Small pimples on elbow joints

The phenomenon of small bumps on the elbow joints may be caused by dermatitis or eczema. It is difficult to figure out the specific cause simply by judging from the small bumps. It is better to make a comprehensive judgment based on the shape and characteristics of the bumps. The biggest feature of dermatitis and eczema is itching, which not only appears in the elbow joints, but also grows in other places. We can first understand dermatitis and eczema and make judgments based on our own situation.

Causes

The causes of dermatitis and eczema are very complex and may be related to the following factors:

1. Internal factors

Chronic infection lesions (such as chronic cholecystitis, tonsillitis, intestinal parasitic diseases, etc.), endocrine and metabolic changes (such as menstrual disorders, pregnancy, etc.), blood circulation disorders (such as varicose veins in the lower legs, etc.), neuropsychiatric factors, genetic factors, etc.

2. External factors

It can be induced or aggravated by food (such as fish, shrimp, beef, mutton, etc.), inhalants (such as pollen, dust mites, etc.), living environment (such as cold, hot, dry, etc.), animal fur, and various physical and chemical substances (such as cosmetics, soap, synthetic fibers, etc.).

Clinical manifestations

The clinical manifestations of dermatitis and eczema are diverse and can usually be divided into three types of skin lesions: acute, subacute and chronic.

1. Acute phase

It manifests as erythema and edema, which may be accompanied by papules, papular rashes, blisters or erosions and exudation. The center of the lesion is often heavier and gradually spreads to the periphery. The pathological manifestations are edema between epidermal cells, sponge formation, and blisters within the epidermis.

2. Subacute phase

Blisters, redness, swelling and exudation decrease, and crusting and desquamation appear.

3. Chronic stage

The skin is mainly rough, thickened and leathery, with moss-like changes, which may be accompanied by pigmentation or hypopigmentation. Histopathologically, the epidermis is thickened, the acanthus layer is thickened, and there is lymphocytic infiltration of the dermal papillae. Hand and foot eczema may be accompanied by nail changes. The rash is generally distributed symmetrically and often recurs. The subjective symptoms are itching, even severe itching.

There is often no clear boundary between the three stages mentioned above. Some patients may experience all three stages at the same time, and some dermatitis does not necessarily have to go through all three stages. The above clinical staging does not indicate the cause or pathogenesis. Based on the cause, site of onset and clinical characteristics, dermatitis that can be classified and diagnosed can be called classified dermatitis (eczema), such as congestive dermatitis, seborrheic dermatitis, etc.; those that have the clinical characteristics of dermatitis and eczema but cannot be further classified are called unclassified eczema. Different types of dermatitis and eczema each have relatively specific clinical characteristics.

treat

First of all, pay attention to avoiding the cause of the disease or various suspected pathogenic factors. Avoid eating spicy food and drinking alcohol during the illness, and avoid excessive scalding, scratching and other stimulation. Infectious inflammation actively controls infection, and the general treatment principles for non-infectious inflammation are as follows:

1. Systemic drug therapy

The purpose is to fight inflammation and relieve itching. Antihistamines, sedatives, etc. can be used, but corticosteroids are generally not suitable.

(1) Acute and subacute phases: intravenous injection of calcium, vitamin C, etc. or intravenous blockade with procaine can be used; ① For patients with skin lesions <30% of the area, topical medications can be combined with oral antihistamines, compound glycyrrhizic acid, etc.; ② For patients with skin lesions ≥30%, 10% calcium gluconate or sodium thiosulfate or compound glycyrrhizic acid preparations can be used intravenously; severe patients can use hormones for a short period of time for 1 week; compound glycyrrhizic acid or tripterygium wilfordii preparations or other immunosuppressants can be used in combination or alternately. Continue to use these drugs for about 2 weeks after stopping hormones, and give antihistamines as appropriate. Or simply use tripterygium wilfordii preparations and immunosuppressants such as cyclosporine until the condition improves; give antibiotics appropriately to patients with extensive skin lesions and erosion, exudation or secondary infection; use immunosuppressants as appropriate, including azathioprine, cyclosporine A (CYA) and interferon. Those with recurrent episodes can try immunomodulators.

(2) Chronic stage: ① For patients with skin lesions <30% of the area, topical medications can be appropriately combined with antihistamines, compound glycyrrhizic acid, etc. for oral administration; for those with poor efficacy, tripterygium wilfordii preparations or immunosuppressants can be added for a short period of time, and the medication can be stopped after the disease is controlled; ② For patients with skin lesions ≥30%, most of them need to take compound glycyrrhizic acid, tripterygium wilfordii preparations or immunosuppressants, immunomodulators, or antihistamines orally; hormones are not recommended.

2. Topical medication

Follow the principles for the use of topical medications. In the acute phase, if there is not much exudation, glucocorticoid cream can be used. If there is a lot of exudation, cold wet compress with 3% boric acid solution can be used. After the exudation decreases, glucocorticoid cream can be used, or it can be used alternately with oil. In the subacute phase, glucocorticoid emulsions and pastes can be used, and antibiotics can be added to prevent and treat secondary infection. In the chronic phase, ointments, plasters, and film-forming agents can be used. For stubborn localized skin lesions, intradermal injections of glucocorticoids can be used.