Parapsoriasis

Parapsoriasis is a General name for several dermatoses, significantly different from each other, but have some common characteristics, chronic course, the spotted-scaly rash, lack of subjective sensations, resistance to therapeutic treatment. In all forms parapsoriasis impaired permeability of capillaries.
Teardrop parapsoriasis. Etiology, apparently, infectious-toxic (toxic of capillarity), some authors have attributed the disease to vasculitis infectious-allergic nature. On the skin of the trunk and extremities appear in a large number of isolated pale pink the size of a lentil hemispherical shape of the papules, covered with scale, which is in the centre papules firmly attached, the edges of lags behind her and reminds Kolodina film. Sometimes scale invisible, but when poskablivanii rash easily detected pityriasis peeling, which is an important diagnostic feature. More intensive scraping leads to the smallest point hemorrhages. The General condition of patients not suffering. Ill more often than women in young and middle age.
On the ground resorbed rash can develop pseudobacteremia (see). When acute guttate parapsoriasis, along with the described rashes appear necrotic nodules, covered with bloody-black crust. Lesions occur acutely, you may experience fever, enlarged lymph nodes. The illness usually lasts 4 to 6 weeks, after which comes the recovery that distinguishes it from other forms parapsoriasis, current chronically.
Plaque parapsoriasis expressed in the appearance on the skin of the trunk or limbs stains from light pink to brown-red, sometimes the size of a palm, otrubevidnyi, rarely melkoplastinchatym peeling; corneal layer of the skin smardan, reminds crumpled tissue paper. The disease is chronic. Sometimes there is a transition of the disease in mushroom avium, which is installed by developing infiltration of the skin in the area of the rash and the emergence of itching.
Lichenoides parapsoriasis. Very rare disease in which the small shiny flat bundles brownish-red, merge to form on the skin reticular figure. Gradually develops superficial skin atrophy with telangiectasia. Some authors consider lichenoides parapsoriasis initial form poykilodermii (see).
The simultaneous existence of different forms parapsoriasis. Forecast for life favorable, except transition in mushroom avium.
The treatment is ineffective; prescribe antibiotics, nicotinic acid, rutin, ascorbic acid, ultraviolet irradiation with teardrop-shaped, acute and lichenoides the parapsoriasis.
When patchy form parapsoriasis for the sick establish clinical supervision.

Parapsoriasis (parapsoriasis). Under this name Brock (L. Brocq) has combined a number of relatively rare skin disease described under different names and characterized erytematosus eruption, lack of subjective sensations, long-term chronic and unresponsive to therapy. Brock distinguished three forms parapsoriasis: teardrop, patchy and lichenology. Many modern dermatologists oppose the concept of Broca and review each of the forms of P. as an independent disease.
Teardrop parapsoriasis parapsoriasis guttata, (synonym pityriasis lichenoides chronica) is characterized vsapaniem on the skin of the trunk and limbs papules plotnostei consistency with the size not more lentils. Color them, at first, pink, gradually becomes reddish-purple or brown. In the centre of the individual papules, you may notice a small bleeding. After a few days on the surface of the papules form a kind of scale in the form of a plate firmly attached in the centre and backward along the edges resembling a film of collodion. Along with papules are observed and poorly expressed spotted elements, also covered the plate scales. They become more pronounced after a warm bath or intravenous nicotine acid. Having existed for a few weeks, papules and spots disappear, but along with these new elements. Papules are grayish-violet can develop on the mucous membrane of the mouth, but this is rare. The disease lasts for years, compounded periodically, especially in autumn and winter, sometimes decreasing or even completely disappearing in summer.
An original version of guttate parapsoriasis is the acute form (synonym: pityriasis lichenoides et varioliformis acuta, parapsoriasis varioliformis). The disease is characterized by the sudden eruption of pimples, in the centre of which is formed hemorrhagic bubble, drying up in the brown-black crust, as if pressed in the centre of pimples. After healing scars remain, like smallpox. Most patients were fever, and malaise, some lymphadenitis. After a few weeks, the disease passes or becomes chronic teardrop parapsoriasis.
Plaque parapsoriasis (pityriasis maculosa chronica; synonym xanthoerythrodermia perstans) is characterized vsapaniem on the skin of the abdomen, buttocks, thighs Unsharp limited spots pink, yellowish-pink or brownish-red, on the surface which marked a slight melkovodnoe peeling, often detected only by poskablivanii. Sometimes the outer layer appears to be folded, reminding crumpled tissue paper. Figure skin often underlined, but infiltration is not observed. Subjective feelings are absent. Spots exist for many months and even years, sometimes in the summer, under the influence of sunlight, they disappear, but appear again in the autumn. In some cases marked the transition in mushroom avium (the emergence of itching!).
Lichenoides parapsoriasis (parapsoriasis lichenoides; synonym.: parakeratosis variegata, lichen variegatus) is a rare disease characterized vsapaniem on the skin of the trunk and limbs small flat knots brownish-red colour, which merge to form a band, formed in net figure. On the surface of the papules, there is a slight peeling. Existing for years, a skin lesion leads to atrophy, and telangiectasia, which creates a varied picture, very similar to poikilodermia atrophicans vascularis Jacobi. In some cases marked the transition in mushroom avium (see the mushroom Avium).
Histopathology parapsoriasis leptogrammica. In the epidermis had little acanthosis and parakeratosis, in the acute form - cell vacuolization maleyeva layer with the formation of small cavities in separate elements - necrosis with scab formation, in the papillary layer of derma - lymphoid infiltration, located mainly around blood vessels. Wall the last sealed, endothelium able proliferation. In the acute form - small hemorrhages.
The etiology and pathogenesis of P. unknown. In relation to acute and teardrop-shaped forms P. (and possibly others) are very likely assume their infectious-allergic (or toxic nature.
Treatment. In acute and teardrop-shaped forms P. good effect of providing a broad-spectrum antibiotic in combination with vitamin (vitamin C, rutin, nicotinic acid). When plaque P. recommended Niacin and vitamin A. In all forms parapsoriasis shown heliotherapy (see).