NeurodermatitisNeurodermatitis

DefinitionDefinitionA common,chronic skin disease resulting from nervous disorder ,A common,chronic skin disease resulting from nervous disorder ,

accompanied with extreme pruritus and localized lichenificationaccompanied with extreme pruritus and localized lichenification

Etiology and PathogenesiEtiology and Pathogenesiss

functional disturbance of nervous systemfunctional disturbance of nervous system 、、excitative and inhibitive disequilibrium of cexcitative and inhibitive disequilibrium of cerebral cortex.erebral cortex.

MotivationMotivation ：： 1.neural and psychogenic facto1.neural and psychogenic factorr 2.diet2.diet

3.gastrointestinal dysfunction3.gastrointestinal dysfunction 4. endocrine disturbance 4. endocrine disturbance

clinical manifestationclinical manifestation

Spasmodic pruritus many 0.5cm±skin cSpasmodic pruritus many 0.5cm±skin c

olour round or polygonal lichen planus olour round or polygonal lichen planus

lichenificationlichenification

More serious in summerMore serious in summer

Has a predilection for the nape,elbows.lower back aHas a predilection for the nape,elbows.lower back and eyelidsnd eyelids

20 ~ 40yr adults（ i ） neurodermatitis circumscripta

clinical manifestation clinical manifestation （（ iiii ） ） neurodermite dissemine neurodermite dissemine ：： widely widely

spreadspread skin-color ancipitous papulars

lichenified

the classic locations are scalp,extremities,upper back ,waist.

spasmodic pruritus

Chronically relapsing course of the disease 、

Differential diagnosisDifferential diagnosis

Chronic eczema Chronic eczema NeurodermatitisNeurodermatitiscausecause Allergy Allergy

reactionreaction ，， environmentenvironmental and physiologic al and physiologic factorsfactors ，， not easy to not easy to findfind

neural and psychogenic distneural and psychogenic disturbanceurbance

InvolveInvolvement ment

symmetrysymmetry ，， any part of any part of the bodythe body ，， especially especially extremities extremities 、、 legleg 、、 extexternal genitalia ernal genitalia 、、 anusanus

asymmetry, mainly napeasymmetry, mainly nape,elbows,lower back,ham,elbows,lower back,ham

lesionslesions AcuteAcute ：： multiformmultiform 、、 oozoozing ing 、、 seasonalityseasonality ，， mormore serious in wintere serious in winterChronic:lichenificationChronic:lichenification

Itching, skin-colour anciItching, skin-colour ancipitous papular, lichenificpitous papular, lichenificationation

Diagnosis and differential diagnosisDiagnosis and differential diagnosis

（（ iiii ）） lichen planus polygonal or triangular ancipitous plichen planus polygonal or triangular ancipitous papularapular ， ，

affect mucous membrane and finger and toe nailaffect mucous membrane and finger and toe nail

Dark red

lavander

（ 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 treatment avoidavoid scratchingscratching

（（ ii ）） P.OP.O ：： 1. antihistamines1. antihistamines 2. ataractics 2. ataractics

（（ iiii ）） ExtExt ：： summersummer ：： Lin.AluminiumLin.Aluminium 、 、 Lin.DexamethasoLin.Dexamethasone andCoaltar ne andCoaltar 、、 Lin.Dexamethasone and propylene Lin.Dexamethasone and propylene GlycolGlycol

winterwinter ：： 5% Cream Benzocaine5% Cream Benzocaine Cream.Dexamathasone.Co Cream.Dexamathasone.Co

intralesional injection of triamciintralesional injection of triamcinolonenolone