About such a disease as eczema, doctors knew a couple of centuries before our era. Then people came to the ancient Greek Aesculapius with complaints of strange skin rashes. The disease was associatively nicknamed "eczeo", since in translation from Greek this word means "to boil". Indeed, an eczematous rash looks more like a boiling surface.
Today, about 40% of patients who visit a dermatologist face the need to treat eczema. This skin disease is not only common, but also socially significant. According to statistics, this type of dermatosis leads to temporary disability in three out of ten cases.
The first thing to understand is that eczema is chronic. The disease proceeds with relapses, which are replaced by short or persistent remissions. The second feature of this allergic dermatosis is the lack of accurate information about its etiological factors. Actually, this explains the impossibility of one hundred percent healing from eczema.
Also wantnote that eczema does not pose a danger to others, as it is not a contagious disease.
What skin disease looks like
Pathology can develop at any age, including children. The first external signs of the disease are profuse vesicular rashes localized in the hyperemic area of the epidermis. In its appearance, a small rash resembles a gurgling, bubbling surface.
A few days after the appearance of the bubbles open, leaving in their place, the so-called "serous wells". As soon as the erosive weeping segments of the skin begin to dry out, a yellow-gray crust forms. Rashes are located locally and symmetrically - this is a definite plus for the treatment of eczema. In the photo, the symptoms of external manifestations are demonstrated quite clearly. The external inflammatory process is accompanied by severe itching, burning, pain. The epidermis of open areas of the body is predominantly affected. Starting treatment for eczema on the hands is the most common reason for contacting a dermatologist in the autumn-winter and spring period, since the disease worsens during the cold season.
Pathogenesis
In fact, an eczematous rash on the skin is the result of serious metabolic disorders in the body. The nature of the origin of the disease is still not fully understood. The only thing that scientists know for sure is that the main role in the development of the disease belongs to a failure in the coordinated work of the immune, endocrine, central and autonomic nervous systems. However, thisnot enough to start the pathological process. To activate a dermatological disease, a simultaneous combination of a number of factors is necessary. The "trigger" in this case can be any external or internal stimulus. Therefore, the elimination of a complex of causes that cause tissue deterioration is the basic principle of treating eczema. Symptoms and external manifestations of this disease occur against the background of the following disorders in the body:
- Weakened immune system.
- Increased levels of inflammatory mediators.
- Sensitization of the body.
- Lack of balance in the sympathetic and parasympathetic innervation of the epidermis.
- Changes in protein and fat metabolism, characterized by a decrease in protein and an increase in cholesterol.
- Inhibition of the antioxidant properties of erythrocytes and plasma.
- Failure of the pituitary-adrenal system.
In the first link of the chain leading to the development of dermatosis, there are immunological and allergic dysfunctions. They lead to the inability of the skin to withstand the effects of exogenous and endogenous factors. "Assistance" in this is provided by disturbances in the work of the endocrine system, metabolism, diseases of the digestive system, liver and pancreas, as well as the presence of chronic infectious and inflammatory foci in the body.
Main Stages
Eczema, which proceeds according to the "classic" scenario, manifests itself already at the erythematous stage. At this stage, there isredness of a certain area of the skin. Without knowing the causes of eczema, treatment on the hands and other parts of the body begins with the use of safe topical anti-inflammatory drugs.
The next stage is vesicular. It is characterized by the appearance of specific vesicles filled with exudative translucent fluid. The size of bubble formations rarely exceeds the head of a pin.
In addition to vesicles, papules and pustules form on the hyperemic surface. When the rash begins to open, they talk about the beginning of the weeping stage. As soon as the stratum corneum peels off, small erosive foci covered with dried scales - serous crusts become visible under it.
Depending on the causes, the treatment of eczema on the hands (the photo shows the manifestations of the disease at one of its stages) can line up in different ways. The main task that specialists set for themselves is to reduce the severity of symptoms. Patients are usually most uncomfortable with:
- Severe itching that scratches the skin of patients. Minor injuries of the epidermis are available routes for the penetration of a secondary infection.
- During the remission period, dryness, peeling and redness of the skin in places of eczematous lesions may remain.
- The surface of the epidermis thickens over time (especially on the palms and feet), pigmentation occurs, cracks appear. All this indicates the development of hyperkeratosis.
Mechanism of development of pathology
If there is oneor a whole range of conditions favorable for the occurrence of dermatosis, the matter remains only with the provoking factor, i.e., the direct cause of eczema. The treatment for this skin disease is to overcome the cascade of autoimmune damaging reactions.
An important role in the development of pathology is played by dysbiosis of the epidermis and intestinal microflora, which is due to the suppression of the growth of "he althy" bacteria by opportunistic and pathogenic ones, and, as a result, a change in the ratio between them.
Such a skin disease can be caused by many reasons. Treatment of eczema in any of the clinical cases, regardless of the etiology, does not lead to complete recovery. The most difficult thing is to prevent relapses of dermatosis in a person who has a hereditary tendency to this disease. By the way, genetic markers of the idiopathic form are confirmed in 40% of cases.
In addition to heredity, neurogenic, allergic, immunological, endocrine and metabolic factors can cause eczema. Treatment (photo shows one of the ways) may be required when exposed to the following factors:
- Stress.
- Infectious pathogens.
- Vaccines.
- Chemicals.
- Medications.
Become an impetus for the development of eczema can be an allergic reaction of the body to food. The most common irritants are citrus fruits, chocolate, strawberries, nuts, honey, cow's milk protein.
Varieties of dermatosis
Unitedclassification of eczema in modern dermatology does not yet exist. However, doctors confirm that the disease has many forms, can be acute, subacute and chronic. Most often, experts adhere to the following typology of eczema:
- True (idiopathic).
- Professional.
- Microbial.
- Seborrheic.
- Children's.
Clinical signs and the nature of the course depend on the specific type of dermatosis, as well as further tactics for the treatment of eczema. It is difficult to determine the type of dermatosis from a photo on the hands or other parts of the body.
Idiopathic eczema
With the true variety of allergic dermatosis, the skin of the extremities is most often affected. For this type of pathology, the above described staging is characteristic. In the case of a bacterial infection, pustules with purulent contents are formed. Weeping eczema is rare in the chronic form.
Idiopathic eczema is also divided into two types:
- Pruriginal. This form is characterized by a small vesicular rash located on the hyperemic epidermis. Outwardly, it resembles millet grains. Pruriginous vesicles do not open, and therefore do not form erosive foci. Most often localized in the places where the elbows, knees, and hips are bent. Remissions are rare for this variety of true eczema.
- Dyshidrotic. It differs from the rest by the presence of small bubbles located between the toes or hands. The treatment of eczema of the dyshidrotic form differs from the treatment of other types of the disease due tofeatures of the vesicular stage: the bubbles may not open, but immediately form a crust. The accumulation of rashes is clearly delimited from the he althy epidermis by severe inflammation, swelling and hyperemia.
Microbial eczema
This species has specific differences. Microbial eczema develops when a person has chronic infections. The pathological process leads to the development of an autoimmune damaging reaction. Most often, it is possible to provoke the development of microbial eczema by such representatives of pathogenic microflora:
- Staphylococcus aureus.
- Hemolytic streptococcus.
- Candida.
- E. coli.
- Pseudomonas aeruginosa.
- Proteas.
Microbial eczema is manifested by an asymmetric rash that affects the shins, the back of the hands, the scalp. Eruptions do not spread, and their surface is covered with yellow-green crusts, sometimes with impurities of lymph and blood. Subspecies of microbial eczema include:
- Varicose. Vesicles appear around trophic ulcers of the legs, which are usually caused by a strong weakening of tissue trophism due to varicose veins. Treatment of eczema on the legs begins with the treatment of the underlying disease.
- Post-traumatic. Eczematous rash concentrates in places of skin damage (wounds, including postoperative wounds, fistulas, burns). Often post-traumatic eczema develops on the stump after limb amputation.
- Nummular. The second name of this form of dermatosis is coin-shaped, which is explained by the largediameter (from one to several centimeters) vesicles. The disease proceeds with severe edema, weeping. Affected areas are delimited from he althy tissues.
- Nipple eczema. To a greater extent refers to the post-traumatic subspecies. It mainly occurs due to injuries of the nipple during lactation. Inflammation of the skin goes through all the described stages.
Seborrheic eczema
A specific feature of this type of disease is the absence of vesicles. Rashes are localized in places of accumulation of sebaceous glands (on the scalp, interscapular space, décolleté, face, neck). The external manifestations of such eczema are distinguished by rounded yellow-pinkish spots covered with dense scales. In patients with seborrheic dermatosis, the hair sticks together in bunches, constantly shines, and serous crusts form in the behind-the-ear areas, which itch a lot.
Occupational eczema
Develops against the background of constant contact with a production stimulus. With professional eczema, the epidermis is affected in areas that are in direct contact with the allergen, so this type of dermatosis rarely occurs on the hands. This form is characterized by traditional staging. The longer the contact with the irritant, the more complications bring relapses. It will not be possible to achieve improvement without eliminating the provoking factor.
Skin disease in children
The cause of eczema in babies is considered atopic dermatitis, which can develop against the background:
- Heredity.
- Hard pregnancy, which was accompanied by toxicosis.
- Pathologies of the kidneys, pancreas, liver.
- Improper diet.
It is worth noting that in childhood, babies are most likely to get eczema, one or both of whose parents suffer from dermatosis. Often childhood eczema is accompanied by asthma, food allergies, intestinal dysbacteriosis. The disease proceeds according to the "standard" pattern, manifesting itself as rashes on the face, head, neck, and gradually spreading throughout the body.
Therapy Methods
Let's consider how eczema is treated. A photo of various eczematous rashes suggests that for each specific case, therapy will be different. In fact, the general scheme for the treatment of eczema is built according to a single algorithm, but the selection of drugs will depend on the severity of the symptoms and the nature of the course of skin pathology. Therapy of dermatosis should be comprehensive and include the following actions:
- For the treatment of weeping, lotions with antiseptic solutions are used: boric acid, "Chlorhexidine", "Resorcinol". You can dry the erosion with the help of "Fukortsin", an alcohol solution of diamond greens.
- To eliminate inflammation during an exacerbation, hormonal ointments are used ("Flucinar", "Celestoderm", "Sinaflan", "Advantan", "Afloderm"). They cannot be applied to wet areas. The duration of treatment is determined by the dermatologist.
- To fight secondary infectionor a microbial form of eczema, the therapeutic plan includes local antibiotics (ointments "Levomekol", "Oxycort", "Pimafukort", "Gyoksizon").
- To start regeneration processes and heal soft tissues, sulfuric, ichthyol, tar ointments are used. These drugs usually replace corticosteroids.
- Salicylic ointment, lotions and oils are used to soften crusts.
Treatment of eczema during an exacerbation completely excludes water procedures. In addition to local medications, they also resort to the use of systemic drugs:
- Antihistamine group ("Loratadine", "Cetirizine", "Claritin", "Tavegil", "Cetrin").
- Antibiotics, taking into account the sensitivity of microflora (Ceftriaxone, Clarithromycin, Erythromycin, Cefuroxime, Ofloxacin, Levofloxacin).
- Anti-inflammatory drugs (Diclofenac, Indomethacin).
- Absorbent solutions to relieve general intoxication (intravenous infusions of "Sodium thiosulfate", "Calcium chloride").
- Sedative medicines (tinctures of valerian, motherwort, combined homeopathic remedies, including Novopassit, Persen, Sedaten).
- Immunomodulators ("Cycloferon", "Viferon").
- Probiotics ("Linex", "Enterogermina", "Bifiform", "Laktovit").
- Enzyme preparations ("Creon", "Festal", "Mezim").
- Vitamin and mineral complexes.
Folk Therapy
The treatment of eczema with folk remedies is often resorted to in order to enhance the therapeuticimpact. Unlike over-the-counter medications, home remedies do not have serious side effects, but this does not preclude the need to consult your doctor about their use. In the absence of contraindications, the following methods of folk treatment of eczema are used:
- Potato compress. Pass the raw root crop through a meat grinder and the resulting slurry, slightly squeezing and wrapping in cotton cloth, apply to the affected area. The procedure is carried out several times a day. For maximum effect, the compress is left overnight.
- Homemade birch tar ointment. To the main component in the amount of 1 tbsp. l. add apple cider vinegar (1 tablespoon) and fish oil (3 tablespoons). The mixture is thoroughly mixed and applied to eczematous rashes twice a day. Keep the product on the skin for no more than 15 minutes.
- Healing mixture of garlic and honey. A few crushed cloves of garlic are mixed with 50 g of honey and rubbed every day on the affected areas on the hands.
- Treatment of eczema on the feet with cabbage. Pass fresh leaves through a meat grinder and mix with egg white. Semi-liquid slurry lubricates the affected areas of the skin several times a day.
- Walnuts. Often this method is used to treat childhood eczema. Nuts (unpeeled) are baked in the oven, 3-4 pieces are enough. As soon as they cool down, they need to be thoroughly crushed with a wooden mortar and add a little fish oil. The finished mass is smeared with eczema on the hands, face, and other areasbody.
Additional recommendations
In addition to the use of these medications and folk remedies, the treatment of eczema can be supplemented with physiotherapy procedures. During remission, UV irradiation, acupuncture, paraffin baths are used, and with exacerbated allergic dermatosis, good results can be achieved:
- Electric sleep sessions.
- Course of aeroionotherapy.
- Electrophoresis.
In addition, the treatment of eczema involves compliance with certain dietary restrictions. The dietary menu is built on the principle of exclusion from the diet of allergens and harmful foods (smoked meats, sweets, canned food, fried, s alty, spicy and fatty foods). Alcohol, strong tea and coffee are not allowed.
Therapy for eczema should be aimed at achieving a long-term remission of the disease, during which it is necessary to eat right, avoid stressful situations, strengthen the immune system with vitamins and probiotics. Taking good care of your skin and keeping it he althy with nourishing lotions and creams is essential.
