Doctors knew about a disease such as eczema 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 called "eczeo", as translated from Greek, this word means "boil." Indeed, the eczematous rash with its appearance is more like a boiling surface.
Today, about 40% of patients visiting a dermatologist face the need to treat eczema. This skin disease is not just 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 that is important to understand is that eczema has a chronic course. 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.
I would also like to note that eczema is not a danger to others, since it is not a contagious disease.
What does a skin disease look like?
Pathology can develop at any age, including children. The first external signs of the disease are abundant vesicular rashes, localized in the hyperemic area of the epidermis. The appearance of a small rash resembles a gurgling, seething surface.
A few days after the appearance of the vesicles open, leaving in their place the so-called "serous wells." As soon as the erosive wetting skin segments begin to dry out, a yellow-gray crust forms. Rashes are local and symmetrical - this is a definite plus for the treatment of eczema. In the photo, the symptoms of external manifestation are demonstrated quite clearly. The external inflammatory process is accompanied by severe itching, burning, pain. The epidermis of open areas of the body is mainly affected. Starting treatment of eczema on the hands is the most common reason for contacting a dermatologist in the autumn, winter and spring, as the disease worsens in the cold season.
Pathogenesis
In fact, an eczematous skin rash is the result of serious metabolic disturbances in the body. The nature of the origin of the disease is still not fully understood. The only thing scientists know for sure - in the development of the disease, the main role belongs to failure in the coordinated work of the immune, endocrine, central and autonomic nervous systems. However, this is not enough to start the pathological process. To activate a dermatological ailment, a simultaneous combination of a number of factors is necessary. In this case, any external or internal stimulus can become a “trigger mechanism”. Therefore, the elimination of a complex of causes of tissue deterioration serves as the basic principle for the treatment of eczema. Symptoms and external manifestations of this disease occur against the background of the following disorders in the body:
- Weakening of the 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 proteins and an increase in cholesterol.
- Inhibition of the antioxidant properties of red blood cells and plasma.
- Failure of the pituitary-adrenal gland 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. Violations 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 have “assistance” in this.
Main stages
Eczema, which proceeds according to the "classical" scenario, declares itself already at the erythematous stage. At this stage, redness of a certain area of the skin is observed. Unaware of the causes of eczema, treatment on the hands and other parts of the body begins with the use of safe external anti-inflammatory drugs.
The next stage is vesicular. It is characterized by the appearance of specific vesicles filled with exudative translucent liquid. The size of the bubble formations rarely exceeds the pin head.
In addition to vesicles, papules and pustules form on the hyperemic surface. When the rashes begin to open, they talk about the beginning of the wetting stage. As soon as the stratum corneum of the skin is desquamated, small erosive lesions covered with dried scales, serous crusts, become visible under it.
Depending on the reasons, the treatment of eczema on the hands (the photo shows the manifestations of the disease at one of its stages) can be built in different ways. The main task that specialists set for themselves is to reduce the severity of symptoms. The greatest discomfort to patients usually brings:
- Severe itching, due to which there are scratches on the skin of patients. Minor injuries of the epidermis are accessible pathways for secondary infection.
- During remission, 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.
The mechanism of development of pathology
In the presence of one or a whole complex of conditions favorable for the occurrence of dermatosis, it remains only a provoking factor, i.e., the direct cause of eczema. The treatment of this skin ailment is to overcome the cascade of autoimmune damaging reactions.
An important role in the development of pathology is played by the dysbiosis of the epidermis and intestinal microflora, which is caused by the suppression of the growth of “healthy” bacteria that are conditionally pathogenic and pathogenic, and, as a result, a change in the ratio between them.
Such a skin disease can be caused by many causes. Treatment of eczema in any of the clinical cases, regardless of the etiology, does not lead to a complete recovery. The hardest thing is to prevent the recurrence of dermatosis in a person who has a hereditary tendency to this disease. By the way, the genetic markers of the idiopathic form are confirmed in 40% of cases.
In addition to heredity, factors of neurogenic, allergic, immunological, endocrine and metabolic nature can cause eczema. Treatment (the photo shows one of the ways) may be required when exposed to the following factors:
- Stress.
- Infectious pathogens.
- Vaccines.
- Chemicals.
- Medication.
An allergic reaction of the body to food products can become an impetus for the development of eczema. The most common irritants are citrus fruits, chocolate, strawberries, nuts, honey, cow's milk protein.
Types of Dermatosis
A single classification of eczema in modern dermatology does not yet exist. However, doctors confirm that the disease has many forms, can occur acutely, subacute and chronically. Most often, experts adhere to the following typology of eczema:
- True (idiopathic).
- Professional.
- Microbial.
- Seborrheic.
- Children’s.
Clinical signs and nature of the course depend on the specific type of dermatosis, as well as further tactics for the treatment of eczema. From the photo on the hands or other parts of the body, it is difficult to determine the type of dermatosis.
Idiopathic eczema
With a true variety of allergic dermatosis, the skin of the limbs is most often affected. For this type of pathology, the staging described above is characteristic. In the case of the attachment of a bacterial infection, pustules with purulent contents form. Weeping eczema is rare in chronic form.
Idiopathic eczema is also divided into two types:
- Pruriginous. 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 of the bend of the elbows, knees, hips. Remissions with this kind of true eczema are rare.
- Dyshidrotic. It differs from the rest by the presence of small bubbles located between the toes or hands. The treatment of eczema of a dyshidrotic form differs from the therapy of other types of the disease due to the peculiarities of the vesicular stage: the vesicles may not open, but immediately form a crust. The accumulation of rashes is clearly demarcated from a healthy epidermis by severe inflammation, swelling and hyperemia.
Microbial eczema
This species has specific differences. Microbial eczema develops in the presence of chronic infections in humans. The pathological process leads to the development of an autoimmune damaging reaction. The most often provoke the development of microbial eczema is possible for such representatives of pathogenic microflora:
- Staphylococcus aureus.
- Hemolytic streptococcus.
- Candida.
- E. coli.
- Pseudomonas aeruginosa.
- Proteins.
Microbial eczema is manifested by an asymmetric rash that affects the lower legs, the back of the palms, and the scalp. Rashes 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 veins. Vesicles appear around trophic ulcers of the lower legs, the cause of which is usually a strong weakening of the trophic tissue due to varicose veins. Treatment of eczema on the legs begins with the treatment of the underlying disease.
- Post-traumatic. An eczematous rash is concentrated in places of skin lesions (wounds, including postoperative ones, fistulas, burns). Often post-traumatic eczema develops on the cult after amputation of the limb.
- Nummular. The second name for this form of dermatosis is coin-shaped, which is explained by the large diameter (from one to several centimeters) of the vesicles. The disease proceeds with severe swelling, weeping. Affected areas are delimited from healthy tissues.
- Eczema of the nipples. To a greater extent refers to the post-traumatic subspecies. It mainly occurs due to nipple injuries during lactation. Inflammation of the skin goes through all the stages described.
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). External manifestations of such eczema are distinguished by rounded yellowish-pink spots, covered with dense scales. In patients with seborrheic dermatosis, the hair sticks together in bundles, constantly glistens, and in the behind-the-ear areas serous crusts are formed, which itch heavily.
Occupational eczema
It develops against the background of constant contact with a manufacturing irritant. With occupational eczema, the epidermis is affected in areas directly in 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 stimulus, the more complications relapse brings with it. Without eliminating the provoking factor, it will not be possible to achieve improvement.
Skin disease in children
The reason for the development of eczema in babies is considered to be atopic dermatitis, which can develop against the background of:
- Heredity.
- Severely ongoing pregnancy, which was accompanied by toxicosis.
- Pathology of the kidneys, pancreas, liver.
- Malnutrition.
It is worth noting that in childhood, eczema is most likely to occur in babies, one or both of whose parents suffer from dermatosis. Often childhood eczema is accompanied by asthma, food allergies, intestinal dysbiosis. The disease proceeds according to the "standard" scheme, manifested by rashes on the face, head, neck, and gradually spreading throughout the body.
Therapies
Consider how eczema is treated. A photo of different eczematous rashes suggests that for each specific case, the therapy will be different. In fact, the general treatment regimen for eczema is built according to a single algorithm, but the selection of drugs will depend on the severity of 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 weeps, lotions with antiseptic solutions are used: boric acid, Chlorhexidine, Resorcinol. Erosion can be dried using Fucorcin, an alcoholic solution of brilliant green greens.
- To eliminate inflammation during an exacerbation, hormonal ointments are used (Flutsinar, Celestoderm, Sinaflan, Advantan, Afloderm). They cannot be applied to wet areas. The duration of treatment is determined by a dermatologist.
- To combat a secondary infection or a microbial form of eczema, local antibiotics are included in the therapeutic plan (ointments Levomekol, Oxycort, Pimafukort, Gyoksizon).
- To start regenerative processes and healing soft tissues, sulfuric, ichthyol, tar ointments are used. These drugs usually replace corticosteroids.
- To soften the crusts, Salicylic Ointment, lotions and oils are used.
Treatment of eczema during an exacerbation period completely eliminates water procedures. In addition to local medicines, resort to the use of systemic drugs:
- Antihistamine group (“Loratadin”, “Cetirizine”, “Claritin”, “Tavegil”, “Tsetrin”).
- 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 infusion 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, Lactovit).
- Enzyme preparations ("Creon", "Festal", "Mezim").
- Vitamin and mineral complexes.
Alternative methods of therapy
The treatment of eczema with folk remedies is often resorted to in order to enhance the therapeutic effect. Unlike drugs with potent drugs, home medicines do not have serious side effects, but this does not exclude the need for advice from your doctor about their use. In the absence of contraindications, the following methods of alternative treatment of eczema are used:
- Potato compress. Feed the raw root crop through a meat grinder and the resulting slurry, slightly squeezed and wrapped 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 ointment from birch tar. To the main component in an amount of 1 tbsp. l add apple cider vinegar (1 tbsp. l.) and fish oil (3 tbsp. l.). 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.
- Therapeutic mixture of garlic and honey. A few chopped garlic cloves are mixed with 50 g of honey and rubbed every day into the affected areas on the hands.
- Treatment of eczema on the legs with cabbage. Feed fresh sheets through a meat grinder and mix with egg white. Semi-liquid slurry lubricate 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. Once cooled, they need to be thoroughly crushed with a wooden stupa and add a little fish oil. The finished mass is lubricated with eczema on the hands, face, and other parts of the body.
Additional recommendations
In addition to the use of these medications and folk remedies, the treatment of eczema can be supplemented by physiotherapeutic procedures. During remission, UV irradiation, acupuncture, paraffin baths are used, and with acute allergic dermatosis, good results can be achieved:
- Sessions of electric sleep.
- Aeroionotherapy course.
- Electrophoresis
In addition, the treatment of eczema involves observing certain dietary restrictions. The diet menu is built on the principle of eliminating allergens and harmful products from the diet (smoked meats, sweets, canned food, fried, salty, spicy and fatty foods). Alcohol, strong tea and coffee are not allowed.
Eczema therapy should be aimed at achieving long-term remission of the disease, during which it is necessary to eat properly, avoid stressful situations, strengthen immunity with vitamins and probiotics. Of great importance is quality skin care and maintaining its healthy condition with the help of nourishing lotions and creams.