What diseases are petechial hemorrhages. Bloody rash: what do petechiae say? . red dots on face after vomiting

Formations on the cover of the skin and adults are a common phenomenon that requires considerable effort to eliminate it. There are different types of formations. Some are localized, others descend lower on the body and affect the entire body, others do not appear at all, but can be transmitted from mother to child in a vertical way. One of the varieties of such formations are petechiae on the skin. will be discussed in our material. With a competent approach to therapy, you can do timely elimination and get impressive results.

What is petechiae

Petechiae are visible skin formations that appear in the process of rupture of blood vessels. They are the result of leakage of blood fluid under the skin surface or in the area of ​​the mucous membranes. There is a local lesion of the layer under the skin, since the diametrical indicators of these phenomena do not exceed 1-2 mm. However, the manifestation of petechiae is carried out immediately after the penetration of the lesion, and they affect the skin in large numbers, covering an impressive area of ​​​​the skin or mucous membrane. The rashes are of a flat type and do not lose their color characteristics, even if you press on them. Such manifestations can occur anywhere - in any area of ​​\u200b\u200bthe body, including the torso, limbs, mouth, and scalp.

There are several generating factors in terms of the formation of petechiae. The main reasons for the formation will be discussed next.

• Capillary traumatic phenomena and injuries. As a result of this lesion, there is a rupture of bodies and particles, blood flows under the surface of the skin. due to the weakness and underdevelopment of the body, the phenomenon may manifest itself during a fall, the same applies to people with fragile skin. a more serious blow is required.
• The lack of vitamin K group entails the occurrence of these phenomena. The fact is that non-compliance with the subtleties of caring for a baby and a lack of healthy nutrition can cause childhood scurvy, represented by diffuse skin hemorrhage and damage to the oral mucosa.
• If a child or adult suffers significantly from coughing fits and similar phenomena, formations can manifest themselves in the area of ​​\u200b\u200bthe mucous membranes of the throat, as well.
• One of the side effects responsible for the appearance of the affected areas may be the use of acetylsalicylic acid, used to eliminate respiratory and viral diseases, including influenza.
• Often acts as a result of the treatment of varicose veins, so the therapy is aimed not only at eliminating the consequences in the form of ugly spots, but also at the use of drugs that provide blood thinning.
• If the patient has frequent bouts of vomiting, it can also be observed in the neck and other parts of the body.
• Regular or constant wearing of tight clothing may form petechiae anywhere in the localization. You can eliminate the situation by eliminating the subject of close contact with the skin.

There are a lot of reasons for the formation of phenomena, therefore the therapeutic complex consists in the fight not only with the consequences, but also with the primary sources.

Pathological causes of the formation of the disease

There are situations when petechiae on the skin (the photo can be seen in the article) appear as separate symptoms against the background of other manifestations and. In this case, it will be necessary to make efforts not only to eliminate the consequences, but also to remove the causes of the disease.

• Thrombocytopenia is a disease caused by a violation of the functions of blood clotting. If the skin suffers minor damage, you can become a victim of serious bleeding. The disease proceeds with constant complications in the areas of soft tissues.
• Lupus erythematosus is a disease accompanied by a serious violation of the blood. During such failures, a change in the structure of DNA occurs through antibodies. In this situation, petechiae can act as signs of a serious autoimmune process.
• Diseases that contribute to the destruction of connective tissues, which can provoke sudden changes in temperature. Due to this phenomenon, the capillaries burst, and the face, limbs may appear.
• Abscess and sepsis are ailments represented by an infected blood process, which can lead to education. In this case, therapy can be administered by several specialists at the same time.
• Gonococci, staphylococci are diseases that are responsible for the processes of impaired blood circulation, occur against a background in which a rash forms in the limbs. In the second case, a purulent rash acts as a sign of the disease, sometimes it can degenerate into gangrene (in the absence of timely qualified help from doctors).

Timely receipt of the help of competent doctors in pathological processes guarantees a quick recovery.

and children appear almost the same, but in the second category of the population it is more common due to the delicate and fragile skin of small children.

Petechiae on the skin, the photos of which are presented in the article, can occur in children. Often this phenomenon takes place due to the curiosity of the kids and their desire to play active games and fight against blunt objects. The formations themselves do not cause threats, however, they spoil the appearance of the baby and can become serious factors for reducing self-esteem in adulthood, if treatment is not started in a timely manner and the formation of new phenomena is not prevented.

Formations on the skin of the face in children can also appear due to other ailments. For example, pathogens are infections and other phenomena associated with problems in the functioning of the immune system, so do not neglect the detected rash. In infancy, a rash that appears can cause the child to have insufficient hygiene. If effective solutions are not taken, the rash will spread, acquire the character of an infection, which will be much more difficult to cope with.

If or have a relatively understandable nature of origin (falls and injuries, mechanical damage, beriberi, insufficiently good hygiene), then there are few reasons for the formation of an ailment in the sky. Usually, children have petechiae in the sky if they abuse solid food and eat a lot of dry buns, vegetables, fruits. To prevent the phenomenon, it is necessary to review the child's diet and include only soft foods in it.

Another reason why petechiae form in the palate in children is that when coughing, the formations affect the mucous membrane of the throat, but with significant phenomena, they spread to the palate. In this regard, the child may feel discomfort. The situation is aggravated by the fact that in certain situations which can be seen in the article, it does not manifest itself in any way, and parents have no idea about the existence of the phenomenon.

There are a lot of reasons for the appearance of petechiae on the legs, since these can be natural phenomena, mechanical damage and pathological processes. In children, they appear due to falls during active games or against the background of serious illnesses.

Also, insufficient hygiene leads to the spread of the rash to the ass, legs and stomach. In adults, the cause may also lie in a fall or in pathologies. Single petechiae can go away on their own, so you should not sound the alarm too much, however, with strong processes and phenomena, medical intervention will be required.

Petechiae treatment with folk remedies

If petechiae have formed, the main task is to establish the cause of their formation and eliminate it. The search for the cause is quite simple: remember if there was any mechanical damage to the skin in the near future, then analyze the drugs you are taking, review your own diet and start diagnosing pathologies if the cause has not yet been identified.

What to do with the formation of petechiae

• The first action is to contact a specialist, especially if the formations appeared on children's skin without any special reasons and provoking factors. Which doctor treats petechiae on the skin depends on the conditions in which they arose.
• This is followed by the treatment of the phenomenon that caused the formation of petechiae. The process is aimed at taking a certain course of drugs and undergoing appropriate therapy, but only a doctor can provide you with effective help.
• Older people develop petechiae due to age-related changes in the blood and skin. Therefore, it is necessary to strictly take care of yourself and prevent any falls and unpleasant situations associated with mechanical damage.
• Wait for the petechiae to disappear. If, in the presence of a disease, petechiae disappeared and reappeared, then with its treatment, problems will not bother you again.

Compliance with the list and algorithm of actions will allow you to avoid serious consequences and create favorable conditions for a quick and high-quality recovery.

Elimination of petechiae folk remedies

It is appropriate to use traditional medicine preparations for the treatment of formations if they arose due to mechanical damage. If the provoking factors are something else, it is necessary to pay attention to the elimination of the disease that is the "culprit" of these manifestations. There is a set of methods that will cure petechiae on the skin, the photos are discussed in the article.

• Ingestion of medicinal herbs aimed at normalizing the function of blood circulation and thinning the blood. It can be herbal decoctions - chamomile, St. John's wort, rosemary, motherwort and other herbs. By the way, you can use special fees, which not only have a liquefying effect, but also perfectly soothe.
• Compresses are also effective methods for the treatment of small formations of children and adults in any bodily areas. "Cold reaction" will reduce the size of the formations and reduce their number until complete disappearance. Ice must be wrapped in a scarf or towel and applied to the area that bothers you.

baby has petechiae

Found (13 posts)

I have already seen enough of them both at home and at the younger child. The youngest during each ARVI on ... due to problems with the liver, there may be petechiae or there would be other rashes... -Danlosa. Could he be the cause? At child(like me) there is indeed a downside...

hematologist February 21, 2011 / Alla

Hello. child 2.5 years on the thigh and above the elbow, dark red dots (two) appeared for 1 month already, they are not ... normal. The dots do not itch, when pressed. do not disappear. The doctor says that this is a hemorrhagic rash, petechiae.But why don't they disappear. Thank you.

Flat red spots on different parts of the body, single and multiple, do not change color, size, location when pulling the skin or pressing, what is it? The slightest bruises, no more than two millimeters in diameter, that occur when red blood cells come out into the interstitial space, are called petechiae.

The appearance of such points on the skin may indicate blood diseases, the presence in the body, autoimmune diseases. Similar rashes can also appear in healthy people with frequent stressful situations. In such cases, the symptoms of petechiae go away on their own after a while.

When the integrity of the capillary walls is violated, blood elements (platelets) begin the process of blood clotting and wound healing. In a normal state, a thrombus forms at the site of injury, which prevents blood from pouring out, if a person has spots, red blood cells come out.

By type of origin, petechiae are:

• Primary small dots of purple color, after which it changes to yellow due to the formation of a dark yellow pigment consisting of iron oxide in the tissues. After a while, the rash loses its clear color.
• Secondary ones are associated with the passage of red blood cells into the nearest tissues. Such formations cannot go away by themselves, they require surgical intervention.

Children with weak immune systems may develop rashes all over their bodies. This may be due to the entry of the virus into the body. The spots are accompanied by fever, pain in the head, shortness of breath. In severe cases, the child may fall unconscious, convulsions, delirium may begin.

Diseases of the body systems lead to a misperception of human immunity in relation to its parts. So, for example, those who perceive the walls of blood vessels as foreign, settle on them and destroy them. The patient feels pain in the muscle tissues, in the left half of the chest, joints, increased sweating.

The appearance of a rash on the skin, accompanied by symptoms, quickly spreading throughout the body, large and blue, requires urgent admission to the hospital.

The reasons

There are several causes of petechiae, which are divided into physical and pathological.

Physical causes of petechiae:

• Injury to a skin area, for example, after a blow in adults and when playing in children.
• Strong emotional shock, causes spots on the face;
• With strong stress during childbirth;
• Some sports can affect the occurrence of spots;
• Tight clothing;
• When pinching the skin, for example, with a tourniquet;
• When aging.

Pathological causes of petechiae include:

• Diseases associated with impaired functioning of the human immune system;
• Infection in the body;
• Insufficient amount of a number of vitamins in the body;
• Autoimmune damage to small vessels;
• Hormonal disbalance;
• Oncological diseases;
• Taking drugs;
• Long-term use of certain drugs.

Petechiae is divided into several types depending on the underlying disease:

• With meningitis, a rash appears in the form of pale stars on the thighs, shins, buttocks, legs, and lower abdomen. Merging with each other, they form wide spots, the surface of which dies off after a while.
• With gonorrhea, the rash focuses on the distal legs, above the joints. It has the form of pustules filled with blood. Bladder disorders occur.
• Staphylococcus manifests itself as petechiae with pus, inside of which there is an infection. Here, cell permeability increases, spots appear on the face.
• In autoimmune diseases (, for example), rashes appear on the limbs, both lower and upper. In addition, a person feels symptoms such as fever, pain in the muscles, joints, general malaise. After some time, the rash disappears, but the skin still differs in color from healthy areas and peels off.

Symptoms of petechiae with inflammation of the walls of blood vessels:

• Pain in the abdomen;
• Inflammation of the joints of the lower extremities;
• Sometimes diarrhea, vomiting, fever.

With chronic petechial hemorrhage on the skin, with inflammation of the capillaries, petechiae are most often localized on the legs. First, a lot of brown small spots, which later disappear, but then reappear. The disease is more common in men than in women.

When an infection enters the body, fever, pain in the muscles, inflammation of the meninges, and dysfunction of the gastrointestinal tract first occur. After some time, these symptoms subside, in return for them come rashes all over the body, which last one day.

Diagnostics

Diagnosis of petechiae includes several methods. In addition to listening to the patient's complaints, collecting an anamnesis, there is also:

• laboratory research, which includes counting all types of blood cells, determining their parameters, measuring hemoglobin levels, determining the ratio of cell mass to plasma;
• puncture of the ilium, calcaneus, tibia or sternum.

Treatment

If a person does not feel a deterioration in well-being, and petechiae have appeared, then they do not need special treatment.

In other cases, the following types of therapy are used:

• If a part of the body is injured and a rash appears, it must be cooled so that they do not spread. For this, a moistened towel is perfect, which is applied for fifteen minutes to the affected area.
• If an infection occurs, a course of antibiotic therapy is prescribed.
• In case of allergy, the element that causes it should be eliminated and the body's sensitivity to it is reduced with the help of drugs, antihistamines are indicated for severe itching.
• With the appearance of a rash associated with impaired immunity, desensitizing drugs, corticosteroids, and substances that seal the vessels are prescribed. The course of treatment in this case lasts up to two months.

After each therapy, patients are prescribed vitamins, blood transfusion, the introduction of blood proteins that have a high molecular weight and lower solubility in water.

Any rash on the skin should alert. For example, a rash can occur with an enterovirus infection and quickly pass. And it can be one of the symptoms of a deadly disease - meningitis. The presence of petechiae and purpura during infectious processes indicates the severity of the disease.

Petechiae appear on the skin as a result of capillary hemorrhages. And, if blood is found under the tissues in large areas, the process is called purpura.

Purpura is a pathological formation that has a purple-red color and does not change it when pressed. Rashes, less than 1-2 cm in diameter - petechiae.

General representations

Petechiae are a special case of purpura and are round in shape. Spots of a red or purple hue are formed in the process that red blood cells leave the vascular bed into the space located between the tissues. They do not rise above the skin and cannot be determined by palpation.

Petechiae on the skin, the photo of which is presented, can be one of the informative signs of such processes as blood diseases, systemic autoimmune and infectious diseases. This type of rash can also appear after a physical injury or excessive pressure (squeezing) of the skin. Rare causes of petechiae are coughing and vomiting (especially in young children). Capillary hemorrhages appear around the eyes.

Places of localization: arms, legs, torso, face, mucous membrane of the eyes or oral cavity. Occurs in all age groups.

The appearance of purpura is a response to changes occurring in the body. Very often, the cause of the occurrence is an insufficient number of platelets and a violation of the processes of blood clotting.

The rash with purpura is most often localized in the lower extremities.

The occurrence of petechiae and purpura may be associated with the appearance of a bacterial, fungal or viral infection: the presence of cytomegalovirus, meningococcus, manifestations of infectious mononucleosis, scarlet fever, septic processes.

Types of purpura

In medical practice, there are several varieties of this disease:

It is formed when the total number of platelets decreases. There is both an independent disease and a symptom of another process. It occurs mainly in girls under 14 years of age.

The mechanism of development is associated with a change in the properties of platelets during infectious processes or the use of a number of medications. Platelets enter the spleen and are destroyed there. The result is thrombocytopenia.

Bruises and petechiae appear on the skin from the slightest blow. An accompanying symptom may be: bleeding from the nose, on the gums, from the uterus.

Rashes can change their color depending on the stage of the pathological process and the statute of limitations: from red to purple, green or yellow (within 10 days after the first spot).

Thrombocytopenic purpura in children can acquire a chronic course (recurrent bleeding). The main type of therapy is resection of the spleen.

Thrombotic thrombocytopenic purpura

Caused by the formation of blood clots due to the use of certain medications, vaccinations, cancer, or meningococcal infection.

The main symptom complex:

• the formation of petechiae and bruises;
• pain symptom in the abdomen and head;
• vomiting and nausea;
• visual function is impaired;
• mental and nervous system disorders.

With such a disease, the vessels of the brain, kidneys, and liver are affected. These processes result in death.

Schonlein-Henoch purpura

An infectious process caused by viruses or bacteria, the use of certain medications, can cause inflammation in the vessels. The first symptoms will be:

• small-spotted rashes;
• the temperature rises to subfebrile numbers;
• pain in the joints, abdominal area;
• diarrhea.

Toxic purpura

It develops with the use of medications that pathologically affect the blood: they strongly thin or, on the contrary, thicken.

allergic purpura

Occurs when there is an allergy to food, drugs, chemicals.

Diseases and petechiae

The rash happens:

1. Primary.

   Passes on its own

2. Secondary.

   It is characterized by the ingress of blood clots into adjacent tissues. Surgery is required to treat them.

There is a relationship between the main symptoms, visual inspection of the rash and the disease. They are listed in the table:

Symptoms

With the formation of petechiae and purpura from the skin the following symptoms may be observed:

• the formation of bubbles with the flowing liquid, the formation of crusts;
• pain;
• the formation of pustules;
• rashes can appear quickly and disappear just as quickly;
• peeling of the skin;
• edema formation.

Common symptoms include:

• loss of appetite;
• symptoms of a respiratory disease;
• increased excitability and irritability (more often in childhood);
• pain in the joints;
• redness of the mucous membrane of the eyes;
• runny nose and sneezing.

Rashes that are accompanied by the following symptoms require immediate medical attention:

• loss of consciousness;
• an increase in body temperature to 38.5 ° C and above;
• any kind of bleeding;
• tachycardia;
• respiratory failure;
• symptoms of meningitis;
• an allergic reaction, which may be accompanied by soft tissue swelling.

It should be remembered that neglect of your health can cost your life!

Diagnostics

If petechiae or purpura appear on the skin, you should consult a hematologist. He will conduct an external examination, collect an anamnesis of the disease and prescribe additional laboratory diagnostic methods. This will help establish the correct diagnosis and prescribe adequate treatment.

During external examination, it is important to pay attention to the location of the rash. According to its location, a preliminary diagnosis can be made.

The main diagnostic methods are a general blood test (thrombocytopenia, ESR / CRP, as well as the level of leukocytes, most likely increased).

Additional methods include:

• a set of tests to assess the functions of the liver;
• a blood test for the level of urea, creatinine, electrolytes;
• study of coagulability indicators using a coagulogram;
• electrophoresis of blood plasma proteins to detect paraproteins.

Auxiliary diagnostic methods:

• autoimmune tests;
• additional diagnostics in the conditions of placement in the clinic (biopsy of the skin and bone marrow).

Rashes that arose spontaneously and passed by themselves are not accompanied by any clinical symptoms and do not require special therapy. But, it is still necessary to undergo a diagnostic examination to identify hidden foci of internal bleeding.

Treatment of purpura

Treatment should be started as early as possible, since in 30% of cases the disease can be fatal.

The main methods of treatment, depending on the cause of the disease:

Restorative therapy:

• vitamin preparations of groups K, P, C;
• transfusion of blood, erythrocyte mass;
• liver extract;
• globulin injections.

The main methods of treatment for purpura include:

• resection of the spleen with thrombocytopenia;
• blocking the action of antibodies on platelets;
• restoration of blood clotting processes;
• hypoallergenic diet.

Strict observance of all medical prescriptions will certainly lead to relief of the general condition and a speedy recovery.

Disease prevention

It is better to prevent any disease than to waste energy, nerves and money on the recovery process.

To prevent the appearance of pathological rashes, it is necessary to protect your skin from childhood: avoid injury, hypothermia or overheating. It is necessary to use drugs (especially those that affect the blood) only under strict medical supervision. If possible, avoid contact with possible allergens.

Prevent the transition of the disease into a chronic or severe form of the course. At the slightest symptoms of the disease - seek medical help.

Changes in the oral mucosa in endocrine diseases

A change in the function of the endocrine glands causes pronounced metabolic disorders, trophic disorders in tissues. Dental manifestations of some endocrine disorders are of great diagnostic value, as they often precede the manifestation of general clinical symptoms of the underlying disease. Therefore, knowledge of the features of changes in the oral mucosa in endocrine disorders helps to identify the early stages of the disease, as well as the correct assessment of local manifestations of the general pathology and the choice of treatment methods.

Diabetes. AT The basis of the disease is a violation of carbohydrate metabolism. In the oral cavity, changes are observed, the severity of which depends on the severity and duration of diabetes. The most characteristic changes in the oral cavity are xerostomia, catarrhal stomatitis and glossitis, fungal stomatitis, mycotic congestion, paresthesia of oral mucosa, trophic disorders, lichen planus.

To serostomy (dry mouth)

- one of the early symptoms of diabetes. Develops due to dehydration. Quite often at the same time constant thirst, appetite are noted. The mucosa becomes slightly moist or dry, cloudy, with a significant accumulation of plaque, often hyperemic.

Catarrhal stomatitis, glossitis occur due to infection, mild vulnerability, due to a sharp decrease in the barrier function of the oral mucosa and its unsatisfactory cleansing (Fig. 138) . This is facilitated by a decrease in salivation. In places of minor mechanical injury, damage to the oral mucosa is observed in the form of hemorrhages, sometimes erosions.

Fungal stomatitis, mycotic stomatitis develop as a result of dysbacteriosis against the background of a sharp decrease in the body's resistance, a decrease in the content of many enzymes in saliva, especially such as lysozyme. Favors this change in acid-base balance

Diabetes. Catarrhal glossitis complicated by candidiasis.

due to an increase in the amount of under-oxidized metabolic products (pyruvic and lactic acids). Fungal lesions of various parts of the oral cavity are characterized by constancy. Mycotic seizures are especially common, with cracks appearing in the corners of the mouth, covered with whitish-gray crusts.

Paresthesia and S OPR occur along with its dryness. The burning sensation of the oral mucosa is often combined with itching of the skin in the genital area and other parts of it. Lesions of the nervous system are manifested by neuritis and trigeminal neuralgia. Taste sensitivity to sweet, salty, sour may decrease. Violation of taste sensitivity is functional in nature and after the treatment is normalized.

Trophic disorders of the OOP are characterized by the appearance of trophic ulcers, which are characterized by a long course with delayed regeneration. The decrease in the regenerative properties of the RMS is due to the violation of redox processes.

The described changes in the oral mucosa do not have specific features characteristic of diabetes. Therefore, in the diagnosis, anamnesis, a general examination of the patient, including laboratory tests, are important. In diabetes, there is an increase in blood sugar, its appearance in the urine.

The dentist treats the patient together with the endocrinologist. With pronounced changes in the oral cavity, taking into account their manifestation, symptomatic treatment is prescribed: fungistatic drugs - for fungal infections (decamine, diflucan, levorin, nystatin, etc.), agents that improve trophism and regeneration - for trophic ulcers (sanguirythrin, camillosan, lutenuric emulsion, vitamins of group B, Vitalong, cocarboxylase), agents that improve carbohydrate metabolism, and correctors of metabolic acidosis (namacyte).

Myxedema develops with insufficient thyroid function. Mostly women are ill. The patient's face has a peculiar appearance: the lips and nose are thickened, the upper eyelids are sharply swollen, the facial expression is indifferent. Patients have anemia, edema and dryness of the oral mucosa. Myxedema is accompanied by a significant increase in the tongue, which sometimes does not fit in the oral cavity, an increase in the lips, gums. Due to swelling of the larynx, the voice becomes deaf.

Treatment of myxedema is carried out by an endocrinologist, prescribing thyroid hormone. The dentist performs oral cavity sanitation and symptomatic treatment if necessary.

Gingivitis of pregnancy is an inflammation of the gums that first occurs during pregnancy or is exacerbated by pregnancy. The development of the disease is associated with the restructuring of the hormonal balance during this period. The occurrence of gingivitis depends on the gestational age. The first signs of it appear at 3-4 months of pregnancy, when the most intense neurohumoral changes occur in the body. In the first half of pregnancy, a mild form, mainly catarrhal gingivitis, is noted. In the second half - the course of the disease is severe, with the development of a proliferative process in the gums. In the initial stage of gingivitis, the gingival margin becomes bright red, swells, and bleeds easily. Gradually, the affected gum becomes dark red, bluish, enlarges, and in the presence of local irritants, hypertrophic gingivitis develops (Fig. 139). Hypertrophic gingivitis of pregnant women has a tendency to polypous growth of individual papillae. Sometimes false epulides develop. hypertrophied

RICE. 139. GINGIVITIS during pregnancy.

gum covers the entire crown of the tooth, bleeds easily, prone to ulceration.

Treatment. Mild forms of gingivitis in a significant number of pregnant women after childbirth are self-healing. Local treatment of gingivitis of pregnant women is carried out according to the principles of treatment of catarrhal or hypertrophic gingivitis.

Prevention of gingivitis of pregnant women consists in the prevention of toxicosis and in the active full sanitation of the oral cavity.

Itsenko-Cushing's disease. The main concern

levaniya is a violation of the main types of exchange. The disease develops as a result of hyperproduction of glycocorticosteroids, which is a consequence of: a) primary violation of the adrenal cortex; b) hyperproduction of ACTH by the adenohypophysis; c) dysfunction of the pituitary gland. The oral mucosa in such patients is edematous, there are impressions of teeth on the tongue and cheeks. Emerging trophic disorders lead to the appearance of erosions and ulcers, characterized by a long course. Often there is candidiasis.

Treatment is carried out in conjunction with an endocrinologist. Shown sanitation of the oral cavity and symptomatic therapy, depending on the clinical manifestations.

Addison's disease due to the cessation or decrease in the production of hormones of the adrenal cortex. The most characteristic symptom of the disease is specific skin pigmentation and mucosal mucosa. In the oral cavity, on the lips, along the edge of the tongue, gums, buccal mucosa

Changes in the oral mucosa in diseases of internal organs and systems

small spots or stripes of a bluish, grayish-black color appear. Subjectively, patients do not feel them. Changes in the mouth and on the skin occur due to the deposition of a large amount of melanin.

The diagnosis of the disease is confirmed by such general symptoms as hypotension, gastrointestinal disturbances (nausea, vomiting, diarrhea), exhaustion. Pigmentation of the oral mucosa in Addison's disease is differentiated from congenital pigmentation and deposits of salts of heavy metals. For treatment, preparations of the adrenal cortex are used.

Changes in the oral mucosa in diseases of the blood and blood-forming organs

In most diseases of the blood and hematopoietic organs, functional and organic changes occur in the oral mucosa, often signaling the development of a pathology of the blood and the hematopoietic system. Often, being the only initial symptom of a disease, changes in the oral cavity, detected in a timely manner by a dentist, with their correct interpretation, facilitate the timely diagnosis of a blood disease. Often, changes in the oral mucosa are so specific that they make it possible to almost accurately diagnose a particular disease of the red or white blood.

Anemia is a condition characterized by a decrease in the number of red blood cells and a decrease in hemoglobin content per unit volume of blood. There are many types of anemia. We will focus only on those in which there are changes in the OM.

Iron-deficient (hypox-chromium) anemia (chlorosis). The occurrence and development of iron deficiency anemia is associated with iron deficiency in the body due to its deficiency in food, loss during bleeding, as a result of malabsorption and iron metabolism disorders. There are early and late chlorosis. Early chlorosis develops as a result of endogenous iron deficiency due to increased consumption

body - the period of growth, pregnancy, lactation. Late chlorosis manifests itself in 30-50 years in women.

With early chlorosis, patients complain of a violation of taste sensations, smell, loss of appetite, nausea. The oral mucosa is without noticeable disturbances, with the exception of a change in its color - it becomes pale. With late chlorosis, all symptoms are more pronounced. Patients complain of pain in the tongue and oral mucosa during the use of sour or spicy foods, dry mouth, paresthesia (burning, tingling, tingling and swelling of the tongue), the presence of angular cheilitis.

The clinical picture of hypochromic anemia is characterized by multiple lesions of teeth by caries, their increased abrasion, loss of the natural luster of enamel. SM of lips, cheeks and gums is pale, edematous. The tongue is edematous, the papillae are atrophied, especially in its anterior half. It becomes bright red and smooth, as if polished, deep folds appear. Sometimes there are hemorrhages, cracks in the corners of the mouth.

The blood picture is manifested by hypochromia

A sharp decrease in the content of hemoglobin in each erythrocyte with a normal or slight decrease in their number. Hemoglobin level - 20-30 g/l. The color index decreases to 0.4 and below. The content of iron in the blood is below normal, the level of plasma proteins and mineral salts is also reduced.

Treatment. Iron preparations, vitamins are prescribed, symptomatic therapy of manifestations in CO is carried out.

Hypoplastic anemia occurs under the influence of exogenous factors - physical (irradiation), chemical and drug, as well as endogenous aplasia of the bone marrow. The causes of congenital hypoplastic anemia have not been established. They are characterized by a sharp anemia of all organs, aplasia of the bone marrow, atrophy of the endocrine glands. In addition to general clinical symptoms, there are changes in the oral mucosa. Against the background of a particularly pale mucosal mucosa, hemorrhages of various sizes appear. Interdental papillae are edematous, cyanotic, bleeding, deep periodontal pockets are found. On the ROM, in addition to petechiae, erosions, ulcers, and necrotic areas are observed.

Anemia Addison-Birmer. Genter's glossitis.

The blood picture is characterized by erythroleukocytopenia.

Treatment. Systematic blood transfusions, injections of sodium nucleinate to stimulate the proliferative function of the bone marrow, desensitizing therapy, steroid hormones are shown. The dentist performs symptomatic treatment of manifestations of hypoplastic anemia.

B 12 - fol i e v o de f and c and t n and i anemia (malignant anemia, pernicious

oznaya anemia, Addison's disease - Birmer) is characterized by a violation of erythropoiesis. Addison-Birmer anemia develops due to vitamin B12 deficiency in the body, resulting from atrophy of the epithelium of the gastric glands and mucoprotein deficiency, which causes the absorption of vitamin B12 from food.

Vitamin B12 and folic acid are essential factors for hematopoiesis. Absorption of vitamin B12 (external factor) is possible only in the presence of the internal factor Kastle (gastromucoprotein), which is produced in the stomach. The combination of vitamin B|2 with gastromucoprotein leads to the formation of a protein-B12-vitamin complex, which, being absorbed, converts folic acid into its active form - folinic acid, which ensures normal erythropoiesis.

More common in women aged 50-60

years. The disease develops imperceptibly, gradually. The clinical picture of the disease consists of a triad: dysfunction of the digestive tract, hematopoietic and nervous systems. One of the early symptoms of the disease is pale skin and oral mucosa, their yellowish tint. Sometimes petechial hemorrhages are observed on the mucosa.

The most characteristic lesion of the oral mucosa in malignant anemia is the Genter's glossitis. The back of the tongue in this case has the appearance of a smooth, shiny, polished surface due to atrophy of the fungiform and filiform papillae, thinning of the epithelium and muscle atrophy. Painful, sharply limited stripes and spots of bright red color of an inflammatory nature appear on the back and tip of the tongue (Fig. 140).

A clinical blood test confirms the diagnosis of pernicious anemia: there is a significant decrease in the number of red blood cells with a moderate decrease in hemoglobin levels and a high color index (1.4-1.6). Erythrocytes are characterized by pronounced aniso- and poikilocytosis with the presence of megalocytes and megaloblasts. Leukopenia, neutropenia, thrombocytopenia are noted.

Treatment is carried out in hematological clinics. Vitamin B12, folic acid, ascorbic acid, campolon, antianemin, iron preparations, blood transfusion, etc. are prescribed. Symptomatic treatment is carried out locally, oral cavity sanitation.

Leukemia is a malignant disease of the hematopoietic organs that occurs as a result of progressive cellular hyperplasia in the hematopoietic organs, when the processes of cell division (proliferation) prevail over the processes of maturation (differentiation). The pathomorphological substrate of the disease is leukemic blast cells that correspond to the parent elements of one of the hematopoietic lineages.

There are acute and chronic leukemia. Based on the clinical, morphological and cytological picture, separate variants of acute leukemia are distinguished: myeloid, lymphoblastic, monoblast, promyelocytic, undifferentiated. The criterion for differentiating the forms of the disease is the cytochemical characteristics of the pathomorphological substrate.

Changes in the oral mucosa in diseases of internal organs and systems

Acute leukemia. Necrosis of the mucous membrane of the cheek along the line of closing of the teeth.

owls in the oral cavity is associated with a sharp decrease in tissue resistance, which is due to a decrease in the phagocytic activity of leukocytes and the immune properties of blood serum. It should be taken into account that the use of cytostatic drugs in the treatment of acute leukemia may be the cause of ulcerative-necrotic processes in the oral cavity (Fig. 143).

Patients with acute leukemia experience pain in intact teeth and jaws (along with pain in other bones), which is explained by direct damage to the bones during the leukemic process.

Bone beams are destroyed under the influence of pressure from leukemic cells and osteolytic enzymes. Pain is caused by increased intraosseous pressure, subperiosteal formation of leukemic infiltrates.

Due to a sharp decrease in the body's resistance, protective forces and under the influence of drugs (antibiotics, cytostatics, corticosteroids), candidiasis often develops.

Differential diagnosis. Manifestations of acute leukemia on the oral mucosa should be differentiated from hypertrophic gingivitis of another etiology, ulcerative necrotic Vincent's stomatitis, hypovitaminosis C, intoxication with salts of heavy metals. Hemogram parameters are decisive in the diagnosis of leukemia.

Treatment is carried out in hematological hospitals. Cytostatics, corticosteroids, broad-spectrum antibiotics, blood transfusions, vitamins are prescribed. Treatment of leukemic stomatitis is symptomatic. Extraction of teeth is contraindicated.

Chronic leukemia occurs less frequently than acute, its development is more favorable; the course is long. Chronic leukemia, depending on the nature of the damage to the hematopoietic organs, is divided into myelo- and lymphocytic leukemia.

Chronic myeloid leukemia passes through two stages: benign (it lasts several years) and malignant (terminal), ongoing 3-6 months. The main symptom of chronic myeloid leukemia in the oral cavity are hemorrhagic manifestations, but much less intense than in acute leukemia. Bleeding gums do not occur spontaneously, but only when injured, teeth are removed. During an exacerbation, there are ulcerative necrotic SOPR lesions.

The terminal period of chronic myelogenous leukemia is characterized by severe anemia, exhaustion, intoxication, insufficiency of cardiovascular activity. In the second stage (as in the first during blast crises), there are many myeloblasts and hemocytoblasts in the blood, a rapid increase in the number of leukocytes in the blood is noted, anemia and thrombocytopenia develop.

Chronic lymphocytic leukemia observed predominantly over the age of 40 years, and in men 2 times more often. It is characterized by a slow onset and a long latent course.

In the initial stage of the disease, an increase in the group of lymph nodes is noted. In the developed stage, there is a generalized enlargement of the lymph nodes, pallor of the skin and mucous membranes, leukemic infiltrates of the gums, tongue, and hyperplasia of the interdental papillae appear. Sometimes the growth of the gingival margin reaches the level of closing of the teeth (Fig. 144). The progression of the disease leads to the appearance of ulcerative-necrotic processes due to the loss of immunity due to the underlying disease, as well as long-term use of cytostatics. Bluefarb (1960) describes specific lesions

Changes in the oral mucosa in diseases of internal organs and systems

Chronic leukemia. Hypertrophy of interdental papillae.

ORM in the form of infiltrates and nodes. They have a test-like consistency, cyanotic color, rise above the level of the RMS. The palate, tongue, tonsils are affected.

Characteristic of chronic lymphocytic leukemia is an increase in the number of leukocytes due to mature lymphocytes with the presence of young forms, the appearance of a large number of leukemia cells - Botkin-Gumprecht bodies.

Treatment is carried out in hematology departments. Assign corticosteroids, cytostatics, antibiotics, drugs that prevent the occurrence of candidiasis, vitamins, iron-ascorbic complex. Local treatment - careful care of the oral cavity, its full sanitation, symptomatic therapy.

Agranulocytosis is a syndrome characterized by a significant decrease in the number or absence of neutrophilic granulocytes in the peripheral blood. There are 4 types of agranulocytosis: infectious, toxic (when taking drugs of mercury, amidopyrine, etc.), caused by the action of ionizing radiation on the body, as well as with systemic damage to the hematopoietic apparatus.

The disease begins with an increase in body temperature, pain when swallowing, the formation of hemorrhages, ulcers on the tonsils. An ulcerative-necrotic process develops on the lips, des-

nah, tongue, buccal mucosa and other areas. Ulcerative necrotic process can spread to the esophagus. Important for diagnosis is the absence of an inflammatory reaction of the tissues around the focus of necrosis. Often the necrotic process is combined with candidiasis

The number of leukocytes is sharply reduced

Up to 0.5 - 1.0 x 109 / l. The diagnosis is made on the basis of anamnesis, clinical picture, results of a study of peripheral blood and bone marrow punctate.

Treatment is carried out in hematology departments. Assign pentoxyl, sodium nucleinate, vitamins, blood transfusion, glucocorticoids. Local treatment is symptomatic, it includes antiseptic treatment of the oral cavity, anesthesia, removal of necrotic tissues, administration of drugs that stimulate regeneration.

Erythremia (polycythemia, Wakez disease). The disease is based on hyperplasia of the cellular elements of the bone marrow, especially the erythrocyte germ. Erythremia occurs at the age of 40-60 years, mainly in men.

Clinical signs of erythremia are due to an increase in the mass of circulating red blood cells and circulating blood volume, an increase in blood viscosity, a slowdown in blood flow, an increase in the number of platelets and an increase in blood clotting.

RICE. 145.

Agranulocytosis. Necrosis of the mucous membrane of the alveolar margin.

Thrombocytopenic purpura (Werlhof's disease). Petechiae on the lateral surface of the tongue.

The disease begins imperceptibly, develops slowly. There is increased fatigue, bleeding gums, bleeding from the nose. A characteristic symptom for patients with polycythemia is the dark cherry color of the mucosa. Lips, tongue, buccal mucosa are bright red, which is due to the increased content of reduced hemoglobin in the capillaries. SO in the area of ​​the alveolar processes is loose, with a bluish tinge, bleeds easily when pressed, the interdental papillae are hyperemic, and also have a dark cherry color. An expressive color border is characteristic - cyanosis of the soft and pale color of the hard palate (Kuperman's symptom). Itching of the skin and paresthesia of the oral mucosa is possible due to increased filling of the vessels and irritation of the interoreceptors of the capillaries with blood. The peripheral blood picture is characterized by a significant increase in the number of erythrocytes (6-8 x 1012 / l), hemoglobin content (160-240 g / l) and a sharply slowed ESR (1-2 mm / h).

Treatment is carried out by a hematologist, making periodic bloodletting and using cytostatic therapy with radioactive phosphorus or myelosan.

Thrombocytopenic purpura (disease

Verlhof). The disease is associated with a violation of the maturation of megakaryocytes and a decrease in their ability to produce platelets.

As a result, the number of platelets in the peripheral blood is significantly reduced. Clinically, acute, chronic and cyclic forms of thrombocytopenic purpura are distinguished. Symptomatic thrombocytopenia is observed in allergic conditions and infectious diseases, radiation sickness, drug intoxication.

Werlhof's disease is characterized by a chronic cyclic course. The main clinical symptom of the disease are hemorrhages in the skin and oral mucosa, as well as bleeding from the nose and gums that occur spontaneously or under the influence of a minor injury (Fig. 146). Due to the fact that hemorrhages do not occur simultaneously in the mucosa, sometimes its individual sections have the color of the rainbow. In general, the mucosa in thrombocytopenic purpura is pale, edematous, atrophied, the epithelium is thinned, erosions or ulcers form in places.

In the peripheral blood, along with a sharp decrease in the number of platelets, their pathological forms are observed - giant platelets. Characterized by weakening or absence of retraction of the blood clot, a positive tourniquet symptom, prolongation of bleeding time.

Treatment. Assign transfusion of blood, plasma, platelet mass, corticosteroids, vitamin K, vikasol, calcium chloride, ascorbic acid, vitamin P.

Care should be taken during dental interventions, to prevent a traumatic effect on the oral mucosa. Complex operations are performed with the permission of a hematologist in a hospital after appropriate preparation.

Changes in oral mucosa in hypo- and avitaminosis

Vitamins play an essential role in the life of the body. The main source of vitamins is food, some vitamins are only partially synthesized by the intestinal microflora or are formed in the body in the process of metabolism from provitamins. Insufficient intake of vitamins from food or a violation of their absorption can lead to the development of hypo- or vitamin deficiency.

Changes in the oral mucosa in diseases of internal organs and systems

but for. Avitaminosis in our time practically does not occur, but there is a partial deficiency of one or another vitamin or group of vitamins.

With hypo- and avitaminosis, diseases occur, accompanied by various pathological processes in the oral cavity. The practitioner most often encounters endogenous hypovitaminosis caused by a decrease in the vitamin supply of the body due to a pathological process (tuberculosis, diseases of the liver, stomach, intestines, brucellosis, rheumatism, etc.). In these diseases, despite a fairly sufficient, high-quality and vitamin-rich diet, there is a decrease in the absorption of vitamins in the stomach and intestines or their conversion into biologically active forms by amination, phorforylation is disturbed. In addition, there is a relative vitamin deficiency that occurs during stressful situations, when the body consumes significantly more vitamins than the physiological diet contains.

Relative vitamin deficiency often develops in pregnant and lactating women, expedition members during the period of adaptation to new climatic conditions, and can also be the result of injury, especially bone injury. The development of hypovitaminosis in the oral cavity (OMD, periodontal disease) may occur due to chronic inflammation, or in connection with chronic irritation with dentures or tartar. Permanent chronic trauma of periodontal tissues with tartar leads to a significant decrease in the content of ascorbic acid in the periodontium, and only one of its removal after a while evens out the content of vitamin C in the tissues.

Isolated forms of deficiency of one of the vitamins are very rare, more often a picture is revealed when the human body feels a lack of several vitamins.

Hypovitaminosis C. Insufficiency of vitamin C (ascorbic acid) leads to a violation of metabolic processes in the body, a decrease in its reactivity (a decrease in phagocytic activity, a violation of the formation of AT, etc.), a disorder in collagen synthesis,

processes of growth and development, a sharp violation of the processes of permeability of capillaries and connective tissue structures.

Changes associated with vitamin C deficiency consist of manifestations of hemorrhagic syndrome and complications caused by secondary infection. Hypovitaminosis is accompanied by weakness, weakness, loss of appetite, fatigue, pain in the limbs. The skin becomes dark due to the accumulation of melanin in it, dry, easily flaky.

Vitamin C deficiency is always manifested by changes in the oral cavity. One of the earliest and most frequent symptoms of the disease is scurvy stomatitis. There are three stages of scurvy stomatitis:

1) scurvy stomatopathy - the initial stage;

2) scurvy reparative stomatitis - advanced stage;

3) scurvy ulcerative stomatitis is a complicated stage.

H the initial stage is characterized by severe gingivitis against the background of pale anemic oral mucosa: the gum looks infiltrated, the gingival margin becomes dark red, and bleeds easily. Sometimes there are single petechiae scattered in the gums and oral mucosa. At the same time, petechiae can be found on the limbs, in the region of the legs. Patients complain of general weakness, drowsiness, rheumatoid pain in the limbs,

pain, rapid fatigue. The initial stage is often accompanied by iron deficiency anemia.

The development of the disease is characterized by significant inflammation of the gums. The gums are sharply swollen, overgrown, loose, covering a significant part of the crowns of the teeth. Especially grow and float on the crowns of the teeth, interdental papillae. The gingival margin acquires a cyanotic shade, bleeds significantly when touched. Blood clots often accumulate along the edge of the gingival papillae. Multiple petechiae and ecchymosis are noted on the oral mucosa. The tongue is coated, sharply swollen, along the edges of it teeth marks are visible. Teeth loosen.

Petechiae, ecchymosis and massive hemorrhages are observed on the mucous membrane of the cheeks, palate and in various parts of the body. General

Hypovitaminosis C. Petechiae on the mucous membrane of the hard and soft palate.

the condition of patients worsens, they become adynamic, the face is pale with an earthy tinge. In connection with hemorrhages in the lungs, hemoptysis may appear, develop

pneumonia (Fig. 147).

The third, complicated stage of the disease occurs due to the addition of a secondary (fusospirillary) infection, as a result of which scurvy ulcerative stomatitis develops. Granulations that have grown along the gingival margin reach the cutting edge or chewing surface of the teeth, and areas of necrosis and ulceration appear on the gums.

The gums bleed intensively, covered with necrotic plaque, with a fetid odor. The ulcerative process extends to the tongue, cheeks, lips, hard and soft palate. Teeth become loose and fall out. The general condition of the patients is extremely severe. Without treatment, the disease can be fatal.

Diagnosis is carried out by determining the content of ascorbic acid in the blood and its daily excretion in the urine after a vitamin load. With C-hypovitaminosis, the content of ascorbic acid in the urine is reduced, and the additionally introduced acid is retained in the tissues and is not excreted in the urine until the body is completely saturated (0.8-1 mg of ascorbic acid in the blood).

The daily requirement of the human body for vitamin C is 50-60 mg, and during pregnancy

ness, increased physical activity, with infectious diseases, with generalized periodontitis, the need for ascorbic acid increases two to three times.

Treatment Assign vitamin C in the form of fruit juices or ascorbic acid. Of the juices, the most effective are lemon, orange, blackcurrant juice, and tomato. Ascorbic acid is prescribed in the first days of the disease in shock doses (0.25-0.35 g 3 times a day). Then the doses are reduced (up to 0.1 g 3 times a day). The drug should be taken not only during the period of pronounced manifestations of the disease, but also after the disappearance of hemorrhagic phenomena. Recovery occurs in 1-1.5 months. In the initial stage of the disease, with proper treatment on an outpatient basis, scurvy gingivitis disappears after 5-7 days. With advanced and complicated stages of the disease, patients are subject to hospitalization. With a combination of the phenomena of hypovitaminosis with anemia, iron ascorbate or ferro-ascorbate should be administered.

Ascorbic acid is best administered with vitamin P or rutin. These drugs enhance the effect of vitamin C. With severe bleeding, in addition, calcium chloride, vitamin K are prescribed.

Locally: sanitation of the oral cavity, careful hygienic care of it, removal of tartar and plaque on the teeth, irrigation of the oral cavity with a weak solution of potassium permanganate, citral solution, 1% galascorbin solution are indicated. Assign irrigation of the gums with water saturated with carbon dioxide, electrophoresis with vitamins C and P or galascorbin.

Scurvy ulcerative stomatitis is treated as Vincent's necrotizing ulcerative stomatitis.

During the peak of the disease, removal of granulations and extraction of teeth are contraindicated.

Hypovitaminosis A. Vitamin A (retinol) is important in the processes of growth and development of the body, regulates the processes of maturation of the epithelium and its keratinization, increases the resistance of the oral mucosa to the action of various traumatic and irritating factors, ensures the normal function of the organ of vision, favors the normal function of the salivary and sweat glands.

Clinical manifestations of hypovitaminosis are due to a decrease in the barrier properties of the skin and oral mucosa, a violation of the normal differential