Lipoid necrobiosis
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Description:
The lipoid necrobiosis - the chronic not hereditary disease of skin connected with disbolism represents the localized lipoidosis with adjournment of lipids in those sites of a derma where there is a degeneration or a necrobiosis of collagen.
The lipoid necrobiosis represents rather rare disease, about 4% of patients with a diabetes mellitus suffer from it. Aged people of 20-40 years are ill a lipoid necrobiosis usually, children and aged are slightly more rare, female persons are more often. The ratio of women and men makes 3:1.
Symptoms of the Lipoid necrobiosis:
On integuments preferential in the lower extremities there are roundish or oval small knots having pinkish-red coloring. In their central part there is retraction of grayish-yellow color. A peripheral part of educations is surrounded with a border of cyanotic-violet color. There can be red color hypodermic small small knots formed due to cystous expansion of hypodermic capillaries. Practically never in the field of pathological educations ulcer defects are formed.
Over time small knots gradually grow in the sizes, turning into disks, to the touch plotnovaty and painless. Skin over them smooth also has specific gloss. The defeat centers are never located on skin one by one, them always a little, and they are symmetric on the right and at the left. If a disease uncomplicated, then the patient does not feel any unpleasant feelings, complaints at visit of the doctor are absent. At emergence of ulcers and superficial defects of skin the itch and pain, burning sensation or prickings develop. Much heavier the disease proceeds when such patient at the same time suffers from a diabetes mellitus.
At the same time increase in content of sugar in blood is noted, and its transformations in an organism are closely connected with transformation of fats. Besides, there is a defeat of small vessels of skin therefore integuments are surprised in a bigger degree.
At the return picture when the content of sugar in blood decreases, there is some normalization of a state: many disks in whole or in part resolve, their total quantity considerably decreases. Most often the disease affects female persons, especially if they have a diabetes mellitus. Approximately only the fifth part of all patients does not have a diabetes mellitus. It gives the grounds to assume that, apparently, these two pathologies are quite closely connected among themselves by a community of origins and the mechanism of development.
At microscopic examination of the affected skin it turns out that in its cells elasticity decreases, in them there are inclusions containing pathological products of the wrong lipometabolism. At the same time connecting fabric is exposed to considerable changes. A special specific kind of a lipoid necrobiosis is the chronic distsiformny progressing Misher's granulomatosis.
At the same time the disks which are formed on the patient's skin are much bigger by the sizes, they more dense, on a consistence remind a board. Especially consolidation is expressed in the central part of a disk, reminding the plaques developing at a scleroderma.
Reasons of the Lipoid necrobiosis:
Risk factors of a lipoid necrobiosis are shifts of a number of metabolic processes, in particular hormonal, carbohydrate and lipidic metabolism, patholologically influence a vascular bed and participate in formation of microcirculator frustration. At a part of patients emergence of a lipoid necrobiosis is preceded by injuries (bruises, scratches, stings of insects and so forth).
The major starting factor of development of pathology is disturbance of transformation of fats in an organism.
Treatment of the Lipoid necrobiosis:
Various antidiabetic drugs, insulin hormone drugs are generally used. As additional therapy drugs of vitamins E are appointed. From physiotherapeutic procedures Bukki's beams, X-irradiation are often applied. If necessary sometimes it is necessary to resort to surgical excision of pathological educations. Various ointments which are especially including drugs of adrenal hormones in the structure are widely applied.
