There is a hard lump on my belly

I believe many people have experienced getting pimples on their bodies. These pimples are not like the pimples on the face. Pimples on the body are generally divided into extracutaneous and intracutaneous. The most common extracutaneous pimples are those caused by acne or dermatitis. This requires understanding whether the bumps on the belly cause pain and itching, and then treating them based on the specific symptoms.

Clinical manifestations of dermatitis

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 (Table 1). Different types of dermatitis and eczema each have relatively specific clinical characteristics.

diagnosis

The diagnosis is mainly based on comprehensive consideration of the cause, site of onset and clinical characteristics. Common dermatitis that can be classified and diagnosed include contact dermatitis, atopic dermatitis, stasis dermatitis, seborrheic dermatitis, etc., all of which have one or several skin inflammatory manifestations such as macules, papules, blisters, plaques, erosions, crusts or lichenification, etc.; those with the above clinical characteristics that cannot be further classified are collectively called eczema, which can be diagnosed according to the site, such as perianal eczema, scrotal eczema, external ear eczema, breast eczema, eyelid eczema, etc., and can also be diagnosed according to factors such as skin lesion stage or season, such as chronic calf eczema, summer dermatitis, etc. The severity of eczema can be scored based on the area and characteristics of the rash.

Differential Diagnosis

Need to be differentiated from the following diseases:

1. Differentiate from other types of dermatitis with specific causes and clinical manifestations

Such as atopic dermatitis, contact dermatitis, seborrheic dermatitis, stasis dermatitis, neurodermatitis, etc.

2. Differentiate from diseases with similar manifestations as eczema

Such as superficial fungal diseases, scabies, polymorphic light eruption, eosinophilic syndrome, Pelagia and cutaneous lymphoma.

3. Differentiate from rare congenital diseases with eczematous lesions

Such as Wiskott-Aldrich syndrome, selective IgA deficiency, high IgE recurrent infection syndrome, etc.