Bullous dermatitis is an inflammatory damage of skin with education on it the bubbles filled with liquid. Most often bullous dermatitis results from contact of skin with any aggressive factor of the external environment. However it can be a symptom of other dermatological diseases, a consequence of metabolic and endocrine violations or manifestation of genetic anomalies. In diagnosis of bullous dermatitis definition of the external factor influencing skin, detection of the accompanying pathology, laboratory diagnostics and a biopsy is of great importance.
At bullous dermatitis bubbles settle down under epidermis (subepidermalno) or directly in is mute (intraepidermalno). Subepidermalny localization of bubbles is characteristic of a bullous pemfigoid, a bullous form of a system red volchanka, a bullous epidermoliz. Intraepidermalny bubbles appear at a bullous eritrodermiya, Hailey-Hailey's disease. At
Reasons of bullous dermatitis
Influence of sunshine and artificial sources of ultra-violet radiation, low and high temperatures, aggressive chemicals (turpentine, , hair-dye, etc.), some plants and medicines belongs to the external factors causing contact bullous dermatitis. At the same time bullous dermatitis is caused by direct influence of a factor (simple contact dermatitis) or the allergic reaction (allergic contact dermatitis) provoked by it.
Bullous dermatitis can be display of infectious diseases: herpes, bullous dermatofitiya, impetigo; inflammatory dermatosis: puzyrchatka, bullous system red wolf cub, bullous ; metabolic violations: the porfiriya, a pellagra, diabetic ё, enteropaticheskiya akrodermatit; genetic anomalies: congenital bullous eritrodermiya, Hailey-Hailey's disease, bullous .
Symptoms of bullous dermatitis
Bullous dermatitis from influence of low temperature are freezing injuries. They are characterized by an initial angiospasm. Then vessels extend and on skin there is a reddening which is followed by burning sensation and pains. Puffiness joins and sluggish bubbles with serous or bloody contents appear. The erosion which are formed after opening of bubbles when healing become covered by crusts. Impact on skin of high temperature causes burns. Their clinical picture is similar to freezing injuries, but bubbles are formed at once after influence. Bullous dermatitis arises at freezing injury or a burn of the II degree.
Solar bullous dermatitis develops within several hours after too long stay under direct beams of the sun. After reddening of skin on it bubbles of the different size are formed. At solar dermatitis the itch, morbidity and burning is noted, temperature increase and violation of the general health is possible. After healing of erosion on skin there are sites of a hyperpegmentation.
Bullous dermatitis from chemical factors, arising on the site of skin contacting to chemical can then accept generalized character. So, at contact with ursoly the favourite arrangement of bubbles at generalization is the person and a neck. The arising hypostasis can take eyelids with full closing of an eye crack.
Metabolic bullous dermatitis develops against the background of the existing endocrine diseases or exchange violations. Diabetic ё arises at diabetes of any type. At it is mute intense bubbles are on disteel departments of legs or hands. Enteropatichesky akrodermatit is connected with a lack of zinc and is characterized by localization of bubbles on disteel departments of extremities, in a mouth, on lips and around eyes.
Hereditary bullous dermatitis usually develops right after the birth. Spontaneous sudden emergence of bubbles and their education in places of insignificant traumatizing skin is characteristic of a bullous epidermoliz. Hailey-Hailey's disease has a clinical picture of a puzyrchatka, but is transmitted in the hereditary way.
Diagnosis of bullous dermatitis
First of all assessment of a clinical picture of bullous dermatitis is carried out. The arrangement of bubbles, their nature, the size, quantity and stages of development, symmetry of defeat, involvement of mucous membranes matters.
In diagnosis of bullous dermatitis of the contact nature much attention is paid to identification of a provocative factor. At suspicion of the infectious nature of bubbles carry out a bacterioscopy and crops of the liquid which is contained in them.
One of informative methods of diagnosis of bullous dermatitis is the biopsy with the subsequent histologic studying. As biopsiyny material take the fresh intact bubble, taking the skin located around it a little. For confirmation of the allergic nature of dermatitis in addition to histologic to a research carry out reactions of direct and indirect immunofluorescence (REEF).
Diagnosis of hereditary bullous dermatitis is carried out with application of an electronic and microscopic research. At suspicion on a porfiriya investigate urine on availability of porphyrines, at suspicion on enteropatichesky akrodermatit in blood define concentration of zinc.
Treatment of bullous dermatitis
In treatment of contact bullous dermatitis the basic is an elimination of a provocative factor. If dermatitis is manifestation or a complication of other diseases, then first of all carry out treatment of the main disease. At hereditary forms of bullous dermatitis symptomatic treatment is carried out.
The kortikosteroidny and antibacterial ointments, anti-inflammatory mixes, means promoting healing of the erosion remaining after bubbles can locally be applied. If necessary make opening of bubbles with careful observance of conditions of sterility.