Dermatosis
The content of the article:
- Causes and risk factors
- Forms
- Dermatosis symptoms
- Diagnostics
- Dermatosis treatment
- Possible complications and consequences
- Forecast
- Prevention
Dermatoses are an extensive group of heterogeneous diseases of the skin and its appendages of various origins (infectious, allergic, immune, etc.), caused by both external and internal (endogenous) causes. This group does not include transient changes in the skin that accompany many diseases and conditions.
Dermatosis is a skin disease
At the moment, the International Classification of Diseases describes about 2.3 thousand pathologies belonging to the group of dermatoses. This diversity can be explained by the following reasons:
- the anatomical complexity of the skin (consists of the epidermis, dermis, subcutaneous fat, sweat and sebaceous glands), each of the elements of which can be involved in the pathological process, both separately and in combination with other structures;
- the specificity of the structure of the skin in various parts of the body (keratinizing, non-keratinizing epithelium, areas with extensive hair or accumulation of sweat glands, etc.);
- availability of dynamic observation without special technical means, which makes it possible to note the slightest differences in painful manifestations;
- exposure to a variety of environmental agents acting as provocateurs or factors contributing to a change in the course of the disease.
Causes and risk factors
All etiological factors that can trigger skin inflammation are conventionally divided into 2 groups: endogenous (internal) and exogenous (external).
The most common external causes are:
- physical factors of influence (mechanical friction, systematic or one-time extreme temperature exposure, ultraviolet or ionizing radiation, exposure to electric current, injury);
- chemicals that can cause disease both through direct contact with the skin and when ingested (aggressive household chemicals, cosmetics, industrial hazards, allergens, medicines, food, etc.);
- biological (bacteria, viruses, protozoa, arthropods, fungi, etc.).
Dermatosis can be caused by skin contact with household chemicals
Usually, for the development of dermatosis, a combination of several factors is necessary: the presence of a provocateur, a weakening of the local skin protection, the failure of the immune response to aggressive action, etc. However, sometimes even an isolated action can provoke a skin disease (for example, a burn or frostbite).
Internal reasons:
- local chronic focus of infection (chronic tonsillitis, pyelonephritis, carious teeth, etc.);
- chronic diseases of internal organs that neutralize and eliminate toxins (for example, erythema of the feet and palms in liver diseases);
- violations of protein, mineral, carbohydrate metabolism;
- regional blood flow disturbances, local microcirculation defects;
- hypovitaminosis;
- lymphatic drainage disorders;
- diseases of the nervous system (both central and peripheral) or functional disorders;
- endocrine pathology;
- metastasis in the skin with malignant neoplasms;
- diseases of the hematopoietic system;
- genetic defect, hereditary predisposition;
- immunosuppression.
Sometimes the cause of dermatosis remains unclear, in which case it is called idiopathic.
Forms
By origin, all dermatoses are divided into 2 categories:
- congenital (developed during pregnancy under the influence of various embryotoxic and teratogenic factors or genetically mediated);
- acquired.
The clinical classification of dermatoses is extensive. According to ICD-10, several groups are distinguished, each of which includes many forms of diseases:
- infections of the skin and subcutaneous tissue;
- bullous disorders;
- dermatitis and eczema;
- papulosquamous disorders;
- urticaria and erythema;
- diseases associated with exposure to ionizing radiation;
- other diseases of the skin and subcutaneous tissue.
Some authors offer alternative classifications of dermatoses, taking into account the etiological factor:
- pyoderma or pustular skin lesions - furunculosis, sycosis, carbuncle, impetigo, etc. More often provoked by staphylococci or streptococci, their combined effects;
- fungal infections or mycoses - trichophytosis, epidermatophytosis, lichen, candidiasis;
- parasitic dermatoses - head lice, scabies, demodicosis;
- infectious - leprosy, skin tuberculosis, borreliosis;
- viral dermatoses - herpes infection, chickenpox and smallpox, molluscum contagiosum;
- genetically determined skin diseases - ichthyosis, neurofibromatosis, epidermolysis, xeroderma;
- allergic dermatoses - urticaria, toxicoderma, eczema;
- neurodermatoses - sometimes combined with allergic ones in the group of itchy dermatoses;
- common connective tissue diseases, collagenoses - periarteritis, scleroderma, systemic lupus erythematosus, sclera;
- dermatitis, acute processes - thermal damage to the skin, diaper, allergic, contact dermatitis;
- autoimmune dermatoses;
- bullous [blistering (gallbladder)] dermatoses;
- erythema (abnormal hyperemia of the skin);
- vasculitis (vascular pathology);
- papulosquamous dermatoses - psoriasis, parapsoriasis, lichen planus;
- reticuloendotheliosis;
- dyschromias (pigmentation disorders) - vitiligo, lentigo, chloasma, photodermatosis;
- tropical dermatoses - yaws, rocky mountain fever;
- benign and malignant skin neoplasms;
- traumatic dermatoses;
- occupational skin diseases;
- dermatoses associated with a violation of trophic processes;
- metabolic diseases;
- other dermatoses.
What dermatoses look like
In addition to what has been presented, a lot of attempts are being made to systematize skin diseases based on various preconditions: the primary or secondary nature of the process, its stability, severity, prevailing primary elements, etc.
Dermatosis symptoms
The symptoms of dermatoses can be very diverse, but all diseases have a common feature - a change in the structural elements of the skin.
In total, 8 types of primary elements are distinguished, characteristic of certain dermatoses.
Cavity-free primaries:
- spot - an element that does not rise above the level of the skin, characterized by local limited dyschromia of the skin. Usually resolves without a trace, although in some cases it can persist for a long time. Transforms into scales or secondary pigment spot;
- a blister is a rapidly evolving element, which is an edema of the papillary layer of the dermis, rising above the level of the skin. Permitted without a trace;
- papule - an element that rises above the level of the skin, evolving into scales, a secondary spot, a crack. Permitted without a trace;
- tubercle. It rises above the level of the skin, transforms into scales, ulcers, crust, is resolved by a scar or cicatricial atrophy;
- node - an element that rises above the level of the skin, transforming into an ulcer, crust, scar, secondary spot. It is resolved by a scar or disappears without a trace.
Cavity:
- vesicle - limited education up to 5 mm in diameter. It goes through the stages of erosion, crust, scales, secondary pigment spot, is resolved without a trace;
- bubble - an element with a diameter of more than 5 mm. It rises above the level of the skin, transforms into erosion, crust, scales, secondary pigment spot, resolves without a trace or scar;
- a pustule is a towering formation filled with purulent contents. Transforms into crust, erosion, secondary pigment spot, ulcer, scar, vegetation.
The following skin diseases are most common in dermatological practice:
- itchy dermatoses (urticaria, neurodermatitis, prurigo, pink lichen, etc.). A characteristic feature is pruritus, which can be an isolated symptom of the disease, and be combined with other symptoms, be a precursor of the main skin manifestations or accompany them;
- infectious, characterized by active inflammatory changes in the skin and proceeding with the formation of pustules, vesicles, nodules. Treatment of dermatoses caused by infectious agents is carried out with the obligatory use of drugs aimed at destroying the causative agent of the disease. After the resolution of the process, cicatricial or pigmentary changes may remain in place of the primary elements;
- fungal dermatoses, which are a type of infectious. They tend to chronize the process and gradually expand the affected area;
- viral dermatoses, provoked by herpes viruses, poxiviruses, human papillomaviruses, are also a type of infectious, characterized by a long (sometimes lifelong) persistent course;
- allergic dermatoses, characterized by violent manifestation, transience (although sometimes they can be protracted, poorly amenable to therapy), undulating course with a return of symptoms after contact with an allergen. Characterized by an increase in the symptoms of dermatosis with each subsequent exposure of the provocateur up to and including anaphylactic shock, Quincke's edema.
Generalized pruritic dermatosis manifests itself as itchy skin
Diagnostics
A type of dermatosis is determined based on an assessment of the condition of the skin, which includes:
- visual inspection (assessment of the nature of the skin elements, their prevalence, the severity of the process, the preferred localization sites);
- diascopy (vitopression);
- determination of the nature of the reaction of the skin to stimuli (Kebner's phenomenon);
- assessment of the type and nature of dermographism;
- assessment of the density of skin elements;
- luminescent study of the skin;
- capillaroscopy.
Dermatosis treatment
The tactics of treating dermatosis is associated with its form, the nature of damage to the skin and is carried out in several stages. The well-being of the disease outcome depends on the rationality of therapy, since dermatoses, as a rule, are accompanied by significant subjective sensations, cosmetic defects, limit the patient's activity and significantly affect the quality of life.
Initially, an etiological factor is identified, on the basis of which etiotropic therapy is selected:
- antifungal agents;
- antiviral;
- antimicrobial;
- antibacterial;
- antiparasitic;
- antihistamines (for allergic dermatoses); etc.
Dermatosis treatment depends on the etiological factor
In the future, symptomatic treatment is carried out. The drugs of the following groups are prescribed:
- keratolytic;
- keratoplastic;
- cauterizing;
- drying;
- anti-inflammatory;
- antipruritic;
- decongestants;
- angioprotectors;
- metabolic;
- detoxification;
- vitamin and mineral complexes;
- fortifying; and etc.
In the treatment of dermatoses, certain rules and sequence of drug use are observed, depending on the severity of the process, the degree of its severity, the presence of weeping foci or foci of keratinization, etc.
Treatment of dermatoses is complex: in addition to pharmacotherapy, methods of physiotherapeutic influence, diet therapy, treatment of concomitant somatic pathology, sanatorium-resort treatment are used, in some cases rational psychotherapeutic influence is used.
Possible complications and consequences
Complications of dermatoses can be:
- chronization of the process;
- uncontrolled progression;
- anaphylactic shock, Quincke's edema;
- infection;
- sepsis.
Forecast
With timely diagnosis and an integrated approach to treatment, the prognosis is usually favorable. For chronic (sometimes lifelong) dermatoses prone to recurrence, the prognosis is determined individually, depending on the severity, prevalence of the process, susceptibility to skin manifestations of the therapy, the general condition of the patient.
Prevention
In order to prevent the development of dermatosis, it is necessary:
- observe skin hygiene;
- limit contact with carriers of infectious skin diseases;
- timely treat skin injuries;
- use personal protective equipment and observe safety precautions at the workplace during industrial contact with aggressive substances;
- participate in medical examination.
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Olesya Smolnyakova Therapy, clinical pharmacology and pharmacotherapy About the author
Education: higher, 2004 (GOU VPO "Kursk State Medical University"), specialty "General Medicine", qualification "Doctor". 2008-2012 - Postgraduate student of the Department of Clinical Pharmacology, KSMU, Candidate of Medical Sciences (2013, specialty "Pharmacology, Clinical Pharmacology"). 2014-2015 - professional retraining, specialty "Management in education", FSBEI HPE "KSU".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
