Signs of skin atrophy. Thin skin what to do. Skin atrophy. Skin atrophy symptoms

Skin atrophy (elastosis) is a group of chronic dermatological diseases that are accompanied by thinning of the skin. The disease is based on partial or complete destruction of collagen fibers - the main component of the connective tissue from which the skin is formed. The second name of the disease was due to the fact that, first of all, the elasticity of the skin is disturbed. The origin and origin of the pathology, the clinical picture, diagnosis and treatment, prognosis and prevention depend on the type of pathology.

Features of skin atrophy

Elastosis - loss of elasticity and thinning of the skin, which develops due to trophic, inflammatory, metabolic, age-related changes in all layers of the dermis. As a result, the connective tissue degenerates - the number of elastic and collagen fibers decreases. Various forms of skin atrophy at different times have been described by scientists as symptoms of somatic diseases. For example, elastosis as a sign of progeria was mentioned in 1904 by the German doctor O. Werner, and in children, atrophy of the skin as a sign premature aging first described in 1886 by the Englishman D. Hutchins. The causes of the pathology are still unknown, the diagnosis is made on the basis of the clinical picture, treatment is required because, along with aesthetic problems, the disease threatens health and life - it can degenerate into cancer.

Skin atrophy is a sign of the following diseases:

atrophic scars.
atrophic nevus.
Atrophoderma Pasini-Pierini.
Connective tissue diseases.
Generalized thinning of the skin caused by aging, intake or increased production of glucocorticoids by the adrenal glands.
Focal panatrophy and hemiatrophy of the face.
Poikiloderma.
Spotted atrophy of the skin.
Aging.
Follicular atrophoderma.
Chronic.
Vermiform atrophoderma.

The most common atrophy of the skin:

associated with the use of glucocorticoids. Prolonged use of ointments containing corticosteroids changes the properties of the skin. In most cases, the changes are local. The thing is that glucocorticosteroids slow down the synthesis of collagen protein and some other substances that provide skin elasticity. The skin is covered with small folds, similar to tissue paper. The skin is easily injured, becomes translucent, cyanotic, a network of small vessels is visible. In some cases, hemorrhages, scars in the form of stars or stripes appear in atrophied zones. They can be deep or superficial, limited or diffuse. With timely diagnosis, this type of atrophy can be cured.
Senile. Age changes properties of the epidermis, caused by a decrease in metabolic activity, in which the skin adapts worse to external influences and internal factors. Most of all, it is affected by hormonal imbalance, malnutrition, nervous overload, rain, wind, sun. Most often, the pathology develops in people over 70 years old, if the same signs are found in patients under 50 years old, premature aging is diagnosed. Dermatitis is especially noticeable on the face, neck and back of the hands. The skin gathers into folds, becomes pale, acquires a gray tint, is easily injured and flaky.
Spotted. Causes - stress, hormonal disruptions, infections. Elastic fibers disintegrate under the influence of the elastase enzyme secreted from the focus of inflammation. The risk group includes residents of Central Europe aged 20-40 years. There are three types of patchy skin atrophy - Jadasson (classic), Schwenninger-Buzzi Pellisari (urticaria).
Idiopathic progressive (Pick's erythromyelia, chronic atrophic acrodermatitis). Most likely has an infectious etiology and develops in the later stages. Microorganisms that cause atrophic changes can remain in the body for many years.
Poikiloderma. A group of diseases that are accompanied by mesh (spotted) pigmentation, petechial hemorrhages, atrophy and telangiectasia (the formation of spider veins on the surface of the skin). It is congenital and acquired. Congenital develops in the first year of life. Acquired provokes lymphoma, systemic lupus erythematosus, lichen planus, scleroderma, exposure to radiation, low or high temperatures.
Rothmund-Thomson syndrome. The disease is inherited, more often - to female children. The reason is a gene mutation on the eighth chromosome. It appears no earlier than two years after birth. Hyperpigmentation, depigmentation, spider veins and atrophy zones are localized on the neck, arms, legs and buttocks. There are problems with hair, nails, teeth. Bilateral cataract is diagnosed in 40% of sick children under the age of 7 years. The disease is chronic and lasts a lifetime.

What skin atrophy looks like can be seen in the photos below.

Skin atrophy symptoms

Atrophy of the skin is accompanied by signs characteristic of a particular form. However, all species have common features:

Color change - from brown to whitish.
Thinning to the state tissue paper.
Visibility through the skin of the vascular network, pinpoint hemorrhages, spider veins.
Excessive dryness.
Smoothed drawing.
Reduced elasticity.
Lethargy, flabbiness, failures.
Folds and wrinkles in the affected areas.

Most often, elastosis is chronic, periods of remission alternate with exacerbations - old foci increase, new ones appear. Sometimes the skin heals on its own.

Causes of skin atrophy

Skin atrophy can be caused by a decrease in the activity of metabolic processes in the elderly, cachexia, beriberi, hormonal imbalances, inflammatory processes, malfunctions of the nervous and circulatory systems.

The main causes of skin atrophy:

Thinning of the skin (aging, rheumatic diseases, use of creams with glucocorticosteroids)
atrophic nevus.
Atrophoderma Pasini-Pierini.
Atrophoderma vermiform.
Facial hemiatrophy.
Focal panatrophy.
Primary and secondary (after inflammatory diseases).
Poikiloderma.
Striae (atrophic scars).
Follicular atrophoderma.
Chronic atrophic acrodermatitis.

Atrophic changes in the skin are caused by long-term corticosteroid therapy, especially often such side effect manifested in the treatment of children.

Skin atrophy in children

Skin atrophy in children most often develops when using corticosteroid creams (ointments), especially products containing fluorine - Fluorocort, Sinalar, etc., as well as potent ointments that are applied to the skin when applying occlusive dressings. In premature babies, spotted atrophy may develop, its cause is the imperfection of physiological processes in the skin. There is also a congenital form, but the signs of the disease appear only 2-3 years after birth.

Diagnosis of skin atrophy

Diagnosis of skin atrophy is based on the results of a survey and examination of the patient. To confirm or refute the diagnosis, the dermatologist prescribes a biopsy. A biopsy study allows assessing the degree of skin thinning, identifying dermal infiltrate, and detecting degeneration of elastic and collagen fibers.

Skin atrophy treatment

The goal of treatment is to eliminate the cause of the disease and stop its development; complete recovery is almost impossible. The doctor recommends symptomatic drugs and auxiliary physiotherapy that stabilize the processes in the body and slow down atrophy.

Treatment of skin atrophy is:

Antifibrotic pills.
Vitamins.
Moisturizers.
Physiotherapeutic procedures - therapeutic baths, balneotherapy.
Spa treatment.

If abscesses, ulcers, neoplasms appear on the skin in the affected areas, consultation of the surgeon and oncologist is required. The surgeon opens the boils and prescribes antibiotics, the oncologist checks the growths. With deep lesions, a transplant may be required, for this it is taken healthy skin buttocks or inner thighs.

Complications of skin atrophy

The disease is lifelong, but does not affect the quality of life. The exception is the defeat of the face, hands and scalp - cosmetic defects cause aesthetic discomfort.

The death of the skin can cause:

Malignant tumors in damaged areas.
Increased vulnerability of the skin.
Uncontrolled distribution throughout the body.
Cosmetic defects - scars, baldness, nail lesions.

Thinned skin is easily damaged, and a dangerous infection can enter the body through wounds.

Prevention of skin atrophy

Prevention of skin atrophy requires the prevention of diseases that can cause such a pathology. For this you need:

Use corticosteroids under medical supervision.
Protect skin from prolonged exposure to sunlight, rain, wind.
In the summer, use sunscreen and stay out of the sun for a long time.
Eat properly.
Use high quality cosmetics.
To live an active lifestyle.
Be outdoors as much as possible.

Skin atrophy is not treated, but it can be prevented. To do this, you should follow the above recommendations, undergo regular medical examinations, and if problems with the skin appear, immediately contact a dermatologist.

White atrophy of the skin is usually called a condition that is caused by a specific lesion of the capillaries and small vessels of the skin. The disease was first described by a French dermatologist G. A. Milian, so the second name of the pathology was given in honor of the scientist.

White skin atrophy is a fairly rare disease that can develop against the background of venous diseases, for example, against the background.

Milian's atrophy is considered a "female" disease, men make up only about 5% of patients with this diagnosis. White atrophy develops, as a rule, in middle age, cases of the disease in people under 30 years of age are extremely rare.

Reasons for development

To date, the causes and mechanisms of development of white skin atrophy have not been fully studied. Some researchers attribute Milian's atrophy to diseases based on ordinary vasculitis or any of its forms, for example,. Inflammation of the walls of blood vessels leads to occlusion (squeezing) of small arteries, which causes a violation of microcirculation and nutrition of skin tissues.

There is an opinion that white atrophy should be attributed to the group of hemorrhagic-pigmented dermatoses caused by varicose veins located on the legs. Changes in the veins cause squeezing of the capillaries, which leads to the development of areas of skin atrophy.

However, not all patients with Milian's atrophy have a history of thrombophlebitis or varicose veins. The development of atrophy can also be observed against the background of hemodynamic disorders that are associated with liver diseases, heart failure, and the development of tumors of a different nature. Cases are described when white atrophy developed against the background of pregnancy and hemodynamic disorders associated with this condition. Also, skin atrophy can be in violation of skin nutrition processes, for example, as a result.

Clinical picture

White atrophy is manifested by the formation on the skin of small scars of an irregular or rounded shape, the color of white porcelain. Around the scars, you can see a thin halo of hyperpigmented skin.

Inflammatory phenomena in the skin tissues with Milian's atrophy are not observed. Does not appear in patients and subjective sensations. The appearance and existence of spots does not cause pain, does not cause itching or other unpleasant phenomena.

The number of spots in Milian's atrophy can be different. Scars can be located in isolation, at a distance from each other. But in some patients, the spots merge, forming foci of a fairly large size.

With white atrophy on the affected skin, it is often possible to notice (spider veins), petechiae and small ones.

In about a third of patients with white atrophy, irregularly shaped ulcers form against the background of lesions. Ulcers are quite painful and extremely difficult to treat.

With Milian's atrophy, the skin of the legs is mainly affected most often, on the back of the foot, and it is also seen in the patient. Spots of atrophy can appear both symmetrically (on both legs) and unilaterally.

With Milian's atrophy, there are no violations of the blood coagulation system, and capillary resistance will not change.

Diagnostic methods

Diagnosis of white skin atrophy is based on the study of the clinical manifestations of the disease and the study of the anamnesis. In addition, a histological examination of the material taken from the affected area may be prescribed.

The histological picture of Milian's atrophy is as follows:

Thinning of the epidermis;
Complete disappearance of elastic fibers;
Hyalinization (compaction) and homogenization of collagen fibers.
Expansion of the passages of small vessels and thickening of their walls.
Dermal infiltration.

It is important to distinguish white atrophy from diseases such as:

Superficial allergic nature.
Lipoid necrobiosis.
Syndrome Itsenko-Cushing.

The main difference between superficial vasculitis and white atrophy is the polymorphism (multivariance) of the rash. With vasculitis, rashes are represented by spots, nodules, bullous and hemorrhagic elements. In addition, rashes with vasculitis are more common, they are located not only on the limbs, but also on the trunk.

Lesions with are located closer to the upper part of the lower leg, and with white atrophy, the bulk of the foci is located in the area of the feet. In addition, with necrobiosis lipoidis, the lesions are larger and they rise above the skin.

Most patients with Ischenko-Cushing's syndrome are obese. In addition, the spots in this syndrome are usually purple or pink, and with Milian's atrophy, the skin in the lesions is white, sometimes with a pearly tint.

Treatment

Unfortunately, there is no effective treatment for white skin atrophy.

The atrophic changes that have occurred are irreversible, to return the skin healthy look impossible. Therefore, the treatment of this disease is aimed at improving microcirculation and preventing the formation of new foci.

As a rule, patients with white atrophy are prescribed vitamins, angioprotectors, and immunostimulants. Recently, it has been customary to use the complex use of curatil and aspirin for a long time.

In the presence of varicose syndrome, a specific treatment is prescribed aimed at restoring the veins - medication or surgery.

With white atrophy, external treatment is widely used, aimed at strengthening and increasing the elasticity of the walls of blood vessels. Apply ointments (for example, Troxevasin) and physiotherapy procedures.

With white atrophy, patients can be prescribed ultraviolet irradiation of the affected skin, the imposition of mud applications, sulfide baths. Useful spa treatment.

With ulceration of lesions in Milian's atrophy, both local and systemic treatment are used. Local treatment consists in the use of antiseptic drugs, taking into account the nature and sensitivity of the discharge from the ulcer. In addition, ointments are used that have a regenerating effect. Systemic anti-inflammatory drugs and antibiotics are also used.

Treatment with folk methods

Significant assistance in the treatment of white atrophy can be provided ethnoscience. However, treatment with drugs should be long and regular. In addition, choosing to use folk remedies, you can not arbitrarily cancel the treatment prescribed by the doctor.

When the first signs of white atrophy appear, it is worth starting to take a tincture of chestnut fruits. You can cook it yourself by pouring 50 grams of carefully crushed fruits with 300 ml of alcohol. You need to insist the remedy in a dark place for a week. Take the prepared infusion should be 10 drops three times a day.

Nutmeg tincture is prepared in the same way. Only you need to take it 20 drops three times a day. The course of taking the tincture should continue until the end of the prepared portion. Then it is recommended to take a break for a week and repeat the treatment again.

Good help in the treatment of Milian's atrophy is the spores of the club club moss plant. A decoction is made from this plant. Take a full spoonful of spores in a glass of boiling water. Cook on very low heat for 20 minutes. Then drink and drink in small portions throughout the day. You need to drink the infusion without filtering along with plant materials.

For the external treatment of white atrophy, wheat germ oil can be used. It is necessary to slightly warm the oil and rub it well into the skin at the locations of the atrophy spots.

Healing oil for the treatment of Milian's atrophy can be prepared independently. You need to take 50 ml of almond and peach oil, as well as dry herbs - yarrow, succession, thyme, eucalyptus, birch buds. Raw materials are taken in equal parts and ground into powder. To prepare the medicine, you need a spoonful of this mixture. Herbal powder is poured into a dark glass dish and both types of oil are poured into it. Then you need to add a tablespoon of glycerin to the oil and shake well again. Lubricate the skin of the legs at the locations of the spots of white atrophy, allow the product to be absorbed.

Juniper baths for the treatment of Milian's atrophy, as well as in the treatment. It is necessary to prepare a decoction of juniper berries. Three quarters of a glass of fruit are taken per liter of water, boiled with low heat for half an hour, allowed to cool. Then filter and dilute with five liters of warm water. Used for forty-minute foot baths. During the procedure, you need to ensure that the areas of atrophy are immersed in the decoction. It is very important that the water for the bath is not hot, it should be pleasantly warm - 36-37 degrees.

Forecast and prevention

Prevention of the development of white atrophy consists in the timely detection and competent treatment of chronic diseases - varicose veins, diseases of the liver, cardiovascular system, gynecological disorders, etc.

The prognosis for life with white atrophy is favorable, however, complete restoration of the skin with already formed areas of atrophy is impossible. It is important for patients with white atrophy to try to avoid any damage to the altered skin and hypothermia in order to prevent the development of complications in the form of ulceration.

Healthy, radiant skin is a gift of God, it adorns a person, like a silk cocoon enveloping the face, emphasizes the beauty of the eyes, lips, nose ... But how annoying it is when problems arise on the skin, for example, stripe-like atrophy of the skin, according to scientific striae (from lat. striae - stripes, stretch marks).

Band-like atrophy of the skin

Skin atrophy Vergetures lineaires - the name of linear scars is given to them by their resemblance to the stripes that remain on the skin after being hit by a belt or vine. They are also known as atrophic bands, pregnancy scars, linear atrophies, stretch bands, etc.

These skin atrophies are elongated, may be elevated, flat, or retracted, but are always soft and easily depressed; they give the impression of being torn or overstretched in the skin; they do not fade, but become less noticeable over time.

Doctors distinguish between physiological (or natural) destruction of the skin, resulting from the gradual aging of the body, and pathological, in which not the entire skin is affected, but its individual sections.

Age-related or physiological atrophy of the skin after fifty years is associated with changes in the hormonal sphere, the tissue blood supply system, chemical composition blood, as well as with violations of the neurohumoral regulation of the physiological functions of the body.

This process develops slowly and gradually over many years. Pathological destruction of the skin is characterized by several signs of division:

by the nature of formation (primary and secondary); by prevalence (diffuse and limited); by the time of appearance (congenital and acquired).

Primary skin atrophy (the photo of which shows the presence of stretch marks, or striae) is due to pregnancy, when there are significant changes in the work of the endocrine organs. With a diffuse lesion of the skin, an impressive part of the surface changes, including the outer layer of the epidermis of the hands and feet.

For a limited form of the disease, the presence of local foci adjacent to unchanged healthy skin is characteristic.
Secondary destruction of the dermis occurs in areas of the body previously affected by other diseases (tuberculosis, syphilis, lupus erythematosus and other inflammatory processes or skin disorders - companions diabetes).

Local skin atrophy after hormonal ointments most often occurs in children, young women or adolescents with uncontrolled use of drugs, especially those containing fluorine (Sinalar or Fluorocort), as well as enhanced action of ointments prescribed for use under an occlusive (sealed) bandage.

The most common form of damage to the structure of the skin is hormonal atrophy of the skin that occurs during pregnancy or obesity associated with metabolic disorders.

During stretching or rupture of elastic fibers, striae appear on various parts of the body. Other triggers for this skin ailment are:

endocrine disorders (including Itsenko-Cushing's disease);
malfunctions of the central nervous system;
eating disorders (including malnutrition);
rheumatic diseases;
infectious lesions (tuberculosis or leprosy);
exposure to radiation and burns;
traumatic injuries;
dermatological diseases (lichen planus, poikiloderma),

as well as the use of drugs containing glucocorticosteroids (including in the form of ointments).

Skin atrophy: tissue biodegradation

The appearance of skin atrophy, despite many provoking factors, is based on the mechanism of local biodegradation of tissues, in which their nutrition is disturbed, the activity of cellular enzymes of the skin is significantly reduced. This leads to the predominance of catabolism processes (destruction of tissue structure) over anabolism (their construction or restoration).

Signs by which it is possible to determine the foci of the disease

The peculiarity of degenerative tissue changes due to skin atrophy is associated with thinning of the skin, subcutaneous tissue, the appearance of translucent vessels and age spots, telangiectasias (spider veins) or malignant neoplasms. Simultaneously with a decrease in the volume of the dermis, local seals of the skin can be noted due to the growth of connective tissue. The areas changed by the disease are more often localized in the face, chest, abdomen, lower back and hips.

Outwardly, they are cavities of the skin, covered with a thinned whitish dermis, resembling tracing paper (or tissue paper). Cosmetic defects in the form of sinking "islands" with different shades:

from pearly white to blue-red or venous reticulum can be adjacent to healthy areas of the skin.

Violation of metabolic processes in the dermis leads to the appearance of folds with thinned skin, any careless touch of which can injure the epidermis.

In elderly patients, stellate pseudo-scars, hemorrhages, or hematomas often occur in the affected area.

Which doctors are needed for diagnosis and treatment

Pathological atrophy of the skin, the treatment of which is a whole complex of various measures, should be examined by many specialists. Dermatologists with the involvement of endocrinologists and neuropathologists, allergists and infectious disease specialists, surgeons and oncologists can confirm or exclude this diagnosis.

Scars located below the level of the skin, which appear as a result of trauma or medical procedures, burns, chicken pox or acne, should be shown first to a dermatologist.

Treatment Method

Treatment options for this disease depend on a number of factors:

etiology and localization of the destructive process, age, state of health and perseverance of the patient.

Skin atrophy after hormonal preparations (including the use of external agents in the form of ointments) can occur after a long time (up to several months!) After completion of treatment by an endocrinologist.

In order to activate the process of tissue repair, it is necessary at the initial stage to stop taking drugs containing corticosteroids.

When is the help of a surgeon required?

It is needed for excision of small atrophic scars, with multiple or large boils, carbuncles, deep purulent processes in tissues, as well as for skin grafting.

Consultation with an oncologist is necessary if various neoplasms appear on the surface of the foci (warts, papillomas, and others).

With the help of a biopsy, the nature of the growths is determined in order to prevent the occurrence of oncological problems.

Procedures

Modern medicine has many different methods for getting rid of an unaesthetic defect, such as atrophy of the skin of the face or any other part of the dermis. In the arsenal of professionals there are:

surgical excision of the lesion;
mesotherapy;
microdermabrasion;
laser therapy;
chemical peeling;
subcision or cutting of scars;
cryotherapy;
electrocoagulation;
enzyme therapy;
moisturizing;
treatment special creams and ointments.

Depending on the degree of the disease, its etiology, the age of the patient and the presence of chronic ailments, the clinic specialist selects the optimal set of procedures.

The standard treatment regimen for skin atrophy includes:

taking multivitamin complexes that stimulate immune and regenerative processes in the patient's body;
physiotherapy procedures that promote the activation of the blood supply to the affected areas of the dermis, as well as injections or taking the drug "Pentoxifylline" (commercial name - "Trental"), which improves blood microcirculation.

At the aesthetic surgery clinic

Considering various ways treatment of this ailment, for optimal results, a dermatologist may recommend surgical correction of scars to make them as neat and invisible as possible.

For this purpose, a laser or a scalpel is used, which lifts the edges of the affected area or transplants skin from healthy areas.

Another method is subcision

It involves cutting and lifting the connective fibers produced by the body at the site of the scar, using a special needle. Raising the bottom of the focus, the needle releases it, leveling the damaged surface of the dermis.

Other ways:

microdermabrasion (skin resurfacing with microscopic crystals);
mesotherapy (injections of therapeutic cocktails into the middle layer of the skin to stimulate the synthesis of collagen fibers, correct scars and age-related atrophic changes);
chemical peeling (with the removal of the upper layers of the skin - from superficial keratinized to median and deep);
enzyme therapy; moisturizing (preparations based on hyaluronic acid); laser therapy.

Methods can be used both to correct scars and to improve appearance skin during aging.

Ointments

Hardware methods for the treatment of destructive processes in tissues can be practiced in combination with the use of external agents.

How is the right ointment selected?

Skin atrophies are diseases of the dermis, which should be treated exclusively by a specialist! Self-treatment of scars and pathologically altered areas of the dermis can lead to a deterioration in their appearance and condition.

To solve an individual aesthetic problem, the doctor prescribes gels and ointments that improve blood circulation in the tissues, their nutrition and oxygenation, have anti-inflammatory and stimulate tissue regeneration properties:

Contractubex, Kelofibrase, Stratoderm, MedGel, Dermatix, Scarguard and Kelo-cote, choosing the most suitable preparation.

Traditional medicine in the fight against destructive skin changes

Treatment of skin atrophy with the help of home baths, lotions and healing oils, taking tinctures, decoctions and infusions from medicinal plants is allowed with the permission of a doctor in combination with traditional methods.

For example, when the initial signs of white atrophy appear (small foci of round or irregular shape in the color of white porcelain), herbalists advise grinding chestnut fruits (100 g) and pouring 0.5-0.6 liters of alcohol on them. Infuse the remedy for a week in a place closed from light rays. Take chestnut tincture inside 10 drops 3 times a day.

A similar homemade nutmeg remedy (prepared in the same way) is used 20 drops at the same frequency.

External folk remedies for skin disease

Powder from dried leaves (string, yarrow, thyme, birch and eucalyptus buds) is diluted in almond and peach oils, taken in equal proportions (50 ml each), and one tablespoon of glycerin is added.

From skin lesions associated with burns, traditional medicine suggests using chamomile flowers, calendula, nettle leaves, yarrow and St.

Decoctions for lotions from these herbs can also be used, in the form of a powder mixed in rosehip, sea buckthorn or corn oil. The addition of yellow has a beneficial effect on the skin. beeswax in homemade "ointments" with vegetable oils and medicinal herbs.

Prevention and improvement of skin appearance

There are several specific measures to prevent the occurrence of destructive skin changes in adults and children:

carefully use hormonal drugs,
avoid prolonged contact with direct ultraviolet rays,
monitor the general health and skin condition,
carry out immediate sanitation of foci of infection in the dermis and in the body as a whole.

Skin atrophy after hormonal ointments requires stopping their use and contacting a doctor. Regular examination and timely detection of serious diseases (diabetes mellitus, dangerous infections, disorders in the hematopoietic system) will also help to avoid problems with the destruction of the skin structure.

Moisturizing the abdomen during pregnancy with creams, olive oil or gels will prevent the appearance of striae (stretch marks). and regular visits to the beautician will help rejuvenate and accelerate the regeneration of the dermis. For all types of atrophy, sanatorium-and-spa treatment is indicated for the prevention and disposal of the disease: sulfuric and hydrogen sulfide baths, therapeutic mud, as well as vitamin restorative therapy.

Medical characteristics of atrophic bands

The length of atrophic bands is from one to several centimeters, the width is from 1 to 10 mm and more; the shape is fusiform or elongated, often wavy. Crimson-red or bluish-red color of fresh scars often turns into pearly white; sometimes, on the contrary, they appear excessively colored. They have sharp edges; the surface can be smooth, folded or divided into large diamonds; to the touch give a feeling of softness and, as it were, emptiness; it seems that thinned skin lies on soft and elusive tissues, such a serious one.

Atrophic streaks are almost always multiple and mostly symmetrical; can appear in a wide variety of areas, most often on the stomach, but are also found on the thighs, lower back, above the knees, on the sides, buttocks, breasts, etc.

The direction of the scars corresponds to the so-called "skin splitting direction" and is perpendicular to the line of greatest tension, which apparently served as the cause of their formation;

on the abdomen they are usually vertical, as well as in the region of the greater trochanters and deltoid muscles, on the sides, on the lower back, above the knee they are transverse, on the mammary glands they diverge in the form of rays.

Linear scars with epidermal atrophy are much more common in women, even regardless of pregnancy. most common cause that causes them is pregnancy; 9/10 pregnant women have them; some women don't get them even after 10 or 15 pregnancies. Among other causes, obesity and typhoid fever are most often indicated.

Thinking to reduce their appearance to a purely mechanical process and seeing the cause in the gradual or sudden stretching of the skin, which certainly plays a large, but not exclusive role, they pointed to the influence of growth, general dropsy, voluminous tumors and injuries.

But it is quite obvious that there is some other influence besides the action of stretching. Indeed, atrophic streaks may be completely absent in huge dropsies of the abdominal cavity, or in cases of very large hernias; it is also unlikely that with the appearance of fullness or with growth, however rapid, there was an actual stretching of the skin; finally, atrophic streaks also appear after weight loss, in typhoid, tuberculosis, other serious infectious diseases and certain nervous diseases.

When an artificial pneumothorax is applied, the scar bands are almost always located on the opposite side or on remote parts of the body. There is an abundance of them in many cases of hirsutism, which is dependent on increased secretion of the adrenal cortex and occasionally manifests itself to a mild degree during pregnancy.

In this case, the fragility of the skin and especially the network of its elastic fibers would be explained by a violation of the intrasecretory activity of the adrenal cortex, which does not exclude the significance of poisoning caused by an infectious principle, or self-poisoning.

The pathoanatomical picture well explains the clinical features of these scars. The epidermis and papillary layer are stretched or folded; connective tissue fibers of the dermis are parallel and atrophied.

The most significant change is the disappearance of elastic fibers, fragments of which, tightened and twisted, are visible on both sides at the border of the scar.

The described scars do not show the slightest inclination to restore normal tissue. No treatment works right; Nevertheless, the appointment of fish oil and preparations of the endocrine glands is indicated. It is doubtful that restraints, pregnancy belts, etc., are of any use as a preventive measure; to neglect them would still be a mistake.

Maculae atrophicae or vergetures rondes, the latter name is inaccurate due to the contradictory meaning of its constituent terms, refers to a disease, which, moreover, is referred to as atrophic spots or post-syphilitic streaks, in all but form, this disease is completely similar to atrophic streaks.

It consists of retracted, flat or raised spots, which, depending on the greater or lesser tension of the skin, can be smooth, flabby or folded; and depending on the prescription of existence, lilac or white; in all cases very sluggish and pliable under pressure. These spots, round or oval in shape, ranging in size from a point to a lentil, are randomly scattered, mostly in significant numbers, on the sides, chest, back and shoulders.

The greatest grounds have an assumption about the connection of maculae atrophicae with syphilis; they appear in the secondary period, sometimes combined with a rash of papular syphilis or with pigmented syphilis of the neck. Sometimes it was possible to trace their development behind the lenticular papules and in their place. But there have been cases when in the atrophied areas it was impossible to establish any traces of previous lenticular papules or at least roseolous spots, the presence of which was definitely denied by the patients themselves.

Their structure is exactly the same as that of linear atrophies and treatment is equally unsuccessful.

Skin atrophy- skin pathology, called skin atrophy, is a group of chronic diseases, which are characterized by the presence of a pathological process provoked by age-related, metabolic, inflammatory, trophic changes in all its layers.

The thinning of the dermis with the epidermis and subcutaneous fat, which is the degeneration of the connective tissue, is accompanied by a gradual decrease in the volume of collagen and elastic fibers.

Such structural changes in the skin are another commonly used name - "elastosis", which means colloidal dystrophy. The problem is relevant not only for aesthetic reasons, but also in connection with the possibility of degeneration of atrophy into cancer.

The disease is represented by various forms of skin atrophy, which were previously described as a symptom of a somatic pathology, such as, for example, progeria.

At the beginning of the twentieth century, the German physician Werner described this symptomatology as a description of hereditary progeria in adult patients, and even earlier, at the end of the nineteenth, a similar description is found in Hutchinson in the presence of signs of premature aging in children.

Why many forms of skin atrophy arise and develop is still not clear, but the etiology and pathogenesis for them are individual. Based on the clinical diversity of manifestations and in accordance with the pathomorphological picture, subsequent actions are determined in the form of diagnosis, methods of treatment, prevention and prognosis.

Dermatology knows many approaches to systematizing the forms of pathology, but from a rational point of view, the following classification is most successful:

First - congenital atrophy, consisting in ectoderm dysplasia, with damage to the skin itself and its appendages in the form of hair, sebaceous and sweat glands, sometimes nails and teeth. It is presented in the form:

atrophic nevus or birthmark, which has the form of a plaque of a limited shape with localization in the layer of the epidermis and dermis, without affecting the subcutaneous fat;
atrophic aplasia, with the absence of skin in some areas of the scalp;
hemiatrophy of the skin on the face, in the form of its asymmetric thinning, with damage to all layers of the dermis, including the underlying muscle tissue.

Second - acquired, provoked by the existing somatic pathology, physical impact and other factors.

It comes in the form:

primary, with unclear etiology and favorable background;
involutive, with the presence of differently located wrinkles;
secondary, resulting from radiation, x-ray, solar exposure to the integument, and as a symptom of chronic diseases.

Symptoms

Common symptoms of pathology, regardless of the etiology and localization, can be considered:

the presence of a focus with thin, dry, soft skin;
painlessness;
lack of hair, sebaceous and sweat glands;
translucent vessels;
slight creasing, like tissue paper, and the feeling of wet suede is tactile;
the presence of dyschromia with shades of red, ending with a whitish color;
in some cases, seals from overgrown connective tissue.

Symptoms of the disease also depend on the genesis, for example:

For the period of puberty and gestation, the presence of different degrees of obesity, the presence of foci of strip-like pathology with hormonal genesis is characteristic. The lesions result from metabolic disturbances and appear as pinkish-whitish bands prone to ulceration. Places of localization - the abdomen and mammary glands.
The same foci, but located on the back, arise as a result of lifting weights.
For spotty and white forms of pathology, vascular genesis is the basis.
Idiopathic, with progress, illustrates borreliosis.
The vermiform form is characterized by puberty, during which small symmetrical focal lesions appear on the cheeks, consisting of clogged follicles, without signs of an inflammatory process.

Skin atrophy itself is a feature of a wide variety of dermatological conditions, including:

pigment xeroderma and (elastosis);
lupus erythematosus and pyoderma;
tuberculosis and syphilis;
porphyrin disease and poikiloderma;
lichen planus and progressive hemiatrophy of the face;
multi-colored lichen and others.

Separately, a special kind of disease is distinguished - corticosteroid, in the form of a reaction to hormones that cause vasoconstriction. As a result, the synthesis of dermal fibers is inhibited and their destruction is enhanced.

Injections of corticosteroids contribute to the destruction of deep dermal layers with underlying tissues.

The greatest negative when taking corticosteroids in the form of tablets, leading to universal atrophy, with such consequences as total thinning of the skin, multiple telangiectasias, traumatic pseudo-cicatricial changes in the back of the hands, signs of stellate atrophy.

The reasons

Dermatologists have identified two fundamental causes that contribute to the emergence and development of pathology - physiological and pathological.

Physiological include the aging process and the period of pregnancy. The onset of skin aging is triggered by damage to cell membranes by free radicals, which are formed in the human body as a result of natural biochemical processes. But these molecules can also come from exposure to toxins such as car exhaust, cigarette smoke, and contaminated foods.

The antioxidant system controls the action of active radicals. When the amount of free radicals does not exceed the norm, they are beneficial in the form of fighting infections, improving blood clotting, and saturating cells with oxygen.

Age increases the mass of these elements to a critical one, which changes their activity from productive to destructive.

Destruction of cells entails intradermal cellular imbalance, degenerative processes with atrophy.

Dermatologists note the role of age-related lipid barrier disorders in the aggravation of the process, as a result of a decrease in estrogen levels during menopause and other factors.

Pregnancy triggers another mechanism, based on a decrease in the functions of fibroblasts for the synthesis of collagen and elastin, but with the preservation of the synthesis of enzymes that destroy them.

The result is a loss of skin strength, a rupture of the collagen and elastic fibers of the dermis due to the growth of the fetus, which increases the load on the skin, but with the integrity of the epidermis.

Fibroblasts actively penetrate into the area with a defect to fill it with elastin and collagen, leading to no less active scarring.

At the next stage, the connective tissue becomes denser due to a decrease in collagen-elastin production, with compression of the lumen of the blood and lymphatic vessels in the emerging scar.

With malnutrition and metabolism in this zone, dystrophy and an irreversible defect in the form of stretch marks, or an atrophic scar, occur.

To pathological - other cases, as a result of the existing pathology. Atrophy here acts as a symptom, therefore, it depends on the characteristics of the disease. However, all types of atrophy have common features, primarily a decrease in tissue volume in the composition of the skin. With the destruction of some cells due to various reasons, the skin cannot cope with its functions, such as protection, thermoregulation, breathing through the pores, participation in metabolic processes, and neuroregulation.

This entails a violation of blood supply, innervation, nutrition of the skin.

Then comes the time for the appearance of foci with impaired trophism and altered skin structure, collagen and elastic fibers decrease in the connective tissue of the dermal layer, cells of the basal layer.

Dehydration of the skin occurs, resulting in thinning of the layers with a decrease in volume, or atrophy. There are cases of pathology with a common character.

Diagnosis and treatment

Diagnosis of atrophy in most cases is not difficult, but if there is difficulty in making a diagnosis, they resort to histological examination.

In therapy, medications are used, the action of which is aimed at:

improvement of trophism, with the intake of xanthinol nicotinate;
function stabilization nervous system, with the intake of B6 and magnesium;
vitamin nutrition of the body with the help of vitamins A and D.

Comprehensive treatment is advisable, using carbonic baths and paraffin baths, natural creams for treating the skin.

In the case of corticosteroid atrophy, medication intake is subject to strict adjustment or cancellation if necessary.

Corticosteroid therapy must take into account cell proliferation, so the best time for it is in the evening. With borreliosis, a course of antibiotics cannot be avoided.

For solutions aesthetic problems resort to the services of a cosmetologist, in severe cases, a plastic surgeon helps to improve the appearance.

Prevention

Atrophy, unfortunately, is irreversible, leading to a violation of the quality of life, despite a favorable prognosis for existence in general.

home preventive measure– regular monitoring by a specialist, in order to avoid the transformation of pathology into oncology.

- a heterogeneous group of chronic diseases, the main symptom of which is the thinning of the skin components: the epidermis, dermis and subcutaneous fat. The process is based on the complete or partial destruction of collagen and elastic fibers - one of the main components of the connective tissue of the dermis. The elasticity of the skin suffers, hence the second name for skin atrophy is elastosis. The etiology and pathogenesis are individual for each type of atrophy, for the most part not fully understood. The clinical diversity of the manifestations of the disease, methods of treatment, diagnosis, prevention, prognosis are proportional to the number of pathologies included in the group.

General information

Skin atrophy is a pathological process as a result of age-related, metabolic, inflammatory, trophic changes in all layers of the dermis and epidermis, leading to degeneration of the connective tissue in the form of a decrease in the volume of collagen and elastic fibers, resulting in thinning of the skin. Such a structural restructuring of the skin is also called elastosis (colloidal degeneration as a result of aging of the dermis). Various forms of skin atrophy were first described by independent scientists as a symptom of somatic pathology. For example, when studying progeria, a hereditary disease of adults, skin atrophy was described by the German physician O. Werner in 1904, and in children, the phenomenon of premature aging, accompanied by skin atrophy, was first described by J. Getchinson back in 1886. The causes of the emergence and development of many forms of skin atrophy are not clear even today. The clinical diagnosis is made on the basis of the pathomorphological picture of the disease. The urgency of the problem is associated not only with aesthetic aspects, but also with the ability of some forms of skin atrophy to degenerate into cancer.

Causes of skin atrophy

It is customary to distinguish two ways of occurrence and development of skin atrophy: physiological and pathological. Physiological include aging and pregnancy, all other cases are the result of pathology. Skin aging begins with damage to cell membranes by free radicals - molecules with an unoccupied electron that are actively involved in various chemical reactions. Free radicals are the result of natural biochemical processes within the human body, but they can also be formed under the influence of toxic substances (exhaust fumes, cigarette smoke, contaminated products). The "behavior" of these active elements is regulated by the antioxidant system of the body - a combination of enzymatic and non-enzymatic mechanisms of inhibition of cell autoxidation. Normally, free radicals help a person cope with infections, improve blood clotting, and saturate cells with oxygen. However, with age, the number of free radicals critically increases, they cease to play a positive role and begin to destroy cells. This leads to intradermal cellular imbalance, degenerative processes in the skin with the development of areas of atrophy. Dermatologists believe that this process is aggravated by an age-related violation of the lipid barrier of the skin (due to a decrease in estrogen levels, menopause), leading to the destruction of the stratum corneum of the epidermis, the destruction of structures that can retain moisture, which contributes to the development of atrophy.

A different mechanism for the formation of atrophic scars - striae - during pregnancy. One of the most significant reasons for their occurrence is considered to be a decrease in the ability of skin cells (fibroblasts) to synthesize collagen and elastin while maintaining the synthesis of enzymes that destroy this collagen and elastin. The skin loses its strength, the collagen and elastic fibers of the dermis are torn, unable to withstand the constant overstretching of the skin by the growing fetus, while the epidermis retains its integrity. A defect is formed - an area where active fibroblasts flock to fill it with collagen and elastin. The stage of active scarring begins. Later, the activity of collagen and elastin production decreases, the connective tissue in the place of the “failure” thickens, squeezing the lumen of the blood and lymphatic vessels inside the emerging scar. Nutrition and metabolism of this part of the dermis are disturbed, inflammation is replaced by dystrophy. This is how an irreversible skin defect is formed - stretching, or an atrophic scar.

Skin atrophy as a result of pathological processes depends on the characteristics of the disease, of which it is a symptom. However, all types of skin atrophy resulting from pathology have common features. The bottom line in this case is to reduce the volume of tissues that make up the skin. For one reason or another, some skin cells are destroyed and cease to perform their usual functions: protection (water-fat "mantle" of the skin), thermoregulation and respiration (pores), participation in metabolic processes (vitamin D synthesis in the epidermis), neuroregulation (receptors ). As a result, there is a failure in the blood supply, innervation, nutrition of the skin, foci of inflammation appear with a violation of trophism, its structure changes: the number of collagen and elastic fibers in the connective tissue of the dermis, cells of the basal layer of the epidermis decreases. The skin is dehydrated. All this leads to a thinning of its layers, a decrease in their volume, that is, to the formation of foci of atrophy. It should be noted that in some cases, skin atrophy can be widespread.

Skin atrophy classification

Prevention is the treatment of the underlying pathology. Corticosteroid therapy should be given in the evening when skin cell proliferation is minimal. The prognosis for life is favorable. Regular monitoring by a dermatologist is shown in order not to miss the possible transformation of skin atrophy into cancer.