The main task of the immune system is to protect the organism from harmful microorganisms and harmful
formations in its environment. In case of any threat posed by microorganisms, foreign substances in the environment or physical and chemical trauma
, defense mechanisms come into play.
All This system, which is necessary for the continuation of life in living things, continues its complex but extremely harmonious
function. Any disruption or disorder in the functioning of the immune system leads to serious
diseases: urticaria (hives), angioedema, food and drug allergies, allergic contact dermatitis,
atopic dermatitis.
URTICARIA
p>Urticaria and angioedema occur as the clinical reflection of different immunological and inflammatory mechanisms
. Urticaria is classically divided into acute and chronic. Cases that last up to six weeks are called acute,
Those that last more than 6 weeks are called chronic urticaria. However, acute attacks may also occur from time to time over the years. The rate of detecting causative factors in acute urticaria is higher than in chronic urticaria.
Skin symptoms in urticaria are red, hard bumps that can be seen all over the body. Their sizes vary widely, they can be 1-2 mm or in the form of plaques covering large areas. In rare cases, blisters may be seen on them. They usually disappear within 24 hours without leaving a trace. The bumps are usually itchy, the itching increases at night. The clinical picture may worsen in the evenings and during menstrual periods. Severe, alarming swelling may occur on the lips and
eyelids.
Acute urticaria: The cause may not be found in 50% of cases. Medicines, foods, food additives, implants, contact and inhalant allergens may be responsible. The reaction develops within minutes. to drugs Acute urticaria occurring with rash is common and clinical findings usually appear within 36 hours after taking the drug. The most common
drug group is antibiotics, especially penicillin, cephalosporin, tetracycline, and sulfonamides. Previous exposure to drugs, familial predisposition, intermittent and multiple drug treatments are factors that increase the risk of urticaria.
Chronic urticaria: Clinical conditions in which wheals continue for more than 6 weeks are called chronic urticaria. .
37% of the cases are accompanied by physical urticaria. Although the factor causing urticaria is rarely detected
, triggering agents are investigated.
Medicines: penicillins, salicylates and other NSAIDs (with non-immunological means)
Foods and food additives: food-related allergies The reaction was detected only in 3.5%.
Food additives are responsible for 10% (most commonly tartrazine, azo dyes, sodium benzoate).
Infections and infestations: viral infections, dental abscesses, urinary infections, gallbladder
/> infections, sinusitis, intestinal parasitoses, hydatid cyst, helicobacter pylori
Inhalant allergens: meadow grass pollens, mold spores, animal dander, house dust mites, cigarette smoke,
chemical allergens
Systemic diseases : lupus erythematosus, Sjögren's syndrome, IgM macroglobulinemia, more rarely
thyroid diseases, lymphoma.
Menstrual cycle and pregnancy: urticaria may flare up in the premenstrual period. If it only occurs
during menstruation, progesterone or estrogen sensitivity is suspected.
Implants: metals placed in the femur, metal dental prostheses, dental amalgam.
Psychological reasons: more in cases of depression and anxiety
frequently.
Complete blood count, hemogram, erythrocyte sedimentation rate, thyroid function tests, blood biochemistry,
complement levels, serum immunoglobulins, serum proteins and electrophoresis, autoantibodies, total
IgE and RAST, if clues are obtained from the anamnesis, skin tests and infection focus research can be performed.
Biopsy should be performed in cases resistant to treatment
Successful treatment The conditions for being diagnosed are questioning the cause by talking to the patient, a good patient-physician
relationship, and a good follow-up.
ATOPIC DERMATITIS
Atopic dermatitis is a chronic, itchy skin. is the disease. Although it can be seen at any age, it begins before the age of 5 in 90% of patients and after the second month in 50%. It is the most common
chronic skin disease of childhood.
The disease develops as a result of the interaction of environmental and genetic factors. Having allergies in the family is an important risk
factor. It negatively affects the quality of life regardless of age. If both parents have allergy
the risk triples.
Atopic eczema differs in its course and clinical features in infancy, childhood and adulthood
. While in infancy there are skin symptoms that are more red, swollen, and located on the outer surface of the face and arms and legs, as age progresses, the skin thickens, becomes coarser, and the color becomes darker. It is mostly located on the eyelids, inner knees-elbows, and neck. In every period, the skin is dry and itchy. In 20 to 30% of cases, skin lesions regress by the end of two years of age. Itching is the most important finding. It increases towards the evening, with sweating and wearing woolen clothes. The most important point in protection is to avoid allergens and irritants
. Chemicals, alkaline soaps, and house dust mites are among these. A physician should definitely be consulted
regarding this matter. It is of great importance to moisturize the skin regularly. 10-20 minutes daily
Moisturizing the skin within the first three minutes after a warm bath increases the skin's barrier function and moisture
rate. Bubble baths and scented bath salts should be avoided. Swimming in chlorinated pools
and entering hot jacuzzis increases skin irritation. It is recommended to avoid woolen and synthetic clothes and wear cotton clothes.
ALLERGIC CONTACT DERMATITIS
It develops against allergenic substances contacted. There are more than 3700 environmental allergens. The sensitization period after the first touch
is 5-25 days, and the clinical response after the second touch usually develops within 24 hours.
Once it occurs, it remains for a lifetime, decreasing or increasing. There may be a genetic predisposition, especially in nickel allergy, but it is not very effective. It constitutes 7% of all occupational diseases. It is more common and severe in women. It is no less common in children; nickel, Peru balsam and rubber are the most common causes. Damaged and dry
skin facilitates eczema. History is very important in diagnosis; the physician must have knowledge about allergens. Occupation, hobbies, cosmetics, clothes, personal belongings, home environment, and topical medications used
should be questioned. The area where it is located varies depending on the allergenic substance. The obvious complaint is itching, and in the initial period, redness, swelling, watering, and crusting are observed. It starts in the area of contact with the allergen substance and may spread. It may occur with allergens reaching through the air. Dust, plants, chemicals, perfume, insecticides are the most common causes. It is diagnosed with a skin patch test.
The most frequently detected allergens:
Nickel: Most common in women, together with hand eczema.
Cobalt: Dental plaque, common in dentures, together with nickel
Chromate: Used in cement, leather industry
Tire: Based on accelerators and antioxidants (PPD, thiuram,
carbamate, mercapto) mostly used in the tire industry
Resins:
Epoxy (usually occupational, adhesive,
hardener)
Acrylates (glue, artificial nails, prosthesis,
printing works, hearing aids)
Formaldehyde (glue, shoes, ink)
Plastics: Industrial origin, eyeglass frame, hearing aid
Textile: Formaldehyde, perfume (in detergent-softener), azo dyes, PPD
Shoes: PPD, adhesive, mercaptothiobenzol, chromate, thiourea, dye, colophony
Medicines: EU , lanolin, balm, imidazole, topical NSAID, transdermal systems, topical corticosteroids,
systemic reactions may occur
Cosmetics: Perfume, PPD, peru balsam, colophony
Plants: Chrysanthemum, tulip, primula obconica, anemone, lichens, tobacco
Wood: Phenol, quinone, terpene, peru balsam, cinnamaldehyde
Skin patch test is applied to the upper back with the patient in a relaxed position. If the adhesive tape has come off
the test should be repeated. It is left on the back for 48 hours and evaluated 20 minutes to 1 hour after opening. It is evaluated again on the 2nd and 4th
days and the last time on the 7th day. Avoidance of allergens is the first step in treatment. The most
important thing is to take legal precautions to limit the use of allergens
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