Neurodermatitis

Definition Definition A common,chronic skin disease resulting from nervous disorder,accompanied with extreme pruritus and localized lichenification

Etiology and Pathogenesis Etiology and Pathogenesis functional disturbance of nervous system 、 excitative and inhibitive disequilibrium of cerebral cortex. Motivation ： 1.neural and psychogenic factor 2.diet 2.diet 3.gastrointestinal dysfunction 3.gastrointestinal dysfunction 4. endocrine disturbance 4. endocrine disturbance

clinical manifestation Spasmodic pruritus many 0.5cm±skin colour round or polygonal lichen planus lichenification lichenification More serious in summer Has a predilection for the nape,elbows.lower back and eyelids 20 ~ 40yr adults （ i ） neurodermatitis circumscripta

clinical manifestation （ ii ） neurodermite dissemine ： widely spread skin-color ancipitous papulars lichenified the classic locations are scalp,extremities,upper back,waist. spasmodic pruritus Chronically relapsing course of the disease 、

Differential diagnosis Chronic eczema Neurodermatitis cause Allergy reaction ， environmental and physiologic factors ， not easy to find neural and psychogenic disturbance Involvem ent symmetry ， any part of the body ， especially extremities 、 leg 、 external genitalia 、 anus asymmetry, mainly nape,elbows,lower back,ham lesions Acute ： multiform 、 oozing 、 seasonality ， more serious in winter Chronic:lichenification Itching, skin-colour ancipitous papular, lichenification

Diagnosis and differential diagnosis （ ii ） lichen planus polygonal or triangular ancipitous papular ， affect mucous membrane and finger and toe nail affect mucous membrane and finger and toe nail Dark red lavander （ iii ） primary cutaneous amyloidosis 1. occur commonly on the shins and upper back ； 2. Small brown papules that group to form infiltrated large moniliform plaque ； 3. Immunoperoxidase stains for keratin is useful. （ ix ） atopic dermatitis 1. Infantile eczema ； 2. A group of papulars that mimic eczema-like lesions ； 3. Active family history

treatment treatment avoid scratching （ i ） P.O ： 1. antihistamines avoid scratching （ i ） P.O ： 1. antihistamines 2. ataractics 2. ataractics （ ii ） Ext ： summer ： Lin.Aluminium 、 Lin.Dexamethasone andCoaltar 、 Lin.Dexamethasone and propylene Glycol （ ii ） Ext ： summer ： Lin.Aluminium 、 Lin.Dexamethasone andCoaltar 、 Lin.Dexamethasone and propylene Glycol winter ： 5% Cream Benzocaine Cream.Dexamathasone.Co winter ： 5% Cream Benzocaine Cream.Dexamathasone.Co intralesional injection of triamcinolone intralesional injection of triamcinolone