Traumatic dermatitis (mechanical dermatitis) is an inflammatory reaction of the skin that occurs in response to mechanical action (pressure, friction). Traumatic dermatitis is local in nature and usually passes when the causal factor is eliminated. Its clinical forms include: dropsy, scuffing, numbness, corn, diaper rash. Diagnosis includes examination, dermatoscopy, bacteriological examination of the discharge or scraping, measurement of skin pH, detection of concomitant trophic disorders. Treatment consists in the elimination of mechanical effects and factors aggravating its effect, the use of local disinfectants and anti-inflammatory agents, carrying out the necessary hygienic procedures.
Along with actinic dermatitis, burns and frostbite, traumatic dermatitis refers to skin lesions caused by the influence of physical factors. Mechanical damaging effects on the skin can lead to its development: friction and pressure. The clinical manifestations of traumatic dermatitis depend on the degree and time of exposure to the skin-damaging factor, as well as on the properties of the skin itself. The most susceptible to the appearance of traumatic dermatitis are people with sensitive skin, persons prone to hyperhidrosis or vice versa increased dryness of the skin, patients with impaired microcirculation and trophic tissues (diabetes mellitus, chronic venous insufficiency, trophic ulcers, atherosclerosis, etc.).
From intense compression and friction of the skin when wearing too tight shoes or clothes, during professional activities or sports, a scuff or a water callus may form. Exposure to the same factors against the background of increased skin moisture leads to the formation of diaper rash. Prolonged, but not so intense, mechanical action on the skin causes the appearance of calluses.
Skin changes in traumatic dermatitis are clearly limited to the zone of exposure to the traumatic factor. They can be manifested by redness and swelling, detachment of the epidermis with the formation of blisters, the formation of erosions, ulcers and even necrotic areas. As a rule, all these symptoms of traumatic dermatitis are accompanied by severe soreness, especially when touching the affected area of the skin. The elimination of the traumatic factor leads to a fairly rapid regression of the symptoms of dermatitis. In most cases, no traces remain on the skin, but with its deep lesion, recovery can occur with the formation of hyperpigmentation or scarring. Repeated mechanical impact can again cause the development of traumatic dermatitis.
Modern dermatology refers to traumatic dermatitis: scuffing, water callus, diaper rash, callosity and corn. Scuffing is manifested by redness, burning and soreness of the skin. If the mechanical impact is not eliminated, bubbles and erosion form in the area of scuffing. Secondary infection with the development of streptoderma, pyoderma, vulgar or streptococcal impetigo is possible. A water callus is a bubble filled with a transparent liquid, often formed on the hands and feet during intense friction with shoes, working tools or sports equipment.
Diaper rash occurs in people with hyperhidrosis or with increased sweating due to overheating (hot climate, too warm clothes). It can also occur with constant maceration of the skin by urine or feces with insufficient care in infants, patients with urinary incontinence, feces or diarrhea. This variant of mechanical dermatitis is localized mainly in the skin folds. It is manifested by redness with indistinct borders, the appearance of cracks and erosions. It is accompanied not only by soreness, but also by itching. A separate clinical form of diaper rash is diaper dermatitis.
Corns and calluses are a consequence of compensatory hyperkeratosis — increased keratinization of the epidermis in response to the constant mechanical impact of a small force. These types of mechanical dermatitis are usually localized on the skin of the palms and feet. They are characterized by local thickening of the epidermis and coarsening of the skin. At the same time, the callosity has no clear boundaries, and the corn, on the contrary, is a clearly delimited cone-shaped formation and may have a root that goes deep into the skin.
Traumatic dermatitis does not always require consultation with a dermatologist. The reason for contacting a doctor is severe soreness, the formation of erosions or the appearance of signs of infection. In case of localization of manifestations of traumatic dermatitis on the foot, a podiatrist’s consultation is recommended. To confirm the diagnosis of traumatic dermatitis, dermatoscopy, pH-metry of the skin, back-seeding of the discharge or scraping taken from the surface of the lesion area can be performed. The presence of concomitant diseases in the patient, leading to trophic disorders, is an indication for the consultation of a vascular surgeon, cardiologist, neurologist, phlebologist, and other specialists.
The main one is the elimination of mechanical injury to the skin and related factors contributing to the development of traumatic dermatitis. It is recommended to observe skin hygiene, wear soft clothes or shoes that fit well in size, use a patch and special pads under the corn, work with gloves. If necessary, patients with traumatic dermatitis are treated for trophic disorders and hyperhidrosis therapy (endoscopic curettage and liposuction of the axillary zone, ultrasound destruction). Air baths are useful.
When worn, baths with potassium permanganate and anti-inflammatory ointments have a good effect. Treatment of diaper rash includes the use of drying powders and local anti-inflammatory drugs. Calluses and calluses are treated with keratolytic drugs and softened in a soda-soap solution, and then the excess keratinized layers of the skin are removed. The treatment of calluses can be carried out during a hardware pedicure or manicure, foot peeling and other procedures.