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The small tortoiseshell (other name – an urtikariya) – an illness which has the allergic nature. The main symptom of this illness is blistering on integuments, and also on mucous membranes. So the human body reacts to irritation. The small tortoiseshell, as a rule, develops very quickly. After the correct treatment of manifestation of the majority of forms of this illness similarly quickly disappear.
Reasons of the small tortoiseshell
Practically any allergen can provoke display of urticaria at the person. It can be both food stuffs, and chemicals, and pollen of plants. The heaviest moment in the course of diagnosis of a disease is definition of the reason of the small tortoiseshell. For this purpose observation and attentiveness is required.
The illness the small tortoiseshell is shown at the person suddenly if the acute form of a disease takes place. At such course of an illness its signs on a face and on integuments of other bodies are expressed accurately, it is easy to distinguish them even on a photo. The chronic small tortoiseshell is most often shown as an effect of disease processes in internals, and also in the presence of disturbance in functioning of a nervous system, especially vegetative.
Not up to the end split proteinaceous products, toxins, and also toxic substances which appear in an organism as a result of failure of functioning of internals become allergens often. The allergy can have also the bacterial nature. Helminthic invasions can also become the reason of display of urticaria.
In medicine of the reason of the small tortoiseshell are subdivided on exogenous (pharmacological, food, physical, temperature) and endogenous (pathology of internals).
Types of the small tortoiseshell
Specialists distinguish several different types of this disease, being guided by the reasons which provoked its development. If the person inclined to manifestations of allergic reactions, broke a diet, so food allergy takes place. Separately by doctors it will be manufactured cold, mechanical, solar forms of the small tortoiseshell. The cholinergic urticaria develops as reaction of a vegetative nervous system to influence of heat or an exercise stress. Also the term "demographic small tortoiseshell" which also develops under the influence of etiopatogenetichesky factors and is physical shape of an illness is used.
Considering features of disease, doctors allocate acute and chronic forms. The chronic recurrent small tortoiseshell develops against an infection. The pigmental small tortoiseshell – result of pathological processes of cells of skin. As the small tortoiseshell in this case looks, depends on intensity of the happening processes. It can sometimes be very pronounced spots of a blue-red shade.
Trying to define what is the small tortoiseshell and as there is this disease at the person, specialists sometimes make the diagnosis "the idiopathic small tortoiseshell". Such allergic reaction is shown without the visible reasons, and, the similar situation takes place rather often. At the same time medicamentous means (ointment, creams, etc.) can not make positive impact on a condition of the patient.
Also the small tortoiseshell at pregnancy is rather often shown. Such allergy at pregnant women can be both result of influence described above by allergen, and reaction to hormonal shifts in an organism of future mother.
Symptoms of the small tortoiseshell
Symptoms of the small tortoiseshell are generally shown by pathological educations on integuments. In more exceptional cases such educations appear on mucous membranes. It can be blisters of the different sizes which rise over skin level, have a pink shade, the edematous, dense form. Blisters can have both roundish, and krupnofestonchaty outlines, sometimes they pale in the center.
The acute small tortoiseshell begins suddenly: symptoms of the small tortoiseshell are shown by an intensive itch, strong rashes, burning on places where there was urticaceous rash. Except visible displays of an illness at the patient disturbance of the general condition of an organism is noted. Limited hypostasis of integuments or a mucous membrane develops. Also the hypodermic fatty tissue of the person or generative organs swells. The type of skin changes: it becomes plotnoelastichesky, skin color – white or pink. Asphyxia and a stenosis in a throat is possible.
Development of the chronic recurrent small tortoiseshell happens, as a rule, in the presence of a chronic infectious disease — cholecystitis, tonsillitis, an adnexitis, etc. In this case symptoms of an illness are shown by disturbance of work of a liver, gastrointestinal tract. At palindromias on different sites of skin blisters appear. At the chronic small tortoiseshell of rash happen less plentiful, but at the same time rash develops on different sites of integuments. Periodically recurrence is replaced by remission which can continue a different span. At recurrence of people suffers from feeling sick – a headache, weakness, the increased body temperature. If gastrointestinal tract hypostasis takes place, at the patient the diarrhea, vomiting, nausea is noted. Besides the person is strongly disturbed by an itch because of which long sleeplessness, neurotic frustration is possible.
Displays of solar urticaria which is a kind of a photodermatosis it is in most cases observed at those people who have diseases of a liver and have disturbances of a porphyrinic exchange at a sensitization to an ultraviolet. Most often the illness is diagnosed for women during the warm period of year. Rashes at the solar small tortoiseshell appear on those sites of skin which are under sunshine barefaced. If at the same time the patient stays on the sun too long, the general reaction – disturbances of breath, cardiac performance can be observed. In hard cases emergence of a state of shock is possible.
The cold urticaria happens primary or secondary. Primary small tortoiseshell – result of impact on the person of cold temperature. Displays of secondary urticaria there is as a result an allergic reaction to the metabolism products which are formed in skin owing to low temperatures.
Also the atypical form of the acute small tortoiseshell which is shown owing to mechanical impact on skin is sometimes diagnosed. At such form of the small tortoiseshell blisters are built linearly, and the itch is not observed.
At the persistent papular small tortoiseshell urtikarny rashes remain throughout a long span and gradually turn into papules. Except persistent hypostasis at the patient the hyperkeratosis and an acanthosis is shown. Small knots appear on extensor surfaces of hands and legs, their color reddish-brown. More often such form of the small tortoiseshell develops at women.
Diagnosis of the small tortoiseshell
As a rule, to diagnose urticaria rather easily. Not only the specialist allergist, but also the doctor of the general practice can make it.
But in certain cases neobkhodzhimo to define what allergen became the reason of such state. In this case a number of additional researches is appointed. This identification of certain autoantibodies, definition of cold agglutinins and cryoglobulins, carrying out the general and developed blood test, hepatic tests, the analysis a calla, urine, a biopsy of integuments.
If at the patient symptoms of system pathology take place, to it carry out rheumatological tests as elements of an urtikariya can meet at some autoimmune diseases.
Differential diagnosis is carried out with a dermatosis of Dyuringa as at this illness similar symptoms are observed.
Treatment of the small tortoiseshell
In modern medicine treatment of the small tortoiseshell is carried out using different drugs which can stop development of allergic reactions. Such means block release of a histamine which is the reason of allergic reaction. Therefore, such medicamentous means are called antihistaminic.
If at the patient the acute small tortoiseshell develops, then also other methods of treatment directed to normalization of the general condition of the patient are applied. If allergic reaction was provoked by medicines or food, the hyposensibilizing drugs, purgatives are shown. If the condition of the patient very heavy, an attack removes administration of adrenaline, corticosteroid means. It has to be applied and outside urticaria medicine. It is the best of all to use antipruritic means.
Before treating a chronic illness, it is necessary to define what etiological factor provoked its manifestations. After identification of allergen it is necessary to eliminate its influence on the patient then it is possible to make the decision on how to cure this illness. But at the same time it must be kept in mind that therapy by folk remedies can be carried out only as an auxiliary measure after permission of the doctor.
But if allergen cannot be defined, then the patient is hospitalized and appoint to it a complete starvation to several days. At the same time it is allowed to drink water. Every day hydrotherapeutic procedures, and also cleansing enemas are carried out.
That patients at whom disturbances in work of a nervous system are observed should carry out therapy using sedatives. It is important to adhere to a diet and to exclude the food and drinks influencing an organism excitingly.
At the solar small tortoiseshell it is necessary to accept the photodesensibilizing means.
To adjust the general exchange processes in an organism, administration of drugs of iron, vitamins, hyposulphite sodium, etc. practices.
As auxiliary methods outside therapy for which folk remedies perfectly are suitable is applied. These are broths of a camomile and a train for bathtubs, also prepare bathtubs from bran, starch. Also ointments with corticosteroid hormones are applied.
Except the described therapy methods important points of complex treatment of the small tortoiseshell is the optimum sleep pattern and rest, a diet, normalization of the general state of health.
The small tortoiseshell at children is treated using the same methods, as at adult patients. However treatment at children of this disease has to be carried out only by the doctor. Parents have to provide observance of a diet at which of a diet products with the content of biologically active agents are excluded. Use of a cleansing enema at the child allows to provide cleaning of an organism of allergen in certain cases. Antihistamines are also surely applied.
Display of urticaria at pregnancy does not exert impact on the developing fruit. But for elimination of such manifestations the doctor appoints to future mother antihistaminic drugs. Also use of the cooling and moisturizing creams which reduce an itch a little practices. It is recommended to wear convenient free clothes, to take a shower more often.
Prevention of the small tortoiseshell
As measures of prevention of development of the small tortoiseshell treatment of gastrointestinal diseases, elimination of the centers of persistent infection, an exception of all factors capable to provoke an allergy is important. It is necessary to observe the balanced diet.
Prevention of the small tortoiseshell at children provides very attentive relation to all irritants. Therefore, all new food stuffs have to be entered into a diet carefully and gradually. It is important to take the measures allowing to strengthen a condition of immune system of the child. If the kid is subject to frequent display of an allergy, it needs to be driven periodically on reception to the specialist allergist.