Edema of the superciliary arches
There are four types of changeshuman face, which, at first glance, it is easy to confuse, although they differ, both in fact and for reasons of occurrence - it is subcutaneous emphysema, edema, puffiness and obesity of the face.
Subcutaneous emphysema (air in the subcutaneouscellulose) develops in such pathological conditions, when air from the pulmonary alveoli enters the mediastinum and subcutaneous cellular tissue of the chest. The reasons for the development of subcutaneous emphysema may be excessive physical activity, severe cough, bronchial asthma, caisson disease (in divers with rapid ascent), chest trauma, pneumothorax (air accumulation in the pleural cavity), emphysema of the mediastinum (air in the mediastinum), fracture of the ribs , ruptured esophagus. A distinctive sign of subcutaneous emphysema is a symptom of crepitus when pressing on the skin (resembling the crunch of snow underfoot). After the treatment of the underlying disease, subcutaneous emphysema, as a rule, resolves itself.
Swelling of the face (fluid accumulation in soft tissues)most often are a sign of nephrotic syndrome, although approximately the face also looks for allergic diseases (angioedema, hives, etc.), inflammatory diseases of the face, protein starvation (hypoproteinemia, hyponatremia). Nephrotic syndrome is a complex manifestation of kidney disease (glomerulonephritis, amyloidosis of the kidneys) or other somatic diseases (rheumatoid arthritis, systemic lupus erythematosus, scleroderma, osteomyelitis, sepsis, toxicosis of pregnant women, blood diseases) characterized by edema, the appearance of protein in the urine (proteinuria), reduction of proteins in the blood (hypoproteinemia) and excess cholesterol (hypercholesterolemia).
Patients complain of weakness, fatigue,decreased appetite, heaviness in the lower back. Edema in the nephrotic syndrome begins with the face, the skin is pale (pale gray), the friable subcutaneous tissue of the eyelids and eyes most of all swells, a swelling of the superciliary arches occurs, pressure pits usually do not remain. The face becomes formless, often changes beyond recognition. Quincke's Edema is an acute condition of an allergic or pseudoallergic (hereditary) nature.
Hereditary form of the edema of Quincke develops inthe result of exposure to minor chemical, thermal or physical factors. Swelling is predominantly limited, the skin is pale pink or pink, itching in most cases is not. It passes by itself. Characteristically, sudden development of edema within the skin, subcutaneous tissue and / or mucous membranes and spontaneous arresting of the process.
The most commonly affected soft tissues of the face, stopand brushes. Much shells, mucous membranes of the bladder, uterus, and joints are much less affected. Quincke's edema of allergic nature develops after contact with the allergen (food, vegetable, medicinal, etc.) and is often combined with urticaria and other allergic diseases (for example, with bronchial asthma, migraine, etc.). It spreads mainly on the face (lips, eyelids). The most formidable variant of the edema of Quincke is the swelling of the larynx due to the danger of death from suffocation. The patients become restless, the face is pale or cyanotic, the voice is hoarse, breathing is difficult, in rare cases, hemoptysis is observed.
Attention! Patients with Quinck's edema show an urgent hospitalization in the intensive care unit.
Obesity, in contrast to edema and subcutaneousemphysema, is never isolated, it is a disease of the whole body. There is an increased deposition of fat in the subcutaneous tissue. In such patients, the body mass index significantly exceeds the normal values (20-25 kg / m 2).
Obesity, as a rule, is accompanied by manyother diseases of internal organs and the endocrine system, and does not preclude the development of another, including acute, disease requiring immediate medical attention.
Note! The body mass index is determined by dividing the body weight in kilograms by the height in meters, squared.
The so-called "moon-shaped face" (obesity andfullness of the face) is a characteristic sign of Cushing's syndrome as a result of an increase in the level of hormones in the adrenal cortex (corticosteroids) in the blood plasma. Cushing's syndrome develops with the following diseases: Cushing's disease (adenoma of the pituitary gland - brain tumor that produces adrenocorticotropic hormone - ACTH), other tumors stimulating the production of ACTH (for example, lung cancer), adrenal tumors that produce corticosteroids, the use of drug corticosteroids in the treatment of others diseases.
This syndrome is also characterized by increasedfacial and body hair (hirsutism), increased fat release, the appearance of acne, thinning of the skin, which seems hyperemic. With adrenal adenoma, in addition to face obesity, there is an increase in body weight and fat deposition in the supraclavicular area, and muscle weakness, osteoporosis, arterial hypertension and diabetes mellitus often develop.
Puffiness (swelling) as a symptomoccurs in diseases such as bronchial asthma, chronic obstructive bronchitis, as well as when lymphatic tract is compressed by a massive outlet of intercellular fluid into the pleural cavity or pericardium. The combination of puffiness of the face with cyanosis and swelling of the neck, torso and upper extremities, swelling and expansion of the subcutaneous veins of the shoulder girdle is noted with thrombosis of the inferior vena cava or compression of its tumors by neighboring organs.
Puffy broad, slow-moving, evenlyThe swollen face, with smoothed contours is typical for patients with myxedema. At the same time, the facial skin is pale yellow, dry, cold, edematous, facial features are enlarged, eyelids are saccularly edematous. The glottis is narrowed, eyes sunken, eyes dull, indifferent, mimicry poor, eyebrows rare.
In congenital character, in newbornsthe disease is often accompanied by drowsiness, constipation, umbilical hernia, non-spreading of the fontanel, an increase in the tongue, jaundice. With the development of the disease in an adult, sharp changes in the character of a person are noted, the patient complains of lethargy, rapid fatigue, lack of interest in life, drowsiness, slowness of movements, hoarseness of voice, taste, smell, hearing is disturbed. In addition, there are pains of incomprehensible localization.
Note! "The face of Corvizar" is a characteristic manifestation of chronic cardiovascular insufficiency. In this case, the patient's face looks like a light, flabby, dull, half-closed eyes, skin color is pale yellow with a cyanotic shade, the mouth is always ajar, as if catching air, lips are bluish-purple.