概述

特应性皮炎(湿疹)是一种会令皮肤发红发痒的病症。它常见于儿童,不过任何年龄的人都可能发病。特应性皮炎长期持续(慢性)并且每隔一段时间往往就会发作。它可能伴有哮喘或花粉症。

目前尚无治愈方法特应性皮炎。不过治疗和自我护理措施可以缓解瘙痒,防止新的症状爆发。例如,避免使用刺激性的肥皂,经常保湿皮肤以及涂抹药物乳膏或药膏,都会有所帮助。

症状

特应性皮炎(湿疹)的体征和症状明显因人而异,包括:

  • 皮肤干燥
  • 瘙痒,可能较为严重,尤其是在晚间
  • 红色至棕灰色斑块,多发于手、脚、脚踝、手腕、颈部、上胸部、眼睑、肘窝和腘窝,以及婴儿面部及头皮
  • 隆起的小包,抓挠时可能渗液并结痂
  • 皮肤变厚、开裂、呈鳞状
  • 抓挠后皮肤擦伤、敏感、肿胀

特应性皮炎最常始于 5 岁前,可能持续至青春期和成年。部分特应性皮炎患者可能会定期发作,然后恢复一段时间,甚至是几年。

何时就诊

如果您或您的孩子出现以下情况,请就医:

  • 感到极度不适,这种疾病正在影响睡眠和日常活动
  • 伴有皮肤感染——确定有无红色条纹、脓液、黄痂
  • 在尝试居家疗法后症状仍未消失

如果您的孩子的皮疹看似已感染并且伴有发热,请立即就医

病因

Mayo Clinic Minute: Eczema occurs in people of all ages

Jason T. Howland: Atopic dermatitis is a sensitivity disease of the skin, similar to asthma in the lungs, hay fever in the sinuses and food allergies in the gut.

Dawn Marie R. Davis, M.D.: It's a multisystem disorder. Inflammation affects the skin, and the skin is more sensitive than usual.

Howland: It's a chronic condition and tends to flare periodically. The symptoms vary.

Dr. Davis: Atopic dermatitis tends to be red, weepy, crusty, itchy, flaky patches, like oval or circular-shaped areas on the skin.

Our skin is like a brick wall. And over time as we age, or genetically if we are predisposed to sensitive skin, it can look like a wicker basket more than a brick wall.

Howland: Adult eczema often occurs in patches on areas of the body prone to friction or sweat.

Dr. Davis: Where your waistband would sit, where your socks or shoes would rub. If you have a watch, where you would wear your watch. If you have a headband or certain things that you wear along your neck, like a necklace or a tie.

It's important to bathe regularly. It's important to hydrate the skin with a moisturizer that is hypoallergenic. It's important to monitor for infection.

Howland: If those self-care steps don't help, your dermatologist may prescribe topical or oral medications, or other therapies.

For Mayo Clinic News Network, I'm Jason Howland.

健康的皮肤有助于锁住水分,并保护人体免受细菌、刺激物和过敏原的伤害。湿疹与影响这种皮肤防护力的基因变异有关。这会使您的皮肤受到环境因素、刺激物和过敏原的影响。

有些患儿的病因可能与食物过敏有关。

风险因素

导致特应性皮炎的主要风险因素是有湿疹、过敏、花粉症或哮喘的个人或家族病史。

并发症

特应性皮炎(湿疹)的并发症可能包括:

  • 哮喘和花粉症。湿疹有时会先于这些病症发生。半数以上患有特应性皮炎的幼儿会在 13 岁前患哮喘和花粉症。
  • 慢性瘙痒性鳞状皮肤。神经性皮炎(慢性单纯性苔藓)这种皮肤病始于一小块瘙痒的皮肤。抓挠该区域会使瘙痒加重。最终可能养成抓挠的习惯。这种状况会使受影响的皮肤变色、变厚和变粗糙。
  • 皮肤感染。反复抓挠会使皮肤破裂,从而导致开放性溃疡和裂口。这会增加细菌和病毒感染的风险,包括单纯疱疹病毒。
  • 刺激性手部皮炎。工作需要经常弄湿手且接触强刺激性肥皂、洗涤剂和消毒剂的人更易患这种病。
  • 变应性接触性皮炎。此病症常见于特应性皮炎患者。
  • 睡眠问题。搔痒周期会使睡眠质量下降。

预防

以下建议可能有助于预防皮炎发作,并尽量减轻沐浴后的干燥:

  • 每天至少润肤两次。确保密封乳霜、软膏和乳液以锁住水分。选择一款或多款适合您的产品。在宝宝的皮肤上涂抹凡士林软膏可能有助于预防特应性皮炎。
  • 尝试识别并避免会导致病情恶化的触发因素。会加重皮肤反应的因素包括汗液、压力、肥胖症、肥皂、清洁剂、灰尘和花粉。减少接触触发因素的频率。

    婴儿和儿童食用某些食物也可能会导致皮炎发作,这些食物包括蛋类、奶类、大豆和小麦。向您孩子的医生咨询如何识别潜在的食物过敏。

  • 缩短洗澡或淋浴时间。将洗澡和淋浴时间控制在 10-15 分钟内。洗澡和淋浴时用温水而不是热水。
  • 用漂白剂洗澡。美国皮肤科学会建议,使用稀释漂白剂洗澡有助于预防皮炎发作。使用稀释后的漂白剂洗澡可以减少皮肤细菌和相关感染。取 1/2 杯(约 118 毫升)家用漂白剂(非浓缩漂白剂)倒入装有 40 加仑(约 151 升)温水的浴缸中。这些计量适用于美国标准尺寸浴缸,温水填充至溢流排水孔处。

    将颈部以下或皮肤受累区域浸泡在水中约 10 分钟。不要将头浸入水中。用漂白剂洗澡时,每周不要超过两次。

  • 仅使用温和的肥皂。选择温和的肥皂。除臭皂和抗菌皂能够清除更多的天然油脂,导致皮肤变干。
  • 将身体仔细擦干。浴后用软毛巾轻轻拍干皮肤,然后趁皮肤尚未变干之前涂抹润肤霜。

Aug. 29, 2022
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