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Odczyn alergiczny – objawy, rozpoznanie i leczenie

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Wysypka, pokrzywka, pęcherze z płynem czy złuszczanie się skóry mogą świadczyć o skórnej reakcji alergicznej. Przy alergii najważniejsza jest odpowiednia profilaktyka i właściwa pielęgnacja skóry. Jakie objawy skórne świadczą o alergii i jak przebiega ich leczenie?

Reakcja alergiczna najczęściej jest spowodowana bezpośrednim kontaktem z czynnikiem uczulającym. Zmiany skórne mogą przybierać różną postać i lokalizację. By złagodzić alergiczne zmiany skórne w praktyce klinicznej najczęściej zaleca się unikanie kontaktu z alergenem czy nawilżanie emolientami.

Co może powodować skórną reakcję alergiczną?

Skórne odczyny alergiczne może wywołać wiele czynników. Do uczulenia dochodzi w wyniku ekspozycji na alergen drogą oddechową, pokarmową lub bezpośrednio poprzez skórę. Alergia powstaje u osób mających prawdopodobnie genetyczne uwarunkowania do reakcji lub w związku z długotrwałym i intensywnym narażeniem.

Do najczęstszych przyczyn alergii skórnej zalicza się alergeny wziewne, np. pyłki roślin, kurz czy sierść zwierząt. Alergię mogą powodować również niektóre składniki naszej diety, takie jak laktoza, jajko kurze, owoce morza czy orzechy, a także dodatki do żywności – glutaminian sodu, barwniki spożywcze. Niektórzy pacjenci zgłaszają skórne zmiany w wyniku reakcji alergicznej na leki (penicylina, neomycyna czy aspiryna), jad owadów czy metale. Do czynników wywołujących skórne reakcje alergiczne zalicza się również niektóre składniki kosmetyków, zwłaszcza konserwanty, barwniki czy kompozycje zapachowe.

Niejednokrotnie ustalenie przyczyny alergii jest trudne do zidentyfikowania, dlatego w przypadku wystąpienia zmiany skórnej warto jest zgłosić się do lekarza – alergologa lub dermatologa. Specjalista po zbadaniu zmian skórnych i zebraniu wywiadu jest w stanie określić, co wywołało alergię i zmianę skórną, a także zleci odpowiednie leczenie.

Jakie objawy skórne świadczą o alergii?

Alergiczną chorobę skóry można podejrzewać, jeżeli pojawiły się następujące objawy i dolegliwości:

  • pokrzywka z pęcherzami o różowej lub porcelanowobiałej barwie, którym towarzyszy świąd lub pieczenie. Większość pokrzywek trwa krótko i ustępuje samoistnie. Czasami stają się jednak długotrwałą chorobą o postaci ostrej (utrzymujące się do 6 tygodni) lub przewlekłej (powyżej 6 tygodni),
  • zaczerwienienie skóry,
  • pęcherze z płynem,
  • drobne grudki na podłożu zaczerwienionej skóry,
  • złuszczanie się skóry,
  • pęknięcia skóry,
  • wysypki skórne,
  • świąd,
  • pieczenie skóry,
  • obrzęk naczynioruchowy – obrzęk skóry i tkanki podskórnej, dotyczący najczęściej twarzy, rąk lub stóp. Niekiedy towarzyszyć może obrzęk śluzówek jamy ustnej, języka, gardła i krtani,
  • szorstkość i rogowacenie skóry.

Ponadto alergia może powodować alergiczne kontaktowe zapalenie skóry, atopowe zapalenie skóry, rzadziej białkowe zapalenie skóry oraz reakcje anafilaktyczne.

Dla klinicystów w celu potwierdzenia reakcji alergicznej szczególną wskazówką diagnostyczną jest związek pomiędzy objawami skórnymi z określonymi czynnikami chemicznymi lub biologicznymi. Ponadto w celu rozpoznania alergii zlecane są dodatkowe badania, no. alergologiczne, badania krwi na oznaczenie poziomu swoistych przeciwciał klasy IgE, testy skórne punktowe i płatkowe.

Leczenie alergicznych zmian skórnych

Osoby, które cierpią na alergię skórną powinny przede wszystkim podejmować działania profilaktyczne, np. polegające na unikaniu alergenu.

W praktyce klinicznej, alergicy poddawani są immunoterapii, tzw. odczulaniu. Leczenie może trwać jednak nawet kilka lat, ale daje dużą szansę na nabycie tolerancji immunologicznej. Pacjentów poddaje się najczęściej leczeniu miejscowemu, które polega na stosowaniu maści, płynów i kremów. Działanie przeciwalergiczne wykazują również kortykosteroidy. W przypadku nasilonych objawów i braku skuteczności preparatów działających miejscowo, wdraża się leczenie doustne – np. leki przeciwhistaminowe, które blokują receptory histaminy i hamują alergiczną reakcję zapalną. W przewlekłym wyprysku opornym na leczenie miejscowe i przeciwhistaminowe, stosuje się leki immunosupresyjne i cyklosperynę A. W ciężkich i rozległych stanach zapalnych skóry, w praktyce klinicznej, podaje się doustnie glikokortykosteroidy.

Jak pielęgnować skórę w przypadku alergii?

Dużą rolę w łagodzeniu alergicznych zmian skórnych odgrywają emolienty, które są silnie nawilżające, odbudowują barierę naskórkową, redukują świąd, regenerują uszkodzoną skórę i działają przeciwzapalnie. Z emolientów nie należy rezygnować w okresie remisji zmian skórnych. Pacjentom zaleca się także stosowanie maści np. dziegciowej lub rumiankowej, które mają działanie przeciwzapalne i pomagają łagodzić zmiany skórne.

Ulgę przyniosą z kolei okłady z chłodnej wody lub soli fizjologicznej, zwłaszcza w pierwszej fazie np. wyprysku. Okłady można stosować kilka razy dziennie przez około 30 minut. Alergiczne zmiany skórne wiążą się również z ryzykiem zakażenia, dlatego pacjentom zaleca się stosowanie środków antyseptycznych, które mają działanie odkażające.

Źródła: medycynapracyportal.pl, a.umed.pl

 

Przeczytaj także: Jak objawia się i jak leczyć kontaktowe zapalenie skóry?

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