Red butterfly sore

Introduction to Red Butterfly Sore Red butterfly sore is an autoimmune disease that can affect multiple organs in the body. This disease is equivalent to Western medicine for lupus erythematosus. More common in women aged 15-40. Common clinical types are disc-shaped red butterfly sores and systemic red butterfly sores. It is characterized by disc-shaped red butterfly sores that occur on the cheeks, mainly as skin lesions, mostly chronic limitations; systemic red butterfly sores, in addition to skin damage, often involve multiple systemic and multiple organs, lesions present Progressive progression has a poor prognosis. basic knowledge The proportion of illness: 0.002% Susceptible people: more common in women aged 15-40 Mode of infection: non-infectious Complications: pruritus

Red butterfly sore cause

Seven emotions (35%):

Due to liver qi stagnation, prolonged fire, causing qi and blood stagnation; or due to illness and qi and blood deficiency, causing lack of heart yang; but in the later stage of the disease, each more yin and yang, involving the spleen, resulting in spleen and kidney deficiency, water wet Inundation, bladder gasification loses power and sees less, cold limbs, lower extremities and even systemic edema embolism, phlegm and blood stasis, internal injuries in the viscera, traumatic skin and disease.

Six sexual intrusions (30%):

Because of the hot poisonous stagnation, smoldering blood, blocking the meridians, it can cause acute attacks and see high fever, muscles and sorrows, joint pain; or the stagnation of evil heat, it is often characterized by low fever, fatigue, dry lips, night sweats, etc. Yin Huowang, liver and kidney deficiency syndrome, heat poisoning internal organs, phlegm blocked in muscles, joints, systemic red butterfly sores.

Other factors (15%):

Lack of internal injuries, pregnancy and childbirth, sun exposure, and internal medicine can all be the cause of the disease.

Red butterfly sore prevention

1. Avoid sun exposure. In summer, special attention should be paid to avoid direct sunlight. When going out, wear a visor or a parasol, or use a light-proof medicine.

2, to avoid colds, cold, severe winter season should be properly protected exposure, such as wearing gloves, wearing thick socks and wearing masks.

3, to avoid a variety of predisposing factors, drugs that are easy to induce this disease such as penicillin, streptomycin, sulfonamides and contraceptives should be avoided, skin lesions should not be coated with irritating topical drugs.

4, avoid alcoholic and other irritating foods; those who have edema should limit the intake of sodium; pay attention to strengthen diet nutrition, eat more vegetables and fruits rich in vitamins.

5, pay attention to work and rest, strengthen physical exercise, avoid fatigue, serious illness should stay in bed.

Red butterfly sore complications Complications pruritus

In addition to skin damage, systemic red butterfly sores often involve multiple systems and multiple organs at the same time. The lesions are progressive and the prognosis is poor.

Red Butterfly Sore Symptoms Common Symptoms Discoid erythema fatigue pruritus Low heat mucosa damage hair follicle horn plug joint pain scaly transient lupus erythematosus

First, the disc-shaped red butterfly sore is more common in women around 20-40 years old, the ratio of male to female is about 1:3, the family can have the same patient. Skin lesions occur on the face, especially on the cheeks and nose, followed by the head, ears, eyelids, and forehead. It can also be found on the back of the hand, the side of the finger, the red part of the lips, and the shoulders. Fresh red or pink spots from the tip of the needle to the size of the lentils or larger, round or irregular. The boundary is clear, the edge is slightly elevated, the center is slightly atrophied, shaped like a disc, the surface is covered with taupe, sticky scales, horny plug under the scales, embedded in the mouth of the hair follicle, the opening of the hair follicle is like a sieve hole, skin lesion There is pigmentation around, with telangiectasia. Skin lesions on the cheeks and nose can fuse with each other and have a butterfly appearance. Mucous membranes can also be involved, mainly in the lips, in addition to scaly erythema, and even ulcers can occur. Generally, there are no symptoms. When it is progressing or after sun exposure, it may have mild itching. A few patients may have systemic symptoms such as low fever, fatigue and joint pain. Some patients' skin lesions can occur at the same time or in multiple parts of the face, scalp, back of the hand, and athlete's foot. This is called disseminated disc-shaped red butterfly sore. About 1% to 5% of discoid red butterfly sore patients with insufficient congenital endowment can be converted into systemic red butterfly sores or secondary skin cancer.

The disease is chronic, the affected part is sensitive to sunlight, the spring and summer are aggravated, the winter is relieved, the disease is not broken, it is difficult to heal itself, and the shallow scar remains after the regression.

Second, systemic red butterfly sores are more common in young and middle-aged women, the ratio of male to female is about 1:10.

The early manifestations of this disease are various, the symptoms are not obvious, the initial organs can be affected by a single organ, or multiple systems are simultaneously violated: often manifested as irregular fever, joint pain, loss of appetite, weight loss, skin erythema and so on.

(1) Symmetrical skin lesions occur in about 80% of patients with skin and mucous membrane damage. Typical cases have butterfly-shaped erythema on the cheeks and nose. They are irregular, bright red or purple, with clear or blurred borders and sometimes scales. When the condition is relieved, the red shift subsides, leaving brown pigmentation and less atrophy. Skin lesions occur in the skin around the nails and under the nails, often hemorrhagic purple red patches, red and swollen when hot, when the time is hidden. Occurred in n, the lips, the performance of the lower lip erythematous cheilitis. In severe cases of skin lesions, there may be generalized erythema multiforme erythema, purple erythema, blisters, etc., oral and vulvar mucosa are erosive, and the hair may gradually become sparse or fall off. There is Raynaud's phenomenon when the hand is cold, which is often an early symptom of the disease.

(two) systemic symptoms

1, fever generally has irregular fever: most of them are low fever, high fever during acute activity, even up to 40 °C -41 °C.

2, joint, muscle pain: about 90% of patients have joint and muscle pain, joint pain can invade the joints of the limbs, mostly migratory, soft tissue may have swelling, but rarely occurs effusion and flushing.

3, kidney damage: almost all systemic red butterfly sores involve the kidneys, but clinical manifestations accounted for about 75%, kidney damage is an earlier, common, important visceral damage, showing the performance of various nephritis, In the early urine, there are proteins, casts and red and white blood cells. In the later stage, renal function damage may occur in uremia and nephrotic syndrome.

4, cardiovascular system lesions: about 45% of patients with cardiovascular disease, with pericarditis, myocarditis, pericardial effusion is more common. Sometimes accompanied by thrombophlebitis, thromboangiitis obliterans.

5, respiratory diseases: mainly manifested as pleurisy and interstitial pneumonia, respiratory dysfunction.

6, digestive system disease: about 40% of patients have nausea and vomiting, abdominal pain, diarrhea, blood in the stool and other gastrointestinal symptoms. 30% of patients have liver damage and are chronic hepatitis-like.

7, neurological disease: nervous system symptoms are more common in the later stage, can be expressed as a variety of mental, neurological symptoms, such as depression, insomnia, schizophrenia-like changes, severe cases may appear convulsions, symptomatic epilepsy.

8, other lesions: lymphatic system can be involved, manifested as local or systemic lymphadenopathy, soft and no tenderness. Involved in hematopoietic system, see anemia, whole blood cell reduction. In addition, about 20% of cases have fundus lesions, such as papilledema and retinopathy.

Red butterfly sore check

Laboratory inspection

(1) General inspection

Blood routine is moderate anemia, about 56% of patients with white blood cells and thrombocytopenia, erythrocyte sedimentation rate, protein and red, white blood cells and casts in the urine, protein electrophoresis albumin reduction, gamma globulin, a2 globulin increased, white globulin ratio Inverted.

(two) immunological examination

1. The positive rate of lupus cells is about 60%, but the specificity is low.

2, the positive rate of anti-nuclear antibody test is more than 90%, wherein the anti-double-stranded DNA antibody has high specificity, the positive rate is 95%, and the titer is directly proportional to the severity of the disease: other such as anti-Sm antibody, anti-SS-A antibody, anti- The positive rate of SS-B antibody was about 30%.

3, complement and immune complex examination, increased circulating immune complexes, serum total complement and C3, C4 decreased, especially C3 decreased significantly.

4, lupus test test, using direct fluorescent immunoassay in the patient's skin and dermal junction examination, visible immunoglobulin and complement deposition, in a granular, spherical or line-like arrangement of yellow-green fluorescent bands, in the systemic red butterfly sore The positive rate of normal skin exposed sites is 50% to 70%, and the lesions are as high as 9096 or more.

Red butterfly sore diagnosis

Differential diagnosis

1, rheumatoid arthritis joint swelling and pain is obvious, rheumatoid nodules can occur; no systemic red butterfly sore unique skin changes; not sensitive to light; anti-rheumatic factors are mostly positive; lupus erythematosus cells and anti-nuclear antibodies negative.

2, rheumatoid arthritis: joint pain, may have joint deformity; no skin lesions unique to red butterfly; rheumatoid factor is mostly positive; lupus cell test is mostly negative.

3, dermatomyositis: more from the face; skin lesions are purple-blue edematous erythema centered on both eyes, multiple myositis symptoms; muscle enzymes, urinary creatine content increased.

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