With the development of society and changes in eating habits and the surrounding environment, allergic diseases are becoming more common. According to studies, the impact of eczema on quality of life is greater than that of certain medical diseases such as diabetes.
A. Causes of eczema
The etiology of eczema is still unclear, and is believed to be caused by a combination of internal factors, such as abnormal immune function, systemic diseases (such as endocrine diseases, nutritional disorders, chronic infections, tumors, etc.) and hereditary or acquired skin dysfunction, plus external factors such as environmental or food allergens, irritants, microorganisms, changes in ambient temperature or humidity, and sun exposure. Psychosocial factors such as stress and anxiety can also trigger or aggravate the disease.
Second, the clinical manifestations of eczema
Acute phase: erythema, papules, blisters, vesicles and exudation, with unclear boundaries.
Sub-acute phase: erythema and exudation is reduced, the vesicular surface crusting, flaking.
Chronic phase: the main manifestations are roughness and hypertrophy, deepening of pigmentation, eczema on the hands and feet may be accompanied by nail changes. The rash is usually symmetrically distributed, often recurrent, and the conscious symptoms are itching, even severe itching.
What laboratory tests can be done to differentiate eczema from other diseases or to screen for possible causes?
The routine blood test has eosinophilia and may also have increased serum IgE, allergen test helps to find possible allergens, patch test helps to diagnose contact dermatitis, fungal microscopy can identify fungal disease, scabies test can help to exclude scabies, serum immunoglobulin test can help to identify congenital diseases with eczema dermatitis lesions, bacterial culture of lesions can help to diagnose secondary bacterial infection, etc. If necessary, skin histopathological examination should be performed.
Fourth, the treatment of eczema
1, basic treatment.
Help patients understand the characteristics of the disease and the impact on health, the efficacy of various treatment methods, to find and avoid allergens, in order to remove the cause of the disease, the purpose of complete treatment.
Protect the skin barrier function: eczema patients have damage to the skin barrier function, prone to secondary irritant dermatitis, infection and allergy and aggravate the lesions, should be selected for treatment of patients without skin irritation, prevention and timely treatment of secondary infections, subacute and chronic eczema of dry skin with moisturizing emollients.
2, local treatment.
Suitable drug formulations should be selected according to the stage of the lesion. Topical glucocorticoids are still the main drug used to treat eczema. According to the nature of the lesions should be selected according to the appropriate strength of glucocorticoids: mild eczema choose weak glucocorticoids; heavy hypertrophic lesions recommended to choose strong hormones; moderate eczema recommended to choose medium-acting hormones. Pediatric patients, facial and skin folds lesions generally choose weak or medium-acting hormones, and strong glucocorticoids are generally applied continuously for no more than 2 weeks to reduce acute tolerance and adverse reactions. Calcium-regulated neurophosphatase inhibitors can also be chosen.
3.Systematic treatment
(1) Antihistamines: Select appropriate antihistamines to stop itching and anti-inflammation according to the patient’s condition.
(2) Antibiotics: For those with extensive infection, systemic application for 7-10 days is recommended.
(3) Vitamin C, calcium gluconate, etc.: they have certain anti-allergic effect and can be used for acute attacks or obvious itching.
(4) Glucocorticosteroids: generally not advocated for routine use, but can be used for patients with clear etiology, short-term can get rid of the cause, severe edema, generalized rash, erythroderma, etc. For rapid control of symptoms can also be used under the guidance of doctors to regulate, to avoid systemic adverse reactions and rebound of the disease.
(5) Immunosuppressants: limited to patients with severe illnesses where other methods are ineffective and the application of glucocorticoids is contraindicated.
4.Physical therapy
Ultraviolet therapy includes long-wave, medium-wave and narrow-spectrum UVB irradiation.
5.Therapeutic Chinese medicine
Chinese herbal medicine can be treated internally or externally, and should be administered according to the condition. Chinese herbal extracts such as compound glycyrrhizin and rehmannia polysaccharide are effective for some patients. It should be noted that Chinese medicine may also lead to allergy, liver and kidney damage, etc., so it must be prescribed and treated in a regular hospital.