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Livedo mesh (Melkersson-Rosenthal syndrome): causes, symptoms, diagnosis, treatment
Last reviewed: 20.11.2021
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The net levido (the Melkerson-Rosenthal syndrome) was first described in 1928 by Melkersson. He observed a patient with recurrent paresis of the facial nerve and persistent edema of the lips, and in 1931 Rosenthal added a third symptom - a folded or tonguous tongue.
Differential diagnosis. If the Melkersson-Rosenthal syndrome is manifested by a single macrocheylite, then it must be differentiated first of all from elephantiasis, which occurs with a chronic erysipelas, and Quincke's edema.
The causes and pathogenesis of the disease have not been fully studied. Some authors refer to it as infectious-allergic, since dermatosis begins or recurs after infectious diseases (angina, influenza, simple bubble lichen, etc.). Preceding factors may also be trauma, functional disorders of the peripheral and central nervous system.
Treatment. A complex treatment is performed, including corticosteroids (25-30 mg per day inside), broad-spectrum antibiotics, antimalarial drugs, antihistamines, vitamins. External - physiotherapy (UHF, darsonval, etc.).
Symptoms of net levido. The syndrome of Melkersson-Rosenthal is more often afflicted by women. It includes a triad of symptoms: paralysis of the facial nerve, macrochilite and folding of the tongue.
The disease usually begins in childhood or adolescence, rarely in adults. The first symptom is paresis of the facial nerve, which eventually transforms into unilateral paralysis of the facial nerve of varying severity.
The second clinical sign of Melkersson's Rosental syndrome is macrochillitis, which develops due to edema of the lip and its infiltration. The lips are thickened and turned, have a dense, less often - a testo-elastic consistency, moderately strained, pits with pressure does not remain. The lip resembles elephantiasis, its margins are loosely adherent to the teeth, without signs of inflammation and regional lymphadenitis. As a result of the swelling of the lips of different intensity, a clear asymmetry of the face appears.
The third sign is a tongue-in-cheek. The surface of the tongue, permeated with folds, becomes bumpy and sometimes keratinized. This hypertrophied folded tongue becomes inactive.
Melkersson-Rosenthal syndrome can occur not only as a triple-negative disease, but also in the form of macrochialitis combined with unilateral paralysis of the facial nerve. Sometimes macrochilite is the only symptom of the disease.