Cholation or perniosis is a specific lesion of the skin, accompanied by soreness and inflammation of the capillaries and arterioles. And this article is designed to answer the main questions about skin refreshing, its characteristics, signs, PMP and other important features. Fertility or perniosis is a specific lesion of the skin, accompanied by soreness and inflammation of the capillaries and arterioles, resulting from repeated exposure to moist cold( with positive indices and abrupt "temperature jumps") and having a chronic course with exacerbations. More common in patients in autumn or spring with moderately cold wet weather.
Pathologies are subject to the following groups:
- people who have previously suffered from frostbite of varying degrees;
- adolescents from 10 years, more often - male( due to long and frequent stay outside the premises);
- women of childbearing age, teenage girls with little weight or complaints about "cold hands and feet";
- specialists working in unheated and unheated areas, including miners, servicemen, rescuers, athletes, firemen, hunters, divers, riders, farm workers.
Further attention should be paid to the clinical varieties of cholera.
Classification of
Pathology is considered as a type of frostbite, not classified. But according to clinical signs, the following are distinguished:
- The diffuse form of with pronounced erythema - reddening( erythema pernio).
- Limited knotty( perniones).
As a rule, both forms in patients with fever are combined. The flow differs hardness and duration. In the warm season, the symptomatology disappears, with the onset of cold weather - signs are exacerbated.
Next, we will tell you about why an adult or a child has a refreshing of feet, cheeks, limbs and other parts of the body.
Causes of
Fever is caused by a weakened function of small dermal vessels, low resistance to repeated combined effects of cold and moisture and subsequent rapid development in tissues of oxygen deficiency( hypoxia).
All manifestations are also the result of not direct cold trauma, as happens with acute frostbite in severe frost, and vascular disorders leading to reflex vasospasm and edema due to increased permeability of their walls.
Factors increasing the likelihood of recuperation:
- Raynaud's disease( neurologic paroxysmal blood circulation disorder leading to atrophy of the tissues of the hands)
- deficiency of iron( anemia), vitamins, especially A, C, B;
- malnutrition or malnutrition;
- cryoglobulinemia( a pathology in which immunoglobulins, when lowered, settle on the walls of the vessels, destroying them);
- neurological disorders, frequent or prolonged stressful situations, weakening the body;
- vegetovascular dystonia, propensity to vasospasm;
- reduced blood fluidity( with high coagulation);
- vascular diseases, including phlebitis, thrombophlebitis, thrombosis;
- chronic diseases( malaria, syphilis, tuberculosis);
- endocrine disorders, diabetes mellitus;
- cold allergy( acute cutaneous and vascular reaction to cold);
- hyperhidrosis( abnormally high sweating) of the hands and feet;
- low body weight( 20% less than the norm with a certain growth).
Symptoms of cholerization
Usually the symptoms of both forms of fever are combined.
Erythematous form
Symptoms of erythematous form in pure form are observed only in women( 98%) and are expressed:
- in the appearance of merging bright red and bluish spots or uniform intense redness and blue skin( erythrocyanosis) on the shins, knees, buttocks, the inner surfaces of the hands in places of folds;
- in puffiness and cold skin with frequent itching;
- in the development of the so-called follicular nodes( perniosis follicularis) in the form of dry colorless or reddish-brown blisters 2 - 3 mm, conical in shape, around the hair follicles.
Combination of erythematous and nodular forms of
Symptoms of fever with a combination of erythematous and knotty forms include:
- swelling, tension of unhealthy shiny skin, cold to touch and painful when pressed;
- appearance of dense painful swellings, similar to plaques of different sizes of blue or cyanotic red, with noticeable borders on fingers, feet, ear shells( above the bony protuberances), nose, cheeks, sometimes - on calves and buttocks;
- diffuse strong reddening of the skin( erythema) with flat, soft and not sharply limited nodes of a bluish-pink color, sometimes with a sinking in the central region;
- for warming and grinding - development of painful itching, tingling, burning;
- appearance of cracks, flushing - blisters filled with watery exudate and surrounded by severe reddening, ulceration;
- development of foci of hyperkeratosis( thickening of the stratum corneum, growth of dry coarse scales), the appearance of point bubbles with dry horny coatings in the center;
- spread of inflammation to the vessels of the deep layers of the skin and underlying tissue;
- deepening of the ulcerative process with the penetration of secondary infection into the lesions.
Diagnostics
Traumatologist, surgeon usually diagnose resuscitation, based on external examination of skin, information on the cold trauma received, risk factors.
From instrumental techniques to clarify the diagnosis of inflammation use:
- dopplerography for assessing the state of blood vessels and circulation;
- RVG or rheovasography, as well as capillaroscopy to determine the patency and the degree of vasospasm.
In addition, in-depth examinations, including a skin biopsy-based histology, may be prescribed to exclude other diseases with similar symptoms.
During ennobling during histological examination, pronounced edema of papillary layer of dermis and endothelium, thickening of capillary walls, thrombosis and expansion of arterioles in combination with other specific pathological changes of subcutaneous tissues are revealed.
Treatment
Treatment, comprehensive reflex therapy.
This English-speaking video tells about 5 ways of helping with refreshing:
Therapeutic methods
Therapeutic methods include:
- ultraviolet irradiation exclusively at doses that do not cause erythema;
- diathermy;
- contrasting baths or shower for strengthening and training of blood vessels;
- massage using camphor or camphor-diachyl ointment
- rubbing with camphor alcohol;
- in the presence of ulcers, cracks - ointments Stellanin, Solcoseryl, Dermatol, Ointment Mikulich, Eplan, Actovegin.
Medication Therapy
The prescription of medicines for reforestation includes:
- vitamin therapy with an emphasis on C, PP, A, B6;
- application of iron preparations( Ferrum Lek), calcium, magnesium;
- use of drugs that strengthen blood vessels that improve blood circulation: Detralex( 2 tablets per day), Flebodia( 1 tablet per day), Nicotinic acid( injections for 10-12 days or tablets);
- medications that prevent the formation of blood clots and maintain blood fluidity: Trombo Ass, aspirin( except for people with "ulcer" and high acidity);
- application of ointments against pruritus: Psilo-balm, Fenistil gel, Nizulin, Akriderm GK, Radevit, Advantan, Gystan;
- antihistamines( anti-allergic), removing itching and swelling: Zirtek, Erius, Suprastin.
Prevention
The probability of developing exacerbations of inflammation warns:
- guarding hands and feet from cold injuries, using protective creams, warm waterproof shoes, insoles, multi-layer gloves made of natural fabrics;
- refusing to smoke, contributing to serious vascular disorders;
- avoiding any conditions in which the vascular circulation is weakened, including the state of involuntary immobility, the use of pressure bandages, cuffs, tight shoes;
- excluding or restricting work in raw cold rooms, on cold air;
- using only serviceable specialized outfit, shoes with professional activity, timely drying.
When exacerbating, it is necessary:
- Warm the affected areas gently, without traumatizing the skin with coarse cloth, intense rubbing or using direct heat from furnaces, fires, hot water( this will worsen the condition or cause a thermal burn much faster than in people who do not suffer from fever).
- Treat areas of lesions with mild antiseptic solutions to prevent the introduction of microbial flora into ulcers, cracks, bursting blisters.
- Avoid combing affected areas.
- Immediately call on doctors to avoid complications if:
- pain is too strong, the swelling is very pronounced;
- if there is a suspicion of additional infection;
- if the condition does not improve within 10 to 14 days;
- if reforestation occurs during a warm time( to identify diseases with similar symptoms).
Complications of
Fertility is not a harmless course of the disease. Without adequate prophylaxis and adequate therapy, it is possible:
- Attachment of infection when introducing pathogens into places of scratching, bursting of blisters, ulcers and subsequent development of purulent processes with unpredictable prognosis.
- The development of Raynaud's disease.
- Appearance or enhancement of cold allergies with serious common-body symptoms.
- Exacerbation or development of vascular disorders in the hands and feet with further trophic, tissue changes, the appearance of trophic ulcers, the development of thrombosis, phlebitis.
- Increased response to cold and rapid occurrence of frostbite by the type of "trench foot", which without active therapy can lead to gangrene and amputation.
Forecast
- Uncomplicated restraint usually takes 7 to 20 days, if the effect of wet cold is discontinued, especially if the temperature of the medium rises.
- Serious skin and tissue damage, with the observance of prophylaxis and surgical response to symptoms, does not occur in most cases.
- Relapses from November to April occur over many years.
This video will tell you about a nervous and cold chill: