Necrolysis epidermal toxic: symptoms, causes, photo

Complex dermatological diseases, which could be life-threatening, are not very common. However, they are. One of these is necrolysis epidermal toxic. This pathology is a rare skin disease that can lead to death.

What is pathology?

Necrolysis epidermal toxic is a severe allergic pathology, the result of which is the delamination of the upper layer of the skin. He subsequently dies off, and the body is subjected to powerful intoxication. Without a qualified treatment, a person may experience sepsis and death.

Bullous transformation and death can be not only skin, but also mucous membranes. The disease is very insidious. The fact is that even internal mucous membranes can be affected , which often leads to gastric bleeding, insufficiency of respiratory activity and other disorders of the body.

Often develops necrolysis epidermal toxic after the use of certain medicines. However, there may be other reasons. The appearance and course of the disease is almost impossible to predict.

Causes of development

The most common cause of the development of pathology is the intake of certain types of drugs:

• Sulfonamides.
• Macrolides: "Erythromycin."
• Penicillin preparations.
• Anticonvulsant: "Lamotrigine", "Carbamazepine", "Phenobarbital."
• Quinolones: "Trovafloxacin."
• Anti-inflammatory nonsteroid drugs: Indomethacin, Ibuprofen, Piroxicam.

The incidence rate is extremely low and amounts to only 1 case per 1,000,000 people per year. Women often suffer. Age also matters, since most cases of development of pathology are observed after 55 years.

In addition to taking medications, the cause of necrolysis may be infection with staphylococcal infection.

Features of the disease

Necrolysis of the epidermal toxic develops quite rapidly. In case of illness, the immune system can not correctly recognize and neutralize a toxic substance, in our case, a drug. The allergic reaction is very strong.

At the same time, immunity attacks the skin, because it considers them to be a foreign body. At the same time, the regulation of the disintegration of protein substances is disrupted. In the skin begin to accumulate toxins, which lead to a general intoxication of the body. If you do not start therapy on time, the person will die.

Varieties and localization

Toxic epidermal necrolysis (the symptoms of pathology we have already considered) can be classified as follows:

1. Idiopathic. It occurs on its own, and its cause may not be established.
2. Caused by the influence of certain medicines.
3. Emerged under the influence of staphylococcal infection. This type of pathology is diagnosed mainly in children. At the same time, the possibility of a fatal outcome is excluded.
4. Combined with other diseases.

Lesions can be found in such places: buttocks, shoulders, chest, abdomen and back, mucous membrane of the oral cavity.

Symptomatology of the disease

Toxic epidermal necrolysis (Lyell's syndrome) is usually characterized by such symptoms:

• General impairment of the body, which manifests itself in loss of appetite, headaches, increased basal temperature. A frequent sign of pathology is increased thirst.
• Pain and discomfort in the mucous membranes. At the same time, their sensitivity significantly increases. For example, when eating while swallowing, the patient feels pain.
• Appearance of red spots, rashes and blisters on the skin and mucous membranes. In most cases, about 30% of the body is affected, although this figure can be significantly larger.
• Peeling of the epidermis. In this case, the skin begins to wrinkle even with a weak touch. If the affected area of the skin is removed, a bleeding wound appears beneath it.
• Renal insufficiency.
• Infectious process. The fact that the skin can not function properly and protect a person from the effects of pathogenic microorganisms. The situation may result in sepsis.
• In the late stages of the pathology, dehydration, tachycardia, and also hypotension can be observed.
• Muscle pain.
• Fever and cough.
• Anorexia.
• Nausea and vomiting.

It should be taken into account that the lesions of the mucous membrane manifest themselves faster than disorders of the skin. If at the initial stages of toxic epidermal necrolysis, whose photo is not for the faint of heart, is weakly visible, then it can be seen very well afterwards.

Diagnostic Features

If you have a suspicion of toxic epidermal necrolysis, then you need to see a doctor immediately. He must conduct a differential and very thorough diagnosis, which includes:

1. Fixation of complaints of the victim. Attention is drawn to every rash, pain.
2. Collection of anamnesis of the patient. That is, the doctor must find out if he has any allergies that contributed to the development of such a complex reaction. It is desirable to find out whether there are any similar problems in the relatives of the patient.
3. External examination of the patient. In this case, the dermatologist draws attention to the shade of the skin, the presence of rashes and blisters on the mucous membrane. The patient can react to the surrounding reality not quite adequately.
4. The analysis of a blood general. It will give an opportunity to determine whether the level of leukocytes is increased, whether there are unripened blood cells, acceleration of erythrocyte sedimentation. If these parameters go beyond the norm, then the situation indicates the presence of an inflammatory process.
5. The blood test is biochemical. If the result is an increased level of bilirubin or too little protein, the patient may have problems with kidney work.
6. The analysis of urine is general. This study is also necessary to determine the functionality of the kidneys. If there is blood in the urine, then the problem is of a global scale.
7. Measurement of heart activity, blood pressure indicators.

Diagnosis is also necessary in order to distinguish toxic epidermal necrolysis from other diseases: pemphigus, scarlet fever, erythema, bullous impetigo, red flat lichen.

Features of treatment

The presented disease must necessarily be treated. Otherwise, the patient can wait for sepsis and death. If the patient has the above described symptoms, then it must be quickly delivered to the hospital. If the course of the disease is severe, the victim is placed in the intensive care unit, where the nursing staff can provide him with proper care.

The ward to which the patient falls will be sterile, which will exclude the possibility of joining other infections. Treatment of pathology involves the elimination of the factor that triggered the disease.

As for drug therapy, corticosteroids and antihistamines will come to the rescue. In addition, infusion therapy should be organized . Antibiotics can be used only if the patient has a secondary infection.

Toxic epidermal necrolysis (what it is, you already know) should also be treated with local remedies that help restore normal skin regeneration: anesthetics (anesthetics), ointments, antiseptics.

In addition, you will need to adhere to such the principles of therapy:

1. It should be as quickly as possible to cleanse the body of previously taken drugs. For this, enemas are used.
2. It is desirable to take drugs that help restore normal water-salt metabolism, for example, "Regidron."
3. The doctor will prescribe medicines to protect the liver, in particular "Gepabene".
4. The intake of substances that reduce the level of blood clotting.

What complications can appear?

If you have diagnosed toxic epidermal necrolysis, complications can be:

• Development of a serious bacterial infection.
• Severe dehydration of the body, which can cause the death of the patient.
• Loss of a significant amount of skin. If a person loses more than half of the epidermis, he is surely to die.
• Drying of the skin, the appearance of scars on it, the change in pigmentation.
• Chronic erosion of mucous membranes.

Forecast

If the treatment of pathology has not been started on time, then the mortality rate can reach 70%. Loss of a large part of the skin will make the patient too susceptible to various infections.

Timely initiation of therapy will help not only to get rid of the disease, but also to avoid such terrible complications as internal bleeding, damage to the genitourinary system, inability to perceive food, kidney and liver failure.

It should be noted that children die from this disease much less often than adults. If the patient has crossed the 60-year boundary, then his prognosis is disappointing. However, proper treatment can improve his condition.

Prevention of pathology

Another name for this pathology, like toxic epidermal necrolysis, is Lyell's syndrome. Photo of this disease is better not to look at impressionable people. This is a complex pathology that can be avoided if you follow preventive measures:

• Medicines must be taken only if they are prescribed by a doctor.
• The specialist should know if you have any allergic reactions.
• Whatever pathology you have, do not take more than 7 drugs at a time.
• Do not self-medicate staphylococcal and inflammatory skin diseases.
• Avoid contact with any irritant that can cause allergies.

As for the treatment, everything depends on the characteristics of the organism and the patient's desire to fight the violation. Be healthy!