Neurodermatitis (Atopic dermatitis) – photo, treatment, symptoms and causes
Neurodermatitis is a common chronic hereditary disease, accompanied by a rash and severe itching, which is characterized by frequent exacerbation, especially in winter. It occurs in 12-20% of the world’s population.
In most cases, the disease manifests itself in children (in 90% of cases), especially often in infants (at 6-12 months), a little less often in babies aged 1-5 years. Over time, the manifestations of neurodermatitis subside and in adults, rashes are much less common. Women suffer more often (65%), especially those living in large cities.
In 70% of children aged 14-17, the disease resolves on its own, and in the remaining 30% it becomes chronic.
Neurodermatitis in the photo with a description
Children’s form of neurodermatitis
Causes of Neurodermatitis (Atopic Dermatitis)
The main cause of the disease is the increased sensitivity of the immune system to certain factors. Provoking factors can be foods (chocolate, honey, nuts, citrus fruits, strawberries, fish, caviar), medicines, plant pollen, animal hair, bird feathers, dry fish food, mold, dust, tobacco smoke and many other substances.
Usually enough hereditary predisposition to cause neurodermatitis. If the manifestations of the disease are found in both parents, then the probability of its development in the baby reaches 81%. If one parent is sick, then this figure is 55%, moreover, it is higher if the mother has a pathology.
Sometimes, in addition to a genetic predisposition, an additional “trigger” is required, which can be:
- infections or smoking during pregnancy;
- artificial feeding;
- allergic reactions to food irritants;
- adverse environmental or climatic conditions;
- physical and mental stress;
- stressful situations;
- infectious and parasitic diseases;
- diseases of the digestive and endocrine systems.
There are 2 stages of neurodermatitis: acute and chronic.
In the acute stage, the skin becomes inflamed, red spots and papules, erosions, weeping areas and crusts form on it. The rash is accompanied by severe itching. If a secondary infection joins, then pustular lesions are found.
The following symptoms of neurodermatitis are characteristic of the chronic stage:
- The lower eyelids are covered with multiple deep wrinkles (Denny-Morgan fold)
- Nail plates acquire a “polished” sheen due to constant scratching of the skin;
- The skin around the eyes darkens, peels off;
- The skin on the sole becomes puffy and flaky, reddens and cracks;
- Eyebrow hairs temporarily fall out due to scratching of the skin of the eyelids (pseudo -Hertoga symptom)
- In places of the most pronounced inflammation in the acute stage, the skin is thickened, skin folds are more clearly visible (skin pattern)
Forms of neurodermatitis
Clinical manifestations of neurodermatitis vary depending on the age of the patient, which is clearly seen in the photo. There are 3 forms of the disease: infant, child and adult.
The infantile form occurs in children of the first year and a half of life and is known as diathesis. It is characterized by an acute course. The skin becomes edematous, covered with bright pink spots, vesicles and crusts, pronounced weeping is observed . Most often, the disease manifests itself on the face, but can capture the scalp, buttocks, shins, hands.
In children 2-12 years old, papules and red spots form on the back of the hands, on the flexion surfaces and in skin folds. The skin becomes dry, covered with cracks, a pattern appears on it. A characteristic feature of childhood neurodermatitis is an “atopic face”: the skin becomes dull in color, and darkens around the eyes, an additional fold forms on the lower eyelid.
In adults, a chronic form of neurodermatitis with rare exacerbations is usually diagnosed. The skin thickens, becomes very dry and cracks, a pronounced pattern is noticeable on it. A pale pink rash covers the face and neck, back and chest, hands and feet.
Treatment of neurodermatitis
Treatment of neurodermatitis should be complex. Only in this case it will be possible to get a positive result.
To cope with the disease, you must:
- stop the patient’s contact with the substance that provokes allergies;
- conduct desensitization – reduce sensitivity to the allergen;
- suppress the inflammatory process in the skin;
- get rid of unpleasant symptoms;
- prevent exacerbations;
- treat comorbidities;
- cleanse the body of toxins;
Treatment should be carried out at any stage of neurodermatitis (acute and chronic). In case of concomitant chronic diseases, the dermatologist recommends that the patient consult with other specialists (therapist, pediatrician, allergist, endocrinologist, gastroenterologist, otolaryngologist, pulmonologist).
Treatment of neurodermatitis depends on the symptoms and cause of the disease, the age of the patient and the severity of clinical manifestations. It consists of taking medications, conducting physiotherapy procedures, psychotherapy.
Medical treatment includes taking:
- immunosuppressive agents in severe disease;
- drugs that improve digestive processes in the presence of pathology of the gastrointestinal tract;
- vitamin complexes (vitamins A and D are most often used);
- calming (sedative) drugs.
Drug therapy (antihistamines and immunosuppressive drugs) is usually prescribed for a short period in order to quickly remove the inflammatory process, relieve itching and stop the appearance of new rashes.
Quite often, the disease is complicated by pathological changes in the organs of the gastrointestinal tract. Enterosorbents , probiotics, prebiotics , enzymes, bacteriophages and hepaprotectors will help to remove metabolic products, destroy pathogenic microflora and normalize digestion .
Quite often, people suffering from neurodermatitis have beriberi. Vitamins and mineral elements can be washed out of the body or poorly absorbed due to malfunctions in the functioning of the digestive system. Vitamin-mineral complexes will help to correct the situation, as well as activate metabolism, accelerate regeneration.
Neurodermatitis causes not only physical, but also psychological discomfort. A person feels unattractive, tries to avoid society, his self-esteem decreases, an inferiority complex develops. In especially sensitive people, psychoses and neuroses may appear, which requires the help of a psychotherapist. The specialist will teach you to relax and control the situation, correct the psychological attitude, which contributes to a quick recovery. With depression, excessive irritability, insomnia, fear, he will select sedatives, sleeping pills, antidepressants, tranquilizers.
The most widely used in the treatment of neurodermatitis are external preparations – hormonal and non-hormonal agents.
When choosing hormonal ointments, the doctor takes into account the age of the patient, the severity of the disease and the localization of the rash. For children, as well as in cases where rashes are located on the face, weak agents are recommended. Stronger drugs will be needed for severe disease and severe thickening of the skin.
Glucocorticosteroid drugs have a powerful effect, quickly relieve inflammation and itching, but they can provoke side effects with prolonged use. Therefore, they can usually be used no more than 2-3 weeks.
For long-term maintenance therapy, doctors prefer non-hormonal drugs, among which Losterin preparations stand out (cream, shampoo, shower gel, zinc-naftalan paste, foot cream, hand cream-soap). They contain a balanced combination of active substances that provide the maximum therapeutic effect and are intended for daily skin care for neurodermatitis and other dermatological diseases. In their composition there are no hormones and dyes. They are not addictive and do not provoke side effects. Means of the Losterin line reduce inflammation and itching, eliminate weeping , have an exfoliating effect, eliminate pathogenic microflora, and restore the affected skin.
Physiotherapy procedures can speed up recovery and increase the effectiveness of treatment:
- ultraviolet irradiation;
- laser therapy;
With a combination of physiotherapy and spa treatment, you can achieve a long-term remission lasting several years.
Important attention in the treatment of neurodermatitis should be given to diet. It is necessary to completely exclude from the diet foods that cause an exacerbation of the disease. The basis of the diet should be vegetable dishes, cereals, dairy products, boiled meat.
Diet for neurodermatitis
Food is often responsible for the exacerbation of neurodermatitis. Which product caused an allergic reaction is determined in the laboratory. Based on the results of the study, a specific elimination diet is prescribed, in which the patient’s diet is limited to products that are harmful to his health. The most allergenic foods are fish and fish broths, fried meats and meat broths, chocolate, citrus fruits, sweet berries, honey, nuts, caviar, mushrooms, spicy, pickled, smoked foods, as well as food coloring. With an exacerbation of the disease, it is necessary to completely abandon dangerous foods, in the future, in agreement with the doctor, they can be gradually added to the daily diet. In addition, under the supervision of a doctor, short-term therapeutic starvation is possible. The basis of the diet of a patient with neurodermatitis should be vegetables, cereals, boiled meat, dairy products. Also, the diet can be compiled based on the presence of concomitant diseases.
Means to improve the functioning of the digestive system
Since the course of the pathology is often complicated by concomitant diseases of the digestive system, the treatment of neurodermatitis is combined with therapy aimed at normalizing the work of the stomach and, mainly, the intestines. It has been proven that with the normalization of digestive processes, the treatment of neurodermatitis is faster, since the level of toxidermia in the body decreases and the processes of tissue regeneration are accelerated.
To regulate the work of the digestive organs, drugs of multidirectional action are used:
- enterosorbents are used to remove metabolic products and remove harmful microflora. However, their intake can lead to leaching of vitamins and trace elements, so it is necessary to artificially compensate for their lack. The course of taking enterosorbents is carried out before the course of taking drugs to regulate bowel function. With neurodermatitis, activated charcoal and preparations with the following active ingredients are most often used: attapulgite , diosmectite , polyhydrate polymethylsiloxane , hydrolytic lignin, povidone ;
- preparations for the normalization of intestinal microflora , which include prebiotics (inulin, lactitol , lactulose, lysozyme), probiotics ( bifidumbaterin , bactisubtil, linex , probifor ) , synbiotics ( laminolact , normoflorin , maltodophilus ) , enzymes (pancreatin), hepatoprotectors (phospholipids, beatin , glycyrrhizic acid, ademethionine ), bacteriophages (pseudomonal, staphylococcal, coliproteic ).
Psychotherapy for neurodermatitis
Neurodermatitis is not only a physical, but also a psychological disease that can lead to negative consequences for the patient’s daily life, for example, secondary psychoses and neuroses. The psyche is affected by both constant physical discomfort, itching, pain, and inappropriate attention or even condemnation from society. The patient, in parallel with the main treatment, needs the help of a psychotherapist, psychologist or psychoneurologist (depending on the severity of the disease), who will teach the patient self-control, relaxation methods, and, if necessary, prescribe drugs:
- sedative herbal remedies;
- drugs for insomnia;
- mild tranquilizers and antidepressants.
For the appointment of psychotropic drugs, good reasons are needed, such as fear, insomnia, increased irritability, and depression. Drugs are prescribed in small or medium doses for a certain period of time.
Prevention of neurodermatitis
To avoid the development of exacerbations, it is recommended to constantly use moisturizing preparations (in particular, Losterin cream ), follow a hypoallergenic diet, wear clothes made from natural fabrics, periodically undergo spa treatment.