treated with penicillin or cephalosporins for at least 10 days.
Antihelminthic drugs are prescribed when worm eggs or specific immunoglobulins are detected in the stool; sometimes several repeated courses of treatment are required.
Cytostatics (Methotrexate) – inhibit the reproduction and maturation of immune cells, thereby reducing their activity and eliminating the manifestations of autoimmune diseases.

Ring-shaped erythema, as a rule, is not an independent disease, but a symptom. Therefore, the approach to its diagnosis and treatment should be comprehensive and comprehensive. It is important to consult a specialist without starting local treatment at home, since a blurred clinical picture significantly complicates the diagnostic search.

Ring-shaped erythema is a chronic infectious-toxic disease, which is characterized by the appearance of ring-shaped non-flaky elements on the skin, which may be accompanied by general malaise, fever, headache, and swelling.

The disease is more common in young men. In children, erythema annulare is rare. Its causes are usually cited as infectious diseases, body poisoning and allergic reactions.

Treatment of annular erythema is hyposensitizing, antihistamines, antibiotic and vitamin therapy.

Causes of ring-shaped erythema

At the moment, scientists have not been able to accurately establish the causes of erythema annulare. Most doctors consider this dermatological disease to be a reactive process caused by the patient’s intolerance to certain medications, chronic bacterial and fungal infections.

It has been established that the development of annular erythema can be provoked by the following factors:

Intoxication of the body;
Endocrine disorders;
Drug intolerance;
Focal infections (cholecystitis, tonsillitis, adnexitis, sinusitis, goiter granuloma and others);
Disturbances in the functioning of the immune system;
Skin mycoses;
Dysproteinemia;
Malignant neoplasms;
Helminthiasis;
Systemic lupus erythematosus.

Researchers believe that a hereditary factor also plays a certain role in the occurrence of this disease, since there are many cases of development of annular erythema in blood relatives.

Symptoms of ring-shaped erythema

Ring-shaped erythema usually manifests itself acutely with the appearance on the skin of coin-shaped red or pinkish-yellow non-flaky spots with eccentric growth in the area of the peripheral ridge with the formation of figured and ring-shaped foci of various shapes, which are localized mainly on the torso. The outer edges of the rings are colored red or red-violet. The diameter of the rings can be more than 15 cm. In some cases, vesiculation and peeling may occur.

The erythemal element in this disease is characterized by:

Ring shape;
Pale center and urticarial margins;
The tendency of the element to grow peripherally;
Flat and smooth surface of the center of the element;
Combining individual rings to form garlands, arcs, scalloped elements;
Localization on the back, torso, abdomen, limbs. Somewhat less commonly, ring-shaped erythema affects the skin of the face, neck, and buttocks;
The period of existence of elements of annular erythema is 2-3 weeks. Then they regress with the formation of pigmentation on the skin, but soon new ones appear, which can merge with fragments of resolving skin elements, forming polycyclic figures.

Sometimes patients with erythema annulare may experience general malaise, fever, headaches, and swelling may occur.

There are several forms of ring-shaped erythema.

Flaky - characterized by the presence of peeling of the skin along the edge of the focus of the erythema element;
Vesicular - characterized by the appearance and rapid disappearance of superficial cavities that rise above the skin and are filled with fluid (vesicles);
Simple garland-shaped - characterized by a short period of existence of the elements (from several hours to several days);
Persistent microgarland-shaped - characterized by the small size of erythemal elements (up to 1 cm in diameter).

The disease usually develops in adulthood and has a chronic course (up to 2-3 months or longer)

But ring-shaped erythema can also occur in children (usually of an unclassified form). Ring-shaped erythema in children is characterized by the appearance of round, pink, bluish or purple spots that tend to merge to form a peculiar pattern on the skin.

Diagnosis of ring-shaped erythema

Since the symptoms of this disease are similar to other dermatological diseases, it may be difficult to make a correct diagnosis.

Therefore, patients with suspected erythema annulare are prescribed the following:

Serological tests (to exclude syphilis).
Histopathological examination of the dermis.

Ring-shaped erythema should be differentiated from such skin diseases as:

Dühring's dermatitis;
Seborrheic eczema;
Granuloma annulare;
Pink lichen of Zhiber;
Chronic urticaria;
Exudative erythema multiforme;
Sarcoidosis;
Tertiary syphilitic roseola.

After the diagnosis is made, the patient must undergo a comprehensive examination to identify the disease that could trigger the development of erythema annulare.

Treatment of ring-shaped erythema

The goal of treating erythema annulare is primarily to eliminate the cause that caused the development of this dermatological disease. To do this, they sanitize foci of infection and normalize the functioning of the endocrine system and gastrointestinal tract.

To relieve the symptoms of annular erythema, patients are prescribed antihistamines, calcium and sodium thiosulfate.

In some cases, it becomes necessary to prescribe antibiotics with a broad spectrum of action (doxycycline, penicillins, erythromycin, fluoroquinolones, azithromycin).

Vitamin therapy is of great importance in the treatment of annular erythema. As a rule, patients are prescribed vitamins A, B and E.

In cases of severe disease, corticosteroids are used.

Disinfectants and antiseptics are used as external means of treating ring-shaped erythema. Local treatment of erythema lesions consists of:

Treating the affected skin with aerosols containing polcortolone, sodium thiosulfate solutions;
Applying wet compresses with amidopyrine solution;
The use of ointments that accelerate epithelization, antihistamine gels, and corticosteroid-based creams.

When treating ring-shaped erythema in children, homeopathic remedies are used. But, as a rule, in childhood this type of erythema goes away spontaneously after the removal of foci of the underlying disease.

In the presence of ring-shaped erythema, patients are also recommended to adhere to a hypoallergenic diet, eliminating from their diet foods that can lead to allergic reactions.

Patients with this type of erythema should be registered with a dermatologist and regularly undergo appropriate examinations.

Thus, annular erythema is a serious disease that indicates the presence of foci of infection in the body, an allergic reaction or poisoning of the body. Therefore, in order to prevent its development, it is necessary to promptly treat fungal and infectious diseases, monitor the functioning of the digestive tract and lead a healthy lifestyle.

Erythema annulare is a type of skin disease in which ring-shaped spots form on the body. In childhood, it most often manifests itself in the torso or limbs. In medicine, another name is used - annular centrifugal erythema of Darier. As a rule, the illness is short-term. However, with weakened immunity or emotional stress, it lasts a long time. According to statistics, girls are more susceptible to pathology than boys.

Causes

Scientists often associate the causes of erythema annulare with genetic predisposition. In addition, people with the following problems are susceptible to the disease:

allergic reactions;
autoimmune pathologies;
malignant tumors;
poisoning of the body;
Lyme disease (develops due to a tick bite);
rheumatism;
helminthiasis;
pulmonary tuberculosis;
endocrine diseases;
fungus, cutaneous mycosis;
weakened immune system;
disruptions in the gastrointestinal tract.

Scientists have not yet reached a consensus on the factors contributing to the development of ring erythema. Often, patients do not have clearly defined reasons for its appearance.

Symptoms

Ring-shaped erythema in children is expressed by the appearance of a red ring on the skin, the center of which is a different color. The appearance of erythema occurs with swelling of the skin, which occurs due to the expansion of capillaries. The pathology is prone to progression. Therefore, the lesion may increase in size and the ring becomes larger.

At the initial stage of the disease, a small pink or red spot forms on the child’s skin. When pressed, it becomes paler or completely blends in with the rest of the skin. Then the middle of the spot begins to lighten, and it turns into a ring with a bright red edging. The element can be transformed into one ring or several.

The skin at the site of erythema may become dry and begin to peel. In some cases, the formation of bubble eruptions along the border is noted. In the photo you can see the nature of the rash.

In addition to the main symptom, there are other signs of the development of pathology:

burning;
elevated temperature;
muscle weakness;
headache;
loss of appetite.

There are the following types of disease:

Diagnostics

At the first symptoms, you should contact a medical facility. A dermatologist or venereologist can diagnose the disease.

As a rule, erythema in children is easily determined by its appearance. In addition to detecting the disease, the specialist finds out the reasons that could provoke its appearance.

To diagnose erythema, the doctor takes particles of the formation and sends them for histological examination..

The standard diagnostic procedure includes the following studies:

serological;
histopathological;
mycological;
examination for the presence of malignant neoplasms;
hematological;
biochemical analysis of blood and urine.

After making a reliable diagnosis, the doctor prescribes adequate treatment. In most cases, therapy takes place on an outpatient basis.

Treatment

Erythema annulare is a complex disease; removing symptoms alone is not enough. To effectively get rid of a disease, it is necessary to establish the cause of its occurrence and eliminate it.

The doctor prescribes a set of therapeutic methods.

If erythema is accompanied by itching and swelling, treatment with antihistamines is necessary to cope with unpleasant symptoms (Fenistil, Trental). A budget-friendly way to get rid of flaking and itching, and relieve inflammatory processes is Zinc ointment.
Glucocorticoid hormonal creams can stop pathological changes in the skin. They act by reducing the division of T-lymphocytes (Akriderm, Sinaflan). The use of these drugs is allowed only as prescribed by a doctor, as there are side effects.
Treatment is supplemented with drugs that stimulate the child’s immune system (Amiksin). To increase the protective function, various vitamin complexes are prescribed.
Means for improving blood circulation in tissues (Curantil). They can increase the rate of regeneration of epidermal cells and help the skin quickly restore its original appearance.

In addition, the following systemic drugs are often included in the complex of local therapy:

Desensitizing agents. They are able to remove allergens and toxins from the patient’s body, reducing the permeability of vascular walls and normalizing immune cells, which helps reduce the release of histamine (Diphenhydramine, Suprastin).
Antibiotics. Used in case of infection that provoked annular erythema (Azithromycin, Doxycycline).
Antihelminthic drugs. Prescribed when tests detect worm eggs or immunoglobulins (Pirantel, Wormox).
Cytostatics. Capable of inhibiting immune cells to reduce their activity. Prescribed for suspected autoimmune diseases (Rosevin).

Since annular erythema is most often not a separate disease, but appears against the background of the underlying disease, the treatment program is developed not only by a dermatologist, but also by other specialists. When the underlying cause is eliminated, the erythema can go away on its own.

Forecast

Erythema is a skin reaction, a signal that a malfunction has occurred in the human body. To eliminate this manifestation, complex treatment is necessary. With timely access to specialists and adequate therapy, the disease can be cured successfully. Symptoms disappear completely within a few weeks of starting treatment.

If the cause of the pathology has not been identified, the erythema goes away on its own. However, there is a high risk of its re-formation. If this happens, the patient is recommended to undergo a detailed examination of the body for the presence of a hidden infection and its treatment.

To prevent ring-shaped erythema from occurring in a child, the following preventive measures are necessary:

timely detection and treatment of various diseases;
compliance with personal hygiene rules;
absence of bad habits;
balanced diet.

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.