Description of the disease Eczema
is an acute or chronic inflammation of the superficial layers of the skin of a neuro-allergic nature occurring in response to external or internal stimuli. It is a variety of skin disorders, such as areas of dry skin, redness, swelling, cracks, dry skin or wet lesions. Such affected skin is easily susceptible to infection. Therefore, acne or pustules may accompany eczema.
Causes of eczema
Eczema has no traditionally recognized cause of occurrence. It can be a variety of external (mechanical, chemical, thermal, etc.) and internal (liver, kidney, gastrointestinal tract, endocrine, nervous system, etc.) factors. Polygenic multifactorial inheritance of eczema with pronounced expression and penetrance of genes has also been established. Therefore, this disease is not considered contagious. At present, up to 40 percent of all skin diseases fall precisely on eczema, an increasing number of people suffer from this disease. Children are no exception. Despite the general belief that eczema is always a long-term or chronic disease, it can have and acute nature, quickly arising and just as quickly disappearing. However, only proper treatment at the first signs of the disease can prevent the disease from becoming chronic and last a lifetime.
Types of eczema
Distinguish such basic forms of eczema: true, microbial, seborrheic, occupational, pediatric and atopic.
It could be:
True eczema usually begins acutely at any age, proceeds with frequent relapses and, as a rule, passes into a chronic stage with periodic exacerbations. In the acute stage, the process is characterized by a rash of microvesicles (as a result of spongiosis), located on an edematous erythematous background. Vesicles quickly open, exposing small pinpoint erosions (eczematous wells), separating serous exudate (sputum) – wet acute eczema.
As the inflammatory phenomena subside, the number of vesicles decreases, erosions dry up and on the surface of the foci appear bran-like flakes and small crusts from dried vesicles. Transition of the process to the chronic stage occurs gradually, accompanied by the appearance of stagnant erythema, scales and cracks. Foci of true erythema are of varying size, indistinct contours and scattered like islands of an archipelago, alternating with areas of healthy skin. The process is usually symmetrical and localized mainly on the back of the hands, forearms, feet, in children – on the face, buttocks, limbs, chest. Itching is bothersome. The process can seize and other areas of the skin. A variant of true eczema is
dyshidrotic eczema, localized on the palms, soles and lateral surfaces of the fingers and characterized by the appearance of many small densely covered vesicles 1-3 mm in diameter, resembling digested cycad grains. Erythema in the lesions due to the great thickness of the stratum corneum in these areas is poorly expressed. Foci of dyshidrotic eczema in the developed form are clearly circumscribed and often surrounded by a rim of the stratum corneum, beyond which new vesicles can be seen during exacerbation. Microerosions, crusts, scales are also seen in the center of the foci.
Microbial eczema occurs more often due to secondary eczematization of foci of pyoderma, mycosis (mycotic eczema), infected trauma, burns, fistulas (paratraumatic eczema), against the background of trophic disorders on the lower limbs with trophic ulcers, lymphostasis (varicose eczema). Foci of lesions in this case are often located asymmetrically, have sharp boundaries, rounded or festooned outlines, on the periphery of which is often visible collar of the stratum corneum. The focus is represented by juicy erythema with lamellar crusts, after removal of which an intensely wet surface is revealed, against the background of which bright red small pinpoint erosions with drops of serous exudate are clearly visible. Microvesicles, small pustules, seropapules are seen around the main focus. Allergic rashes (allergic rashes) may occur away from the main focus.
A peculiar type of microbial eczema is
nummular (coin-shaped) eczema, characterized by the formation of sharply circumscribed round lesions with a diameter of 1.5 to 3 cm or more, bluish-red in color with vesicles, seropapules, sputum, scales on the surface. Foci of lesions are more often localized on the back of the hands and extensor surfaces of the extremities.
Seborrheic eczema is often associated with the presence of Pityrosporum ovale in lesions. Fungi of the genus Candida may also play an antigenic role. Seborrhea and associated neuroendocrine disorders are implicated in the development of the disease. Affected scalp, forehead, skin folds behind the ear flaps, upper chest, interscapular region, folds of the extremities. On the scalp against the background of dry hyperemic skin there is a large number of gray bran-like scales, serous yellow crusts, after removal of which exposes the wet surface. The boundaries of the foci are clear, the hair is glued. In the folds of the skin – edema, hyperemia, deep painful cracks, on the periphery of foci – yellow scales or scales-crusts. On the trunk and extremities there are yellow-pink flakes with clear boundaries, in the center of foci – sometimes small nodular elements.
nummular (coin-shaped) eczema, characterized by the formation of sharply circumscribed round lesions with a diameter of 1.5 to 3 cm or more, bluish-red in color with vesicles, seropapules, sputum, scales on the surface. Foci of lesions are more often localized on the back of the hands and extensor surfaces of the extremities.
Children’s eczema presents with clinical signs of true, seborrheic, and microbial eczema, and these signs may be combined in various combinations, with some areas showing predominant signs of true eczema and others of seborrheic or microbial eczema. Signs of eczema in children (usually on artificial feeding) appear at the age of 3-6 months. Foci of lesions are symmetrical, their boundaries are indistinct. The skin in the lesions is hyperemic, edematous, on this background there are microvesicles and areas of sputum in the form of wells, as well as yellow-brown crusts, scales, rarely papules. At first, the cheeks and forehead are affected (the nasolabial triangle remains intact), then the process spreads to the scalp, ear lobes, neck, extensor surfaces of the limbs, buttocks, trunk. Children suffer from itching and insomnia. The clinical picture of seborrheic eczema can develop as early as 2-3 weeks of life against the background of reduced nutrition. The rash is localized on the scalp, forehead, cheeks, ear lobes, behind the ear and neck folds.
Occupational eczema is an allergic skin disease that develops as a result of contact with irritants in the workplace. At first, open areas of the skin are affected: the back of the hands, forearms, face, neck, less often – shins and feet. The lesions are hyperemic, edematous, with the presence of vesicles, wet and itchy. Over time, signs characteristic of true eczema appear. The course is long, but regression occurs quickly after the elimination of contact with the production allergen. However, each new exacerbation becomes more severe.
Atopic eczema – Patients with atopic eczema have very dry skin with a tendency to flake. The skin may become red and inflamed in some areas. This inflammation is accompanied by intense itching, causing the patient to scratch the skin. The scratching is an open gateway for bacterial infection and pustules appear on the affected skin in this area.
Eczema is chronic with periods of exacerbations and remissions and is often complicated by the accession of pyoderma and herpes.
Eczema: treatment with cellular preparations
Derm.Com dermatology specialists at CoolaserClinic’s dermatology division recommend cellular treatments for eczema.
