Dermatitis comprises a huge group of skin diseases. They can be caused by external reasons, and internal.
ICD 10 code
According to the International Classification of Diseases, 10th revision, dermatitis and eczema are coded L20-L30. Moreover, the terms “dermatitis” and “eczema” refer to one block of diseases.
Allergic dermatitis is a disease that is very often diagnosed in both adults and children, and patients with dermatitis often come across such a concept as the ICD code for allergic dermatitis - 10: what is this code and why is it needed?
Before determining the ICD-10 code for dermatitis, you should understand what kind of disease it is, what types and manifestations of dermatitis there are.
ICD 10. Class XII (L00-L99) | Medical practice - modern medicine of diseases, their diagnosis, etiology, pathogenesis and methods of treating diseases
If it is necessary to identify a toxic substance, use an additional external cause code (Class XX). Excludes: neonatal erythema toxicum (P83.1) L53. 1 Erythema annular centrifugal L53.
3 Other chronic patterned erythema L53. 8 Other specified erythematous conditions L53. 9 Erythematous condition, unspecified.
Erythema NOS. Erythroderma
Causes
Causes of dermatitis on the skin in children
Often in children, dermatitis is formed under the influence of environmental factors. Pathology is observed in children from the first months of life. In children over 4 years of age, dermatitis is very rare.
Genetic aspects. Atopic dermatitis in combination with deafness (221700, r).
Pathogenesis Increased IgE content, often revealed by positive skin tests and specific antibodies (IgE) to some inhalation and food allergens.
Peripheral blood eosinophilia is characteristic. Decreased levels cellular immunity: reduction in the severity of delayed-type hypersensitivity reactions (incl.
including in skin tests for tuberculin), a decrease in the number of T lymphocytes (primarily CD8 cells) and their functions, which leads to an increased susceptibility to the development of viral and fungal infections Disorders autonomic regulation and intracellular regulatory systems.
Atopic dermatitis ICD 10
Seborrhea (seborrheic dermatitis) is a chronic skin disease associated with the sebaceous glands of the face, skin folds and scalp. Currently, seborrhea has become quite widespread, especially among representatives of the stronger half of humanity.
The disease causes the sebaceous glands to produce an increased amount of secretion, which contains too many fatty acids. As a result, seborrhea, the treatment of which is most often required by young people aged 25 to 27 years, leads to skin deformation, hair loss and other serious consequences.
The disease can develop on the skin of any part of the body, but the most widespread is the so-called T-zone (seborrhea on the face, affecting the forehead, nose and chin).
In addition, the décolleté area, that is, the chest and back, is also at risk. This localization is explained by the fact that it is on these parts of the body that the most a large number of sebaceous glands.
Skin inflammations provoked by internal or external causes are classified as dermatitis. This disease has many symptomatic courses, so it has many features of manifestation and types.
Dermatitis can be associated with allergies or inflammation, and have acute or chronic forms. Such skin rashes can be either seasonal or independent of the time of year.
Dermatitis unites a huge group skin diseases. They can be triggered by both external and internal reasons.
- decreased functional characteristics of the skin;
- disturbances in homeostasis;
- various pathological processes.
Symptoms (clinical picture) of seborrheic dermatitis
Seborrheic dermatitis in adults:
- SD of the scalp;
- SD of the face;
- SD of the trunk;
- generalized form of diabetes.
Seborrheic dermatitis in children:
- SD of the scalp (“baby cap”);
- SD of the trunk;
- Leiner's disease.
Rashes with seborrheic dermatitis are located on the skin of the scalp, face, ears, upper body, mainly in the area of the sternum and shoulder blades, and in large folds.
In adults, one of the earliest signs of the disease on the scalp may be dandruff, later redness appears and flaking increases.
Subsequently, clearly demarcated plaques form, often merging and occupying large area spreading to the skin of the forehead. Sometimes serous-purulent crusts may be observed, after removal of which a weeping surface is revealed.
On the face, rashes are localized in the area of the cheekbones, wings of the nose, forehead, nasolabial folds, glabella, eyebrows and are usually combined with damage to the scalp.
The rashes are represented by round or ring-shaped foci of erythema; infiltration, peeling and crusting are possible. The skin in the affected area acquires a grayish-white or yellowish-red tint, and the follicular openings are clearly visible.
Blepharitis may develop with the appearance of crusts along the edge of the eyelid and the accumulation of masses of horny cells around the eyelashes.
Types of pathologies
- L21.0 Seborrhea of the head"Baby's cap"
- L21.1 Seborrheic infantile dermatitis
- L21.8 Other seborrheic dermatitis
Use during pregnancy and breastfeeding
Since clinical experience with terbinafine in pregnant women is very limited, it should not be used during pregnancy unless the expected benefit to the mother outweighs the potential risk to the fetus.
Terbinafine is released from breast milk Therefore, during the period of treatment it is necessary to stop breastfeeding. The infant should not be allowed to come into contact with treated skin surfaces. local form terbinafine.
Symptoms (signs)
Research methods Blood test: eosinophilia Increased serum IgE If the allergic nature of the disease is suspected, skin tests with allergens Dermographic test: white dermographism Test with intradermal injection of acetylcholine.
Differential diagnosis Contact dermatitis Scabies Seborrheic dermatitis Psoriasis Chronic lichen simplex Ichthyosis.
Symptoms
To make a diagnosis, additional symptoms that accompany a certain inflammatory process are important.
Seborrheic dermatitis in typical cases affects those areas of the skin that are characterized by significant development of the sebaceous glands and their increased activity.
The characteristic clinical symptoms of the disease are peeling and inflammation of the skin, accompanied by itching. Classic option is the symmetrical involvement in the pathological process of the skin of the scalp, the borders of hair growth, eyebrows, eyelashes, the mustache and beard area, nasolabial folds, the skin of the external auditory canals and the behind-the-ear areas.
Seborrheic dermatitis of the trunk is usually localized in the sternum, in the folds of the body, including the axillary, inguinal, navel, skin under the mammary glands and anogenital area.
In severe cases of this disease, it can have the character of a widespread exfoliative process up to erythroderma. One of characteristic features seborrheic dermatitis on the scalp is the presence of small flour-like white scales, although in some cases peeling can also take on a large-plate character.
This variant of the course is characterized by the absence of acute inflammatory changes in the skin and is considered as dry seborrhea. Many patients with dandruff complain of itchy skin.
According to a number of patients, these flakes appear due to dry skin, so they prefer to wash their hair less often, which actually contributes to further accumulation of flakes and an increase in dandruff, which subsequently ends in the appearance of inflammatory changes in the skin.
It should be noted that in some cases, inflammatory erythema is not always visually detected on the scalp due to massive layering. More severe manifestations of seborrheic dermatitis on the scalp are characterized by erythematous spots and plaques covered with mealy or sebaceous scales, and in some cases yellowish scaly crusts and hemorrhagic crusts that appear as a result of scratching.
In some patients, the affected area may include the hairline and forehead skin. Manifestations of seborrhea on the face, behind-the-ear areas, and skin of the ear canals are usually determined in the form of erythematous-flaky lesions accompanied by itching.
When the lesion is localized on the face, patients may complain of a burning sensation in areas of the skin affected by seborrhea. In some cases, papules may appear on the skin of the cheeks, forehead, and nasobuccal folds as a result of infiltration of inflammatory spots.
Seborrhea often becomes clinically evident when men with the condition grow a mustache and beard, and regresses when facial hair is removed.
If treatment is not carried out, peeling can become significant, with the scales becoming thick, yellow and greasy and, in some cases, secondary bacterial infection.
Both dry and oily forms of seborrhea lead to:
- increased oiliness of the skin;
- peeling of the skin;
- unpleasant itching;
- hair loss.
In addition to the above symptoms, scalp seborrhea, which should be treated as quickly as possible, leads to the formation of dandruff. Cell renewal occurs in all people without exception, but with seborrhea this activity occurs many times faster.
Diagnosis of seborrheic dermatitis
Research methods If ACD is suspected, a skin patch test is performed with a standard set of contact allergens attached to a patch tape that fixes them on the skin for 48–72 hours.
The reaction is assessed 20 minutes after removal of the allergen. Identification of a possible photosensitizer.
Differential diagnosis Infections caused by HSV Bullous pemphigoid Seborrheic dermatitis Atopic dermatitis.
The diagnosis of seborrheic dermatitis is usually straightforward and is based on the characteristic clinical picture, but in some cases it is necessary to conduct a histological examination of a skin biopsy.
At histological examination a perivascular infiltrate of lymphocytes and histiocytes and moderate spongiosis are noted. Follicular plugs are detected due to orthokeratosis and parakeratosis, as well as accumulation of neutrophils at the mouth of the follicles.
By using dyes, visualization of yeast cells is possible.
Differential diagnosis
Seborrheic dermatitis must be differentiated from psoriasis, dermatophytosis of the scalp, face, trunk, allergic dermatitis, atopic dermatitis, plaque parapsoriasis, rosacea; It is also necessary to exclude demodicosis.
Psoriatic rashes are usually bright pink or deep red in color, significantly thickened, with pronounced gray-white peeling, and there are positive signs of the stearin spot phenomenon, terminal film and pinpoint bleeding.
Rashes on other areas of the skin and damage to the nail plates are possible.
When differentially diagnosing DM and atopic dermatitis in children, the localization of skin lesions should be taken into account: with atopic dermatitis, the rashes are located in the forearms and shins.
The results of allergy tests, as well as high level immunoglobulin E testify in favor of atopic dermatitis.
When carrying out differential diagnosis with fungal diseases, it is necessary to conduct a microscopic examination to detect elements of the fungus.
If allergic dermatitis is suspected, skin tests are required.
Treatment
"Allergic contact dermatitis"
(arranged alphabetically).
Management tactics The impact of a possible etiological factor should be eliminated. Diet excluding spicy foods and alcoholic beverages; limiting table salt and carbohydrates.
Drug therapy
Locally Cold disinfectant lotions with 2% resorcinol solution, 3% solution rum boric acid, Burov's liquid (1:40 dilution) HA - ointments with high activity, for example, fluacinolone acetonide (0.025% ointment) 3-4 times a day, preferably under a compress.
Complications Addition of pyogenic, yeast infection Malignancy in radiation dermatitis (radiation cancer) Transformation of allergic dermatitis into eczema.
In case of exacerbation, a restriction in diet is recommended for 3–4 weeks. If there is a hereditary predisposition to atopic diseases, the introduction of solid complementary foods is not recommended until 6 months of age, and obligate allergens are not recommended until a year. Protective regime, it is recommended to wear cotton clothes.
Hay fever).
General methods of therapy are normalization of metabolism, the use of low-alkaline detergents, if necessary - medicinal shampoos with chalcogenide compounds, shampoos with zinc pyrithioneate, tar, azoles (ketoconazole, bifonazole).
Care. To prevent dandruff, you need to use hygiene products such as shampoo or soap.
Shampoo can be dry or liquid. Dermatologists advise washing your hair at least once every 5 days.
However, in cases where hair quickly becomes oily, you should use shampoos for daily care. They are more gentle than regular shampoos.
Their advantage is that they wash away only the required amount of oil from the scalp without damaging it and allowing you to use such products quite often.
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Treatment Goals
- regression of rashes;
- elimination of fungal infection;
- prevention of secondary infection;
- eliminating itching.
General notes on therapy
The choice of treatment tactics for diabetes depends on the severity of clinical manifestations, duration of the disease, and information about the effectiveness of previously administered therapy.
The disease requires regular treatment using systemic and topical therapy over a long period of time.
For external treatment, agents are used that have anti-inflammatory, antipruritic, antifungal, and in case of secondary infection, antibacterial and antiseptic effects.
IN acute stage process with severe itching and sleep disturbances, it is advisable to use antihistamines and sedatives.
Indications for hospitalization
Leiner's disease
Drug therapy
External treatment
Topical glucocorticosteroid drugs
In cases of severe inflammation with hyperemia and oozing, it is advisable to use glucocorticosteroid drugs with a moderate or high degree of anti-inflammatory activity.
As the severity of inflammation decreases, glucocorticosteroid drugs with weak or moderate anti-inflammatory activity are used.
- betamethasone valerate 0.1%, cream, ointment,
- betamethasone dipropionate 0.025%, cream, ointment,
- hydrocortisone butyrate 0.1%, cream, ointment,
- methylprednisolone aceponate 0.1%, cream, ointment,
- mometasone furoate 0.1%, cream, ointment,
To avoid the risk of adverse events associated with long-term use of corticosteroid drugs, it is possible to use zinc pyrithione or topical calcineurin inhibitors
- zinc pyrithione 0.2% aerosol, cream
- tacrolimus 0.03%, 0.1% ointment,
- pimecrolimus 1% cream,
Anti-inflammatory drugs for local application(in the form of lotions):
- resorcinol, 1% solution
- boric acid, 2% solution
- potassium permanganate, 0.01–0.1% solution
1–2% alcohol solutions of aniline dyes (diamond green, fucorcin) are used externally as antiseptics.
Topical antifungals
Ketoconazole, bifonazole and ciclopiroxolamine in the form of cream and shampoo can be used to treat patients with diabetes. The use of ketoconazole for prophylactic purposes helps maintain remission.
Bifonazole and ciclopiroxolamine can be prescribed in the form of shampoo 3 times a week. The shampoo should be applied to the scalp and beard area.
Exposure time is 5-10 minutes before rinsing. After the exacerbation is relieved and remission is achieved, the frequency of shampoo use can be reduced to twice a week or as needed.
When a secondary infection occurs, use ointments or, if indicated, aerosols containing antibacterial drugs:
- oxytetracycline hydrochloride/hydrocortisone acetate, aerosol,
- oxytetracycline hydrochloride/hydrocortisone acetate, ointment,
- hydrocortisone neomycin natamycin cream/ointment,
- triamcinolone acetonide/tetracycline hydrochloride, aerosol,
- hydrocortisone fusidic acid, cream,
Subsequently, glucocorticosteroid drugs with weak and moderate anti-inflammatory activity and pastes containing 2–3% birch tar, naftalan oil, and 0.5–1% sulfur are used.
Systemic treatment
For severe itching - antihistamines
- acrivastine 8 mg
- loratadine10 mg
- fexofenadine 120–180 mg
- terfenadine 60 mg
- cetirizine 4 mg
- calcium gluconate, injection solution 10%
- calcium pantothenate 100 mg
Non-drug therapy
Selective phototherapy 20–25 procedures.
Special situations
Treatment tactics for diabetes in children include removing crusts, eliminating weeping, preventing fungal infections and proper care.
The scalp is treated with 2% salicylic ointment. When bathing a child, use shampoos with ketoconazole, zinc, and tar.
Vitamins are prescribed internally (ascorbic acid, thiamine, pyridoxine, calcium pantothenate).
For severe and moderate forms it is used complex treatment using short courses of antibacterial drugs (ampicillin, oxacillin), infusions of saline solutions and glucose with 5% ascorbic acid, and immunoglobulin injections.
Intramuscular injections of vitamins B1 and B6 are prescribed. Vitamins C, B1, B2 are used internally.
Enzymes are prescribed to eliminate dyspeptic syndrome gastrointestinal tract(Abomin, Pancreatin, Mezim-Forte, etc.). When monitoring the nutrition of a child with seborrheic dermatitis, the type of feeding is taken into account.
It is necessary to select an adapted milk formula for artificial feeding and prescribe a complete diet balanced in proteins, fats and microelements to mothers of breastfed children.
Requirements for treatment results
- improvement of the general condition of the patient;
- reducing the severity of inflammation;
- cessation of exudation and itching.
Tactics in the absence of treatment effect
In severe cases of diabetes or resistance to external therapy, oral antifungal drugs may be prescribed.
- itraconazole 200 mg
- terbinafine 250 mg
- fluconazole 50 mg
- ketoconazole 200 mg
prevention
There are no methods of prevention.
Treatment of seborrheic dermatitis is quite difficult process. If a woman suffers from this disease, then she needs to pay attention to resolving menstrual cycle.
Seborrheic dermatitis treatment also involves treatment of all pathological abnormalities in the patient’s body (nervous system, internal organs). Only then can the most effective result be achieved.
It is also important to carry out necessary measures for the prevention of seborrhea. Natural therapeutic and preventive factors are best suited to regulate the fatty functions of the skin.
First of all, of course, you need to strictly observe hygiene measures (as for oily skin). You should take baths with mineral water, spend more time in the fresh air, and sunbathe in the sun.
Patients should avoid eating canned, fatty, spicy foods. You need to eat more vegetables, fruits, and dairy products.
In addition, people suffering from this disease need healthy sleep, physical exercise..
If a person is diagnosed with scalp seborrhea, the treatment is similar to the procedures that we use to get rid of dandruff. Shampoos containing zinc pyrithione are most effective. salicylic acid, tar, selenium sulfide and ketoconazole.
Just keep in mind that with frequent use, selenium sulfide promotes more intensive work of the sebaceous glands and can aggravate the course of the disease. In addition to cosmetics, scalp seborrhea is treated with glucocorticosteroids.
If you have seborrhea, you must follow a strict diet, avoid fried, spicy, spicy and fatty foods. Sweets, including chocolate, are also excluded from the diet.
All these products contribute to the production of sebum and have a detrimental effect on the condition of internal organs. Useful properties have cereals, fruits, vegetable dishes, salads dressed not with mayonnaise, but vegetable oil, and dairy products.
If a person has skin seborrhea, treatment consists of restoring the normal functioning of the autonomic and digestive systems. For this purpose, the patient is prescribed medications that normalize the functioning of the digestive tract, multivitamins, and microelements (zinc, sulfur).
On early stages shows very good results local treatment. The affected areas of the skin are treated with weak solutions of calendula, salicylic or boric acid, and valerian.
Lubrication not only cleanses the surface of the skin, but also prevents the development of all kinds of inflammatory reactions. It is recommended to use exfoliating agents simultaneously with alcohol-containing solutions.
Vitamin and herbal creams, which contain various antiseptic substances, are especially useful. Patients are often prescribed antifungal drugs, but in the case of seborrhea they act more as prophylactic agents that prevent reappearance diseases.
Indications for use
For oral administration. - onychomycosis caused by dermatophytes; — mycoses of the scalp; — fungal infections of the skin - treatment of dermatomycosis of the trunk.
Shins. Stop.
And also yeast skin infections. Caused by fungi of the genus Candida (for example Candida albicans) - in those cases.
When localization. The severity or extent of the infection determines the appropriateness of oral therapy.
For external use (all dosage forms for external use - gel, cream, ointment, spray - except for the film-forming solution). - prevention and treatment of fungal skin infections, including mycoses of the feet (foot fungus), inguinal athlete's foot (tinea cruris), fungal infections of the smooth skin of the body (tinea corporis), caused by dermatophytes such as Trichophyton (including T.
Rubrum, T. Mentagrophytes, T.
Verrucosum, T For external use (film-forming solution). Treatment of mycoses of the feet (foot fungus, tinea pedis).
When taken orally. Liver dysfunction; suppression of bone marrow hematopoiesis, cutaneous lupus erythematosus or systemic lupus erythematosus.
Terbinafine should be used with caution in patients with concomitant diseases such as psoriasis or lupus erythematosus due to the possible exacerbation of these diseases.
For external use. Liver and/or renal failure; alcoholism; inhibition of bone marrow hematopoiesis; tumors; metabolic diseases; occlusive vascular diseases of the extremities.
Inside, outside.
Orally, parenterally, locally, including conjunctivally.
Contraindications
Hypersensitivity. When taken orally.
Heavy. Chronic or active liver disease; renal dysfunction (Cl creatinine
The disease allergic dermatitis is a skin ailment that can affect a person at any age. In addition, allergic dermatitis occurs even in pregnant women, which is very dangerous. According to the international classification according to ICD-10, the disease has code L23. We will learn the causes and methods of treating allergic dermatitis from this material.
A skin disease that is triggered by contact with external irritants is called allergic dermatitis. The reason for the formation of this type of skin disease is not only the mechanical method of exposure. Allergies occur through inhalation of irritants, which occurs in frequent cases. Allergic dermatitis can appear due to the following factors:
- perfumery;
- paints and varnishes and polymer materials;
- metals;
- medicines.
The underlying cause of the development of the disease is excessive sensitivity to allergens. Their local influence can cause the disease to spread throughout the body. You can cure a dermatic disease yourself at home, but first visit a doctor. The danger of the disease is due to the fact that dermatitis can develop into a complication stage, causing swelling of the throat and symptoms of suffocation. In this case, it is necessary to hospitalize the patient.
What causes the disease
Allergic dermatitis is provoked through the influence of both external and internal irritants. Their volumes are too small for the immune system to recognize it in time. If the provocateur of the disease comes into contact with blood proteins, then in this case an irritant is formed in large sizes.
Contact dermatitis - acute or chronic inflammatory disease skin caused by the irritating or sensitizing effect of exogenous factors. Incidence: 669.2 per 100,000 population in 2001.
Code according to the international classification of diseases ICD-10:
Classification Primary irritation dermatitis (simple contact dermatitis) Allergic contact dermatitis (ACD) Phototoxic dermatitis (see Photodermatitis).
Atopic dermatitis is a chronic inflammatory skin disease accompanied by itching and eczematization, often associated with a hereditary predisposition to atopy and having typical localization sites, often combined with respiratory manifestations of atopy - allergic rhinitis, conjunctivitis, bronchial asthma.
Incidence: 102.7 per 100,000 population in 2001.
Causes
The disease is caused by skin contact with an allergen. Such irritants may include:
- chemical substances;
- coloring matter;
- household chemicals;
- some food products;
- medications;
- perfumery;
- cosmetical tools;
- some materials, including construction materials.
In this disease, the skin reacts sharply to contact with an irritant, resulting in a characteristic rash. All people are equally susceptible to the disease, regardless of age and gender.
The list of irritants that cause dermatitis is very long. Each patient can detect an individual skin reaction to seemingly safe substances and materials.
Etiology. Allergens - the leading role belongs to food, household, epidermal, pollen.
Genetic aspects. Atopic dermatitis in combination with deafness (221700, r).
Risk factors Pathology of pregnancy (risk factor for the child) Viral diseases during pregnancy (risk factor for the child) Preeclampsia, especially in women with complicated allergy history(risk factor for the child) Artificial feeding Improper diet Functional disorders of the gastrointestinal tract: biliary dyskinesia, dysbacteriosis, helminthiasis Violation of the integrative function of the central and vegetative nervous system Antibacterial therapy during pregnancy and lactation (risk factor for the child) Various foci chronic infection Frequent and uncontrolled use of drugs Skin infections often lead to exacerbations and worsening of atopic dermatitis.
Pathogenesis Increased IgE content, often revealed by positive skin tests and specific antibodies (IgE) to some inhalation and food allergens.
Eosinophilia of peripheral blood is characteristic. Decreased levels of cellular immunity: decreased severity of delayed-type hypersensitivity reaction (including
including in skin tests for tuberculin), a decrease in the number of T lymphocytes (primarily CD8+ cells) and their functions, which leads to an increased susceptibility to the development of viral and fungal infections. Disorders of autonomic regulation and intracellular regulatory systems.
Etiology unknown.
Pathogenesis: polyvalent (less often monovalent) sensitization of the skin, as a result of which it reacts inadequately to various exogenous and endogenous influences.
Sensitization is promoted by stressful experiences, endocrinopathies, diseases of the gastrointestinal tract, liver, as well as mycoses of the feet, chronic pyococcal processes and allergic diseases.
IN childhood eczema is pathogenetically related to exudative diathesis.
Classification of the disease
In the International Classification of Diseases, the disease is classified as eczema and allergic skin reactions caused by contact with an irritant. Allergy with dermatitis according to ICD-10 has code L23.
Depending on the type of irritant that provoked toxic-allergic dermatitis, ICD-10 assigns it a code in the range L20-L30.
Thus, dermatitis of unknown etiology, the causes of which cannot be identified, is designated by ICD-10 code L23.9.
Having figured out how allergic dermatitis is classified and what code is assigned to it according to ICD-10, it is important to know how the disease manifests itself in children and adults.
There are several types of contact dermatitis, depending on the type of irritant:
- contact;
- Tosi-allergic;
- atopic;
- erythema.
Children often experience perianal dermatitis, which, according to ICD-10, belongs to other types of skin allergic reactions. Perianal skin irritation is characterized by the formation of a rash and itching in the anal area. Often this form appears in response to neglect of hygiene rules.
The contact form of an allergic skin reaction develops directly through physical contact with an allergen.
The toxic-allergic form of the disease appears in cases of severe poisoning and when the allergen enters the patient’s respiratory tract.
Symptoms (signs)
A pathognomonic sign is a sharply demarcated edge of the lesion.
The process primarily involves areas of skin with a thin epidermis (eyelids, genitals, etc.).
The skin of the palms and soles is most resistant to irritation; The skin of deep folds is not affected.
Forms of contact dermatitis Simple contact dermatitis - erythematous, vesicular - bullous, necrotic - ulcerative ADC Acute form: papules, blisters, blisters with surrounding erythema, weeping, itching.
Initially, rashes appear only at the site of contact with an irritating substance or allergen; subsequently they can spread Chronic form: thickening with lichenification, erythema, peeling, and in some cases erosion.
Clinical manifestations General signs Severe itching Dry skin Facial erythema (mild to moderate) Pityriasis alba (lichen) - areas of hypopigmentation on the face and shoulders Characteristic fold along the edge of the lower eyelid (Denny's sign/Morgan's line) Increased pattern of palm lines (atopic palms) By clinical course three periods are distinguished: infant (up to 2 years), children (from 2 to 10 years) and adolescent-adult (over 10 years) Infant period Hyperemia, swelling, weeping Later, areas of infiltration and peeling, papular elements and areas of lichenification appear Localization mainly in forehead, cheek areas Children's period The process is localized mainly in the area of skin folds. Characterized by infiltrated dry skin, pityriasis-like peeling, multiple excoriations. An “atopic face” is formed (the face is wrinkled, with folds, areas of peeling, pasty, somewhat reminiscent of senility) Adolescence - adult period Skin infiltration, lichenoid papules, lichenization predominate , excoriation Localization mainly in the skin of the face and neck; the flexor surfaces of the limbs, wrists, and upper chest are also affected. In patients over 40 years of age, typical localization is the neck and dorsum of the hands.
Clinical picture. Eczema is observed at any age, on any part of the skin (usually on the face and upper extremities).
There are true, microbial, seborrheic and occupational eczema.
True eczema occurs acutely, subacutely and chronically.
Acute eczema is characterized by bright edematous erythema with multiple tiny blisters, when opened, point erosions are formed with abundant weeping, the formation of crusts and scales.
Subjectively - burning and itching. The duration of acute eczema is 1.5 - 2 months.
In the subacute course, inflammatory phenomena are less pronounced:
the color of the lesions becomes bluish-pink, swelling and weeping are moderate, burning and itching subside; infiltration joins.
The duration of the process is up to six months. At chronic course the clinical picture is dominated by skin infiltration; blisters and weeping erosions are difficult to detect, subjectively itching.
A type of true eczema is dyshidrotic eczema, which is localized on the palms and soles and is manifested by abundant blisters, sometimes merging into continuous foci, and multi-chamber blisters with a dense covering, when opened, weeping areas are exposed, bordered by a fringe of the stratum corneum.
Microbial eczema, in the pathogenesis of which sensitization to microorganisms (usually pyococci) plays a significant role, is characterized by an asymmetrical location, often on the extremities, rounded outlines, clear boundaries of the exfoliating stratum corneum, the presence of pustules and is often associated with fistulas, long-term non-healing wounds, trophic ulcers (paratraumatic eczema).
The course is indefinitely long, recurrent
Seborrheic eczema is pathogenetically related to seborrhea. Occurs in infancy and after puberty.
Localized on the scalp, behind ears, is evident in the sternum area and between the shoulder blades.
Its peculiar features are a yellowish color, a layer of fatty scales, the absence of pronounced weeping, mild infiltration, and the tendency of the lesions to regress in the center with simultaneous growth along the periphery.
Occupational eczema, morphologically similar to true eczema, affects exposed skin areas (hands, forearms, neck and face), which are primarily exposed in production conditions. harmful effects chemical irritants, and has a less persistent course, since sensitization with it is not polyvalent, but monovalent.
Allergy skin tests are used for diagnostic purposes.
Symptoms (signs)
The skin's reaction to an irritant is manifested by a rash. Depending on the type of disease and the duration of contact with the allergen, the rash can be either moderate or extensive, affecting large areas of the skin.
Light form characterized by the formation of small islands of blistering rash. The blisters are pink, but the skin between them is not inflamed.
Extensive damage is characterized by the appearance of dense nodules and swelling of the skin. Severe form of the disease is accompanied by fever, severe itching skin and discomfort associated with swelling.
With erythema, a reddish ring-shaped rash appears. The center of the ring usually does not differ from healthy skin, the spot is clearly defined, and the borders of the spot are swollen.
There are several forms microbial eczema:
- Nummular (coin-shaped) eczema.
The skin lesions are round and have clear edges. Dimensions are about 1-3 cm, expansion of the pathological area is possible.
- Mycotic or fungal.
Diagnostics
Research methods If ACD is suspected, a skin patch test is performed with a standard set of contact allergens attached to a patch tape that fixes them on the skin for 48–72 hours.
The reaction is assessed 20 minutes after removal of the allergen. Identification of a possible photosensitizer.
Differential diagnosis Infections caused by HSV Bullous pemphigoid Seborrheic dermatitis Atopic dermatitis.
Research methods Blood test: eosinophilia Increased serum IgE If the allergic nature of the disease is suspected, skin tests with allergens Dermographic test: white dermographism Test with intradermal injection of acetylcholine.
Diagnostic criteria are applied - a set of mandatory symptoms. Typical localization of the skin process - popliteal fossa, elbow creases, back of the neck, face. Family history of atopic diseases. Tendency to ichthyosis. Onset of the disease in early age(up to 2 years).
Differential diagnosis Contact dermatitis Scabies Seborrheic dermatitis Psoriasis Chronic lichen simplex Ichthyosis.
Treatment
Allergic contact dermatitis according to the ICD-10 classification belongs to the class of allergic skin reactions. Diagnosis requires consultation with two specialists - a dermatologist and an allergist. To determine the irritant, you need to take a blood test.
The success of treatment of allergic dermatitis largely depends on whether the allergen can be identified. The mild form of the disease goes away on its own, without therapeutic measures, a few days after the elimination of the irritant.
If the disease is accompanied by itching and discomfort, the patient is prescribed antihistamines. As a rule, such tablets quickly relieve unpleasant symptoms and also help reduce swelling of the skin.
For local treatment of affected areas, salicylic or zinc ointment. Both drugs improve skin regeneration, helping to quickly get rid of irritating rashes.
A severe form of the disease may be accompanied by the formation of blisters. If the bubbles burst, a wound forms in their place.
This form of the disease additionally requires antiseptic treatment in order to avoid infection. If this cannot be avoided, treatment is supplemented with antibiotic ointments.
Regardless of the degree of damage, treatment should only be prescribed by a specialist.
Management tactics The impact of a possible etiological factor should be eliminated. Diet excluding spicy foods and alcoholic beverages; limiting table salt and carbohydrates.
Drug therapy
Locally Cold disinfectant lotions with 2% r - resorcinol rum, 3% r - boric acid rum, Burov's liquid (1:40 dilution) HA - ointments with high activity, for example, fluacinolone acetonide (0.025% ointment) 3-4 r/ days, preferably under a compress.
Systemic GC (only in severe forms with a large area of damage), usually prednisolone 0.5–1 mg/kg/day with gradual withdrawal over 10–14 days Antihistamines - hydroxyzine 25–50 mg 4 times a day or diphenhydramine 25–50 mg 4 times a day If a secondary infection occurs, antibiotics: erythromycin 250 mg 4 times a day.
Complications Addition of pyogenic, yeast infection Malignancy in radiation dermatitis (radiation cancer) Transformation of allergic dermatitis into eczema.
The prognosis is favorable.
General recommendations Diet Elimination of causally significant allergens (elimination diet), limiting the consumption of potentially allergenic and histamine-liberating foods and additives. In newborns and children, obligate allergens are isolated that contribute to the development of dermatitis: eggs, milk, wheat, nuts.
In case of exacerbation, a restriction in diet is recommended for 3-4 weeks. If there is a hereditary predisposition to atopic diseases, the introduction of solid complementary foods is not recommended until 6 months of age, and obligate allergens - up to a year. Protective regime, it is recommended to wear cotton clothes.
Heat worsens the course of atopic dermatitis, so the temperature in the room should not exceed +25 ° C. If an allergy to mites or house dust is detected, adhere to a dust-free elimination regime. Treatment concomitant pathology and sanitation of chronic foci of infection It is possible to carry out specific immunotherapy(cm.
Local therapy: baths are useful, but it is necessary to use emollients. In case of acute weeping inflammatory process, lotions, aerosols, water mash, powders, pastes, creams are used. Local GCs (for example, methylprednisolone aceponate in the form of an emulsion or cream) are the drugs of choice for the treatment of atopic dermatitis in acute period In case of infection, it is necessary to treat the skin with rami antiseptics and use local antibacterial agents, as well as drugs that combine local GCs with antibacterial drugs (for example, betamethasone + salicylic acid with gentamicin) For subacute inflammatory processes - creams, pastes, powders For chronic inflammatory processes, ointments are prescribed (for example, methylprednisolone aceponate in the form of an ointment or fatty ointment), warming compresses For severe infiltration in the lesions - ointments and creams with keratolytic properties Physiotherapy - ultraviolet irradiation in suberythemal doses helps reduce the duration of exacerbation and has a preventive effect.
Systemic therapy First generation antihistamines, for example chloropyramine, clemastine, second generation hifenadine - acrivastine, ebastine, third generation loratadine - fexofenadine Apply mast cell membrane stabilizers - ketotifen GK for a short course until the effect is achieved (usually 1–2 weeks) with gradual withdrawal - only with severe exacerbation and with ineffectiveness of other treatment methods For secondary infection Antibiotics (usually erythromycin or semisynthetic penicillins) For herpetic infection- acyclovir 200 mg every 4 hours for 5–10 days If the treatment is ineffective, possible concomitant contact dermatitis should be excluded. Sedative therapy is often necessary. Currently, plasmapheresis is widely used, aimed at removing toxins.
Course and prognosis. Chronic illness, prone to stopping with age. In 90% of patients, spontaneous recovery is observed during puberty. In some adults, transformation into localized eczema occurs (chronic dermatitis of the palms or soles, dermatitis of the eyelids).
Synonyms Atopic eczema Constitutional dermatitis Prurigo Beignet.
ICD-10 L20 Atopic dermatitis
Therapy for this type of disease should begin with identifying and eliminating the cause. Therefore, for this purpose, diagnostic tests and studies are carried out to identify the pathogen and, at the same time, determine its sensitivity to drugs.
After this procedure, the maximum selection is made effective remedy, to eliminate the pathogenic microorganism. For this purpose, antibacterial, antifungal, and antiviral drugs are used.
In addition to etiological therapy, symptomatic therapy is carried out. It includes the prescription of antihistamines, anti-inflammatory drugs, and vitamin therapy. In some cases, according to indications and after immunogram studies, immunostimulating medications are used.
Local treatment of the affected skin with antiseptics and astringents is performed.
In severe cases, drugs based on corticosteroid hormones are used. Their dosage needs to be controlled and discontinued gradually.
Physiotherapy procedures are also used to treat microbial eczema: ultraviolet irradiation, laser therapy.
There are also quite a few recipes known traditional medicine. Here are some of them:
Treatment involves identifying and eliminating the irritating factor and treating concomitant diseases. The skin, especially the affected areas, should be spared as much as possible from local irritation.
The diet during exacerbations is predominantly dairy-vegetable. Prescribe antihistamines and sedatives, including tranquilizers.
For acute symptoms accompanied by swelling and weeping, diuretics, calcium supplements, ascorbic acid and routine. Locally - for swelling and weeping, lotions from solutions of rivanol, furatsilin; to eliminate them - pastes (2 - 5% boron-naphthalan, boron-tar, etc.
), then ointments (sulfur, naphthalan, tar); in case of sudden infiltration - thermal procedures. At all stages, corticosteroid ointments are widely indicated (for pyococcal complications - combined with antimicrobial components).
For stubborn, delimited lesions, especially dyshidrotic eczema, use ultra-soft x-rays. Common, persistent forms require oral corticosteroids.
Severe forms are subject to treatment in a hospital followed by spa therapy.
Contact dermatitis is an acute or chronic inflammatory skin disease caused by the irritating or sensitizing effect of exogenous factors. Incidence: 669.2 per 100,000 population in 2001.
Classification Primary irritation dermatitis (simple contact dermatitis) Allergic contact dermatitis (ACD) Phototoxic dermatitis (see Photodermatitis).
Incidence: 102.7 per 100,000 population in 2001.
Allergic dermatitis is a disease that is very often diagnosed in both adults and children, and patients with dermatitis often come across such a concept as the ICD code for allergic dermatitis - 10: what is this code and why is it needed?
Before determining the ICD-10 code for dermatitis, you should understand what kind of disease it is, what types and manifestations of dermatitis there are.
Causes of the disease
The disease is caused by skin contact with an allergen. Such irritants may include:
- chemical substances;
- coloring matter;
- household chemicals;
- some food products;
- medications;
- perfumery;
- cosmetical tools;
- some materials, including construction materials.
In this disease, the skin reacts sharply to contact with an irritant, resulting in a characteristic rash. All people are equally susceptible to the disease, regardless of age and gender.
The list of irritants that cause dermatitis is very long. Each patient can detect an individual skin reaction to seemingly safe substances and materials.
Etiology. Allergens - the leading role belongs to food, household, epidermal, pollen.
Genetic aspects. Atopic dermatitis in combination with deafness (221700, r).
Pathogenesis Increased IgE content, often revealed by positive skin tests and specific antibodies (IgE) to some inhalation and food allergens.
Eosinophilia of peripheral blood is characteristic. Decreased levels of cellular immunity: decreased severity of delayed-type hypersensitivity reaction (including
including in skin tests for tuberculin), a decrease in the number of T lymphocytes (primarily CD8 cells) and their functions, which leads to an increased susceptibility to the development of viral and fungal infections. Disorders of autonomic regulation and intracellular regulatory systems.
Etiology unknown.
Pathogenesis: polyvalent (less often monovalent) sensitization of the skin, as a result of which it reacts inadequately to various exogenous and endogenous influences.
Sensitization is promoted by stressful experiences, endocrinopathies, diseases of the gastrointestinal tract, liver, as well as mycoses of the feet, chronic pyococcal processes and allergic diseases.
In childhood, eczema is pathogenetically associated with exudative diathesis.
There can be many reasons for the appearance of the disease, but the main ones are irritants of a chemical, biological and physical nature.
ICD disease codes
The acronym ICD stands for International Catalog of Diseases and Health Problems. Disease codes are a kind of medical language, which unites and organizes everything medical diagnoses.
Any problem of the patient indicated in the documentation through the appropriate code becomes clear and accurately identified by any doctor in any country. There is only one condition - the country must be a member of the World Health Organization (WHO).
The purpose of creating an international classification of diseases:
- Statistical accounting of health problems, their identical designation, in which words are excluded. Complete replacement of the diagnosis with the corresponding disease codes (letters and Roman Arabic numerals) avoids confusion when translating from one language to another.
- Diagnosis of diseases and routing of treatment based on accumulated world experience.
The need to create a global catalog of diseases, injuries, pathological conditions(ICD 10 code) explained general work over the protection of public health.
From time to time (approximately once every 10 years) this regulatory document is revised, supplemented and clarified. This occurs under the control and direct guidance of WHO.
After the revision, a new type of ICD is introduced. Currently, the classification of the tenth revision is in force - ICD 10.
Note! ICD 10 codes contain not only a description of diseases, but also detailed description necessary treatment indicating medical supplies.
Correct diagnosis of a disease determines the success of its treatment and the further prognosis for the patient’s life. In the case of allergic dermatitis, the doctor must diagnose the type of disease with similar external manifestations.
The official diagnosis for allergic dermatitis may be one of those listed in the table below.
Codes of allergic dermatitis according to ICD 10
You can find the ICD 10 code for dermatitis in the class of diseases of the skin and subcutaneous fat. Since the pathology has a large number of varieties, it occupies an entire section of dermatitis and eczema in the ICD 10 revision.
It should be noted that in this document, dermatitis and eczema are used interchangeably as synonyms.
The section includes the following types of pathological processes:
- L20 – atopic form of the lesion (manifestation of an allergic reaction);
- L21 – seborrheic skin lesions;
- L22 – diaper-type dermatitis (in young children due to mechanical irritation of the skin);
- L23 – allergic contact inflammatory process (represents an allergy of a local nature, for example, due to household chemicals);
- L24 – simple contact irritation;
- L25 – unspecified contact pathology;;
- L26 – exfoliative variant of skin lesions;
- L27 – skin pathology caused by ingestion of various substances(for example, medicinal);
- L28 – lichen simplex and prurigo;
- L29 – itching;
- L30 – other options pathological process on the skin.
Despite the fact that in ICD 10 dermatitis has a code determined by the etiological factor, the principles of diagnosis and treatment of the disease differ little. The main action of the doctor is to identify the cause of the formation of rashes and eliminate these factors from the patient’s life.
Features of diagnosis and treatment
Making a correct diagnosis for this type of skin lesion is made difficult by the large number of conditions that can cause this condition.
The doctor carefully questions the medical history, trying to find out what exactly triggered the pathological process.
In addition to the survey and inspection, there are laboratory research and allergy-specific techniques such as skin testing. Before conducting a provocative test, the doctor makes sure that there is no acute process, which he relieves with medication.
The basic principles of treatment of the pathological process are based on eliminating the aggressor affecting the skin. To relieve symptoms (rashes, swelling, redness and itching), topical creams and ointments with antihistamines or corticosteroid hormones are used.
These same medications can be prescribed systemically for severe forms of the disease. The doctor should take into account that in ICD 10, dermatitis is divided into many points, each of which also has divisions.
To view the treatment protocol, it is important to establish the diagnosis as accurately as possible.
The International Classification of Diseases, 10th revision, was introduced as a single document for recording cases of human morbidity, reasons for their treatment, and treatment outcomes.
Entering into it by specialists all cases of the development of the disease, as well as the drugs and methods that were chosen for therapy, allows doctors around the world to effectively fight diseases, relying on global experience.
An unfavorable environmental situation has a negative impact on the health of any person. According to WHO, about 50% of the world's people suffer from various allergic diseases, each of which has its own code in the international classification of diseases.
Note. In this block, the terms dermatitis and eczema are used interchangeably.
Excluded: chronic (childhood) granulomatous disease (D71) dermatitis. dry skin (L85.3). artificial (L98.1). gangrenous (L88). herpetiformis (L13.0). perioral (L71.0). congestive (I83.1 - I83.2) diseases of the skin and subcutaneous tissue associated with exposure to radiation (L55-L59)
Excludes: limited neurodermatitis (L28.0)
Excludes: infectious dermatitis (L30.3)
L22 Diaper dermatitis
Diaper room. erythema. rash Psoriasis-like rash caused by diapers
Included: allergic contact eczema Excluded: allergy NOS (T78.4) dermatitis.
NOS (L30. 9).
contact BDU (L25. 9).
diaper (L22). caused by substances taken orally (L27.
—). century (H01.
1). simple irritable contact (L24.
—). perioral (L71.
Includes: simple irritant contact eczema Excludes: allergy NOS (T78.4) dermatitis.
contact BDU (L25. 9).
diaper (L22). caused by substances taken orally (L27.
—). century (H01.
1). perioral (L71.
0) eczema of the external ear (H60. 5) diseases of the skin and subcutaneous tissue associated with exposure to radiation (L55-L59).
Included: contact eczema, unspecified Excluded: allergy NOS (T78.4) dermatitis.
NOS (L30. 9).
allergic contact (L23. -).
caused by substances taken orally (L27. -).
century (H01. 1).
simple irritable contact (L24. -).
perioral (L71. 0) eczema of the external ear (H60.
5) damage to the skin and subcutaneous tissue associated with exposure to radiation (L55-L59)
L26 Exfoliative dermatitis
Gebra's pityriasis Excludes: Ritter's disease (L00)
Excluded: unfavorable. drug exposure NOS (T88.7). reaction to food, excluding dermatitis (T78.0 -T78.1) allergic reaction NOS (T78.4) contact dermatitis (L23-l25) drug. photoallergic reaction (L56.1). phototoxic reaction (L56.0) urticaria (L50.-)
Excludes: neurotic scratching of the skin (L98.1) psychogenic itching (F45.8)
Excluded: dermatitis. contact (L23-L25). dry skin (L85.3) small plaque parapsoriasis (L41.3) stasis dermatitis (I83.1 -I83.2)
Types of allergic reactions and their codes according to ICD-10
In the 10th classification, diseases caused by the response of the immune system are divided into different groups depending on the symptoms and characteristics of the course:
- contact dermatitis (L23);
- urticaria (L50);
- rhinitis (J30);
- dysbacteriosis (K92.8);
- unspecified allergy (T78).
- L00-L99 Diseases of the skin and subcutaneous tissue
- L20-L30 Dermatitis and eczema
- L23 Allergic contact dermatitis
- L23.0 Allergic contact dermatitis caused by metals
- L23.1 Allergic contact dermatitis due to adhesives
- L23.2 Allergic contact dermatitis caused by cosmetics
- L23.3 Allergic contact dermatitis caused by drugs in contact with skin
- L23.4 Allergic contact dermatitis caused by dyes
- L23.5 Allergic contact dermatitis caused by other chemicals
- L23.6 Allergic contact dermatitis caused by food in contact with skin
- L23.7 Allergic contact dermatitis caused by plants other than food
- L23.8 Allergic contact dermatitis caused by other substances
- L23.9 Allergic contact dermatitis, cause not specified
Symptoms (signs)
Clinical picture
A pathognomonic sign is a sharply demarcated edge of the lesion.
The process primarily involves areas of skin with a thin epidermis (eyelids, genitals, etc.).
The skin of the palms and soles is most resistant to irritation; The skin of deep folds is not affected.
Forms of contact dermatitis Simple contact dermatitis - erythematous, vesicular - bullous, necrotic - ulcerative ADC Acute form: papules, blisters, blisters with surrounding erythema, weeping, itching.
Initially, rashes appear only at the site of contact with an irritating substance or allergen; subsequently they can spread. Chronic form: thickening with lichenification, erythema, peeling, and in some cases erosion.
Diagnostics
Research methods If ACD is suspected, a skin patch test is performed with a standard set of contact allergens attached to a patch tape that fixes them on the skin for 48–72 hours.
The reaction is assessed 20 minutes after removal of the allergen. Identification of a possible photosensitizer.
Differential diagnosis Infections caused by HSV Bullous pemphigoid Seborrheic dermatitis Atopic dermatitis.
Medicines and medical products for the prevention and/or treatment of “Allergic contact dermatitis” (arranged alphabetically).
Management tactics The impact of a possible etiological factor should be eliminated. Diet excluding spicy foods and alcoholic beverages; limiting table salt and carbohydrates.
Drug therapy
Locally Cold disinfectant lotions with 2% resorcinol solution, 3% boric acid solution, Burov's liquid (1:40 dilution) HA - ointments with high activity, for example, fluacinolone acetonide (0.025% ointment) 3–4 r/ days, preferably under a compress.
Complications Addition of pyogenic, yeast infection Malignancy in radiation dermatitis (radiation cancer) Transformation of allergic dermatitis into eczema.
The prognosis is favorable.
Group medications and medical supplies for the prevention and/or treatment of “Allergic contact dermatitis” by pharmacological group
There are several different opinions about the group of diseases to which atopic dermatitis belongs. Some experts believe that we are talking about a skin disease, others insist that this is a genetic variation of the disease, and the third group points to the immune nature of dermatitis. In fact, all theories are true. Atopic dermatitis is a genetic disorder (complicated by heredity) that leads to a pathological immune response of the body, which appears as a lesion of the skin. Due to its prevalence, it is important to know what atopic dermatitis is (ICD-10, symptoms, difference from a number of other diseases).
Atopic dermatitis is a very common disease, affecting about 20% of children and 6% of adults. According to all-Russian data, in our country this skin disease, accompanied by itching and other unpleasant symptoms, affects about 10% of the population. It often occurs along with other allergic processes and disorders caused by various allergens.
Factors leading to the development of the disease include:
- bronchial asthma;
- hay fever;
- allergic conjunctivitis;
- hives.
This condition is called atopic syndrome. It is characterized by a long-term course with repeated new inflammations.
Classification according to ICD-10
In accordance with the international medical classification, the diagnostic code for atopic dermatitis is L20.
Main code: Chapter XII – diseases of the skin and subcutaneous tissue.
Clinical picture
Atopic dermatitis is a chronic skin disease of inflammatory etiology, manifested by dry skin, red rash, swelling, and itching. Most often, the lesions are located on the hands. Other areas are the surface of the neck, face and other parts of the body.
However, the disease can develop into a wet form. In this case, the risk of infection increases.
Atopy usually appears in children in infancy and disappears at an older age (over 20 years). Symptoms and their severity vary depending on clinical form diseases.
In accordance with the course, three periods of the disease are distinguished:
- infant;
- children's;
- adult.
Infant form
Usually appears at 3 months of age. During this period, red pimples predominate, including blisters with scales or phlegm on the cheeks, chin, torso, limbs, and head. Babies are restless, and in severe cases, sleep disturbances occur.
Children's uniform
The characteristics of atopic dermatitis acquire typical features. During exacerbation, the rash appears in the elbows, under the buttocks, on the arms and legs.
Manifestation in several degrees is possible. From rough, dry skin, the disease easily transforms into blisters and wet spots, then into cracked skin. By about 7 years of age, about 50% of patients with the childhood form forget about the disease.
Adult form
The disease in adults either persists from childhood or occurs in adulthood. The affected areas are similar to the childhood form, sometimes affecting the skin of the face and neck.
Differential diagnosis
Some forms of atopic dermatitis are diagnostically difficult. For example, when localized only on the eyelids, corners of the lips, and hands, the symptoms are similar to those of neurodermatitis (with atopy occurring in 60% of cases). Manifestation on the nipples, genitals, arms, legs can be mistaken for mycosis (in this case, special antibacterial drugs for external use do not help, since they do not act against the pathogen).
Today, “extended criteria of the new millennium” are used in diagnostics. Based on these criteria, the term “atopy” is confirmed only after a demonstrated increase in IgE levels. The disease is characterized by peripheral blood eosinophilia (increased eosinophils above 450/μl). During the diagnostic process, it is often revealed positive antibodies in blood serum or skin.
Treatment
The principles of treatment include, first of all, measures to remove known triggers, creating a safe environment to prevent an allergic reaction.
Modern drugs used for atopy are topical calcineurin B inhibitors.
In severe cases of the disease, plasmapheresis is used to purify the blood.
“Skin is a reflection of the soul.” This statement proves that a person’s mental state significantly influences the course of the disease. When psychological problems, do not be afraid to visit a psychosomatic dermatologist or psychologist. Psychotherapy can have miraculous effects on the disease.
