异位性皮肤炎

title: 诊断.
content: 异位性皮肤炎是指因遗传导致皮肤异常因而病变,会反复发作且搔痒难当即异常敏感,痒也是异位性皮肤炎最主要的特征,同时易伴随其它过敏性体质,目前发病机制仍然未解。  初次发作多于婴幼儿时期,总病患大约占总婴幼儿3%~5%,约30%的病患于1岁~5岁时发病,约有20%气喘病童会同时有此病症,更约有50%的异位性皮肤炎患者合并带有气喘、过敏性鼻炎的问题,此类病患通称"异位性体质",症状可持续数年到十数年不等。但通常在病情获得控制下,随着年纪的增长有半数以上的病人慢慢好转而痊愈。
title: 判断.
content: 临床学上诊断判定异位性皮肤炎的条件,须符合下列条件三项或以上:
title: 机制、发生原因.
content: 虽然至今医疗科学尚无法得知发病机制,但经由多数的临床研究发现数项确定因素:
title: 分期.
content: 目前医学临床上将此症分为三期:
title: 异位性体质.
content: 临床上,诊断异位性皮肤炎,通常会借由视诊,判断患者是否亦为异位性体质:
title: 治疗.
content: 异位性皮肤炎是一种慢性皮肤病,因此治疗过程需要长时间耐心配合,配合医师的治疗;一般投以外用类固醇药膏及止痒的抗组织胺药口服药,若有感染问题则并用抗生素,而极少数急性严重发作则可以口服的类固醇快速改善症状,但副作用大,因此须由医师判断后使用。  严重反复发作的孩子,则建议做进一步的『特异性IgE抗体、过敏性皮肤测试(针刺检查)、贴布试验』等检验,可提早找出过敏原以作为预防。  提高肌肤保湿功能与屏护力是照护异位性皮肤炎的首要步骤,患者不可轻忽。  近几年来,开始有皮肤科医师用湿敷疗法,做为异位性皮肤炎的第一线治疗。针对比较严重、病灶面积大、年纪小的婴幼儿,考量到很多全身性治疗的可能风险,湿敷疗法就成了另一项治疗利器。  目前新一代治疗药物主成分Tacrolimus,可选择性的抑制免疫细胞合成细胞激素的功能,而改变发炎细胞的表面抗原,但并不会影响纤维母细胞合成胶原蛋白的能力,因此明显降低副作用,效果较目前一线药物类固醇药膏缓慢,投药初期会有轻微灼热、刺痒感,短时间即会消失,且若投药量控制得宜即无全身性副作用,但此成分禁止使用于感染性皮肤病灶,同时使用期间需避免日晒或紫外线照射。
title: 改善.
content: 目前就诊时多会针对病患提出建议以改善病情,而原则上皆是尽量避免刺激、远离病原体、降低雷刚受损:
title: 新闻事件.
content: 异位性皮肤炎非传染病,但有女童患者被游乐园拒于门外。

Summary: 异位性皮肤炎(英语:Atopic dermatitis,简称AD),又叫过敏性皮肤炎或异位性湿疹(Atopic eczema),常见症状包含发痒、红肿,以及皮肤龟裂。发炎区域常有清澈液体流出,液体会随着发炎时间越久而越浓。异位性皮肤炎常初发于孩提时期,严重程度则随年纪变化:未满足岁的孩童身上红疹常遍布全身;年纪稍大时影响范围则主要位于腘窝及肘窝处;成人则好发于手脚。抓搔病灶会使症状恶化,并提升皮肤感染的风险。许多患者常合并有干草热及哮喘的症状。 异位性皮肤炎的真正原因目前仍不清楚,但一般相信与遗传学、免疫功能异常、环境因子,以及皮肤穿透性过低有关。如果双胞胎中有一人是异位性皮肤炎的患者,那么另一个有 85% 的几率也患有该病症。另外居住于都市及干燥区的民众也较容易罹患异位性皮肤炎。太常洗手及暴露于某些化学因子会使症状恶化。情绪压力不会导致异位性皮肤炎,但也可能使症状恶化。异位性皮肤炎并非传染病。诊断需依据症状及征象做判断,且必须排除接触性皮炎、银屑病、脂溢性皮炎等疾病才能确诊。 异位性皮肤炎的治疗包含避免接触风险因子。尽量维持每日沐浴,并浴后涂敷润肤膏的习惯。病灶处可以涂抹类固醇软膏,并给予止痒药物。可能造成症状恶化的因子包含穿着羊毛衣物、使用肥皂及香水、氯、灰尘,以及烟。光照治疗对于某些人可能有效。当治疗无效时可以尝试口服类固醇,如果有细菌感染视情况合并外用或口服抗生素。如果怀疑皮肤炎是由食物过敏引起,则需尝试改变饮食。 全球有五分之一的人口在人生中的某个阶段受到异位性皮肤炎影响,其中又以孩童居多。男性和女性之间的盛行率则无显著差异,有些人的症状会自动改善。异位性皮肤炎有时称为湿疹,但这个词包含其他皮肤状态,较无特异性。 其他同样描述这种疾病的词汇还有「婴儿湿疹」(Infantile eczema)、「屈部湿疹」(Flexural eczema)、「贝尼耶素质性痒疹」(prurigo Besnier)、「过敏性湿疹」(allergic eczema),以及「神经性皮炎」(neurodermatitis)。

Atopic dermatitis: Atopic dermatitis (AD), also known as atopic eczema, is a long-term type of inflammation of the skin (dermatitis). It results in itchy, red, swollen, and cracked skin. Clear fluid may come from the affected areas, which often thickens over time. While the condition may occur at any age, it typically starts in childhood, with changing severity over the years. In children under one year of age, much of the body may be affected. As children get older, the areas on the insides of the knees and elbows are most commonly affected. In adults, the hands and feet are most commonly affected. Scratching the affected areas worsens the symptoms, and those affected have an increased risk of skin infections. Many people with atopic dermatitis develop hay fever or asthma. The cause is unknown but believed to involve genetics, immune system dysfunction, environmental exposures, and difficulties with the permeability of the skin. If one identical twin is affected, there is an 85% chance the other also has the condition. Those who live in cities and dry climates are more commonly affected. Exposure to certain chemicals or frequent hand washing makes symptoms worse. While emotional stress may make the symptoms worse, it is not a cause. The disorder is not contagious. The diagnosis is typically based on the signs and symptoms. Other diseases that must be excluded before making a diagnosis include contact dermatitis, psoriasis, and seborrheic dermatitis. Treatment involves avoiding things that make the condition worse, daily bathing with application of a moisturising cream afterwards, applying steroid creams when flares occur, and medications to help with itchiness. Things that commonly make it worse include wool clothing, soaps, perfumes, chlorine, dust, and cigarette smoke. Phototherapy may be useful in some people. Steroid pills or creams based on calcineurin inhibitors may occasionally be used if other measures are not effective. Antibiotics (either by mouth or topically) may be needed if a bacterial infection develops. Dietary changes are only needed if food allergies are suspected. Atopic dermatitis affects about 20% of people at some point in their lives. It is more common in younger children. Males and females are equally affected. Many people outgrow the condition. Atopic dermatitis is sometimes called eczema, a term that also refers to a larger group of skin conditions. Other names include "infantile eczema", "flexural eczema", "prurigo Besnier", "allergic eczema", and "neurodermatitis".