The group of dermatitis unites inflammatory diseases of skin of various character. Classify dermatitis depending on the causes and localization of defeat. Healthy skin of the person possesses protective functions, but at long influences of aggressive substances or at decrease in immunity protective properties of skin decrease owing to what there is dermatitis. In group of dermatitis carry atopic dermatitis, simple and allergic contact dermatitis, aktinichesky, medicamentous dermatitis, etc. The general principles of treatment of any dermatitis are: elimination of the factor which provoked dermatitis, local anti-inflammatory therapy and a detoxication.
The group of dermatitis unites inflammatory diseases of skin of various character. Classify dermatitis depending on the causes and localization of defeat. Healthy skin of the person possesses protective functions, but at long influences of aggressive substances or at decrease in immunity protective properties of skin decrease owing to what there is dermatitis. The contact with any irritant can be the cause of contact dermatitis: physical, chemical, biological and mechanical. The inflammatory reaction of skin proceeding as an allergy or mechanically caused inflammation is caused by strong irritation. Extent of clinical manifestations depends on type of an irritant, time of impact on skin and on its features. That is, dermatitis can be shown both by easy reddening of skin, and deep ulcer defeats.
Persons with allergic predisposition as a result of contact with the sensibilizing substances usually have an allergic contact dermatitis. When there is a contact with anti-genes, response of the slowed-down type develops, allergen enters interaction with cages terms and complexes an anti-gene antibody are developed, that is the immune system of an organism becomes hyper sensitive to this irritant and at repeatedly contact with an anti-gene inflammatory reaction of skin or dermatitis is observed. At the allergic nature of dermatitis response can come right after contact with an irritant, at the subsequent meeting or in 5-7 days; speed of the immune answer and intensity of manifestations depend on concentration of antibodies in blood of the person. In development of allergic dermatitis hereditary predisposition and existence in the anamnesis of diseases of allergic character is of great importance (, bronchial asthma).
At women at long therapy is vulgar eels and a rozatse corticosteroids, skin becomes thinner, its structure and the chemical composition of skin fat is changed that leads to perioralny and periorbitalny dermatitis as skin in a mouth and around eyes the most sensitive. Perioralny dermatitis occurs at children with the increased salivation and in the period of a teething. The provocative moments in development of perioralny dermatitis are chronic diseases of the digestive system, dysfunctions of a hormonal background, existence of the centers of a chronic infection in an organism. At people, the suffering bulimias or neurologic frustration it is possible to observe dermatitis in perioralny area because of frequent contact with sour contents of a stomach, owing to provocations of vomiting.
Children of early and middle age in the presence of the burdened allergic anamnesis and at irrational food have an atopic dermatitis. Atopic dermatitis has a chronic current even if only one episode was diagnosed; at people of adult age under adverse conditions atopic dermatitis can recur.
Displays of dermatitis
The symptomatology of dermatitis depends on severity of a disease. So, at simple contact dermatitis easy reddening of skin, local temperature increase and insignificant infiltration is noted, at some patients the itch and feeling of a pricking on an affected area is possible. But at long contact with an irritant dermatitis can be shown in the form of ulcer and necrotic defeats, the becoming wet bubbles after which opening accession of a secondary infection is possible. Though in the anamnesis of a disease the starting factor the contact with an irritant lies after all, as distinguishes the complicated forms of dermatitis from piodermiya. The important clinical point for diagnostics is accurate restriction of a zone of defeat, contact dermatitis develops only on the place of influence of the irritating factor, it is necessary to differentiate it from allergic dermatitis.
At allergic dermatitis the course of a disease sharper, puffiness and reddening are expressed more brightly, the itch joins; an important symptom in development of allergic dermatitis distribution of clinical manifestations on sites of skin which did not contact to an irritant allergen is considered.
Perioralny dermatitis is shown in the form of small small knots and gnoynichok which are localized around a mouth, on cheeks, in nososhchechny folds and on a nose bridge. Existence of a narrow rim of healthy skin around a red border of lips is an important diagnostic sign. The course of such dermatitis long, rashes develop gradually, the itch, a peeling, dryness and feeling of tightening of skin is noted. For women, especially young age, cosmetic defects add feeling of psychological discomfort.
Atopic dermatitis is characterized by eritematozny rashes with tendency to an ekssudation and formation of vesicles, elements are localized in a knee - elbow bends, on buttocks and on a face. At adults at a recurrence of atopic dermatitis of a rash are also noted in places of bends, but papular infiltration develops on the shelled dry skin with tendency to a dermografizm.
Causes of dermatitis
Influence of exogenous and endogenous factors is the cornerstone of pathogenesis of dermatitis. Carry the external reasons to exogenous, and to endogenous – internal.
Mechanical influences, such as friction and long squeezing are the external reasons that leads to cracks, attritions and puffiness. Physical impact of high and low temperatures, ultra-violet, radioactive and x-ray radiation are the factors provoking dermatitis too. Salts of heavy metals, acids, alkalis, household chemicals, chemical warfare agents are the reason of dermatitis because of contact with chemicals. Some plants, mushrooms, bacteria and viruses cause a local inflammation terms too, most often it is primroses, plants of family lyutikovy, a cow-parsnip and yasenets.
Endogenous factors which reduce protective functions of skin are hypo - and avitaminosis, metabolism violations, endocrine violations, such as Addison's disease and a sklerodermiya. Administration of drugs of group of antibiotics, sulfanylamides and application novocaine - the containing medicines most often provokes medicamentous dermatitis. Dermatitis of allergic character can result from violation of a diet (a wild strawberry, chocolate, abuse of coffee). Diseases at which the endointoxication is noted quite often are complicated by dermatitis which is characterized by dryness, a peeling and a severe skin itch.
Perioralny dermatitis arises owing to abuse of cosmetics, irrational local treatment of hormonal medicines, sometimes medical toothpastes which contain fluorine are the reason of such dermatitis. A lack of vitamins A and E cause dryness of skin that can provoke emergence of perioralny dermatitis.
Violation of food at infantile age, violation of food of pregnant women, existence of the anamnesis burdened by allergic diseases and psychological frustration is the main reasons for atopic dermatitis. Statistical data on incidence of atopic dermatitis at adults confirm that people of an asthenic constitution with frustration of mentality as disturbing depressions and with chronic diseases of digestive tract, caused by low enzymatic activity, diskineziya and dysbacterioses enter into risk group.
Diagnosis of dermatitis
Clinical manifestations and existence in the anamnesis of a disease of contacts with the irritating factors are usually enough to diagnose dermatitis. From laboratory researches for confirmation of the diagnosis carry out clinical blood test (in blood the eozinofiliya is noted), definition of concentration of immunoglobulins and conducting skin allergic tests. At allergic dermatitis skin tests help to establish allergen or group of allergens which are the reason of dermatitis. For diagnosis of the diseases accompanying dermatitis consultation of the gastroenterologist, therapist, allergist and other experts can be required.
Basic principles of treatment of dermatitis
First of all it is necessary to eliminate influence of the irritating factor not to allow further damages of skin. The hypoallergenic diet improves a condition of skin, both at allergic, and at other types of dermatitis. For elimination of an itch, reduction of infiltration and puffiness antihistaminic medicines, such as , , are appointed. At the same time antihistaminic medicines of the last generation do not cause drowsiness and violations of attention that gives the chance to patients with dermatitis to lead a normal life.
If necessary appoint detoksikatsionny therapy – absorbent carbon, a hydrolytic lignin, intravenous injections of thiosulphate of sodium. But at intravenous detoksikatsionny therapy, especially if dermatitis of allergic character, it is necessary to carry out previously tests on sensitivity to medicines. The medicines containing calcium reduce an organism sensitization, but in the presence in the anamnesis of bronchial asthma it is better to refuse such medicines.
Local treatment of dermatitis consists in use of hormonal ointments. If the dermatitis which is becoming wet with existence of vesicles, then processing by antiseptics and infusions of a camomile, bark of an oak render the drying effect, the damp drying bandages with antiseptics and ointments yield good result at treatment of the becoming wet contact dermatitis.
If the course of dermatitis is complicated by formation of vesicles and , then bubbles open with observance of rules of an asepsis and antiseptics, and process a surface aniline dyes. Use of iodic solutions on affected areas is forbidden, they can process only edges of a wound not to allow spread of an infection.
As the itch and unpleasant feelings at dermatitis are caused by neurologic frustration which interfere with the fastest treatment, purpose of light sedative medicines of a phytogenesis is shown to all patients. These are tinctures of a motherwort, a valerian, a peony. Glycine and the combined phytomedicines also render good sedative effect.
If pancreas dysfunction is the main reason for dermatitis, then replacement enzymatic therapy is necessary. In this case administration of drugs of Pancreatinum is necessary after each meal. At dysbacterioses inclusion in a diet of fermented milk products, therapy by prebiotics is expedient. As soon as normal intestinal microflora is restored, the dermatitis symptomatology usually dies away.
Prevention of dermatitis
The balanced diet, respect for personal hygiene and sanitary and hygienic norms at the organization of work are the fundamental moments in prevention of dermatitis. It is necessary to exclude from a diet a citrus, chocolate, nuts, fish and fish dishes. Coffee, cocoa, sharp spices and sauces, vinegar and mayonnaise it is not recommended to eat at dermatitis too. Eggplants, mushrooms, eggs, the whole milk, a wild strawberry, strawberry, rich pastries, smoked products fried and baked dishes during treatment of dermatitis should not be present at the menu. And the use of low-fat fermented milk products, green vegetables and easy soups do medicamentous therapy of dermatitis by more productive.