Vulvar eczema

　　Eczema is an acute or chronic skin inflammation caused by internal and external factors, with a complex etiology. Allergy is an important cause of eczema, and allergens can come from the outside or inside of the body. The main ones are:

　　1. External allergens:Such as chemical drugs, cosmetics, dyes, radiation, etc.; certain animal toxins, eggs, fish, shrimp, milk, and other heterologous proteins, as well as certain plant pollen or dust in the air.

　　2. Internal allergens:Such as internal lesions, intestinal parasites, certain metabolic products, gastrointestinal diseases, and autoantigens produced by human tissues under the influence of certain factors.

　　3. Local stimulation:Such as increased vaginal discharge, scratching, urinary fistula, etc.

　　4. Mental factors:Such as mental stress, over fatigue, depression, etc., which can disrupt the function of the nervous and endocrine system, increase the sensitivity of the skin to various stimulating factors through nervous reflexes or endocrine influence, and induce eczema.

　　Vulvar eczema can affect the vulva and surrounding skin, with symptoms of severe itching. In the acute stage, erythema, edema, papules, and vesicles cluster together. In addition to its clinical manifestations, it can also cause other diseases. This disease is prone to bacterial or fungal infections.

　　Vulvar eczema can affect the vulva and surrounding skin, with symptoms of severe itching.
　　1. Acute stage
　　Erythema, edema, papules, and vesicles cluster together. Vesicles can merge,溃破, macerate, exude, and crust. The lesions are often symmetrically distributed, more localized, and recurrent.
　　2. Subacute stage
　　Maceration and exudation decrease, and crusts and desquamation appear.
　　3. Chronic stage
　　After the acute stage, the inflammatory response becomes mild, manifested as thickened skin, fissures, desquamation, accompanied by hyperpigmentation or hypopigmentation.

　　The key to preventing vulvar eczema lies in identifying the cause and removing potential triggering factors, avoiding the use of drugs and lotions that irritate the vulvar skin, keeping the vulvar area as dry as possible, and avoiding contact with allergens: such as hot water, scratching, friction, and stimulation; refrain from eating spicy foods, drinking alcohol, strong tea, and coffee, etc.

　　1. If the vulvar eczema is caused by an allergy, the allergen should be removed immediately, and plenty of water should be consumed.

　　2. Keep the external genitalia clean and hygienic, and use personal bath utensils. Change and wash underwear daily.

　　3. Avoid spicy and stimulating foods such as fish and crabs, and maintain a light diet.

　　Routine examinations include: urinalysis, vaginal secretion examination, blood routine, stool routine, immunopathological examination, routine gynecological examination of the vulva, and others.
　　1, For those suspected of having contact factors, patch testing should be performed to find allergens. During the acute phase, when complicated with bacterial infection, peripheral blood white blood cells and neutrophils increase.

　　2, Pathological examination of living tissue in the lesion area.

　　Eating more of the following 4 vegetables can help prevent and treat vulvar eczema:

　　1, Bitter melon:Bitter melon contains quinine, which has the effects of clearing heat, detoxifying, and stopping itching. It can be used to treat diseases such as heat toxicity, boils, boils, and eczema.

　　2, Tomato:Tomatoes contain abundant vitamin A, vitamin B1, vitamin B2, vitamin C, niacin, vitamin E; and contain malic acid, citric acid, calcium, phosphorus, iron, and solanine, etc. Tomatoes have the effects of moistening the throat, stopping cough, promoting digestion, cooling the blood, calming the liver, clearing heat, etc. The fruit acid in tomatoes has a protective effect on vitamin C, so it can effectively supplement vitamin C; solanine has the effects of antibacterial and anti-inflammatory, reducing vascular permeability, so the external application of tomato juice for eczema can have the effects of stopping itching and contraction.

　　3, Leek:Leek contains carotene, vitamin B, vitamin C, calcium, phosphorus, iron, protein, fiber, and other nutrients. Leek also has the effects of detoxifying and removing dampness, so leek juice can be applied externally to treat eczema.

　　4, Celery:Rich in fiber, vitamin B2, and vitamin C, as well as a large amount of minerals, trace elements. Celery has the effects of removing dampness and promoting diuresis, which can effectively prevent and treat the recurrence of eczema.

　　What foods should vulvar eczema patients avoid?

　　(1) Avoid spicy and irritating foods: Spicy and irritating foods can affect the endocrine system in the body, causing skin itching and affecting treatment. Spicy and irritating foods include chili, pepper powder, mustard, green onions, garlic, white wine, and others.

　　(2) Avoid fatty foods: Fatty foods mainly refer to oil and fat. Excessive intake of these foods can promote the secretion of sebaceous glands, worsening the condition. At the same time, it is also necessary to eat less sweet and salty foods to facilitate the recovery of the skin.

　　(3) Avoid seafood and irritant, sensitizing foods when itching is severe.

　　Routine treatment methods for vulvar eczema

    Stage treatment

　　(1) Acute phase: mainly local treatment. Use cold saline wet compresses during the acute phase. Apply zinc oxide ointment when erythema, blisters, and exudation are not obvious. When there is no exudate or pustules, 1% phenol-laden magnesium trisilicate wash can be used externally. When there is obvious exudation, a 3% boric acid solution with 1:8000 to 1:5000 potassium manganate solution can be used for cold wet compresses. If there is erosion, it is advisable to use a compound copper sulfate solution for external washing to prevent and contract; for secondary bacterial and fungal infections, corresponding antibacterial and antifungal ointments can be selected, such as 0.5% neomycin ointment, 2% oxytetracycline and zinc oxide ointment for application, wet compresses with 0.1% isothiazolin (rifamycin) solution, and during the scab stage, in addition to wet compresses, acetate triamcinolone (triamcinolone acetonide) ointment, fluocinolone acetonide ointment, and others can be applied to contract and relieve itching, and keep dry.

　　(2) Subacute stage: For eczema skin with mild infiltration, scabbing, and desquamation, ointments and creams can be used, and various corticosteroid creams can also be selected.

　　(3) Chronic stage: The treatment principle for chronic eczema is to relieve itching, inhibit epidermal cell proliferation, and promote the absorption of dermal inflammation. When the skin has hypertrophy and infiltration, apply flufenamic acid (flufenamic acid butyl ester ointment, Buter) for rubbing; 5% to 10% compound turpentine ointment, 2% boric acid, and corticosteroid ointment can also be selected. For chronic and refractory cases, cryotherapy or radioactive isotope (32p)敷贴 or superficial X-ray irradiation therapy can be used. If necessary, triamcinolone acetonide (Kenalog), urea ointment, and other corticosteroids can be used locally for packing, which can increase the efficacy.

　　Medication Treatment

　　Treat the cause of the disease, keep the vulva clean, avoid scratching, rest well, and avoid eating foods that are easy to cause allergies. Antihistamines and other drugs can be taken orally.

　　(1) Antihistamines and other drugs: 25mg of diphenhydramine, 3 times a day, taken orally. 8mg of chlorphenamine (Pyrithione) 3 times a day, taken orally. For those with severe itching, 10ml of 5% calcium bromide can be injected intravenously; or 10ml of 10% calcium gluconate can be injected intravenously, once a day.

　　(2) Vitamins: Large amounts of vitamin C can be administered intravenously or orally, and B-group vitamins can be taken orally for treatment.

　　(3) Hormones: Can be used for acute severe eczema. Prednisone, dexamethasone, and other treatments can have certain effects on eliminating inflammation, relieving itching, and reducing exudate. Due to many adverse reactions, attention should be paid to controlling the use. It should not be used for elderly chronic eczema, as recurrence and other adverse reactions occur quickly after discontinuation.

　　(4) For infected patients, appropriate antibiotic treatment should be added.