Red face

Introduction In daily life, we often see a part of people's facial redness, and the naked eye can see an expansion of capillaries, some of which are red or purple-red spots, spots, lines or stellate damage, this is the capillary Vasodilatation, commonly known as blood red silk. It is a kind of skin damage that occurs on the face or the trunk. Most of them are acquired. Some patients are congenital. Facial telangiectasia is the main cause of beauty. It is mostly caused by women. The clinical manifestation is the filament of the face. , spotted, star-shaped or flaky erythema. Look carefully to see a lot of red blood vessels on the skin, just like a silky red thread. Many women who love beauty are often troubled by their flushed faces, but many people may not know that red blood will not only affect your beauty, but also affect your health, seriously affecting the skin's nutrition, and over time, resulting in inadequate skin nutrient supply. Causes symptoms of roughness, dryness and premature aging. In the theory of traditional Chinese medicine, it is called "red red noodles", and the reason is attributed to heart stasis and poor blood flow.

Cause

A, epidermal basal cell aging is unable to release collagen, elastin, tensin, curling protein, fibronectin (collectively called cytoskeleton), causing the capillaries of the dermis to float out of the dermis and run to the epidermis.

B, caused by capillary elastic fiber defects. There are many factors that cause capillary elastic fiber defects, including long-term UV exposure, long-term use of corticosteroids, skin resurfacing, infection, or hereditary capillary structural abnormalities.

C, the stratum corneum and the epidermis are destroyed. At present, many so-called freckle creams are actually chemical exfoliation preparations, or have a very strong exfoliation effect, which easily causes telangiectasia of the facial skin. The result is the formation of sensitive skin, which is not only allergic to many things, or intolerant, but is often a telangiectasia of the face, which is tricky and difficult to treat.

D, long-term use of antihypertensive drugs, lack of vitamins.

an examination

The blood vessels are covered with organs and organs, which are divided into arteries, veins and capillaries. Fine arteries, veins, and capillaries are distributed throughout the skin and mucosa, and telangiectasia refers to filamentous, stellate, or arachnoid changes in the blood vessels or mucosal surfaces. It is bright red, the glass piece does not fade after being pressed, single or multiple hair, slow development, or no obvious increase after occurrence, can be limited to a certain part, but also can be widely ranged, either local change or some A special manifestation of the disease. Most of them can't subside on their own, benign, affecting beauty. Capillary expansion can be primary, such as vasospasm, hereditary benign telangiectasia. It can also be secondary to diseases such as scleroderma and rosacea.

Differential diagnosis

Capillary expansion needs to be differentiated from the symptoms below.

First, the congenital malformation of the capillaries, that is, the congenital capillary wall is so weak that it cannot shrink. The disease occurs mostly at the time of birth or shortly after birth on the face, neck and back of the pillow, and in the scalp. Can be unilateral, scatter, or both sides, multiple. Initially on the skin or mucous membrane, there is a different size, light red or dark red, or purple red skin lesions, from the tip of the needle to a limb or half of the trunk, the color is deepened after crying, the boundary is clear, the shape is different, not high The skin is locally high, and after compression, part or all of it fades and the surface is smooth. With age, children or young adults may have symptoms or nodular lesions on them, most of which occur in the calves and feet, which can be painful purple-blue nodules and plaques, which can still be broken. In the pathological dermis, the telangiectasia increases with age, and the telangiectasia can increase and extend to the deep and subcutaneous layers of the dermis.

Second, spider-like capillary expansion. Most occur in normal children, pregnant women and patients with liver disease. The cause is unknown and may be related to estrogen. The lesion is shaped like a spider, and the radial telangiectasia is visible to the naked eye, resembling a spider's foot. Slightly bulged, arterial pulsation can be seen after compression. They vary in size from 1 to 1.5 cm in diameter. Occurs in the face, neck, hands, can also occur in the upper part of the trunk. Most patients are single-shot, often on one side, such as multiple, it is necessary to exclude liver disease. If the spider-like telangiectasia occurs in the nasal mucosa and the lips, it is difficult to distinguish it from hereditary hemorrhagic telangiectasia. If it occurs in children, most of them persist and it is difficult to resolve naturally. If it occurs in pregnant women, it is expected to disappear about 6 months after delivery, such as the possibility of recurrence in the same pregnancy. It is not uncommon for the disease to continue to decline.

Third, hereditary hemorrhagic telangiectasia. It is an autosomal dominant disease characterized by expansion of the capillaries and venules of the skin, mucous membranes and viscera with bleeding. The cause of the disease is still unknown. The basic pathological changes are congenital capillary vasomotor defects, which show that the blood vessel wall is thin. Some hairs from the blood vessels, small arteries and venules are composed of only one layer of endothelial cells, and only one layer is muscleless and inelastic. Surrounded by connective tissue, the blood vessels can not shrink, and the aneurysm-like enlargement of capillaries, arterioles, and venules can occur. Some patients have abnormal blood coagulation, and the fibrinogen activator component of the surrounding tissues of the capillaries increases, causing an increase in fibrinolytic activity and bleeding. More from childhood, the incidence of disease increases with age. Typical skin lesions are: spotted bright red or purplish red spotted maculopapular rash. Generally, the diameter is <4~5mm, which can also be expressed as linear or spider-like telangiectasia. The boundary is clear, whitening after compression, and loosening can be quickly restored. This skin lesion persists and cannot resolve on its own. Typical diagnostically significant skin lesions are clusters of the back of the hand, small telangiectasia, and purplish red or bright red dots. The skin occurs on the face, ears, upper torso, nail bed, lips, tongue, sputum, and nasal mucosa. It can also affect internal organs such as the digestive tract, liver, spleen, lung, meninges and brain. Nasal bleeding is the most prominent, especially in early childhood, repeated nasal resistance can lead to severe anemia. The degree of bleeding is different. The lesion is slightly smaller than 1~4mm in the nose. It is slightly protruding, bright red dot or line-like telangiectasia. It is actually a small fistula connecting tiny and tiny veins. Local bleeding occurs after rupture. Secondly, the lips, soft palate, buccal mucosa, tongue root, tongue edge, and the base of the tongue have rounded telangiectasia, which can also cause bleeding. Such as involving the internal organs, can cough blood, vomiting blood, blood in the urine and blood in the stool, arachnoid hemorrhage. For example, the lungs 1 have difficulty breathing, purple sputum, erythrocytosis, and phalanx. Pathology In the telangiectasia region of the skin, large irregular veins with thin walls are seen. Laboratory examination of anemia can be aggravated by repeated bleeding, and the blood coagulation test is normal. There are pulmonary arteriovenous fistulas, peripheral blood shows erythrocytosis, clotting time, platelets are normal, clotting factor V can be slightly reduced. Repeated episodes of hemorrhage in childhood gradually develop into telangiectasia on the mucous membrane of the skin, and even internal bleeding. Experiment: no special abnormalities, obvious family history, generally not difficult to diagnose.

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