As spring turns to autumn, it is again the season of suffering for allergic rhinitis patients, with symptoms such as itchy nose, sneezing, runny nose and nasal congestion, which seriously degrade the quality of life. In addition, allergic rhinitis may also cause complications such as asthma, sinusitis, conjunctivitis, etc. Some studies have even found that allergic rhinitis is associated with other respiratory diseases such as chronic obstructive pulmonary disease, gastroesophageal reflux, sleep apnea syndrome, etc. Therefore, it is necessary to learn how to properly stay away from allergens:.
Food allergy
Compared to other allergens, food allergies are generally easier to identify, but it is important to note that food allergy symptoms are not only obvious, but also appear urgent and severe, and may even be life-threatening. For example, people who are allergic to peanuts can go into anaphylactic shock or even die once they eat peanuts, so people who are allergic to a certain food should avoid eating such foods in the future.
Airway allergy
If you are allergic to airways, for example, such as allergic to pollen, then every year in spring and autumn when there is more pollen, you can leave the environment if you have the conditions, such as moving from the north to live in the south, and the allergy symptoms will naturally disappear; if you cannot completely leave the living environment, you can take such means as wearing a mask when you go out, going to the suburbs as little as possible, closing doors and windows, and cleaning your nasal cavity in time to minimize the exposure to allergens.
Mite allergy
Mites are also a common allergen, and it is difficult to avoid them completely, no matter they “escape” to the south or the north, they can only be reduced by using mite proof mattresses, air filters, mite insecticides, washing bedding with warm water, regular exposure to the sun, freezing plush toys, thoroughly cleaning carpets, reducing dust and other methods.
Doctor’s tips
Since it is impossible for patients to completely avoid allergens, certain medications are also needed, regarding specific medications to make a
Chronic actinic dermatitis is a common clinical skin disease that occurs in middle-aged and elderly people and is easily misdiagnosed as eczema or neurodermatitis. According to spectral studies of chronic photodermatitis, there is an interconversion between chronic photocontact dermatitis, persistent photosensitivity due to systemic medication, persistent photoreactivity, and ray reticulocyte hyperplasia, which suggests that the above diseases can be viewed as a spectral series of diseases that can be classified as chronic photodermatitis, or photodermatitis/ray reticulocyte hyperplasia syndrome. This is a group of chronic dermatitis and eczematous disorders seen at light sites.
Etiology
The causative spectrum of the disease includes medium- and long-wave ultraviolet and visible light, and the etiology is still unknown. Clinical and histopathologic and immunohistochemical findings suggest that the disease is a delayed metaplasia. Common photosensitizers that act as allergens include certain plant components, fragrances, and photosensitizing drugs.
Clinical manifestations
Diffuse bright red, slightly edematous macules with scattered red papules and mild exudation, in the form of eczematous dermatitis. This is followed by infiltrative, thickened mossy papules and plaque damage with a small amount of scaling, dark red color, and well-defined borders. There are nodules fused into plaques on the forehead or mastoid area, and the nodules reduce the wrinkles of the loose skin and give a translucent appearance. The facial lesions may have a lion face appearance.
The lesions are found on the face, neck, back of the hand and other exposed areas, and on the neck, the lateral and posterior parts of the neck near the posterior cervical papillae are common. In male patients, the sparse area of the top of the head is often involved, and the extensor side of the forearm is also commonly involved, and non-exposed areas can also be involved, and severe cases may occasionally show a tendency to erythrodermia.
Patients account for 90% of males, 90% between 50 and 75 years of age, and rare under 50 years of age. The incidence is higher in outdoor workers. Most patients are Caucasian, but blacks and yellows have also been reported.
Many patients have a long medical history, but often do not provide a clear history of light-induced dermatitis and frequent summer episodes, and often contact allergy to specific certain allergens is not clear, but nevertheless, contact allergy coexists with photosensitivity reactions. The course of the disease is chronic and the lesions often remain untreated for years.
Diagnosis
(1) Persistent dermatitis or eczematous lesions, which may be accompanied by infiltrative papules and plaques. (ii) Involving mainly exposed areas or may extend to others, occasionally presenting as erythroderma.
②The minimal erythema volume measurement is abnormally sensitive to UVB, and some are also sensitive to UVA and visible light, and the photoexcitation test and photomarker test may be positive; ③Histopathological changes resemble chronic eczema and/or pseudolymphoma.
Differential diagnosis.
(a) general dermatitis eczema-like disorders without a clear history of photosensitivity; the distribution of lesions is generalized and symmetrical or predominantly at the contact site, and the minimum erythema volume is measured without abnormal response to UVB.
(b) Transient photoreactivity refers to exogenous photosensitive contact dermatitis and photosensitive drug rash, etc., there is still photosensitivity reaction within 1-2 weeks after avoiding photosensitizers, after which it can rapidly improve and heal, there is no persistent photoreactivity, the patient can have abnormal sensitivity to UVA during this period of time, positive light spot patch test, but normal sensitivity to UVB.
(c) Polymorphic heliotrope has a clearer history of photosensitivity, the disease has acute intermittent episodes, with more pronounced seasonality and fluctuations, and is mostly seen in young and middle-aged women. Photobiological assays are generally negative, but a few are also sensitive to UVB and/or UVA.
Laboratory tests.
①Light test: irradiation of non-exposed parts of the skin without lesions with a single wavelength of light showed abnormal sensitivity to UVB (wavelength 280-315 nm) and UVA (wavelength 315-400 nm), and occasionally to visible light (wavelength 400 mn or more).
② Photomarker test: some patients showed positive reaction to certain contact photosensitizers and suspected photosensitizing drugs.
Prevention and treatment
Identify and try to avoid as much as possible all possible contact with allergens and exposure and consumption of various supplies and drugs containing photosensitizers. Strictly avoid sunlight exposure; highly sensitive individuals should only use incandescent lamps or live and work in dark rooms. Use topical shading agents with a broad spectrum of shading. Wear broad-brimmed hats and long-sleeved clothing when going out.
Oral nicotinamide and hydroxychloroquine, supplemented with antihistamines and B vitamins. During the acute exacerbation period, small doses of glucocorticosteroids or tretinoin preparations can be added to control the disease. In severe cases, reaction stop can be used.
Topical treatment is generally with glucocorticoid preparations, topical tacrolimus, and local cold spray treatment for the face. Chinese herbal medicine can be used to dispel wind and heat, activate blood circulation and remove blood stasis, such as thornbush, forsythia, silverflower, forsythia, raw earth, salvia and xuan shen.
Avoid eating photosensitive foods
Celery, purple clover, amaranth, shepherd’s purse, marjoram, cilantro, mustard, figs, snow lettuce, purple cabbage, fennel, turnip leaves, mud snail, citrus, lemon, mango, pineapple, etc. We hope you will go to the hospital to consult a professional doctor’s opinion.