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"code": "A67",
"name": "Пинта [карате]",
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"lead": "Нарушение здоровья, относящееся к группе другие болезни, вызываемые спирохетами",
"description": "Пинта (карате) является редким кожным инфекционным заболеванием и поражает кожу и слизистые оболочки без вовлечения в процесс внутренних органов, суставов и костей. ",
"etiology": "<p>Возбудитель заболевания Treponema Carateum Herrejin. По морфологическим и антигенным свойствам она сходна с бледной трепонемой. Возбудитель пинты обитает в почве, на растениях, фруктах. Инфицирование происходит при прямом и непрямом контактах с больным человеком. Возбудитель проникает через поврежденную кожу или слизистые оболочки. Доказана передача возбудителя насекомыми (комары, клопы, мошки). Заболеванию особенно подвержены дети. Среди эндогенных факторов следует выделить низкую иммунную реактивность, повышенную потливость кожи и щелочную реакцию ее водно-липидной мантии. Среди экзогенных факторов особенно выделяются скученность населения, микротравмы и мацерация при высокой температуре и влажности тропического климата. </p>",
"pathogenesis": "<p>Проникают трепанемы через поврежденные участки кожи и слизистые оболочки. Затем они локализуются преимущественно в роговом слое эпидермиса, где развивается гиперпигментация, утолщение кожи, межклеточный отек. Также происходит нарушение пигментной функции, так как наблюдается гибель меланоцитов. Поражаются регионарные лимфатические узлы. В поздней стадии развивается очаговая атрофия эпидермиса. </p>",
"diagnostics": "<p>Диагноз пинты основываются на появлении характерных пятен на коже и стадийности их изменений без нарушения общего состояния, за исключением кожного зуда. Диагноз подтверждается обнаружением в соскобах кожи трепонем; в поздних стадиях болезни становится положительной реакция Вассермана. </p>\r\n<p>Применяются серологические реакции, реакции иммунофлюоресценции - обнаруживаются специфические антитела к трепонеме. </p>",
"treatment": "<p>Лечение проводят дюрантным и препаратами пенициллина, типа бициллина, или новыми препаратами – экстенциллнн, ретарпен и др. Детям и взрослым, контактировавшим с больными, проводят профилактическое лечение бициллином.</p>",
"prevention": "<p> </p>\r\n<p>Профилактические мероприятия сводятся к выявлению и лечению больных и лиц, находящихся с ними в тесном контакте. Специфической профилактики не разработано. </p>",
"clinical_picture": "<p>Инкубационный период 7-20 дней. </p>\r\n<p>На месте внедрения трепонемы образуется эритематозная зудящая папула (узелок), размеры которой постепенно увеличиваются до нескольких сантиметров (примерно на 1 см в течение месяца). Вокруг папулы через 6-12 мес появляются мелкие пинтиды, зудящие, многочисленные, различного цвета (голубого, серого, бурого, желтого, фиолетового, красного и др.) разной величины и формы: круглые, овальные, неправильные; они шелушатся и напоминают чешуйчатый лишай или становятся лихеноидными (утолщенным). </p>\r\n<p>В поздней третьей стадии болезни - на коже обилие ахроматичных и пигментированных пятен; появляется утолщение подошв и ладоней, болезненные трещины, пигментные нарушения ногтей. </p>\r\n<p>Физическое состояние больных не нарушается, сохраняется трудоспособность, и заболевание продолжается неопределенно длительное время. </p>",
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