Eczema (eczema; Greek ekzema an enanthesis) - a chronic inflammatory disease of blankets of skin of the neuroallergic nature; it is characterized by polymorphism of rashes, tendency to a moknutiya and a persistent course.
Forms and manifestations of eczema
The abundance of clinical forms and options is characteristic of eczema. In most cases eczematic process proceeds in the form of consecutive stages. So, the initial (erythematic) stage of eczema is characterized by the poured, not having a clear boundary, pruritic erubescence. In the second (papular) stage against the background of an erythema small edematous small knots are noted or the center of defeat is transformed to an edematous plaque. Due to the continuing increase of hypostasis the small knots turn into small bubbles that is typical for following — a vesicular stage of eczema. Under pressure of the inflammatory exudate accumulating in skin the bubbles burst, on their place there are small (dot) erosion from which serous liquid ("serous wells") constantly flows. This state is most typical for eczema and is top of development of eczematic process; it received the name of the becoming wet stage (the old name of eczema — "becoming wet deprive"). The origin of the term "eczema" (analogy to the beginning to boil liquid when the bursting bubbles are formed) is also connected with this stage. The serous exudate shrinking on a center surface forms stratification of crusts that is characteristic of a krustozny (korochkovy) stage E. After falling away of crusts against the background of a stagnant erythema the moderate peeling in the form of small whitish scales (squamous stage) remains for a long time, then skin takes a normal form. The described development cycle of eczematic process lasts from several days to several months. The polymorphism of vysypny elements is characteristic of E., i.e. at the same time in the center of defeat different stages of process are provided. The stage is defined by quantity of vysypny elements of a certain type.
At prescription of initial defeat up to 2 months the eczema is called sharp, the state a moknutiya is typical for it. In case of a long course (from 2 to 6 months) when puffiness and moknutiye are less significant, tell about subacute eczemas. The main forms of eczema differ in tendency to a persistent long-term recurrent course in the form of the consecutive periods of aggravations and subsiding of process that characterizes chronic eczema. At all forms of eczema the itching of skin is observed.
The main clinical forms of eczema are true, professional, microbic and seborrheal.
True eczema meets most often. The persistent wavy course, consecutive change of eczematic process, ambiguity of etiological factors, a polyvalent sensitization, polymorphism of vysypny elements, symmetry of their arrangement, localization of the centers on any part of the body (mainly on the back of brushes, feet) and prevalence of defeat, resistance to the carried-out therapy, tendency to frequent recuring are characteristic of it. The genetic predisposition is quite often noted,
For true eczema which is localized on skin of palms and soles the different considerable thickness of epidermis, usually insignificant coloring of the inflammatory centers, bubbles large and dense to the touch sometimes merging in multichamber bubbles — disgidrotichesky eczema are characteristic.
Professional (contact) eczema differs in a monovalent sensitization and easily revealed etiological factor. Arises and becomes aggravated only at influence of the production allergen which caused it. Usually has limited character, it is localized on the parts of the body available to contact with professional allergen (for example, brushes, forearms, a face, a neck). Professional eczema differs in a favorable course, quickly regresses and does not recur after elimination of contact with the allergen which caused se. The diagnosis is confirmed by skin tests with production allergen. Aggravation true eczema under the influence of professional harm does not give the grounds to consider it occupational disease since it can develop as a result of influence of many other factors, and often and for no apparent reason.
Microbic eczema is usually caused by a skin sensitization to piokokkovy flora. Asymmetry of localization, a sharp course, confinedness to the pyoderma centers, fistulas and ulcers, plentiful pustulation and purulent crusts, often roundish outlines and sharp borders of the centers of defeat are characteristic of it.
Seborrheal eczema is observed against the background of seborrhea; process begins with a hairy part of the head, then passes to a face, a back, area of a breast. The moknutiya, unsharp borders of the centers, stratification of fat scales, a constant itching of skin are characteristic of this form of eczema absence expressed. Seborrheal eczema can be complicated by a pyoderma in the form of a folliculitis, a furunculosis, impetigo. It is promoted by numerous raschesa during a paroxysmal severe itching.
Causes of eczema
1. Dust and pincers. Many people are subject to an allergy to dust and ticks from what on their skin there are rashes which bring strong discomfort. Such allergy, can also become the beginning of eczema.
2. Food. Many people suffer from food allergy. Seafood, especially mollusks and eggplants, are one of the most potentially dangerous substances capable to cause allergies or eczema.
3. Chemicals. Chemicals as a part of laundry detergents or toilet soap can become the reason of appearance of rash and allergic reaction. Here it is possible to carry: cleaners for a toilet and various disinfectants.
4. Climate changes. Many people badly I react to change of weather. Along with seasonal diseases of flu and cold, the incidence of eczema and skin rash increases. In off-season, in the preventive purposes, it is possible to accept antiallergic means.
5. Hygiene. In personal hygiene it is necessary to adhere to golden mean. If to wash seldom, it can lead to emergence of inflammatory processes on skin and develop as a result into eczema. But also regular acceptance of a shower can do much harm if to use soap with high content of alkali and artificial fillers. Try that your soap was rn neutral and did not overdry skin.
6. It is possible to be infected with eczema if you spend time with the person the patient with eczema. It, as we know, extends through touch. It does not mean that you should refuse communication with this person, but try not to touch his affected areas of skin.
7. Stings of insects. Stings of insects often become start to start eczema. Try to use mosquito grids and every time when you were bitten by an insect, do not forget to process the place of a sting an antiseptic agent.
8. Stress. If you were long enough subject to a stress, there is a chance that it to be reflected in your skin. Our organism can cope with infections, but the stress causes decrease in immunity and makes us defenseless against the attack of allergens.
9. Changes in the environment. If you moved to other city recently or just replaced the apartment, there are chances that skin will react to it. It can be caused by many reasons: other water, air, food and/or new plants, animal. You have to monitor constantly changes to define on what you have a reaction.
10. Hormonal changes. Can lead changes of a hormonal background to eczema as appearance of pimples at puberty. Make tests. Timely medical care can correct hormonal failure and save you from eczema.
Diagnosis of eczema
The diagnosis of acute eczema is made on the basis of its features. Eczema is one of the most widespread diseases of integuments with difficult and rare diagnostics of an etiological factor. Inflammatory changes in acute eczema extend to the neighboring sites. This polymorphic disease, i.e. on an affected area is localized several stages of its development. The sharp course of eczema is quite often quickly stopped without treatment, but also the forms which are difficult responding to treatment can meet. It often after treatment can recrudesce. A primary clinical symptom is the itching, and only in the becoming wet stage painful symptoms begin to prevail.
Eczemas need to be differentiated from itch, a trichophytia. At an intensive scabby invasion (infection) the severe itching develops, hair quickly become rare, and on affected areas of skin rare brown crusts which have size about lentil grain are formed. In blood high percent of eosinophils (12% and above) that in eczema does not happen. Eczema is not infectious, unlike itch. Damage of skin at ectoparasites (fleas, vlasoyeda, louses, etc.) is characterized by symptoms of an itching and existence of parasites, their eggs, and signs of inflammation of skin have mild character. A trichophytia, or cutting deprive, it is shown by baldness, formation of a thick layer of roundish scales which sometimes have the merging character. The itching has not significant character. During the microscopic examination find a mushroom activator, and at blood test - the low level of eosinophils.
Treatment of eczema
For easing or elimination of a skin itching in eczema, as a rule, appoint antihistaminic (antiallergic means): Suprastinum, Tavegil, Zirtek, Erius, etc.
1. Topical treatment of eczema
External (local) treatment of eczema depends on a set of factors and is appointed only the attending physician.
At true, disgidrotichesky and other forms of eczema which are followed by opening of bubbles and moknutiy skins within several days lotions with antiseptic agents can be appointed: 2% boric acid, weak solution of potassium permanganate, silver nitrate of 0.025%, etc. Lotions put as follows: bandage or a gauze are put in several layers and moistened in antiseptic agent solution, then put on the surface of the injured skin for 7-10 minutes.
The main way treatment of eczema are ointment and cream, the containing hormones (corticosteroids). Thanks to these means it is possible to accelerate process of healing of wounds and cracks on skin and also to reduce intensity of inflammation.
- Elok is issued in the form of cream, ointment and lotion and at the correct use removes inflammation and weakens eczema symptoms. Elok recommend to apply to skin in the field of inflammation by a thin layer once a day. Duration treatment is defined by the attending physician.
- Advantan is also issued in several dosage forms. Fat Advantan cream is recommended at very dry skin, for example, in disgidrotichesky eczema. Advantan cream is appointed, as a rule, in eczema in a stage a moknutiya. Medicine is applied to skin by a thin layer once a day. Duration of treatment is defined by the attending physician and can be several months.
- Lokoid is issued in the form of cream and ointment which should be applied to skin in the field of inflammation 3-4 times a day within several weeks.
It is necessary to remember that the local means containing corticosteroids have side effects: thinning of skin, tendency to accession of a fungal and bacterial infection, etc. in this connection their appointment is carried out only by the attending physician.
Topical inhibitors of a kaltsinevrin (Takrolimus, Pimekrolimus) is a new group of non-hormonal drugs which has noticeable effect in treatment of eczema. Takrolimus (Protopik) is issued in the form of ointment, Pimekrolimus in the form of cream. These means not only weaken inflammation of skin, but also reduce an itching. Doses and duration of use of drugs are also defined by the attending physician.
2. System treatment of eczema
System (general) treatment of eczema is appointed at a heavy course, inflammation of extensive sites of skin, lack of effect of topical treatment. In eczema, as a rule, prescribe the medicines suppressing immunity (immunosuppressors):
- Corticosteroids (Prednisolonum, Triamcinolonum, etc.) can be appointed in the form of tablets or pricks. Doses and duration of treatment is defined corticosteroids only by the attending physician.
- Cytostatics (Cyclosporine A, the Methotrexate, etc.) appoint at a persistent heavy course of eczema and also erythrosis.
Treatment of eczema folk remedies
Pulp of grated crude potatoes, having slightly wrung out and having turned in cotton fabric, to put to the place affected with eczema. To carry out this procedure several times a day and for the night, combining lotions and compresses with intake of crude potatoes inside.
Several times a day to moisten places of defeat with juice of fresh potatoes or to apply the bandages moistened in this juice. It is good to combine such procedure with potatoes juice drink, taking from a portion a part of juice for applique on the sites affected with eczema.
Traditional medicine recommends to use juice of crude potatoes with honey for treatment of eczema that repeatedly enhances effect of treatment. Having carefully washed 11 having peeled crude potatoes, to grate it on a small grater. To 0.5 glasses of the received gruel to add 1 teaspoon of honey and to mix. To put the received mix on a piece of bandage or a gauze napkin and to put to an affected area of skin. The gruel layer on a gauze has to be not less than 1 cm. The napkin with gruel should be recorded bandage and to hold not less than 2 hours. Mix should be removed together with a napkin, and carefully to remove the part which filtered through a gauze the pallet, the back of a knife, etc. Well additionally for the night to apply a bandage with propolisny ointment to the struck surface, and in the afternoon again to repeat appliques from potatoes and honey.
To mix 1 tablespoon of pure tar with 3 spoons of fish oil and 1 tablespoon of apple cider vinegar, to pound, impose this ointment on a rag and to put to the places affected with eczema.
To mash boiled garlic and to mix with equal amount of honey, to put on cotton fabric to the site of skin affected with eczema from above to close wax paper and to stick. To wash a sore point with the purified gasoline in the morning, again to smear and stick. When scales are not any more, it is possible to do a bandage only for the night, previously having processed the place sick with eczema gasoline.
To mix the gruel made of 3 heads of garlic from 50 g of honey and to rub daily to the sites of skin affected with eczema. To grate carrots, to wring out juice and to put a residue on eczema daily 2-3 times.
To do medicinal bandages with gruel of the fresh cabbage mixed with ovalbumin. It is necessary to apply bandages to the places affected with eczema 1-2 times a day.
At the becoming wet eczema poultices from the leaves of cabbage welded in milk and mixed with bran help. It is necessary to do poultices 1-2 times a day.
To take a cabbage leaf 2 minutes in undiluted apple cider vinegar, then to knead before emergence of juice and to impose on the struck place. To record a bandage. Helps from pain and an itching in eczema, itch and other skin diseases.
In wet eczema at children to bake in an oven 3 walnuts in a shell until they gain dark brown color. When nuts cool down, carefully istoloch, to add 1 teaspoon of fish oil and 1-2 times a day to grease a sore point.
To grind the washed-out, dry-through scales of sea fishes in flour in the coffee grinder and together with fish oil to apply on skin wounds in eczema.
To take inside in eczema on 1 tablespoon at breakfast and a dinner corn oil within 1 month, washing down with 1 glass of warm water with 1 teaspoon of apple cider vinegar and the added honey to taste. This means not only helps to get rid of eczema, but also softens skin, giving it elasticity.
Prevention of eczema
Eczema – quite dangerous disease as this disease involves the increased danger of infection with viral infections. As a result of recurrent development of viruses Kaposha's eczema can develop. This form of eczema proceeds very hard, often leads to the death of the patient. That is why prevention of eczema is necessary.
Against eczema enter preventive actions:
- 1. Obligatory observance of a diet and maintaining a healthy lifestyle by pregnant women, otherwise the child gets into risk group. In particular, it is recommended to pregnant women:
- to avoid consumption of excessive amount of milk, sweet, eggs;
- to try to enrich food with vitamins (vegetables, boiled meat, fermented milk products);
- to use fruit, but to limit at the same time inclusion in food of citrus, red berries, peaches, apricots.
- 2. In the presence of varicose symptom complex, burns, freezing injuries it is necessary to observe the recommendations of the doctor in accuracy and not to self-medicate at all.
- 3. The nursing mother in whom eczema of nipples is found has to decant milk in order to avoid transfer of a disease to the child.
- 4. In the presence of an allergy or manifestations, similar to it, on any given substance it is necessary to try to avoid contact with it as most often eczema has the neuroallergic nature.
- 5. Respect for personal hygiene.
Treatment-and-prophylactic measures are without fail carried out concerning pregnant women as the allergens which are in mother's blood easily get through a placenta. It is the reason of development subsequently in the child of various allergic diseases including eczemas. The newborn's organism as a result is weakened, and he is not able to resist to influence of the allergens getting with mother's milk.
At the found disease it is impossible to self-medicate, and at the first symptoms of eczema it is necessary to see a doctor. Late begun treatment can lead to undesirable consequences. In order to avoid aggravations by the patient with eczema it is recommended:
- to observe personal hygiene, besides, such measures are prevention of infection with the consecutive viral and bacterial infections affecting skin;
- to avoid too frequent shower, at reception of a bathtub for softening of water and medical effect it is necessary to add broth of a camomile, bark of an oak, bran to water;
- to avoid overheating;
- to exclude from a diet allergens (citrus, red berries) which can cause exacerbation of eczema, alcohol, salty, spicy, marinated and preserved foods;
- sick children cannot be overfed and underfed;
- to avoid contact with synthetic powders in order to avoid formation of allergic reaction;
- not to wear the linen made of wool, synthetic materials, a flannel as they are capable to cause irritation of skin.
Patients with eczema during remission are on obligatory dispensary accounting, have to visit the dermatologist regularly. In passing with treatment of eczema the examination regarding presence of associated diseases which can complicate a basic course is performed. Special attention is paid to a condition of digestive tract. In order to avoid palindromias the patient appoints sanatorium treatment, dispensary observation is periodically undertaken. Patients have to observe carefully the mode of life and food, to avoid interaction with allergens.