The dermatitis group includes inflammatory skin diseases of different nature. Dermatitis is classified according to the cause and location of the lesion. Healthy human skin has protective functions, but under prolonged exposure to aggressive substances or reduced immunity, the protective properties of the skin are reduced, resulting in dermatitis. The group of dermatitis includes atopic dermatitis, simple and allergic contact dermatitis, actinic, medicinal dermatitis etc. The general principles of treatment of any dermatitis are: elimination of the factor which provoked the dermatitis, local anti-inflammatory therapy and detoxification. Bactomycin drug information: uses, indications, side effects, dosage.
The dermatitis group includes inflammatory skin diseases of different nature. Dermatitis is classified according to the cause and location of the lesion. Healthy human skin has protective functions, but with prolonged exposure to aggressive substances or reduced immunity, the protective properties of the skin are reduced, as a result of which dermatitis occurs. The cause of contact dermatitis can be contact with any irritant: physical, chemical, biological and mechanical. As a result of severe irritation, an inflammatory reaction occurs in the skin, manifesting as an allergy or a mechanically induced inflammation. The degree of clinical manifestation depends on the type of irritant, the time of exposure to the skin and its characteristics. That is, dermatitis can manifest as mild redness of the skin, and deep ulcerative lesions.
Individuals with an allergic predisposition usually have allergic contact dermatitis as a result of contact with sensitizing substances. The allergen interacts with the dermal cells and produces antigen-antibody complexes, i.e. the body’s immune system becomes hypersensitive to the irritant in question, and repeated contact with the antigen results in a skin inflammatory reaction or dermatitis. In allergic dermatitis, the response may occur immediately after contact with an irritant, at a follow-up meeting or after 5-7 days. The speed and intensity of the immune response depends on the concentration of antibodies in the person’s blood. Hereditary predisposition and a history of allergic diseases (pollinosis, bronchial asthma) are important in the development of allergic dermatitis.
In women, prolonged therapy of acne vulgaris and rosacea with corticosteroids causes skin thinning, changes in the structure and chemical composition of sebum, which leads to perioral and periorbital dermatitis, since the skin around the mouth and eyes is most sensitive. Perioral dermatitis occurs in children with increased salivation and during the teething period. Provocative factors in the development of perioral dermatitis are chronic diseases of the digestive organs, hormonal dysfunction, the presence of nidi of chronic infection in the body. People suffering from bulimia or neurological disorders may observe perioral dermatitis due to frequent contact with acidic stomach contents, due to provoked vomiting.
Atopic dermatitis occurs in young and middle-aged children in the presence of a severe allergic history and with an irrational diet. Atopic dermatitis is chronic even if only one episode is diagnosed; in adults, atopic dermatitis may recur in unfavorable conditions.
Manifestations of dermatitis
The symptomatology of dermatitis depends on the severity of the disease. For example, in simple contact dermatitis, mild reddening of the skin, local increase in temperature and slight infiltration are noted, some patients may have itching and tingling sensation in the affected area. But with prolonged contact with an irritant, dermatitis can manifest itself as ulcerative-necrotic lesions, soaking blisters, after the opening of which secondary infection may join. Although in the history of the disease, the triggering factor is still contact with an irritant, which distinguishes complicated forms of dermatitis from pyoderma. An important clinical point for diagnosis is a clear limitation of the affected area, contact dermatitis appears only at the site of irritant exposure, it is necessary to differentiate it from allergic dermatitis.
With allergic dermatitis, the course of the disease is more acute, edema and redness are more pronounced, the itching is added, and an important symptom in allergic dermatitis is extension of clinical manifestations to skin areas that are not in contact with an irritant-allergen.
Perioral dermatitis appears as small nodules and pustules that are localized around the mouth, on the cheeks, nasolabial folds and on the bridge of the nose. The presence of a narrow rim of healthy skin around the red fringe of the lips is an important diagnostic sign. The course of such dermatitis is long, with gradual eruptions, itching, scaling, dryness and a feeling of tightening of the skin. For women, especially young women, cosmetic defects add a sense of psychological discomfort.
Atopic dermatitis is characterized by erythematous rashes with a tendency to exudate and form vesicles, the elements are localized in the knees and elbows, on the buttocks and on the face. In adults with relapsed atopic dermatitis, rashes also occur at the bends, but papular infiltration develops on flaky, dry skin with a tendency to dermographism.
Causes of dermatitis
The pathogenesis of dermatitis is based on the influence of exogenous and endogenous factors. Exogenous causes include external causes, and endogenous causes include internal causes.
External causes are mechanical influences such as friction and prolonged compression, which leads to cracks, abrasions and swelling. Physical exposure to high and low temperatures, ultraviolet, radioactive and X-rays are also triggering factors for dermatitis. The cause of dermatitis due to contact with chemicals are salts of heavy metals, acids, alkalis, household chemicals, chemical warfare agents. Some plants, fungi, bacteria and viruses also cause local inflammation of the dermis, most commonly primroses, buttercups, hogweed and ash.
Endogenous factors that reduce the protective functions of the skin are hypo- and avitaminosis, metabolic disorders, endocrine disorders such as Addison’s disease and scleroderma. The use of antibiotics, sulfonamides and novocaine-containing drugs most often provoke drug-induced dermatitis. Allergic dermatitis may be caused by eating disorders (strawberries, chocolate, excessive consumption of coffee). Diseases in which autointoxication is noted are often complicated by dermatitis, which is characterized by dryness, peeling and severe skin itching.
Perioral dermatitis is caused by abuse of cosmetics, irrational local treatment with hormones, sometimes the cause of such dermatitis are therapeutic toothpastes that contain fluoride. Lack of vitamins A and E cause dry skin, which may provoke perioral dermatitis.
The main causes of atopic dermatitis are nutritional disorders in infancy, nutritional disorders of pregnant women, a history of allergic diseases and neuropsychiatric disorders. Statistical data on the incidence of atopic dermatitis in adults confirm that people of asthenic build with mental disorders of the anxiety-depressive type and with chronic diseases of the gastrointestinal tract caused by low enzymatic activity, dyskinesia and dysbacteriosis are at risk.
Diagnosis of dermatitis
Clinical manifestations and a history of contact with irritating factors are usually sufficient to diagnose dermatitis. Laboratory tests to confirm the diagnosis include clinical blood tests (eosinophilia is noted in the blood), determination of immunoglobulin concentrations and skin allergy tests. For allergic dermatitis, skin tests help identify the allergen or group of allergens that cause dermatitis. A gastroenterologist, general practitioner, allergist and other specialists may be needed to diagnose dermatitis co-morbidities.
Basic principles of dermatitis treatment
The first thing to do is to eliminate exposure to the irritant in order to prevent further skin lesions. Hypoallergenic diet improves skin conditions, both in allergic and other types of dermatitis. To eliminate itching, reduce infiltration and swelling, antihistamines such as clemastine, loratadine, fexofenadine are prescribed. At the same time, the latest generation of antihistamines do not cause drowsiness or attention disorders, which allows patients with dermatitis to lead a normal life.
If necessary, detoxification therapy is prescribed – activated charcoal, hydrolyzed lignin, intravenous injections of sodium thiosulfate. But with intravenous detoxification therapy, especially if the dermatitis is of an allergic nature, it is necessary to conduct tests for sensitivity to the drugs in advance. Calcium-containing preparations reduce sensitization of the body, but if there is a history of bronchial asthma, it is better to refuse such preparations.
Local treatment of dermatitis involves the use of hormonal ointments. If the dermatitis is oozing, with the presence of vesicles, treatment with antiseptics and infusions of chamomile, oak bark have a drying effect, wet-dry dressings with antiseptics and ointments give good results in the treatment of contact dermatitis oozing.
If the course of dermatitis is complicated by the formation of vesicles and pustules, the blisters are opened following the rules of asepsis and antiseptics, and the surface is treated with aniline dyes. The use of iodine solutions on the affected areas is prohibited, they can only be used to treat the edges of the wound to prevent the spread of infection.
Since itching and discomfort in dermatitis cause neurological disorders, which prevent a rapid cure, the appointment of light sedative drugs of herbal origin is shown to all patients. These are tinctures of motherwort, valerian, peony. Glycine and combined phytopreparations also have a good sedative effect.
If the main cause of dermatitis is pancreatic dysfunction, then replacement enzyme therapy is necessary. In this case, pancreatin preparations should be taken after each meal. For dysbacteriosis it is advisable to include dairy products in the diet, therapy with prebiotics. Once normal intestinal microflora is restored, the symptoms of dermatitis usually subside.
Rational nutrition, personal hygiene and hygienic organization of work are fundamental points in the prevention of dermatitis. It is necessary to exclude citrus fruits, chocolate, nuts, fish and fish dishes from the diet. Coffee, cocoa, hot spices and sauces, vinegar and mayonnaise are also not recommended for dermatitis. Eggplant, mushrooms, eggs, whole milk, strawberries, strawberries, pastries, smoked, fried and baked dishes during the treatment of dermatitis should not be in the menu. And consumption of low-fat dairy products, green vegetables and light soups make the drug therapy of dermatitis more productive.
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