Erythema

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    Definition

    Circumscribed, varying in size, polyitiological (exogenously or endogenously triggered) solitary, sharply or indistinctly limited, pale to satiric or bluish-livid, normothermic or hyperthermic or, less frequently, also hypothermic, red, anemic stain.

     

    Erythema differs in color, size, arrangement and is a contrast to the non-red, bright environment and is only noticeable by this contrasting. In the case of a universal reddening, an erythrodermia naturally lacks the contrast to a normal environment.

     

    Furthermore, when assessing solitary erythema or multiple erythemas, various clinical aspects should be considered and evaluated diagnostically. These are in particular:

    size

    Number and distribution (solitary, multiple, grouped, disseminated, exanthematic, universal)

    Dynamics (static, acute, acute persistent, chronic persistent, crescendo reaction with increasing dynamics, wave dynamics with increasing phase, plateau phase and decrescendo phase)

    Arrangement and shape (gyrated, herpetiform, serpiginous, in Blaschko lines, segmental, annular, target-like or kokarden-like, polymorphic, reticulate, defined by the exogenous trigger, random)

    Structural and functional assignment (follicular, sweat glands, sebaceous glands, contact points, textile covered, heliotropic, random)

    Topographical classification (various body regions, field skin, groin, face, nose, auricle, capillitium, intertriginous)

    Limitation (sharp-edged, blurred, bumpy, jagged, random)

    Color (mattress, light red, satirical, hemorrhagic [transition to purpura], blue-red)

    Temperature (hypo-, normal-, Hypertherm)

    Consistency (unchanged, slightly to moderately increased [palpable erythema as transition to papule])

    Symptoms (mild itching, intense itching, burning itching, pain)

    Socialization with metabolic diseases, pregnancy, malignant tumors, autoimmune diseases

    Exogenous release: Physical (cold, heat, pressure, UV rays), biochemical (exertion, water, irritants), allergic (contact allergens), bacterial or mycotic infections.

    Endogenous release: bacterial, viral, mycotic infections, ADRs (drug reactions), food allergies

    Association with fever and / or other general symptoms (arthralgia, intestinal symptoms, fatigue).

    Furthermore, a distinction is made between solitary erythema and erythema as a partial symptom of a generalized or exanthematic disease (eg drug eruption or classical infectious diseases).

    In English, this flare-up of erythema is called “flare-up”. This distinction is possible in most cases from a visual diagnostics point of view. It is of great importance for further investigation (exclusively regional examination or whole-body examination).

    Another groundbreaking aspect to be assessed is heliotropic of erythema, the dynamics of erythema (acute or persistent), and the evaluation of the general condition of rashes.

    By the term erythema, the dermatologist understands a skin reddening, which is caused by an increased blood circulation of the affected body area.

    The causes are many-sided and must be clearly identified in order to initiate adequate treatment. The prognosis depends on the underlying disease, but usually, the erythema fades by itself after a short time.

    What is erythema?

     

    The word erythema is derived from the ancient Greek term “erythema”, which means “redness” or “inflammation”. He describes the only symptom of erythema, the reddening of the skin. This can occur in different color intensity, size, expansion and strength.

    Erythema is one of the so-called primary sclerosis. These are skin redness and skin changes that result from a pathological process that takes place directly in the skin.

    They do not affect other diseases. For this reason, primary sclerosis has a high diagnostic value. Other important skin changes in this group are macula, a skin redness caused by pigmentary disorders, papules, and cysts.

    Causes

    The causes of erythema are versatile. It is therefore not possible to make general statements.

    Basically, however, it can be said that erythema, on the one hand, can be a normal phenomenon that is possible in all people, if it occurs as a blush.

    Shame red, which is called by dermatologist Erythema pudor, is colloquial, for example, with the saying “blush someone in the face” and is harmless. On the other hand, erythema is an important symptom of many skin diseases.

    Important examples are disc rose, Stevens-Johnson syndrome, and scalded skin syndrome.

    The disc rose affects mainly adolescents and shows on the extremities and on the face. The disc-like, fingernail-sized erythema often occurs together with joint pain, fatigue, and mild fever and heal spontaneously after some time.

    Patients suffering from Stevens-Johnson syndrome also suffer from a severely disturbed general condition.

     Symptoms of this disease are erythema, high fever, herpes-like blisters in the mouth and genital area and conjunctivitis. Causes of Steven Johnson syndrome are often insufficiently healed infections or allergic reactions.

    The “scalded-skin syndrome”, also known as Lyell’s syndrome, is life-threatening because in those affected, the entire epidermis dissolves from the body.

    It then dies and the protective function of the skin is massively disturbed. Cause of this disease are serious allergies or side effects of certain medications.

    Symptoms, complaints & signs

    Erythema can cause various symptoms and discomfort. The disease manifests itself primarily by a conspicuous reddening of the skin, which can be felt on different parts of the body. Most erythema occurs in heavily perfused body regions, for example, on the chest, the arms or the genital area.

    Erythema can be recognized by its discoloration when it prints. Usually, it does not cause any pain. However, the causative disorder may cause pain and other symptoms in the later stages.

    Depending on the cause of erythema, serious discomfort may occur. If the symptoms are caused by bleeding on the skin, itching and pain usually appear as well.

    If the erythema occurs as a precursor of eczema, it comes in the course of further skin lesions, to bleeding and itchy skin. In the absence of treatment, erythema increases in size and may spread over the entire arm, chest or genital area.

    For larger erythema sensory disorders are conceivable. In addition, sufferers often feel a sense of sickness, which increases with the increase in redness of the skin. If erythema is treated early, it usually causes no further symptoms or discomfort.

    diagnosis

    The skin reddening usually falls on the affected person himself and he goes to the dermatologist. It is important to describe the observed symptom as precisely as possible.

    when making an appointment so that an emergency classification can be made. Otherwise, it could happen that the patient waits for an appointment for a very long time.

    The dermatologist should be able to recognize at first glance whether there is erythema, a hemorrhage or the precursor of eczema. It is helpful in the diagnosis to put pressure on the affected area because if this is discolored, there is clearly erythema.

    In most cases, the dermatologist will refer the patient to a general practitioner to diagnose and treat the underlying condition. Nevertheless, a dermatologist should first be consulted to rule out other diseases.

    Complications

    In the case of erythema, it depends on the cause of the complications associated with the erythema. If the erythema is caused by an infection, dangerous symptoms may develop without treatment.

    Thus, secondary infections of the affected skin areas but also other organs can form, which can be life-threatening.

    Treatment with antibiotics is indicated as a cause of erythema in a bacterial infection, and erythema caused by fungal infections should also be treated with medication.

     But treatment with medication can also lead to complications, as allergic reactions and intolerances are possible. These can also manifest themselves in skin symptoms, in extreme cases, a life-threatening allergic shock may occur with circulatory failure.

    If an allergic reaction is a reason for the occurrence of erythema, in a contact allergy usually the avoidance of the triggering substance is sufficient. The skin reddening usually disappears by itself, without the need for further treatment.

    However, as part of allergic reactions, it can also lead to inflammatory changes in the erythema that spread to deeper layers of the skin.

    Secondary infections are another potential complication. Likewise, even with adequate treatment, scarring can occur in the affected areas.

     As a complication of inflammatory skin processes also fever and a diminished general condition are possible.

    When should you go to the doctor?

    Erythema should be clarified by the doctor as soon as complications arise. Redness on the skin, fever or joint pain, in any case, require medical attention. The same applies to bleed, itching and other symptoms that affect well-being.

    Especially if the symptoms have not subsided after two to three days at the latest, an appointment with the general practitioner should be made. People who find that erythema is a cosmetic blemish also talk to a therapist.

    In particular, over large lesions should be discussed with a specialist before psychic moods set. If inferiority complexes or depression are already noticeable, seek immediate psychological advice. The sooner mental suffering is treated, the less likely it is to have long-term consequences.

    Thereafter, people who have a history of pre-existing conditions such as Stevens-Johnson syndrome or a skin condition should go to the doctor for erythema.

    In general, the erythema indicates serious illness and must, therefore, be investigated and treated if necessary. In severe complications, the emergency medical service is best turned on.

    Treatment & Therapy

    The treatment of erythema depends on the underlying disease diagnosed. While some causes, such as the disc rose, can not be treated, other causes can be treated with a timely diagnosis. The erythema itself can not be treated.

    A special form of erythema is erythroderma, which occurs when more than 90% of the body is affected.

    Erythroderma means in ancient Greek as much as “red skin”. The skin is severely inflamed and the vessels are dilated. There is a loss of fluid, protein and salt, which can lead to life-threatening sequelae.

    Due to the vasodilation, patients suffer from severe heat loss of the body and thus excessive hypersensitivity. The first indication of erythroderma is, therefore, affected by others as always too warm clothing style affected. Like erythema, erythroderma is not an independent disease.

    It is a symptom and therefore an important indicator of other diseases and manifestations such as age, drug intolerance or psoriasis.

    Outlook & Forecast

    Depending on the cause of the erythema, the reddening of the skin may develop differently. If a harmless inflammation is a cause, it usually stops after just a few hours to days.

    For serious skin diseases, however, erythema can persist for weeks and months. Patients with chronic skin disease suffer permanently from skin changes.

     Nevertheless, the prognosis is usually good – erythema is usually unproblematic and causes no itching and pain other complaints.

    In some cases, erythema may develop eczema, which may increase in size and cause concomitant symptoms such as fever. In the worst case, eczema can lead to inflammation and sepsis.

    A spread to the internal organs is conceivable and associated with a rather poor general prognosis. With early treatment, however, the prospect of a speedy recovery is good.

    The dermatologist can prescribe suitable medicines and skincare products that can reliably treat skin lesions. Basically, erythema has good prognosis. 

    If the lesions are clarified early and treated, they usually resolve again or at least do not progress. In the case of erythema, it depends on the cause of the complications associated with the erythema.

    If the erythema is caused by an infection, dangerous symptoms may develop without treatment. Thus, secondary infections of the affected skin areas but also other organs can form, which can be life-threatening.

     

    Treatment with antibiotics is indicated as a cause of erythema in a bacterial infection, and erythema caused by fungal infections should also be treated with medication.

    But treatment with medication can also lead to complications, as allergic reactions and intolerances are possible.

    These can also manifest themselves in skin symptoms, in extreme cases, a life-threatening allergic shock may occur with circulatory failure.

     

    If an allergic reaction is a reason for the occurrence of erythema, in a contact allergy usually the avoidance of the triggering substance is sufficient.

    The skin reddening usually disappears by itself, without the need for further treatment. However, as part of allergic reactions, it can also lead to inflammatory changes in the erythema that spread to deeper layers of the skin.

     

    Secondary infections are another potential complication. Likewise, even with adequate treatment, scarring can occur in the affected areas. As a complication of inflammatory skin processes also fever and a diminished general condition are possible.

     

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