Pochesukh () — the itching dermatosis, basic elements of rash at which are small small knots with small bubbles in the center. The expressed itch leads to combing of places of rashes and emergence of deep ekskoriation. Distinctive feature of a pochesukha is the rash arrangement on razgibatelny sites of extremities without involvement of sgibatelny surfaces. Diagnostics of a pochesukha is carried out by dermatological survey, a research of bodies of a GIT and an exception of similar skin diseases. Treatment consists in purpose of a diet, vitamins, physical therapy, antihistaminic and sedatives.
The modern dermatology distinguishes three clinical kinds of a pochesukha: pochesukha of adults, children's and nodal pochesukha. The children's pochesukha develops generally within the first year of life of the child, but can occur at children up to 5 years. Pochesukhy adults people of advanced age are ill. The nodal pochesukha is observed, as a rule, after 50 years and is more often at women.
Causes of a pochesukha
The organism sensitization leading to development in skin of processes of an allergic inflammation is considered the main reason for development of a pochesukha. Foodstuff concerns to the main agents sensibilizing an organism. At babies it is protein of cow's or maternal milk, at more advanced age — mushrooms, flour products, eggs, a citrus, chocolate, strawberry, some species of fish. At adults smoked products, honey, coffee, alcohol, sharp products and spices can act as food sensitizers.
In development of a pochesukha in children the constitutional tendency to allergic reactions which is shown in the form of ekssudativny diathesis and also various fermentopatiya of a digestive tract is important. As the contributing factor, both at children, and at adults, the autosensibilization and an endointoxication of an organism from intestines at dysbacteriosis can act, a helminthic invasion, dyskinesia of biliary tract. Adults provocative factors in development of a pochesukha can have neuroemotional frustration (sleep disorders, a neurasthenia) and some diseases of the general character (diabetes, tumors of internals, , chronic hepatitis, cirrhosis, cholecystitis, etc.).
According to some authors emergence of a pochesukha is caused by stings of insects (mosquitoes, ticks, fleas) and the disease should be carried to epizoonoza. This hypothesis is confirmed by big prevalence of a disease in rural areas, its seasonality and positive results of allergic test with anti-genes of insects at most of the diseased.
The children's pochesukha begins with emergence on skin of disseminated and plentiful rashes in the form of small knots of 3-5 mm in size on which surface small bubbles appear over time. Bubbles burst with formation of the dot erosion covered with serous crusts. Along with existence of rash on skin of a trunk and the person, the arrangement of a large number of rashes on the razgibatelny surfaces of extremities is typical. Papulovezikula at a pochesukha can settle down on skin of palms and soles. At the same time they have the bigger size (5-7 mm), the edematous basis and an inflammatory rim. Distinctive feature of a pochesukha is the intensive itch. As a result of combing in places of rashes multiple ekskoriation appear.
At the diseased pochesukhy children along with rashes psychological violations are observed: a capriciousness, a bad dream, tearfulness, the increased irritability. These symptoms can be caused as a disease (a severe itch and an endointoxication of an organism), and congenital lability of nervous system in a consequence of features of the constitution.
In many cases independent regress of symptoms of a pochesukha after an exception of food of the child of cow's milk and children's mixes is observed. But there can be a transition of a children's pochesukha to atopic dermatitis, pruriginozny eczema or a pochesukha of adults. Signs of similar transformation are emergence of a white dermografizm, reduction of a belly reflex and disappearance plantar. At such children dryness of skin, , increase in femoral and inguinal lymph nodes is noted.
Pochesukh of adults it is characterized by intensively itching nodular rashes on skin of a stomach, buttocks, a back and the razgibatelny surface of hands and legs. The person and the sgibatelny surface of extremities usually are not affected. Dense semi-spherical or conic papules of brownish-red coloring up to 5 mm in size are typical for a pochesukha of adults. Along with it the papules differing in bright red color and the most severe itch can be observed. The multiple ekskoriation covered with hemorrhagic crusts are noted.
Adults the sharp and chronic current can have Pochesukh. In the last option the neurotic syndrome gradually joins skin symptomatology: sleep disorders, irritability, the expressed emotional lability.
The nodal pochesukha differs in a chronic and long current. Rashes are presented by dense papules of semi-spherical shape. Their size fluctuates from 6 do15 mm. At a nodal pochesukha of a rash settle down generally on skin of a razgibatelny surface of legs, is more rare — on hands and a trunk. Infection of elements of a pochesukha in the course of combing can often lead to development of an ostiofollikulit, follikulit, piodermiya or furunkulez.
Diagnostics of a pochesukha
Diagnosing a pochesukha, the dermatologist has to perform inspection and Dermoscopy of rashes. At suspicion on accession of a secondary infection it is carried out scrape for identification of the activator and its sensitivity to antibacterial medicines. Emergence of a pochesukha against the background of violations of digestive tract or endocrine pathology demands consultation of the gastroenterologist or the endocrinologist. The research a calla on eggs of helminths and the analysis on dysbacteriosis is conducted. If necessary to patients with pochesukhy ultrasonography of a liver and a pancreas, hepatic tests, a research of enzymes of a pancreas is appointed.
Important point in diagnostics of a pochesukha is the exception of dermatological diseases which have a similar clinical picture. The arrangement of rash and morphological features of elements of a pochesukha in most cases allow to distinguish it from atopic dermatitis, itch and a toksikodermiya.
At atopic dermatitis, unlike a pochesukha, rashes are localized on the sgibatelny surfaces of extremities. At itch Dermoscopy allows to find the typical courses, and the positive result of a research on itch confirms the diagnosis. Communication from rashes with the use of medicines is characteristic of taxidermy. The nodal pochesukha needs to be differentiated from red flat depriving.
Treatment of a pochesukha
The important place in treatment of a pochesukha belongs to a diet. At children of chest age for decrease in a sensitization of an organism to maternal milk it is recommended in 15 min. prior to feeding to give 10 drops of the decanted milk. At a pochesukha inclusion in a diet of cottage cheese, kefir and carrot juice is necessary earlier. Pregnant women and the feeding women should avoid the use of a large number of a citrus, eggs, fish, pork, a pickles.
Fermented milk products (fermented baked milk, cottage cheese, kefir), boiled beef, sunflower oil, fruit and vegetables are recommended to the children of advanced age and adults suffering from pochesukhy (especially carrots, cabbage, spinach and peas). At detection of a gelmintny invasion carry out expulsion of helminths. Sanitation of the centers of a chronic infection is also necessary: carious teeth, otitis, sinusitis, chronic tonsillitis, treatment of gastrointestinal diseases and dysbacteriosis.
In treatment of a pochesukha apply the enzymes improving digestion (Pancreatinum, etc.), group B vitamins, vitamins A and With, antihistamines (, , , , , etc.), medicines of calcium and sedative medicines (peony tincture, a valerian). The good effect is rendered by medical bathtubs with bran, broth of bark of an oak, a train or a camomile. As additional resources at a pochesukha use of ointments and creams with glucocorticoids is possible. In hard cases appoint small doses of glucocorticosteroids inside.
From physiotherapeutic methods at a pochesukha apply suberitemny doses of Ural federal district, an electrodream, with a hydrocortisone, an induktotermiya, microwave therapy on area of adrenal glands, a medicinal electrophoresis, DDT on area of cervical sympathetic knots.