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Skin myxedema

Skin myxedema — group of the dermatosis caused by different types of a dysthyroidea. Against increase of function of a thyroid gland the symmetric limited pretibialny myxedema can develop; at a hypothyroidism there is a symptom complex of a diffusion myxedema (including the general disorders, changes of skin). The tuberous form of a myxedema which can proceed with lowering or increase of functions of a thyroid gland is less often observed. As kinds of a myxedema of skin consider myxedematous lichenins and Arndt's scleromyxedema — Gottrona at which deviations of functions of a thyroid gland are absent. For group designation of the specified diseases sometimes use the term "mucinoses" as capturing the essence of the processes happening at them — the increased adjournment of mucopolysaccharides or glikozaminoglikan in a derma.

Inspection at the endocrinologist (definition of a functional condition of a thyroid gland, hypophysis) is shown. At a hypothyroidism (sometimes as well at normal function of a thyroid gland) Thyreoidinum on 0,05 g of 1 — 3 time a day (the individual scheme of treatment) is shown. At a hyper thyroidism apply mercazolil on 0,005 g 2 — 3 times a day, diiodotyrosine on 0,05 g 2 — 3 times a day.

Some patients need consultation of the psychoneurologist as cases of development of various forms of a mucinosis after psychological injuries are known; according to indications use the means influencing a nervous system. Appoint the drugs improving peripheric circulation: andekalin, dilminat, komplamin which promotes also reduction of production of mucin.

In a pathogeny of a pretibialny myxedema attach significance to excess products of thyritropic hormone and other dysfunctions of a hypophysis, autoimmune processes; the disease quite often develops after a thyroidectomy, treatment of a toxic craw anti-thyroid drugs. At this form Prednisolonum on 30 mg/days (a daily dose increase up to 40 — 50 mg), dexamethasone on 5 — 6 mg/days and other corticosteroid drugs which can be applied in a combination with Thyreoidinum (slows down production of thyritropic hormone) on 0,05 — 0,1 g 3 times a day is sometimes effective.

At myxedematous lichenins and Arndt's scleromyxedema — Gottrona give pathogenetic value to the paraproteinemia which is often revealed at patients (is, according to some authors, reflection of autoimmune processes), disorders of function of fibroplasts in skin, to abnormal liver functions, changes in a microcirculator bed. Recommend cytostatic means, sometimes in combination with corticosteroid drugs. Some specialists observed partial permission of rashes at a scleromyxedema from use of Triamcinolonum on 24 mg/days (3 weeks). According to indications appoint the hepatotropic means improving peripheric circulation of means.

Recommend to enter into the defeat centers 0,1 g of a lidaza in 1 ml of 0,5% of solution of novocaine of 1 times in 5 — 7 days (6 — 7 injections), to cut away them hydrocortisone suspension, to carry out an electrophoresis of 10% of solution of potassium of iodide, fonoforez a hydrocortisone.

 
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