Dermatitis or otherwise known as eczema, is a skin disorder present with redness, itching, dryness, scaling, thickening of skin, fissuring. It starts with redness, swelling, and formation of papules (raised patches on skin). As the condition progresses, formation of papulo-vesicles, vesicles, and blisters are formed from which there is continuous discharge of mucus starts. Later on, when the papules heal they form thickening and fissures are formed. Itching is the important feature of this condition.
Types of dermatitis
1- Irritant contact dermatitis
It is mainly caused by damage to the skin by an irritant. This irritant can be a chemical or any physical agent. Excessive use of these agents can lead to this condition. It may appear in many forms ranging from dryness to redness. It can be easily seen dorsal parts of the fingers and hands in housewives or nurses with chronic irritation caused by frequent hand washing.
2- Irritant contact dermatitis is more common than allergic contact dermatitis.
3- Allergic contact dermatitis
It can be seen in two forms
- Acute allergic contact dermatitis – It is characterised by features of acute eczema like redness, formation of papules, formation of vesicles, and continuous discharge from affected site.
- Chronic allergic contact dermatitis– It can be due to repeated exposure to the allergen (substance which causes allergy). It is characterised by dryness, scaliness, thickening and fissuring of skin.
Common allergens are as follows-
Cheap jewellery (earrings, or metal accessories on clothing such as studs on jeans).
In men- watches can cause dermatitis. This type of dermatitis is as a result of Nickel sulfate as a allergen.
Other type of allergen is, Chromate sensitivity. This is often seen as occupational dermatitis. It is often seen in labourers as cement is the cause of dermatitis. So they form a chronic disease. It is characterised by dryness, scaliness, or hyperkertotic lesions.
4- Medicine caused dermatitis
Dermatitis can also be caused by medicines like neomycin and lanolin are common sensitizers which can cause this condition.
Cosmetics like deodorant sprays can also cause contact dermatitis.
5- Berloque Dermatitis
This type of dermatitis is due to interaction of light above 320 nm and methoxy-psorlen in bergmot oil found in perfumes used as such or present in cosmetics and oils used for hair or skin. It can occur as small spots if perfume was sued as spray, as irregular smudges if perfume was applied with the hand or cotton balls. If hair oil is used, the pigmentation is seen in forehead, ears, side of face and upper central part of the back in females.
6- Atopic Dermatitis
This is seen within family. Genetic and environmental factors play a vital role in this type of condition. It is seen with various type of disease like asthma, urticaria, hay-fever or allergic dermatitis. These patients have increased IgE antibodies in their body. Patient has usually yellow face. He has persistent itching. If atopic dermatitis is seen during the period of infancy, it is called infantile eczema. Lesions in this type appear at any time between 2-6 months of age and continue to appear during the first two years of life. Baby has severely itchy, red papules which oozes exudation and form crusts on the cheeks. It can spread to other parts of the body. Sometimes pus is seen in these lesions as a result of secondary infections. This condition can cure itself, and patient be symptom less in entire life. But at times this condition can reach to childhood stage. Childhood stage, starts from two years of age onwards. This condition is seen mainly in folds of forearm and folds of legs. The condition is very itchy, mild red in color. At times thickening of skin is seen. As the age advances, the lesions tend to become more dry and thickened. At this time it involves the face, neck and trunk. This is adulthood stage. At times whole body can be involved.
It is an inflammatory and pigmentary reaction of the skin to sunlight in the presence of chemicals in some plants called furocoumarins. If the patient is exposed to the leaves of the plant as during lying down on lawns or sea beaches, the pattern of the lesion may resemble the shape of leaves of that plant.
8- Exfoliative Dermatitis
It is also called erythroderma. In this the whole-body skin becomes red and scaly. Patient is unable to control temperature. So he suffers chills and rigors. These patients develop other infections in the form of various raised nodules of the skin. They may develop infection of lungs. In severe cases there may be loss of hair, but this condition is temporary. ‘
9- Dermatitis Herpetiformis
It is seen as itchy urticarial, patches which is red in color. These patches are often seen as groups. It is mainly seen in buttocks. These patches are symmetrical. This seen in adults and middle-aged people. This condition can be symptom less at times but can appear again.
Causes of Dermatitis
- lichen planus
- Generalised contact dermatitis
- Drugs like isonicotinic acid hydrazide, para-chloroquine and sulphonamides.
Site of dermatitis
Hands- site of irritant and allergic contact dermatitis. It is seen in house-wives.
Face-Here cosmetics and medicines are important allergens. Allergy from exposure to sunlight and its sensitivity can also be seen in cases.
Mucosa of mouth can be sensitive to flavours of toothpaste. Allergic reaction to dental amalgams of nickel, mercury, pallladium or gold can also be seen. It starts with redness and swelling, and progresses to formation of ulcers, atrophy, and formation of leukoplakia in later stages.
Homeopathic Medicines used for treatment of Dermatitis
1- Anacardium orientale – These kinds of patient have weak memory, has depression and very irritable. Patient has fear of examination. There is weakness of all senses, like sight, and hearing. They do not want to work, they lack self confidence. There is empty feeling in the stomach which is relieved by eating. Eating relieves all discomfort. Patient has anxiety when walking. He feels as if pursued. Patient is also absent minded. He is very revengeful, has suspicion on other. Patient has intense itching. Complaints of eczema. Swelling is seen in body. It is good remedy for urticaria, Lichen planus and neurotic eczema. Ulcers are seen on forearm. Patient has sickly face, with hollow eyes. He has dark rings around eyes. He looks wild, childish. Has expression less face. Eczema is seen of face and neck.
- Worse- application of hot water.
- Better-from eating, from rubbing.
- Dosage-200 potency, given 3 times a day for 10 days.
2- Arsenicum album-Patient is very weak. He cannot do slightest work. Pains are burning type. The feeling of burning is relieved by heat. Patient’s condition is worse when he eats watery fruits. He has gradual loss of weight from impaired nutrition. Patient is very angry and restless. He has fear of death. He has fear of being left alone. He has great despair, which drives him from place to place. He lacks courage. Skin is itching and burning. There are various eruptions which are dry, rough, scaly. This is worse from cold and from scratching. Pus filled eruptions are also seen. It can be given for urticaria, with burning and restlessness. It is very good remedy for psoriasis.
- Worse- wet weather, after midnight, from cold , from cold drinks or foods.
- Better- from heat, from warm drinks.
- Dosage- 1M potency, 2 times a day for 10 days.
- Best result is obtained when the medicine is taken in any part of the day, except midday and midnight.
3- Borax Veneta- Patient has fear of downward motion. He has extreme anxiety, from going downstairs. Patient is excessively nervous and easily frightened. He is sensitive to sudden noises. He has fear of thunder. It can be given for psoriasis . Itching is seen on the finger joints. Patient has unhealthy skin. It can be given for herpes. Eruptions are seen on fingers and hands with itching and stinging. The face of the patient is pale and swollen and has earth like expression. Patient is obese with light weight. Skin of the patient is wrinkled. Patient has herpetic eruptions on face.
- Worse- from downward motion, noise, smoking, warm weather, after menses.
- Dosage- 200 potency, 3 times a day, for 10 days.
4- Cantharis vesicatoria- Skin complaint of this remedy is often associated with urinary complaints, as this remedy often acts on gastric and urinary system. There is intolerable, constant urging to urinate. Patient is very anxious. He has restlessness, which ends in rage. He has constant attempts to do something, but accomplishes nothing. It is given for Dermatitis with bleb formation. It can be given when patient has secondary eczema around scrotum and genitals, followed by excessive perspiration. There are various vesicles with burning and itching. It can be given for Sunburn. Burning with rawness can be better by cold applications. It can cure burning in soles of feet at night.
- Worse- from touch, urination, drinking cold water or coffee.
- Better- rubbing.
- Dosage-30 potency, 3 times a day, for 20 days.
5- Flouric acid-It is remedy for bed sores, ulcerations, varicose veins and ulcers. It is suited for old age people, or those people who are prematurely aged. Patient lacks any emotions towards thos eloved most. They are unable to realise their responsible. They are very happy persons. It can be given when patient has itching especially in the various openings of body and this is worse by warmth. There is profuse sour, offensive perspiration.
- Worse- warmth, morning, warm drinks.
- Better- cold, while walking.
- Dosage- 30 potency, 2 times a day for 10 days.
6- Lycopodium- It is suited for people who develop disease gradually. They are very weak. Patient has difficulty in digestion. This remedy suited to old people, with earth like complexion, having difficulty in uric acid synthesis. All symptoms which begins from right goes to left. All conditions are worse from about 4 to 8 p.m. Patient wants everything warm. These people are intellectually very intelligent, but physically are very weak. They have weakness especially in morning. Skin is very unhealthy and ulcers are form very easily. There are various kinds of abscesses beneath the skin. These abscess are worse from warm applications. There is violent itching along with fissured eruptions. Patient has chronic eczema associated with urinary, gastric and liver disorders. Skin becomes thick because of the this condition. Patient has brown spots and freckles which is worse on left side of face and nose. There is offensive secretions, especially of feet.
- Worse- on right side, from right to left, from above downward, from 4 to 8 p.m., from heat, in warm room, from hot air, from warm applications.
- Better- by motion, after midnight, from warm food and drink, on getting cold, from uncovering.
- Dosage-30 potency 3 times a day, for 20 days.
7- Nux- vomica-It is suited to people who are thin, quick, active, nervous and irritable. He does a good deal of mental work. Because of this mental strains he lives a sedentary life. He do prolong office work and do over work. He is habitual of taking drugs like coffee, wine, excess of tobacco, opium. He is very irritable and sensitive to all impressions. He cannot bear noises, odours, light. He does not want to be touched. Even the least ailment affects him greatly. His body burning hot, especially the face. He is very sensitive to cold. His skin is very red and unhealthy.
- Worse- morning, from mental exertion, after eating, from touch, from taking spices, from stimulants, from taking narcotics, from dry weather, from cold.
- Better- from taking a nap, in the evening, while resting in damp, wet weather.
- Dosage-200 potency , 3 times a day for 15 days.