Neurodermatitis: symptoms and treatment, on the face, onhands, children and adults

Update: October 2018

Neurodermatitis is a chronic allergic skin disease,
manifested at any age. Today, atopic dermatitis is like
diagnosis, in nature does not exist. In the international classification
his diseases were replaced by atopic dermatitis in children and atopic
dermatitis in adults).

However, in the old-fashioned way, many continue to call this skin
neuroderitis disease. The name it originated as an indication of
combined pathology of the skin and nervous system. For the first time it was
proposed by French dermatologists Jacquet and Brock in 1891 and
lasted until the nineties of the last century.

Origin of neurodermatitis

Initially, the occurrence and development of this disease
was regarded as an inadequate response to the stress of the nervous system with
the involvement of blood vessels and skin, a kind of skin vegetative-vascular
dystonia. Especially in this direction research has advanced
Soviet dermatologists. So, Loginov found in the skin of patients
an excess of adrenaline-like substances, Grinchar noted
neurovascular instability.

However, later on in the first place in the pathogenesis of neurodermatitis
delayed allergic reactions have come true
genetically determined high level of class immunoglobulins
E or features of the complement system, responsible for the rapid development
allergies at the first contact with the allergen.

The more:

  • synthetic hygiene products
  • medications taken
  • the more food components in contact with the body
  • the more polluted the air wastes
  • plants are saturated with nitrates and herbicides
  • the higher the percentage of residual chlorine in cleaned drinking
    water

the higher the risk of developing atopic dermatitis in adults.

Children prone to developing atopic dermatitis are usually already in
the first months of life have such an anomaly of the constitution as
exudative diathesis, which later without adequate change
lifestyle, nutrition and treatment is transformed into a full
Neurodermatitis, the symptoms of which are increasing, and the treatment is difficult
year to year. The timing of this transformation may occur as
younger children age and move to adult period
of life.

Neurodermatitis Forms

There are focal neurodermatitis, in which skin changes
located in limited areas and diffuse atopic dermatitis or
common when the pathological process is subject to more
two areas of the skin.

  • for example, neurodermatitis of the elbows and popliteal areas
    will be considered limited
  • when neurodermatitis is added to the face or skin of the buttocks,
    the disease becomes diffuse
  • with almost continuous skin lesions, atopic dermatitis is called
    total

Also в зависимости от основных типов кожных изменений бывает
neurodermatitis psoriasis-like (foci in the form of plaques),
hypertrophic (growth of the skin by the type of warts), white (with
depigmentation sites), decalvating (affecting the scalp and
causative baldness), follicular (spiky
skin sprawl), the linear form is a strip
depigmentation.

TOожные симптомы нейродермита

Neurodermatitis is a multifaceted disease during which
aggravations and remissions are noted. At different stages of this
A chronic process can experience various skin changes.

The disease most often affects the flexor surface.
extremities (elbow and popliteal fossae, forearms, wrists),
face, buttocks, back of neck, scalp.
Less common are changes in the palms and soles, hips, back and abdomen.
In general, processes are prone to migration, especially when protracted
and long-term therapy. So, atopic dermatitis in children, starting with
lesions of the cheeks and scalp, neurodermatitis gradually
captures the flexor surfaces of the arms and legs and then can
be diffuse.

  • Peeling and dryness

For atopic dermatitis is typically small or large plate. Scales
are located in limited areas of often reddened and
compacted skin. Excessive dryness of the skin makes it easy
trauma and impaired barrier function.

  • Papules

Nodules or different sized elevations also occupy limited
plots in the form of ill-defined foci. Sometimes due to
allergic component papules may be replaced by small pustules.
(bubbles with transparent content) arising due to
vacuole degeneration of cutaneous epithelium cells and detachment of the upper
layers of the epidermis intercellular edema.

  • TOожный зуд и расчесы

Itching pronounced, aggravated by ingestion
allergens (especially food or drugs), in contact with
water or external environmental conditions (cold air or water,
by the wind). Often provoked by contact allergens (local
effects of glue, creams, detergents). Characterized by night itching.
Combs – linear excoriation (skin tearing). This is direct
consequence of itching.

  • Cracks

Cracks – разрывы кожи из-за ее сухости. Most often occur on
lines of elastic fibers. Very characteristic cracks when
mechanical tension of the skin especially against the background of unfavorable
temperature conditions (in cold air) or due to
additional degreasing (frequent washing, aggressive cleaning
chemical antiseptics). Typical cracks in the corners of the mouth, in
corners of the eyelids, at the folds of the arms and legs, palms and fingers, in
podjagodichnyh folds.

  • Moisture

Occurs in areas of skin damage: in places of scratching or
cracks. At the same time blood or lymph is secreted from skin defects,
which dries up after a while with the formation of crusts.

  • Lichenification

This is a thickening of the skin, the coarsening of its pattern on the field of chronic
inflammation and injury. Often worn geographically. Highly
characteristic for many years of neurodermatitis, persist in
periods of remission. Typical features of the patient are thickening and
coarsening of the lower eyelid.

  • Hyperpigmentation

These are areas of darkening of the skin around the periphery of the lesions and in places
frequent scratching. Also при длительной терапии ГTOС на фоне
hypercortisolism can darken the skin of the knees, elbows, natural
folds and white line of the abdomen.

  • Depigmentation sites

Leucoderma is also a long-existing sign that persists.
out of aggravation and associated with damage to skin areas containing
pigment cells. TOак правило, пигментация постепенно
recovers if the skin area is not exposed again
exacerbation of the disease.

  • White dermographism

If the patient’s skin is held with a finger or a blunt object,
slightly pressing them. That will remain resistant white strip
(lasting more than 5 minutes), indicating perverted
vascular response (prolonged capillary spasm) on the background
the predominance of influences of the sympathetic nervous system, spasmodic
vessels

Common manifestations of atopic dermatitis

Since the allergic skin process is not isolated from everything
organism and at the heart of it are not only allergic, but also
vascular and neural reactions then neurodermatitis will manifest
in addition to skin symptoms, changes in overall well-being,
neurological status and even psychological appearance
the patient.

Emotional lability

manifested by instability of mood, increased
irritability, flashes of aggression against the background of frequent suppressed
moods. This is due to the predominance of sympathetic tone, and
also frequent primary itching, neurotic patients. Less often
(mainly in adolescents and adults) there are protracted
depression desocialization (often with long-term treatment
glucocorticoid and secondary adrenal insufficiency, and
also awareness of your defect appearance, as well as diffuse
forms with a heavy flow and localization of pathological processes
on the face and other exposed parts of the body). In this regard, the most
Palmar localization of the disease is considered unsuccessful, since
frequent aggravations in these areas, weeping, cracks break and
normal self-service, and also limit labor
activity of patients.

Sleep disturbance

Sleep disturbance is most associated with itchy skin during periods
exacerbations. Insufficient sleep at night prevents children from doing well
adapt to children’s groups, complicates their learning in
daytime hours and also increases asthenia.

Asthenization

General depression leads to learning difficulties,
трудовой деятельности и повседневной of life. Fast fatiguability,
depression often narrows the social circle and interests of patients.

Reduced immunity

Reduced immunity развивается по двум направлениям. The original
low levels of class A immunoglobulins that protect the skin and
mucous membranes, causes an easier occurrence of purulent
skin infections (which contributes to its regular trauma and
violation of barrier function). In addition, the skin is more easily affected and
viral agents (molluscum contagiosum, warts, herpes).
General immune status worsens due to a deficiency of the cortex.
adrenal glands (existing initially and aggravated by
long-term glucocorticoid therapy). The end result is frequent
colds, infectious processes.

Neurodermatitis treatment

Often, atopic dermatitis is treated very truncated and attention is given to
only skin manifestations. For the relief of which is sent
local treatment. However, it is worth considering the process in the complex and
pay attention to all stages of treatment.

Diet

Starting therapy, especially in babies, is always with dietary
events. Ideally, when you can isolate the main allergens,
provoking the process and remove them from the food. In adults also
spice and alcohol intake is limited. Children try to lead on
breastfeeding or transfer to cow hydrolyzates
squirrel.

Dysbacteriosis treatment

For periods of exacerbations, correction is also recommended.
dysbacteriosis and enterosprrent courses (Polyphepane, Enterosgelya).
Sorbents to get involved is impractical because they lead to
удалению из кишечника не только allergens. But also vitamins,
reimbursement is often difficult due to dietary restrictions and
intolerance to synthetic analogues.

Common mode

Normalization of the general regime should provide full
night (and for children and naps), sufficient stay on
fresh air and rational mental and physical stress,
excluding fatigue and over-stimulation of the nervous system.
treatment of neurodermatitis in adults with a total lesion,
localization on the palms, secondary purulent complications may
be conducted on an outpatient basis with the issuance of a disability certificate.

Sedatives

If necessary, patients are prescribed courses of sedation.
drugs or carried out drug therapy more rough
neurological or mental problems.

Antihistamines

Antiallergic component of the treatment includes
antihistamines, often 2 and 3 generations, which have less
inhibitory central nervous system effect and simultaneously block the effects of histamine
and stabilize mast cells. However, first-generation drugs
still apply. They act relatively quickly and give
drowsiness, which is generally not bad when itching dermatosis (see
allergy pills).

  • First generation: Fenistil tablets or drops (Demitenden),
    Tavegil (Clemastine), in tablets or injections of Pipolfen
    (Promethazine), Fenkrol (Hifenadine), Suprastin (Chlorpyramine).
  • The second-generation drug – Ketotifen (Zaditen) is preferred.
    with combinations of the skin process with bronchial obstruction.
  • Third generation drugs: Astelong, Astemizol,
    Akrivastin, Atselastin, Allergodil, Histalong, Histim, Claritin,
    Clarincens, Loratadine, Levocabastine, Sempreks, Telfast, Terfenadil,
    Teridin, Tsiterizin, Ebastin.

Glucocorticoids for systemic use

In tablets or injections, used in severe
common process during periods of exacerbation or availability
allergic complications in the form of acute allergic reactions
(urticaria, angioedema).

  • Semisynthetic GKS: Prednisolone, Triamcinolone,
    Dexamethasone.
  • Natural: Hydrocortisone, Cortisone.

Ointment treatment

Ointment treatment с глюкококртикоидами проводится один раз в сутки.
Apply a thin layer, do not rub. When the course reception is not
cause adverse systemic action (Itsenko-Cushing syndrome.
adrenal insufficiency, skin atrophy and diabetes mellitus).
When taken over the years, their own emissions are gradually reduced.
adrenal hormones and systemic side effects develop
(see hormonal psoriasis ointments – their side effects).

  • Weak non-fluorinated methylprednisolone aceponate,
    hydrocortisone.
  • Moderate strength. Fluorinated: Lorinden, Lokarken, Esperson,
    Triacort, Ftorokort, Afloderm. Non-fluorinated: Lokoid,
    Latikort.
  • Strong. Non-fluorinated: Advantan, Elokom, Fluorinated:
    Sinaflar, Flutsinar, Sinalar, Celestoderm. Beloderm, Kutiveyt,
    Dermoveit.

Non-hormonal ointment

The main task of non-hormonal drugs is to dry the skin.
(Zinc ointment or paste, Ski-derm) and have a softening effect
(Gistan). However, some drugs have anti-inflammatory
action (Apilak), drugs based on tar and ichthyol), as well as
reduces itching (Elidel, Glutamol). Also enjoy healing
ointments (Bipanten, Panthenol) – see dermatitis ointments.

Autosoil is made from the blood of the patient at the peak
acute neurodermatitis. With them, the patient receives antibodies against
allergens.

Neurodermatitis treatment on the hands

In the hands of the disease, the palmar or
back of fingers, palms and interdigital spaces. Also
characteristic lesions of the flexion of the wrist. All this is strong
complicates the lives of patients and requires the most careful and
painstaking treatment (see treatment of dermatitis on the hands).

In addition to all major groups of drugs and directions
non-drug treatment has to pay special attention
hand hygiene. For this purpose, use antiseptics (Miramistin),
and also prefer antiseptic wound healing ointments
(Bipanten, Panthenol).

In the period of remission, they try to limit contacts with aggressive
factors. Use gloves when doing homework and on
harmful industries, avoid hands chilling and apply fatty
protective cream.

Folk treatment of atopic dermatitis

In traditional folk medicine, atopic dermatitis is treated
numerous baths and poultices with flocks and infusions of medicinal
herbs (celandine, succession, calendula, chamomile, oak bark). TO
Unfortunately, these water procedures do not lead to anything. Neurodermatitis,
like any other weeping and itchy dermatosis from water only
sharpens and itches with new power.

Therefore, eating your child’s atopic dermatitis does not
zaparivayte it in the bath, and just take to competent
allergist What can be brought into prolonged remission today
with a competent integrated approach, with the help of popular methods
really turn into a full-fledged chronic disease with severe
over.

Neurodermatitis and army

Depending on the goals and objectives of the recruit or who
plans to enter service under the contract, you can rejoice or
grieve

The common form of atopic dermatitis (neurodermatitis) with
lichenification of the skin of the face, popliteal and ulnar fossae or total
difficult-to-treat lesion for all species services
recognized category D (not fit for military service).

It is assumed that this is often recurrent
form (at least 2 exacerbations per year over the past
commission of years). If exacerbations are less common or not manifested in
the last 5 years, there is no reason to establish category D.

Limited neurodermatitis with focal lichenification will be evaluated,
as category B, it is limited in time (it is not called for in peaceful
time).

Thus, atopic dermatitis, today is considered a skin
allergic nature of the disease and requires timely
systemic treatment with observation by a competent dermatologist and
allergist. Treatment of atopic dermatitis with folk remedies
Unfortunately, hopelessly.

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