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"etiology": "<p>Главной причиной, вызывающей дерматит любого вида, является соприкосновение кожи с любыми раздражителями из окружающей среды. </p>\r\n<p>Вещества, наиболее часто вызывающие контактный дерматит: </p>\r\n<ul>\r\n<li>никель – металл, широко применяемый для изготовления монет, украшений, пряжек, посуды, а также зубных протезов; </li>\r\n<li>латекс – используется для изготовления презервативов, резиновых перчаток, детских пустышек, сосок и игрушек; </li>\r\n<li>лекарственные кремы и мази, в состав которых входят антибиотики, гормоны; </li>\r\n<li>косметические средства, предназначенные для ухода за кожей, и декоративная косметика; </li>\r\n<li>бытовая химия (стиральные порошки, средства для мыться посуды и др.); </li>\r\n<li>синтетические материалы, используемые для изготовления одежды; </li>\r\n<li>различные вещества, такие как краски, клей, чернила и др. </li>\r\n</ul>",
"pathogenesis": "<p>Простой контактный дерматит обусловлен прямым повреждением клеток верхнего слоя кожи - эпидермиса. Из поврежденных клеток высвобождаются различные биологически активны вещества (медиаторы воспаления и факторы хемотаксиса), вызывающие расширение сосудов (эритема), выход жидкости в дерму и эпидермис (отек и волдырь) и клеточную инфильтрацию. Наблюдается внеклеточный и внутриклеточный отек эпидермиса. </p>\r\n<p>Простой контактный дерматит, вызванный однократным воздействием едкого вещества, например сильной кислоты или щелочи, на кожу, называют химическим ожогом . При химическом ожоге воспаление развивается в течение нескольких минут и часов. Белее легкая форма простого контактного дерматита возникает при многократном воздействии слабого раздражающего вещества, например мыла или моющего средства, и проявляется через несколько недель или месяцев после первого контакта с этим веществом. У больных атопическими заболеваниями , особенно диффузным нейродермитом , кожа более чувствительна к действию раздражающих веществ. </p>",
"diagnostics": "<p>Диагноз ставится на основании дерматологической симптоматики. Проводятся аппликационные кожные пробы (не ранее 2 недель после купирования симптомов дерматита), гистологическое исследование кожного покрова.</p>",
"treatment": "<p> </p>\r\n<p>Лечение заболевания необходимо начинать с исключения контакта кожи с аллергеном. Если развитие контактного дерматита связано с профессиональной деятельностью пациента, то необходимо постоянное использование защитных средств (перчатки, маски, защитные костюмы). </p>\r\n<p>Больным, у которых выявлена аллергическая реакция на никель, рекомендуется соблюдение диеты, ограничивающей продукты, содержащие это вещество (геркулес, греча, пшено, соя, чечевица, томаты, семечки, шоколад, какао). </p>\r\n<p>Больным рекомендуется в течение нескольких дней принимать антигистаминные средства. </p>\r\n<p>При выраженном воспалительном процессе на пораженном участке кожи пациентам назначается местное применение мазей, кремов или лосьонов, содержащих кортикостероиды. Гормональные мази наносятся на чистую кожу 1–2 раза в день тонким слоем. Длительность курса лечения обычно не превышает 2 недель. </p>\r\n<p>При обширных поражениях, а также тяжелых реакциях организма на контакт с аллергеном, врач может назначить системные кортикостероидные препараты для приема внутрь</p>",
"prevention": "<p>Профилактика этого заболевания заключается только в исключении контакта кожи с веществами, вызывающими аллергическую реакцию. При случайном попадании на кожу известного раздражителя необходимо немедленно тщательно смыть его под проточной водой с мылом. </p>\r\n<p>При аллергии на бытовую химию (стиральные порошки, средства для ухода за домом) следует использовать специальные гипоаллергенные средства, но даже при их применении необходимо использовать защитные перчатки. Одежду следует выбирать из натуральных материалов. Рекомендуется отдавать предпочтение украшениям из благородных металлов (золото и серебро). </p>",
"clinical_picture": "<p>В зависимости от характера вещества, воздействующего на кожу, и индивидуальных особенностей проницаемости эпидермиса может развиться один из трех вариантов острого контактного дерматита: эритематозный, буллезный или некротический. </p>\r\n<p>Эритематозный дерматит проявляется покраснением и отеком контактировавшего с раздражителем участка кожи. Болезненность и зуд выражены слабо. Возможна сухость кожи и появление на ней трещин. </p>\r\n<p>Буллезный вариант простого контактного дерматита представлен пузырями различного размера, заполненными прозрачной жидкостью. Пузыри появляются на гиперемированном фоне и лопаются с образованием эрозий. Характерна болезненность, чувство жара или жжения. </p>\r\n<p>Некротический дерматит возникает при воздействии едких веществ (кислот или щелочей) и характеризуется образованием изъязвлений, поверхность которых покрыта струпом. Выражен болевой синдром. После того, как происходит заживление язв, на коже остаются рубцы. </p>\r\n<p>Хроническая форма простого контактного дерматита развивается при многократном воздействии слабого раздражителя. Наиболее часто поражается кожа рук. Заболевание, как правило, связано с использованием средств бытовой химии или профессиональной деятельностью. Хронический дерматит характеризуется усилением рисунка кожи, застойной гиперемией (покраснением), инфильтрацией, сухостью кожи и гиперкератозом (утолщением кожи). В некоторых случаях наблюдаются атрофические процессы в коже. Субъективные ощущения слабо выражены и мало беспокоят больного. </p>",
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