Eczema is a polyetiological chronic disease with skin lesions that is prone to relapse and is the most common cause of disability in the practice of dermatology. According to the location of pathogenesis and etiology, there are several clinical types of this pathology. Dyshidrotic eczema is one of them.
Description
In the main structure of skin pathologies, this clinical form is present in 8% of patients. Every person has the opportunity to get sick with an illness, there is no exact data on the relationship of this disease with sex, they are detected in women and men equally, the age category of prevalence is people from 25 to 50 years old, this disease is much less often diagnosed in patients of other ages, especially in children. Residents of the city suffer from this disease more often than residents of villages.
Reason of origin
Long-term studies show that the first places among the causes of dyshidrotic eczemaoccupy:
- occupational hazard factor;
- surface contact with active substances;
- misuse of drugs;
- use of detergents and cosmetics;
- rarely an illness is caused by neuropsychic trauma or prolonged stress;
- abrasions, abrasions, burns;
- hypothermia;
- solar radiation;
- viral diseases.
Is the disease contagious?
Dyshidrotic eczema is not transmitted from person to person. In about 20% of cases, it is not possible to identify the real cause of the disease. Half of the people have a hereditary predisposition to allergies, the presence of pollinosis in parents, atopic dermatitis or bronchial asthma. The cause of eczema is a violation of sweating, often hyperhidrosis of the feet and hands, which is determined by the instability of the autonomic nervous system, a disorder of neuroendocrine regulation of the endocrine glands. In children, pathology can cause neuro-arthritic and catarrhal-exudative diathesis. In such conditions, there is a high excitability of the autonomic nervous system, especially hyperhidrosis of the palms and feet. Dyshidrotic eczema is often found in washers, plasterers, cleaners, workers in chemical organizations, car services, that is, in those people who, by the nature of their speci alty, have direct contact with aggressive substances.
Signs and symptoms
With increased local sweating, the liquid inexcretory ducts of the sweat glands can linger and form:
- sago-like rash, looks like small blisters with a hard coating and a transparent substance inside;
- First, the first manifestations of the rash appear on the lateral parts of the fingers, then they move to the palms or plantar region of the extremities;
- the patient feels severe itching;
- after swelling and hyperemia of local tissues appear;
- vesicles can open on their own or as a result of itching, forming small surface erosions with abundant transparent discharge, the skin of the palms and feet begins to peel off;
- secondary infection often appears, as a result of which wounds can fester, cracks appear on the skin, hyperkeratic layers, skin pattern increases (lichenization);
- pain is connected to an unpleasant itch.
Stages and forms
The disease can take place in all stages at once, thus, when observing, you can see primary rashes, purulent vesicles, skin peeling, erosion and other signs that occur simultaneously. The disease often has a chronic form with stages of remissions and exacerbations. Treatment is poor. Exacerbations cause stress conditions, contact with chemicals, with surfactants, microtrauma, abrasions of the palms and feet, excessive insolation, and allergies. Manifestations of a rash of dyshidrotic eczema on the hands (photo below), which occur in situations of severe stress, in hot weather, go away on their own whenexclusion of the cause if the possibility of secondary infection is eliminated.
It is necessary to pay attention to the fact that people without medical education should not make their own conclusions and establish treatment, it is important to remember that many medical errors occur precisely through the fault of the patients themselves. Untimely appeal to doctors for help, as well as self-treatment, can significantly distort the symptomatic picture, which can significantly complicate high-quality diagnostics. Eczema of the feet and hands should be distinguished from:
- dyshidrotic mycosis;
- plantar psoriasis;
- contact dermatitis;
- and other types of eczema.
And to find out the differences between dyshidrotic eczema (pictured) and mycosis is possible only within the walls of the laboratory, examining tissue scrapings under a microscope. Also, these two pathologies can be diagnosed and combined in one patient.
Diagnosis
A competent specialist can easily diagnose a pathology, relying only on a visual examination of the patient, specific rashes and their locations. The study of the general information of the patient and his immediate family may indicate a hereditary form of the disease. Finding out the exact time of onset of symptoms and blood tests will help to detect other causes of the pathology. In addition, laboratory tests of scrapings are carried out to detect the bacterial cause of infection. Culture of the serous interior of the vesicles can reveal the non-infectious naturediseases. This type of eczema is also differentiated from various fungal skin lesions, psoriasis, dermatitis and other types of eczema. After all the test results are received, the doctor draws up a personal treatment regimen for each patient, taking into account the causes of origin and the stage of symptoms.
Treatment of dyshidrotic eczema
There are quite a few methods of treatment, success requires an individual approach to each patient, the impact on the main detail of the pathogenetic chain (cause of origin). Before treatment, pathological sources are detected and exterminated, which served as a motivating factor - scars after skin lesions, lesions of internal organs, chronic infectious diseases, neuroses. And also, as far as possible, various external circumstances that can have an irritating effect on the skin and nervous system of the patient are excluded. It is not necessary to use several different external agents or oral medications at the same time, in case of intolerance, it will be more difficult to find out which substance stimulated it. Since this category of patients experiences hypersensitivity to drugs, therefore, the ointment is first used in the treatment of dyshidrotic eczema in a limited area, after tolerance has been established in all affected areas. With eczema, the main details of the pathogenetic chain are:
- hormonal disruptions;
- impaired immunity;
- disorders of excretory functions;
- violations of carbohydrate, proteinfat metabolism;
- disorders of the functions of the digestive system;
- disorders of the central nervous system;
- disorders of the autonomic nervous system, which are associated with the exchange of neurotransmitters.
With dyshidrotic eczema of the hands, treatment must be systemic. The main part is aimed at restoring the affected functions of the body as a whole. The course is prescribed, taking into account the stage of the inflammatory process, the presence of the appearance of a rash and pyoderma. The purpose of local therapy is to reduce or eliminate the skin manifestations of the disease, to restore the patient's ability to work. In this case, the means are used, which we will consider in more detail.
Sedatives and antihistamines
Sedatives (hypnotics, sedatives) are prescribed, as well as antihistamines, such as Cetrin, Zirtek, Tavegil, Suparstin, Erius, calcium preparations parenterally. These medications will help relieve an allergic reaction and normalize the emotional background.
Local funds
In case of weeping eczema with manifestations of pyoderma, lotions from solutions are prescribed, dressings are changed every 15-20 minutes:
- boric acid 1-2%;
- resorcinol 0.25%;
- tannin;
- furatsilin;
- silver nitrate.
Creams and ointments: "De-Panthenol", "Epidel", "Destin", "Losterin", "Eplan", "Radevit", "Aisida", "Solcoseryl", "Timogen", "Fenistil", Gistan, Naftaderm, Videstim.
When adding a secondary infection, it is necessary to apply antibacterial ointments - "Levosin", "Bactroban", "Fucidin", "Erythromycin" and "Gentomycin" ointments. Antiseptics can be used - solutions of Miramistin and Chlorhexidine before applying ointments. After the elimination of acute manifestations of the disease, if there are cracks and erosions, ointments that include corticosteroids are recommended only as directed by a doctor with a short course of pulse therapy. It is highly discouraged to use hormonal ointments for a long time, since during their use other external agents may be poorly tolerated and there will be delays in the regression of the rash, they can cause systemic auxiliary effects, steroid dependence and, with prolonged use, can lead to skin atrophy. What else does the treatment of dyshidrotic eczema of the hands involve?
Physiotherapy
Physiotherapy methods are often used. Physical influences can have a beneficial effect on improving the body's resistance, enhance protective and adaptive mechanisms, and reduce the amount of drugs:
- Together with ultrasonic, laser and magnetic effects.
- Cryotherapy.
- Darsonvalization will also be effective.
- Acupuncture.
- Herbal and aromatic baths.
- Electro sleep.
- Recommended radon, mineral, hydrogen sulfide baths.
- Mud treatment in the course of spa treatment. Rest in the summer and autumn seasons contribute to the rapidrecovery, and climate change is also having a good effect.
After such therapy, a significant optimization of the conditions of the skin and the general conditions of the patient's body is recorded.
How to treat dyshidrotic eczema, not everyone knows. A qualified dermatologist will help with this.
Vitamin Therapy
To prevent relapses, it is no less useful to use phyto-vitamin therapy, which is selected for any type of eczema. Vitamins E and A or multivitamin preparations that contain these vitamins - nicotinic acid, ascorbic acid, Retinol, Riboflavin and B vitamins, in particular B1, B6 and B12.
Protection of the skin from external influences
When working with unfamiliar or chemical elements, you must protect your hands with rubber gloves so as not to damage sensitive skin. Wear cotton gloves underneath. This is because the surface inside the rubber gloves is treated with various powders, which tend to irritate the skin, and with the accumulation of natural moisture can cause maceration.
Hygiene
With dyshidrotic eczema of the hands, shampoos and shower gels with dyes and fragrances should not be washed; baby soap or a specially designed hypoallergenic skin care product are considered ideal. The same tips for caring for bed linen and clothes that need to be rinsed twice after automatic washing. If availableskin manifestations on the feet, tights and socks made of synthetics should not be used, in addition to the fact that they cannot absorb moisture and allow air to pass through sufficiently, they can also awaken an allergic reaction. It is important to choose shoes that are “breathable” and comfortable, preferably also made from natural materials. Shoes should be well looked after, washed and dried thoroughly to avoid fungal and bacterial lesions in dyshidrotic eczema on the feet.
Diet
Prevention measures include stabilizing the daily regimen, following a diet, eliminating foods that can awaken allergies, as well as spicy, s alty foods, table s alt, various smoked meats, sausages and cheese, fast-digesting carbohydrates are also needed exclude - flour products, sugar, chocolate products, honey and alcoholic products.
Psychologist help
Dyshidrotic eczema on the legs (we presented the photo), in addition to physical inconvenience, causes rather sensitive moral suffering to the patient due to his unattractive appearance of open skin areas and the increased attention of people around him. If the patient is not able to solve this complex problem on his own, then he is advised to be treated by a psychotherapist.
