Neurodermatitis Definition A common chronic skin disease resulting

Neurodermatitis

Definition A common, chronic skin disease resulting from nervous disorder , accompanied with extreme pruritus and localized lichenification

Etiology and Pathogenesis functional disturbance of nervous system、 excitative and inhibitive disequilibrium of cerebral cortex. Motivation： 1. neural and psychogenic factor 2. diet 3. gastrointestinal dysfunction 4. endocrine disturbance

clinical manifestation 20 ~ 40 yr adults （i）neurodermatitis circumscripta Spasmodic pruritus many 0. 5 cm±skin colour round or polygonal lichen planus lichenification More serious in summer Has a predilection for the nape, elbows. lower back and eyelids

clinical manifestation （ii） neurodermite dissemine ：widely spread skin-color ancipitous papulars lichenified the classic locations are scalp, extremities, upper back , waist. spasmodic pruritus Chronically relapsing course of the disease、

Differential diagnosis Chronic eczema cause Allergy reaction， environmental and physiologic factors，not easy to find Neurodermatitis neural and psychogenic disturbance Involveme symmetry，any part of the asymmetry, mainly nt body，especially extremities 、 nape, elbows, lower back, ham leg、external genitalia 、anus lesions Acute：multiform、oozing 、Itching, skin-colour seasonality，more serious in ancipitous papular, winter lichenification Chronic: lichenification

Diagnosis and differential diagnosis Dark red （ii）lichen planus lavander polygonal or triangular ancipitous papular， affect mucous membrane and finger and toe nail （iii）primary cutaneous amyloidosis 1. occur commonly on the shins and upper back； 2. Small brown papules that group to form infiltrated large moniliform plaque； 3. Immunoperoxidase stains for keratin is useful. （ix）atopic dermatitis 1. Infantile eczema； 2. A group of papulars that mimic eczema-like lesions； 3. Active family history

treatment avoid scratching （i）P. O： 1. antihistamines 2. ataractics （ii）Ext：summer：Lin. Aluminium、 Lin. Dexamethasone and. Coaltar 、Lin. Dexamethasone and propylene Glycol winter： 5% Cream Benzocaine Cream. Dexamathasone. Co intralesional injection of triamcinolone