Allergic dermatitis is a common dermatological disease of an allergic nature, developing as a response to the effect of an irritating factor, in our case the allergen. The onset of allergic dermatitis is largely predetermined by the predisposition of the patient's organism to the development of allergic reactions. The speed of dermatitis varies from a few hours to several weeks
Causes of allergic dermatitis
Allergic dermatitis is an allergic reaction of the body of delayed action, in other words, the allergy develops over a long period of time, in the case of a sufficiently long contact of the organism with a provoking stimulus. In such cases, allergic reactions involve specific immune cells (more often lymphocytes), and antibodies. This is confirmed by studies of the material obtained from the pathological focus, during which there is always a fairly characteristic sign - in the pathological focus there are large accumulations of immune cells that left the bloodstream.
The allergens that provoke the development of this disease are allergies most often. Most often these are various washing powders, nickel, chrome, insecticides and their compounds. A lot of allergens among cosmetics and drugs: various hair colors, antibacterial ointments, sintomycin emulsion, etc. Directly the allergen itself can often cause an allergic reaction due to its very small size, but getting into the bloodstream it comes into contact with fairly large proteins blood. But the resulting compounds and become the most provoking the development of a response by allergens.
Recently, special importance in the development of contact allergies (the allergy develops due to the contact of the stimulus with the skin) is attached to the phagocyte cells that are directly in the skin layers, which are capable of absorbing and then digesting allergens and the immune complexes in the skin (chemically bound to the immune protein allergen). Already after a lapse of just a few hours from the moment that the provoking allergen gets on the skin, in a person sensitive to it, the number of these cells can increase by several orders of magnitude
This kind of dermatitis develops due to the effect on the skin of the plants contained in the milky juice and pollen, sensitizer substances. The most pronounced allergenic properties are observed in plants of the family of lily, euphorbia, rumpus and citrus. Often the cause of the development of allergic skin inflammation is such a houseplant of the primrose family as Primula (the reaction provokes the substance contained in the plant - a primitive).
Symptoms of allergic phytodermatitis: Bubble rashes; redness of the skin area (erythema); burning and itching of the skin (usually on the hands).
Treatment begins with the mandatory removal of the remnants of the irritant from the skin, for which the affected area is carefully wiped with a cotton swab soaked in ethyl alcohol. Then, corticosteroid ointments (Deperzolone, Prednisolone), as well as softening ointments based on boric acid, are applied to the site of the rash for the purpose of removing the inflammatory process. According to the indications can be used antihistamines
Toxico-allergic dermatitis (toxemia)
This type of dermatitis develops as a consequence of the ingestion of the allergen through the respiratory system, the gastrointestinal tract, intravenous or intramuscular injections. It is the intake of medications that is the most common cause of the development of toxic-allergic dermatitis. The most pronounced allergic properties are observed in some anesthetics, sulfonamides and antibiotics. Caused by a single drug, the toxemia in different people can manifest themselves with different symptoms. So, if dermatitis is caused by the use of antibiotics, most often observed flaky erythematous rashes (rarely blisters). If dermatitis develops due to the administration of sulfanilamide preparations, a fixed erythema is usually observed on the oral mucosa, hands and groin, which is resolved by residual pigmentation after a few days after the provoking drug ceases.
The most severe form of toxic-allergic dermatitis is Lyell's syndrome , which manifests itself after several hours / days after the drug has been severely impaired, which is manifested by symptoms such as dehydration, general weakness, headache , significant fever, nausea, vomiting. Against the background of erythema in the gluteal, axillary folds and in the groin, there are bubbles, in the places of opening which form erosive areas. Depending on the degree of severity, exfoliation of the epithelium can capture from 10 to 90% of the skin, which, in the absence of proper adequate treatment, often leads to death.
Treatment of toxic-allergic dermatitis consists in the hypensensibilization of the body, neutralizing the toxic effect of the drug and in removing it from the body, for which anti-inflammatory and antihistamines are prescribed. Therapy of Lyell's syndrome is usually performed in the intensive care unit and consists of the use of high doses of antihistamines and glucocorticoid drugs, as well as in intravenous drip detoxification. In case of development of concomitant conjunctivitis, hydrocortisone ophthalmic ointment and drops with dexamethasone are prescribed. Affected areas of the skin are irrigated with corticosteroid aerosols, treated with anti-inflammatory and disinfectants.
Corticosteroids should be given with extreme caution, as they can cause the development of skin atrophy (often on the face). It should also be borne in mind that the local use of antibiotics can lead to the stability of bacteria and the subsequent development of allergies. In connection with the possible development of such serious contraindications, dermatologists usually recommend the non-hormonal cream Skin-Cap, based on the activated zinc pyrithione. External treatment of allergic dermatitis with this cream can begin as early as the first year of life, since it completely lacks side effects typical for local antibiotics and hormonal drugs. According to the anti-inflammatory effect Skin-Cap cream is absolutely inferior to hormonal preparations, and due to its antifungal and antibacterial action it significantly reduces the risk of infection and normalizes the microflora of the skin
Allergic contact dermatitis
This kind of dermal damage to the skin develops in the case of repeated contact with a specific allergen, since during the first contact a sensitization phase begins, in other words it is a formation of a specific immunity against the allergen for about two weeks. After that, upon repeated contact with the stimulus, the body triggers an immune response, which is expressed by an allergic reaction. After the termination of contact with the provoking substance, the symptoms of the disease completely disappear.
Most often the development of contact dermatitis is caused by detergents, various dyes, cosmetics, washing powders, salts of certain metals (chrome, cobalt, nickel), as well as chemical components found in agriculture, construction and industry.
Symptoms of allergic contact dermatitis:
• Emerging at the site of rupture of erosion blisters, which are resolved by pigmentation
• Vesicular rash, manifested by filled transparent bubbles
• Edema of the lesion site
• Clearly delimited area of redness in the place of direct contact with the allergen
First of all, the treatment of allergic contact dermatitis should be aimed at eliminating contact with a provoking allergen. In case of a professional nature of the disease, when contacting the irritant is due to the peculiarities of a specific professional activity, personal protective equipment (masks, gloves, special footwear, etc.) should be used, and at the end of the work shift you must take a shower. If this does not bring the desired positive results, you should think about changing professional activities. To ease the symptoms of contact dermatitis, the use of antihistamines (Histalon, Simprex, Fenistil) and corticosteroid ointments (Deperzolone, Prednisolone)
Symptoms of allergic dermatitis
The clinical manifestations of this disease resemble the symptoms of the acute stage of eczema. Initially, large spots of redness appear on the skin, after which against the background of which the smallest multiple vesicles are formed, which then burst, leaving in their place continuously wetting superficial skin defects. In their place, small crusts and scales can develop in large numbers. The main focus is absolutely always located in the place of direct contact of the human skin with the allergen.
Allergic dermatitis, like any allergic reaction, is a disease not only of the directly affected organ or area of the body, but of the whole organism as a whole, so the appearance of secondary lesions can be observed in any part of the body. Most often, these are spots of redness, areas of edema and small vesicles, which can range from the site of direct exposure to the allergen very far.
For example, with an allergic skin reaction to mascara, it is possible to develop reddening spots so large that the skin of the entire face, shoulders and neck will be covered. Almost all patients with rashes on the skin complain of a severe vexing intense skin itching, which often disrupts normal night sleep and everyday life
Allergic dermatitis in children
In children, allergic dermatitis can develop at absolutely any age, and in the youngest it is often combined with food allergy. In the youngest children, this condition is usually called thrush. Dermatitis in children can be both chronic and hereditary.
The development of skin allergic reactions in children is usually due to any failure of the immune system and for a push to develop the disease, only a small provoking factor, in our case, an allergen, suffices. Under his influence, at the beginning of the course of allergic dermatitis there is a barely noticeable slight reddening on the buttocks and cheeks, red crusts on the nape and insignificant places of skin peeling. Most often, rashes appear on the legs, arms, back, scalp and cheeks. The places of redness are accompanied by itching, scaling and subsequent coarsening of the skin. Usually the symptoms of allergic dermatitis in children are manifested in the first year of life, from two to six months old. To a small child, due to severe itching, allergic dermatitis causes very severe suffering.
With the worsening of allergic dermatitis in children, the symptoms of the disease become even more pronounced: erythema (redness) is even more noticeable, the affected areas of the skin swell, the rash is transformed into vesicles (filled with transparent contents of the vesicles), the itching is markedly enhanced. After this, there comes the so-called subacute phase, characterized by a fading of symptoms, in which redness partially disappears, but on the skin there are still dry red crusts. After this, the period of complete disappearance of all cutaneous manifestations of the disease occurs. However, unfortunately the disappearance of all skin symptoms does not mean that the child is completely healthy, since allergic dermatitis is a chronic disease.
Allergic dermatitis in children , depending on their age, proceeds in different ways, according to what it was divided into the following conditional phases:
• Infant phase. It often begins with the eighth week of life and manifests skin lesions (usually on the forehead and cheeks) of an acute eczematous nature. After that, changes gradually begin to appear on the forearms, shoulders and lower legs (rarely on the buttocks and trunk). Infant phase of allergic dermatitis can sometimes be cured spontaneously, but more often its transition to the next phase
• Children's phase. This phase begins after one and a half years and lasts until the most transitional age. During the course of the childhood phase, the rash often spreads throughout the body, thereby forming continuous lesions, which are covered with crusts as a result of permanent scratching. Usually, rash spots are observed in the popliteal and ulnar folds, on the hands, on the upper chest and on the lateral surfaces of the neck. In most children, the rash with time remains only on the knee and elbow folds
• Adult stage. This stage occurs during the transition period and in its clinical symptomatology is no different from the symptoms of allergic dermatitis in adults
. Diagnosis of allergic dermatitis . Most often, the diagnosis of allergic dermatitis does not cause any special difficulties and is based on the patient's data obtained during the survey and on a thorough visual examination of his skin. In all observed cases, the manifestations of an allergic reaction are specific and specific for allergic dermatitis, however, to confirm the correctness of the diagnosis, the use of skin allergic tests
Treatment of allergic dermatitis
The tactics of treating allergic dermatitis is based on the results of the preliminary examination and is assigned exclusively individually. Unfortunately, as practice showed, it is possible to eliminate the cause causing this terribly unpleasant skin disease of an allergic nature not always and not all. But the symptoms and possible consequences can be removed with the help of special desensitizing therapy and hypoallergenic diet.
Since histamine usually causes inflammation of the skin, antihistamines should be used in the treatment of allergic contact dermatitis, better than the third generation (Telfast, Zirtek, Erius, etc.), which are virtually devoid of side effects compared to the first and second generation drugs. For local treatment for inflammation of the skin with the presence of erosions and blisters, corticosteroid ointments Elidel, Advantan, Lokoid are recommended. If allergic contact dermatitis develops on the face, apply Advantan emulsion, which is applied a thin layer on the skin of the face (slightly rubbing) no more than once a day.