Distinguish nursery pruritus (strofulus, children urticaria), and adult nodosum (nodose neurodermatitis). The latter two may be acute or chronic. Pruritus in adults is a rare phenomenon. Statistics show that about 2% of patients referred to a dermatologist, have such a problem.
What it is?
Scrapie (purigo) - is itching dermatosis, in which the basic elements of the rash act small nodules with small bubbles in the center. Intense itching provokes scratching those places where there is a rash, so that there are deep excoriation.
The main factor - the sensitization of the organism. Result - allergic inflammation of the skin.
- in infants - a protein of cow or human milk;
- older children - eggs, pastries, strawberries, chocolate, some types of fish and mushrooms;
- provoke pruritus in adults - honey, smoked, spice, spicy foods, alcohol.
Other causes of pruritus:
- violation of the biliary tract activity;
- sleep disturbances;
- hereditary tendency to allergic reactions;
- worm infestation;
- tumors of internal organs;
- chronic hepatitis;
- Hodgkin's disease.
Scientists drew attention to the seasonality of the disease in rural areas. Many researchers believe: pruritus occurs when the insect bites - ticks, mosquitoes, fleas.
This neyrodermatoza are four main varieties:
- Adult (prurigo, prurigo Besnier) - a kind of dermatosis that most often occurs in the elderly. Often, the disease manifests itself in adults that a child suffering from diathesis or urticaria. Provoke rash in most cases foods or endointoxication body occurring when malfunction of the digestive tract or due to other diseases.
- Children scrapie (strofulyus, papular urticaria) - allergic skin disease, occurring most frequently in children aged up to 5 years, but may occur earlier: during dentition, or in response to new product. For scrapie particularly prone children with exudative diathesis, goiter, or gastrointestinal disease. Disease is manifested in the form of dense blisters filled with serous fluid, or severely itchy rash with dense small papules.
- Senile (senile pruritus) - affects people after 70 years of suffering from various pathologies of the endocrine system, atherosclerosis, Metabolic disturbances. With age, and due to various diseases, most of which have already passed in the chronic form, the skin becomes dry and flaky, there are bouts of the night itching, and then - and characteristic of scrapie rash.
- Nodosum (second name - scrapie Gaida) - a rare form of dermatosis, which are prone to women with a fragile psyche or immunocompromised. Most often provoking factor in the development of the disease are regular stress or severe nervous shock. At risk can be attributed to people suffering from endocrine diseases, diseases of the biliary system and the liver.
Children scrapie - Symptoms
Child view scrapie usually begins with the characteristic appearances on the skin rashes that may be in the form of nodules, not larger than 5 mm. After some time on the surface of such lesions may appear small bubbles.
If these bubbles burst, then in their place are formed point of erosion, which are coated with a special kind of crusts - a serous crust. It should also be said that in addition to rash, located on the face and body, such lesions can be concentrated on the extensor surface of the extremities. Interestingly, the papulovezikul location can be on the skin of the palms, and the skin of the feet. Their size can be up to about 5-6 mm, they may have a base and a special type of edematous inflammatory rim. The main feature of pruritus is a very strong characteristic only for her itch. If you comb the affected scrapie places that can appear in a large number of excoriations.
In addition to the main symptoms in children may experience a variety of neuropsychiatric disorders, such as poor sleep, previously uncharacteristic moodiness, increased irritability, tearfulness. Such symptoms may be explainable both the scrapie accompanied by intense itching and general autointoxication organism and labilnomtyu nervous system congenital type.
Very often patients suffering from scrapie, characterized by the fact that the symptoms may come to naught after the power of the will is possible, for example, milk. However, there are also cases where the transformation of children's scrapie in pruriginous ekzmu or atopic dermatitis. The main sign of this change may be the appearance of a white dermographism type or reduced type abdominal reflex, and plantar possible extinction. In children suffering from scrapie, there may be a characteristic of dry skin, increased femoral (or groin) lymph nodes or anhidrosis.
Symptoms in adults
Pruritus in adults is characterized by the presence of plaques formed on the extensor surfaces of the arms and legs. Papules have a brownish-red tint. their size is about five millimeters. Form dense to the touch formations - conical or hemispherical.
Acute itching sensations cause other elements of the bright red hue. When the patient combing them, education is transformed into specific wounds covered with hemorrhagic crusts.
When scrapie developed into a chronic form, you experience the following symptoms:
- irritability without any apparent reason;
- instability in the emotional background.
Senile pruritus is extremely rare and mainly affects older women. Symptoms of the disease in this case is not much different from the symptoms of "adult" scrapie. Patients complain of itch, provoked the formation of dense papules brownish-gray hue, a diameter of about one centimeter.
Nodular pruritus characterized by a strong, paroxysmal itching. As the disease itchy sensations become stronger. Often anomaly occurs in individuals suffering soldier's heart or diabetes.
What is scrapie: photo
The photo below shows how the disease manifests itself in adults.
Diagnose scrapie dermatologist, who inspects and assigns dermatoscopy rash. In the event of the accession of secondary infection is already scraping bakposev that identifies the pathogen and sensitivity to antibiotics. If pruritus arises against gastrointestinal diseases and endocrine diseases, it requires consultation with an endocrinologist and a gastroenterologist. Appoint additional examination of feces on helminths, as well as analysis on a dysbacteriosis.
By indications doctor prescribes ultrasound pancreas, liver, liver function tests. It is important to exclude dermatological diseases with similar clinical picture the diagnosis of scrapie. Nodular prurigo is hard to differentiate from lichen planus. rash location especially when scrapie possible to distinguish it from scabies, atopic dermatitis, and drug reaction.
In the case of atopic dermatitis, the rash will be localized, usually on the flexor surfaces. In the case of scabies held dermoscopy will find typical for her moves, while the positive result of its investigation to confirm the diagnosis. It should also be said that for toksidermii characteristic will bond rashes and drug administration.
treatment of pruritus
She was treated with pruritus in adults and children must necessarily begin with a diagnostic measures - necessary set precipitating factor in each case of disease, and to remove it only in that case treatment will successful.
If scrapie occurred in children or in women during pregnancy and lactation, they definitely need to be screened for the presence / absence of worms in the body. That worm infestation is most often accompanied by an allergic reaction, which is why the development of pruritus may be associated with this factor. If we consider the disease has developed against the background of the pathologies of the gastrointestinal tract or other systems the body, the first doctor prescribes a course of treatment of, and then taken therapeutic measures in relation to scrapie.
The main preparations in the treatment of pruritus scheme are antihistamines which can eliminate an allergic reaction and reduce the itching sensation. The duration of administration depends on the severity of the disease.
As the desensitizing agents can be assigned:
- calcium pantothenate;
- calcium gluconate;
- sodium thiosulfate;
- chelators: Sorbeks, liquid coal, Smecta, Laktofiltrum, Enterosgel, and others.
Featured with scrapie antihistamines:
To eliminate dysbiosis probiotics are recommended:
- Atsilakt et al.
recommended course intake of pancreatic enzymes to improve digestion processes:
- Enzistal et al.
In severe pruritus or absence of recourse by the rash use PUVA therapy and systemic steroids are appointed:
In severe disorders of mental and emotional state of a patient appointed sedatives or tranquilizers:
- Peony tincture;
- New Pass;
- Adaptol et al.
For the topical treatment of rash elements are held such events:
- glucocorticosteroid ointments;
- application with a 2% boric ichthyol or a 2% boric naphthalan ointments;
- bath with bran and infusion of chamomile, oak bark or succession.
In some cases, alternative treatments can be used to treat rashes:
- irrigation liquid nitrogen or chloroethyl;
- injection (obkalyvanie) with hydrocortisone, tselestonom, dexamethasone or a solution of methylene blue with novocaine.
Depending on the diagnostic results of patient surveys with scrapie may need to carry out treatment of the following diseases and conditions:
- diseases of the gastrointestinal tract;
- chronic diseases of upper respiratory tract;
- worm infestation;
- endocrine disease;
- oncological diseases.
Doctors believe that an important factor in the treatment of this disorder is the food - it has to be balanced and fortified.
The diet of an adult patient should consist of fruits and vegetables, fish and dairy products. In principle, any strict restrictions on food there, but it is necessary to adhere to the following rules:
- Animal fats should be replaced with sunflower oil;
- prefer not to fatty foods, food, cooked by steaming or by baking;
- refuse food, rich in carbohydrates - pastries, pasta, potatoes;
- limit the amount of salt consumed, and preferably completely abandon it.
Scrapie quite unpleasant disease, which not only changes the appearance of the person, but also has a direct impact on the psycho-emotional background, the rhythm of life. Only competent treatment and compliance with all the recommendations of the attending physician will help to get rid of this disease.
From physiotherapeutic methods when used scrapie suberythermal dose UVR, electric, phonophoresis hydrocortisone, inductothermy, microwave therapy on the area of the adrenal glands, iontophoresis, DDT on the area of the cervical sympathetic nodes.