Skin atrophy is a condition in which the layers of the skin are gradually destroyed, become thin and cannot perform their protective functions. There are several types of disease, each of which has its own distinctive features. The mechanisms of development of the condition are still not fully understood, but scientists have identified several factors that can provoke it. To cure the disease, you need high-quality diagnostics and an integrated therapeutic approach.
What is a disease and why is it dangerous?
Layers of the skin can break down and become thinner, losing their elasticity. Typically, this process occurs as a result of hormonal changes, inflammatory, age-related and metabolic processes.
Physiological atrophy
The skin of patients looks thin and dry, and its natural or premature aging begins. Patients observe hair loss in the affected areas, increased sensitivity to sunlight, and the appearance of vascular networks (stars).
If you study such skin under a microscope, you can notice structural changes in cells, hair follicles, sebaceous and sweat glands.
The reasons for the development of this condition are still not fully understood. Experts identify several factors that can trigger the disease.
Causes of the disease
Physiological or pathological factors can provoke the development of the disease. Skin aging is natural. Atrophy can always be observed in older people, and it is especially pronounced after 70 years.
The following diseases can provoke premature thinning of the epidermis:
- damage by bacteria, fungi, viruses;
- hormonal imbalance;
- disruption of the central nervous system;
- autoimmune lesion;
- mechanical damage;
- metabolic disorder;
- external and temporary exposure to chemicals;
- radiation exposure;
- excessive sun exposure;
- genetic predisposition.
Skin atrophy is very often observed after hormonal ointments (see photo below).
Pathological atrophy after the use of hormonal creams
This phenomenon occurs with long-term local hormone therapy or incorrectly selected doses of the drug.
Classification
There are several forms of the disease, which are classified into hereditary and acquired. Atrophy can be primary or secondary (occurs against the background of another health problem).
Experts identify the following forms:
- senile (physiological);
- spotted (anetoderma);
- vermiform (cicatricial erythema acne, reticular symmetrical atrophoderma of the face, vermiform atrophoderma of the cheeks);
- neurotic (“glossy skin”);
- progressive facial hemiatrophy (Parry-Romberg);
- Pasini-Pierini atrophoderma (superficial scleroderma, flat atrophic morphea);
- lipoatrophy;
- panatrophy;
- idiopathic progressive skin atrophy (acrodermatitis chronica acrodermatitis, acrodermatitis chronica acrodermatitis Herxheimer-Hartmann, Pick's erythromyelosis);
- strip-shaped;
- white (Milian's atrophy);
- kraurosis of the vulva;
- poikiloderma (“mesh skin” or “motley skin”).
The classification also depends on the location of the atrophy. By location it happens:
- diffuse - localization is blurred, occurs on any part of the body;
- disseminated - the lesion looks like islands among healthy skin;
- local - the disease is determined only on one part of the body.
Each form has its own symptoms and requires increased attention and proper treatment.
Symptoms
The pathology has common manifestations that are observed in all forms.
Main symptoms of skin changes:
- dryness;
- peeling;
- change of usual color;
- smoothness of the skin pattern;
- flabby appearance;
- transillumination of blood vessels.
The skin becomes papery as the fat layer thins out. It can change color to pale white, brown or brown.
Diagnosis and treatment methods
At the first noticeable changes in the skin, you should consult a doctor. Diagnosis of the disease consists of examining the affected area and examining skin cells for changes. The patient must undergo a full examination to determine the cause of the disease.
At the moment, there is no effective treatment that would stop atrophy and restore the skin. All actions of doctors are aimed at slowing down thinning and improving the patient’s quality of life.
The course of treatment includes medication and physiotherapy. Doctors prescribe:
- mineral and vitamin complexes;
- antifibrotic drugs;
- moisturizing creams;
- balneotherapy;
- medicinal baths;
- Spa treatment.
Treatment lasts for a long time, patients require regular use of moisturizers.
Physiotherapy
Physiotherapy helps maintain healthy skin during an exacerbation and improves the effects of medications.
Patients are prescribed:
- mesotherapy;
- microdermabrasion;
- chemical peeling;
- cryotherapy;
- electrocoagulation;
- enzyme therapy.
In case of a complex course of the disease, laser excision of the lesions can be performed. Therapeutic and preventive massage may also be prescribed. In this case, there is no special complex of physical therapy.
Traditional treatment
Alternative medicine products are allowed to be used only as prescribed by a doctor. These can be medicinal baths, herbal compresses or alcohol tinctures.
Chestnut tincture effectively fights atrophy.
To prepare it you will need:
- 100 g chestnut;
- 0.5 l of alcohol.
Preparation of tincture:
- Place the chestnut in a glass jar after passing it through a grinder.
- Fill with alcohol.
- Leave for 2 weeks in a dark place.
Use tincture 10 drops three times a day. Using the same recipe, you can prepare a tincture of nutmeg and take 20 drops 3 times a day.
Nutrition rules
With atrophy, great importance is attached to diet. Some products can improve skin condition.
- natural cheeses;
- chicken eggs;
- fish and seafood;
- meat (beef, rabbit, chicken, turkey);
- Pine nuts;
- flax seeds;
- fresh vegetables and fruits;
- mushrooms;
- legumes;
- cereals cooked in water;
- spinach;
- parsley
It is useful to drink celery juice if you do not have stomach diseases, including gastritis.
Prognosis and complications
It is impossible to cure atrophy, so the prognosis will always be unfavorable. In most cases, the disease does not in any way affect the ability to work and the quality of life of patients, except in cases where the skin of the face or scalp is affected, creating a severe cosmetic defect.
Complications include mechanical damage, since thin skin is easily injured. Persistent wounds and abrasions increase the risk of infection from bacteria and viruses.
Prevention
Atrophy can develop at any age, and it is impossible to reduce the risk of primary skin thinning. To prevent secondary atrophy, it is enough to promptly treat diseases that can provoke it.
You should also not use hormonal ointments and other drugs without a doctor’s prescription, change dosages or use them for longer than the prescribed time.
Skin atrophy is caused by various disorders in the body or due to long-term use of medications. If there have been cases of atrophy in your family, then you can reduce the risk of its development by leading a healthy lifestyle, using moisturizing ointments and creams, and not sunbathing (especially from 12 to 16 hours). Timely diagnosis of the disease and comprehensive treatment will slow down the process of cell destruction, which will preserve performance and a normal quality of life.
– a heterogeneous group of chronic diseases, the main symptom of which is the thinning of the skin components: 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 - elastosis. The etiology and pathogenesis are individual for each type of atrophy, and for the most part have not been fully studied. The clinical variety of manifestations of the disease, treatment methods, diagnosis, prevention, and 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 connective tissue in the form of a decrease in the volume of collagen and elastic fibers, resulting in thinning of the skin. This structural restructuring of the skin is also called elastosis (colloid 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 doctor O. Werner in 1904, and in children the phenomenon of premature aging, accompanied by skin atrophy, was first described by J. Hutchinson back in 1886. The causes of the occurrence and development of many forms of skin atrophy are not clear today. The clinical diagnosis is made based on the pathomorphological picture of the disease. The relevance 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 ones 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 inside the human body, but they can also be formed under the influence of toxic substances (exhaust gases, cigarette smoke, contaminated products). The “behavior” of these active elements is regulated by the body’s antioxidant system – a set of enzymatic and non-enzymatic mechanisms for inhibiting 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 increases critically; 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 age-related disruption of the lipid barrier of the skin (caused by a decrease in estrogen levels, menopause), leading to destruction of the stratum corneum of the epidermis, destruction of structures capable of retaining moisture, which contributes to the development of atrophy.
Another 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 tear, 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 at the site of the “failure” becomes denser, compressing the lumen of the blood and lymphatic vessels inside the emerging scar. The nutrition and metabolism of this area of the dermis are disrupted, inflammation is replaced by dystrophy. This forms an irreversible skin defect - a stretch mark, 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 point in this case is to reduce the volume of tissues that make up the skin. Some skin cells, for one reason or another, 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, and nutrition of the skin, foci of inflammation arise with disruption of trophism, and its structure changes: the number of collagen and elastic fibers in the connective tissue of the dermis and cells of the basal layer of the epidermis decreases. The skin becomes dehydrated. All this leads to 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.
Classification of skin atrophy
Prevention consists of treating 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 recommended in order not to miss the possible transformation of skin atrophy into cancer.
Healthy, radiant skin with impeccably even texture and uniform color is the key to the beauty and success of its owner, regardless of his gender. With age or as a result of injury, as well as exposure to other pathological factors, negative changes occur in the tissue composition of the dermis: the superficial and deeper layers become thinner, the volume and number of elastic fibers decrease, causing processes of skin atrophy.
These aesthetic defects appearing on open areas of the human body (face, décolleté, collar area, hands and the rest of the surface) spoil the overall impression of appearance. Often they cause most women and men not so much physical as moral suffering. Immediate consultation with a doctor and adequate treatment will help avoid irreversible pathological changes in the dermis.
Classification
Doctors distinguish between physiological (or natural) destruction of the skin, which occurs as a result of the gradual aging of the body, and pathological, in which not the entire skin is affected, but its individual areas. Age-related or physiological atrophy of the skin after fifty years is associated with changes in the hormonal sphere, the blood supply system to tissues, the chemical composition of the blood, as well as disturbances in 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 time of appearance (congenital and acquired).
Primary skin atrophy (a photo of which demonstrates the presence of stretch marks, or stretch marks) is caused by pregnancy, when significant changes occur in the functioning of the endocrine organs.
With diffuse damage to the skin, an impressive part of the surface changes, including the outer layer of the epidermis of the arms and legs. The limited form of the disease is characterized by the presence of local foci adjacent to unchanged healthy skin.
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 that accompany diabetes).
Local skin atrophy most often occurs in children, young women or adolescents with uncontrolled use of drugs, especially those containing fluoride (Sinalar or Fluorocort), as well as the enhanced action of ointments prescribed for use under an occlusive (sealed) dressing.
Etiological development factors
The most common form of damage to the structure of the skin is hormonal skin atrophy, which occurs during pregnancy or obesity associated with metabolic disorders. When elastic fibers are stretched or ruptured, striae appear in various parts of the body.
Other triggers for this skin disease include:
- endocrine disorders (including Itsenko-Cushing's disease);
- disruptions in the functioning of the central nervous system;
- eating disorders (including exhaustion);
- rheumatic diseases;
- infectious diseases (tuberculosis or leprosy);
- radiation exposure and burns;
- traumatic injuries;
- dermatological diseases (lichen planus, poikiloderma), as well as the use of drugs containing glucocorticosteroids (including in the form of ointments).
The appearance of skin atrophy, despite many provoking factors, is based on the mechanism of local biodegradation of tissues, in which their nutrition is disrupted and the activity of cellular skin enzymes is significantly reduced. This leads to a predominance of the processes of catabolism (destruction of tissue structure) over anabolism (their construction or restoration).
Signs by which foci of the disease can be identified
Cosmetic defects in the form of sunken “islands” with various shades: from pearly white to bluish-red or venous networks can coexist with healthy areas of the skin. Disruption of metabolic processes in the dermis leads to the appearance of folds with thinned skin, any careless touch to which can injure the epidermis. Elderly patients often develop stellate pseudoscars, hemorrhages or hematomas.
Which doctors are needed for diagnosis and treatment?
Pathological skin atrophy, the treatment of which involves a whole range of different measures, should be examined by many specialists. Dermatologists with the involvement of endocrinologists and neurologists, allergists and infectious disease specialists, surgeons and oncologists can confirm or exclude this diagnosis. Scars located below the skin level, which appear as a result of trauma or medical procedures, burns, chicken pox or acne, should first be shown to a dermatologist.
Treatment method by professionals
Treatment methods for this disease depend on a number of factors: etiology and localization of the destructive process, age, health status and perseverance of the patient. Skin atrophy after hormonal medications (including the use of external agents in the form of ointments) can occur 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 to stop taking medications containing corticosteroids at the initial stage. In case of secondary pathology of the dermis, the doctor recommends initially curing the underlying (preceding) disease, and then proceeding to improve tissue trophism, saturate the body with vitamins and, in some cases, use antibiotic therapy.
In what cases is the help of a surgeon required? It is needed for excision of small, multiple or large boils, carbuncles, deep purulent processes in tissues, as well as for Consultation with an oncologist is necessary if various neoplasms (warts, papillomas and others) appear on the surface of the lesions. Using 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 area of the dermis. The arsenal of professionals includes:
- surgical excision of the lesion;
- mesotherapy;
- microdermabrasion;
- laser therapy;
- chemical peeling;
- subcision or cutting of scars;
- cryotherapy;
- electrocoagulation;
- enzyme therapy;
- hydration;
- treatment with special creams and ointments.
Depending on the degree of the disease, its etiology, the patient’s age and the presence of chronic ailments, the clinic specialist selects the optimal set of procedures.
The standard treatment regimen includes: taking multivitamin complexes that stimulate immune and regenerative processes in the patient’s body; physiotherapeutic procedures that help activate the blood supply to the affected areas of the dermis, as well as injections or administration of the drug “Pentoxifylline” (commercial name “Trental”), which improves blood microcirculation.
At the aesthetic surgery clinic
Considering various methods of treating this disease, to achieve 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 scalpel is used to lift the edges of the affected area or skin is transplanted 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. By lifting the bottom of the lesion, the needle releases it, leveling the damaged surface of the dermis.
Other methods:
- microdermabrasion (skin polishing 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 removal of the upper layers of skin - from superficial keratinized to middle and deep);
- enzyme therapy;
- moisturizing (with preparations based on hyaluronic acid);
- laser therapy.
The methods can be used both to correct scars and to improve the appearance of aging.
Ointments
Hardware methods for treating destructive processes in tissues can be practiced in combination with the use of external agents. How to select the right ointment? Skin atrophy is a disease of the dermis that should only be treated by a specialist! Self-medication of scars and pathologically changed 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 tissues, their nutrition and oxygen saturation, have anti-inflammatory properties and stimulate tissue regeneration: Contractubex, Kelofibrase, Stratoderm, MedGel, Dermatix, Scarguard and Kelo-cote, selecting the most suitable drug .
Traditional medicine in the fight against destructive skin changes
Treatment of skin atrophy using 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 initial signs of white atrophy appear (small round or irregularly shaped foci the color of white porcelain), herbalists advise crushing chestnut fruits (100 g) and pouring 0.5-0.6 liters of alcohol into them. Infuse the product for a week in a place protected from light rays. Take chestnut tincture orally, 10 drops 3 times a day. A similar home remedy of nutmeg (prepared in the same way) is consumed in 20 drops with the same frequency.
External folk remedies for skin ailments
Powder from dried leaves (seed, 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. For skin lesions associated with burns, traditional medicine suggests using chamomile flowers, calendula, nettle leaves, shoots of yarrow and St. John's wort, cudweed and knotweed. Decoctions of these herbs can also be used for lotions, in the form of powder mixed in rosehip, sea buckthorn or corn oil. Adding yellow beeswax to homemade “ointments” with vegetable oils and medicinal herbs has a beneficial effect on the skin.
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 consulting 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 stretch marks. Skin care and regular visits to a cosmetologist will help rejuvenate and accelerate the regeneration of the dermis. For all types of atrophy, sanatorium-resort treatment is indicated for the prevention and relief of the disease: sulfur and hydrogen sulfide baths, therapeutic mud, as well as vitamin restorative therapy.
The term “skin atrophy” combines a whole group of skin diseases, the manifestation of which is the thinning of the upper layers of the skin - the epidermis, dermis, and sometimes the subcutaneous fatty tissue located underneath them. In some cases, even tissues localized deeper than the pancreas are affected. Visually, the skin of such patients is dry, as if transparent, wrinkled. Spider veins on the body - telangiectasia - can also be detected.
When examining atrophied skin under a microscope, there is a thinning of the epidermis, dermis, a decrease in elastic fibers in their composition, degeneration of hair follicles, as well as sebaceous and sweat glands.
There are quite a few reasons for this condition. Let's take a closer look at the diseases that accompany them and the causative factors of each of them.
Diseases that occur with skin atrophy
- Atrophic scars.
- Poikiloderma.
- Chronic atrophic acrodermatitis.
- Primary or secondary anetoderma (spotty atrophy of the skin).
- Follicular atrophoderma.
- Atrophic nevus.
- Pasini-Pierini atrophoderma.
- Atrophoderma vermiform.
- Focal panatrophy and hemiatrophy of the face.
- Generalized (that is, throughout the body) thinning of the skin. He is called:
- patients taking glucocorticoids or increased production of them by the adrenal glands;
- connective tissue diseases;
- aging.
Let's take a closer look at some of them.
Glucocorticoid-associated skin atrophy
Long-term and irrational use of ointments with corticosteroids often leads to atrophic changes in the skin.One of the side effects of steroid hormone therapy that patients often experience is atrophic changes in the skin. In most cases, they are local in nature and arise as a result of irrational use of hormone-containing ointments.
Glucocorticosteroids suppress the activity of enzymes responsible for the synthesis of collagen protein, as well as some other substances that provide nutrition and elasticity to the skin.
The damaged skin of such a patient is covered with small folds, looks senile, and resembles tissue paper. Easily injured as a result of even minor impacts on it. The skin is translucent, a network of capillaries is visible through it. In some patients it takes on a bluish tint. Also, in some cases, in areas of atrophy there are hemorrhages and star-shaped pseudo-scars.
Damage may be superficial or deep, diffuse, localized, or streaky.
Skin atrophy caused by corticosteroids may be reversible. This is possible if the disease is detected in time and the person stops using hormonal ointments. After injection of corticosteroids, deep atrophies usually occur, and it is quite difficult to restore the normal structure of the skin.
This pathology requires differential diagnosis with panniculitis, as well as other types of skin atrophies.
The main point in treatment is the cessation of exposure to the causative factor on the skin, that is, the patient must stop using glucocorticoid-based creams and ointments.
To prevent the development of skin atrophy, it is necessary, along with treatment with local hormonal drugs, to take medications that improve metabolic processes in the skin and the nutrition of its cells. In addition, steroid ointment should be applied not in the morning, but in the evening (it is at this time that the activity of the cells of the epidermis and dermis is minimal, which means that the damaging effect of the drug will also be less pronounced).
Senile skin atrophy
This is one of the age-related changes, which is the result of a decrease in the ability of the skin to adapt to external factors, as well as a decrease in the activity of metabolic processes in it. More than others, the skin is affected by:
- state of the endocrine system;
- human nutrition;
- sun, wind;
- stress and so on.
Senile atrophy is fully expressed in people aged 70 years and older. If noticeable signs of atrophy are detected before the age of 50, they are regarded as premature aging of the skin. The process of atrophy progresses slowly.
The changes in the skin of the face, neck and back of the hands are most pronounced. It becomes pale, with a grayish, yellowish, brownish tint. Elasticity decreases. The skin is thinned, flabby, dry, and easily folds. Peeling and spider veins are also noticeable on it. Easily injured.
Increased sensitivity to cold, detergents and other drying substances. Patients often suffer from severe itching.
Unfortunately, cures for old age have not yet been invented. Elderly people are advised to avoid exposure to adverse factors on the skin and use softening, fortified, nourishing creams.
Patchy skin atrophy (anetoderma)
This is a pathology characterized by the absence in the skin of elements responsible for its elasticity.
The causes and mechanism of development of the disease have not been fully studied to date. It is believed that disturbances in the functioning of the nervous and endocrine systems are of some importance. There is also an infectious theory of the occurrence of the disease. Based on a study of the cellular composition of the affected tissue and the physicochemical processes occurring in it, it was concluded that anetoderma probably occurs as a result of the breakdown of elastic fibers under the influence of the enzyme elastase, which is released from the site of inflammation.
This pathology mainly affects young women (from 20 to 40 years old) living in central European countries.
There are several types of patchy skin atrophy:
- Jadasson (this is a classic version; the appearance of atrophy is preceded by focal redness of the skin);
- Schwenninger-Buzzi (foci appear on externally unchanged skin);
- Pellisari (anetoderma develops at the site of an urticarial (blister-like) rash).
Primary and secondary anetoderma are also distinguished. Primary often accompanies the course of diseases such as scleroderma. Secondary occurs against the background of some other diseases, when the elements of their rashes resolve.
Babies with varying degrees of prematurity may also develop patchy skin atrophy. This is explained by the immaturity of physiological processes in the child’s skin.
There is also congenital anetoderma. A case of this disease occurring in a fetus whose mother was diagnosed with intrauterine borreliosis is described.
Classic type of patchy atrophy
It begins with the appearance on the skin of a varying number of spots up to 1 cm in size, having a round or oval shape, pink or with a yellowish tint. They are found on almost any part of the body - face, neck, torso, limbs. The palms and soles, as a rule, are not involved in the pathological process. The spots gradually increase, reaching 2-3 cm in diameter in 1-2 weeks. They can rise above the surface of the skin and even thicken.
After some time, at the site of such a spot, the patient discovers atrophy, and the process of replacing one with another is not at all accompanied by any subjective sensations. Atrophy begins from the center of the spot: the skin in this area wrinkles, becomes pale, thinned, and rises slightly above the surrounding tissues. If you press here with your finger, you feel as if there is emptiness - your finger seems to fall through. Actually, it was this symptom that gave the pathology its name, because “anetos” translated into Russian means “emptiness.”
Anetoderma Schwenninger-Buzzi
It is characterized by the appearance of hernia-like spots of atrophy on previously unchanged skin of the back and arms. They rise significantly above the surface of healthy skin and may have spider veins on them.
Anetoderma Pellisari type
First, swollen pinkish-colored elements (blisters) appear on the skin, in place of which atrophy subsequently occurs. The patient has no itching, pain or other subjective sensations.
Any type of this pathology is characterized by thinning of the upper layer of skin in the affected area, a complete absence of elastic fibers, and degeneration of collagen fibers.
The antibiotic penicillin plays a major role in treatment. In parallel with it, the following may be prescribed:
- aminocaproic acid (as a drug that prevents fibrinolysis);
- drugs that stimulate metabolic processes in the body;
- vitamins.
Idiopathic atrophoderma Pasini-Pierini
Other names of the pathology: flat atrophic morphea, superficial scleroderma.
The causes and mechanism of development of the disease have not been reliably established. There are infectious (antibodies to the Borrelia microorganism are found in the blood serum of such patients), immune (antinuclear antibodies are present in the blood) and neurogenic (foci of atrophy are usually located along the nerve trunks) theories of the disease.
More often, young women suffer from this pathology. Lesions can be located on the back (more often) and other parts of the body. In some patients, only 1 lesion is detected, in others there may be several.
The focus of atrophy is hyperpigmented (that is, brown), round or oval in shape, and large in size. Vessels are visible through the skin. The tissue adjacent to the focus of atrophy is not visually changed.
Some dermatologists regard idiopathic Pasini-Pierini atrophoderma as a transitional form between plaque scleroderma and skin atrophy. Others consider it a type of scleroderma.
Treatment includes penicillin for 15-20 days, as well as drugs that improve tissue nutrition and blood circulation in the affected area.
Idiopathic progressive skin atrophy
This pathology is also referred to as chronic atrophic acrodermatitis or Pick's erythromyelia.
It is assumed that this is an infectious pathology. It occurs after a tick bite infected with. Many dermatologists consider it a late stage of infection. The microorganism remains in the skin even at the stage of atrophy, and is isolated from lesions more than 10 years old.
Factors that provoke the development of atrophy are:
- injuries;
- pathology of the endocrine system;
- microcirculation disorders in one or another area of the skin;
- hypothermia.
The following stages of the disease are distinguished:
- initial (inflammatory);
- atrophic;
- sclerotic.
The pathology is not accompanied by subjective sensations, so patients in some cases do not notice it.
The initial stage is characterized by the appearance of swelling and redness of the skin with unclear boundaries on the torso, extensor surfaces of the limbs, and less often on the face. These changes can be focal or diffuse in nature. The lesions increase in size, become denser, and peeling is found on their surface.
A few weeks or months after the onset of the disease, the second stage begins - atrophic. The skin in the affected area becomes thin, wrinkled, dry, and its elasticity is reduced. If there is no treatment at this stage, the pathological process progresses: a halo of redness appears along the edge of the lesions, atrophic changes develop in the muscles and tendons. The nutrition of skin cells is disrupted, resulting in hair loss and a sharp decrease in sweat production.
In half of the cases, the disease is diagnosed at this stage, and with treatment it undergoes reverse development. However, if the diagnosis is never made, its third stage develops - sclerotic. At the site of foci of atrophy, pseudosclerodermic compactions are formed. They are distinguished from classic scleroderma by their inflammatory coloration and vessels visible from under the compaction layer.
Other manifestations are also possible:
- muscle weakness;
- damage to peripheral nerves;
- joint damage;
- lymphadenopathy.
Elevated ESR and globulin levels are found in the blood.
It is necessary to distinguish this disease from similar diseases:
- erythromelalgia;
- scleroderma;
- idiopathic atrophy of Pasini-Pierini;
- lichen sclerosus.
For the purpose of treatment, the patient is prescribed antibacterial drugs (usually penicillin), as well as general restoratives. Creams and ointments enriched with vitamins are used topically to soften the skin and improve its trophism.
Poikiloderma
This term refers to a group of diseases whose symptoms include telangiectasia (spider veins), reticular or patchy pigmentation and skin atrophy. There may also be pinpoint hemorrhages, peeling of the skin and small nodules on it.
Poikiloderma can be congenital or acquired.
Congenital develops immediately after the birth of a child or in the first 12 months of his life. Its forms are:
- congenital dyskeratosis;
- Rothmund-Thompson syndrome;
- Mende de Costa syndrome and other diseases.
Acquired disease occurs under the influence of high or low temperatures, radioactive radiation, and also as a result of other diseases - skin lymphoma, systemic lupus erythematosus, lichen planus, scleroderma, and so on.
Poikiloderma can also manifest itself as one of the symptoms of mycosis fungoides.
Rothmund-Thomson syndrome
This is a rare hereditary pathology. It mainly affects females.
Skin atrophy or atrophoderma is a whole group of chronic diseases. The main symptom is thinning of the skin layers. With this pathology, the skin changes; this can be caused by a decrease in elastic tissue. The second name of the disease is elastosis (colloid degeneration as a result of aging of the dermis).
Description
The process of atrophy consists of the destruction of one of the main components of the skin - collagen and elastic fibers, which results in degeneration of connective tissue. Skin atrophy is often found in women, as it can appear as a result of skin stretching during pregnancy, obesity, problems with the endocrine system, diseases of the central nervous system, after serious infectious diseases, as a result of age-related and trophic changes.
Atrophied skin becomes thinner, gathers in folds - they cannot be smoothed out, the skin becomes dry, pearl-white or reddish in color, and a network of veins can be visible through it.
Classification
Skin atrophy is considered an irreversible, non-treatable condition. Atrophy is divided into:
- limited, when individual atrophic areas appear;
- diffuse, when skin atrophy occurs due to aging of the body;
- primary (an example is facial hemiatrophy);
- secondary, which can become a complication after an illness (tuberculosis, lupus erythematosus, syphilis), or can be triggered by exposure of the skin to sun rays, x-rays, radiation;
- congenital - these can be birthmarks, aplasia;
- acquired form.
The congenital form is a dysplasia (developmental abnormality) of the ectoderm, which is considered the source of epithelial skin cells; it affects not only the skin itself, but hair, nails, teeth, even the sebaceous and sweat glands.
Skin atrophy can also be divided into:
- atrophic nevus, is a plaque-like birthmark located in the epidermis or dermis;
- atrophic is characterized by the absence of skin on small hairy areas of the head;
- hemiatrophy of the face, in which thinning of the facial skin occurs, asymmetrically, affecting all layers of the dermis, and this process also affects muscle tissue;
- involutive atrophy of the skin is represented by various wrinkles.
The seriousness of this disease lies in the ability of some types of atrophy to transform into cancer.
Causes
Aging and pregnancy can be attributed to physiological causes, and everything else refers to pathological problems. In people who are always outdoors, in the sun or in the wind, this pathological condition manifests itself much faster.
The main causes of atrophy are:
- generalized thinning of the skin (aging, rheumatic diseases, use of glucocorticoids);
- the occurrence of atrophic scars, chronic atrophic acrodermatitis, poikiloderma (variegated skin with spotty or reticular pigmentation);
- anetoderma (which can appear after inflammatory diseases, characterized by the absence of elastic tissue);
- atrophic nevus;
- panatrophy (death of the skin, when the process occurs in all its structures: epidermis, dermis, fiber);
- follicular atrophoderma (impaired skin nutrition).
Skin atrophy may be caused by a reaction to corticosteroid therapy. These could be creams that contain fluoride-containing substances (fluorocort, sinalar), the use of which is not controlled by a doctor. Often women and children become “hostages” of the use of such ointments.
Atrophy can also be caused by a weakening of metabolic processes in the body, as well as pathological processes caused by cachexia (depletion of the body), lack of vitamins (beriberi), hormonal disorders, malfunction of the circulatory system, and inflammation.
Symptoms
The first symptoms that indicate the beginning of skin problems are:
- thinning of the skin and decreased elasticity;
- the skin becomes dry, wrinkles are noticeable (like tissue paper) that do not want to straighten out;
- when stroked, the skin looks like wet suede;
- changes color (skin tone becomes grayish or bluish);
- the surface begins to peel off.
Skin atrophy can also include: the appearance of warts or senile keratomas (specific dark brown growths that look like freckles), (squamous cell skin cancer). Often these pathologies appear in areas that are exposed to nature. Overgrowth of connective tissue is possible, causing thickened areas of the skin to appear, and this pathology can provoke.
During pregnancy or puberty, areas of band-like atrophy may occur due to hormonal changes. They can be seen on the abdomen, mammary glands, they resemble pinkish-white stripes. Lifting heavy weights can cause atrophy on the back, and during puberty, worm-like skin atrophy (acne) appears.
Diagnosis and treatment
Diagnosing skin atrophy is quite simple, but if a serious pathology occurs, then they resort to histological examination. Atrophy cannot be cured, but to improve the condition, you can try drugs that will improve skin nutrition (xanthinol, nicotinate), to improve the functioning of the nervous system, the use of B6 + magnesium is suitable, and vitamin therapy is also prescribed. The aesthetic appearance of the skin can be improved by seeking the help of a cosmetologist or plastic surgeon.
