I. What is dermatitis eczema? How is it defined?
Dermatitis eczema is a common type of allergic skin disease, accounting for about 30% of dermatology outpatients. It is an inflammatory skin disease caused by the interaction of various internal and external factors. Anyone who has itchy, erythematous, papular, blistering, flaky, hypertrophic and other polymorphic lesions, with a tendency to exude and fuse, and who has difficulty in making an etiological diagnosis, can be diagnosed as eczema.
The first thing you need to do is to get a good idea of what you are looking for.
Dermatitis eczema skin diseases include: contact dermatitis caused by contact with external substances (cosmetics, diapers, lacquer dermatitis), eczema that can be further classified as atopic dermatitis, seborrheic dermatitis, bruising dermatitis, self-sensitivity dermatitis, periwound infectious eczema, chronic simple moss, ringworm rash, hand dermatitis, polymorphic sun rash, etc.; eczema that cannot be further classified as perianal eczema, calf eczema The eczema that cannot be further classified such as perianal eczema, calf eczema, scrotal eczema, breast eczema, external ear eczema, spring eczema, summer eczema, itchy rash, etc.
What are the common substances that contact allergies?
1. Metals: such as nickel, chromium and cobalt, etc.
2. Rubber chemicals: rubber slippers, gloves, tires, such as mercaptobenzoyl thiazole, thiuram (thiuram) mixture.
3. Topical drugs: such as neomycin, ethylenediamine.
4. Beauty and skin care products: such as hair dyes, perfumes, cosmetics and skin care products (lanolin).
5. Wearing clothes: such as shoes, gloves, clothes (containing formaldehyde or dyes).
6. plants: such as ivy (ivy) poison, aloe vera, etc.
Fourth, what are the clinical manifestations of eczema?
The lesions can be divided into acute, subacute and chronic phases.
Acute phase: itchy papules and blisters on the basis of erythema, often with exudation and vesicles;
Sub-acute phase: the exudation of blisters decreases and crusting and flaking occur;
Chronic phase: mainly with skin hypertrophy, mossy changes, can be accompanied by hyperpigmentation or hypopigmentation.
V. What are the main features of atopic dermatitis?
The main features (must have 3).
1, pruritus.
2. Typical morphology and distribution: flexural lichenification in adults, facial and extensor involvement in infants and children
3, Chronic dermatitis or chronic recurrent dermatitis
4. Personal or family history of atopic diseases (asthma, allergic rhinitis, AD)
VI. What are the secondary features of atopic dermatitis?
Secondary symptoms (with 3): dry skin disease, cataracts, labyrinthitis, recurrent conjunctivitis, perifollicular eczema, facial pallor or erythema, food intolerance (food allergy), irritant hand dermatitis, ichthyosis, elevated IgE, rapid-onset (type I) skin test reactivity. Skin infections: Herpes aureus simplex, infraorbital folds, pruritus on sweating, periorbital keratosis, papillary dermatitis, periorbital dark halo, increased palpebral lines, white furunculosis, white scratchy skin sign, wool allergy, etc.
How to choose topical medication for atopic dermatitis patients?
Topical medications mainly include
1.Emollient (emulsion, fragrance-free) to protect the skin barrier function.
2.Glucocorticoids (do not exceed 2 weeks)
3.Non-hormonal topical medications: glycolic lotion, boric acid solution, zinc oxide oil, vitamin E cream, etc.
Eight, eczema dermatitis patients how to regulate diet?
1, allergen detection test to determine which foods should not be eaten, but negative results can not completely rule out food allergies.
2. Restricted diet. The first step can be to restrict milk and eggs (including chicken), after 3 weeks of restriction, and then one kind of one kind of addition, add one kind per week, observe whether there is a reaction within a few hours to 3 days after consumption, and if so, restrict the food.
3. For those who are allergic to milk, you can switch to soy products.
Does the condition of atopic dermatitis remit with age?
Very few new adults have no previous history of dermatitis, but definitely the AD condition will gradually remit with age.
X. How to find allergens?
If contact dermatitis is suspected, patch test should be done; if photo-contact dermatitis is suspected, patch test should be done; if atopic dermatitis is suspected, allergen screening should be done; if eczema caused by food or inhalation allergy is suspected, allergen intradermal test, allergen in vitro detection test or excitation test should be done.
Eleven, how to detect exposure to allergens?
Patch test is an examination technique used to detect skin allergic reactions to the suspected allergens. It has diagnostic value for delayed skin allergic reactions and is the “gold standard” method for confirming the cause of contact dermatitis patients. Indications: contact dermatitis, occupational dermatitis, hand eczema, cosmetic dermatitis, etc.
XII. How to determine the specific method and result of patch test?
Patch test method: 20 kinds of test antigens configured are injected into IQ core chamber (about 25μl) (made of inert polyethylene plastic) and applied to the patient’s upper back, sealed for 48 hours (or 24 hours) after removal of the patch test, and the results are observed after 20 minutes interval. The results were observed at 20-minute intervals. The results were also observed again at 72 hours and 96 hours after the spot test. Determination of results: The results were determined according to the International Contact Dermatitis Research Group (ICDRG) criteria. The graded degree of skin changes were determined by magnification at different times of positive patch test.
What is “housewife’s hand”?
Hand eczema, also known as “housewife’s hand”, is caused by housewives who do a lot of housework, wash and rinse all day long and come into contact with washing powder and detergent, which are relatively strong irritants, making it easy to get eczema on the hands. It happens to women with allergies.
What are the possible factors for hand dermatitis?
1, the patient’s epidermis is thin, poor protection against material stimuli
2. Poor tolerance to chemical substances
3, lack of vitamins, fatty acids or proteins
4. Dry skin (genetic, excessive washing)
5. Circulation disorders (winter cold causes blood circulation disorders)
6, too frequent exposure to irritants, such as editors, clerical staff repeatedly wet the end of the finger to facilitate flipping through the paper, resulting in finger-end dermatitis
7, minor skin trauma
8, secondary bacterial or fungal infections
9, frequent contact with allergy-prone substances in daily life, such as laundry detergent containing traces of chromium, in paint, glue, wood may contain traces of nickel
10. Ingestion of allergens. After local contact sensitization, if the same allergens are then ingested, in addition to causing systemic contact dermatitis, can also cause hand dermatitis recurrence or aggravation. Nickel is contained in many foods, such as chocolate and mushrooms.
The first thing you need to do is to get rid of the problem.
Find the cause, quickly remove the contact and actively symptomatic treatment
1, stop using the current cosmetics, avoid contact with the chemical composition of the similar or related cosmetics to prevent recurrence;
2, internal medication: anti-allergic drugs, depending on the severity of the disease to give glucocorticoids, etc.;
3, external medication: depending on the acute, chronic, subacute; exudation, non-exudation; with or without infection to determine the dosage form.
4, contact allergen determination, find the real allergic substances, avoid re-exposure.
How to prevent and control the phenomenon of skin allergy caused by ingestion of mango?
First of all, let’s understand what is mango dermatitis? Usually refers to allergic contact dermatitis caused by the juice, skin, leaves, or stems of mangoes. The oleoresin laccase and diphenol antigens in mangoes are cross-reactive with contact allergens in the laccase family, members of the laccase family in tropical and subtropical plants, which are sensitized by laccase (3-pentadecane catechol). Mango dermatitis may be clinically similar to poison ivy dermatitis, with linear papules characteristic of phytodermatitis, but also with widespread lesions.
Recently, it has been reported in the foreign literature that the 5-mm subcutaneous pulp of mangoes can cause allergic contact dermatitis. The lesions manifest as irregular pruritic erythema and periorbital edema on the face, neck, and hands, often after eating peeled mangoes. They subside after oral anti-allergy and topical treatment with 0.05% fluorine easy hormone ointment. Treatment of mango dermatitis is based on the same principles as allergic contact dermatitis. Peeling and removing part of the surface pulp may be a safer way for allergic patients to continue to enjoy mangoes.
What bad habits can lead to aggravation of dermatitis eczema?
Excessive scratching, hot water scalding, use of alkaline detergents, poor diet and drug abuse can aggravate dermatitis eczema.
1. Excessive scratching:
Itching is the most common clinical symptom of dermatosis, but excessive scratching can aggravate it. As a result, the more you scratch, the more you scratch, forming a vicious circle. Therefore, patients with skin diseases must control their hands while treating them and avoid scratching as much as possible.
2. hot water scalding: many patients for the sake of a moment of fast with hot water scalding rash, although this can solve the momentary itch, but after the itch will intensify, especially acute eczema and other dermatitis, hot water scalding can make capillary permeability increased, promote the release of allergic substances in large quantities, resulting in exudation and erosion aggravated, making the condition worse.
3. the use of alkaline detergents: many patients with skin diseases, such as chapped hands eczema patients have the habit of repeatedly using alkaline soap, laundry detergent or washing spirit to wash their hands. In fact, these detergents tend to lead to drier skin, making chafing and itching worse. The old pruritus with soap bathing can inhibit sebum secretion, making the skin drier, thus aggravating itching. Therefore, such patients can try oil-rich soap.
4. poor diet: some people can eat seafood, dog meat, beef and mutton, fish, shrimp, crab, nymphs and various irritating foods, such as eating chili, pepper, garlic, cinnamon, leeks, etc., and induce eczema, urticaria and other allergic skin diseases, or make it worse. Therefore, for allergic people, should avoid spicy and stimulating products, diet should be light, can eat appropriate fruit, supplement multivitamins.
5. drug abuse: it can be said that the abuse of drugs and aggravation of skin diseases are common. The long-term topical use of hormones for facial seborrheic dermatitis can easily lead to intractable hormone-dependent dermatitis, acute vesicular exudative eczema, and the abuse of ointment preparations can also lead to the spread of the rash and aggravation of exudation.