Większości schorzeń skóry głowy nie towarzyszą stany zapalne, a jedynie zmiany miejscowe o charakterze łagodnym. Znane są dwa rodzaje zapalenia skóry głowy – atopowe (AZS) i łojotokowe (ŁZS). Ze względu na to, że początkowe objawy obu schorzeń są podobne i mogą przypominać łupież, stany te bywają mylone, mimo różnych przyczyn powstawania zmian.
Zarówno w przypadku atopowego zapalenia skóry, jak i łojotokowego zapalenia skóry, objawy obejmują nie tylko skórę głowy, ale i inne miejsca na ciele, jak skóra twarzy lub karku. W zależności od schorzenia mogą również występować na klatce piersiowej lub kolanach.
Objawy atopowego zapalenia skóry (AZS)
Atopowe zapalenie skóry to przewlekłe schorzenie, które najczęściej pojawia się w dzieciństwie. W ok. 90 proc. przypadków pierwsze objawy występują przed ukończeniem 5. roku życia.
Wśród objawów klinicznych wyróżniamy uporczywy świąd oraz zapalne zmiany skórne o charakterze wypryski. Istotna jest również lokalizacja zmian skórnych, zależna od wieku pacjenta. U niemowląt objawy występują na głowie, czole i twarzy oraz w miejscach podatnych na otarcia, jak kolana i łokcie. W przypadku dzieci powyżej 2. roku życia zmiany ujawniają się przede wszystkim na wewnętrznych stronach nadgarstków, łokciach i kolanach, a także za uszami. Dorośli najwcześniej obserwują zmiany na twarzy, karku, dłoniach i stopach. Ponadto u pacjentów z AZS występują również takie objawy, jak:
- suchość skóry,
- świąd podczas pocenia,
- rogowacenie okołomieszkowe,
- przebarwienia powiek i zaciemnienia wokół oczu,
- nawrotowe zapalenie spojówek,
- nietolerancja niektórych pokarmów,
- reakcja alergiczna na wełnę,
- zaostrzenie zmian skórnych w wyniku stresu,
- rumień na twarzy.
Atopowe zapalenie skóry uznawane jest również za pierwszą manifestację kliniczną choroby alergicznej. Wśród dzieci częstym powikłaniem AZS jest dychawica oskrzelowa i alergiczny nieżyt błony śluzowej nosa.
Objawy łojotokowego zapalenia skóry głowy (ŁZS)
Łojotokowe zapalenie skóry jest przewlekłą chorobą, której towarzyszy silny stan zapalny skóry. Najczęściej choroba pojawia się w wieku dojrzewania, jednak dużo przypadków rozpoznaje się również u niemowląt i osób po 50. roku życia. Zmiany chorobowe charakteryzują się czerwonymi, kolistymi plamami z wyraźnie czerwonym brzegiem. Do występujących objawów zaliczamy:
- świąd,
- złuszczanie otrębiaste,
- łojotok,
- tłuste strupy na skórze,
- przerzedzenie włosów,
- rumień na skórze,
- grudki,
- krostki (niekiedy bolesne),
- wysięk,
- łysienie.
Zmiany często występują nie tylko na skórze głowy, lecz również czoła, okolicach zausznych i karku. Mogą również pojawić się pomiędzy łopatkami, na mostku, twarzy, a także w okolicy narządów płciowych i odbytu, czyli w miejscach określanych jako okolice łojotokowe. W nielicznych przypadkach choroba może rozwinąć się do uogólnionego zapalenia skóry.
ŁZS wynika z nadmiernego wydzielania się sebum przez gruczoły potowe, jednak nieznana jest przyczyna tego stanu. Niektórzy naukowcy uważają, że czynnikami wpływającymi na powstawanie łojotokowego zapalenia skóry są zaburzenia układu odpornościowego i hormonalnego, inni zaś zwracają uwagę, że ŁZS może być wywołane przewlekłym stresem i depresją. Czynnikami wyzwalającymi stan zapalny są m.in.: zakażenie drożdżakowym grzybem Pityrosporum ovale, zmęczenie, stres, trądzik zwyczajny, otyłość, nieprawidłowe odżywianie, nadużywanie alkoholu czy choroby neurologiczne.
Źródła:
Bednarek M. i Musiał C., Najczęstsze problemy pacjenta trychologicznego – choroby skóry głowy, „Kosmetologia Estetyczna” 2019, nr 3, s. 393- 396.
Małek E. Rozpoznawanie zaburzeń wzrostu, uszkodzeń i chorób włosów, Radom 2007, s. 15-18.
Wanak-Karzak M. i Kurzawa R., Atopowe zapalenie skóry – pierwsza manifestacja kliniczna choroby alergicznej.
Woldan-Tambor A. i Zawilska J. B, Atopowe zapalenie skóry (AZS) – problem XXI wieku, „Farm Pol” 2009, nr. 65(11), s. 804-811.
Przeczytaj także: Badania: cząsteczki alphaCT1 wspierają proces leczenia blizn chirurgicznych
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