Is the skin on my leg always dry?

At present, there is no cure for ichthyosis, but if patients can strengthen skin care and combine drug treatment, the symptoms can be improved to some extent.

First of all, we must strengthen skin care. When the climate is dry in winter, skin dehydration will increase relatively and skin damage will be aggravated. So winter is the focus of nursing. Eat more foods rich in vitamin A, such as carrots, cream, sweet potatoes, cod liver oil, chlorophyll and pork liver. Don't bathe too often in winter and don't use too much soap. Apply skin care oil after bathing to protect the skin, reduce scales, and maintain proper moisture and adequate nutrition. In addition, pay attention to warm clothes to avoid skin irritation caused by cold; Avoid spicy stimulation. This can make patients comfortable, alleviate their illness and achieve the effect of prevention.

Secondly, under the above care, the condition is still serious, so consider medication:

(1) western medicine treatment

① Oral administration: large dose of vitamin A,10 ~ 300,000 u or vitamin A acid daily 1mg/kg/ day. However, long-term use may lead to poisoning symptoms such as decalcification of bones and alopecia.

② External treatment: External use of 10% urea fat, 0. 1% vitamin A acid cream or 20% cod liver oil ointment has certain effect on relieving skin dryness, desquamation and chapped skin.

(2) Chinese medicine treatment

① Oral administration: For patients with blood deficiency and wind dryness syndrome without family history, childhood onset, dry skin and physical weakness, take Shiquan Dabu Pill with Atractylodes rhizome ointment; Blood stasis syndrome has a family history, since childhood. People with dry skin, rough skin, chapped eyes and black eyes take Xuefu Zhuyu oral liquid.

② External treatment: 60g of almond can be ground into decoction for external washing, and then 90g of walnut and milk 10g can be pounded into paste for external use; For blood stasis syndrome, Radix et Rhizoma Rhei 15g, Ramulus Cinnamomi 20g and Semen Persicae 30g can be decocted in water and cleaned, and then applied with Angelica paste (20g of Angelica sinensis, 50g of sesame oil and 6g of yellow wax, the sesame oil is boiled first, then the Angelica sinensis is decocted until burnt, the residue is removed and the temperature is kept, and yellow wax is added to make a paste).

Ichthyosis is a common hereditary keratotic skin disease, which is called pityriasis in traditional Chinese medicine. According to the different modes of inheritance, it can be divided into:

1. Autosomal dominant ichthyosis vulgaris:

1 common. It usually begins several months after birth, and gets worse with age, with severe symptoms in winter and mild symptoms in summer.

② Basic features: dry skin, yellowish brown rash or dirty brown scales in rhombic or polygonal shape, upturned edges, tiny or chaff-like center close to the skin.

③ The rash mainly occurs on the extended side of limbs, followed by the back, and there may be slight scales on the head, which can spread to the whole body in severe cases, but the armpit and hip folds often do not spread, and there may be keratosis damage of hair follicles on the back of the hand.

④ Most patients feel unwell because the secretion of sebaceous glands and sweat glands is reduced, resulting in dry skin and less sweating.

2. Sex-linked ichthyosis vulgaris

1). Rare. The recessive inheritance of attribute association only occurs in men (women are carriers) and occurs shortly after birth.

2). The rash is widely distributed, and the buckling and folding parts can also be involved. The abdomen is heavier than the back, and the rash scales are large and obvious, which can involve elbow fossa, armpit and fossa.

3). slit mirror examination, both men and women can see that there are many small turbid spots on the posterior wall of cornea or elastic membrane.

3. Epidermolytic hyperkeratosis ichthyosis (congenital ichthyosis-like erythroderma) is an autosomal dominant genetic disease, formerly known as bullous ichthyosis-like erythroderma. At birth, the disease has horny skin thickening and armor-like scales covering the whole body. After birth, desquamation leaves a rough and wet surface and loose blisters can be seen. Scales formed on it again. There are gray thick or verrucous scales in groin, wrist, armpit and elbow where limbs bend and fold, and some parts have warts, so it is also called porcupine ichthyosis.

4. Lamellar ichthyosis (congenital ichthyosis-like erythroderma) is an autosomal recessive inheritance, which was previously called vesicular ichthyosis-like erythroderma, and it can be divided into two types: mild and severe.

1). The worst cases are ugly fetuses, mostly stillbirths or postpartum deaths.

2). The lighter case is the so-called layered ichthyosis, which occurs immediately after birth. After the outer stratum corneum is thin, such as collodion stratum corneum, the skin is red and peeling.

5. Localized linear ichthyosis

Autosomal recessive inheritance is a variation of lamellar ichthyosis.

The following prescriptions have the effects of nourishing blood and moistening skin:

1. Mulberry porridge: Mulberry 15g, 30g jujube and 60g japonica rice are cooked into porridge.

2. Sesame cake: glutinous rice flour 100g, black sesame 30 g, brown sugar 15g. First, cook glutinous rice and brown sugar into rice, mash it into cakes, and sprinkle black sesame seeds on the cakes.

3. Mushroom skin peptone: pigskin 100 g, auricularia auricula 15 g, and proper seasoning. Wash the pigskin first, chop it and boil it into peptone, then add black fungus and seasoning.

4. Turtle longan porridge: 20 grams of longan meat, 30 grams of nail fish and 50 grams of glutinous rice are boiled into porridge, and appropriate seasoning is added before eating.

5. Take jujube 10 g, glutinous rice 50 g, black sesame 12 g and black bean 15 g, and cook porridge every day.

6. Sea cucumber porridge: 60 g of japonica rice and 60 g of fat sea cucumber are cooked into porridge.

7. Jujube sugar: 500 grams of honey, 300 grams of rock sugar, 60 grams of black sesame seeds and 200 grams of black dates. First, black dates are cooked, peeled and pitted, the meat is mashed, then black sesame seeds are added, and then honey is boiled. When it turns into paste, add jujube paste and black sesame seeds, cut into candy pieces and eat them often.

References:

2001March 01June 5438+05: 14 Sina Life

Q: I was born in June1year. I was a man when I was 3 years old. My symptoms are dry skin, less sweat secretion, heavy winter and light summer, and more dandruff. My limbs are heavy. My skin cracked after being blown by the wind or exposed to muddy water for a long time in winter. There are many dandruff in winter, mainly on my legs, which is neither painful nor itchy, and various treatments are ineffective.

The hospital said that this disease is not silver nitrate disease and ichthyosis, but a stubborn skin disease with unclear pathogenesis. I don't know what to do.

Dr. Wu replied: You should first consider the possibility of ichthyosis. Because your description looks like ichthyosis. Because of abnormal keratinization, the patient's skin updates very quickly, so a lot of dandruff is produced and the moisturizing ability is obviously reduced. Because the winter climate is relatively dry, the sebum secretion on the skin surface is reduced, and the moisturizing effect is insufficient, resulting in dry skin and easy itching.

Ichthyosis is a hereditary disease, and there is no good treatment at present, especially for patients with mild symptoms like you. Mainly to keep the skin moist, reduce dandruff and prevent eczema and other skin diseases. Ichthyosis patients often get worse when the climate is dry in winter, showing itching and desquamation.

Therefore, for ichthyosis patients, it is necessary to pay attention not to bathe too frequently in winter, to use less alkaline bath lotion, and to keep the water temperature not too hot. After bathing, apply moisturizing products when the skin is not completely dry.

If you still itch after using the above methods, you can take antihistamines orally to relieve itching during the onset. In addition, glycerin can be used to lubricate the skin locally, and hormone drugs should be used externally for severe eczema-like changes.

Congenital ichthyosis:

Clinical manifestations can be divided into the following types:

(1) autosomal dominant ichthyosis vulgaris is a common mild ichthyosis. When one or both parents are ill, there are often many people in the family, but there is no gender difference. Often from childhood, with the increase of age, the symptoms are most obvious in adolescence, and then stop developing. Skin lesions vary in severity, from dry skin without obvious scales in winter to powdery desquamation after scratching, which is called xeroderma. Or there are brown or light brown scales at the mouth of the hair follicle caused by the tip of the needle and the size of the hair follicle, which is called ichthyossfoll folliculitis. Some scales are grayish white with mica luster, which is called glossy ichthyosis. More keratin hyperplasia is abnormal; It can be as thick as 1cm or more, with rough, prickly or papillary surface and dark gray or grayish brown surface, just like bark. This is called superb ichthyosis.

Symmetrical friends of this disease are in limbs and trunk, especially elbows and knees. In severe cases, it can spread to the whole body, accompanied by hyperkeratosis of palms and soles, sellar fissure and nail changes. Yamagata, scalp, elbow fossa, armpit, buccal fossa, vulva and gluteal groove are often not invaded, or only slightly scaly. Usually, there are no symptoms of self-awareness. In winter, due to the decrease of sweat glands and sebaceous glands, the skin is dry and feels itchy and uncomfortable. If it is chapped, it will hurt. Patients often have ectopic constitution, such as hay fever and asthma.

Histopathology: the stratum corneum was obviously thickened, and the granular layer became thinner or disappeared. The thickening of stratum corneum is related to the slow degeneration of desmosomes between stratum corneum cells, which makes stratum corneum cells unable to fall off normally. Spine cells became thinner and pigment in basal layer increased. Because hyperkeratosis extends into the hair follicle, the hair follicle corner plug is formed. Sweat gland cortical gland will shrink. There is no obvious change in dermis, or there is a small amount of lymphocyte infiltration around blood vessels.

(2) Sex-linked ichthyosis vulgaris: rare. Because the gene of this disease is on the X chromosome, it is only found in men, and it can occur after birth or in infancy. Skin lesions are slightly different from the upper type, and the scales are large and obvious, yellow-brown or dirty black scales, and the skin is dry and rough, often all over the body, and armpits, national fossa and elbow fossa can also be involved; The abdomen is heavier than the back. If the face is involved, it is generally limited to the front of the ear and the side of the face, and hair follicle keratinization does not occur. Palmar and plantar skin is normal, and skin lesions do not decrease with age, but sometimes increase sharply. As a carrier of this disease, women generally don't get sick, and sometimes they only see thin scales on their forearms and calves. There may be small cloudy spots on the posterior wall and posterior elastic membrane of cornea, which will not affect vision.

Histopathological hyperkeratosis, normal or thickened granular layer, slightly thickened spinous layer, no obvious change in dermis, and sometimes lymphocyte infiltration around blood vessels.

Clinical common congenital ichthyosis-like erythroderma and lamellar ichthyosis are as follows:

(3) Epidermolytic hyperkeratosis ichthyosis, also known as bullous congenital ichthyosis-like erythroderma, is an autosomal dominant genetic disease with high distortion rate. It is rare in clinic. After birth or a few months after birth, extensive and local damage may occur. A generalized person is born with armor-like scales all over his body, and then falls off after birth, resulting in flushing and scales all over his body. The surface of the peeled scales is moist, the erythema can gradually disappear, and thick warty scales can appear again. This restriction only exists on the flexion side and fold wall of the limb. In severe cases, wart defects and hyperplasia or localized caressing and hyperplasia damage may occur, which is called porcupine ichthyosis. In the first few years of the disease, there may be leaking scars or large scars of different sizes. Using antibiotics to control infection can reduce the occurrence of water scar. Involvement of the palm will affect the function.

Histopathological manifestations showed hyperkeratosis of epidermis, thickening of granular cell layer, reticular vacuolation of cells above spinous layer, sometimes desmosomes were only connected to one side of spinous cells, spinous process of epidermal cells was released, water mark or large scar on epidermis, and chronic inflammatory infiltration in superficial dermis.

(4) Lamellar ichthyosis is autosomal recessive inheritance. After birth, the whole body is tightly wrapped by a wide layer of artificial cotton colloidal film, which often causes eversion of eyelids and lips. After a few days, the membrane falls off, and the skin appears extensive subchronic flushing, with gray-white or gray-brown polygonal or rhombic scales on it, with fixed center and free edges. Symmetry often occurs in the whole body, especially in the flexion of limbs, elbow fossa, national fossa, armpit and vulva. Hyperkeratosis of palms and soles, overgrowth of nails and hair.