atopic dermatitis
Introduction
Introduction to atopic dermatitis Atopicdermatitis, also known as atopic eczema or atopic dermatitis, is a chronic, relapsing, pruritic skin disease, the meaning of atopic: (1) susceptible to asthma, allergic rhinitis, eczema Familial tendency. (2) Allergic to foreign proteins. (3) High IGE in serum. (4) Blood eosinophilia. Typical atopic dermatitis has the above four characteristics in addition to the specific clinical manifestations of eczema. The understanding of this disease is still inconsistent, the cause is more complicated, and it is generally considered to be related to various factors such as heredity and environment. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of infection: non-infectious Complications: herpes simplex
Cause
Causes of atopic dermatitis
1. Genetic factors: 70% of patients have a history of genetic allergies such as atopic dermatitis, asthma, and allergic rhinitis.
2, allergens: (1) house dust mites; (2) food; (3) infectious allergens; (4) pollen; (5) contact with irritants and allergens.
Prevention
Atopic dermatitis prevention
The general prevention principle is more difficult to find the cause of the disease, and the prevention and treatment focuses on the infancy.
1. Try to avoid all external stimuli such as wearing light, soft, loose, do not force and scratch.
2. Avoid over-cleaning, especially with soap or disinfectant. Do not wrap the area with rubber or plastic cloth.
3. The temperature is suitable.
4. Minimize allergens in the environment.
5. Pay attention to diet.
6. Always pay attention to digestive function.
Complication
Atopic dermatitis complications Complications herpes simplex
Cataracts can occur in patients with long-term atopic dermatitis between 20 and 30 years of age. Cataract may be a specific manifestation or a result of extensive systemic or topical use of corticosteroids. Herpes simplex may sometimes be given to patients with atopic dermatitis. A serious febrile illness (herpetic eczema).
The dust mites in the mattresses, cushions and carpets in the home can obviously aggravate the condition of atopic dermatitis.
Symptom
Atopic dermatitis symptoms common symptoms papules eczema diarrhea itchy skin dry local lymph nodes swollen scaly herpes pustule blood stasis
The disease has different characteristics at different ages and is usually divided into three stages:
(1) Infancy
Also known as infant eczema, usually occurs in the second or third month after birth, and also reported in the second or third week after birth, but the diagnosis is difficult at this time, the lesion mainly occurs in the cheeks, amount, The scalp, individual cases can be developed to the trunk, limbs, the characteristics of the rash can be divided into two types, exudation type and dry type.
Exudative type of eczema occurs mostly in obese exudative babies, starting from the cheeks, erythema occurs, the boundary is unclear, dense papules on the erythema, papules, blisters, blister and exudate, and exudate drying Yellow and thick suede, often due to itching, scratching, friction and partial spasm, revealing a lot of exudate of red smashed face, heavy can affect the entire face and scalp, if there is secondary infection visible pustules With local lymphadenopathy and even fever, systemic symptoms, a small number of children due to improper treatment extended to the whole body into erythroderma, and often accompanied by diarrhea, malnutrition, systemic lymphadenopathy.
Dry type rash is common in thin babies, dark red dark patches, dense small papules and no blistering, dry skin without obvious exudation, surface with grayish white scaly scales, often involving the face, trunk and limbs, chronic It can also be slightly infiltrated with hypertrophy, chapped, scratched or bloody.
In addition to the above two types, some people also have a seborrheic type, which is characterized by skin lesions occurring in the scalp, behind the ear and other areas of sebaceous glands, which can produce yellow thick sputum, but its basic characteristics and exudation type are similar.
No matter which type has severe itching, it causes the baby to cry and sleep, the course of the disease is chronic, good and bad in the middle of the process, a bad stimulation or taking a sensitive diet, a sudden change in climate, wearing tight hair, silk clothes The infection worsens with infection or washing with soap, but the general trend is to gradually reduce with age.
(2) Childhood
80% before the age of 5, the skin lesions are divided into eczema and pruritus.
The symptoms of eczema-type skin lesions are similar to subacute and chronic eczema in adults. They are mostly needle-shaped papules, herpes and small blisters, which are fused into a piece, which is relatively dry, covered with grayish white scales, slightly infiltrated skin, and partially mossy. It occurs mostly in the flexor side of the elbow fossa and the two calves, and can also affect the outside of the neck and other parts of the limbs.
The pruritic skin lesions show itch pruritus in the body, and the extremities and back of the extremities occur frequently. The papules are large, skin color or tan, the first riser is red, the papules are dry, the surface is rough and thin, and the old ones are small. Hard, most of the rash is scratched at the top, visible scratches, blood stasis, may be associated with local lymphadenopathy.
(3) Youth and adulthood
Mainly manifested as chronic lichen lesions, mostly located in the head and face, neck and elbow and knee joint flexion, symmetric distribution, obvious pigmentation, obvious scratches, white skin scratches positive.
Examine
Examination of atopic dermatitis
1. Blood routine examination: including red blood cells, white blood cells, hemoglobin and the number of platelets. The blood routinely collects the finger blood or the peripheral blood of the earlobe by acupuncture. After dilution, it is dropped into a special calculation disk, and then the number of blood cells is calculated under a microscope.
2. Urine routine: including urine color, transparency, pH, red blood cells, white blood cells, epithelial cells, casts, protein, specific gravity and urine sugar qualitative.
3. The blood eosinophil count in the patient's blood increased, and the lgE in the patient's blood cleared. It can be detected by passive transfer test that the skin test with specific antigen can be positive.
Diagnosis
Diagnosis and differentiation of atopic dermatitis
diagnosis
Diagnosis can be performed based on clinical performance and laboratory tests.
Differential diagnosis
The key to the identification of this disease with infant eczema is that the former has "ectopic", while the latter does not.
Atopic dermatitis should also be differentiated from infantile seborrheic dermatitis, which usually begins on the 3rd to 4th week after birth. The rash is erythema and oily scales, lacking pleomorphic characteristics, and occurs in the head. Involved in the eyebrows, nasolabial folds, behind the ears, neck, etc., consciously itchy or not itchy, the prognosis is good, often can be cured within a few months.
