Lille black disease

Introduction

Introduction to Lille Black Disease

Riehlmelanosis is a pale brown to dark brown pigmentation that occurs on the face. It is usually in the form of a coin. It can be accompanied by obvious itching of the skin. Patients with severe itching can cause skin ulceration due to scratching of the skin. .

basic knowledge

The proportion of illness: 0.001%

Susceptible people: no specific population

Mode of infection: non-infectious

Complications: swelling

Pathogen

The cause of Lille melanosis

(1) Causes of the disease

The cause is unclear and may be:

1. Malnutrition, lack of vitamin A, vitamin C, vitamin D, niacin, etc.

2. Long-term external use of cosmetics containing light-sensitive substances (such as: tar derivatives), combined with the sun to induce the disease.

3. Most of the patients are women, many of them have pigment changes during menstruation, so it is thought to be related to endocrine function such as gonads, pituitary, adrenal cortex and thyroid.

(two) pathogenesis

The pathogenesis is still unclear.

Prevention

Lille melanosis prevention

The etiology of this disease is not clear, and may have certain correlation with environmental factors, genetic factors, dietary factors, and mood and nutrition during pregnancy. Therefore, it is impossible to directly prevent the disease against the cause. Early detection, early diagnosis, and early treatment are important for indirect prevention of this disease, and can also reduce the incidence of infection complications. For patients with existing infections, antibiotics should be used as soon as possible.





Complication

Lille melanosis complications Complications swelling

In addition to the melanin pigmentation of the skin, it is accompanied by obvious skin itching, which can be destroyed due to skin integrity, so it can cause skin bacterial infection or fungal infection due to scratching, usually secondary to low body constitution, or long-term use of immunosuppressants. And patients with fungal infections such as onychomycosis, such as concurrent bacterial infections may have fever, skin swelling, ulceration and purulent secretion and other performance.

Symptom

Lille melanosis symptoms common symptoms reticular pigmentation spots itching thin appetite loss slow pulse weak spleen

More common in women aged 30 to 50 years, there is a long history of contact with tar or lubricating oil. At the beginning, local itching is red, and later it becomes a reticular pigmentation spot, which is light brown to dark brown. Can be divided into 3 phases: inflammation period: mild flushing, swelling, a little sputum-like desquamation, there may be itching and burning sensation; pigmentation period: with the regression of inflammation, pigmentation, often confined around the pores, the initial point Shape, can be fused into a tablet in the future, some patients can enter the atrophic period, and the skin is mildly depressed and atrophy consistent with the pigmentation site. The skin lesions start from the ankle, and then spread to the forehead, cheeks, ears, and ears. Even to the neck, shoulders, etc., the closer to the center of the face, the less the mouth and the lower jaw are not invaded, the mucous membrane is not involved, may have slow pulse, headache, loss of appetite, weight loss, general weakness.

Examine

Lille black disease check

Laboratory tests for urinary 17-ketone, 17-hydroxyketone and aldosterone were reduced, ACTH test, water test were normal.

Histopathology: mild epikeratosis of the epidermis, intercellular edema in the lower part of the spinous layer, basal cells may have liquefaction and degeneration, dermal papilla layer and submucosal melanin increased, which may be free or phagocytosed by melanocytes, perivascular inflammatory cells Infiltration, the lower part of the spinous layer can be seen under the electron microscope. The basal layer and the upper layer of the dermis have denatured cells (eosinophils). The melanosomes are in the cells at the beginning, and then free and phagocytosed by melanocytes.

Diagnosis

Diagnosis and identification of Lille melanosis

Diagnostic criteria

According to the pigmentation spots, it is a reticular purple-brown, and the predilection site can be diagnosed.

TCM syndrome differentiation:

1. Because the spleen deficiency can not be subtle, the blood and blood deficiency, the skin is dying.

2. Because of the lack of kidney water, you can't make a fire.

Differential diagnosis

1. Chloasma: It is mostly on the cheeks, distributed in a butterfly shape, without erythema, and no symptoms.

2. Reticulum atrophic skin heterochromia: local dark brown, reddish brown, bronze spots, reticular distribution, and leukoplakia and telangiectasia, conscious itching, joint pain and burnout.

3. Edison's disease: systemic pigmented spots, and systemic symptoms caused by adrenal insufficiency, laboratory tests for urinary 17-ketone, 17-hydroxyketone and aldosterone reduction, ACTH test, water test is not normal.

4. Tar black disease: diffuse pigmentation in exposed parts such as the face and neck, not limited to the sides of the face, often with acne-like inflammatory reactions.

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