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Dermatitis (from Greek derma – skin) is an inflammatory damage of skin which develops owing to impact on it of various factors of environment. Kinds of dermatitis set, for example, allergic, perioral, atopic dermatitis and many others. And some other can be the adverse factors influencing skin chemical, mechanical, physical.
Allergic dermatitis develops as a result of contact with irritants (allergens), at persons who have to them hypersensitivity. Reaction of the slowed-down type is the cornerstone of this type of dermatitis, and predisposition to allergic reactions matters here. Usually slowed down reaction happens so: allergen gets on skin, it is taken by epidermis cells, in response to it the immune system forms antibodies owing to what the person becomes hyper sensitive to allergen. Similar reaction to influence of allergen can develop several weeks, dermatitis symptoms during this period can amplify or disappear on the contrary. The most widespread irritants are various chemicals in paint and varnish products, synthetic glues, turpentine and its components, salts of cobalt and chrome, and also cosmetics, medicines, stylish powders, and some plants (a primrose, an angelica, etc.).
At contact dermatitis of substance, getting into skin, are capable to cause an inflammation due to allergic or other reaction. Contact dermatitis can arise at hit on skin of various biological, mechanical or other irritants. Expressiveness of displays of a disease depends on time and force of action of an irritant.
Perioral dermatitis most often affects women of young age and children, and is shown in the localized rashes (papules) in perioral area (near a mouth and (or) a century and an eye). It is considered that the main role in development of a disease is played by various ointments and cream as a part of which there are corticosteroid hormones which are used at treatment of eels and other inflammations of skin, a rozatse and seborrheal dermatitis. The reason of perioral dermatitis also use of the fluorinated toothpastes can become possible. Some note communication of perioral dermatitis with hormonal dysfunction and gastrointestinal tract diseases.
Emergence of puffiness, easy erubescence, bubbles, rashes in the form of red points and spots, and at long action of a strong irritant – formation of ulcers and cracks on skin can be symptoms of contact dermatitis. The area of defeat from an irritant – same, as well as the area of its contact with skin.
Symptoms of dermatitis of an allergic form are very similar to how contact dermatitis is shown, however proceed more sharply, the itch, a peeling, a hyperemia is observed. There can be rashes which are grouped, gradually forming crusts. Symptoms of such dermatitis can be sometimes similar to eczema symptoms (becoming wet deprive). The inflammation can extend also out of site limits where there was an influence of an irritant.
Symptoms of perioral dermatitis are shown in emergence of small reddish papules (small knots) and pustules, generally around a mouth, on cheeks, around eyes. Rashes usually appear gradually, within several days and weeks. Erubescence amplifies at reception of spicy food. Feature of these rashes are a thin rim of healthy skin which adjoins the inflamed border of lips. The inflamed papules cause an itch and burning, skin is pulled together, sometimes there is an intolerance of the moisturizing and other cosmetics.
Basic reasons on which there is contact or allergic dermatitis can be divided on exogenous and endogenous, i.e. acting from the outside of and from within an organism.
Treat external factors:
- chemical: alkalis, acids, varnishes, paints, salts of alkaline metals (nickel, chrome, cobalt), synthetic materials and pitches, compounds of mercury, etc.
- biological: various plants (ivy, wormwood, cow-parsnip, ambrosia, chrysanthemums, tulips, etc.), bacteria, fungi
- physical: x-ray and radoactive radiation, impact on skin of very high and low temperatures, and also electric current, etc.
- mechanical: pressure, friction of skin
Internal causes of developing of dermatitis belong:
- disbolism and various endocrine disturbances (scleroderma)
- medicines (antibiotics, novocaine, etc.)
- foodstuff (for example, wild strawberry, etc.)
Are the reasons of perioral dermatitis hypersensitivity to certain cosmetic and to medicines (lipsticks, creams, lotions) as a part of which there are corticosteroids, the fluorinated toothpastes, insolations, synthetic fabrics, etc.
Diagnosis of dermatitis
For statement of the diagnosis "dermatitis", both contact, and allergic, the blood analysis (eosinophilia) which becomes on an empty stomach is conducted. At allergic dermatitis at the patient increase in eosinophils – leukocytic cells is noted. Various allergological tests, for example, of test on skin can be carried out. These skin tests (RTML, RSAL, etc.) consist in drawing on skin of allergen and definition of reaction to it. Skin tests happen application (drawing on a skin surface) and scarifying (drawing by a prick a needle, etc.).
Increase of the Ig E level in blood usually demonstrates that the irritant has the allergic nature. Also the dermatologist (or the allergist) will surely carry out visual survey of the patient and will listen to complaints.
Therefore at emergence of bubbles and the expressed erubescence it is worth seeing as soon as possible a doctor for timely statement of the diagnosis.
Treatment of dermatitis
The basic principle of treatment of dermatitis is elimination of effect of allergen and observance of a hypoallergenic diet. The type of allergen is defined by diagnosis of dermatitis then necessary drugs are appointed. For elimination of effect of allergen the antihistamines (tavegil, klaritin, telfast, Suprastinum) hyposensibilizing (a calcium gluconate), sedative (glycine, persen, collecting herbs), corticosteroid substances (Lokoid, Tselestoderm, Synaflanum, Belosalik) are appointed. If symptoms of dermatitis are expressed poorly, then topical treatment (creams, aerosols), in more started cases – antihistaminic and other drugs inside is appointed.
At observance of a hypoallergenic diet it is necessary to exclude the following products: citrus, fish, mushrooms, smoked products, eggs, milk, chocolate, coffee, strawberry, medical.
In addition also vitamin therapy (Riboflavinum, Ascorutinum, B6) and physical therapy can be appointed (cryomassage, etc.). Also there is a treatment of associated diseases. At the correct treatment forecasts very favorable.
Treatment of dermatitis of an allergic form consists in identification of allergen and elimination of its influence on skin, use of outside means, and also, in the complicated cases – use of sedative and antihistaminic drugs. In the presence of bubbles on skin bandages with broths of herbs or with solution of boric acid are used.
At improvements, it is necessary to make thrifty use of skin, to protect it from influence of sunshine.
At treatment of contact dermatitis the wet drying bandages, and after drying of bubbles — special corticosteroid ointments are used.
Peroral dermatitis is treated with use of antihistaminic drugs for removal of an itch. Apply lotions with a camomile and a sage, Unguentum Tetracyclini. Also antibiotics (erythromycin, metacycline, etc.) can be appointed. Also it is necessary to refuse the cosmetics applied earlier, creams and ointments. Usually, when following to instructions of the doctor, noticeable improvement comes already in few weeks, there is no recurrence usually. It is also necessary to keep to a sparing diet, not to use acid, smoked, salty and spicy, and also alcohol and coffee.
Complications of dermatitis
In the absence of treatment allergic dermatitis can be transformed to eczema, and long use of hormonal cure for perioral dermatitis can lead to thinning of skin, and also to appearance of hormonal eels. Also complications of dermatitis can to a basic disease bacterial (pyoderma) or a viral infection, and also a gradual atrophy of skin, i.e. disturbance of its protective properties. At a pyoderma on skin there are pustules which afterwards are drying up and which are becoming covered by crusts that often is followed by temperature increase. Thus, if there were first symptoms of dermatitis better at once to see a doctor. Among preventive measures it is possible to note observance of a healthy lifestyle, timely treatment of various diseases, and also observance of safety measures on production.
Section: Dermatology (Skin diseases)