Neurodermatitis

Description:

The chronic skin disease having the neurogenic and allergic origin which is shown in the form of the papular rashes inclined to merge which are characterized by an itch.

Neurodermatitis symptoms:

At diffusion neurodermatitis there is an infiltration from likhenizatsiy skin arising against the background of neostrovospalitelny erubescence. The centers of the affected skin are located more often on a face, a neck, elbow bends and in subnodal hollows, and also on the internal surfaces of hips and in the field of generative organs. The centers of defeat are presented by primary morphological elements in the form of the epidermo-dermalny papules having usual skin color. These papules in some places merge among themselves and form sites of continuous papular infiltration. In the centers skin dry, with a set of excoriations and small scaly scales. In the field of skin folds cracks against the background of infiltration are often formed.

The typical clinical picture of neurodermatitis is presented by damage of skin in the rash form, a severe itch, neurotic disturbances of different degree, a white dermographism, a pronounced pilomotor reflex. Depression of function of adrenal glands at neurodermatitis is expressed by a hyperpegmentation (swarthiness) of skin, weight reduction, increased fatigue, weakness, lowering of arterial pressure, low secretion of a gastric juice, a hypoglycemia (decrease in glucose of blood), urination reduction, allergic reactions.

Seasonality during neurodermatitis is characteristic: in the summer improvement is observed, and in the winter process escalates.

Limited neurodermatitis

Limited neurodermatitis, despite defeat of certain sites of skin, causes in patients painful sufferings because of a sharp itch in the defeat centers which arises in the evenings or to nights more often. The characteristic locations of limited neurodermatitis are the back and side surfaces of a neck, skin around an anus and generative organs with involvement in process of skin of an internal surface of hips, mezhjyagodichny folds, flexion surfaces in large joints. At the initial stages of process skin in places of defeat is externally not changed. Eventually as a result of an itch and having combed dense papules, places with scaly scales appear. Further some, more often lichenoid papules merge among themselves therefore continuous papular infiltration of a flat form of oval or round outlines from light pink till brownish-red color is formed.

Over time the skin drawing is emphasized, exaggerated, i.e. lichenification develops. The shagreen type of skin forms. At limited neurodermatitis in typical cases distinguish three zones: central, average and peripheral.

There is an erythema not of ostrovospalitelny character against the background of which excoriations or raschesa are quite often observed, fresh or covered with hemorrhagic (bloody) crusts. At an aggravation of process the peeling amplifies, the erythema becomes brighter. The disease proceeds is long, quite often for years.

Neurodermatitis reasons:

Internal causes, such as are the cornerstone of neurodermatitis: disturbance of normal functioning of a nervous system, internals, metabolism. Considerable value has influence of harmful factors of the environment. The leading symptom of neurodermatitis is the constant and intensive itch which arises against the background of various neurotic frustration. It is the increased or lowered excitability, bystry permeability, emotional lability, an adynamy, sleeplessness, etc. Besides, patients with neurodermatitis have disturbances of the autonomic nervous system that is shown in the form of a resistant white dermographism, disturbances of thermal control, department of sweat and skin fat, a pronounced pilomotor reflex etc.

At some patients of disturbance of functions of the central nervous system have secondary character because of it is long the existing painful itch and sleeplessness. In these cases these frustration burden the course of neurodermatitis and in fact are pathogenetic factors.

Thus, a peculiar vicious circle when heavy neurodermatitis worsens frustration of a nervous system is formed, and these neurotic frustration make heavier neurodermatitis. Most of patients with neurodermatitis has disturbances of functioning of bark of adrenal glands, a thyroid gland, gonads. The emotional instability, nervous irritability, sleep disorders caused by an intensive and long itch are stressorny factors for an organism. They break function of bark of adrenal glands, reducing it more often, and at long and a severe disease and exhaust it. The exhausted adrenal glands react allocation of low amount of corticosteroid hormones (a cortisone and a hydrocortisone). As corticosteroid hormones have antiinflammatory properties, and the need for them at patients with neurodermatitis is increased, reduction of their allocation leads to strengthening of inflammatory reaction. All this causes an aggravation of pathological process on skin, emergence or strengthening of allergic reactions. This mechanism influences a process aggravation at patients with neurodermatitis after psychological injuries. At patients with neurodermatitis function of a thyroid gland is often increased, and also quite often there is dysfunction of gonads, i.e. neuroendocrinal dysfunctions and allergic reactions play the leading role in an etiology and a pathogeny of this disease. An overstrain of a nervous system for a long time and disturbance of work of closed glands create a background for development of allergic reactions and neurodermatitis which is skin neurosis. At neurodermatitis the large role is played by predisposition of an organism to allergic reactions of various type.

Points a set of factors to it.

    * People who at children's age had an eczema which arose against the background of diathesis have often widespread neurodermatitis. In addition to children's eczema and other types of eczema at a long current pass into neurodermatitis.
    * Against the background of focal neurodermatitis allergic rash and an itch are available on sites of skin, remote from the main center.
    * Many patients with neurodermatitis have hypersensitivity to medicines, especially to antibiotics, and also to foodstuff.
    * Often neurodermatitis occurs at patients with various diseases of allergic genesis (bronchial asthma, a small tortoiseshell, vasculomotor rhinitis, etc.).
    * A considerable part of patients with neurodermatitis has sharply positive immunological reactions which indicate existence in an organism of autoantibodies.

The reason of limited neurodermatitis and local itch in the field of an anus is the chronic inflammation of a mucous membrane of a lower part of a large intestine. This inflammation develops against the background of chronic gastritis, a coloenteritis, colitis, a gastroenterocolitis which often are followed by disturbances of a chair. Locks conduct to an organism endointoxication owing to penetration of toxic substances from intestines. At diarrhea the slime which is present at Calais irritates a mucous membrane and skin in the field of an anus that leads to emergence or an exacerbation of neurodermatitis in this area.

The background for development of fungal and barmy infections is created. Besides, the proctal itch can arise in the presence of an anal fissure, hemorrhoidal nodes (outside and internal), a helminthic invasion (first of all pinworms).

The mechanism of limited neurodermatitis of external genitals are neurosexual disturbances, an inflammation of genitalias (acute and chronic), hormonal dysfunctions of gonads.

Treatment of Neurodermatitis:

At diffusion process sedative (soothing) drugs are appointed, the psychotherapy is carried out. At persistent disease, the exhausting itch, at tendency to merge of the centers of defeat and in cases when other methods of treatment are low effective, apply corticosteroid hormones in the low and gradually decreasing doses.

For normalization of activity of the central nervous system tranquilizers (Seduxenum, Elenium, a librium, etc.), ganglioblokator are appointed (Nanophynum, aminazine, Hexonium, geksametony, etc.).

For the purpose of decrease in a sensitization of an organism use antihistaminic drugs which possess also antipruritic action: tavegil, Suprastinum, Dimedrol, isopromethazine, etc. Vitamins of group B, PP, A are reasonable. The patient of advanced age appoint methyltestosterone. From physiotherapeutic means radonic and hydrosulphuric bathtubs, uviolizings are recommended. Well bathtubs with broth of a train, oak bark and a camomile help.

After hydrotherapeutic procedures dry skin needs to be greased with fat nutritious oils, preferably olive. Also apply ointments with Naphthalanum, tar, sulfur, Ichthyolum which have keratoplastichesky effect. On the separate struck centers impose ointments with corticosteroid drugs ("Synalarum", "Locacortenum", Flutsenar, "Ftorokortum", etc.). If there is consecutive infection, then apply aniline paints, ointments "Oxycortum", "Geocortonum", "Locacortenum of N", "Locacortenum Vioformum".

The patient the diet with restriction of acute and smoked products is necessary, for salt, alcoholic drinks. For prevention of a recurrence and lengthening of remissions (improvements) long stay of patients with summer in the south is recommended, it is desirable on the Southern coast of the Crimea, sanitation of the centers of persistent infection, an exception of medicinal, household and food-borne allergens is necessary.