Nummular eczema. Causes and treatment, the photo on the feet of children, adults, what it is. Folk remedies, ointments, laser Triderm at home

A distinctive feature of nummular eczema is the formation of red patches on the skin. Inflammation begins with the limbs, and then proceeds to other areas of the body. The causes of this disease are caused by internal factors. Lack of treatment can lead to serious complications and the transition to a chronic form of inflammation.

What is eczema nummular

Coin (or nummullyarnaya, discoid, patchy) eczema - a skin lesion characterized formation of multiple foci of rounded form as nummular plaques ( «nummus» is Latin "coin"). This disease often has the character of a chronic, recurrent and difficult to treat.

The occurrence of rash have been observed mainly in people older male. Disease refers to a variety of microbial eczema, i.e. starting factor for its formation are pathogens.

Recently there has been an increased incidence of diseases accompanied by increased resistance to traditional treatments. In children, the disease is rare, the average age of the beginning of the first eruption is 5 years. For many patients, it is accompanied by atopic dermatitis. deterioration occurs most often in the winter season.

Types of nummular eczema

Nummular eczema, causes, and treatments which are described above, can occur in three major forms:

1. Acute. On reddened skin rashes observed various elements (nodules, bubbles).
2. Subacute. The characteristic features of this form - redness, thickening of the skin, crusting, flaking.
3. Chronic at which there oozing, increased dermal pattern, skin discoloration (blanching or, conversely, a darkening) soreness.

Stage and grade of nummular eczema

Nummullyarnaya eczema develops as follows:

1. Erythematous stage. There are some pockets of redness, most often on the hands and feet, which is then distributed on the body.
2. Papular stage. On the inflamed and edematous skin nodules occur bespolostnoy.
3. Vesicular stage. Gradually formed dot erosion blisters filled with liquid.
4. Weeping stage. Bubbles burst, the affected area "get wet."
5. Cortical stage. After the resolution of skin lesions form crust.

These changes can occur both in stages or simultaneously. The presence of several types of lesions at once is a characteristic feature of this type of eczema.

Severity of the disease evaluated by several parameters:

• erythema (redness);
• Moisture;
• form a seal in the skin;
• Bubble presence pustular lesions related to infection by staphylococci or streptococci;
• inflammation of the lymph nodes;
• area of ​​skin lesions.

The total score for this search may be from 3 to 36, and the degree of severity is as follows:

• light - <15 points;
• average - 16-25 points;
• heavy> 25 points.

The symptoms of nummular eczema

Nummular eczema, causes and treatment of diseases which are associated with the internal organs and microbial infection, characterized by the following main features:

• inflammatory foci have rounded shapes and clear contours;
• plaques composed of nodules, bubbles, crusts (serous or purulent), small erosions;
• when dry form lesions - intensive peeling;
• in the presence of serous bubbles occurs moknutie;
• The most typical location - the feet (foot, lower leg), at least - the hand (back of the hand, forearm), shoulders, hips, abdomen;
• severe pruritus.

Often patients crusts yellow, which indicate a secondary bacterial infection by staphylococci or streptococci.

The causes of nummular eczema

Nummular eczema referred to polyetiological diseases caused by a variety of internal and external factors.

The reasons for its occurrence are:

• genetic predisposition;
• the presence of other skin diseases, atopic dermatitis in children;
• endocrine disease;
• the presence of foci of chronic bacterial or fungal infections in the body;
• lowered immunity;
• deterioration of the antioxidant system of the organism;
• allergies caused by skin contact with antigens.

According to medical research, patients with this deviation there is a high contamination of the skin by Staphylococcus aureus (in 40-93% of cases). Its active reproduction promotes skin dryness and its damage due to scratching.

As other risk factors are the following:

• effects on the skin of household chemicals;
• stress;
• violation of the diet, eating spicy and fatty foods, food allergens;
• bad habits, alcohol abuse;
• diseases of the intestine, liver, pancreas;
• taking certain medicines.

Diagnosis of nummular eczema

The diagnosis is established on the basis of the symptoms listed above, and the results of the following types of tests:

• KLA, OAM;
• blood chemistry;
• a blood test for HIV and hepatitis;
• fecal worm eggs, dysbiosis; coprogram;
• study antibody levels to various allergens and parasite antigens;
• taking scrapings from the skin to detect bacterial or fungal pathogen and its sensitivity to antibiotics;
• determination of total IgE immunoglobulin levels using the ELISA method;
• taking a biopsy sample from the damaged skin to its microscopic examination.

Differential diagnosis with diseases such as:

• melkoblyashechny parapsoriaz;
• Gibert zoster;
• seborrheic dermatosis.

When to see a doctor

At the first signs of this disease should immediately consult a doctor. Early treatment can help prevent the transition of the disease into a chronic form that is amenable to treatment difficult. At the first stage it is necessary to consult a dermatologist. It will determine the type of skin disease and suggest a plan of medical actions.

The Appointments may also be necessary to consult an allergist, immunologist, gastroenterologist, neurologist and therapist.

Prevention nummular eczema

Nummular eczema, the causes of which can be of various nature, requires an integrated approach. After the medical treatment necessary to observe the preventive measures that help to avoid a recurrence.

These include:

• diet, exclusion of products that are allergens or lead to deterioration in working GI (Citrus fruits, eggs, chocolate, cocoa, hot spices, tomatoes, beans, mushrooms, caffeine, alcohol and carbonated drinks; concentrated broth and fat dishes, nuts, whole milk);
• elimination of stress;
• the use of moisturizers to the skin;
• avoiding contact with allergens;
• wearing clothing made of hypoallergenic materials;
• use neutral detergents;
• Regular cleaning of premises and air humidification.

Therapies nummular eczema

Nummular eczema, causes, and treatments which are similar to those in atopic dermatitis, is eliminated by local and systemic drugs.

The following basic groups of assets:

• moisturizing and ozhiryayuschie - dry skin;
• antihistamines and topical corticosteroids - for severe itching;
• antibacterial - if there is evidence of bacterial infection;
• combined (with corticosteroid, antibacterial and antifungal components) - when plural character rash.

Medications

Medicines for external treatment at nummular eczema are listed in the table below.

The main component	Tradename	price, rub.	The dosage per day. / Duration of the course
antiseptic preparations
1% alcohol solution of brilliant green	brilliant green	20-80	2-3 / 5-14 days, on eruption area
fukortsin	fukortsin	30-80
0.05% aqueous solution of chlorhexidine bigluconate	chlorhexidine	11-30
glucocorticosteroids
Oxytetracycline + hydrocortisone, aerosol	Oksikort	450	2 times / 5-7 days
Betamethasone dipropionate cream, ointment	Akriderm	230	2 times / 7-14 days
Diprosalik	550
betamethasone	150
Beloderm	200
Dayvobet	1200
Hydrocortisone 17-butyrate ointment	Lokoid	300	2 times / 2-4 weeks.
Latikort	135
Clobetasol propionate cream	Dermoveyt	470	2 times / 7-10 days
Kloveyt	330
Pauerkort	400
Mometasone furoate cream	mometasone	312	1 time / 2-4 weeks.
Momat	190
antibacterials
Gentamicin ointment	gentamicin	115	2 times / 7-10 days
Clindamycin gel	Klindovit	400
Tetracycline, ointment 3%	tetracycline ointment	100
Erythromycin ointment	erythromycin ointment	100

After subacute inflammation apply paste (ichthyol, naphthalane, tar, zinc, boron). Their application can be combined with glucocorticosteroids. If signs of secondary bacterial infection, inflammation of lymph nodes or receptacles, feverish prescribe systemic antibacterials.

Used drugs are listed in the table below:

Title	Dosage for adults, mg	Multiplicity receiving a day / number of days of	Average price, RR.
doxycycline	100	2/ 7-10	25
levofloxacin	250-500	2/ 5-7	340
ofloxacin	200	50
ciprofloxacin	250-500	40

If there is a pronounced itching recommended antihistamines listed in the table below.

Title	Dosage for adults, mg	Multiplicity receiving a day / number of days of	Average price, RR.
suprastin	25	3/ 5-10	130
Mebhydrolin (Diazolin)	100	2/ 5-10	60
Clemastine (Tavegil)	1	160
Dimethindene (Fenistil)	4	1/ 5-10	370
levocetirizine	5	1/ 14-28	370

Traditional methods

Nummular eczema, causes, and treatments which are described above also lends itself to treatment via folk remedies.

Among the most common following recipes:

1. A handful of leafs of sugar and 1 liter of boiling water and keep on heat for 5 minutes. Then infuse 15 min., Not allowing complete cooling fluid. The solution was applied to the damaged skin as a wet gauze bandage for half an hour. After that you must anoint the trouble spots of zinc ointment. If there is a feeling of burning or additional rash ointment to cancel. This indicates the presence of an allergic reaction to it. This procedure is performed daily for 20 days, then make a break for 2 weeks. During a break, you can use other recipes of traditional medicine.
2. Raw potato grate, mush put on the damaged areas and to fix a bandage. Let stand for half an hour. It is also recommended to use the juice of raw potatoes for greater efficiency. Drink it should be immediately after cooking.
3. Large leaves of aloe and kalanchoe cut, smear the juice plant trouble spots. This should be done several times during the day as often as possible. Since aloe gently dries the skin, it is recommended to use a moisturizer.
4. A mixture of henna and basma natural (without additives) in equal proportions pour boiling water and stir. Should get a paste. It needs to infuse for about 1 hour. Agent is applied in the form of a gauze bandage and the skin is maintained for 1.5 hours. The procedure is repeated every 2 days until symptoms disappear.

Other methods

One of the most modern facilities for the treatment of nummular eczema is Triderm cream. It comprises 3 main components, providing Sun (gentamicin sulfate), antifungal (clotrimazole) and anti (betamethasone diproprionate) effect.

It includes also the original composition buffer (sodium dihydrogen phosphate and phosphoric acid), which helps to maintain normal skin pH.

With this drug has a complex action and has a high efficiency. It is applied to the affected area 2 times a day to relieve symptoms. It is on the market as its cheaper counterparts, generic - Akriderm HA Canison Plus.

Of physiotherapy following methods are used for the treatment of this disease:

1. Phototherapy with ultraviolet waves of medium length (311 nm). The procedure is performed 4-5 times a week, and the total number of sessions - 25-30.
2. Laser therapy. Leather processing low-level laser rays reveals therapeutic effect in 34% of patients. Exposure time is 3 min., And the entire course comprises 15-30 sessions are conducted daily.
3. PUVA therapy. Its principle consists in irradiating the skin with ultraviolet rays prior administration into the body of the photoactive substance. Treatment is carried out 4 times a week, the course consists of 15-20 procedures. PUVA therapy is used in cases where the patient has extensive skin lesions.

possible complications

When left untreated microbial eczema, which include nummullyarnaya may become chronic. These patients 2-8 exacerbations per year, the duration of which ranges from 2 weeks to 3 months.

Complications of the disease include the following events:

• Secondary infection with Staphylococcal infection as a result of skin damage due to scratching;
• chronic inflammation of the skin, which can lead to the formation of malignant process;
• education boils;
• inflammation of the lymph nodes;
• fever as a result of intoxication;
• erysipelas, associated with streptococcal infection.

In severe cases of erysipelas can result in death. Children may experience yet another negative effect - eczema vaccinatum after vaccination against smallpox. It can lead to sudden infant death due to sepsis.

Nummular eczema - a dermatological disease, in many cases, turning into a chronic form.

Its causes are primarily connected with endocrine disorders, heredity and lowered immunity. More than half of patients on the skin is detected Staphylococcus aureus, so treatment is complex - with antibacterial, moisturizing and anti-inflammatory agents.

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Author: Baimurzina Regina