Dermatitis dermatovenereology. Dermatitis

Dermatitis means inflammation of the skin, but dermatologists use this term to define a special group of inflammatory skin diseases. Clinically, they manifest themselves as more or less clearly defined erythema, usually accompanied by itching. Lesions go through 3 stages - acute, subacute and chronic. Primary elements are spots, papules, vesicles, edematous spots, plaques; secondary - crusts, scales, cracks and lichenification. Primary histological changes are characterized by spongiosis (intercellular epidermal edema), the presence of lymphocytes or eosinophils in the dermis and epidermis.

DERMATITIS- arises as a result of direct influence on it external factors. There are simple contact and allergic dermatitis.

SIMPLE DERMATITIS occur in all people when the skin is exposed to obligate (obligatory) irritants, which can be chemical (concentrated mineral acids, alkalis, boiling water), physical (UV rays, high and low temperatures, etc.), biological (hogweed), mechanical ( friction, prolonged pressure). Degree of expression inflammatory phenomena depends on the strength of the irritant and the time of its exposure to the skin, and therefore, in the development of simple dermatitis, 3 stages (forms) are distinguished: erythematous, vesiculobullous and necrotic-ulcerative. Inflammatory changes in area strictly correspond to the site of exposure to the stimulus and occur without a latent period. Simple dermatitis, both at work and at home, often develops as a result of an accident (burns, frostbite).

ALLERGIC DERMATITIS arise under the influence of facultative irritants (sensitizers) in persons with hypersensitivity to them and pathogenetically represent a delayed-type allergic reaction. Most often, allergic dermatitis develops as a result of repeated exposure of the skin to synthetic washing powders, cosmetics, medications, chromium, nickel, etc. Skin changes in allergic dermatitis, unlike simple dermatitis, occur after a latent period, which ranges from 7-10 days to a month or longer. The clinical picture of allergic dermatitis is similar to that of acute eczema, and therefore its course is divided into erythematous, vesicular, weeping, cortical and squamous stages. The process is accompanied by itching. Inflammatory phenomena can extend beyond the skin area where the irritant is applied. Diagnosis of simple dermatitis usually does not cause difficulties due to the absence of a latent period between exposure to the irritant and the occurrence of typical skin changes. When diagnosing allergic dermatitis, the localization of the lesion (usually open areas of the skin of the hand, face) and the eczema-like nature of the inflammatory changes in the skin are taken into account. Often, to confirm the diagnosis, they resort to allergic testing. skin tests, which are mandatory when identifying an occupational sensitizer (occupational dermatitis).
Treatment : for simple and allergic dermatitis, the main elimination of the action of the irritant. For simple dermatitis in the form of chemical burns from concentrated acids and alkalis with a remedy emergency care is a long and abundant rinsing of them with water. For severe erythema with edema, lotions and corticosteroid ointments are indicated; for vesiculobullous rashes, the blisters are opened, followed by the application of disinfectant cold lotions, as well as ointments with corticosteroids and antibiotics (Lorinden C, celestoderm with garamycin, etc.). Treatment of patients with necrotic-ulcerative manifestations is carried out in a hospital, and with allergic dermatitis according to the principles of treatment of acute eczema.

PELLAGROID DERMATITIS- dermatitis that develops under the influence of insolation in people who abuse alcohol and suffer from liver diseases. The disease is similar to pellagra. The lesions are characterized by symmetrical diffuse erythema with swelling on the forearms, dorsum of the hands, face, and neck. Unlike pellagra, there is no skin atrophy, damage to the mucous membranes, or general severe phenomena.
Treatment : exclusion of alcohol, correction of liver disorders. Nicotinic acid, xanthinol nicotinate, vitamins B, B1, B3, B5 are prescribed in normal doses, and photoprotective ointments are prescribed locally (Shield, Luch). IN acute period lotions with a 1-2% solution of amidopyrine, resorcinol, tannin, etc., and corticosteroid ointments are indicated.

PERIORAL DERMATITIS- a disease of the facial skin caused by opportunistic microflora due to an increase in its quantity and a change in its qualitative composition. It occurs predominantly in women, often young and middle-aged. Predisposing factors are the use of corticosteroid ointments for acne vulgaris, seborrheic and drug dermatitis, rosacea; thinning of the epidermis; outbreaks chronic infection, severe infectious diseases; dysfunction of the digestive tract, hormonal dysfunction, taking contraceptives. In the pathogenesis of the disease, a large role is given to the inhibition of local mechanisms of antibacterial resistance of the facial skin, a decrease in the general resistance of the body, an increase in the tension of cellular and (or) humoral immunity, including to bacterial allergens; hormonal imbalance. The skin lesion is characterized by non-follicular, 1-2 mm in diameter hemispherical papules from pale pink to bright red and single waxy, shiny translucent pseudopustules. Papules do not tend to grow, do not merge, are often located in isolation or are grouped into poorly defined small lesions, the surface of which is often covered with whitish translucent scales. Erythema and teloangiectasias are not always found. The rash is localized only on the skin of the face, without affecting other areas, including the neck. There are 3 localization options: perioral, periorbital and mixed. The diagnostic feature is a narrow, 2-3 mm in diameter, rim of unaffected, paler skin around the red border of the lips. Subjective sensations are usually absent. The onset of the disease is nonspecific, development is usually rapid, the course is monotonous, and there are no stages.
The diagnosis is usually not difficult. It is necessary to differentiate from rosacea, seborrheic dermatitis, acne vulgaris, pyoderma.
Treatment : discontinuation of corticosteroid ointments with subsequent relief of the “exacerbation reaction” that occurs 5-10 days after their discontinuation. Clinical manifestations of “withdrawal dermatitis” are characterized by bright red erythema, sometimes significant swelling of the entire facial skin, an increase in local temperature, an increase in the number and area of ​​rashes, the appearance subjective feelings in the form of a sharp burning sensation, itching, and tightness of the skin. The duration of “withdrawal dermatitis” is 7-10 days, its treatment includes hypoallergenic diet, desensitizing and diuretic drugs, local herbal lotions and indifferent creams or oil: it is not recommended to use cosmetics or soap. Then tetracycline is prescribed in medium doses (if perioral dermatitis occurs against the background of seborrheic skin changes), metronidazole according to a permanent regimen (if perioral dermatitis is combined with rosacea or diseases gastrointestinal tract), decaris, methyluracil, biogenic stimulants, antihistamines, vitamins, belloid (for severe neurotic disorders). Locally use alternating lotions from herbal infusions (chamomile, string, sage, nettle) with pastes with 2-5% naphthalan and tar, with increased dryness indifferent creams with olive or peach oil. In the case of a combination of perioral dermatitis and demodicosis, acaricidal agents are prescribed. Cryomassage with carbonic acid snow or liquid nitrogen is also used in courses (2-3) of 10-12 sessions per course. At the same time, concomitant pathology is identified and corrected.

SEBORRHICAL DERMATITIS inflammatory dermatosis in infants. Develops in the 1st month of life, often at the end of the 1st week and the beginning of the 2nd; lasts for 3-4 months, then regresses. There are 3 degrees of severity of the process: mild, moderate and severe. The disease begins with hyperemia and slight infiltration of the skin folds (behind the ear, cervical, axillary, inguinal-femoral) with dissemination of scaly maculopapular elements of a numular nature along the periphery of the lesions ( mild degree), which makes it necessary to differentiate dermatitis from psoriasis. The process of moderate severity extends beyond the boundaries of skin folds, involving significant areas smooth skin on the scalp. Characterized by erythema, infiltration, peeling. Minor dyspeptic disorders are characteristic: regurgitation 3-4 times a day, loose stool. In severe forms, at least 2/2 of the skin is affected; on the scalp there is a “bark” of fatty scales against the background of erythema and infiltration of the skin. Dyspepsia and slow weight gain are also characteristic. The condition is very close to that of desquamative Leiner-Moussou erythroderma, but regresses faster (lasts 3-4 months). Complications such as otitis media, anemia, and pneumonia are possible.

Treatment : at mild degree Only external treatment is indicated: 2-3% naphthalan, ichthyol ointment; for moderate and severe degrees, antibiotics are prescribed (for 10 days), blood transfusions, plasma transfusions, glucose with ascorbic acid, vitamins A, C, group B.

SCHISTOSOMIC DERMATITIS(cercarial dermatitis, swimmer's itch, water scabies) - acute inflammation of the skin, predominantly urticarial in nature. It occurs in humans upon contact with cercariae of the larval stage of some adult helminths, usually found in polluted water bodies. The causative agents are usually larvae (cercariae) of schistosomes of waterfowl (ducks, gulls, swans) and, less commonly, some mammals (rodents, muskrats, etc.), which, having penetrated the thickness of human skin, die before reaching puberty. The disease often occurs in tropical countries of Africa and Asia, and rarely in Russia. Human infection usually occurs through swimming or working in ponds, swampy, stagnant or slow-moving bodies of water contaminated by the feces of infected birds, mammals or people. When a person comes into contact with cercariae, they attach to the skin and quite quickly, with the help of a special biting apparatus, penetrate into the thickness of the skin. Further migration of cercariae in the skin is facilitated by the lytic effect of the secretion they secrete. The clinical picture of schistosome dermatitis is characterized by some variability and depends on the immunobiological state of the body, the intensity and duration of contact with cercariae. At the moment of cercariae penetration into the skin, patients feel sharp pain. After a few minutes or 1-3 hours, the feeling of pain turns into intense itching. At the same time, erythematous spots appear at the sites of cercariae penetration, which turn into blisters the size of beans. As exudation increases, bubbles containing a clear opalescent liquid appear on the blisters. In the case of pyococcal infection, blisters can transform into pustules (in weakened people, especially children, ecthyma may develop). In most cases, after 4-5 days the severity of the inflammatory phenomena decreases, and after 10-14 days the process resolves without a trace. Cases of the development of diffuse hyperemia involving almost the entire skin (schistosomal erythroderma) have been described. Histologically, swelling and local lysis are noted in the epidermis around the site of penetration of cercariae into the skin epithelial cells and the presence of intraepidermal “passages” filled with neutrophils and eosinophils; in the dermis there is an infiltrate consisting of polymorphonuclear leukocytes and lymphocytes. Diagnosis is made based on typical clinical picture and anamnesis. Treatment is mainly symptomatic: lotions, itching talkers, creams, ointments. It is also advisable to prescribe desensitizing and detoxifying agents (diphenhydramine, calcium chloride, sodium thiosulfate), drinking plenty of fluids, and in case of pyococcal infection, antibiotics. Preventive actions are reduced to the destruction of mollusks and rodents. From measures personal protection It is recommended to lubricate the skin with 40% dimethyl phthalate ointment before bathing, and after bathing, dry thoroughly with a towel.

LECTURE No. 3. Atopic dermatitis

Atopic dermatitis (or diffuse neurodermatitis, endogenous eczema, constitutional eczema, diathetic prurigo) is a hereditary chronic illness the whole body with a predominant skin lesion, which is characterized by polyvalent hypersensitivity and eosinophilia in the peripheral blood.

Etiology and pathogenesis. Atopic dermatitis is a multifactorial disease. The model of multifactorial inheritance in the form of a polygenic system with a threshold defect is currently considered the most accurate. Thus, hereditary predisposition to atopic diseases is realized under the influence of provoking environmental factors.

An inadequate immune response contributes to increased susceptibility to various skin infections (viral, bacterial and mycotic). Superantigens of bacterial origin are of great importance.

An important role in the pathogenesis of atopic dermatitis is played by the inferiority of the skin barrier associated with impaired ceramide synthesis: the skin of patients loses water, becoming dry and more permeable to various allergens or irritants that enter it.

The characteristics of the psycho-emotional status of patients are essential. Characteristic features of introversion, depression, tension and anxiety. The reactivity of the autonomic nervous system changes. There is a pronounced change in the reactivity of blood vessels and the pilomotor apparatus, which is dynamic in nature in accordance with the severity of the disease.

Children who had early age manifestations of atopic dermatitis represent a risk group for the development of atopic bronchial asthma and allergic rhinitis.

Diagnostics. To make the correct diagnosis, basic and additional diagnostic criteria are used. The criteria proposed at the First International Symposium on Atopic Dermatitis are used as a basis.

Basic criteria.

1. Itching. The severity and perception of itching may vary. As a rule, itching is more disturbing in the evening and at night. This is due to the natural biological rhythm.

2. Typical morphology and localization of rashes:

1) in childhood: damage to the face, extensor surface of the limbs, torso;

2) in adults: rough skin with an accentuated pattern (lichenification) on the flexor surfaces of the limbs.

3. Family or individual history of atopy: bronchial asthma, allergic rhinoconjunctivitis, urticaria, atopic dermatitis, eczema, allergic dermatitis.

4. The onset of the disease in childhood. In most cases, the first manifestation of atopic dermatitis occurs in infancy. This is often due to the introduction of complementary foods, the prescription of antibiotics for some reason, or climate change.

5. Chronic relapsing course with exacerbations in the spring and autumn-winter seasons. This characteristic feature of the disease usually appears no earlier than 3 to 4 years of age. A continuous off-season course of the disease is possible.

Additional criteria.

1. Xeroderma.

2. Ichthyosis.

3. Palmar hyperlinearity.

4. Follicular keratosis.

5. Increased level immunoglobulin E in blood serum.

6. Tendency to staphyloderma.

7. Tendency to nonspecific dermatitis of the hands and feet.

8. Dermatitis of the breast nipples.

9. Cheilitis.

10. Keratoconus.

11. Anterior subcapsular cataract.

12. Recurrent conjunctivitis.

13. Darkening of the skin of the periorbital area.

14. Infraorbital Denny–Morgan fold.

15. Facial pallor or erythema.

16. White pityriasis.

17. Itching when sweating.

18. Perifollicular seals.

19. Food hypersensitivity.

20. White dermographism.

Clinic. Age periodization. Atopic dermatitis usually manifests itself quite early - in the first year of life, although its manifestation is possible at a later date. The duration of the course and the timing of remissions vary significantly. The disease can continue into old age, but more often its activity subsides significantly with age. There are three types of atopic dermatitis:

1) recovery up to 2 years (most common);

2) pronounced manifestation up to 2 years with subsequent remissions;

3) continuous flow.

Currently, there is an increase in the third type of flow. At an early age, due to the imperfection of the child’s various regulatory systems and various age-related dysfunctions, the effect of external provoking factors is much more pronounced. This may explain the decrease in the number of patients in older age groups.

In conditions of deteriorating environmental conditions, the role of external factors is increasingly increasing. These include the impact atmospheric pollution and occupational aggressive factors, increased contact with allergens. Psychological stress is also significant.

Atopic dermatitis occurs with chronic recurrence. Clinical manifestations of the disease change with the age of patients. Long-term remissions are possible during the course of the disease.

The clinical picture of atopic dermatitis in children aged 2 months to 2 years has its own characteristics. Therefore, the infant stage of the disease is distinguished, which is characterized by the acute and subacute inflammatory nature of the lesions with a tendency to exudative changes and a certain localization - on the face, and with widespread lesions - on the extensor surfaces of the limbs, less often on the skin of the body.

In the vast majority of cases, there is a clear connection with nutritional stimuli. Initial changes usually appear on the cheeks, less often on the outer surfaces of the legs and other areas. Disseminated skin lesions are possible. The lesions are located primarily on the cheeks, in addition to the nasolabial triangle, the unaffected skin of which is sharply demarcated from the lesions on the cheeks. The presence of rashes on the skin of the nasolabial triangle in a patient with atopic dermatitis at this age indicates a very severe course of the disease.

The primary ones are erythematoedematous and erythematosquamous lesions. With more acute course Papulovesicles, cracks, oozing, and crusts develop. Characterized by strong itchy skin(uncontrolled scratching movements during the day and during sleep, multiple excoriations). An early sign atopic dermatitis may be milky crusts (the appearance on the skin of the scalp of fatty crusts of a brownish color, relatively tightly fused to the underlying reddened skin).

By the end of the first – beginning of the second year of life, exudative phenomena usually decrease. Infiltration and peeling of lesions increase. Lichenoid papules and mild lichenification appear. Follicular or pruriginous papules may appear, and rarely, urticarial elements. In the future, complete involution of the rash or a gradual change in morphology and localization is possible with the development of the clinical picture characteristic of the second age period.

Second age period(childhood stage) covers ages from 3 years to puberty. It is characterized by a chronically relapsing course, often depending on the season of the year (exacerbation of the disease in spring and autumn). Periods of severe relapses may be followed by long remissions, during which children feel practically healthy. Exudative phenomena decrease, pruriginous papules, excoriations predominate, and a tendency to lichenification, which increases with age. Eczema-like manifestations tend to cluster, most often appearing on the forearms and lower legs, resembling plaque eczema or eczematids. Erythematosquamous rashes around the eyes and mouth, which are difficult to treat, often appear. At this stage, typical lichenified plaques may be present in the elbow bends, popliteal fossae and on the back of the neck. Characteristic manifestations of this period also include dyschromia, which is especially noticeable in the upper back.

During development vegetative-vascular dystonia grayish pallor of the skin appears.

By the end of the second period, the formation of changes typical for atopic dermatitis on the face is possible: pigmentation on the eyelids (especially the lower ones), a deep fold on the lower eyelid (Denny-Morgan symptom, especially characteristic of the exacerbation phase), in some patients - thinning of the outer third of the eyebrows. In most cases, atopic cheilitis is formed, which is characterized by damage to the red border of the lips and skin. The process is most intense in the area of ​​the corners of the mouth. The part of the red border adjacent to the oral mucosa remains unaffected. The process never spreads to the oral mucosa. Erythema with fairly clear boundaries is typical; slight swelling of the skin and red border of the lips is possible.

After the acute inflammatory phenomena subside, lichenification of the lips is formed. The red border is infiltrated, peels off, and has multiple thin radial grooves on its surface. After the exacerbation of the disease subsides long time Infiltration and small cracks in the corners of the mouth may persist.

Third age period ( adult stage) is characterized by a lesser tendency to acute inflammatory reactions and a less noticeable reaction to allergic irritants. Patients mainly complain of itchy skin. Clinically, the most characteristic lesions are lichenified lesions, excoriations and lichenoid papules.

Eczema-like reactions are observed mainly during periods of exacerbation of the disease. Characterized by severe dry skin, persistent white dermographism, and a sharply enhanced pilomotor reflex.

Age-related periodization of the disease is not observed in all patients. Atopic dermatitis is characterized by a polymorphic clinical picture, including eczematous, lichenoid and pruriginous manifestations. Based on the predominance of certain rashes, a number of such clinical forms diseases in adults such as:

1) lichenoid (diffuse) form: dryness and dyschromia of the skin, biopsy itching, severe lichenification, a large number of lichenoid papules (hypertrophied triangular and rhombic skin fields);

2) eczema-like (exudative) form: most typical for the initial manifestations of the disease, but in adults, skin changes such as plaque eczema, eczematid and eczema of the hands may predominate in the clinical picture of the disease;

3) pruriginous form: characterized by a large number of pruriginous papules, hemorrhagic crusts, excoriations.

Among the dermatological complications of atopic dermatitis, the first place is occupied by the addition of a secondary bacterial infection. In cases where it prevails staphylococcal infection, they talk about pustulization. If the complication of the disease is caused primarily by streptococci, impetiginization develops. Sensitization to streptococci and eczematization of streptoderma foci often develop.

With prolonged existence of inflammatory changes in the skin, dermatogenous lymphadenopathy develops. Lymph nodes can be significantly enlarged and have a dense consistency, which leads to diagnostic errors.

Treatment. Therapeutic measures for atopic dermatitis include active treatment in the acute phase, as well as constant strict adherence to the regimen and diet, general and external treatment, and climatic therapy.

Before starting therapy, it is necessary to conduct a clinical and laboratory examination to identify factors that provoke exacerbation of the disease.

For successful treatment atopic dermatitis, detection and control of risk factors are very important, causing exacerbation diseases (triggers - nutritional, psychogenic, meteorological, infectious and other factors). The elimination of such factors significantly facilitates the course of the disease (sometimes to complete remission), prevents the need for hospitalization and reduces the need for drug therapy.

In the infant phase, nutritional factors usually come to the fore. Identification of such factors is possible with sufficient activity of the child’s parents (careful keeping of a food diary). Further role food allergens decreases slightly.

Patients with atopic dermatitis should avoid foods rich in histamine (fermented cheeses, dry sausages, sauerkraut, tomatoes).

Among non-food allergens and irritants, dermatophagoid mites, animal hair, and pollen occupy a significant place.

Colds and respiratory viral infections can cause atopic dermatitis to worsen. At the first symptoms of a cold, it is necessary to start taking antisensitizing medications.

In children younger age great value have nutritional factors such as enzyme deficiency, functional disorders. It is advisable for such patients to prescribe enzymatic preparations and recommend treatment at gastrointestinal resorts. With dysbacteriosis, intestinal infections targeted correction is also carried out.

For mild exacerbations of the disease, you can limit yourself to prescribing antihistamines. The most commonly used are new generation histamine H1 receptor blockers (cetirizine, loratadine), which do not have side sedative effects. Drugs in this group reduce the body’s response to histamine, reducing smooth muscle spasms caused by histamine, reducing capillary permeability, and preventing the development of tissue edema caused by histamine.

Under the influence of these drugs, histamine toxicity decreases. Along with the antihistamine effect, drugs in this group also have other pharmacological properties.

For moderate exacerbations of the disease, in most cases it is advisable to begin therapy with intravenous infusions solutions of aminophylline (2.4% solution - 10 ml) and magnesium sulfate (25% solution - 10 ml) in 200 - 400 ml of isotonic sodium chloride solution (daily, 6 - 10 infusions per course). In the lichenoid form of the disease, it is advisable to include atarax or antihistamines with a sedative effect in therapy. For an eczema-like form of the disease, atarax or cinnarizine is added to therapy (2 tablets 3 times a day for 7–10 days, then 1 tablet 3 times a day). It is also possible to prescribe antihistamines that have a sedative effect.

External therapy is carried out according to the usual rules - taking into account the severity and characteristics of inflammation in the skin. The most commonly used creams and pastes contain antipruritic and anti-inflammatory substances. Naftalan oil, ASD, and wood tar are often used. To enhance the antipruritic effect, phenol, trimecaine, and diphenhydramine are added.

In the presence of an acute inflammatory skin reaction with weeping, lotions and wet-dry dressings with astringent antimicrobial agents are used.

When the disease is complicated by the addition of a secondary infection, stronger antimicrobial agents are added to external remedies.

Externally, for mild and moderate exacerbations of atopic dermatitis, short courses of topical steroids and local calcineurin inhibitors are used.

The external use of drugs containing glucorticosteroids for atopic dermatitis is based on their anti-inflammatory, epidermostatic, coreostatic, antiallergenic, and local anesthetic effects.

In case of severe exacerbation of the process, it is advisable to carry out a short course of treatment with glucocorticosteroid hormones. The drug betamethasone is used. The maximum daily dose of the drug is 3–5 mg with gradual withdrawal after achieving a clinical effect. The maximum duration of therapy is 14 days.

For severe exacerbations of atopic dermatitis, it is also possible to use cyclosporine A (daily dose 3–5 mg per 1 kg of patient body weight).

Most patients in the acute phase require psychotropic medications. A long course of itchy dermatosis often provokes the appearance of significant general neurotic symptoms. The first indication for prescribing drugs that inhibit the function of cortico-subcortical centers is persistent night sleep disorders and general irritability of patients. For persistent sleep disturbances, sleeping pills are prescribed. To relieve excitability and tension, small doses of atarax are recommended (25–75 mg per day in separate dosages during the day and at night), a drug that has a pronounced sedative, as well as antihistamine and antipruritic effect.

Use in therapy physical factors must be strictly individual. It is necessary to take into account the forms of the disease, the severity of the condition, the phase of the disease, the presence of complications and concomitant diseases. In the stabilization and regression phase, as well as as a prophylactic agent, general ultraviolet irradiation is used.

Prevention. Preventive measures should be aimed at preventing relapses and severe complicated course of atopic dermatitis, as well as preventing the occurrence of the disease in risk groups.

From the book Skin and venereal diseases author Oleg Leonidovich Ivanov

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From the book Lemon Treatment author Yulia Savelyeva

ATOPIC DERMATITIS Atonic dermatitis (syn. atonic eczema, constitutional eczema) is a hereditary allergic dermatosis with a chronic relapsing course, manifested by an itchy erythematous-papular rash with lichenification phenomena

From the book Children's Diseases. Complete guide author author unknown

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From the book Dermatovenerology author E. V. Sitkalieva

ATOPIC DERMATITIS With the appearance in environment huge amount substances entering the human body, its the immune system experiences high stress, protecting the body from substances foreign to it. Atopic dermatitis is a multifactorial dermatosis with

From the book Paramedic's Handbook author Galina Yurievna Lazareva

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From the book Herbal Treatment. 365 answers and questions author Maria Borisovna Kanovskaya

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From the book Chaga mushroom against 100 diseases author Evgenia Mikhailovna Sbitneva

Atopic dermatitis Atopic dermatitis (diffuse neurodermatitis) is a skin disease characterized by itching, skin rashes and a chronic relapsing course. There is a clear seasonality: in winter - exacerbations and relapses, in summer - remissions. Provoking

From the book Golden Mustache and other natural healers author Alexey Vladimirovich Ivanov

Dermatitis Dermatitis is an inflammation of the superficial layers of the skin caused by increased sensitivity to allergens or certain internal factors (for example, nervous tension). The causes of the development of dermatitis (eczema) are chronic stress, metabolic disorders

From the book Folk remedies in the fight against allergies author Galina Anatolyevna Galperina

From the book Birch, fir and chaga mushroom. Recipes medicines author Yu. N. Nikolaev

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From the book Home Directory of Diseases author Y. V. Vasilyeva (comp.)

Dermatitis Dermatitis is an inflammation of the skin that occurs upon contact with chemicals (synthetic detergents, industrial and drug allergens etc.) or physical (high and low temperatures, Sun rays, x-rays, electric current)

From book Therapeutic dentistry. Textbook author Evgeniy Vlasovich Borovsky

Dermatitis When an allergen or other irritating substance comes into contact with the skin, inflammation or dermatitis develops. Signs of the disease are swelling, redness and itching of the skin. In addition, blisters appear on the skin, which eventually crack and

From the book Complete Medical Diagnostics Guide by P. Vyatkin

From the book Diseases from A to Z. Traditional and unconventional treatment author Vladislav Gennadievich Liflyandsky

11.10.5. Atopic cheilitis Atopic cheilitis (cheilitis atopicalis) is one of the symptoms of atopic dermatitis or neurodermatitis, i.e. it belongs to the group of symptomatic cheilitis. The disease is more common in children and adolescents of both sexes aged 7 to 17

Impeccable appearance plays a big role for modern man. The condition of the skin, hair and nails indicates health. The study of diseases associated with the skin and venereal diseases is carried out by dermatopathologist. This medical field includes several areas:

. dermatology;

Mycology.

Dermatology is aimed at the study of diseases of the skin, hair, nails and mucous membranes. In terms of treatment and diagnosis, dermatology interacts with other branches of medicine: toxicology, hematology, rheumatology, oncology, neurology and allergology. Experts are actively studying diseases related to related sciences.

Venereology studies infections that are sexually transmitted. On modern stage It is customary to distinguish between new and old types of sexually transmitted diseases. Classic diseases include gonorrhea, syphilis, and chancre. Urogenital diseases include herpes, papilloma virus, chlamydia, acquired immunodeficiency syndrome.

Mycology deals primarily with fungal infections. Within its framework they study beneficial features mushrooms, the possibilities of their use in practice, as well as the harm of mushrooms. Fungal diseases are caused by spores that can enter the body through airborne droplets.

Skin is the largest human organ. It is affected by many external factors that can cause diseases of various natures. Skin diseases not only cause physical inconvenience, but also cause moral suffering. Diseases of dermatitis are often expressed externally: rashes, pustules, discoloration, bad smell.

A large proportion of diseases can be cured in a modern dermatology center, especially in the early stages. However, some infections can lead to serious consequences, irreversible skin changes and cosmetic defects. Therefore, when choosing a specialist, you need to take into account his competence in related fields.

Dermatologist

A dermatologist must be well versed not only in dermatology, but also in other medical fields - immunology, endocrinology, genetics, therapy, neurology. By external manifestations a good specialist is able to identify the disease and begin appropriate treatment. To identify the type of infection, you need to undergo tests:

. smear;

Scraping;

Blood analysis.

The treatment process depends on many indicators. Most often, for any type of disease, special medications or ointments are prescribed. Modern science does not stand still, new domestically produced drugs are being produced, as well as imported drugs. Exist alternative ways treatment:

. laser therapy;

Electrotherapy;

Ultrasound therapy;

Ozone therapy.

The patient is examined according to a specific list and algorithm. The use of a systematic approach in dermatology makes it possible to eliminate not only external signs disease, but also the causes of its occurrence. Treatment usually takes place on an outpatient basis, but day hospital treatment is also possible.

Skin diseases

A number of diseases can be examined and treated at the dermatovenerolitis clinic. Diseases of the skin, hair and nails are constantly increasing in number. New health risk factors are emerging. The most common diseases are psoriasis, eczema, lichen, acne, dermatitis, scabies, herpes and sexually transmitted infections. Let's take a closer look at some of them.

Psoriasis is chronic illness, affecting the skin in the form of red spots. In some cases there are no visible manifestations of the disease. At the site of the lesion, tissue compaction occurs. Light spots that resemble wax form: they are popularly called paraffin lakes. There are many ways to deal with existing illness, however, it is incurable. Despite the many treatment methods and the level of medicine full recovery impossible. Over time, the disease progresses, and relapses are possible.

Eczema is an inflammation of the skin in the form of a rash. The causes of this disease are not known. There is an opinion that it may be caused by a malfunction in the nervous or endocrine system. Patients with eczema experience skin lesions in the form of blisters or rashes.

Regardless of the type of disease, the result of treatment depends on the stage of development and the degree of neglect. Precautions and personal hygiene must be observed. It is the prerogative of every person to seek help from a specialist in a timely manner.

Dermatitis - inflammatory reactions of the skin in response to irritants external environment.. The name “dermatitis” is used by many skin diseases, such as seborrheic dermatitis, atopic dermatitis, dermatitis herpetiformis, etc.

Clinical picture of dermatitis

The most common of these diseases are:

Contact dermatitis and toxicoderma

For example, if an inflammatory reaction in the skin occurs when using a cream with some medicinal substance, then this is contact dermatitis, and if the same substance is given in tablets and a rash appears on it, this is toxicoderma.

Simple contact dermatitis

The action of a strong irritant (for example, a burn, acid or alkali) causes simple inflammation - simple contact dermatitis. Simple contact dermatitis is caused by irritants: friction, pressure, radiation and temperature effects, acids and alkalis, substances of certain plants (nettle, hogweed).

In simple contact dermatitis, direct damage to skin tissue occurs. The manifestations of simple dermatitis and its course are determined by the strength and duration of exposure (for example, the degree of burns). Symptoms of simple contact dermatitis appear immediately or shortly after the first contact with the irritant, and the area of ​​​​the lesion corresponds to the area of ​​​​contact. Sometimes a chronic course of dermatitis is possible with prolonged exposure to the irritant.

Allergic dermatitis and eczema

Allergic dermatitis is based on an allergic reaction to a substance called an allergen. Allergic dermatitis, like other forms of allergies, occur in individuals who are more or less predisposed to it.

Allergic contact dermatitis, unlike simple allergic contact dermatitis, does not develop immediately after contact with the irritant, and not on the first contact. For an allergic reaction (sensitization) to form, it takes up to several weeks from the first contact. Then, upon repeated contact, dermatitis develops. The area of ​​change on the skin may extend beyond the contact area.

For acute manifestations Allergic contact dermatitis is also characterized by bright redness of the skin, erythema with pronounced swelling. Next, bubbles and even bubbles may appear, opening and leaving weeping erosions (wetting). The subsiding inflammation leaves crusts and scales. This complex is often called eczema.

Seborrheic and perioral dermatitis

Seborrheic dermatitis is a chronic inflammatory disease, affecting those areas of the head and body where the sebaceous glands are developed. Most often these are the borders of the scalp, forehead, cheeks and nasolabial folds. Dandruff is often considered mild or initial form seborrheic dermatitis.

The cause of dandruff and seborrheic dermatitis is most often considered to be a complex of factors leading to the proliferation of yeast fungi of the genus Malassezia on sebum-rich skin. These fungi are excreted from the skin of most people. Normally, these are harmless inhabitants of the skin - commensals. Therefore, the disease cannot be considered purely infectious, since almost all of us carry these fungi on ourselves.

Under certain conditions, the body loses the ability to control the growth of Malassezia. The reproduction and activity of fungi leads to increased peeling of the skin.

Atopic dermatitis

A very complex disease, a chronic and genetically determined inflammatory skin lesion of an allergic nature. It can be caused by several or even many factors - allergens, and not only contact ones, but also those received by inhalation (pollen, dust) or with food ( food allergy). Thus, atopic dermatitis is not strictly contact by definition.

Atopic dermatitis usually develops in early childhood and resolves soon, but can remain lifelong. Synonyms for atopic dermatitis in adults are neurodermatitis and eczema, and in children - diathesis.

Cause allergic reaction skin can also be caused by internal factors:
- disturbances in the functioning of the gastrointestinal tract (dysbacteriosis, constipation, digestive disorders, etc.);
- liver diseases (hepatitis, cholecystitis, etc.);
- chronic infectious diseases;
- hormonal disorders;
- various skin diseases;
- taking a number of medications.

Dermatitis, treatment

Treatment of dermatitis is prescribed by a dermatologist and comes down primarily to identifying the allergen, a detailed survey of the patient about the features of his work, a thorough analysis of the medical history and identification of possible etiological agents. In the treatment of dermatitis, both local and general medications are used.

Dermatitis, prevention

- compliance with safety regulations at work and at home;
- timely sanitation of focal infections and mycoses of the feet;
- use of antibiotics and other sensitizing medications strictly according to indications, taking into account their tolerability in the past.

Definition. Dermatitis is a contact acute inflammatory lesion of the skin that occurs as a result of direct exposure to obstructive or optional irritating factors of a chemical, physical or biological nature.

Classification.

Simple contact dermatitis.

Allergic dermatitis:

• a) of domestic origin;
• b) industrial origin.

Clinic.Simple dermatitis. The inflammatory reaction occurs at the site of exposure, strictly corresponding to the boundaries of the stimulus. The severity of inflammatory phenomena depends on the strength of the irritant, the time of exposure and, to some extent, on the properties of the skin of a particular localization. Stages: erythematous, vesiculobullous, necrotic. Often simple dermatitis manifests itself in everyday life as burns, frostbite, and abrasion of the skin when wearing ill-fitting shoes. With prolonged exposure to a low-strength irritant, congestive erythema, infiltration and peeling of the skin may occur. Simple dermatitis develops without incubation period and usually proceeds without disturbing the general condition of the body. The exception is burns and frostbites of large area and depth.

Allergic dermatitis. The clinic is similar to acute stage eczema: against the background of erythema with unclear boundaries and edema, many microvesicles are formed, leaving oozing microerosions, scales, and crusts upon opening. At the same time, although the main changes are concentrated at the sites of exposure to the allergen, the pathological process goes beyond its influence, and due to the general allergic reaction of the body allergic rashes such as seropapules, aesicles, areas of erythema can also be observed at a considerable distance from the site of exposure. The process is usually accompanied by severe itching.

Diagnostics. It is based on the anamnesis and clinical picture. To confirm allergic dermatitis, they resort to skin tests with the proposed allergen (compress, drip, scarification), which are mandatory to identify the production antigen. Tests are performed after the elimination of clinical skin changes. Differential diagnosis carried out with eczema, toxicerma.

Treatment.Simple dermatitis Most often they are treated bridge-wise. The irritant must be eliminated. For severe erythema with swelling, lotions are indicated (2% solution boric acid, lead water, etc.) and corticosteroid ointments (sinalar, fluorocort, flucinar), at the vesiculobullous stage, the blisters are opened, their covers are preserved and they are soaked in disinfectant liquids (methylene blue, gentian violet, etc.) and the application of epithelializing and disinfecting ointments ( 2-5% dermatol, celestoderm with garamycin). Treatment of patients with necrotic skin changes is carried out in a hospital.

Treatment allergic dermititis includes, in addition to eliminating the irritant, hyposensitizing and external therapy. Prescribe 10% calcium chloride 5-10 ml IV, 30% sodium thiosulfate 10 ml IV, 25% magnesium sulfate 5-10 ml IM, antihistamines (suprastin, fenkarol, tavegil, etc.), local lotions of 2% boric acid solution, etc., corticosteroid ointments (Lorinden S, advantan, celestoderm, etc.)

Prevention. Avoid exposure to hazardous factors, work in special clothing.