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Eczema. Etiology, pathogenesis, treatment

Eczema is understood as a chronic persistently recurring skin disease, manifested by a characteristic eczematous inflammatory skin reaction (in the form of grouped small vesicles) caused by various exogenous and endogenous factors that lead to the development of multivalent skin sensitivity in patients.

Etiology and pathogenesis. Eczema is a disease of the whole organism with characteristic manifestations on the skin. The same clinical forms of eczema (nummular, dyshidrotic eczema, eczematide) can have different etiologies and pathogenesis.

Mostly exogenous eczema can be of allergic and non-allergic origin. In allergic genesis, an allergic reaction is a manifestation of a delayed-type hypersensitivity in response to repeated exposure to allergens while suppressing cellular and humoral immunity. With reduced skin tolerance to irritating substances, a non-allergic inflammatory eczematous reaction occurs in places of constantly repeating effects of subtoxic agents. With endogenous (atopic) eczema, constitutional (endogenous) influences prevail that are genetically predetermined and regulate the functions of the immune, hormonal, and neurovegetative systems, as well as the structural and functional properties of the skin. Violations of the cellular and humoral parts of the immune system occur.

In the vast third group with microbial eczema, its various clinical forms exist. In this group, the occurrence of an eczematous reaction is equally affected by both exogenous factor (microbial flora) and endogenous - an acquired temporary local dysregulation of skin functions.

Treatment.
If the patient has one of the forms of eczema, which is part of a group of predominantly endogenous variants of the disease, it is important to prescribe a treatment that is used for exacerbations of atopic dermatitis (antihistamines, sedatives, hypnotics, desensitizing agents). With microbial eczema, it is important to rationally affect the initial microbial (fungal) lesion, to identify and normalize local disturbances (microcirculatory, neurotrophic) in the regulation of the protective function of the skin. With common persistent eczema, short-term administration of small doses of a glucocorticosteroid drug is possible. When localizing foci on the limbs, reflex physiotherapeutic procedures are prescribed for the corresponding paravertebral nodes.

External treatment is carried out taking into account the stage of eczema. The choice of forms and means of external therapy depends on the severity and characteristics of the inflammatory reaction of the skin. In the case of attachment of a secondary infection and with microbial eczema, the development of which was preceded by a pyococcal (mycotic) process in the skin, antimicrobial (antimycotic) action should be used. In uncomplicated cases of eczema, the short-term use of modern corticosteroid drugs with the highest safety index is justified.
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Eczema. Etiology, pathogenesis, treatment

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