Skin manifestations of pregnancy
Pregnancy is a normal physiological process, and during pregnancy, the mother’s body undergoes a series of adaptive changes due to endocrine changes, which can easily produce skin diseases. Pregnancy skin diseases can be itchy in mild cases and can cause fetal death in severe cases, so they should not be taken lightly. Common skin diseases are mainly the following.
1, pruritus of pregnancy: pruritus of pregnancy is caused by the role of hormones during pregnancy, so that excessive stasis of bile acids in the skin, about 20% of pregnant women involved in late pregnancy, the vast majority of pregnant women in the first pregnancy, the head, trunk, limbs and other places can appear intensely itchy, the most obvious abdomen and lower limbs, no primary damage, mild cases have little effect on pregnancy, serious cases of pregnant women, premature labor and postpartum hemorrhage. Treatment can be antihistamines.
2, pregnancy itchy rash: it occurs in pregnant women in the middle and late stages of pregnancy, the pregnant women have most small nodules or papules scattered all over the body, accompanied by severe itching, especially at night. The rash usually fades on its own within 3 weeks after delivery, with temporary pigmentation. If the rash is severe, stillbirth may occur. The treatment can be topical glucocorticoids.
3, pruritic urticarial papules and plaques of pregnancy: lesions occur in late pregnancy, often 1 to 2 weeks before delivery. The incidence is 0.5%. The main manifestations are papules, papules, urticaria-like damage and plaques, often accompanied by severe itching; the lesions are mostly confined to the abdomen and inner thighs, and can subside soon after delivery. The lesions are limited to the abdomen and thighs and disappear soon after delivery. If necessary, antihistamines can be used to treat the condition.
4, pregnancy herpes: mostly occurs in the middle and late pregnancy, early papules and urticaria-like damage, followed by clusters of herpes, can cause premature birth, newborns can occur blisters, and recurrence can be caused by another pregnancy or oral contraceptive drugs, treatment can be oral glucocorticoids.
5, herpes-like pustulosis: mostly occurs in late pregnancy, manifested as a widespread distribution of pustules on the erythematous lesions, which can cause hypocalcemia, reduced blood albumin, fever or death in pregnant women, and even cause stillbirth. Treatment can be oral glucocorticoids.
It is important to pay attention to cleanliness and hygiene during pregnancy, in addition to proper nutrition and a balanced diet. If you find yourself suffering from a skin disease, you should immediately go to a hospital dermatology department for examination and treatment, and do not blindly use medication for autonomy.
Skin manifestations of endocrine diseases
Diabetic dermatosis is a fairly common problem that
Diabetic progressive necrolysis of lipids (NLD) almost always occurs in patients with diabetes mellitus or positive glucose tolerance test. The lesions are orange-yellow in color, located in front of the shins, and may form ulcers in advanced stages; NLD is caused by microangiopathy, but control of diabetes mellitus has little effect on the course of the disease. Intradermal glucocorticoid injections may occasionally stop the expansion of the damage, but should be used with caution as they may cause atrophy and ulceration.
② Acanthosis nigricans, which seems to occur more frequently in insulin-tolerant patients than in patients with insulin receptor abnormalities (e.g., receptor deficiency due to anti-receptor antibodies), requires high doses of insulin in such patients.
Gastrointestinal bleeding and skin lesions
Some diseases with skin lesions can be associated with gastrointestinal bleeding.
1. Hereditary hemorrhagic capillary dilation: It is an autosomal dominant disorder. Patients have clusters of capillary dilation in the lips, oral and nasal mucosa, and sometimes even in the skin of the extremities. In addition, the entire gastrointestinal tract also exhibits capillary dilation. The most common manifestation is recurrent rhinorrhea, and recurrent gastrointestinal bleeding can also occur.
2, gastrointestinal polyps or cancer: can cause occult bleeding or hemorrhage in the gastrointestinal tract. gardner syndrome can manifest as skin cysts, osteomas and multiple adenomatous polyps in the colon.
3. Vasculitis: it can affect the gastrointestinal veins, leading to mucosal bleeding and necrosis. Purpura is often manifested by gastrointestinal colic or bleeding and is usually accompanied by palpable purpura, arthritis and nephritis.
4, inflammatory bowel disease (IBD): can be divided into Crohn’s disease and ulcerative colitis. Both types have manifestations of abdominal pain, blood in the stool and diarrhea and small oral ulcers, erythema nodosum, gangrenous pyoderma and vasculitis.
Skin lesions in nephropathy
Patients with nephropathy often show skin involvement, and there are at least four possible pathways for skin changes to occur:
(i) uremia ;
②Multisystemic damage;
③Dialysis;
(iv) immunotherapy in renal transplant patients.
Skin manifestations of primary heart disease
There are more cutaneous manifestations of primary heart damage, such as embolic phenomena that can occur in bacterial endocarditis, cholesterol emboli, or left atrial mucinous tumors, much like cutaneous vasculitis. Drugs used to treat heart disease or hypertension have potential adverse effects on the skin, especially quinidine induced thrombocytopenia, which can lead to death; thiazide diuretics often cause photosensitivity and can cause drug-induced subacute cutaneous erythema vera.
Cutaneous manifestations of pulmonary disease
Acute nodal disease is characterized by asymptomatic bilateral hilar lymph node enlargement, erythema nodosum, arthritis, and uveitis. Infections are another group of diseases that may involve both skin and lung involvement, usually with the lungs being the site of the primary infection and the skin lesions being a reactive course of the infection (e.g., erythema multiforme in mycoplasma pneumonia) or the spread of the infection (e.g., budding mycosis).
Cutaneous lesions associated with malignancy
In 1976, Curch proposed five criteria to analyze the relationship between skin disease and other visceral neoplasms:
(i) The occurrence of skin disease and malignancy at the same time or the diagnosis of malignancy when skin disease is confirmed;
(2) parallel course of disease, i.e. if the tumor is treated, the skin disease improves, or if the tumor grows again, the skin disease recurs;
(iii) The type or location of the tumor is consistent;
(iv) statistically significant correlation;
⑤ Some kind of genetic syndrome is associated. In fact the first four criteria apply to traditionally related diseases, while the fifth criterion applies to genetic diseases.