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Atopic dermatitis in Vietnamese men

14:43 07/12/2021

Most cases begin in early childhood. The obvious sign of the disease is dry skin lesions along with itching. Because itching scratched a lot, the skin thickened, the more the patient itch, the more he scratched, leading to the "Itch-Scratch" disease cycle, which made the disease worse and possibly infected with bacteria. The disease has genetic, familial factors and is often seen in men with allergic diseases, unlike asthma, allergic rhinitis. Whether up to 35% of children with atopic dermatitis will have signs of asthma in their lifetime. Concluding the disease is not difficult, based on some clinical symptoms, blood IgE levels are often increased.

Epidemiology:

number of cases: Currently, there is no survey on the prevalence of atopic dermatitis in Vietnamese men. According to reports in different countries, the number of cases ranges from 7 to 20% [1, 2, 3, 4]. According to the report of the National Institute of Dermatology Clinic, at times atopic dermatitis accounts for about 20% of the patients who come to us for testing [5].

Age of onset: Usually in the first two months, up to 60% of children with atopic dermatitis develop in the first year, 30% in the first 5 years, and only 10% develop between 6-20 years of age. It is extremely rare for people to have a flare-up of the illness in adulthood.

Regarding gender, there is no significant difference between men and women, there are some reports that men have no less than women.

Genetic factors, the family believes that 60% of men with atopic dermatitis who conceive also have this disease. If both parents have atopic dermatitis, up to 80% of children will have it.

Several factors contribute to the onset and severity of the disease, including: some allergens in the air such as some waste products of house bugs, wool. The exotoxin of Staphylococcus aureus is responsible for the superantigen that stimulates the activation of T lymphocytes as well as macrophages. Endogenous antigens: In the patient's serum, there are IgE antibodies capable of inducing IgE or inflammatory response T lymphocytes. Food: foods that can also promote disease such as eggs, milk, peanuts, soybeans, fish, flour

There are a number of other factors that cause outbreaks or exacerbations of the disease, which is a decrease in the function of the skin's protective barrier along with a decrease in the ceramic layer of the skin, making the skin more susceptible to water loss leading to dry skin. The disease season is usually in autumn and winter, mild in summer. Children's and parents' woolen clothes, along with even these from dogs and cats, carpeting or bedding, also aggravate the condition.

clinical signs

Acute period: The disease manifests itself when the initial stage is red skin with unclear boundaries, some papules with clusters of papules, vesicles excreting fluid, no scabs. The skin is edematous, oozing fluid, crusted with exudative psoriasis. Scratches caused by scratching create sudden marks, staphylococcal superinfection creates pustules along with yellow excretory scales. The disease is usually located on the forehead, cheeks, chin, more severe can spread to the hands and body.

Subacute signs with milder recognizable signs, non-edematous skin, fluid secretion.

in the chronic period, the skin is thick and dark, clearly demarcated, lichenified, painful cracks; This is a complication of the patient scratching a lot. Lesions are often found in some large folds, palms, feet, fingers, neck, nape, wrists, and legs.

Disease manifestations: dry skin, erythema- pruritus forming a pathological spiral: itching-scratching-erythema-itching. At the same time, the patient also has a number of different symptoms such as allergic rhinitis, conjunctivitis of the eyes and throat irritation, asthma. Disease symptoms such as dermographism, ichthyosis vulgaris, and keratosis pilaris may be seen in patients with atopic dermatitis.

common areas of the face, forehead, flexed face of some limbs, back of the neck, eyelids, wrists, backs of hands, insteps, serious situations have the risk of spreading to the whole body.

Evolution:

Without treatment, the disease progressed for many months or years. Approximately 50% of the disease resolves in infancy, although many cases persist for many years, presumably into adulthood. Many patients have asthma or some other allergic diseases.

Diagnose:

Today there are diagnostic criteria for atopic dermatitis given, we use the criteria of Hanifin as well as Rajka (1980). For atopic dermatitis should have at least 3 leading criteria + at least 3 minor criteria.

4 main standards:

1. Itching.

2. Chronic or chronically relapsing dermatitis.

3. Typical lesion morphology and area (Typical distribution and morphology of AD rash).

Children: localized eczema of the face, extensor areas.

Older children as well as older men: Thickening of the skin, Lichen folds.

4. Personal or family history of atopic diseases such as asthma, allergic rhinitis, atopic dermatitis.

Sub-criteria:

one. Dry skin (Dry skin).

2. Cheilitis.

3. Anterior subcapsular cataract.

4. Inflammation of the conjunctiva with return of eye irritation.

5. Face: Red, pale.

6. Food intolerances.

7. Hand eczema.

8. Elevated IgE levels.

9. Characteristic Immediate Type One Positive Skin Reaction (Immediate s

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