Buschke-Fischer Symmetrical Disseminated Macular Keratoderma (A. Buschke, 1868-1943, German Dermatologist; N. Fischer, 1884-1943, German Dermatologist)

Buschke-Fischer, symmetrical disseminated keratoderma maculosa or Buschke-Fischer disseminated keratoderma is a rare skin disease characterized by the appearance of symmetrical patches on the skin, which may be accompanied by itching and dryness.

The disease was first described in 1902 by two German dermatologists - Alfred Buschke and Nikolaus Fischer. They named it “patchy disseminated symmetrical keratoderma” after the fact that symptoms of the disease appear symmetrically on both sides of the body.

Symptoms of Bushe-Fish symmetrical disseminated macular keratoderma can appear as symmetrical spots with jagged edges and a scaly surface. These spots can come in a variety of sizes and colors, including red, brown, yellow, and white.

One of the reasons for the appearance of Bushe-Fisher symmetrical disseminated keratoderma may be a genetic predisposition. Risk factors may also include ultraviolet radiation, stress, diet and other factors.

Treatment of Bushe-Fish disseminated symmetric macular keratoderma may include the use of creams and ointments containing corticosteroids, as well as topical preparations containing vitamin A. In some cases, the use of systemic corticosteroids may be required.

Buschke-Fisch symmetrical disseminated macular keratoderma is a rare disease that can cause discomfort and lead to a decrease in quality of life. However, timely treatment and prevention can help prevent the development of this disease and improve the quality of life of patients with it.

Buschke-Fischer symmetrical disseminated macular keratoderma is a rare skin disease characterized by a symmetrical arrangement throughout the skin of multimorphic rashes that look like multiple spots and papules of various sizes (from a pinhead to a pea) with a predominant localization on the extensor surfaces of the extremities , back, inner surface of the shoulders. Pathognomonic manifestations of the disease also include the presence of multiple, including petechial, elements with unchanged skin in the neighborhood. In typical cases, the size of such elements is not the same (as was noted by E. G. Pevzents and D. L. Scott). A. M. Gudkov considers it a typical form of the disease, combining all the above-mentioned pathognomons (including the plaque-like nature of the rashes in homologous zones).

The skin process begins with the appearance on the limbs adjacent to the body of itchy blisters on an inflammatory basis, accompanied by photophobia and lacrimation. Their desquamation, tendency to peripheral growth, compaction and the appearance of hemorrhages inside the elements are possible. Subsequently, the rash becomes papular, and the pigment begins to spread to unaffected areas. In the presence of hyperpigmentation, you can notice the blanching of the hairs above the rash.

The pathological process can be localized either only on the extremities (foot, lower leg, forearm), or occur simultaneously on both arms and legs. The papules are grayish-yellow in color and often flake off with the formation of stearic scales. Rashes can be accompanied by subjective sensations of various kinds. Itching, burning and soreness often occur both in the papules themselves and in the hairs surrounding them. Peeling of the stratum corneum of the skin is observed.

When the rash resolves, yellowish pigmentation is observed, which never spreads to intact skin. Not only the affected skin, but also the nail plates of the hands and feet are colored with a weightless pearlescent change. In a number of patients, acanthosis is detected microscopically, and in fresh rashes, detached epidermal cells form acantholytic plugs. Such epithelial dissociation is usually accompanied by damage to the hair in its shaft. Mixed acantholysis with the acanthotic stage are observed. Perivascular or mixed edema of the dermis is often detected, as a result of which