Treatment of seborrheic dermatitis, pityriasis versicolor (lichen versicolor), etc.

Pityriasis versicolor

Pityriasis versicolor
or
pityriasis versicolor
is a fungal skin disease that affects the stratum corneum of the epidermis. Sweating, hot climate, seborrheic skin conditions are predisposing factors for the occurrence of pityriasis versicolor. The incidence of pityriasis versicolor is higher in women and young people. Outbreaks of infection and relapses of pityriasis versicolor are recorded during the hot season. Infection occurs through contact and household contact through the use of shared combs, household items, as well as through direct contact of a sick person with a healthy person.

Pityriasis versicolor begins with the appearance of a single round pink spot, then the same spots, but of a smaller diameter, appear on smooth skin and scalp. With pityriasis versicolor, the skin changes are non-inflammatory in nature, the spots are usually yellowish-brown in color, and when they are scraped, slight pityriasis-like peeling is noted. Pityriasis versicolor spots tend to grow peripherally and merge; there is no itching or other subjective sensations.

Compliance with the rules of personal hygiene is the only prevention of pityriasis versicolor. It is impossible to completely get rid of mycotic cells, and therefore in spring you should use cosmetics with an antifungal effect and avoid sun exposure to prevent relapse.

Pityriasis rosea - symptoms and treatment

Classic form of the disease

Symptoms of the classic form of pityriasis rosea are:[4]

The mother's plaque is a single large flat oval spot, 2 to 5 cm in size, pink or red in color with clear boundaries, covered with thin scales and larger scales along the periphery, which gives it a ring-shaped appearance. The most typical localization is the neck, torso, and less commonly, limbs. It is the initial symptom of the disease.
“Christmas tree” - rashes in the form of small (from 0.5 to 2 cm) numerous scaly papules and plaques of an oblong oval shape of pink color with a “collar” of gray scales located along the lines of Langer’s skin tension, which gives them when localized in the chest or back area looks like tree branches. This rash occurs several days (less often weeks) after the appearance of the maternal plaque.
Itching is not a mandatory symptom of the disease and occurs in about a quarter of patients.

Atypical forms of the disease

Atypical variants of pityriasis rosea occur in approximately 20% of cases.[5] The uncharacteristic nature is manifested in the morphology of the elements of the rash, its size and location.[4] Some authors believe that children with atopic dermatitis are more predisposed to atypical variants of pityriasis rosea than adults.

Vesicular pityriasis rosea is a generalized rash of vesicles (vesicles) with a diameter of 2-6 mm, often forming “rosettes” and accompanied by severe itching. It is most common in children and adolescents and can be localized to the scalp, palms, and soles.[6]

Hemorrhagic pityriasis rosea is characterized by a purpuric eruption that occurs on the skin and, quite often, on the oral mucosa.[7]

Urticarial pityriasis rosea presents as blistering lesions, making it similar to hives. This type of disease is accompanied by intense itching.[7]

Papular pityriasis rosea is a rare form of the disease that is more common in young children and pregnant women. It manifests itself as rashes of several small papules measuring 1-2 mm, which may be present along with classic spots and plaques.[8]

Pityriasis rosea, similar to erythema multiforme - with this type of disease, along with the classic symptoms, target-shaped lesions are noted.[9]

Follicular pityriasis rosea is characterized by a rash of follicular papules grouped into round plaques. They often occur alongside classic lesions.[7]

Giant Darier's pityriasis rosea presents as very large plaques ranging from 5 cm to 7 cm, with individual lesions reaching the size of the patient's palm.[11]

Vidal's ring-shaped ring-shaped rosacea is localized primarily in the axillary and groin areas and is characterized by large ring-shaped rashes.[12]

Hypopigmented pityriasis rosea most often occurs in dark-skinned and dark-skinned people and presents as hypopigmented scaly plaques with a typical localization.[7]

Lichen rosea inversus is characterized by rashes in the folds - axillary and groin areas, elbow and popliteal fossae.[3]

Acral rosacea presents as a typical rash on the extremities—the forearm, wrist, palm, calf, and sole.[14]

Unilateral pityriasis rosea is an extremely rare variant that occurs in both children and adults. In this form, the rashes are located on one side of the body.[15]

Blaschkoid pityriasis rosea is characterized by lesions along Blaschko's lines (pattern-shaped pigmentation).[16]

Oral lesions in pityriasis rosea occur in 16% of patients in the form of erosions, bullous or hemorrhagic eruptions, but they are usually asymptomatic.[17]

Asbestos pink lichen is a very rare form of the disease, presented in the form of plaques in the scalp area, covered with thick, dense gray scales. Clinically it mimics pityriasis amiantacea.[18]

Decapitated pityriasis rosea - rashes of only secondary small elements occur without the previous appearance of a maternal plaque. Occurs predominantly in children.[7]

Recurrent pityriasis rosea

Recurrence of pityriasis rosea occurs in 1-3% of patients.[19] Frequent relapses are considered a very rare occurrence. However, there are case reports with more than two episodes. The exact etiology is not known, but a possible cause is the reactivation of herpes viruses (varicella zoster, Epstein-Barr, types six and seven).[20]

Seborrheic eczema

Seborrheic eczema

- chronic dermatosis, manifested by rashes of small nodules, gradually forming plaques covered with dense, greasy scales and crusts, which, when removed, reveal a moist surface. Rashes of seborrheic eczema are localized on the head, behind the ears, on the face, in natural folds of the skin, in the umbilical region, on the skin of the torso and the flexor surfaces of the arms and legs. It is one of the clinical forms of eczema. The disease can occur equally in people of both sexes and of any age. Often seborrheic eczema develops against the background of seborrhea or as a complication of seborrheic dermatitis. In HIV-infected people, it can be one of the first manifestations of AIDS. A feature of seborrheic eczema in such patients is its spread throughout the entire skin.

Atopic dermatitis and neurodermatitis

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Atopic dermatitis and neurodermatitis
are skin diseases accompanied by dryness, redness, irritation of the skin and severe itching. They have a recurrent form.
Atopic dermatitis and neurodermatitis
have much in common, there are also
differences.
For example , with neurodermatitis, the main symptoms are small dry rashes on the arms, legs, back and groin area, which are accompanied by severe itching.A weeping rash is not typical for this disease.

Atopic dermatitis
most often
occurs in children
under 12 years of age.
More than half of cases are detected in the first year of a child’s life. In adults,
this disease manifests itself in the form of
neurodermatitis
.
Heredity plays a very important role. Even if one parent suffers from neurodermatitis, the child will develop atopic dermatitis in 8 cases out of 10. Due to environmental deterioration in cities, poor nutrition and, as a consequence, decreased immunity, cases of atopic dermatitis and neurodermatitis among the population have increased several times in recent years . Factors that contribute to the occurrence of neurodermatitis and atopic dermatitis in adults
include:

allergens: house dust, animal hair, plant pollen, mold, some types of products;
hormonal imbalance in the body;
stress, depression;
vaccinations given without prior prophylaxis or during an exacerbation of the disease;
self-medication;
problems with the gastrointestinal tract;
using household chemicals without gloves;
neglect of hygiene rules.

Doctors, depending on the location, distinguish linear, follicular hypertrophic and psoriasis-like neurodermatitis. But a more common classification is:

focal - damage to skin areas in one limited area;
diffuse – if there are more than two affected areas.

In the most severe form of the disease, the patient's entire skin is affected, except the palms and nasolabial triangle.

Those who have suffered from neurodermatitis for a long time experience noticeable changes on their face: peeling and thinning of the skin on the eyelids, the appearance of pigment spots around the eyes, cheilitis, and additional deep wrinkles around the eyes. All these signs give a person a tired, painful appearance and are called “atopic face.”

Another type of atopic dermatitis is contact dermatitis.

Difference between neurodermatitis and atopic contact dermatitis

is that
contact dermatitis
is a skin disease that occurs under the influence of physical, chemical and biological factors
only from the external environment
.

Atopic contact dermatitis can occur even when wearing jewelry made of precious metals.

Dermatologists have divided the causes of atopic contact dermatitis into two large groups:

Obligate – alkalis, acids, temperature changes, poisonous plants (nettle, milkweed) and animals (jellyfish, caterpillars), radioactive radiation;
Optional - metal salts, turpentine, formaldehyde, some ointments, washing powders, cosmetics.

', '~DETAIL_TEXT' => '
Neurodermatitis is an outdated name for atopic dermatitis. The term “neurodermatitis” is used to emphasize the role of functional disorders of the nervous system in this disease.

Atopic dermatitis neurodermatitis

- skin diseases accompanied by dryness, redness, irritation of the skin and severe itching. They have a relapsing form.

Atopic dermatitis and neurodermatitis

They have a lot in common, but there are also
differences.
For example, with neurodermatitis, the main symptoms are small dry rashes on the arms, legs, back and groin area, which are accompanied by severe itching.
A weeping rash is not typical for this disease. Atopic dermatitis
most often
occurs in children
under 12 years of age.
More than half of cases are detected in the first year of a child’s life. In adults,
this disease manifests itself in the form of
neurodermatitis
.

Heredity plays a very important role. Even if one parent suffers from neurodermatitis, the child will develop atopic dermatitis in 8 out of 10 cases.

Due to environmental deterioration in cities, poor nutrition and, as a consequence, decreased immunity, cases of atopic dermatitis and neurodermatitis among the population have increased several times in recent years.

Factors that contribute to the occurrence of neurodermatitis and atopic dermatitis in adults

can be attributed:

allergens: house dust, animal hair, plant pollen, mold, some types of products;
hormonal imbalance in the body;
stress, depression;
vaccinations given without prior prophylaxis or during an exacerbation of the disease;
self-medication;
problems with the gastrointestinal tract;
using household chemicals without gloves;
neglect of hygiene rules.

Doctors, depending on the location, distinguish linear, follicular hypertrophic and psoriasis-like neurodermatitis. But a more common classification is:

focal - damage to skin areas in one limited area;
diffuse – if there are more than two affected areas.

In the most severe form of the disease, the patient's entire skin is affected, except the palms and nasolabial triangle.

Another type of atopic dermatitis is contact dermatitis.

Difference between neurodermatitis and atopic contact dermatitis

is that
contact dermatitis
is a skin disease that occurs under the influence of physical, chemical and biological factors
only from the external environment
.

Atopic contact dermatitis can occur even when wearing jewelry made of precious metals.

Dermatologists have divided the causes of atopic contact dermatitis into two large groups:

Obligate – alkalis, acids, temperature changes, poisonous plants (nettle, milkweed) and animals (jellyfish, caterpillars), radioactive radiation;
Optional - metal salts, turpentine, formaldehyde, some ointments, washing powders, cosmetics.

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Neurodermatitis is an outdated name for atopic dermatitis. The term “neurodermatitis” is used to emphasize the role of functional disorders of the nervous system in this disease.

Atopic dermatitis neurodermatitis

- skin diseases accompanied by dryness, redness, irritation of the skin and severe itching. They have a relapsing form.

Atopic dermatitis and neurodermatitis

Heredity plays a very important role. Even if one parent suffers from neurodermatitis, the child will develop atopic dermatitis in 8 out of 10 cases.

Factors that contribute to the occurrence of neurodermatitis and atopic dermatitis in adults

can be attributed:

allergens: house dust, animal hair, plant pollen, mold, some types of products;
hormonal imbalance in the body;
stress, depression;
vaccinations given without prior prophylaxis or during an exacerbation of the disease;
self-medication;
problems with the gastrointestinal tract;
using household chemicals without gloves;
neglect of hygiene rules.

Doctors, depending on the location, distinguish linear, follicular hypertrophic and psoriasis-like neurodermatitis. But a more common classification is:

focal - damage to skin areas in one limited area;
diffuse – if there are more than two affected areas.

In the most severe form of the disease, the patient's entire skin is affected, except the palms and nasolabial triangle.

Another type of atopic dermatitis is contact dermatitis.

Difference between neurodermatitis and atopic contact dermatitis

is that
contact dermatitis
is a skin disease that occurs under the influence of physical, chemical and biological factors
only from the external environment
.

Atopic contact dermatitis can occur even when wearing jewelry made of precious metals.

Dermatologists have divided the causes of atopic contact dermatitis into two large groups:

Obligate – alkalis, acids, temperature changes, poisonous plants (nettle, milkweed) and animals (jellyfish, caterpillars), radioactive radiation;
Optional - metal salts, turpentine, formaldehyde, some ointments, washing powders, cosmetics.

Sharing our experience

If the skin is exposed to one of the factors for a long time, then a large number of skin cells die, which leads to the formation of deep ulcers, which form scars when healing. These formations do not tan in the sun and differ in color from the rest of the skin.

Material prepared by: Ravodin Roman Anatolchevich, Doctor of Medical Sciences, Associate Professor

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Causes of seborrheic eczema

Factors predisposing to the development of seborrheic eczema are increased secretion production by the sebaceous glands, gastrointestinal diseases (gastritis, peptic ulcer), liver disorders (hepatitis, cirrhosis), hormonal abnormalities (diabetes mellitus, imbalance of estrogen and androgens, obesity), vegetative dysfunction. -vascular dystonia. It has been noted that seborrheic eczema often occurs against the background of reduced immunity, which in turn can be caused by frequent acute respiratory viral infections, severe illness, or a chronic infectious focus (sinusitis, sinusitis, otitis media, tonsillitis, etc.).

It is not known about any skin condition predisposing to this disease, nor about the cause of the development of lichenification, however, it can develop secondary to a chronic eczematous process. Differences in clinical morphology, size and localization of lesions have led to the division of the disease into several clinical forms that are common throughout the world. It is especially common in people of Asian origin and relatively rare in the black population. Mostly women are affected, with the peak incidence occurring between the ages of 30 and 50. Itching, obviously, is a cause, and not just a symptom of the disease. This is the main factor in the development of lichenification, probably arising as a result of the activity of mediators or proteolytic enzymes. Nervous stress and psycho-vegetative disorders lead to the unconscious habit of rubbing and constantly scratching the skin, as a result of which the skin thickens and skin lines are accentuated.

Lichenification may occur secondary to many pruritic dermatoses, and some authors suggest that lichen simplex chronicus is a minimal variant of atopic eczema in adults with a personal or family history of atopic disorders. Others believe that the occurrence of the disease is associated with dysfunction of internal organs, such as cholecystopathy, diabetes mellitus and constipation. Lichenification also occurs during other dermatoses of irritation or as a complication of persistent skin lesions of various types, such as chronic contact dermatitis, asteatogic and coin-shaped eczema, seborrheic and congestive dermatitis, lichen planus, pruritus of the anus and vulva, and rarely psoriasis.

The distinction between lichenification and some types of prurigo is not entirely clear in terminology and practice. In some patients, chronic rubbing and scratching of the skin leads to the formation of nodules called prurigo nodosa or lichenification nodosa. Intense itching may be associated with an increase in the amount of neuropeptides, calcitonin-gene-related peptide, and substance P-immunoreactive nerve fibers. Some patients (eg, blacks) develop papular and follicular lichenification. There may be an innate predisposition to the development of lichenification and its persistence.

Symptoms of seborrheic eczema

Seborrheic eczema begins with the appearance of small pink-yellow nodules on the skin. The nodules enlarge and merge with each other, which leads to the formation of infiltrated disc-shaped plaques. The plaques have a diameter of 1-2 cm and are covered with numerous dense fatty scales. When the scales are removed, a slightly damp surface is revealed underneath; pronounced weeping is not typical.

The lesions of seborrheic eczema have clear boundaries and uneven edges. At the beginning of the disease they may be dry, but then take on a typical “greasy” appearance. Itching, as a rule, is mild and does not bother patients much.

Typically, seborrheic eczema rashes are located on the head: in the hair growth area, on the forehead, in the eyebrows, in the nasolabial folds, around the mouth and behind the ears. When foci of seborrheic eczema are localized on the scalp, they grow along the periphery, eventually moving to the edge of hair growth and to the forehead.

Seborrheic eczema often causes damage to the skin of the eyelids with the development of blepharitis.

How to distinguish psoriasis from dermatitis - similarities and differences

Atopic dermatitis and psoriasis are similar in the following:

may be hereditary;
develop in stages, periodically aggravate;
the skin turns red and itches in the affected areas;
microcracks and peeling appear.

In the first stages, the differences between psoriasis and seborrheic dermatitis are almost invisible and a conclusion about the disease can only be drawn based on the results of examination and diagnosis. But over time, the clinical picture becomes more clear. For psoriasis:

pale pink plaques;
do not fade when pressed;
do not swell;
scales are large, whitish.

For dermatitis:

the symptoms are acute with a transition to the chronic stage, while psoriasis is sluggish, chronic;
no dry white plaques;
blisters with suppuration may appear.

The difference between dermatitis and psoriasis can only be determined by a dermatologist - the sooner the nature of the lesion is determined, the faster and more successful the treatment.

How is seborrheic dermatitis different from psoriasis?

It is more difficult to distinguish between psoriasis and seborrheic dermatitis. They look like lesions on the scalp with scales. The differences are as follows:

psoriasis plaques are thicker and brighter in color;
seborrheic scales are smaller and paler;
seborrheic with a yellowish tint, removed without pain;
psoriasis plaques are removed with a residual small drop of blood - blood dew syndrome.

Such subtle differences are only visible under special dermatological equipment.

Eczema or psoriasis

It is easier to distinguish eczema from psoriasis by the form of the disease. Eczema is cured faster, while chronic psoriasis is less treatable and can affect the nails and internal organs. Eczematous lesions are characterized by:

severe itching, burning;
lack of clear boundaries, blurriness;
damage to the most delicate areas of the skin: folds, areas between the fingers;
severe swelling of the affected area.

Do not try to diagnose yourself and determine whether it is eczema, psoriasis or dermatitis.
Dermatological specialists provide rapid diagnosis and effective treatment of psoriasis and dermatitis in adults and children. Modern equipment and proprietary treatment methods with 25 years of successful use are your opportunity to quickly identify and overcome skin diseases. September 9, 2021
Author of the article: dermatologist Mak Vladimir Fedorovich

Diagnosis of seborrheic eczema

The diagnosis of seborrheic eczema is made by a dermatologist. Often, a visual examination of skin lesions is sufficient for this. Dermatoscopy, fluorescent diagnostics, and examination of skin and hair scrapings for pathogenic fungi are also carried out.

To identify underlying diseases and foci of chronic infection, patients with seborrheic eczema may be prescribed consultations with other specialists: gastroenterologist, endocrinologist, gynecologist, otolaryngologist, neurologist. For the same purpose, additional examinations are carried out: gastroscopy, ultrasound of the abdominal organs, hormonal and immunological blood tests, pelvic ultrasound, rhinoscopy, pharyngoscopy, etc. Patients with damage to the eyelids need to consult an ophthalmologist.