Cauzele sunt multiple si cuprind agravarea bolilor de fond precum lupus eritematos, dermatita atopica , dermatita de contact , pemfigusului, psoriazis , sarcoidozei, dermatitei de staza etc. Peste 60 de medicamente au fost implicate in etiologia eritodermiei. The causes are multiple and include worsening of underlying disease such as lupus erythematosus, atopic dermatitis , contact dermatitis , pemphigus, psoriasis , sarcoidosis, etc. stasis dermatitis. More than 60 drugs have been implicated in the etiology eritodermiei.
Pacientii necesita internare in spital, mai ales cei pediatrici care prezinta si febra, hipotensiune si soc toxic. Patients requiring hospitalization, especially those who have pediatric fever, hypotension and toxic shock. Se va mentine pielea hidratata, evita scarpinatul, factorii precipitanti, steroizii topici si se vor trata afectiunile de fond. Eritrodermia este rezistenta la terapie daca cauza de fond nu a fost tratata. It will keep skin hydrated, avoid scratching, precipitating factors, topical steroids to treat disorders and substance. Erythroderma is resistant to therapy because if the fund has not been treated. Evolutia este marcata de multiple exacerbari si este necesara terapia cu corticosteroizi . The evolution is marked by multiple exacerbations and corticosteroid therapy is necessary.
Complicatiile includ deshidratarea , infectia bacteriana sau fungica, hipotermia, dezechilibrul electrolitic, insuficienta cardiaca . In general prognosticul pe termen lung la pacientii cu boala indusa farmacologic dup ace agentul lezant este inlaturat este bun. Complications include dehydration , bacterial or fungal infection, hypothermia, electrolyte imbalance, heart failure . In general, long-term prognosis in patients with pharmacologically induced disease lezant agent is removed after the needle is good. Pentru pacientii cu eritrodermie idiopatica prognosticul este negative. For patients with idiopathic erythroderma prognosis is negative. Recurenta frecventa sau simptomele cronice necesita terapie steroidica pe termen lung si prezinta sechele. Frequently recurring or chronic symptoms require long-term steroid therapy and shows the scars. Pentru pacientii cu o boala de fond sau neoplasm prognosticul devine cel al afectiunii declansatoare. For patients with a disease or cancer prognosis background becomes the trigger of the disease.
Patogenia eritrodermiei Pathogenesis eritrodermiei
Eritrodermia poate apare ca raspuns la terapia medicamentoasa, boli sistemice sau o entitate idiopatica. Erythroderma may occur in response to drug therapy, a systemic disease or idiopathic entity. Peste 40% dintre cazuri implica existent unei boli cutanate. Over 40% of existing cases of disease involving the skin. aproximativ 10% dintre cazuri sunt rezultatul reactiilor medicamentoase. approximately 10% of cases are drug reactions. 40% sunt cauzate de boli sistemice. 40% are caused by systemic disease. Restul sunt idiopatice. The rest are idiopathic.Epidermul normal are un turnover rapid al celulelor epiteliale. Normal epidermis has a rapid turnover of epithelial cells. Diviziunea celulara apare in stratul bazal. Basal cell division occurs. Pe masura ce celulele migreaza spre periferie devin keratinizate. As the cells migrate to the periphery become keratinized. Acest process necesita 10-12 zile. This process requires 10-12 days. Celulele ramin in stratul cornos pentru inca 14 zile inainte de a se descuama. Cells in the stratum corneum remain for another 14 days before they exfoliate.
In eritrodermie rata mitotica a stratului bazal creste iar timpul de tranzitie scade, de aceea sunt pierdute mai multe cellule de pe suprafata. The basal layer erythroderma mitotic rate increases and decreases during the transition, so many cells are lost from the surface. Mecanismul responsabil nu este cunoscut. The mechanism responsible is unknown.
In eritrodermie apare o crestere a perfuziei pielii cu dereglare a temperaturii si hipotermie pina la insuficienta cardiac. The erythroderma is a growth disorder of the skin perfusion and hypothermic temperatures up to heart failure. Rata metabolic bazala creste pentru a compensa pierderea de caldura. Basal metabolic rate increases to compensate for heat loss. Pierderea de fluide prin transpiratie este crescuta fata de rata metabolic bazala. Fluid loss through sweating is increased from basal metabolic rate. Pierderea marcata de celule epiteliale prin descuamare determina hipoalbuminemie. Marked epithelial cell loss by desquamation cause hypoalbuminemia. Edemul este frecvent prin trecerea fluidului in spatial extracelular. Edema is commonly by passing fluid in the extracellular space.
Cauze si factori de risc de eritrodermie Causes and risk factors of erythroderma
Afectiuni sistemice: Systemic diseases:- limfomul cu celule T, leuvemia, mielomul multiplu , - T-cell lymphoma, leuvemia, multiple myeloma ,
-carcinomul de polamin, prostate, colon, tiroida Polamin-carcinoma, prostate, colon, thyroid
- boala grefa contra gazda , imunodeficiente- HIV , boala Hodgkin . - graft versus host disease , immunodeficiency, HIV , disease Hodgkin .
Afectiuni cutanate: Skin:
-psoriazis, dermatita seboreica , dermatita atopica -Psoriasis, seborrheic dermatitis , atopic dermatitis
-dermatita de staza, dermatita de contact, pitiriazis rubra pilara -Stasis dermatitis, contact dermatitis, pityriasis rubra Pilar
-pemfigus foliaceu, micozis fungoides, dermatofitozele, lichen plan. -Pemphigus foliaceous, micozis fungoides, dermatophytosis, lichen planus.
Cauze farmacologice: Pharmacological Causes:
-dimercaprol, codeine, captopril, hidantoina, aur, iod -Dimercaprol, codeine, captopril, hydantoin, gold, iodine
-penicilina, cefalosporine, minociclina, izoniazida -Penicillin, cephalosporins, minocycline, isoniazid
-fenitoina, alopurinol, mercur, arsenic, quinidina -Phenytoin, allopurinol, mercury, arsenic, quinidine
-barbiturice, aspirina, carbamazepina. -Barbiturates, aspirin, carbamazepine.
Idiopatice. Idiopathic.
No comments:
Post a Comment