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Neurodermatitis

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Neurodermatitis

Neurodermatitis

Neurodermatitis is a chronic skin disease of the neurogenic-allergic type, occurring with periods of remission and exacerbation.

In medical terminology, the term "neurodermatitis" was first used in 1891. At that time, this name characterized the pathological process, accompanied by primary skin itching and scratching.

Currently, atopic dermatitis is a disease that accounts for about 40% of the total number of all skin lesions.

Most often, it is detected in childhood, but in the puberty period (puberty), in the absence of other pathologies, it disappears independently. However, parents should be very careful, since in the absence of adequate treatment of neurodermatitis, complications may develop (changes in skin texture, formation of seals, as well as the likelihood of infection being added).

As a prevention of neurodermatitis in childhood, experts recommend that the rules of general hygiene and breastfeeding be strictly adhered to. At the same time, to prevent the development of the pathological process in adults, professional and mental (psychological) hygiene should be observed.



The causes of the development and development of neurodermatitis

  1. Hereditary predisposition
  2. Stress, nervous breakdowns and long-term negative emotions.
  3. Harmful production factors.
  4. Prolonged mental stress and heavy physical labor.
  5. Pathology of the digestive system.
  6. Systematic violation of the regime of the day.
  7. Food, drug and other types of intoxication.
  8. Environmental factors provoking the development of allergic reactions (dry food for aquarium fish, animal hair, woolen things, house dust, some cosmetics, down stuffed pillows and blankets, pollen, food preservatives and some food).
  9. Medications.

Only after the cause of neurodermatitis has been clarified can the treatment of the disease be started.

Types of Neurodermatitis

Neurodermatitis is a disease that has several types that determine the degree of prevalence of the pathological process on the patient's skin.

Limited Neurodermatitis

With the development of a focal form of neurodermatitis, patients complain of the appearance of skin rashes in a confined space. As a rule, in this case, plaques consisting of small papular formations are localized in the neck, on the back of the knees, as well as in the elbow pits, in the anus and genitals. Most often, these plaques are arranged symmetrically and have a regular oval shape. Their color can range from pink to brown. In the affected lesions, the skin is dry, infiltrated, with characteristic lichenification (skin pattern). The peripheral part of the affected lesion is pigmented. It gradually turns into healthy, unchanged skin. In the center of the focus during the examination, it is possible to identify an area that consists of papules as large as a pinhead (or a little more). Papules have a shiny surface and irregular shapes.

With focal neurodermatitis (as with its other forms) no soak is observed. Pathological foci are usually covered with hemorrhagic crusts or gray-white scales. After they fall away, hyper-or depigmented spots remain. During the development of the disease, patients complain of itching, which is aggravated by irritants, and also at night.

Diffuse atopic dermatitis

Diffuse atopic dermatitis , or, as it is also called by clinicians, atopic dermatitis , is a more severe form of pathology characterized by the occurrence of multiple lesions. As a rule, they are localized on the upper and lower extremities (in the popliteal cavities and elbows), as well as on the trunk. However, diffuse atopic dermatitis often affects the neck, genitals, anus and face. In this case, the lesions are confluent, lichenified and infiltrated skin sites. In some places, in addition to lichenification, flat shiny nodules appear. Sometimes patients after scratching, there is a short weeping. As a result, lesions may become infected, complicated by lymphadenitis or pyoderma. Patients suffering from diffuse atopic dermatitis, distinguishes swelling and redness of the skin, often covered with small scales.

In the case when the disease develops in childhood, lesions can also occur on the scalp and around the eyes. During puberty, the pathological manifestations in children often subside.

Hypertrophic Neurodermatitis

Neurodermatitis Ehrmann is a rare form of pathology in which the lesions are located on the inner surface of the thighs and in the inguinal-femoral folds. In this case, patients have a pronounced infiltration and lichenification of the skin, and a pronounced itching, having paroxysmal character. Often the pathological process is accompanied by the appearance of warty-like formations (Kreibich warty atopic dermatitis).

Linear atopic dermatitis

This is a pathology in which the lesions are located mainly on the extensor surfaces of the arms and legs and are in the form of stripes, sometimes with a warty or flaky surface.

Pointed follicular neurodermatitis

With the development of this form of the disease, the papules are located along the mouths of the hair follicles and have a pointed shape.

Depigmented Neurodermatitis

This form of the disease is characterized by the appearance of severe depigmentation (partial or complete loss of pigment by the tissues) in the affected areas.

Dekalviruyuschy neurodermatitis

As a rule, the pathological process affects areas of the body covered with downy hair, and is accompanied by their loss.

Psoriasiform Neurodermatitis

In this case, the lesions are red seals, covered with small silver-white scales. Most often they are localized on the head and neck.

Symptoms of Neurodermatitis

Neurodermatitis symptoms

Neurodermatitis symptoms

The most common signs of the disease include itching, rash, peeling, redness of the skin and neurotic disorders. The most characteristic symptom of neurodermatitis is the occurrence of severe pruritus before the appearance of a rash. Then, small skin nodules with a shiny surface gradually form on the skin. Initially, they do not differ in color from normal skin, and then acquire a brownish-pink color. After some time, the nodular formations begin to merge, forming a solid, covered with flakes or hemorrhagic crusts, a focus with blurred boundaries. The affected skin becomes bluish or purple staining. At the same time, depigmented areas are often observed in old foci.

It should be emphasized that with neurodermatitis the area of ​​distribution of the pathological process is diverse and depends on its type. Most often the lesions are located in the groin, the fold between the buttocks, in the scrotum, on the labia majora, in the popliteal and elbow folds, and also on the neck. With the development of the disease there is a significant decrease in the function of the adrenal glands, in connection with which the patient's skin darkens. However, patients often lose body weight, which has a very negative impact on the general condition of their body. There is also a decrease in blood pressure, there are complaints of fatigue, weakness, apathy and increased nervous irritability. When conducting a diagnostic laboratory study, there is a decrease in the level of glucose in the blood and a decrease in the secretion of gastric juice.

In some cases, atopic dermatitis can cause the development of lymphadenitis (inflammation of the lymph nodes), and this, in turn, leads to a deterioration in the work of many organs.

As a rule, relapses of the disease occur in the cold season, and in the summer period, on the contrary, patients show significant improvements in their health status.

It should be noted that the persons who have localized lesions on the hands are subject to the greatest suffering. This is due to the fact that the hands are most susceptible to the influence of moisture and mechanical stress, aggravating the course of the pathological process.

Diagnosis of atopic dermatitis

First of all, when making a diagnosis, various types of neurodermatitis are differentiated from pruritus, lichen planus, chronic eczema, fungoid mycosis, lymphatic erythroderma, vulvar kraurosis, etc.

Also, data of anamnesis (including family history) are necessarily taken into account. The patient is visually examined, a blood test is taken (to determine the level of immunoglobulin E in serum) and samples from the affected area (in the presence of pustules, bacposus is taken to the microflora). It should be noted that in people suffering from neurodermatitis, the level of class E immunoglobulins in the blood serum is elevated, as well as in these patients there are significant defects in cellular immunity, a decrease in the number of T-lymphocytes is observed, and an increased number of eosinophils is detected in peripheral blood.

Neurodermatitis treatment

The treatment tactics for neurodermatitis is aimed at eliminating the disorders that have provoked the development of the pathological process, as well as at preventing relapses and prolonging remissions.

General therapeutic activities

  1. A strict diet that provides for a complete restriction of marinades, spices, chocolate, spicy and smoked products, citrus fruits, cocoa, whole cow milk, eggs, strong meat broths, etc.
  2. The ban on the presence in the living room of domestic animals, aquarium fish and flowering plants (especially if sensitization is detected).
  3. Daily wet cleaning, as well as the rejection of the carpet, which may be dust mites.
  4. If possible, the clothing of a patient suffering from neurodermatitis should be spacious to eliminate possible friction and pressure. Synthetic and wool things in this situation are contraindicated.
  5. A prerequisite for the patient: a full sleep, the complete elimination of fatigue and stressful situations.
  6. Restriction of water procedures.

The use of sedative and psychotropic drugs

In order to reduce the likelihood of developing neurotic reactions, patients are shown taking psychotropic and sedative drugs, tranquilizers and antidepressants. I would like to emphasize that from herbal preparations, experts recommend using valerian root tincture or peony tincture.

Remediation of chronic infection foci

This is one of the most important conditions that must be met during the complex treatment of neurodermatitis.

Normalization of the gastrointestinal tract

In the event that a patient suffering from neurodermatitis has a dysfunction of the digestive system, then during treatment he is shown taking enzyme preparations (mezim forte, festal, digestal, pancreatin, etc.). In intestinal dysbiosis, probiotics are prescribed, and in severe chronic forms of neurodermatitis, hepatoprotectors.

Systemic drugs used in the treatment of neurodermatitis

The main role in the treatment of this pathology is played by antihistamines (H-histamine blockers).

Generation I drugs include clapyramine, mebhydrolin, chlorpheniramine, promethazine, diphenhydramine.

Terfenadine, astemizole, and fexofenadine are second-generation drugs.

The third generation of drugs includes ebastine, cetirizine and loratadine.

However, in the treatment of neurodermatitis, patients are shown to receive ketotifen (mast cell membrane stabilizer) and cyproheptadine (histamine receptor blocker with antiserotonin activity).

Currently, the most popular drugs of the second and third generations, have a prolonged action and do not have side effects on the central nervous system (impaired reaction speed and coordination of movements, drowsiness, lethargy, etc.).

During exacerbation of the pathological process, patients are shown intravenous administration of a 10% solution of calcium gluconate or 30% sodium thiosulfate. In the event that a secondary bacterial infection joins the acute form of neurodermatitis and furunculosis develops, patients are prescribed antibacterial therapy with the use of broad-spectrum antibiotics.

In severe cases, in violation of the general condition and the occurrence of severe exudation for a short time and with great caution, hormone therapy is prescribed.

At the same time, not so long ago, immune preparations stimulating T-lymphocytes (levamisole, thymalin, timogen, t-activin) were used in the complex therapy of neurodermatitis, and myelopid was used to support B-cell immunity. Also, many experts and patients speak well about cyclosporine. This is an immunosuppressant, which is indicated for the treatment of very severe forms of neurodermatitis, which are not amenable to treatment with traditional drugs.

It is also mandatory during the treatment period that the patient is given vitamin therapy using vitamins A, B, and E.

Preparations for the local treatment of neurodermatitis

For local treatment of neurodermatitis in dermatological practice, various lotions are used (boric, resorcinol, tannin), as well as pastes with tar, ichthyol, naphthalan, etc. In severe cases, non-halogenated corticosteroid ointments of prolonged action that do not cause atrophy and thinning are applied to the affected skin. skin integument. These drugs have a minimum of side effects, and therefore they are allowed to use even in the treatment of young children.

Physiotherapy treatment

A procedure such as phototherapy (using a quartz lamp, ultraviolet irradiation or selective phototherapy) has proven itself very well in treating neurodermatitis. Selective phototherapy, involving the use of UV rays with a wavelength of 315-320 nm, is indicated for patients suffering from neurodermatitis only during the period of remission of the disease. The duration of treatment is 15-20 procedures.

Also, as a physiotherapeutic treatment for neurodermatitis, dermatologists recommend cryomassage (use of liquid nitrogen) and irradiation of lesions with a medical laser.

At the same time, sanatorium and resort treatment (the coast of the Black and Dead Seas) has a very beneficial effect on the patient's body.

Extracorporeal hemocorrection

This is a procedure that involves the processing of components of the patient's blood plasma, or the removal from it of harmful products that trigger the development of the pathological process.

Prevention of Neurodermatitis

In order to prevent the development of neurodermatitis, experts recommend carrying out timely treatment of childhood eczema and atopic diathesis, as well as constantly maintain normal physical and mental well-being. The skin should be constantly protected from overheating or hypothermia, exposure to aggressive substances and other irritants. At the same time, people who are prone to the development of allergic reactions are advised to exclude from their diet foods that can trigger the development and exacerbation of the pathological process, as well as limit the consumption of carbohydrates and salt.


| January 1, 2015 | | 11 198 | Uncategorized
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