1.Allergic dermatitis medication
Internal drug treatment
In mild cases of allergic dermatitis, oral antihistamines such as paracetamol 4 mg 3 times a day and cycloheximide 2 mg 3 times a day can be taken. Vitamin C tablets 200 mg 3 times daily or second-generation antihistamines such as cetirizine, imipramine, loratadine, etc., 10 mg once daily may also be given orally. Either one or a few combinations of these drugs may be used. Intravenous administration is also possible: 10 ml of 10% calcium gluconate or 0.64 g of sodium thiosulfate can be given once daily for 7-10 days.
In severe cases, corticosteroids, such as prednisone 10 mg, are used under the guidance of physicians three times a day. For anaphylactic shock, dexamethasone 10 mg can be injected intramuscularly or intravenously, or 0.1% epinephrine 0.5 ml can be injected subcutaneously. For those with abdominal pain and diarrhea, scopolamine 10mg can be injected intramuscularly.
Topical drug treatment
(1) The topical treatment of atopic dermatitis should follow the principles of topical medication. In the different stages of dermatitis apply different forms and components of drugs. In the acute stage, when there is a lot of exudate, wet compresses can be used; when there is little exudate, oil can be used; in the subacute stage, less exudate can be used; with scales and no exudate, emulsions and burnt agents can be used.
In the chronic stage, ointment, hard cream, emulsion and tincture can be used.
Specifically, the acute exudation is obvious, you can use 3% boric acid solution, 1:20 acetic acid solution or 1:8000 potassium permanganate solution to do cold wet compress. When the lesions are mild erythema, papules and small blisters, topical application of furnace glycolic lotion can be given. Topical glucocorticoids can be used in the subacute and chronic stages.
(2) Topical glucocorticoids: The pharmacological effects of topical glucocorticoids in the treatment of atopic dermatitis mainly include anti-inflammatory, anti-allergic, immunosuppressive and anti-proliferative effects. Clinical agents with high efficiency and low adverse effects should be selected. Young or facial lesions should be treated with topical hormones that do not contain fluoride, such as 1% hydrocortisone cream and 0.1% mometasone furoate cream. For the rest of the body, preparations such as 0.1% tretinoin cream, 0.05% halometasone cream or 0.1% clofloxacin cream can be used. The characteristics of topical glucocorticoid preparations are.
(i) Definite efficacy, suitable for all kinds of dermatitis.
②Easy to use, with various dosage forms such as cream, ointment, gel, solution, coating and hard cream.
③There are certain adverse reactions, such as skin atrophy, pigmentation and skin capillary dilation, as well as easy dependence with long-term use. Local and systemic adverse reactions of topical glucocorticosteroids are mostly related to long-term use.
Precautions for topical glucocorticosteroids.
① Avoid continuous use of strong glucocorticosteroids for more than 2 weeks;
②Prohibit long-term continuous use;
(3) Strong glucocorticosteroids should not be used on the face, neck, scrotum and other thin and tender skin areas, and the elderly and children should be cautious in applying them to large areas.
(3) New topical immunomodulators without glucocorticoids can also be used, including.
①0. 1%, 0. 03% tacrolimus ointment (Putrepis) is a macrolide derivative, FDA clinical trials have shown that 28%
The FDA clinical trials showed that 28% ~37% of eczema patients improved by 90% after applying Putrepis. It is indicated for all kinds of moderate and severe allergic dermatitis.
②1% Pimecrolimus cream (Ayninda), a derivative of cystatin megalactam. It is indicated for mild and moderate allergic dermatitis. The main adverse reactions of topical immunomodulators include pruritus, burning sensation, tingling and other local irritation reactions.
(4) The tendency of infection should be combined with antibacterial drugs. Since bacteria and fungi can induce or aggravate the condition of atopic dermatitis, some experts suggest that anti-infective preparations can be added to exudative lesions, such as 2% mupirocin cream, 1% econazole cream, etc.
2.Physical therapy
According to the condition of skin lesions, some patients can choose ultraviolet radiation or radiation therapy.
3.Psychotherapy
As many patients with chronic atopic dermatitis have recurring episodes, it is easy to lose confidence in the treatment, resulting in worries, depression and other adverse emotions, which in turn aggravates the disease and affects the effectiveness of treatment. Therefore, patients with chronic eczema and poor results should be given a comprehensive treatment including psychotherapy.
4, prevention and control of atopic dermatitis precautions.
Regardless of which part of the body suffers from dermatitis, the intense itching will bring greater pain to patients and even affect their normal work and life. The occurrence and development of dermatitis is related to various factors. Due to individual differences, variations may occur in different individuals or at different times in the same individual. In addition to dietary factors, inhalants, such as pollen, dust, mites and bacterial and fungal infections on the body surface, changes in the living environment and the various substances to which they are exposed may be common external causes of dermatitis. Internal lesions in the body, such as tonsillitis, cholecystitis, neuropsychiatric factors, changes in endocrine and metabolic status, such as during menstruation and pregnancy, can be the main internal causes of dermatitis. To prevent the occurrence of dermatitis, it is necessary to take into account the basic condition of the patient himself and to avoid as much as possible all the suspected causative factors.
(1) It is important to avoid re-stimulation of the area, to avoid scratching the area as much as possible, to avoid washing the area with hot water or soap and water, and to avoid applying strong stimulants to the area, which are common factors that can easily worsen or re-occur.
(2) Learn as much as possible about the basic rules for the occurrence and development of dermatitis, cooperate with the doctor’s treatment, and establish confidence in curing the disease.
(3) Avoid irritating foods such as onion, ginger, garlic, strong tea, coffee, alcohol and other foods that can easily cause allergies, such as fish, shrimp and other seafood.
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