It's cold in winter./kloc-What's wrong with children aged 0/2?

It is probably eczema. It is a common inflammatory skin disease, and its clinical characteristics are polymorphic rash, exudation tendency, symmetrical distribution, conscious severe itching, easy to recur and incurable for many years.

[etiology]

The reason is complicated. Mostly due to the interaction of some external or internal factors. Causality is complicated and there are many other influencing factors, so it is different from contact dermatitis. The cause is not easy to remove, and it is easy to relapse and chronic.

External factors: such as chemicals, cosmetics, spices, dyes, detergents, animal toxins, eggs, fish and milk, exotic protein, pollen, dust, bacterial infection, sun exposure, cold, scratching, etc.

Internal causes: allergic constitution, metabolism, endocrine or digestive tract dysfunction, neuropsychiatric dysfunction, fatigue, mental stress, focus infection, intestinal parasitic diseases, varicose veins, hyperhidrosis, dry skin, etc.

[Pathogenesis]

It may be a delayed allergic reaction caused by complex internal and external factors. But some eczema has nothing to do with allergic reactions. The change of patients' responsiveness often involves many factors, some of which are still unclear and need to be studied in the future.

Traditional Chinese medicine believes that this disease is often caused by improper diet, drinking or overeating spicy products that stimulate the wind, hurting the spleen and stomach, and losing health of the spleen, leading to accumulation of damp heat, exogenous wind-heat and damp evil, internal and external evil fighting, phlegm and turbidity overflowing and soaking the skin. Or because of weakness, spleen dampness and skin dystrophy. Or because of the long-term accumulation of damp heat, it consumes yin and blood, and turns dryness into wind, resulting in blood deficiency and wind dryness, and the skin is not right.

1. Symptoms and diagnostic points

acute eczema

(1) The lesions were polymorphic. After a regular course of disease, it begins with diffuse flushing, and then develops into papules, blisters, erosion, exudation and scabbing, and constant seed coat lesions coexist.

(2) Lesions are often patchy or diffuse, and the boundary is not obvious. It can occur in all parts of the body, especially the head, face, distal limbs and scrotum. Often symmetrical onset, severe cases can spread all over the body.

(3) After acute inflammation, it tends to be moist and erosive. After proper treatment, it can be cured in about 2-3 weeks, but it is often easy to relapse.

(4) Conscious burning and severe pain.

Subacute eczema

(1) is a stage between acute eczema and chronic eczema, which is often caused by the failure or improper treatment of acute eczema and the course of disease migration.

(2) Skin lesions are lighter than acute eczema, mainly papules, scabs and scales, with only a few blisters and mild erosion.

Chronic eczema

Often due to improper treatment of acute and subacute eczema, it will not heal for a long time or recur. Due to the different parts of the disease, the clinical manifestations may be slightly different, but they generally have the following characteristics:

(1) is mostly confined to a certain part, such as the back of hand, calf, elbow fossa, scrotum, vulva, etc. The border is obvious and there is no inflammation.

(2) The skin of the affected area is thick and rough, with obvious ridges and furrows, showing moss-like transformation. The color is brownish red or brown, and the surface is often accompanied by chaff scales, scratches, scabs and pigmentation. New papules or blisters can still appear on some lesions, and a small amount of serosity oozes after scratching. Occurred in hands, feet and joints, often chapped or wart. Conscious pain affects activities.

(3) The chronic course of disease is light and heavy, with no regularity, and often presents acute or subacute attacks repeatedly, especially when mental stress occurs.

(4) There are no symptoms at ordinary times, and there is severe itching before going to bed or when you are nervous.

Eczema attacks, some weeks later in the acute or subacute phase of recovery, usually due to repeated attacks, each stage can cross or exist at the same time. Therefore, different stages of rash can appear in different parts at the same time. There are lichenoid skin thickening, new papules and blisters or redness, erosion, scabbing and desquamation. There are also a few patients with acute eczema whose initial symptoms are not obvious, which are subacute or even chronic eczema.

2. Dialectical analysis

Damp-heat type: acute onset and short course of disease. Bored and thirsty. Constipation and oliguria. Skin lesions flush, fever, swelling and exudation. Tongue is red, white or yellow. The pulse string is slippery or slippery. Syndrome differentiation belongs to both damp-heat and infiltration of skin.

Spleen deficiency and dampness excess type: long course of disease, thirst, dry stool or diarrhea, thick skin lesions or a small amount of exudation, or scratches and scales. Pale tongue, fat tongue body or teeth marks, white or greasy tongue coating, slow or slippery pulse, syndrome differentiation belongs to spleen deficiency and dampness, leading to skin dystrophy.

Type of blood deficiency and wind dryness: chronic course of disease, hypertrophy of skin lesions, chapped keratinization, or scabbing with scratches. Pale tongue with white fur. Pulse is thin or slow. Syndrome differentiation is a chronic disease that consumes yin and blood, and blood deficiency and wind dryness lead to dislocation of skin nail.

3. Differential diagnosis

(1) Contact dermatitis should be differentiated from acute eczema.

(2) Neurodermatitis should be differentiated from chronic eczema.

(3) Seborrheic dermatitis can have eczema-like changes, but the disease mainly occurs in the head, chest, back center, armpits, pudendal parts and other parts with more sebum secretion. It often spreads downward from the head, and the damage is mainly yellow-red or bright red spots, covered with greasy scales or scabs.