慢性自發性蕁麻疹引焦慮
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每5人就有1位發生過蕁麻疹,其中約1~2%屬於慢性蕁麻疹患者,而慢性自發性蕁麻疹病患更佔有6成之多。
由於慢性自發性蕁麻疹會反覆發作,長期下來易導致身心俱疲,更可能合併失眠、焦慮症、憂鬱症等症狀。為改善慢性自發性蕁麻疹,找出令人發癢的原因,許多人試圖從食物下手,將其歸咎於「食物過敏」。
不過,食物真是導致慢性自發性蕁麻疹的原因嗎?一旦罹患慢性自發性蕁麻疹,患者又該如何進行自我檢測,協助醫師釐清病程?《Hello醫師》邀請到台大醫院皮膚部主治醫師朱家瑜為大家一一說明!
食物過敏非主因!慢性自發性蕁麻疹常見原因有這些
朱家瑜表示,曾有位尼姑因身上起疹而就醫,經醫師診斷為食物過敏所引起之蕁麻疹;為免復發,她多年來只吃自種的蔬菜配白飯,症狀卻無因此明顯改善。輾轉求診於朱家瑜醫師諮詢後,才發現自己罹患的是「慢性自發性蕁麻疹」,與食物過敏毫無關聯。
朱家瑜醫師指出,不少病患常誤以為將身體出現膨疹、紅腫、搔癢感等蕁麻疹典型症狀,是由食物過敏所引起,所以平時會自動避開食用某些食物,殊不知症狀不但沒有好轉,還持續反覆發作。
其實由食物過敏所引起的大多為急性蕁麻疹,反覆發作時間小於6週,而多數慢性自發性蕁麻疹則與心理壓力大、免疫系統失調、慢性發炎、人體自體免疫系統有關,反覆發作時間會長達6週以上,需要長期接受藥物治療才會好轉。
8種常見的濕疹類型
濕疹(Eczema)是「引發皮膚紅腫、發炎的皮膚病」總稱,它包含的範圍相當廣泛,依照不同的症狀,大概能分成以下8種類型:
手部濕疹:手部濕疹的症狀多樣,最常見的就是在手掌上長水泡、破裂容易流膿的「汗皰疹」以及由於接觸刺激性物質或過敏原,而導致手掌龜裂脫皮、紅腫疼痛的「富貴手」。
錢幣狀濕疹:又稱錢幣狀濕疹性皮炎,患部會生出如硬幣狀的圓形紅斑,甚至起疹子、水泡、流膿,通常因對特定細菌或其他物質(如金屬)過敏,或因蚊蟲叮咬搔抓而引發此症。
異位性皮膚炎:又稱異位性濕疹,好發於兒童,患者手肘、膝窩、腕部等關節處以及胸口會出現乾癢、紅腫症狀,若是搔抓則會導致破皮、滲出液、結痂等慢性濕疹性病狀,大部份病童會在10~12歲前慢慢痊癒,只有少數人會持續至長大成年。
接觸性皮膚炎:可能因皮膚接觸過敏原或刺激性物質而引發,紅腫和發癢是此類皮膚炎的典型症狀,若患者不停搔抓或持續與過敏原和刺激物接觸,也可能形成水泡、引發脫皮、起疹等症狀。(延伸閱讀:什麼狀況該刺破水泡?6步驟安全搞定)
神經性皮膚炎:又稱慢性單純苔癬,好發於過敏性體質或因心理壓力而引發,但不具傳染力。病患會因搔癢而不斷反覆搔抓,導致患部出現如皮革或鱗片般的腫塊,可能呈紅色或是比膚色更深的顏色。
鬱滯性皮膚炎:因為腿部靜脈血栓以及外傷導致靜脈功能不全所引起,會使得小腿下方出現紅腫、濕疹,嚴重的話會導致鬱滯性潰瘍或是靜脈潰瘍。
汗皰疹:多發生於患者手指、腳趾的側邊,急性期會出現散佈型的小水泡,使患者奇癢難耐,不慎抓破會流液,並增加細菌感染風險;而若是反覆發作,則容易轉為慢性,水泡也可能變得比較不明顯,轉為出現乾燥、發紅、脫皮、疼痛等症狀。
脂漏性皮膚炎:患者的患部會出現明顯發紅與脫屑現象,好發於頭皮、鼻側、眉毛、胸部與頸部等區域,引發原因可能與皮屑芽孢菌(Malassezia,或稱馬拉色菌)感染有關。(延伸閱讀:不勝其癢!脂漏性皮膚炎的原因與改善)
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