Atopic dermatitis (neurodermatitis)

In most cases, patients with this allergy on the skin in the family there is someone with allergy problems such as. the same skin lesions, urticaria, angioedema, allergic changes in the sinuses, allergic rhinitis, bronchial asthma, etc. friendly.On infancy changes occur on the face and scalp as inflammatory eczema (aka. "Milk scab"). Gradually disappear spontaneously in 50% of cases. In childhood, it occurs when the rocker pages of major joints: elbows, knees, forearm, ankle, and on the neck; not so rare any inflammatory changes in the hands and fingers; can be affected by other portions of the skin, in particular in generalized form, but still less. It is very unpleasant when it appears in the genital area and the anus. Changes can be acute in this case the skin is inflamed, red, present moisturizing, blisters, cracks in the skin, scabs. Frequent changes are mostly chronic. At unchanged skin nodules are seen dark red or brownish color. Described nodules can be covered with tiny whitish scales or small scab, or cracks in the skin. The skin unaffected by the changes is extremely dry. In adults, the changes are present on the face, neck, upper parts of the hull, because chronic eczema which frequently returns. It is present in all patients severe itching, especially at night. Atopic dermatitis can be treated but not cured. The therapy is very difficult given that the individual, there is no standard therapy for all patients. Usually begins with topical corticosteroids alone or in combination with antibiotics. In severe cases, can be applied and systemic corticosteroids, and cyclosporine possible, and systemic antibiotics (according to the antibiotic). Because of the strong itching are used systematically antihistamines, phototherapy (OR-A and UV-B). More recently applied immunomodulators tacrolimus and Pimecrolimus. Prevention of atopic dermatitis should be carried out by cut measures. In milder stage of the disease is important regular, intensive care of the skin, ie, the application of fatty cream. It is important to remove the relevant provocation factors, removal of contact relevant antigens, skin irritants, nutritional and psychological factors, It must be avoided potential allergens (eg. Breast feeding, housing in a dry place free of dust, no animals, no smoking), proper dress, (without wool), intensive care of the skin, especially in intervals with milder symptoms of the disease. Furthermore, it is important to consult on the choice of profession (avoiding activities in the dust, and work in the unclean, contaminating the skin with exposure of allergens). In the vast majority of patients there was an almost complete regression of skin lesions after exposure to the sun and swimming in the sea (heloimarinoterapy), and after a stay in the mountains during the summer months.

Natural treatment

When it comes to atopic dermatitis, natural remedies a certain advantage compared to traditional therapy can have many side effects, especially in children. Exceptionally useful have proven creams and ointments containing extract of comfrey, considering that it is a plant for the replacement of corticosteroids. Besides, a very good and creams are based on calendula and evening primrose oil and black cumin, almond, olive or St. John's Wort oil. Recommended and cream with the addition of urea or essential fatty acids, as well as oral intake of omega-3 (fish, flax oil, walnuts) and omega-6 fatty acids (evening primrose, borage). Rinse skin tea oak bark can also be helpful. Atopic dermatitis is very important to get regular moisturizing skin creams and oils, in order to compensate for the reduced amount of lipid and increased water loss. Besides, it is necessary to avoid the use of soap, shampoo, detergents, cosmetics, and all other products that enhance the skin from drying out. Instead, the recommended products that moisturize the skin and neutral natural soaps. Also, avoid long showers and sudden changes in water temperature, and skin always rinse and pat dry gently patting towel. Though atopic dermatitis is accompanied by intense itching, scratching, and try to avoid scratching the affected area due to the release of inflammatory substances in cells of the skin, reduced skin barrier function, but also allows the penetration of various allergens and irritants.

Evening Primrose Oil

Such as cleaning the liver, oral ingestion of vegetable oil of evening primrose (Oenothera biennis) is mandatory therapy for all skin problems, especially dermatitis. Its main ingredient is gamma linolenic acid, which alleviates the lack of lipid skin. The lack of lipids can lead doupalnih condition. Take evening primrose in a dose of one teaspoon three times a day after meals. After three weeks of a break of at least two weeks. If necessary, you can repeat the treatment.

LIQUORICE

Licorice (Glycyrrhiza glabra) is applied locally on the skin by herpes, eczema, psoriasis and atopic dermatitis. It is considered natural plant corticosteroid, which helps remove inflammation and irritation. Studies show that the effect of the pharmaceutical more corticosteroids. It is an effective 2% gel for topical use of the active ingredient of liquorice: 18-beta-glycyrrhizic acid. With this you can and lubricate the affected places several times a day with the tea of licorice.

Excellent FILIPINO RECIPE

Fry for a handful of white rice in the pot without oil until it turns black as coal. Add 2/3 cup water and cook for two minutes. Apply the mixture on the affected area. Let's make it hot to the limit tolerance. Allow 1-2 hours on the skin. This procedure can be performed up to twice a day, allegedly helped many suffering from dermatitis.

Seborrhea

Seborrhea inherited as an autosomal dominant, and its clinical appearance depends of several factors. In addition to hormonal influences (androgen in puberty, estrogen decline in the premenstrual part of the cycle) which are important and emotional excitement, a change in tone of the vegetative system, and nutritional factors (fatty foods, strong spices, alcohol, coffee), which also acts via the vegetative nervous system . The skin on the seborrheic areas is oily and shiny. On the face, especially the cheeks to the nose, and the nose and mouth openings of the sebaceous glands are often expanded. Due to downtime in the tallow gland bags, formed comedones. The hair is oily. Seborrhea scalp is often paired with peeling (ityriasis seborrhoides) and if the shell large and fatty talking about tinea amantacea. At the same time the emergence of seborrhea ii androgenetic baldness is considered to be a separate joint effects of hormonal influences (prevalence of androgen - DHT). Seborrhea is often accompanied by increased secretion of sweat (hyperhidrosis).

Seborrheic dermatitis

The basic conditions for the development of seborrheic dermatitis seborrhoeal are hereditary constitution and hormonal and vegetative dysfunction. Inflammation of the skin occurs due irritation of an agent (fat the changed composition, decomposition products of bacteria, sensitization of the bacteria or their products, mechanical trauma). In recent times greater significance is given to the fungus Pytyrosporum ovals in the development of the disease. Changes in the skin are located on the seborrheic areasand less often may be affected and the area below the breast and armpit, elbow and knee pit. On the entire scalp is observed sharply limited foci different size and shape, pinkish-red, covered with a whitish-yellowish scales. Foci often tend to coalesce, and sometimes exceed the scalp skin on the forehead and the skin around the ears. They are located on the face and in the eyebrows, on the part of the skin above the eyes, the middle of the forehead, eyelids, around the nostrils. Seborrheic dermatitis occurs in the form of pink more or less severely limited redness, with tiny peeling of the surface layer of the skin. Rotary are on the ear lobe and spoljašnjme ear canal. Dandruff scalp disorder is associated with seborrheic dermatitis.

NATURAL TREATMENT

Seborrhea, seborrheic dermatitis, dandruff - stress, nutrition and natural solution Each hair has a sebaceous gland that secretes sebum (fat) that makes a a protective layer of moisture, heat, fluid loss through the skin, gives the skin elasticity and hinders bacterial growth. In a human the sebaceous glands found only where hair growth and hair (scalp). On the entire scalp are follicles in which is located the hair roots. The outer part of the hair is a dead part, but the root of the living part. Next to each follicle is located sebaceous glands that secretes sebum. Below follicles are capillaries which lead to the root of food and oxygen through the skin papilla and hair follicles through the entrance gets oxygen through the skin. As in the whole organism, and the scalp has its fungi, which are in the normal equilibrium very useful, but as soon as they increase the amount, there is a disease, in this case, the scalp. We're talking about fungus called Malassezia, which is a permanent resident of the scalp and feeds on sugars and lipids from sebum and thus forms a protective layer of the skin, and is helpful if there are up to 40% as it creates a natural protection. But when it rises above 40% begins to create problems. One of these problems is just seborrhea that occurs due to disorders of the sebaceous glands, ie, increased secretion of fat-sebum which is of course a cause stress, which causes the itching and flaking of the skin, and frequent infections of the scalp which can be nor a little harmless. Poor nutrition and climate conditions can also affect the appearance of seborrhea. Large amounts of fat encourage breeding fungus malasezzia, and leads to increased cell death and the creation of dandruff, which in addition to aesthetic problems, medical big problem. Dandruff can be dry and fat. When Malassezia multiplies to 70-80% of the bacterial flora, it penetrates through the follicular entry in the sebaceous glands and create inflammation. So inflamed sebaceous glands secrete excessive amounts of sebum, which is mixed with dandruff on the scalp, creating impermeable layer of fatty dandruff. The root hair is blocked and does not get food and oxygen. After a few months, the follicle closes and heals, and as a result will weaken the hair and baldness and hair waste even in tufts. Dry dandruff occurs when fat mixed and closed completely and follicle so the hair root is not getting food and oxygen. Sebaceous glands are blocked and are not able to give your hair the necessary fat. As I have already stated, and seborrhea and dandruff can cause serious medical problem and not treating them occurs seborrheic dermatitis - an autoimmune disease that is causing aesthetic and medical problems. The fungus malesezija exceed the limit of 80%, and is often in the classic medicine and need hospital treatment. In addition to the entire scalp seborrhea can be extended in the face, behind the ears, between the shoulder blades, under the breasts and armpits and on her knees and elbows. Seborrheic dermatitis and seborrhea often occur in infants and children, and affects from 5 to 10% of the adult population. It is not known why but much more frequently in men than in women, and usually occurs in puberty due to excessive secretion of hormones. Treatment of these diseases requires large angažnman and needs to heal inside and out, and of course, relaxation and meditation in order to overcome stress and regulate the diet that should be eliminated fat, spicy foods, excessive salt, sugar and milk. Diet should be rich in fish, grains - especially millet, buckwheat, etc., Fresh fruit and vegetables, and nutrition should include sesame seeds, flax and pumpkin, and use olive oil, coconut and flaxseed because they are rich in unsaturated fatty acids. There are combinations of herbs that packed as tea regulate excessive secretion of certain hormones, and thus the excessive secretion of fat, and cleansing the body and returning the same in the proper balance. Of course for outdoor applications are also used ointments that contain a mixture of herbs and propolis that create balance and protect the skin of the scalp, and block excessive fungal growth, and thereby stimulate hair growth.

Pemphigus

Pemphigus is a rare disease of adults (40-60 years). Manifested by numerous bubbles (intraepidermally), erosions, scabs, and without treatment ends in death. In addition to changes in the skin and present in the oral mucosa in the form of erosion. In addition to local corticosteroid therapy, the patient is given high-dose systemic corticosteroids (prednisone / prednisolone, combined with the immunosuppressant azathioprine and mycophenolate mofetil.

ETIOLOGY:

The disease is of unknown etiology. As a causative agents are mentioned allergies and viral infections, as evidence that this dermatiza result of allergic reactions serves finding specific antibodies. Thus, in the blood serum and exudate are immunoglobulins belonging to the IgG class. Only in the early stage of the disease and IgA are detected. These antibodies are specific organs, because they react only with platelet-stratified epithelium.

CLINICAL:

The disease is characterized by formation of lumps on her skin unchanged or mucosa.Chronic pemphigus often affects the oral mucosa skin. It was found that in one third of patients, oral changes first occur in the oral mucosa, and in one third of the lumps appear in the mouth and on the skin. Very rarely, only 13% of patients, the changes do not affect the mouth and appear only on the skin and mucous membranes other. Primary efflorescence that occurs in the oral cavity is a lumps the size of grains of lentils, peas, hazelnuts, walnuts and a smaller to a chicken egg. lumps are filled with clear serous fluid pale more yellow caste. They occur in all parts of the oral mucosa. It is believed that the lumps rarely occur in the pink part of the lip and the gums. The roof lumps is very thin, so they quickly are sprayed, so that the former can not be seen in the mouth. After spraying lumps, there are surface erosion which sometimes can affect large parts of the oral epithelium. Severe damage are accompanied by increased salivation. Saliva is colored with blood, runny or drips from his mouth. The pain was very sharp, diet is difficult, because the liquid food irritates the damaged area.The disease progresses rapidly. Before using corticosteroids disease during two to three years always ended lethally. lumps the skin and mucous membranes nearby appear on the skin or mucous membranes unchanged. Practically there is no place where they do not occur.As a special predilective place for the emergence of lumps points out the umbilical and periubilikalni area.And lumps by the skin filled with clear serous fluid. Lumps on the skin lasting a few hours or days. Spraying lumps resulting erosion covered crust consisting of the dried secretions and the rest of the epidermis. Below the crust is formed epithelialization, and at that point you can re-occur lumps. Near the old bullous change occurs, further similar during the, resulting in large areas of skin are affected by the and half-naked. Changes to take months, the patient skinny and eventually dies. The diagnosis of oral pemphigus used Ni kolskijev (Nikolsky) phenomenon and Kolins (Tzank) ci-to diagnostic test.

PHENOMENON Nikolsky (Nikolsky) is corporeal test that helps determine the diagnosis of pemphigus.

During pemphigus (pemphigus vulgaris) weak and break the intercellular connections of the epithelium. This is highly emphasized in the spinous layer and such a phenomenon called acantholysis. The epidermis of the skin in patients with pemphigus are sepparating and the individual cells spinous layers are separated. Simultaneously, fluid accumulates in the epithelium, and thus form the lumps. The weakening of cells connection takes place throughout the skin and mucosa skins. Such a process does not have to manifest the appearance of lumps. During clinical examination, skin may appear unchanged. Nikolsky observed that, if the tissue, on skin seemingly unchanged, exert pressure, will soon be on the site form a lumps. This phenomenon has been used as an aid in determining the diagnosis of pemphigus.In a person with a suspected suffering from pemphigus chooses one region of the skin where there are lumps, and which looks unchanged. You could make sufficient pressure, this place should have a bone base. Such is for example podlekti - c ^. This place is pressed with your finger and then watched. Nikolsky phenomenon is positive if the epidermis at the site of pressure is separated, or if it forms a lumps. If you have already created a lumps exert pressure, lumps will increase. While it is useful in the diagnosis of pemphigus, the test Nikolsky not pathognomonic for the disease and can not be taken as a sure sign of pemphigus. This test can be positive for other skin diseases, especially those which lead to the weakening of the links in the epithelium and creating intraepithelial lumps.The lack of test Nikloskog is that is not positive throughout the disease, the most common is a positive at a time when the skin appear lumps.Niklosky phenomenon, despite the fact that is not a sure sign of pemphigus, if positive may facilitate the determination of diagnosis of pemphigus. A negative test does not rule Niklosky pemphigus and, if necessary, can be repeated many times. Chankov TEST is based on laboratory analysis of material removed from lumps.The epithelium of persons with pemphigus accumulating liquid, there arises the intercellular edema. Consequently weak and torn the intercellular connections. This particularly occurs between the spinous cell layer. This phenomenon is known as acantholytic lumps. In addition, the surface layers of the epithelium is separated from the spinous cells and the basal layer. Consequently lumps is localized near the basal .embrane, in the lower third of the epithelium. In lumps located called. damaged cells that the author called Canak cells. Such cells are circular in shape with a large sails. The essence Cank test lies in determining the presence of segregated cells in the material samples taken from lumps of the people patients with suspicion of being sick from pemphigus.Segregated Canak or cells are formed as a consequence of the described acantholysis, and degeneration, and epithelial changesin particular cells of the epithelial of layers, which are located near the basement membrane. Stratified squamous epithelia cells, which in healthy persons and stellate cells of the basal layer, which in healthy persons cube or a parallelepiped, in persons with pemphigus become globular. Such cells are called damaged cells, or cells Canak. They can be completely separate, but is more common in groups. Segregated cells have very the big mainsail, so it is very poor in the cytoplasm. The entire cytoplasm is pushed to the periphery and color are strongly basophilic. Hromatin is distributed diffusely. In the cytoplasm can clearly see the mainsail. The boundary between the sails and cytoplasm is clearly expressed. The sail of segregated cells not only a great, but the hype disrupted. often meet and exchange forms the sails. It may be doubled, twisted and changed in other ways. Determining the presence of segregated cell is performed in the material of the lumps. Select is fresh, unruptured lumps and its roof was punctured with a sharp instrument or needle. When the fluid has leaked, lumps is wide open. The material is taken from the bottom of ezom lumps. Material with loops is applied in a thin layer on glass slide for microscopy. made smear is dried in air. Painting smear is performed by the method of May-Grünwald (May-Gmvald) and Gimzo (Giemza). Plate of smear poured two minutes with May-Grinvaldovom color. To make the countdown, smear it during the three minutes overflows with distilled water whose electrochemical reaction neutral. Then he carried the overflow plate solution by Gimzo week three minutes. In order to remove excess paint, plate with smears are washed again for three minutes in distilled water neutral chemical reaction. preparation was air-dried and is then ready for testing Cytodiagnostical microscope. Microscopy is VTsIOM under immersion. when microscopic smear of lumps, it is necessary not only to ascertain the presence of damaged cells, but to determine their quality. The cells that are characteristic of pemphigus not only acantholytic and free, but also degenerate. In this manner, and the like differ from damaged cells in other diseases. Such cells for other diseases have not degenerated. Only degenerate acantholytic cells called segregovane cells.

Bullous pemphigoid

Bullous pemphigoid is a rare but serious disease of older age (60-80 years); death is possible. Clinically visible tense blisters (under the skin) on the changed skin, as well as erosion of the skin covered with purple bruises, and scabs. Mucous membranes are usually not affected by the. In addition to local corticosteroid therapy, giving the medium a strong dose of immunosuppressants (prednisone / prednisolone 40-60 mg / day). Sometimes gives erythromycin (2 g / day).

Dermatitis herpetiformis

Dermatitis herpetiformis is a rare disease of younger men. Because of the extremely chronic course and subjective problems significantly reduces quality of life. The skin is red, covered with bubbles and nodules, changes are usually distributed symmetrically on the arms, legs, upper back and the sacral region. The patient complains of severe itching or burning sensation. Sometimes it engages mucous membranes of the oral cavity. Is present sensitivity to gluten (enteropathy) in nearly all patients (similar to celiac disease in children). The treatment is administered a local, symptomatic, antiinflammatory therapy in order to reduce itching (hydrocortisone). Gluten-free diet (based on rice and corn).

Dermatitis herpetiformis Duhring (DHD) is a pruritic, chronic, papillae lovezikulozno (bullous) disease which is associated with asymptomatic (or symptomatic) of gluten sensitive enteropathy (GSE) and granular IgA deposits in the dermal papilla tops. And if has passed than a hundred years since Louis Duhring in 1884 first described the disease, our knowledge of the etiopathogenesis of the disease is still incomplete. In patients with ADHD in a high percentage (85-90%) there is a community with HLA-DR3 and HLA-haplotype DQw2 which probably is involved in the pathogenesis of the disease. Genetic predisposition for sensitivity to gluten may manifested as an isolated disease of the small intestine (coelia) or a skin disease associated with gluten sensitive enteropathy (GSE). The genetic expression of the disease can vary. In patients with DHD most of circulating autoantibodies region of IgA class. IgA antibodies are directed to target antigens, such as the: tissue transgiutaminaze (main -autoantigen endomizijum smooth muscle), gliadin and reticulin. Anti-reticular antibodies react with endomizij smooth muscle and connective tissue under mukozejejunuma. And if the mechanism by which gluten and lead to the formation of deposits in the skin is still unclear, it is assumed that there is stockpiling of circulating immune complexes (gluten + IgA + C3, C5, CSA) in sublaminadensa zone in the dermal papilla peaks which represents the trigger for creation of inflammatory answer stockpiling of neutrophils and create cleft (vesicle, bull).

Clinical picture:

The disease can begin at any age group, but usually occurs between 2 and 4 decades. Men get sick twice as often as women. The disease is intense pruritus; pruritus precedes changes permanent accompanying symptom of the disease. The predilection of the elbows, knees, glutes, limit hair and skin of the forehead, neck and shoulders. Changes are localized symmetrically composed of papules and small, tense vesicles (bula) herpes schedule on erythematous base. Because of the intense pruritus changes are Eksk-Risan, sometimes find it difficult vesicles. Mucous membranes are not affected by the. Gluten sensitive enteropathy associated with DHD may be clinically manifest or asymptomatic. DHD is a chronic disease which are characterized remissions and exacerbations; that they last longer, the DHD is a lower intensity, and 10-30% of patients entering in complete remission. If complications occur, most commonly the result of side effects of therapy (dapsone: mild hemolytic anemia, agranulcitoza, platelet-pence; sulfapyridine: crystallization in the kidneys). Patients with gluten sensitive enteropathy have an increased tendency to develop gastrointestinal tract lymphoma. In some patients the DHD may be associated with atrophy of the stomach and hipoaciditetom, a certain number of patients showing clinical and serological signs of thyroid disease.

Diagnosis and differential diagnosis:

Diagnosis is based on clinical features, histological and immunofluorescence finds. The disease must be differentiated from others, bullous auto-immune diseases. Next to auto immune bullous disease should be taken into consideration and scabies, eczema, prurigo and papular urticaria.

Treatment:

The drug of choice for the treatment of DHD e diaminodifenilsulfon (dapsone). For patients who can not be treated dapsone may be applied sulfapyridine. Dapsone at a dosage of 50-100 mg / day or sulfapyridine in the dose of 2-3 g / day lead to rapid resolution of changes in the skin, but have no effect on the improvement of the pathological finds in the small intestine. Before the therapy introduced dapsone is necessary to determine the level of glucose-6-phosphate dehydrogenase (GPD) in erythrocytes because people with reduced values of GPD at risk to develop severe hemolytic anemia and methemoglobinemia.

Discoid lupus erythematosus (DLE)

The disease occurs more often in women (20-40 years), the chronic course. They appear plate foci initially red, then bold and and eventually atrophic, usually on the face, scalp, mouth, nose. The disease has a tendency to create new foci, which are to be merged. In 5% of cases without treatment develops systemic lupus erythematosus. It is used locally-anti-inflammatory therapy (topical corticosteroids), cryotherapy foci (freezing "snow" of carbon dioxide), in severe cases, is given to chloroquine. Long term therapy lasts about two years or is treatment carried out at intervals. Instead of chloroquine can be given hydroxychloroquine because of less risk of retinopathy. Therapeutic options are still and corticosteroids or retinoids, sulfones, azathioprine, and thalidomide. Also, it is necessary to avoid UV rays.