Monetovidny eczema
Description:
Monetovidny (numulyarny) eczema - the eczema form which is characterized by existence of often generalized, strongly pruritic, roundish (monetovidny) centers of an eczematic inflammation. Adults are ill more often, men more often than women. The beginning is gradual, without explicit deterioration and without existence of eczema in the anamnesis. Monetovidny eczema often begins with several isolated centers standing; over time there are multiple centers without any specific arrangement. The centers often are resolved or improve after use of topical corticosteroids, but after the termination of their use sometimes are returned to the same place.
Symptoms of monetovidny eczema:
Accurately limited, shelled, round eczematic plaques appear on a trunk and extremities. Moknutiye of the centers and vesiculation are characteristic of disease outbreaks. Consecutive infection can provoke flash a bolezniya. Crusts of honey-yellow color indicate secondary impetiginization.
It is one of the most difficult eczema forms for treatment. Course of a disease changeable and unpredictable. This state can be chronic and recurrent within several years. Having created, the centers tend to keep the size and to recur on earlier affected skin.
Monetovidny eczema
Diagnosis:
The scrappy test yields a positive take in 1/3 cases. Crops can reveal Staphylococcus aureus existence. Antibacterial treatment usually helps, but often does not lead to remission.
Differential diagnosis. Psoriasis (often more symmetric and "geographical" nature of defeat with silvery scales). Fungal infections (the centers regress in the center and are shelled on the periphery; the research about the GAME helps with carrying out the differential diagnosis). A skin T-cellular lymphoma on the lower extremities (it can be taken for monetovidny eczema; the biopsy will help to exclude the diagnosis).
Treatment of monetovidny eczema:
It is necessary to cancel all the optional outside moisturizing drugs accepted inside medicines, dietary additives and drugs from herbs for, at least, 3-4 months. It is necessary to conduct a research on existence of mycosis of feet; a fungal infection, at its existence, treat antifungal drugs as generalized monetovidny eczema can sometimes be "ids-reaction to a fungal infection. It is necessary to apply aggressively a topical steroid of average force of action and the softening emolenta. The topical steroid is applied on the affected skin twice a day within 2-3 weeks. It is the best of all to continue treatment week or a little more longer, than it is necessary for permission of the centers. Efficiency of a topical steroid amplifies at occlusion under a polyethylene film or under a special suit for the sauna, and also at reception moistening bathtub skin before drawing a topical steroid or when using both of these methods.
Consecutive infection treat system antistaphylococcal antibiotics (for example, cefalexin on 250 mg four times a day). In case of an itch appoint antihistaminic drugs. System steroids are not applied to prolonged treatment. The phototherapy can lead to permission of the centers if outside therapy was inefficient. Ultraviolet In narrow and a wide range best of all is suitable for phototherapy; Psoralenum plus ultraviolet And can be applied if ultraviolet In was inefficient.
