Sarcoidosis of the skin: causes, symptoms and treatment

Sarcoidosis until recently was considered a rare disease. But nowadays, with the availability of the newest diagnostic methods, it has been diagnosed more often. For the first time this illness was described more than a century ago. Then he was considered one of the forms of tuberculosis. However, later this claim was denied by official medicine.

Definition

Sarcoidosis is a systemic disease. It leads to damage to organic systems and tissues. The most common cases are the occurrence of sarcoidosis of the lungs and skin. Otherwise, this ailment is called the Behnier-Beck-Shauman disease (in honor of those doctors who worked on studying this pathology). Sarcoidosis has an inflammatory character. Refers to the group of granulomotoses. In the process of development of pathology, inflammatory cells accumulate, which are called granulomas.

Sarcoidosis became the object of attention of therapists, pulmonologists and general practitioners. The study of the causes of the disease, its diagnosis and treatment is relevant among physicians. Sarcoidosis can now be detected not only on the basis of the results of fluorography studies, but also on skin signs.

Spread of the disease

Most often, sarcoidosis of the skin, the symptoms of which will be discussed below, is diagnosed in middle-aged people. More often the pathology is found in women. This disease is extremely rare in children. The most important symptom of the disease is the appearance of granulomas. They are nodules, located in the form of limited foci. Can vary in size and shape. The disease does not belong to infectious diseases. Often, sarcoidosis occurs without any symptoms and is detected only when the patient's medical examination.

Etymology of the disease

The exact causes of this ailment remain unknown. But most doctors believe that the development of this pathology is affected by a variety of causes, including immunological, environmental and genetic factors. According to the available theory, pathogenic fungi, bacteria, parasites, pollen of plants and toxic substances also influence. Officially, this ailment is non-infectious. However, it is impossible to completely exclude the possibility of the influence of microbial agents in the development of a disease such as sarcoidosis of the skin.

The reasons for its occurrence are unknown until now. There are two theories about this. According to the first, sarcoidosis is inherited. Fans of the second opinion argue that the emergence of ailment is associated with the individual immune response of the body to hormonal changes. The main cause is considered hereditary features of immunity, that is, its specific reaction to these or other effects. As a rule, for the emergence of ailment there are several reasons. It should be noted that every third or sixth patient has a lesion of the skin of sarcoidosis.

The main types of sarcoidosis

As already mentioned, in the first place for the disease are characterized by rashes on the skin. These are certain pathological changes that are expressed in the formation of red nodules, spots and plaques. With this disease, there is a so-called erythema nodosum. The most common is small-node sarcoidosis. It is characterized by the appearance of a large number of small red spots that transform over time into nodules of dense consistency. Large-node sarcoidosis is expressed in the appearance of single nodules and rarely multiple. Skin lesions in this case are expressed in the presence of sufficiently large globular knots, characterized by sharp boundaries.

Other forms of the disease

There are other varieties of the disease. Physicians distinguish:

1. Diffusive-infiltrative sarcoidosis. Eruptions on the skin are formed in the form of dense plaques. They are localized on the head or face. The boundaries of the formations, which have a brown color, are thus blurred. In diameter reach 15 cm.
2. Angiolyupoid Broca-Porye. Neoplasms are observed on the nose and cheeks. As a rule, in the beginning, they are spots of red or of the color of the flowers. In their place, then appear plaques of brown hue.
3. Biliary-Tenneson's lupus erythematosus. The place of distribution is the face and ears. The lesions are red-violet and flat.
4. Sarcoid Daria-Russi. This form of the disease is characterized by large nodes located under the skin and representing infiltrates. Localization is the area of the abdomen, thighs and axillae.
5. Nodal-subcutaneous type. There are subcutaneous nodes on the legs or trunk. Formations are few, they are painless and mobile. Sarcoids can merge, forming infiltrative plaques with a bumpy surface.

In general, sarcoidosis of the skin, the treatment of which we consider in this article, is of a periodic nature. At a time when nodules disappear, in the outbreaks, the skin is different from healthy tissue. It has pigmentation and flakes. The exception is Benjet-Tenneson's lupus. In this case, the foci after the disappearance of the rashes are no different from healthy tissue. Sarcoidosis of the skin, the photo of which is presented in the article, demonstrates the large lesions of the patient's face. Next - about the symptoms.

Sarcoidosis of the skin: signs of disease

Specific symptoms of the disease: plaques, nodes, cicatricial sarcoidosis, maculo-populistic changes. Among the rare manifestations can be noted: ulcers, psoriasis-like changes, ichthyosis, alopecia, nail damage. It is noted that most of the lesions of the skin are accompanied by mild symptomatology. However, there are chronic skin lesions that lead to human disfigurement.

Sarcoidosis of the skin, photos and symptoms of which are presented in the publication, has other distinctive features. Its peculiarity is the formation of dense tubercles on the skin of the limbs, the face and in some cases the trunk. The color of the seals changes from pinkish red to cyanotic and brown. Often there is a fusion of elements, there are brown spots of small size on the skin, in some cases, the tubercles are manifested.

Sarcoidosis of the scalp may be one of the first manifestations of the disease. In this case, it is necessary to diagnose other organs and systems that can also be inflamed. The defeat of the scalp, as a rule, is combined with the presence of rashes on the skin of the forehead. In the center of the foci a decrease in the density and diameter of the hair is observed, which may become the beginning of the formation of alopecia areata.

Small-Scale and Large-Scale Sarcoidosis

Sarcoidosis is small-scale and large-scaled. In the first case, nodules are most often located on the face, in the area of the elbow joints, decollete, shoulder blades. Their size is small - about 0.5 cm. They are solid and dense, in color - a brick shade or reddish-cyanotic. Sometimes nodules can spread throughout the body. Palpation is painless. With the course of the pathological process, the skin areas in the foci are pigmented. Around the affected areas, clear pigment borders are formed.

If we consider the second variant, then there arise the appearance of separate nodes. In size, they are larger than in the previous case: they reach 2 cm. They do not differ in color from small ones. Most often appear in the face, neck, groin, sometimes - on the outside of the hands. Acne eruptions of red or white can form. Over time, the nodes often dissolve and leave behind a pigmented surface of the skin.

Medication

As a rule, patients with sarcoidosis are prescribed the following drugs: non-steroidal anti-inflammatory drugs, hormones. Complex treatment is provided. The best ways to treat cutaneous forms of this disease are glucocorticoids, methotrexate and antimalarial drugs. Hormonal ointments are rubbed into the affected area, and the drugs are applied inside. In addition to these funds, the patient is prescribed sedative medications and in some cases, antidepressants.

Changes in the skin that spoil the appearance adversely affect the overall condition. The patient in this case may become depressed, fixated on his problem. Sarcoidosis of the facial skin has a particularly negative effect on the patient's psychological state. It turns out a vicious circle: the nervous breakdown provokes the development of the disease even more, stimulating the appearance of new foci. Also except for the above-mentioned preparations, physiotherapeutic procedures are also connected: ultrasound, laser therapy and electrophoresis with hydrocortisone. Currently, the disease is not fully understood. Therefore, in some cases, treatment is difficult. Doctors prescribe surgical techniques that eliminate symptoms.

Sarcoidosis of the skin: treatment with folk remedies

Sarcoidosis can be treated with folk remedies. They contribute to the fact that the granulomas will resolve, in addition, the immunity in general will be strengthened. As a folk remedy used in this disease, often tincture of propolis. It can be purchased both in a pharmacy and done by yourself. To do this, 100 g of propolis must be insisted in a bottle of vodka for a month. Apply the following: 25-30 drops dissolve in boiled water or milk, drink once a day in the morning, on an empty stomach. Course - 28 days.

Often sarcoidosis is treated with herbs. For example, for this purpose, tincture of the radio is used . 15-20 drops of medicine must be dissolved in boiled water. Take in the morning: before breakfast and lunch. The product must be drunk in two courses, each of which is equal to 25 days. The break between them is 2 weeks. Also good results are given by herbal tea, which includes the root of the althaea, stalks of oregano and sage, marigold flowers, leaves of the bird mountaineer and plantain. Ingredients must be mixed in equal parts. Then 1 tbsp. L. Mixture pour boiling water (1.5 cups). Insist for an hour in a wrapped form. Take 2 tbsp. L. Four times a day. The course of treatment is 28 days. Break is a week. So it is necessary to repeat 4 times.

Very effective and a decoction of grape cuttings. It is necessary to boil 300 g of bunches of grapes in 1.5 liters of water. Cook for 15-20 minutes, cool and strain. Drink with honey, like tea, for 100-200 grams per day. Sedative properties have tea from eucalyptus leaves, which is also used for this disease. In the morning it is necessary to cover 50 grams of crushed leaves in a thermos bottle and pour half a liter of water. In the evening, drink 100 g of infusion with honey.

It should be noted that the broths considered in the treatment of sarcoidosis are used not only inward, but also in the form of lotions (except for eucalyptus tea). In the initial stage of the disease, it is recommended to use also onion ointment. It is prepared as follows: grated onions are mixed with sunflower oil and applied to the skin. Among other things, you can make baths with sage, chamomile, string and calendula.

Recommendations

There are a number of recommendations, compliance with which will contribute to a faster recovery. As such, preventive measures against recurrence of the disease do not exist. However, there are certain tips that will reduce the risk of sarcoidosis. Among them: the maintenance of a healthy lifestyle (rejection of nicotine), the treatment of diseases that cause weakening of immunity, the observance of a non-strict diet and a rational diet. Food should be eaten 5-6 times a day in small portions. Equally important is the ecology of the area, and it is also necessary to undergo a full medical examination in the clinic.

It is necessary to exclude dairy products from the diet, reduce the consumption of sweets and salt. But the amount of fruits and vegetables, on the contrary, increase. You should choose the fruits with the highest content of vitamin C. Avoid skin contact with aggressive substances that can cause irritation and allergy. If the patient is provided with adequate systemic treatment, the disease will quickly recede. Life expectancy does not affect this illness.

Biopsy

For the earlier recognition of sarcoidosis, the most effective method is biopsy. It is used for early diagnosis of the disease with the help of a minimally invasive procedure. In sarcoidosis, various organs and systems of the body can be affected. Simultaneously with the skin, the disease can affect the lymph nodes, liver, spleen, heart and nervous system. If a patient has sarcoidosis of the skin, he must undergo a complete examination. Because often with this disease, other organs are also affected.

Specific and nonspecific lesions

Skin lesions are divided into specific and nonspecific. Consider the first form. Foci of erythema nodosum occur without the appearance of deformities, but are characterized by soreness in palpation. May be accompanied by arthritis, fever. When the disease worsens, there is also fatigue and rashes on the skin, which last about 3-6 weeks. At the beginning of the development of the disease appear warm, painful reddish knots on the lower limbs. Bilateral formations, the size of which is from 1 to 5 cm, can change their color several times: from bright red and violet to yellow and green. Exceptions are usually not observed. The nodes mostly heal without scarring. Nonspecific manifestations include calcification of the skin and lymphodema.

Sarcoidosis of the skin, the symptoms of which are expressed by specific lesions, is usually a patchy-papular type. There are foci of red-brown or lilac color, in size reaching less than 1 cm. They spread in the face, neck, lips, ear shells, extremities and upper back. Typical granulomas show no signs of infection. Old scars, which are then damaged for some reason, can be infiltrated with sarcoid granulomas.

Examination

In a disease called sarcoidosis of the skin, the diagnosis usually involves a biopsy procedure and a general blood test with a leukocyte formula and the number of platelets. In this case, in some cases leukopenia, thrombocytopaedy, anemia, eosinophilia, decrease in skin reactivity, hypergammaglobulinemia are observed. In addition, patients are examined for calcium in daily urine and serum. Half of the patients had hypercalciuria, and 13% had hypercalcemia. The level of ACE in serum is analyzed. In more than half of cases, it is elevated in patients. There is also a biochemical blood test. It should also take into account the increase in ESR and antinuclear bodies.

With sarcoidosis, chest X-ray and computed tomography are performed, as often this disease is accompanied by their defeat. For more accurate diagnosis, a skin biopsy is performed, after which the material, including dermis and subcutaneous fat, is sent for histological examination.

Compliance with diet

For a speedy recovery, you must adhere to a certain diet, which includes products containing Omega-3 fatty acids. They stimulate the production of hormones, which are aimed at reducing inflammation. In addition to fish oil and flax seeds, you need to eat fruits, vegetables and nuts. In this case, it is necessary to exclude those products that increase the risk of inflammation. For example, vinegar and other synthetic acid forms. It is necessary to minimize the consumption of sugar, flour products, fried, salty foods, spicy sauces and condiments, sweet fizzy drinks, dairy products.

In this article we have considered a fairly rare disease - sarcoidosis of the skin, photos and symptoms of which clearly demonstrate the clinical manifestations of this ailment. Treatment is carried out mainly hormonal drugs. The prognosis in the presence of an acute form is usually favorable. Therapy is often prescribed on an outpatient basis.