Bullous dermatitis: how to stop the progression of the disease?

Буллезный дерматит: как остановить прогрессирование болезни?Dear readers, welcome you! Today our review is completely dedicated to bullous dermatosis.

The skin has the largest number of diseases than any other organ. It was she who first meets along «the way» all the negative factors of the environment.

Almost all of them it provides us with protection, but have very pronounced harmful effects when our skin is unable to cope with them, for example, burns, frostbite, dermatitis of a different nature.

In this article we will talk about the dermatitis, which are accompanied by formation of bubbles, or as they are called, bulls.

A group of diseases bullous dermatitis

To vesicular dermatoses can be attributed to four groups of diseases, which differ in the dimensions of the primary element:

  • Dermatitis autoimmune: pemphigus vulgaris, bullous pemphigoid, epidermolysis bullosa acquired;
  • From congenital: epidermolysis bullosa and epidemiologicheskii hyperkeratosis;
  • Infectious origin: herpes simplex and zoster, impetigo;
  • Allergic origin: toxic epidermal necrolysis and Stevens-Johnson syndrome.
  • Dermatitis burns

    Буллезный дерматит: как остановить прогрессирование болезни?In the burn of 2 degrees in a few minutes after exposure to the causative factor to develop the first signs of bullous dermatitis: erythema, blisters, are sharply painful, and strenuous.

    At the opening of the bladder formed by erosion, crusty, purulent or bloody contents.

    After the rejection of crusts remains hyperpigmentation. In some severe cases may develop scar atrophy.

    Consequences of frostbite

    Буллезный дерматит: как остановить прогрессирование болезни?When exposed to extremely low temperatures, the blood vessels of the skin spazmiruyutsya, so the blood flow slowed dramatically. After that comes the flushing, filling with blood of the damaged area.

    Congestive hyperemia lead to swelling in his background, bubbles appear, sluggish, filled with hemorrhagic or serous content, then cover and erosion.

    Of subjective sensations: pain and burning sensation.

    After a sunburn

    Буллезный дерматит: как остановить прогрессирование болезни?Bullous dermatitis after a sun burn starts to occur after 4-6 hours, reaching a maximum in 12-24 hours.

    Clinical picture: erythema, blisters. Their opening leads to the formation of erosions and crusts, and further to hyperpigmentation.

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    General symptoms: fainting, burning sensation, pain, palpitations, sensation of heat and increase in temperature.

    The effect of chemical factors and plants

    The most common stimuli such as turpentine, ursol, and meadow plants. The symptoms are similar to the typical bullous dermatitis: erythema, against which bubbles or the bubbles. Next of the elements is dominated by erosion and crust.


    Буллезный дерматит: как остановить прогрессирование болезни?A group of diseases, which is accompanied by the formation of bubbles without acantholysis: bullous pemphigoid Lever (pemphigus makroekonomicheskaya), subcause pemphigoid, pemphigus benign of the oral cavity.

    The causes of these diseases become different factors: drugs, autoimmune processes.

    Bullous pemphigoid occurs in individuals older than 60 years occurs with formation of bubbles with a diameter from 0.5 to 2 cm on the skin (inguinal folds, the abdomen, the flexor surface of the upper limbs) and mucous membranes of the mouth (see photo).

    The elements are tense, the contents of hemorrhagic, serous. After a few days they are replaced by erosions with fibrinous coating.

    Dermatitis herpetiformis Duhring is accompanied by a polymorphic rash, burning and itching. There may be fever, malaise, acute.

    Mucosa and skin swelling, erythema, blisters. The process quickly docked at the background of adequate treatment.

    Subcause pemphigoid is localized on the mucous membranes of the mouth, the bubbles with a tight lid and tense, serous or hemorrhagic contents.

    A typical symptom is the formation of bubbles in the same places, with the result that over time, scars are formed.

    The group of diseases known as pemphigus is very difficult in treatment and prognosis. They often lead to disability, and some of their species to death.

    Let’s move on to treatment

    First, consider the principles of treatment of autoimmune bullous forms of dermatitis.

    In the first place are drugs from the group of corticosteroids. It is the purpose of them in a shock dose helps to stabilize the progress and to stop a rash.

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  • Effective administration of methylprednisolone as pulse therapy. Dose of 1 gram for 3 days. Administered in 15 minutes prescribed dose, then gradually reduce to 150 mg per day;
  • In practice has a value and the other form of the introduction of the GKS. If dissemination is prescribed 60 mg. of prednisone orally 60 mg. intramuscularly. When it comes down to reduce the dose, cancel parenteral administration;
  • In benign pemphigus makroekonomicheskoi in parallel with the GCS prescribed anti-malarial remedies, antihistamines.
  • To reduce the dose of hormonal drugs, prescribed non-pharmacological methods: hemosorption, plasmapheresis and drugs – heparin and inhibitors of proteases (Contrykal).

    Will be useful to injection, gamma globulin, vitamins, interferon, transfusion of plasma or blood, Riboxin and diphenylsulfone.

    Local treatment

    Буллезный дерматит: как остановить прогрессирование болезни?The localization of the lesions on the mucous membranes of the oral cavity recommend: methotrexate, doxycycline, phenytoin, nizoral, a complication of fungal infections, nizoral and fluconazole.

    When pyoderma — antibacterial drugs of wide spectrum of action, in the presence of steroid diabetes — antidiabetic drugs, after consultation with the endocrinologist.

    The patient himself can carry out rinsing the mouth with soda solution, boric acid mixed with 0.5% novocaine.

    Topical topical therapy in the treatment of pemphigus is of secondary importance. Applied to the skin sprays that contain corticosteroids and antibiotics (oksikort, oxiconazole, polcortolon), corticosteroid creams, fukortsin and xeroform, sintomitsinovoy liniment.

    Therapy of burns and frostbite

    Буллезный дерматит: как остановить прогрессирование болезни?Thermal burns treated comprehensively. At first it is necessary to immediately cool the skin, for that affected area to keep under running cold water for 10-15 minutes, then put a bandage of gauze or bandage, soaked in cold water.

    It is strictly forbidden to remove clothing, as you will damage the skin, can remain scars and the healing will be long.

    Also you can’t miss burns oils, creams, ointments, they retain heat, preventing cooling.

    At hand it is desirable to have panthenol for the ambulance.

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    The doctor cleans the surface of burn, plenty of treats with antiseptics, after which disinfects the area of skin around. Bubbles don’t open, exfoliated epidermis is not removed.

    Treatment thermal burns carried out using polimixinov ointments, panthenol, emulsion levomitsetina, the drug Ruccola.

    Most justified the imposition window gauze bandages. This reduces the recovery time to 3 days, allows you to use less local products, the skin breathes faster and is covered with granulation tissue, crusts.

    Treatment of frostbite at the stage of first aid is of great importance, since up to 90% of patients receive treatment in this period.

    It is strictly forbidden to warm the limb or other body part rubbing. Carefully cut clothing covering the skin surface, special insulating bandages.

    Top wear plastic bags. If this is not possible, then take a sheet or other large cloth dipped in hot water (from a thermos, radiator), applied on top of clothes (chest, abdomen), but not on the skin.

    Then put on the patient. In the hospital gradually warm in the bath, raising the temperature.

    At the end of the article make an interesting video about the disease:

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