接触性皮炎:发病方面的临床表现及合理选择外敷治疗

Q4 Medicine Meditsinskiy Sovet Pub Date : 2023-09-27 DOI:10.21518/ms2023-263
M. M. Tlish, M. E. Shavilova
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引用次数: 0

摘要

接触性皮炎是许多国家最常见的皮肤病之一,尤其是职业性皮肤病。这种病理被认为是由直接暴露于环境因素引起的炎症性皮肤病。专性刺激物对表皮细胞有直接的破坏作用,并且由于先天免疫系统的激活,导致任何人的皮炎的发展。兼性刺激物的作用与延迟的IV型细胞介导的过敏反应有关,当易感个体暴露于具有致敏特性的物质时,会导致疾病的发展。接触性皮炎症状的严重程度和性质取决于刺激物的类型和生物体的个体特征。接触性皮炎治疗有效的必要条件是消除过敏原。为了抑制炎症反应,外用糖皮质激素是一线药物。该疾病的使用方便和症状的缓解速度可导致这类药物的使用失控,对此,本文分析了局部使用糖皮质激素的必要条件和规则。当他们开处方时,注意力集中在发展皮肤干燥症的风险上。本文描述了一种预防表皮屏障功能障碍的现代方法,该方法基于使用含有外用糖皮质激素与神经酰胺结合的制剂。我们提出了我们自己的临床观察接触性皮炎患者用这种药物治疗,同时证明了明显的积极动态的皮肤病理过程和主观症状的消退没有发展的副作用。
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Contact dermatitis: etiopathogenetic aspects of the formation of the clinical picture and the rational choice of external therapy
Contact dermatitis is one of the most common skin diseases in many countries, especially among occupational dermatoses. This pathology is considered as an inflammatory skin disease caused by direct exposure to environmental factors. Obligate irritants have a direct damaging effect on the cells of the epidermis and, due to the activation of the predominantly innate immune system, lead to the development of dermatitis in any person. The action of facultative irritants is associated with a delayed type IV cell-mediated allergic reaction, which causes the development of the disease when exposed to substances with sensitizing properties in predisposed individuals. The severity and nature of the symptoms of contact dermatitis depend both on the type of irritant and on the individual characteristics of the organism. A necessary condition for the effectiveness of the treatment of contact dermatitis is the elimination of the allergen. To suppress the inflammatory response, topical glucocorticosteroids are the first-line drugs. The ease of use and the speed of relief of the symptoms of the disease can lead to the uncontrolled use of this group of drugs, in this regard, the article provides an analysis of the necessary conditions and rules for the use of topical glucocorticosteroids. Attention is focused on the risk of developing skin xerosis when they are prescribed. A modern method for the prevention of epidermal barrier dysfunction based on the use of preparations containing topical glucocorticosteroid in combination with ceramides is described. We present our own clinical observations of patients with contact dermatitis treated with this drug, while demonstrating a pronounced positive dynamics of the skin pathological process and regression of subjective symptoms without the development of side effects.
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来源期刊
Meditsinskiy Sovet
Meditsinskiy Sovet Medicine-Medicine (all)
CiteScore
0.70
自引率
0.00%
发文量
418
审稿时长
6 weeks
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