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Published byBerniece Singleton Modified over 9 years ago
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Neurodermatitis
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Definition Definition A common,chronic skin disease resulting from nervous disorder,accompanied with extreme pruritus and localized lichenification
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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
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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
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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 、
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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
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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
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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
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