Interstitial granulomatous dermatitis - causes, symptoms, treatment
- 13 Jul 05:45
- Disease Of The Skin
Interstitial granulomatous dermatitis is a rare inflammatory disease of the skin. For this dermatitis the reactions of tissues of granulomatous type are characteristic, while the formation of the immune complexes in the blood and necrobiosis of collagen is noted.
In this case,, if there are symptoms of arthritis in addition to skin manifestations of granulomatous dermatitis, the disease is called Ackerman's syndrome.
- 1 Causes of development
- 2 Clinical picture of
- 3 Methods of diagnosis
- 4 Treatment of
- 4.1 Recommendations to
- patients 5 Forecast and prevention of
- 6 Photo
Causes of development of
Precise reasons for the development of interstitial dermatitis could not be identified. The disease is among idiopathic, that is, caused by obscure reasons.
However, recent studies have revealed the link between granulomatous dermatitis and diseases caused by autoimmune or lymphoproliferative causes. Sometimes the development of dermatitis provokes the introduction of some medications.
Sometimes interstitial granulomatous dermatitis is associated with vasculitis, red system lupus, rheumatoid arthritis. Cases of connection of granulomatous dermatitis with autoimmune thyroiditis - a violation of thyroid function, which is often developed in elderly women.
Thus, despite the fact that interstitial granulomatous dermatitis continues to be considered an idiopathic condition, more and more researchers believe that this dermatitis is a secondary disease caused by various autoimmune disorders. In addition to rheumatoid arthritis and red lupus erythematosus, the development of interstitial dermatitis may cause Charga-Strauss syndrome, which is still called allergic granulomatosis.
Sometimes interstitial dermatitis is one of the first symptoms of lymphoproliferative diseases( tumor tissue of the lymphatic system) - chronic lymphatic leukemia, lymphocytes, lymphosarcoma, lymphoma, lymphogranuloma, and others.
There have been cases of granulomatous dermatitis development, as the corresponding reaction of the organism to the use of certain medicinal products. This reaction is especially frequent when intravenous drugs are administered.
Clinical picture of
Interstitial granulomatous dermatitis refers to diseases characterized by polymorphism of symptoms. Skin manifestations can be presented as nodules, plaques or papules. The rashes can be located on any areas of the skin, certain areas of localization of the rash are not marked.
In most patients, the appearance of rashes with interstitial dermatitis is not anxiety. When rash is located, for example, on the back, the patient may for a long time not notice the manifestations of the disease.
However, some patients notice the appearance of itching in the area of the location of the rash elements. In this case, the skin may have noticeable linear damage to the scratches.
Elements of rash in granulomatous dermatitis tend to have a dense consistency. The color of the skin in the area of rash can be unchanged or have a pearly-pink tinge.
Rashes with granulomatous dermatitis in 7-10 days are solved on their own. At the same time, a new rash may appear immediately or after a while.
Some patients have symptoms of arthritis with the appearance of skin rash or even earlier. Usually, joints are affected symmetrically, arthritis develops deforming and not erosive. The joints on the upper extremities are most often affected.
A variety of clinical symptoms with interstitial granulomatous dermatitis greatly complicates the diagnosis. For the diagnosis it is necessary to conduct a biopsy and histological examination. General tests with this disease do not reveal any specific changes.
Histological studies will detect the presence of diffuse infiltration, indicating inflammation that covers virtually the entire dermis. There may be pronounced subepidermal edema, the presence of granulocytes, eosinophils, basophils.
After histological confirmation of a patient's diagnosis, it is necessary to refer for additional examinations to exclude the presence of autoimmune or lymphoproliferative diseases. In addition, it will be necessary to find out whether the patient has recently undergone a long course of treatment with intravenous administration of the drug.
Because interstitial granulomatous dermatitis is rare, randomized clinical trials of this disease are lacking. That is, the generally accepted proven scheme of interstitial dermatitis does not exist.
Currently, corticosteroids are used to treat this disease. According to specialists' observations, hormonal drugs have moderate effectiveness, however, they are now the drugs of choice. Most commonly used prednisone.
In addition, for the treatment of interstitial dermatitis, antimalarial drugs and drugs that suppress the immune system( immunosuppressants) are used. Ciclosporin, Dapson, Metotrex.
The administration of immunoglobulins is possible, however, this type of treatment does not always have a therapeutic effect. Typically, this method of treatment is not a first-line therapy and is used if the above-described methods of treatment do not produce a result.
- Patients Corticosteroids can cause bone strength defects, so patients are advised to take vitamin D and calcium supplements further. This recommendation is especially important for elderly patients. When taking calcium, be careful not to develop calcinosis.
- Patients with overweight and cellulite as a consequence are advised to maintain a low calorie diet and moderate physical activity. The fact that treatment with Prednisolone promotes even more weight gain, and obesity is associated with the risk of developing diabetes and other diseases.
- In the treatment of interstitial dermatitis, corticosteroids will need to be reviewed for those patients who are of normal weight. The fact is that steroids provoke high levels of glucose in the blood. Therefore, it is worth cutting down the amount of sweets in their menu, replacing them with fruits and vegetables. It is advisable to regularly monitor the level of glucose, for this it is worth to buy a glucose meter.
- Patients undergoing treatment for interstitial dermatitis and psoriasis are advised to stop smoking. The fact is that this bad habit not only exacerbates health, but also increases the side effects of used medications.
- Patients are advised to carefully follow all the recommendations of the physician for the treatment of dermatitis. Regular reviews will reduce the risk of side effects from taking medication.
Forecast and prevention of
The prediction of interstitial granulomatous dermatitis is uncertain, since it depends on the course of the underlying disease. Some patients have spontaneous cure from interstitial dermatitis, in other diseases it occurs over the years, with alternating periods of remission of varying duration and exacerbations.
Prevention of interstitial dermatitis is not developed.