Brilliant zoster - Not one of the common chronic skin disease of unknown origin and development mechanism. Ill mostly boys of preschool age. The primary element of the rash is considered granuloma - a tight knot the size of a pinhead, reminiscent of hearth productive inflammation in tuberculosis, rheumatism, syphilis, sarcoidosis and other diseases. It has a tendency to merge, distribution. Localization of lesions typical of: the head of the penis, lower abdomen, elbows, knees. Dermatoses virtually never occurs on the face, scalp, palms and soles. Subjective sensations are not present. Special diagnostics available. Treatment - symptomatic.
Shingles - a rare benign chronic dermatosis. As an independent nosological unit known since 1907 when the clinical picture described in detail on pages dermatological messenger Dr. Pincus. Since chronic zoster with monomorphic eruptions in the form of nodules on the skin surface received a second name - Lichen Pincus. This melkouzelkovy dermatosis, in all likelihood, an infectious-allergic nature, with the typical localization of lesions characteristic for boys 3-9 years. Genetic predisposition have been identified, there is no seasonality. Quality of life does not violate the illness, causing inconvenience purely cosmetic nature.
At present, it is assumed that a brilliant zoster - is a species of lichen planus or specific afterimpression the presence of a child in the body of tuberculosis bacilli. The increased incidence of tuberculosis in Russia makes acquaintance with a brilliant lishaёm quite relevant. At the same time it should be emphasized that the structure of the lichen and the frequency of its occurrence have not changed for decades, which gives the right to speak about the independence of the external depriving brilliant, constantly changing factors.
dermatology focuses on infectious-allergic nature of the disease. In infectious disease component indicates the obligatory presence of focal infection during the examination of the child and the positive result of antibiotic therapy. In favor of the allergic genesis indicates rather frequent a history of atopic dermatitis patients, which was significantly confirms sensitization disposition of the body.
Classify brilliant versicolor due to monomorphic clinic is not accepted in dermatology, but on rare cases it should be mentioned. One of them - a brilliant post-traumatic shingles when primary cells appear directly on the site of injury. To include rare and generalized form of the disease, in the case of a sharp decrease in immunity after suffering stress, hypothermia, severe illness. The primary elements of the rare forms of brilliant stripping can be hemorrhagic, vezikulёznymi, perforating, merging, palmar-plantar. However, it is rather casuistry than the rule.
dermatologist. In order to eliminate the focal foci of infection should be clinical examination of the child at a minimum: the KLA, OAM, fluorography. In the case of the rare forms of the disease using specific skin tests, histological examination. The typical morphological picture. Histologically, there are two types of primary structural elements: the granuloma-bump and granuloma inflammatory nontubercular origin. Both are located in the upper layers of the dermis, have sharply defined boundaries consist of lymphocytes, phagocytes, blast cells. In the central part of the "new-born" granuloma - a blood vessel in the tubercles "retirement age" - necrosis.
More relevant is the differential diagnosis. Brilliant zoster should be distinguished from a mere "goose skin" or follicular hyperkeratosis - the nature of the nodules and the prevalence of the process ( "goose bumps" has a tendency to total capture of the skin, with its "knots" is none other than the compacted hair follicles) ; of lichen planus - in color and size, "millet zёrnyshek" (in lichen planus primary cells are larger and brighter, can be transformed into plaques).
Differentiate from the spinous brilliant lichen lichen can be on the "symptom grater" (if you hold a hand over skin with rashes spinous lichen, who on top of the node is "spinule" hyperkeratosis, will feel that you had a hand on the grater). From lichenoid tuberculosis skin and lichenoid syphilides brilliant zoster significantly differentiated only by the results of histology and complete clinical examination of the patient. But for the differentiation of follicular brilliant depriving mutsinoza enough patient age (mutsinoz affects not children, and adult men). In addition, follicular mutsinoz occurs on the scalp, in the eyebrows and neck, lichen and shiny - no.
physiotherapy (UVR). Showing pine baths or bath with bran. External used 1-2% resorcinol, salicylic, sulfur ointment. In the case of resistance shown hormonal ointment baby cream in a ratio of 1: 1. Good results give a spa treatment (Matsesta).
The forecast taking into account the favorable samorazresheniya process. Ad hoc prevention does not exist. However, the hardening of the child, strengthening its immune system, playing sports, rational schedule, lack of inadequate physical and mental stress, coupled with annual preventive check-ups by a pediatrician - a guarantee of the absence of meetings with a brilliant lishaёm.