The distribution of dermatological lesions in patients with hemiplegia and hemiparesis

Background: Neurologic system and dermis take place of the same embriyologic neuroectodermal origin. Several studies have shown the relationship between the neurological disordes and some dermatoses. Objective: This study is designed to detect the distribution of the skin lesions among the stroke patients and influence of the neurologic defects on the prognosis of dermotological diseases/situations. Methods: 140 stroke patients who were referred to the Neurology and Physical-Rehabilitation Medicine Departments of Akdeniz University were enrolled in the study. Their detailed dermatological and neurological examinations were performed. The patients were followed up prospectively over 2 years for the dermatological diseases which are occurred, increased, decreased or disappeared on the paralyzed side. McNemar and Wilcoxon signed rank-tests were used to analyze the differences between the affected/unaffected side for each sign/disease. The X2 test was used to analyze categorical data between the right/left side involvement and between the plegic/paresthetic patients. Results: The lesions of bullous pemphigoid occurred after the onset of hemiplegia. Irritant contact dermatitis had fade away after the onset of hemiplegia on the paretic extremity. Irritant contact dermatitis was statistically significantly decreased in right-sided hemiplegia compared to left-sided hemiplegia. Immobilization-induced elimination of the contactants might have potentially contributed to the amelioration of the disease activity. The lesions of several eczematous dermatitis had fade away after the onset of hemiplegia on the paretic extremity. Decubitus, ecchymosis, intertrigo and erytrasma grew considerably after the onset of hemiplegia on the paretic side. Immobilization, sensorial loss, selective proliferation of microbial agents by the occlusion, increased natural warmth and humidity might have potentially contributed to the lateralization of these dermatoses. Localized telangiectases occured on the paretic side. This could be a new phenomenon for the detection of the affected side among the stroke patients. Limitations: Our study should be supported by further reseachs.