Eczema (eczema) is a common skin disease related to allergic reactions in children, with a complex etiology, a variety of rash patterns, and an often prolonged and recurrent course.
I. Etiology: the genetic quality of the individual and a variety of internal and external factors related to.
(a) Internal factors.
1. Infectious lesions: tonsillitis, dental caries, parasitic diseases
2, chronic gastrointestinal diseases, gastrointestinal dysfunction
3.Mental state
(II) External factors
1, food allergens: milk, eggs, fish, shrimp
2, inhalation allergens: animal fur, fungi, pollen, dust
3, physical factors: sunlight, heat and cold, local stimulation, overstimulation
Second, clinical manifestations.
Acute phase: erythema, papules, blisters, vesicles and exudate.
Subacute phase: scaling and crusting mainly, with a small amount of papules, blisters, small vesicles.
Chronic phase: thickening of the skin, mossy changes and pigmentation.
Eczema in children is more common in acute and subacute eczema.
Third, infantile eczema: three stages of the clinical manifestations of atopic dermatitis.
1, infancy: that is, infantile eczema.
(1) exudative type: mostly seen in fatter infants, often onset 2 weeks-3 months after birth. Prevalent sites: face, forehead, scalp. Rash pattern: erythema, densely distributed pinpoint-sized papules, blisters, surface vesicles, oozing or crusting.
(2) Dry type: Mostly seen in infants aged 6 months-1 year who are thin and weak. The rash is widely distributed: face, trunk, and extremities. Rash pattern: dense small papules on light red patches, no blisters, dry, scaly skin, no obvious exudation.
(3) Seborrheic type: Mostly seen in small infants aged 1-3 months, seen as flushed skin on the scalp, between the eyebrows, and behind the ears, with yellow oily scales or crusts on them.
2.Childhood: It can evolve from infancy, and there are also those with direct onset at the age of 2-4 years. Prevalent sites: mainly involving the limbs and face, often confined to the elbows and N fossa; rash pattern: clusters of small papules, dry and fused into patches, with local skin thickening or moss-like changes.
3. Youth and adulthood: occurring after the age of 12, the lesions are similar to those of childhood, with erythema and papules on the flexural side of the limbs, and skin infiltration and thickening or mossy changes.
Diagnosis: Diagnosis is made based on medical history, rash pattern, and disease duration.
IV. Treatment.
(a) Remove the cause: reduce the pathogenic factors
(B) systemic treatment: antihistamines: antiallergic, antipruritic
Vitamins B and C, calcium: non-specific anti-allergic effect
Glucocorticoids: anti-inflammatory, antipruritic (easy to relapse after discontinuation; easy to produce dependence and adverse reactions, not recommended)
γ-interferon: 1-2 times a week for those with severe IgE elevation
(iii) Local treatment: select the appropriate dosage form and drug according to the skin lesion.
(ii) Acute stage: when there is only redness, papules and blisters without exudation, 1% stove glycolic lotion can be used.
When there is vesicle and exudate, cold and wet compresses such as 3% boric acid solution, aluminum acetate solution or 0.02% furacilin solution should be used.
Subacute phase: zinc oxide paste, coal tar paste, glucocorticoid cream.
Chronic phase: alternating glucocorticoid cream and non-hormonal (such as: coal tar) ointment.
V. Prevention and care.
1, avoid stimulation of triggering factors: avoid mechanical stimulation (scratching, scalding, direct sunlight); reduce exposure to allergens; eczema infants as far as possible breastfeeding, breastfeeding mother less milk, eggs, nuts and other allergenic foods, add solid foods after 6 months.
2, to ensure the intake of vitamins, avoid excessive intake of sugar and fat
3.Use less soap, no alkaline soap, no cosmetics except face oil suitable for babies
4.Do not wear chemical fiber, woolen clothes, cotton is appropriate, clothes should be loose, do not wear too much cover
5, in order to avoid scratching the skin infection, can be loosely wrapped in soft cloth hands
6, scalp and other parts of the scab, can be used to disinfect the cooking oil wet compress, after a period of time and then gently scrubbed
7, in the eczema attack, not for vaccination, to avoid adverse reactions