Eczema is a polyetiological chronic disease with skin lesions that is prone to relapse and is the most common cause of disability in dermatology practice. In accordance with the location of pathogenesis and etiology, there are several clinical types of this pathology. Dyshidrotic eczema is one such.
Description
In the basic structure of skin pathologies, this clinical form is present in 8% of patients. Every person has the opportunity to get sick with an ailment; there is no exact data on the relationship of this disease with sex; women and men are identified equally, the age category of prevalence is people from 25 to 50 years old, they are much less likely to diagnose this disease in patients of other ages, especially in children. Residents of the city suffer from this disease more often than villagers.
Reasons for origin
Long-term studies show that the first places among the causes of dyshidrotic eczema are:
- occupational hazard factor;
- surface contact with active substances;
- misuse of drugs;
- the use of detergents and cosmetics;
- rarely the disease is caused by a psychological trauma or prolonged stress;
- scuffs, abrasions, burns;
- hypothermia;
- solar radiation;
- viral diseases.
Is the disease contagious?
Dyshidrotic eczema is not transmitted from person to person. In approximately 20% of cases, it is not possible to identify the real cause of the disease. Half of people have a hereditary predisposition to allergies, the presence of parents with hay fever, atopic dermatitis or bronchial asthma. The cause of eczema is sweating disorders, often hyperhidrosis of the feet and hands, which is determined by the instability of the autonomic nervous system, a disorder of the neuroendocrine regulation of endocrine glands. In children, neuro-arthritic and catarrhal-exudative diathesis can cause pathology. In such conditions, there is a high excitability of the autonomic nervous system, in particular hyperhidrosis of the palms and feet. Dyshidrotic eczema is often found in washers, plasters, cleaners, workers in chemical organizations, car services, that is, those people who, by the nature of their specialty, have direct contact with aggressive substances.
Signs and Symptoms
With increased local sweating, the fluid in the excretory ducts of the sweat glands can linger and form:
- a sag-like rash, looks like small bubbles with a hard coating and a transparent substance inside;
- first, the first manifestations of the rash occur on the lateral parts of the fingers, then pass on to the palms or the plantar region of the limbs;
- the patient at the same time feels severe itching;
- after edema and hyperemia of local tissues appear;
- vesicles can open themselves or as a result of scratching, forming small surface erosions with copious 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, the skin pattern intensifies (lichenization);
- pain is connected to an unpleasant itch.
Stage and Form
The disease can pass in all stages at once, thus, during observation, you can see the primary rashes, purulent vesicles, peeling of the skin, erosion and other signs that occur simultaneously. The disease often has a chronic form with stages of remissions and exacerbations. Treats poorly. Exacerbations cause stress, contact with chemicals, surfactants, microtrauma, rubbing of the hands and feet, excessive insolation, allergies. Manifestations of a rash of dyshidrotic eczema on the hands (photo below) that occur in situations of severe stress in hot weather go away on their own if the cause is eliminated, if the likelihood of a secondary infection is eliminated.
It is necessary to pay attention to the fact that people without a medical education should not independently conclude and establish treatment; it is important to remember that many medical errors arise precisely because of the fault of the patients themselves. Untimely appeal to doctors for help, as well as self-medication can significantly distort the symptomatic picture, which can significantly complicate the quality diagnosis. It should distinguish eczema of the feet and hands from:
- dyshidrotic mycosis;
- plantar-palmar psoriasis;
- contact dermatitis;
- and other types of eczema.
And to find out the differences between dyshidrotic eczema (pictured) and mycosis can only be done in the walls of the laboratory by examining tissue scrapings under a microscope. Also, these two pathologies can be diagnosed and combined in one patient.
Diagnostics
A competent specialist can easily diagnose a pathology, relying only on a visual examination of the patient, specific rashes and their location. A 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 the onset of symptoms and blood tests will help to find other causes of the pathology. In addition, laboratory tests of scraping are performed to detect the bacterial cause of infection. Sowing the serous inside of the vesicles can determine the non-infectious nature of the disease. Differentiation of this type of eczema from various fungal skin lesions, psoriasis, dermatitis and other types of eczema is also carried out. After all the test results are obtained, the doctor draws up a personal treatment regimen for each patient, taking into account the causes of origin and the stage of symptoms.
Treatment for dyshidrotic eczema
There are quite a few treatment methods, for success, an individual approach to each patient is required, exposure to the main part of the pathogenetic chain (cause of origin). Before treatment, pathological sources are detected and exterminated, which served as an inducing factor - scars after skin lesions, damage to internal organs, chronic infectious diseases, neuroses. And also, whenever possible, various external circumstances are excluded, which can have an irritating effect on the patient’s skin and nervous system. You do not need to use several different external drugs 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;
- immunity disorders;
- violation of excretory functions;
- disorders of carbohydrate, protein fat metabolism;
- digestive system disorders;
- 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, given the stage of the inflammatory process, the presence of the appearance of a rash and pyoderma. The goal of local therapy is to reduce or eliminate skin manifestations of the disease, to restore the patient's ability to work. In this case, tools are used, which we will consider in more detail.
Soothing and antihistamines
Prescribing sedatives (sleeping pills, sedatives), as well as antihistamines, such as Tsetrin, Zirtek, Tavegil, Suparstin, Erius, parenteral calcium preparations. These drugs will help relieve an allergic reaction and normalize the emotional background.
Local funds
With weeping eczema with manifestations of pyoderma, lotions from solutions are prescribed, dressings are replaced 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, Weidestim.
When secondary infection is added, it is necessary to use antibacterial ointments - Levosin, Bactroban, Fucidin, Erythromycin and Gentomycin ointments. You can use antiseptics - Miramistin and Chlorhexidine solutions before applying the ointment. After elimination of the acute manifestations of the disease, if there are cracks and erosion, ointments that include corticosteroids are recommended only by prescription by a short course of pulse therapy. It is not recommended to use hormonal ointments for a long time, since during their use other external agents can be poorly tolerated and there will be delays in the reverse development of the rash, they can cause systemic auxiliary effects, steroid dependence and can lead to skin atrophy with prolonged use . What else involves the treatment of dyshidrotic eczema of the hands?
Physiotherapy
Physiotherapy methods are often used. Physical effects can have a beneficial effect on improving the body's resistance, strengthen protective and adaptive mechanisms, and reduce the number of drugs:
- Together with ultrasonic, laser and magnetic influences.
- Cryotherapy.
- Darsonvalization will also be effective.
- Acupuncture
- Herbal and aromatic baths.
- Electrosleep.
- Radon, mineral, hydrogen sulfide baths are recommended.
- Mud therapy in the course of spa treatment. Rest in the summer and autumn seasons contribute to a quick recovery, and also has a good impact on climate change.
After such therapy, significant optimization of the conditions of the skin and 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 relapse, it is equally 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 are nicotinic acid, ascorbic acid, Retinol, Riboflavin and B vitamins, in particular B1, B6 and B12.
Protecting the skin from external influences
When working with unfamiliar or chemical elements, protect your hands with rubber gloves so as not to damage sensitive skin. Cotton gloves should be worn under them. 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, you can not wash with shampoos and shower gels with dyes and fragrances, baby soap or a specially designed hypoallergenic skin care product are considered ideal remedies. The same tips for the care of bedding and clothes, which after automatic washing must be rinsed twice. If there are skin manifestations on the feet, you can not use tights and socks made of synthetics, in addition to the fact that they can’t absorb moisture and air enough, they can also cause an allergic reaction. Shoes are important to choose a "breathable" and comfortable, preferably also from natural materials. Shoes should be well looked after, thoroughly washed and dried to avoid fungal and bacterial lesions with dyshidrotic eczema on the legs.
Diet
Prevention measures include stabilizing the daily routine, dieting, and eliminating foods from the diet that can trigger allergies, as well as spicy, salty foods, salt, various smoked meats, sausages, and cheese, and fast-digesting carbohydrates should be excluded - flour products, sugar, chocolate products, honey and alcohol products.
Psychologist's help
Dyshidrotic eczema on the legs (the photo we presented) in addition to physical inconvenience causes rather sensitive moral suffering to the patient due to his unattractive appearance of exposed skin and increased attention of people around. If the patient is not able to independently solve this complex problem, then he is advised to receive treatment from a psychotherapist.