How should frictional lichenoid rash be handled?

summary

It is also known as papular dermatitis in children, recurrent pityriasis of elbow and knee in summer and sandy dermatitis. More than in spring, summer and early autumn, children often have a history of playing with sand or contact with rough objects. The lesions are often symmetrically distributed, mostly confined to the dorsum of the hand and the extensor side of the forearm. Sometimes they can be seen in the exposed parts of the knuckles, elbows and knees that are vulnerable to irritation and friction, and occasionally widely involve the wrist, feet and trunk. The lesions were flat or hemispherical papules with the size of millet grains, which were often densely integrated but not fused. They were covered with fine chaff like scales, showing mild lichenoid change and mild inflammation. Generally, the normal skin color is more than that in spring, summer and early autumn. The children often have a history of playing with sand or contacting rough objects. The lesions are often symmetrically distributed, mostly confined to the dorsum of the hand and the extensor side of the forearm. Sometimes they can be seen in the exposed parts of the knuckles, elbows and knees that are vulnerable to irritation and friction, and occasionally widely involve the wrist, feet and trunk. The lesions were flat or hemispherical papules with the size of millet grains, which were often densely integrated but not fused. They were covered with fine chaff like scales, showing mild lichenoid change and mild inflammation. Normal skin color.

How should frictional lichenoid rash be handled?

1. The heavier ones may be light red. Generally no symptoms, sometimes mild itching. The disease is self limited, but it is easy to recur after exposure to the original stimulus. During the whole course of the disease, the lesions remained dry without blisters, erosion and exudation. You can't eat seafood and all kinds of spicy food. Teach children to play less sand, reduce friction and control behavior.

2. Avoid sand and other friction stimulation, preschool children should be more care, reduce the chance of mechanical friction. Generally, only symptomatic treatment is needed, such as calamine lotion for external use or ointment with low concentration of keratin promoter, such as 3% black bean oil and zinc oxide ointment, or corticosteroid ointment, 3-4 times a day. If necessary, antihistamines can be used throughout the body.

3. It should be differentiated from the common insect bite dermatitis and caterpillar dermatitis in childhood. These two papules may be larger, edema and inflammation are often obvious, conscious pruritus severe. Sometimes it is not easy to distinguish from papular acrodermatitis in children, but the latter has more extensive rashes, larger papules up to the size of mung bean, flat, red color, larger liver and positive serum, which is caused by natural infection of hepatitis B virus.

matters needing attention

The pathogenesis is not clear; It is generally believed that it is related to contact with some objects or mechanical friction, such as playing with sand, toys, etc. due to children's active and poor self-control ability, they do not pay attention to the contact mode and posture, resulting in frequent contact between exposed skin and sand, toys and other friction substances, resulting in the onset of disease. Some people think that it is caused by virus infection, but it has yet to be proved by experiments.