breast eczema
Introduction
Introduction to breast eczema Breast eczema (breasteczema) is a non-specific allergic inflammation that occurs in the skin of the nipple and areola. It can occur in both men and women, but it is more common in lactating women, most of which are bilateral lesions, and some patients are unilateral. The rash is pleomorphic, often with cleft palate, itching, and easy recurrence. Sometimes it can be accompanied by skin damage in other parts of the body. basic knowledge Probability ratio: 1.3% of women over 20 years old Susceptible population: more common in lactating women Mode of infection: non-infectious Complications: Eczema-like cancer
Cause
Causes of breast eczema
The cause of breast eczema is more complicated, mostly due to the combination of exogenous factors and internal factors, and the result of interaction.
Physical and chemical factors (30%)
The body is exposed to the outside world such as dust, pollen, sunlight, cold, hot, humid, sweaty, friction and animal fur debris, chemicals, cosmetics, rayon, dyes, plastic products, etc. can be induced, eat certain foods such as Alien proteins such as fish, shrimp, eggs, crabs or milk can make breast eczema worse.
Infection (20%)
Chronic infections, chronic cholecystitis, chronic tonsillitis, fungal contamination, intestinal parasites and other inflammatory reactions can induce breast eczema.
Other factors (20%)
Allergies, history of atopic diseases such as skin disease eczema, food allergies, familial tendencies, metabolism, endocrine, digestive tract dysfunction, excessive mental stress, excessive body fatigue.
Pathogenesis
1. Pathogenesis: This disease is a delayed type of allergic reaction caused by the combination of internal and external factors. Patients may have certain eczema quality. The disease is caused by some factors. Due to the complicated etiology, the exact pathogenesis needs further study.
2. Pathological staging: According to the pathological changes of breast eczema, the clinical can be divided into three phases:
(1) Acute phase: blister formation in the epidermis, a certain degree of intracellular or intercellular edema around, inflammatory cell infiltration in the epidermis, vasodilation in the superficial dermis, interstitial edema.
(2) Subacute phase: blister formation in the epidermis, inflammatory cell infiltration between epidermal cells, hypertrophy of the middle layer of spine cells, accompanied by varying degrees of keratinization, and obvious neutrophil infiltration in the dermis.
(3) Chronic phase: no blisters, significant hypertrophy of the spinous layer with epithelial hyperplasia, hyperkeratosis of the epidermis may also have incomplete keratinization, mild edema in the epidermis, chronic inflammatory cell infiltration in the dermis, and thickening of the small vessel Cell and collagen fibers proliferate.
Prevention
Breast eczema prevention
The disease occurs in the summer, and there are multiple allergies. The incidence of infants and young children is higher than that of adults.
1. Remove the cause
(1) Although the cause of eczema is not easy to be clear, we should still ask for a detailed history, conduct necessary systematic examinations, try to find possible causes and remove them.
(2) People with allergies should try to avoid contact with substances that are allergic to allergies (see sensitizers in the cause) in addition to clothing and food, and strengthen physical exercise to improve allergies.
2. Avoid stimulating factors
Once eczema occurs, as a patient, try to avoid irritating factors, including scratching, boiling water, soaping, drinking and spicy food, so as not to aggravate the condition of eczema.
3. Early diagnosis, early treatment
According to the clinical features of eczema, itching is severe, pleomorphic damage, oozing tendency, good limbs flexion and easy recurrence, easy to make a diagnosis, tending to densely distributed red papules, herpes simplex with intense itching, help Early treatment of eczema, because most of the early eczema belongs to the acute phase or subacute phase, so the principle of external medication should be followed.
Complication
Breast eczema complications Complications eczema-like cancer
Eczema-like cancer can occur in very few cases.
Symptom
Breast eczema symptoms Common symptoms Nipple peeling milk deposits areola, itching, severe pain, papules, skin infiltration, nipple, cleft palate, herpes
More common in lactating women, most of them are bilateral breast lesions, a few are unilateral, the lesions are in the nipple, areola, especially in the lower part of the breast. In the acute phase, the skin is densely packed with large papules, herpes or small blisters. The basement is flushed, with a little exudation and erosion surface, and there is serous exudation, which can develop into erythema, crusting, and with desquamation. The skin lesions are easy to change to subacute or chronic and long-term unhealed, or relapse, in Asia. Acute and chronic skin infiltration, rough, hypertrophy, nipple splitting, but the lesions are soft, no ulcers, nipples are not invaded, consciously itching, infants can have severe pain when sucking, easy to cure after stopping breastfeeding.
Examine
Breast eczema check
1. Local skin exfoliation cell examination or print examination: pathological changes of inflammatory reaction in skin cells.
2, blood routine examination.
3, scraping part of the diseased skin tissue examination can help to diagnose.
4, cut biopsy has the most diagnostic value. Check for histopathological changes, with parasitic or fungal infections.
Diagnosis
Diagnosis of breast eczema
diagnosis
According to the following characteristics, it can be diagnosed as breast eczema:
1 occurs in lactating women.
2 occurs in the nipple, areola and lower part of the erythema, exudate, erosion, crusting, scaling, cleft palate and itching.
3 After the recovery, it is easy to recurrent, and the characteristics that can be cured after stopping breastfeeding can be diagnosed.
Differential diagnosis
Nipple eczema-like cancer
Also known as Paget disease, clinically characterized by eczema-like manifestations of nipples and areola, mostly unilateral, more common in middle-aged and older women, even seen in male breasts and other areas rich in apocrine glands, lesions in the nipple, The areola and its surroundings have an eczema-like appearance, and the red rash with clear borders is visible. The skin is thickened, slightly thickened, hard, and clearly separated from the normal skin edge. Although the eczema dressing treatment can be temporarily improved, But soon after recurrence, and prolonged unhealed, the lesion spread, the nipple flattened, sag, or even completely eroded, may be accompanied by breast lumps and (or) nipple discharge, cytology can help diagnose.
2. Contact dermatitis
There is a clear history of contact with the item, the more common is the topical application of wind oil, toilet water, safflower oil or other medicines, topical application of adhesive plaster, use of dark bra, etc., local lesions appear as a single pimples Or blisters, clear boundaries, asymmetry, skin lesions quickly reduce or disappear after removal of the cause.
