[Clinical manifestations]
1. If the reaction is mild in the early stage, there may only be erythema and papules; Severe reactions can cause erythema, edema and blisters; If the stimulation is more intense (such as acid and alkali, etc.). ), it will cause bullae and even necrosis. Due to the long-term repeated stimulation of weak stimulation, it can be manifested as dryness, infiltration, thickening, moss and chapping.
2. Skin lesions mostly occur in exposed parts such as fingers, back of hand, wrist, forearm, face and neck.
3. The scope of dermatitis is usually limited to the contact area, the edge is generally clear, and the arrangement pattern varies with the contact object. Skin lesions that occur in loose tissues such as eyelids and external genitalia are often accompanied by obvious edema; Occurring on the scalp is prone to secondary infection.
4. The local area is often accompanied by different degrees of itching, burning and even pain. If the skin lesions are extensive and serious, they may be accompanied by fever and general malaise.
5. The disease can be cured in about 1-2 weeks if the etiology is removed and handled properly. Repeated contact with allergens or improper treatment can prolong the course of disease, and the infiltration and thickening of skin lesions show eczema-like changes.
[diagnosis]
1. The disease can be diagnosed according to the contact history of irritants and the characteristics of skin lesions in stimulated parts.
2. In allergic patients, the patch test is positive.
[therapy]
1. western medicine treatment
(1) external drug therapy
① Use calamine lotion when there is slight redness, papules and blisters without exudation. Appropriate amount of carbolic acid, camphor or menthol can be added to relieve itching.
② When acute dermatitis has obvious exudation, 3% boric acid solution or 1: 20 aluminum acetate solution can be used for cold compress and wet compress.
③ When acute dermatitis is red and swollen, blisters and exudation are few, zinc oxide oil can be applied externally, and 2% ~ 5% bran distillate oil or fish oil can be added.
(4) From dermatitis to subacute stage, 2% ~ 5% turpentine or other distillate oil emulsion or paste can be used, and various corticosteroid creams can also be used.
(2) Oral drugs: oral antihistamines and vitamin C; Intravenous injection 10% calcium gluconate. Severe systemic cases can be treated with corticosteroids for a short time, such as oral prednisone 30mg per day or intravenous dexamethasone 5mg.
2. Chinese medicine treatment
(1) internal processing
① Toxic damp heat: acute dermatitis, redness, blisters, erosion and exudation, accompanied by thirst, yellow urine, extremely hot headache, red tongue, thin yellow fur and slippery pulse.
Treatment: clearing away heat, promoting diuresis and detoxifying.
Prescription; Gentiana scabra 15g, Gardenia jasminoides Ellis 10g, Radix Rehmanniae 10g. Scutellaria baicalensis Georgi, Cortex Moutan, Herba Violae, Flos Lonicerae 15g, Radix Arnebiae L5g, Rhizoma Alismatis 10g, Caulis Akebiae 10g, and Radix Glycyrrhizae 6g.
② Wind, heat and dryness; Repeated attacks, skin lesions are chronic dry and hypertrophy, pale tongue, thin and white fur, and thin pulse.
Treatment; Clearing heat and expelling wind, nourishing yin and moistening dryness.
Prescription; Herba Schizonepetae10g, Radix Saposhnikoviae10g, Periostracum Cicadae 6g, Gypsum Fibrosum 30g (fried first), Radix Rehmanniae10g, Cortex Moutan10g, Radix Angelicae Sinensis10g and Radix Paeoniae Rubra10g.
(2) external therapy
① For patients with flushing and papules, use Sanhuang lotion for external use or take it with cold boiled water of indigo naturalis 4-5 times a day.
(2) In case of erosion and exudation, 30g of dandelion or wild chrysanthemum can be used for cold compress and wet compress. You can also use 10% phellodendron bark liquid to wet compress.
(3) For patients with erosion and dementia, indigo naturalis ointment can be applied externally, 3-4 times a day.
[Prevention and Care]
1. It is not advisable to wash or rub with hot water or soapy water, and the antipruritic drugs with strong irritation are prohibited.
2. Make clear the cause and avoid continuing contact with allergens.
3. Occupation-related personnel should improve working procedures and operating processes and strengthen protective measures.
4. Drink plenty of boiled water and avoid spicy, greasy and fishy things.