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"pathogenesis": "<p>Стафилококк созержит токсин эксфолиатин, вызывает отслойку эпидермиса непосредственно под зернистым слоем.</p>",
"diagnostics": "<p>-Лабораторные исследования крови и мочи, для опредения интенсивности воспалительного процесса и состояния организма</p><p> - Цитологическое исследования содержимого пузыря (при наличии пузырей)</p><p> - гистологическое исследование кожи</p>",
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Заражение происходит через кожные покровы и слизистые.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Повышают риск развития заболевания:</span></p>\r\n<ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">микротравмы (ссадины, царапины, укусы и др.);</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">несвоевременная обработка ран;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">мацерация кожи;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">несоблюдение правил личной гигиены;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">тактильный контакт с носителем инфекции;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">общие предметы быта;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">анемия;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">сниженный иммунитет;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">высокая влажность климата;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">сахарный диабет, атеросклероз.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Группы риска развития импетиго:</span></p>\r\n<ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">климатические условия: повышенная влажность и температура воздуха;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">снижение защитного барьера организма, в том числе при беременности, при наличии сопутствующих соматических патологий;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">наличие кожных заболеваний, сопровождающихся зудом (ветрянка, экзема, педикулез и др.);</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">нарушенный обмен веществ;</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">нарушение целостности кожных покровов (ссадины, царапины, порезы, микротрещины, эрозии);</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">люди с повышенным потоотделением.</span></li>\r\n</ul>",
"pathogenesis": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">На коже постоянно находится большое количество стафилококков и стрептококков. Это - представители так называемой транзиторной флоры, способные заражать кожу, даже не размножаясь на её поверхности. Латентность их существования обусловлена защитной функцией кожи. При нарушении целостности кожных покровов в результате травмы, мацерации (разбухания дермы при длительном контакте с жидкостью), дисфункции потовых и сальных желёз, изменения нормальной кислотности кожи открываются входные ворота для проникновения инфекции. Усугубляется этот момент нарушением правил личной гигиены, снижением иммунитета.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Затем в дерме развивается воспаление, направленное на уничтожение инфекционного антигена с восстановлением дефекта кожи. Воспаление начинается на участке соединительной ткани – гистионе, состоит из фаз альтерации, экссудации, пролиферации. Альтерация - выброс в кожу из повреждённых клеток медиаторов воспаления. Медиаторы включают фагоцитоз, увеличивают проницаемость стенки сосудов, начинают за счёт бактерицидных свойств обеззараживать участок воспаления. Кроме того, они вызывают вторичную альтерацию (гистолиз), подключают к воспалению иммунные механизмы, регулируют пролиферацию за счёт работы макрофагов. Причём весь этот процесс действует по принципу обратной связи. Фаза экссудации наступает почти мгновенно вслед за альтерацией, включает в себя ряд процессов: изменяет вязкость крови, повышает проницаемость капилляров, вызывая миграцию составных частей крови в очаг воспаления с образованием экссудата, воспалительного клеточного инфильтрата. Пролиферация завершает процесс. В результате последовательного осуществления всех фаз воспаления кожа восстанавливается полностью или рубцуется (в зависимости от величины и глубины первоначального дефекта).</span></p>\r\n<p> </p>",
"diagnostics": "<div style=\"text-align: start;\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Диагноз ставит дерматолог на основании анамнеза, клинических проявлений. При наличии сомнений в диагнозе проводят дерматоскопию. Дополнительно применяют специфические методы исследования: окрашивание мазков экссудата по Граму (видны кокки под микроскопом), посев отделяемого булл на флору и антибиотикограмму.</span></p>\r\n</div>",
"treatment": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Лечение неосложнённых форм импетиго проводят в амбулаторных условиях. Терапия преследует две цели: устранить причину патологии и улучшить общее самочувствие пациента. Обычно для купирования процесса достаточно наружных средств: очаг поражения обрабатывают 2% камфорным спиртом, пузыри после вскрытия – фукорцином, мазями с антибиотиком. Фоново назначают витаминотерапию, иммуностимуляторы, натрия дезоксирибонуклеат. Запрещаются все водные процедуры. Курс лечения - 10 дней. Если заболевание продолжает распространяться, подключают антибиотики по индивидуальным схемам: внутрь или в/м в инъекциях. Назначается диета с отсутствием сахаросодержащих продуктов, так как глюкоза является благоприятной питательной средой для распространения микробов. </span></p>\r\n<p><span id=\"docs-internal-guid-570d5c20-7fff-75ea-920d-673d17a07c7f\"> </span></p>",
"prevention": "<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Для исключения повторного инфицирования важно знать и соблюдать основные меры профилактики. Загрязнения кожи – один из основных факторов, повышающих риск заражения. Поэтому соблюдение правил личной и трудовой гигиены – основное профилактическое мероприятие. Важно также укреплять иммунитет, вести активный образ жизни, правильно питаться, поддерживать баланс витаминов и минералов в организме. </span></p>",
"clinical_picture": "<p>Различают импетиго стафилококковое, стрептококковое и стрептостафилококковое. <br /> <br />Стрептококковое импетиго начинается с образования мало возвышающихся, склонных к периферическому росту фликтен - полостных элементов типа пузырей размером от 2 до 10 мм и более в диаметре. рассеяны или скучены группами, окружены узким ободком гиперемии. Содержимое фликтен сначала прозрачное, затем мутнеет и быстро ссыхается в светло-желтые корки, отпадающие через 5-7 дней, после чего остается депигментация. <br /> <br />К разновидностям стрептококкового импетиго относится простой лишай лица или сухая пиодермия - очаги мелкопластинчатого шелушения с незначительным покраснением кожи. <br /> <br />Другая разновидность стрептококкового импетиго - стрептококковые заеды, которые чаще встречаются у детей. Начинаются они с появления в углу рта пузыря с вялой тонкой покрышкой, на его месте быстро образуется щелевидная эрозия, после удаления которой, обнаруживается красная влажная легко кровоточащая поверхность с трещиной в центре. Спустя 1-2 часа заеда вновь покрывается коркой. Процесс может сопровождаться небольшой болезненностью при открывании рта. Процесс часто распространяется на слизистую оболочку полости рта. Иногда импетиго возникает изолированно во рту, где на месте быстро вскрывающихся фликтен образуются болезненные , покрывающиеся гнойным налетом. <br /> <br />Разновидностью пузырного импетиго является и поверхностный панариций, при котором фликтена возникает на ногтевом валике дугообразно вокруг ногтя на месте заусениц при травмах (например, во время маникюра), уколе иглой и т.д. При травмировании такая фликтена вскрывается и образуется мокнущая эрозия в большим количеством стрептококков в отделяемом. <br /> <br />Стафилококковое импетиго (фолликулит) <br />Фолликулит - это воспалительное поражение волосяного мешочка, вызванное стафилококками. Фолликулит может быть поверхностным или глубоким. Поверхностный фолликулит характеризуется образованием множественных небольших (1-2 мм, отдельные могут достигать 5 мм) гнойничков, пронизанных в центре волосом и окруженных узкой розовой каймой. На 3-4 день их содержимое подсыхает, появляются желтые , после отпадения которых, на коже не остается следов. <br /> <br />При глубоком фолликулите на коже образуются болезненные узелки красного цвета величиной 5 мм и больше в диаметре, иногда с гнойничком посредине. Через несколько дней узелок рассасывается или нагнаивается, а затем вскрывается. После заживления такого узелка часто остается рубчик. <br /> <br />Смешанное (стрептостафилококковое) импетиго <br />При сочетании стрептококковой и стафилококковой инфекции развивается смешанное (вульгарное) импетиго, при котором содержимое фликтен бывает гнойным, а корки - массивными. При снятии корок обнажается влажная эрозированная поверхность. <br />Располагается вульгарное импетиго обычно на лице и других открытых участках кожи. К заболеванию склонные дети, подростки и молодые женщины. Без лечения рядом с бывшими высыпаниями или на отдаленных участках кожи возникают новые фликтены, процесс нередко принимает распространенный характер. Имеет значение перенос инфекции на новые участки через руки и белье. <br /> <br />Осложнения импетиго <br />Чаще всего заболевание заканчивается без последствий, но могут быть и осложнения. Одними из самых неприятных осложнений являются осложнения на почки (нефриты) и на сердце (миокардиты). <br /> <br />Стафилококковое импетиго может осложниться распространенными гнойными процессами - абсцессами и флегмонами.</p>",
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"etiology": "<p>Основным патогенетическим фактором является повышенная чувствительность кожи к раздражителям, по-видимому, за счет разрастания нервных окончаний, и предрасположенность к гиперплазии эпидермиса в ответ на механическую травму. В возникновении заболевания важную роль играют функциональные нарушения нервной и эндокринной систем, аллергическое состояние организма, заболевания желудочно-кишечного тракта. Указывают также на наследственную предрасположенность.</p>",
"pathogenesis": "<p>Патофизиологические процессы, лежащие в основе расстройства, неизвестны, однако могут включать нарушение восприятия и обработки нервной системой ощущения зуда. Кожа, склонная к развитию экзематозных заболеваний (например, атопического дерматита), более склонна к лихенификации.</p>",
"diagnostics": "<p>Диагноз устанавливается при осмотре. Полностью сформировавшаяся бляшка имеет внешнюю зону, состоящую из дискретных коричневатых папул, и центральной зоны, представленной сливающимися папулами, покрытыми чешуйками. К клинически похожим состояниям относятся микоз гладкой кожи, красный плоский лишай и псориаз; простой хронический лишай можно отличить от этих состояний при помощи микроскопического исследования соскоба во влажном препарате с гидроксидом калия и биопсии.</p>",
"treatment": "<p style=\"display: inline !important;\"> </p>\r\n<p>Первичная терапия пациента заключается в его обучении и разъяснении эффектов расчесывания и трения. Вторичное лечение состоит в применении глюкокортикостероидных препаратов (например, триамцинолона ацетонида, флуоцинонида); хирургической пленки, пропитанной флурандренолидом (накладывается утром и меняется на новую пленку вечером, может оказаться более предпочтительной, поскольку окклюзия предотвращает расчесывание). Маленькие зоны поражения можно обколоть (внутриочаговые инъекции) длительно действующим глюкокортикостероидным препаратом, например триамценолона ацетонидом 2,5 мг/мл (разведенным в физиологическом растворе) в дозе 0,3 мл/см2 площади очага поражения; лечение можно повторять каждую 3–4-ю неделю. Пероральный прием антигистаминных препаратов, блокирующих H1-рецепторы, может оказать положительный эффект. Мази также могут быть действенными. Крем с капсаицином местного применения может быть также полезным, но жжение в начале может сделать эту терапию неприемлемой для пациентов.<br /> <br /> Ключевые моменты</p>\r\n<ul>\r\n<li>Хроническое шелушение приводит к дальнейшему зуду, создавая порочный круг.</li>\r\n<li>Зуд, сухость, шелушение, гиперпигментированность, лихениеновые бляшки возникают неправильной овальной или угловой формы на ногах, руках, шее и верхней части туловища, а иногда в аногенитальной области.</li>\r\n<li>Диагноз устанавливается на основе результатов клинических исследований, но исследование влажного препарата с гидроксидом калия и биопсия могут помочь в дифференциальной диагностике.</li>\r\n<li>Пациенты должны быть осведомлены о замкнутом круге, который начинается с царапин и продолжается зудом; кортикостероиды местного применения и антигистаминные препараты помогают контролировать зуд.</li>\r\n</ul>",
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"clinical_picture": "<p align=\"justify\">Заболевание начинается с зуда кожи. Симптомы простого хронического лишая локализуются преимущественно на задней и боковой поверхностях шеи, в подколенных и локтевых сгибах, аногенитальной области, на внутренней поверхности бедер, в межъягодичных складках. Но очаги могут появляться и на других участках кожного покрова, в том числе на волосистой части головы. В начале кожа в местах зуда внешне не изменена. Со временем под влиянием расчесов появляются полигональные папулы плотной консистенции, местами покрытые муковидными чешуйками. Папулы сливаются и образуют бляшки овальной или округлой формы, которые имеют цвет от розового до буровато-красного. Кожа утолщается, становится грубой, выражен кожный рисунок (лихенификация). На высоте развития заболевания в очаге различают три зоны. Периферическая, или наружная, зона пигментации окружает очаг поражения в виде пояса и обычно пи наружная, ни внутренняя границы неясны. Средняя, папулезная, зона состоит из узелковых высыпаний бледно-розового, сероватого или желтоватого цвета, величиной от булавочной головки до небольшой чечевицы. Папулы неправильной формы и нерезко ограничены, почти не возвышаются над окружающей кожей. Их поверхность утолщена, гладкая и в результате расчесов часто покрыта кровянистой корочкой. Внутренняя зона характеризуется выраженной инфильтрацией кожи. Нередко эта зона является единственным проявлением в клинической картине болезни.</p>\r\n<p align=\"justify\">В практике дерматовенеролога часто встречаются следующие атипичные и редкие разновидности ограниченного нейродермита:</p>\r\n<p align=\"justify\">Депигментированный нейродермит. При длительном течении ограниченного нейродермита возникают вторичные гипопигментации (витилигоподобные изменения). Считают, что они появляются в результате расчесов. При этом часто создается впечатление, что имеется сочетание двух процессов - нейродермита и витилиго.</p>\r\n<p>Гипертрофический (бородавчатый) нейродермит. При данной форме на фоне типичной клинической картины ограниченного нейродермита имеются отдельные узелковые и даже узловатые высыпания, весьма сходные с таковыми при узловатой почесухе. Такие очаги возникают преимущественно на внутренних поверхностях бедер, по могут локализоваться и па любых других участках.</p>\r\n<p align=\"justify\">В результате сильного зуда кожи головы выпадают волосы, кожа истончается, блестит, но не атрофична, процесс не связан с фолликулярным аппаратом. Такая форма заболевания получила название декальвирующий нейродермит.</p>",
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"etiology": "<p>В большинстве случаев кожный <a href=\"/symptom/zud/\" title=\"Перейти на страницу симптома Зуд\">зуд</a> имеет нервно-аллергическую природу. Различают также два вида зуда:</p>\r\n<p>· физиологический, возникающий при укусах и ползании по коже насекомых;</p>\r\n<p>· патологический может быть симптомом различных кожных болезней (экзема, <a href=\"/symptom/shelushenie_kozhi/\" title=\"Перейти на страницу симптома <a href=\"/symptom/shelushenie_kozhi/\" title=\"Перейти на страницу симптома Шелушение кожи\">Шелушение</a> кожи\">псориаз</a>, <a href=\"/symptom/zud/\" title=\"Перейти на страницу симптома Зуд\">чесотка</a>), следствием тяжелых общих заболеваний и других состояний (беременность, <a href=\"/symptom/nervoznost/\" title=\"Перейти на страницу симптома Нервозность\">невроз</a>).</p>",
"pathogenesis": "",
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"treatment": "<p>Общие рекомендация для пациентов с кожным зудом включают диету с исключением острой, соленой пищи, кофе и алкоголя, избегание перегревания и контакта с горячей водой, раздражающими тканями и химическими веществами (стиральные порошки, чистящие средства и др.), а также щелочными мылами, усиливающими <a href=\"/symptom/izmeneniya_struktury_kozhi/\" title=\"Перейти на страницу симптома Изменения структуры кожи\">сухость кожи</a>. Регулярно (до нескольких раз в день) рекомендуется наносить на зудящие участки увлажняющие (на основе вазелина или глицерина) и охлаждающие средства (например, крем с ментолом). При воспалительных процессах кожи применяют местные стероиды, а также новейшие негормональные средства – ингибиторы кальциневрина (такролимус и пимекролимус), которые обладают выраженным противовоспалительным и противозудным эффектом и, в отличие от гормональных средств, не вызывают таких нежелательных побочных эффектов, как, например, атрофия (истончение) кожи.</p>",
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"clinical_picture": "<p>На основании современных представлений о механизмах возникновении зуда выделяют 4 его типа:</p>\r\n<ul>\r\n<li>\r\n<p>Пруритоцептивный <a href=\"/symptom/zud/\" title=\"Перейти на страницу симптома Зуд\">зуд</a> возникает при воспалении, повреждении или сухости кожи (<a href=\"/symptom/zud/\" title=\"Перейти на страницу симптома Зуд\">зуд</a> при чесотке, крапивнице, укусе насекомого).</p>\r\n</li>\r\n<li>\r\n<p>Невропатический <a href=\"/symptom/zud/\" title=\"Перейти на страницу симптома Зуд\">зуд</a> наблюдается при повреждении нервной системы и часто сочетается с расстройствами чувствительности (например, при опухолях головного мозга).</p>\r\n</li>\r\n<li>\r\n<p>Нейрогенным называют <a href=\"/symptom/zud/\" title=\"Перейти на страницу симптома Зуд\">зуд</a>, возникающий без признаков повреждения структур нервной системы (например, <a href=\"/symptom/zud/\" title=\"Перейти на страницу симптома Зуд\">зуд</a> при застое желчи).</p>\r\n</li>\r\n<li>\r\n<p>Особой формой является психогенный <a href=\"/symptom/zud/\" title=\"Перейти на страницу симптома Зуд\">зуд</a> - тяжелый, длительный, не сопровождающийся какими-либо кожными заболеваниями. Основой такого состояния является, как правило, подавленное эмоциональное состояние.</p>\r\n</li>\r\n</ul>",
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"treatment": "<p>При лучевой терапии повышается уровень гистамина в крови, в связи с чем при длительном проведении облучения целесообразно с профилактической целью назначать антигистаминные препараты, витамины Е, В6. С и рутин, а также проводить антиоксидантную терапию. Для лечения эритематозного и сухого дерматитов применяются кортикостероидные кремы до ликвидации реакции. В дальнейшем используются косметические мази, содержащие витамины А и Е. При буллезном дерматите проводят интенсивное противовоспалительное и болеутоляющее лечение. Для уменьшения воспалительных явлений после обработки кожи антисептиком, вскрытия пузырей и удаления корок используются примочки с 0,01% раствором фурацилина. Далее применяются кортикостероидные мази и питательные витаминизированные кремы или 10% метилурациловая мазь, которые ускоряют эпителизацию.</p>",
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"clinical_picture": "<p align=\"justify\">Повреждения кожи ионизирующим излучением делят на ранние и поздние. Ранние проявляются в период облучения или в течение 3-х месяцев после него. Поздние повреждения кожи могут развиваться спустя годы после лучевого воздействия. Между ранними и поздними лучевыми повреждениями существует промежуточный период длительностью от нескольких месяцев до многих лет.</p>\r\n<p align=\"justify\">Острый лучевой дерматит относится к ранним повреждениям кожи. При дозе облучения 8-12 Гр возникает эритематозная форма острого лучевого дерматита. Она характеризуется покраснением кожи на участке облучения, появлением зуда и болезненности. Отмечается <a href=\"/symptom/shelushenie_kozhi/\" title=\"Перейти на страницу симптома Шелушение кожи\">шелушение</a> и <a href=\"/symptom/vypadenie_volos/\" title=\"Перейти на страницу симптома Выпадение волос\">выпадение волос</a>. Через 3-4 месяца рост волос восстанавливается. Эритематозная форма считается допустимой реакцией кожи на облучение, поскольку она не ведет к появлению поздних осложнений.</p>\r\n<full></full>\r\n<p align=\"justify\">Облучение кожи в дозе 12-20 Гр приводит к развитию буллезной формы лучевого дерматита. Она возникает на фоне покраснения, зуда, болезненности, отечности кожи и характеризуется появлением серозных пузырей. Когда пузыри вскрываются, на их месте образуются <a href=\"/symptom/izmeneniya_struktury_kozhi/\" title=\"Перейти на страницу симптома Изменения структуры кожи\">эрозии</a>, которые покрываются корками и заживают в течение 2-3 месяцев. Буллезный лучевой дерматит сопровождается увеличением регионарных лимфоузлов, повышением температуры тела и выпадением волос.</p>\r\n<p align=\"justify\">При дозе облучения более 25 Гр развивается некротическая форма лучевого дерматита. Она сопровождается выраженными болями, высокой температурой, слабостью, бессонницей. Тяжесть состояния пациента зависит от площади пораженного участка кожи. Кожные проявления проходят от стадии покраснения и пузырей до образования длительно незаживающих язв. Причем язвы могут возникать в обход буллезной стадии.</p>\r\n<p align=\"justify\">Хронический лучевой дерматит может быть следствием острого или развивается первично в результате многократного воздействия на кожу малых доз ионизирующего излучения. Его возникновению способствуют повышенная инсоляция, сахарный диабет, воздействие на кожу химических раздражителей, сосудистая патология, гнойная инфекция и др. К проявлениям хронического лучевого дерматита относятся: <a href=\"/symptom/izmeneniya_struktury_kozhi/\" title=\"Перейти на страницу симптома Изменения структуры кожи\">сухость кожи</a>, образование трещин, гиперкератоз, участки гипо- и гиперпигментации, атрофические лучевые язвы.</p>",
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