Protoderma

protodermaProtoderma - skin disease, evolved as a result of prolonged drug intake bromine, especially potassium bromide, people with a heightened sensitivity to it. The rash usually appears on the face, legs, buttocks. Clinically there are: generalized rash resembling vaccine rash, urticaria, exudative erythema; methyl acne, different congestive-bluish color, sluggish current, large elements with a tendency to merge; knotted bramadero characterized by the appearance of a soft-like plaques purple color, which usually izyaslau, but sometimes it can disappear without ulceration. Should differentiate with iododerma (see), vegetative hand, foot (see), mycosis. The prognosis is favorable. Treatment: the cessation of intake and excretion of drugs bromine (diuretics and laxatives means), 10% solution of chloride calcium to 10 ml intravenously, 10 injections; naruzhno - frequent warm bath with a solution of potassium permanganate and lubrication aniline dyes, in the case of ulcerations shown ointment with antibiotics; knotted at bramadero - mercury ointment, antiseptic dressing. Prevention: treatment with drugs bromine conduct courses with a break at the first appearance of skin rash taking the drug immediately stop.

Protoderma (bromine + GK. derma - skin - disease arising at introduction (inwards intravenously) salts of bromine, especially large doses of bromide, sodium, and characterized by lesions of the skin, scalp, lower limbs, genitals, back. Generalized rash with bramadero occurs more often in children and may remind rubella. The rash can be polymorphic: roseolous, urticarnae resembling vaccine rash, rash varicella and so on, are More likely to occur the so-called bromide acne (bromica acne, Fig. 1), rarely spotted generalized rash and even more rarely - knotted, or vegetative, protoderma (bromoderma tuberosum, s. vegetans, Fig. 2)sometimes ending fatally.

knotty (vegetative) protoderma
Fig. 2. Knotty (vegetative) protoderma.

Bromide acne linked balances-hair follicles, at least - with sweat glands and represent acne pustules brownish-red colour with swollen red bezel; acne tend to group together, to merge, to nagnaivatsya and to form extensive scalloped shape pockets. Upon healing sometimes left scars. Lesions develop due to changes in the reactivity of the organism caused by sensitization after repeated impacts bromide salts. When the knotty bramadero there are few like formation of soft texture, flat, brownish-red with violet shade, often covered with crusts.
Sites not skrivas, can dissolve, either izjasnite and form scar.
Differential diagnosis with pyoderma (see), tuberculosis of the skin (see), syphilis (see)uzlovataya erythema (see), vegetative hand, foot (see), deep mycosis (see), Mycobacterium mushroom (see). Clinical features, connection of the disease with the introduction bromide and, if necessary, laboratory studies give the opportunity to make a correct diagnosis.
Treatment. When the rash should cease immediately the introduction of salts of bromine.
For quick removal of bromine recommended diuretics, intravenous or subcutaneous large number of physiological or 0.1 n solution of sodium chloride; desencibilizirutuyu therapy [10% solution of calcium chloride - inside (on 1 table. L. 3 times a day) or intravenous (10 ml)], antihistamines (diphenhydramine, diazolin, promethazine, suprastin, pipolfen), multivitamin, arsenic, iron, phosphorus. According to some authors, nicotinic acid prevents the development of bromizma; designate it inside of 0.1 g 3 times a day during treatment with bromine; course is not less than 3-4 weeks. In heavy over - corticosteroid hormones, antibiotics, baths with potassium permanganate. Local antiseptic ointment, ultraviolet radiation, and other