Atypical dermatitis — heredity and start-up mechanisms
Specific features and types of the disease
Atypical dermatitis (AD) is an inflammatory process on the skin caused by a hereditary predisposition. The disease is chronic, can take severe forms, relapses are not excluded.
The pathology manifests itself in infants and from time to time there are its symptoms throughout life.
AD is divided into types:
- Localized — skin rashes in one or several small areas with clear outlines.
- Common — multiple affected places, borders remain clear.
- Diffuse — rash rapidly covers almost the entire body.
The type of disease in question may take the following forms:
- Erythematous — one of the most common, this form occurs in 50% of cases.
- Lichenoid — 20% of cases of the number of people suffering from AD.
- Eczematous — 25% of cases recorded.
The main causes of AD
The reasons for the acquisition of such an undesirable disease:
- Genetic predisposition and anomalies.
- Reduced immunity.
- Violation of the gastrointestinal tract.
- Chronic diseases of the gallbladder and/or liver.
- Failures of the ANS.
- Thyroid dysfunction.
The primary cause is inherited predisposition. There are many other factors that cause this disease, in particular, failures in the work of organs and systems, especially immune.
The vast majority of cases are of a genetic nature. The presence of one or another atopic disease in several relatives is stated in family history. Allergies to certain foods, bronchial asthma, and pollinosis are more frequent cases. AD is transmitted through the female line in 60% of cases. For the paternal line, the numbers are much less, only 20%.
As for the twins, identical ones will inherit the same signs, in particular, a predisposition to atypical dermatitis in 70% of cases. In dizygotic cases, concordance probability is 20%.
As a result of immunogenetic studies, physicians find a reasoned confirmation of the presence of a genetic factor.
Some people have genetic abnormalities in the form of thinned skin, which makes it vulnerable and easily prone to skin ailment. Disorders at the gene level are as follows:
Sebostasis — increased dryness of the epidermis, caused by poor sebum production.
Insufficient production of filaggrin (a protein that is responsible for the normal moisture of the skin, regulation of the process of keratinization).
The failure of the lipid barrier — the loss of skin protection from the penetration of harmful microorganisms.
No less important reason is the weakening of the immune system. The human body is in a state of insecurity when the limit of protective properties is reduced to a minimum. As a result, sensitivity and inadequate perception of irritating factors are increased.
Against the background of disorders of the immune system, rapid growth of IgE immunoglobulins is observed. At the cellular level, changes also occur, the number of suppressors and killer cells is reduced, as a result, an imbalance occurs.
Starting factor may be a violation of the digestive tract. In a healthy state, the internal intestinal walls are covered with Peyer’s patches, which are immunomodulators. They, in fact, are a reliable barrier to harmful effects. If the protection is violated, the path for harmful microorganisms is open, and they are sent to the blood by the direct course. If this pathology takes on a chronic form or if the patient develops helminthic invasions, immunity is the first to suffer, which will increase the allergic reactions. As a result, a person has skin pathology.
Liver and gallbladder dysfunction as well can act as an impetus to the appearance of AD.
An immune allergic process is triggered by the influence of factors. They are called triggers. They are divided into specific, characteristic for a particular person and non-specific types.
Triggers of the first type:
- Food allergens.
- Components of pharmacological drugs.
The first most often cause the aggravation of the disease. Such allergens are contained in the next food:
- Milk, soy, eggs.
- Lobsters, crabs, oysters.
- Walnuts, peanuts, almonds.
- Cocoa, chocolate.
The second type of allergen is found in some medicines:
- Antibiotics — Amoxicillin and other penicillin group drugs.
- Sulfonamides — Sulfalene, Sulfadiazine.
- Anticonvulsants — Depakote, Tegretol.
Aeroallergens are factors from the external environment. They cause dermatitis, which can be aggravated by the presence of pollinosis and/or bronchial asthma:
- Wool and animal enzymes.
- Flower pollen.
- Household dust.
- Chemical vapor.
Triggers of non-specific areas are the weather, especially in the off-season; exposure to household chemicals; exacerbation of emotions; strong experiences; synthetic or wool clothing.
Another provoking factor is an occupational hazard when a person has to contact for a long time or inhale harmful fumes or be under stress. People of such professions are most prone to AD.
Symptoms of the disease
The main signs, according to which, it is possible to suggest the presence of AD, are itching, excessive dryness of the epithelium, redness, and rash.
Itching accompanies the patient throughout the illness. It is especially pronounced in cases of lichenoid form when it does not pass even after the disappearance of the rash. In regard of unstoppable itching, a person is not able to tolerate and is forced to scratch the skin in order to quench it a little, but as a result, he is lurking the danger of infection. When the epidermis is injured, wounds appear through which pathogens can get.
Increased dryness of the skin (xerosis) leads to coarsening, roughness and flaking. These are obvious signs of AD. At the first stage, the patient feels the tightness of the skin. Next, peeling occurs, the skin turns red and begins to itch. At the stage of more severe destruction, the coarsening of the skin, the appearance of erosions, deep cracks are observed.
На фото атипичный дерматит у взрослых:
With atypical dermatitis, rashes are noticeable, they are divided into primary and secondary. The first type appears in healthy skin areas. A secondary form is observed against the background of the previous one.
Primary lesions include:
- Spots, localized irregular redness.
- Bubbles with a clear yellowish liquid inside, in severe form with blood particles.
Secondary type includes:
- Crusts and scales.
- Cracks, erosion, wounds.
- Lichenification, coarsening and thickening.
- Hypopigmentation, when skin becomes discolored.
It is important to deal with the symptoms on certain parts of the body that have specific signs.
Dermatitis of the mucous membranes of the mouth is called cheilitis, its main feature is cracked lips with deep folds, very noticeable increased dryness. It is possible for the scales and severe itching to appear.
For patients suffering from chronic skin disease for many years, atopic face forms, creating a kind of extreme fatigue with the following symptoms:
- The face is pale.
- Eyelids are scaly.
- There is a cheilitis.
- The folds on both eyelids become noticeably deep.
Atypical dermatitis of a hairy region of the head especially actively extending to the back of the head and forehead. The appearance of white scales, severe itching are the main signs of the disease.
Lobes of the ear, foot, hand are often affected.
Dermatitis in children has the same symptoms of adult patients. It is accompanied by skin lesions on the face, on the chin, elbows, under the knees. The rash becomes wet, exudative. Often, the rash is transformed into bright red crusts.
На фото симптомы атипичного дерматита у детей:
According to the basic symptoms, the person himself can assume the presence of atypical dermatitis. To confirm or refute such an opinion, an examination and consultation of a dermatologist are necessary. The patient will also need a visit to an allergist, who will find out the presence of hereditary signs, will test for allergens, collect an exhaustive history:
- Genetic predisposition.
- Professional features.
- Stage of the disease.
- Seasonal signs.
- Additional symptoms of colds.
- Chronic diseases.
- Terms of life.
- Reaction to pets.
Based on the information received, the doctor refers the patient to the specialized doctors — a gastroenterologist, an endocrinologist.
Diagnostic measures include laboratory tests:
- Definition of changes in the composition of the blood. An increase in the number of eosinophils is characteristic of AD, more than 5% for children and up to 15% for age-related patients.
- The level of concentration of immunoglobulin E.
- The Phadiatop test allows you to more accurately diagnose disease and identify its cause.
- The presence of allergen-specific antibodies.
Allergological tests are carried out according to such methods:
- Conduct scarification research.
- Prick allergy tests.
With the positive results of allergic methods of diagnosis, the doctor confirms the intended suspicions.
How to treat AD?
The treatment complex is based on the elimination of irritants and the blocking of triggers. In milder forms of illness, this may be enough to get rid of dermatitis.
If the disease progresses, taking medication inside and the use of external remedies are recommended.
Prednisolone is widely used among hormonal drugs.
In cases of the non-hormonal agents, Fenistil can be prescribed at the initial stage.
In a complicated form, the hormone cream Depo-Medrol and/or Elidel are recommended.
Hydrocortisone is prescribed to eliminate edema, remove redness, stop allergic reactions.
Elocom cream can help to cope with the incessant itching.
Dermovat is an external remedy with immunosuppressive and anti-inflammatory effects.
Aclovate is used to narrow blood vessels and relieve inflammation.
Ichthammol ointment is used to prevent unwanted cornification, eliminate infection, prevent secondary infection.
Dorogov’s antiseptic stimulator creams, Actovegin activate metabolic processes, act as effective antiseptics, has a regenerating effect due to the normalization of the lipid layer.
Sulfathiazole silver, Solcoseryl, Thymine ointments also have healing and antiseptic effect.
The group of emollients, which are reducing hypersensitivity, include Topicrem, Lipikar, TriXera, Atoderm, Xemoze.
Tablets of the sedatives’ group, membrane stabilizing, antihistamines can be used as well. Tofisopam, Alprazolam, Ketotifen, Cromoglycate sodium, Zyrtec, Suprastin, Bexidal, Clemastine, Loratadine, Persen, Atarax, Amitriptyline are among such remedies.
If the considered type of the disease develops against the background of chronic illnesses, the treatment program should include corrective measures aimed at eliminating pathologies.
Pathogenetic treatment with Sodermix cream works well on the restoring of the skin and eliminating itching. It has no side effects and is easily tolerated by young and adult patients.
Treatment is prescribed in accordance with the stages of the disease. In the period of the acute form, membrane stabilizers, antihistamines, glucocorticosteroids are prescribed. The need for antibiotics occurs when the skin is infected.
At the stage of remission, supportive therapy is shown, like immunomodulators, moisturizing external agents, sorbents, vitamins use; spa treatment and physiotherapy conduction.
Physical therapy is an integral part of treatment, it enhances the effect of taking medications:
- UV exposure.
- The impact of dynamic currents on the paravertebral nodes.
- Paraffin treatment.
- Electric sleep therapy.
No matter how accurate the selection of pharmacological drugs is, you can’t achieve recovery without a diet.
With the help of a nutritionist, an individual diet is prepared for each patient. The doctor is guided by the basic principles: exclude allergen-containing products; saturate the diet with beneficial microelements and vitamins; exclude meals that give the load on the liver; introduce products that contribute to the normalization of the digestive system; exclusion of gluten.
Forecasts and prevention
Positive predictions are obvious if a person turns to a specialist in time and will follow his recommendations. Complications that lead to a weakening of the organs and systems are not excluded. It is much more difficult to get rid of the severe form, especially if it has become chronic.
In order not to fall into the risk group, it is enough to observe basic hygiene requirements and stick to a healthy diet and an active lifestyle.