Shamberg disease (chronic pigment purpura, hemosiderosis of the skin) is called chronic pathology, which is caused by damage to the skin capillaries.
As a result, punctate petechiae (hemorrhages, as if punctured by a needle) appear on the skin, which turn into spots of brown or brown color.
The disease has fairly typical manifestations: rashes are symmetrical, but have external diversity.
This happens because new and old hemorrhages can be on the skin at the same time.
With Shamberg’s disease, there are no general disturbances of well-being, since there is no hemorrhage anywhere except in the skin vessels. The course of the disease is benign, does not give complications and does not violate the general state of health.
There are four types of Shamberg disease:
1. Petechial type
Mostly masculine. Rashes appear on the skin of the thighs and lower legs – these are different spot sizes with an uneven contour.
Spots consist of many grouped small point hemorrhages. As they develop, they become brown-yellow or brown-brown. On the skin there is no swelling and discomfort.
2. Teleangiectic type.
Rashes are located all over the body, they appear as “medallion-like” spots, in the center of which telangiectasias are located (deformed and dilated subcutaneous vessels) and along the edges – point hemorrhages. Rashes do not hurt and do not itch, do not cause discomfort.
3. Lichenoid type of Shamberg’s disease.
Rashes are scattered throughout the body. There may be nodules on the skin, they are abundant and multiple. There are point hemorrhages. There are stains with deposition of pigment and skin nodules with a shiny, unchanged surface.
4. Eczematous type.
These are manifestations of the petechial type of Shamberg’s disease , in which there are also signs of eczema.
Unlike the symptoms of the first type of Shamberg’s disease , the lesions are swollen, with bubbles, nodules and even crusts. They itch like a typical eczema.
In order to establish an accurate diagnosis, consultation and then treatment with a dermatologist is necessary.
Sometimes an additional visit to the allergist-immunologist is required.
The initial diagnosis is established on the basis of typical manifestations on the skin and descriptions of the dynamics of the rash by the patient himself.
One of the main diagnostic methods for determining the disease is Shamberg dermoscopy affected area – the study of the upper layers of the skin under the microscope.
In Shamberg’s disease, the doctor will find:
- changes in capillaries with their swelling,
- special extensions along the vessels (allergens accumulate in them),
- red blood cells outside the vessels
- areas of ulceration of blood vessels
- the vessels are constricted due to the proliferation of intact areas of the vessels (to try to close the defects).
The treatment is based on:
diet therapy with the exception of potentially allergenic and irritating products (chocolate, citrus, strong drinks in the form of coffee and tea, fried foods with a crust, smoked meats, alcohol and citrus are excluded),
It is recommended to eliminate skin bruises,
It is necessary to exclude hypothermia of the legs and arms,
only moderate loads are shown,
rehabilitation (thorough treatment ) of chronic foci of infection – dental caries, tonsillitis, endocrine pathology, chronic diseases,
Careful and delicate skin care with the use of exclusively hypoallergenic cosmetics is necessary.
From drug therapy are used:
since Shamberg’s disease is immune, corticoid hormones (prednisone and its analogues) are used,
apply means that inhibit inflammation of the walls of blood vessels,
vascular preparations that stimulate regeneration and drugs that prevent blood from coagulating inside the capillaries ( disaggregants ) are shown.
In severe cases of Shamberg’s disease, methods are used to remove immune complexes from the blood — hemosorption, plasma exchange, and cryoprecipitation.
The prognosis for the disease is favorable, since it does not affect the general state of health and development of the organism. But the quality of life of Shamberg’s disease violates – patients are embarrassed by their appearance, they cannot wear open clothes.
The mechanisms of the disease are not precisely established, but one of the versions is more preferable. It is believed that damage to the walls of blood vessels has an autoimmune nature, that is, the cells of their own blood vessels are perceived as an allergen, and they are attacked by the immune system.
As a result, the walls of blood vessels are damaged, holes are formed in them, through which a little blood goes under the skin. Visually, it looks like a pinpoint hemorrhage. Gradually, iron from red blood cells that have entered the skin begins to transform into a special pigment, hemosiderin. It has a brown color and gives a specific color to the skin.