vulvar eczema
Introduction
Introduction to vulvar eczema Vulvar eczema is a common allergic, inflammatory vulvar skin disease with obvious tendency to exude. It is generally thought to be caused by type IV allergic reaction. Its main features are pleomorphic skin lesions, recurrent attacks, and symmetry. Itching is severe, and the eczema is scarred. When the condition improves and heals, the skin does not leave any scars. basic knowledge Sickness ratio: 0.1% Susceptible people: no special people Mode of infection: non-infectious Complications: urinary tract fungal infection
Cause
Causes of vulvar eczema
Mental factors (15%):
Such as mental stress, excessive fatigue, depression and other disorders of the neuroendocrine function, through the nerve reflex or endocrine effects to increase the susceptibility of the skin to various stimulating factors, and induce eczema.
External allergens (20%):
Such as chemicals, cosmetics, dyes, radiation, etc. Some animal toxins, eggs, fish, shrimp, milk and other heterologous proteins as well as some plant pollen or dust in the air.
In vivo allergens (18%):
Such as in vivo lesions, intestinal parasites, certain metabolic products, digestive tract diseases and human organisms under the influence of certain factors, the production of autoantigens.
Local irritation (20%):
Such as increased vaginal secretions, scratching, urinary fistula and so on.
Pathogenesis
The pathological changes are mainly exudative lesions, acute phase: intracytoplasmic and intercellular edema, sponge formation, blister containing a small amount of lymphocytes, telangiectasia, infiltration of a small number of lymphocytes and tissue cells around the blood vessels, epidermal stratum corneum There is a slurry that oozes out and scars. Subacute phase: skin lesions are mild hypertrophy, parakeratosis, intraepithelial cells and intercellular edema, a few blisters, and more lymphocytes and tissue cells infiltrating around the dermal vessels. In the chronic phase, epidermal cells are hyperkeratotic or focal keratosis, dermal telangiectasia, lymphocytes around the blood vessels, tissue cell infiltration, and thickening of the spinous cell layer.
Prevention
Vulvar eczema prevention
The key lies in prevention, finding the cause, removing possible pathogenic factors, avoiding the use of drugs and lotions that are irritating to the vulva skin, keeping the vulva as dry as possible, and avoiding contact with allergic substances: hot water, scratching, friction and irritation, etc. Fast foods such as spicy food, drinking, strong tea and coffee.
Complication
Vulvar eczema complications Complications, urinary tract fungal infections
Concurrent bacterial or fungal infections.
Symptom
Vulvar eczema symptoms Common symptoms Itching vulva pruritus herpes herpes scaly pigment loss skin rough eczema pimples
Female vulvar eczema occurs in the labia majora and sinus sulcus. The duration of the disease is uncertain, the attack is irregular, and the usual symptoms are not obvious. When it is sleeping or mentally stressed, itching is accompanied by itching. Infection, local redness occurs, and small pus points appear in the center of individual rashes. The acute phase is characterized by severe itching and diffuse flushing of the vulva. The skin lesions are pleomorphic, with no obvious boundaries, the disease progresses further, and the needle surface appears on the skin surface. Papular, herpes, or small blisters, basal congestion, damage to the border is unclear, and then erosion, edema, exudation aggravated, scratching due to burning and intense itching, injury to the epidermis, causing infection and scarring, and may be accompanied by groin Lymph node enlargement, fever and general malaise, if treated improperly, repeated episodes can prolong the course of disease and turn into chronic lesions. In the chronic phase, due to repeated scratching, there will be a small amount of serous exudation at the scratch site, and the disease will not heal. Infiltration and hypertrophy in the epidermis and dermis, rough skin, mossy hardening, clear boundary, often with scaly scales on the surface, touch Moist or hard crusts, severe chapped may occur, there is pain when active, and pigmentation due to the blood scab, brown or skin depigmentation.
Examine
Examination of vulvar eczema
1, suspected of contact factors, should do patch test to find allergens, acute blood cells and neutrophils increased in the acute phase combined with bacterial infection.
2. Histopathological examination of the lesion area.
Diagnosis
Diagnosis and treatment of vulvar eczema
diagnosis
According to the clinical manifestations and medical history can be diagnosed, pathological examination for diagnosis.
Differential diagnosis
1. Acute eczema needs to be differentiated from vulvar contact dermatitis.
2. Chronic eczema needs to be differentiated from neurodermatitis and genital pruritus.
3. Keratosis eczema should be differentiated from psoriasis without psoriasis, the boundary of the lesion is clear, and the silvery white scale is covered.
4. Identification with female leukoplakia, female leukoplakia is seen in women over 40 years old, the damage mainly affects the clitoris, the labia minora and the mucous membrane part of the labia majora, which is grayish white with hyperkeratosis and severe itching.
5. Identification with eczema infection, eczema infection has many clear boundaries, the edge is ring-shaped, small pustules can be seen, the skin lesions are erythema, exudate and crusting, sputum is yellow oily, underarm is bright red smashed surface, wrinkle In the pleated area, eczema infection often forms a fissure.
