Aseptic dermatitis treatment. Atopic dermatitis, how to treat and whether chronic atopic dermatitis can be cured

The International Classification of Diseases previously defined this disease as diffuse neurodermatitis. Now, according to ICD-10, the disease is called atopic dermatitis and has code L20, which indicates a pathological effect on the skin and subcutaneous tissue. Atopic dermatitis is also called childhood eczema.

If the disease manifests itself in young children, its cause is most likely hereditary or related to the characteristics of pregnancy. Such children may also suffer from other types of allergies - asthmatic attacks, allergic rhinitis or conjunctivitis, or lack of tolerance to certain nutrients. The occurrence of the disease in more late age usually associated with influence external factors. Atopic dermatitis is more often found in children under one year of age and takes without necessary therapy chronic form with periodic exacerbations throughout life.

In addition to genetic predisposition, the prerequisites for atopic dermatitis in infants may be:

In addition to these reasons, risk factors for eczema in infants include various household allergens - from detergents and baby care products to pharmaceuticals.

Those parents who themselves suffer from allergies should be especially attentive to the effects of adverse factors. If both father and mother have such hypersensitivity, the likelihood of childhood eczema in their heir increases to 80 percent. Is one parent hypersensitive to antigens? The risk is halved.

Atopic dermatitis in older children (2–3 years old) can manifest itself against the background psycho-emotional stress, passive smoking, excess physical activity, bad ecology in the place of residence, frequent infectious diseases. These same factors provoke exacerbation of eczema when chronic course illness.

But contact with pets can play a role positive role. Italian scientists conducted a study and found that if there is a dog in the house, the risk of developing allergic dermatitis is reduced by a quarter. Communication between a pet and a child not only gives the immune system an impetus for development, but also relieves stress.

Main signs of the disease

Symptoms of atopic dermatitis in infants:

• skin itching, worse at night;
• the appearance of seborrhea scales on the head;
• redness and cracks on the cheeks, in the area of ​​​​the eyebrows and ears;
• loss of appetite;
• poor sleep, due to itching.

In difficult cases, not only the scalp is affected. There may be atopic dermatitis on the arms, neck, legs, buttocks. Sometimes irritation is accompanied by pyoderma - small pustules, when scratching which the child can get a secondary infection, resulting in difficult-to-heal wounds.

In the process of growing up, if the disease cannot be stopped, the signs are modified or supplemented. So, if the baby is already 1 year old, the skin pattern may intensify and dry, flaky patches of thickened skin may appear under the knees, in the elbows, on the wrists, feet and neck. At 2 years old, almost half of the children suitable treatment gets rid of the disease. But some children suffer even after two years: the infant stage of the disease passes into childhood, and then into adolescence. Painful areas are hidden in skin folds or localized on the palms and soles. Exacerbations occur in winter, and in summer the disease does not manifest itself.

Such dermatitis in a child can become an “allergic march”, and subsequently add allergic rhinitis and bronchial asthma. Every fifth patient additionally develops hypersensitivity to bacterial microflora, which contributes to a complicated and protracted course of the disease.

Clinical picture and diagnosis of the disease

It is important to differentiate atopic dermatitis in children from other skin diseases. After all, the symptoms may be similar to those of scabies, pityriasis rosea, psoriasis, microbial eczema or seborrheic dermatitis.

The diagnosis must be made experienced doctors: dermatologist and allergist-immunologist. Doctors conduct the following diagnostic studies: collect a complete medical history, find out the possibility of a hereditary predisposition, conduct a thorough examination and refer the baby for general analysis blood. A high serum IgE concentration will confirm the diagnosis.

Mild form of atopic dermatitis in a child

Moderate atopic dermatitis with secondary infected wounds from scratching

Diagnosis of atopic dermatitis in children takes into account not only the patient’s age, but also the stages of the disease:

1. Initial stage (signs): hyperemia (redness), swelling of tissues, peeling, most often on the face.
2. Severe stage: Skin problems spread to other parts of the body, unbearable itching, burning, and small papules appear.
3. Features of remission: Symptoms decrease or disappear altogether.

Therapy for allergic disease

Complete healing is possible with proper treatment on initial stage. But we can talk about clinical recovery if an average of 5 years have passed since the last period of exacerbation.

Experienced doctors who know how to cure atopic dermatitis believe that only complex therapy. It includes proper nutrition, strict control of the surrounding space, taking medications and physical therapy. You may need the help of not only an allergist and dermatologist, but also a nutritionist, gastroenterologist, otolaryngologist, psychotherapist and neurologist.

Diet for atopic dermatitis in children

Diet therapy is extremely necessary: ​​it is food allergens that can cause a violent skin response. In first place are products made from cow's milk. If a “milk” allergy is detected in an “artificial” baby, mixtures with soy substitutes will be preferable for him: “Alsoy”, “Nutrilak soya”, “Frisosoy” and others.

However, it may turn out that the baby does not accept soy. For children in the first year of life, hypoallergenic formulations with an increased degree of protein hydrolysis are suitable: Alfare, Nutramigen, Pregestimil, and others. If you have a reaction to gluten, you will have to eliminate cereals or replace them with gluten-free ones.

In difficult cases, the doctor may prescribe a complete hydrolyzate, for example "Neocate", along with "" therapy

For complementary feeding, you should not choose foods with high sensitizing activity, for example, citrus fruits, nuts, honey, strawberries.

Subsequently, when preparing a diet, you need to take into account that when reacting to milk protein, an allergy to beef is real. The baby’s body, which does not perceive mold fungi, will give a violent response to yeast products - from bread to kefir.

The diet for atopic dermatitis in children requires a special menu. Broths, mayonnaise, marinades, pickles, fried foods, and foods containing dyes and preservatives are not recommended.

Sample menu for this disease:

1. Breakfast - porridge from soaked buckwheat with vegetable oil.
2. Lunch – vegetable cream soup, some boiled chicken, freshly squeezed apple juice.
3. Dinner – millet porridge with vegetable oil.

For a snack – gluten-free cookies, an apple.

You should choose artesian or still mineral water for drinking. It should be at least 1.5 liters per day so that toxins can be freely excreted in the urine.

The doctor may also prescribe fish oil to strengthen the child's immunity and strengthen cell membranes.

Environmental control

The famous pediatrician Komarovsky is confident that with atopic dermatitis in children, the main thing is to eliminate the effect of irritating factors on the skin. For this you need:

• regular wet cleaning, washing of linen, covers on upholstered furniture;
• keeping toys perfectly clean;
• use of hypoallergenic detergent compositions;
• refusal of washcloths and hard towels;
• lack of electrical appliances in the bedroom;
• selection of loose clothing made from natural fabrics.

You can only bathe your baby in dechlorinated, filtered water. Use baby soap only once a week. After washing, the skin is blotted with a gentle towel and an emollient preparation is applied, for example, Bepanten cream or Bepanten ointment in difficult cases, Lipikar or F-99.

It is important to avoid nonspecific risk factors - nervous and physical overload, passive smoking, infectious diseases.

Necessary emollients

How to treat atopic dermatitis? In acute conditions, your doctor may prescribe corticosteroids for external use. Compositions for softening and moisturizing are constantly needed. Emollients are ideal for atopic dermatitis in children.

Here is a list of the most popular means:

• "Locobase lipicrem." The same company produces another cream for atopic dermatitis in children - Locobase Ripea. In the first case, the active component is liquid paraffin, which softens the skin. In the second - ceramides, cholesterol and polyunsaturated fatty acid, promoting skin regeneration.
• A series of “Topicrem” products for the care of atopic children. For kids, lipid-replenishing balm and Ultra Rish gel, which cleanses the skin, are suitable.
• Milk or cream "A-Derma" is a good preventive measure, moisturizes and protects the skin.
• Stelatopia series from the manufacturer Mustela. These are creams, emulsions and bathing compositions that soften the epidermis and help its regeneration.
• Lipikar balm. It contains lipid-replenishing shea and canola oils, glycine to relieve itching and wound healing thermal water. In addition, the La Roche-Posay pharmaceutical laboratory has created hygiene products “Lipikar surgra”, “Lipikar Sindet”, “Lipikar bath oil”, suitable for children with atopic dermatitis.

These products reduce peeling and inflammation, restore the water and lipid balance of the skin, cleanse the skin of impurities and prevent the development of bacteria. Emollients penetrate no further than the epidermis, which in principle eliminates side effects. Therefore, they can be used even for the youngest patients.

Systemic pharmaceutical treatment

Sometimes systemic therapy is also necessary. The course may include:

• Antihistamines. Those with a relaxing effect (Suprastin, Tavegil) are useful if the baby cannot sleep due to itching. And new generation pharmaceuticals (“Cetrin”, “Zyrtec”, “Erius”) in all other cases - they do not provoke drowsiness and are very effective.
• Antibiotics for secondary infections. For atopic dermatitis in children, antibiotic ointments (erythromycin, gentamicin, xeroform, furacilin, levomikol, others) are ideal. The drug “Zinocap” is good - it has not only an antibacterial, but also an antifungal and anti-inflammatory effect. In difficult cases, doctors prescribe antibiotic tablets. Antibiotics should be used only under medical supervision so as not to intensify the allergic process. Applications with Vishnevsky ointment can also be applied to wounds; this drug helps fast healing wound
• Anti-viral and fungal agents – if a corresponding infection has been introduced.
• Immune modulators prescribed by an allergist-immunologist and vitamin complexes with B15 and B6 to accelerate skin regeneration.
• Drugs to improve digestion (“Panzinorm”, “Pancreatin”, “Creon”, “Festal”), as well as choleretic agents and hepatoprotectors (“Gepabene”, “Essentiale Forte”, “Allohol”, infusion of corn silk or rosehip berries) .
• Enterosorbents (“Enterosgel”, “”, activated carbon) to block intestinal toxins.

Therapy for allergic dermatitis performed on an outpatient basis. But if the skin is seriously damaged, hospitalization is indicated for the baby.

Treatment with folk remedies and physiotherapy

Treatment of atopic dermatitis in children with traditional methods is carried out only under the supervision of a doctor. Healing decoctions and potions, which abound in any forum about medicinal herbs and traditional medicine, can only harm the child if there is an individual intolerance.

The safest of these remedies are cleansing baths. They help relieve itching and discomfort.

They bathe the baby in a weak solution of potassium permanganate, in water with the addition of a decoction of celandine or string, chamomile, and calendula. Pour the mixture well into the bath potato starch with water (a small spoon of powder per liter). The water should not be too hot, and the procedure itself should not last more than 15 minutes. Bathing with the addition of oatmeal also has a very good effect on the condition of the baby's skin.

Ointments based on birch tar also have a therapeutic effect on inflammation.

Sanatorium-resort treatment and physiotherapeutic procedures are very useful for atopic children. During remission, pearl, sodium chloride, hydrogen sulfide, iodine-bromine baths, and mud therapy are suitable. If symptoms are severe, use electrosleep, magnetic therapy, carbon baths, and relaxation procedures.

Atopic dermatitis in infants is a chronic immune inflammation of the child’s skin, characterized by a certain form of rashes and their staged appearance.

Childhood and infant atopic dermatitis significantly reduces the quality of life of the entire family due to the need for strict adherence to a special therapeutic diet and a hypoallergenic lifestyle.

Main risk factors and causes of atopic dermatitis

A risk factor for atopic disease is often a hereditary history of allergies and. Factors such as constitutional features, nutritional disorders, and insufficiently good care for the child are also unfavorable.

Understanding the pathogenesis of this allergic disease will help you understand what atopic dermatitis is and how to treat it.

Every year, scientists' knowledge about the immunopathological processes occurring in the body during atopic childhood is increasing.

During the course of the disease, the physiological skin barrier is disrupted, Th2 lymphocytes are activated, and immune defense is reduced.

Concept of the skin barrier

Dr. Komarovsky, in his articles popular among young parents, touches on the topic of the characteristics of children's skin.

Komarovsky highlights 3 main features that are important in breaking the skin barrier:

• underdevelopment of sweat glands;
• fragility of the stratum corneum of the children's epidermis;
• high lipid content in the skin of newborns.

All these factors lead to a decrease in protection skin baby.

Hereditary predisposition

Atopic dermatitis in infants can occur due to a filaggrin mutation, in which changes occur in the filaggrin protein, which ensures the structural integrity of the skin.

Atopic dermatitis develops in children under one year of age due to a decrease in the local immunity of the skin to the penetration of external allergens: the biosystem of washing powder, the epithelium and hair of pets, fragrances and preservatives contained in cosmetic products.

Antigenic loads in the form of toxicosis in pregnant women, taking medications by a pregnant woman, occupational hazards, highly allergenic food - all this can provoke an exacerbation of an allergic disease in a newborn.

• food;
• professional;
• household

Prevention of allergies in infants can be a natural, as long as possible, rational use medicines, treatment of diseases of the digestive system.

Classification of atopic dermatitis

Atopic eczema is divided according to age stages into three stages:

• infant (from 1 month to 2 years);
• children's (from 2 years to 13);
• teenage

In newborns, the rash looks like redness with blisters. The bubbles break easily, forming a wet surface. The baby is bothered by itching. Children scratch out rashes.

Bloody purulent crusts form in places. Rashes often appear on the face, thighs, and legs. Doctors call this form of rash exudative.

In some cases, there are no signs of weeping. The rash looks like spots with slight peeling. Affected more often hairy part heads and face.

At 2 years of age, sick children have different skin increased dryness, cracks appear. The rashes are localized in the knee and elbow pits, on the hands.

This form of the disease has the scientific name “erythematous-squamous form with lichenification.” In the lichenoid form, peeling is observed, mainly in the folds and elbow bends.

Facial skin lesions appear at older ages and are called “atopic face.” Pigmentation of the eyelids and peeling of the skin of the eyelids are observed.

Diagnosis of atopic dermatitis in children

There are criteria for atopic dermatitis, thanks to which the correct diagnosis can be made.

Main criteria:

• early onset of the disease in an infant;
• itching of the skin, often occurring at night;
• chronic continuous course with frequent serious exacerbations;
• exudative nature of the rash in newborns and lichenoid in older children;
• presence of close relatives suffering from allergic diseases;

Additional criteria:

• dry skin;
• positive skin tests during allergy testing;
• white dermographism;
• presence of conjunctivitis;
• pigmentation of the periorbital region;
• central protrusion of the cornea - keratoconus;
• eczematous lesions of the nipples;
• strengthening of the skin pattern on the palms.

Laboratory diagnostic measures for severe atopic dermatitis are prescribed by a doctor after examination.

Complications of atopic dermatitis in children

Frequent complications in children include various types of infections. The open wound surface becomes a gateway for Candida fungi.

Prevention of infectious complications consists of following the recommendations of an allergist regarding the specific use of emollients (moisturizers).

List of possible complications of atopic dermatitis:

• folliculitis;
• boils;
• impetigo;
• anular stomatitis;
• candidiasis of the oral mucosa;
• skin candidiasis;
• Kaposi's eczema herpetiformis;
• molluscum contagiosum;
• genital warts.

Traditional treatment of atopic dermatitis

Treatment of atopic dermatitis in children begins with the development of a special hypoallergenic diet.

An allergist prepares a special elimination diet for a mother with atopic dermatitis in her baby. This diet will help you maintain your health for as long as possible. breast-feeding.

An approximate hypoallergenic elimination diet for children under one year of age with atopic dermatitis.

Menu:

• breakfast. Dairy-free porridge: rice, buckwheat, oatmeal, butter, tea, bread;
• lunch. Fruit puree from pears or apples;
• dinner. Vegetable soup with meatballs. Mashed potatoes. Tea. Bread;
• afternoon tea Berry jelly with cookies;
• dinner. Vegetable and cereal dish. Tea. Bread;
• second dinner. Formula or .

The menu for a child, and especially for a child with atopic dermatitis, should not contain spicy, fried, salty foods, seasonings, canned food, fermented cheeses, chocolate, or carbonated drinks. On the menu for children with allergic symptoms limit semolina, cottage cheese, sweets, yoghurts with preservatives, chicken, bananas, onions, garlic.

Mixtures based on it will also help in the treatment of atopic dermatitis in a child.

In case of hypersensitivity to cow's milk proteins, the World Organization of Allergists strongly does not recommend the use of products based on non-hydrolyzed goat's milk protein, since these peptides have a similar antigenic composition.

Vitamin therapy

Patients with atopic dermatitis are not prescribed multivitamin preparations, which are dangerous from the point of view of the development of allergic reactions. Therefore, it is preferable to use single preparations of vitamins - pyridoxine hydrochloride, calcium pathotenate, retinol.

Immunomodulators in the treatment of allergic dermatoses

Immunomodulators that affect the phagocytic component of immunity have proven themselves in the treatment of allergic dermatoses:

1. Polyoxidonium has a direct effect on monocytes, increases resistance cell membranes, is able to reduce the toxic effect of allergens. It is used intramuscularly once a day with an interval of 2 days. A course of up to 15 injections.
2. Lycopid. Strengthens the activity of phagocytes. Available in 1 mg tablets. May cause an increase in body temperature.
3. Zinc preparations. They stimulate the restoration of damaged cells, enhance the action of enzymes, and are used for infectious complications. Zincteral is used at a dose of 100 mg three times a day for up to three months.

Hormonal creams and ointments for atopic dermatitis in children

It is not possible to treat severe atopic dermatitis in children without the use of local anti-inflammatory glucocorticosteroid therapy.

For atopic eczema in children, both hormonal creams and various forms of ointments are used.

Below are basic recommendations for the use of hormonal ointments in children:

• in case of severe exacerbation, treatment begins with the use of strong hormonal agents - Celestoderma, Cutivate;
• to relieve symptoms of dermatitis on the torso and arms in children, the drugs Lokoid, Elokom, Advantan are used;
• It is not recommended to use Sinaflan, Fluorocort, Flucinar in pediatric practice due to serious side effects.

Calcineurin blockers

An alternative to hormonal ointments. Can be used on the face and natural folds. The drugs Pimecrolimus and Tacrolimus (Elidel, Protopic) are recommended to be used in a thin layer on the rash.

These drugs should not be used in immunodeficient conditions.

The course of treatment is long.

Products with antifungal and antibacterial activity

For infectious uncontrolled complications, it is necessary to use creams containing antifungal and antibacterial components - Triderm, Pimafucort.

The previously used and successful zinc ointment was replaced by a new, more effective analogue- activated zinc pyrithione, or Skin-cap. The drug can be used in one year old child in the treatment of rashes with infectious complications.

For severe weeping, an aerosol is used.

Dr. Komarovsky writes in his articles that there is no more formidable enemy for a child’s skin than dryness.

Komarovsky advises using moisturizers (emollients) to moisturize the skin and restore the skin barrier.

The Mustela program for children with atopic dermatitis offers a moisturizer in the form of a cream-emulsion.

The Lipikar program of the La Roche-Posay laboratory includes Lipikar balm, which can be applied after hormonal ointments to prevent dry skin.

Treatment of atopic dermatitis with folk remedies

How to cure atopic dermatitis permanently? This is a question that scientists and doctors around the world are asking themselves. The answer to this question has not yet been found. Therefore, many patients are increasingly resorting to homeopathy and traditional methods of traditional medicine.

Treatment with folk remedies sometimes brings good results, but it is better if this method of treatment is combined with traditional therapeutic measures.

When the skin gets wet during a severe exacerbation of allergic dermatosis, folk remedies in the form of a lotion with a decoction of string or oak bark help well. To prepare the decoction, you can purchase a series in filter bags at the pharmacy. Brew in 100 ml of boiled water. Use the resulting decoction to apply lotions to the rash areas three times during the day.

Spa treatment

Most Popular sanatoriums for children with manifestations of atopic dermatitis:

• sanatorium named after Semashko, Kislovodsk;
• sanatoriums “Rus”, “DiLuch” in Anapa with a dry maritime climate;
• Sol-Iletsk;
• sanatorium "Klyuchi" Perm region.

• limit your child’s contact with all types of allergens as much as possible;
• give preference to cotton clothes for your baby;
• avoid emotional stress;
• Trim your child’s nails short;
• the temperature in the living room should be as comfortable as possible;
• try to keep the humidity in the child’s room at 40%.

What follows Avoid for atopic dermatitis:

• use alcohol-based cosmetics;
• wash too often;
• use hard washcloths;
• take part in sports competitions.

Thank you

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

What is atopic dermatitis?

Atopic dermatitis- it is genetically determined, chronic illness skin. Typical clinical manifestations of this pathology are eczematous rash, pruritus and dry skin.
On this moment The problem of atopic dermatitis has become global, because the increase in incidence in recent decades has increased several times. Thus, in children under one year of age, atopic dermatitis is registered in 5 percent of cases. In the adult population, this figure is slightly lower and varies from 1 to 2 percent.

For the first time, the term “atopy” (which from Greek means unusual, alien) was proposed by scientists Coca. By atopy he understood a group of hereditary forms of increased sensitivity of the body to various environmental influences.
Today, the term “atopy” refers to a hereditary form of allergy, which is characterized by the presence of IgE antibodies. The reasons for the development of this phenomenon are not completely clear. Synonyms for atopic dermatitis are constitutional eczema, constitutional neurodermatitis and prurigo (or pruritus) of Beignet.

Statistics on atopic dermatitis

Atopic dermatitis is one of the most frequently diagnosed diseases among the child population. Among girls, this allergic disease occurs 2 times more often than among boys. Various studies in this area confirm the fact that residents of large cities are most susceptible to atopic dermatitis.

Among the factors that accompany the development of childhood atopic dermatitis, the most significant is heredity. So, if one of the parents suffers from this skin disease, the likelihood that the child will have a similar diagnosis reaches 50 percent. If both parents have a history of the disease, the chances of a child being born with atopic dermatitis increase to 75 percent. Statistics show that in 90 percent of cases, this disease manifests itself between the ages of 1 and 5 years. Very often, in about 60 percent of cases, the disease debuts before the child reaches one year of age. Much less often, the first manifestations of atopic dermatitis occur in adulthood.

Atopic dermatitis is a disease that has become widespread in recent decades. Thus, in the United States of America, at the moment, compared with data twenty years ago, the number of patients with atopic dermatitis has doubled. Official data suggests that today 40 percent of the world's population is struggling with this disease.

Causes of atopic dermatitis

The causes of atopic dermatitis, like many immune diseases, remain not fully understood today. There are several theories regarding the origin of atopic dermatitis. Today, the most convincing theory is the theory of allergic genesis, the theory of impaired cellular immunity and the hereditary theory. In addition to the direct causes of atopic dermatitis, there are also risk factors for this disease.

Theories for the development of atopic dermatitis are:

• theory of allergic genesis;
• genetic theory of atopic dermatitis;
• theory of impaired cellular immunity.

Theory of allergic genesis

This theory connects the development of atopic dermatitis with congenital sensitization of the body. Sensitization is the body's increased sensitivity to certain allergens. This phenomenon is accompanied by increased secretion of immunoglobulins E (IgE). Most often the body develops increased sensitivity to food allergens, that is, to food products. Food sensitization is most common in infants and preschool children. Adults tend to develop sensitization to household allergens, pollen, viruses and bacteria. The result of such sensitization is an increased concentration of IgE antibodies in the serum and the launch immune reactions body. Antibodies of other classes also take part in the pathogenesis of atopic dermatitis, but it is IgE that provokes autoimmune phenomena.

The amount of immunoglobulins correlates (is interrelated) with the severity of the disease. Thus, the higher the concentration of antibodies, the more pronounced clinical picture atopic dermatitis. Also involved in disruption of immune mechanisms mast cells, eosinophils, leukotrienes (representatives of cellular immunity).

If in children the leading mechanism in the development of atopic dermatitis is food allergy, then in adults pollen allergens become of great importance. Pollen allergy among adults occurs in 65 percent of cases. Household allergens are in second place (30 percent); epidermal and fungal allergens are in third place.

Frequency of different types of allergens in atopic dermatitis

Genetic theory of atopic dermatitis

Scientists have reliably established the fact that atopic dermatitis is hereditary disease. However, it has not yet been possible to establish the type of inheritance of dermatitis and the level of genetic predisposition. The latter figure varies in different families from 14 to 70 percent. If both parents in a family suffer from atopic dermatitis, the risk for the child is more than 65 percent. If this disease is present in only one parent, then the risk for the child is halved.

Theory of impaired cellular immunity

Immunity is represented by humoral and cellular components. Cellular immunity refers to a type of immune response in the development of which neither antibodies nor the compliment system take part. Instead, immune function is carried out by macrophages, T lymphocytes and other immune cells. This system Particularly effective against virus-infected cells, tumor cells and intracellular bacteria. Disturbances at the level of cellular immunity underlie diseases such as psoriasis and atopic dermatitis. Skin lesions, according to experts, are caused by autoimmune aggression.

Risk factors for atopic dermatitis

These factors significantly increase the risk of developing atopic dermatitis. They also influence the severity and duration of the disease. Often, the presence of one or another risk factor is the mechanism that delays the remission of atopic dermatitis. For example, gastrointestinal pathology intestinal tract the child may be held back from recovery for a long time. A similar situation is observed in adults during stress. Stress is a powerful psycho-traumatic factor that not only prevents recovery, but also aggravates the course of the disease.

Risk factors for atopic dermatitis are:

• pathology of the gastrointestinal tract;
• stress;
• unfavorable ecological environment.

Pathology of the gastrointestinal tract (GIT)
It is known that the human intestinal system performs a protective function of the body. This function is realized thanks to the abundant intestinal lymphatic system, intestinal flora and immunocompetent cells that it contains. A healthy gastrointestinal system ensures that pathogenic bacteria are neutralized and eliminated from the body. IN lymphatic vessels there is also a large amount of intestines immune cells, which at the right time resist infections. Thus, the intestines are a kind of link in the chain of immunity. Therefore, when there are various pathologies at the level of the intestinal tract, this primarily affects the human immune system. Proof of this is the fact that more than 90 percent of children with atopic dermatitis have various functional and organic pathologies of the gastrointestinal tract.

Gastrointestinal diseases that most often accompany atopic dermatitis include:

• biliary dyskinesia.

These and numerous other pathologies reduce barrier function intestines and trigger the development of atopic dermatitis.

Artificial feeding
Premature transition to artificial formula and early introduction of complementary foods are also risk factors for atopic dermatitis. It is generally accepted that natural breastfeeding reduces the risk of developing atopic dermatitis several times. The reason for this is that breast milk contains maternal immunoglobulins. Later, together with milk, they enter the child’s body and provide him with the formation of immunity for the first time. The child’s body begins to synthesize its own immunoglobulins much later. Therefore, in the early stages of life, the child’s immunity is provided by immunoglobulins from mother’s milk. Premature cessation of breastfeeding weakens the baby's immune system. The consequence of this is numerous abnormalities in the immune system, which increases the risk of developing atopic dermatitis several times.

Stress
Psycho-emotional factors can provoke exacerbation of atopic dermatitis. The influence of these factors reflects the neuro-allergic theory of the development of atopic dermatitis. Today it is generally accepted that atopic dermatitis is not so much skin disease as much as psychosomatic. This means that the nervous system plays a crucial role in the development of this disease. This is confirmed by the fact that antidepressants and other psychotropic drugs are successfully used in the treatment of atopic dermatitis.

Unfavorable ecological environment
This risk factor has become increasingly important in recent decades. This is explained by the fact that emissions from industrial enterprises create an increased burden on human immunity. An unfavorable environment not only provokes exacerbations of atopic dermatitis, but can also participate in its initial development.

Risk factors are also living conditions, namely the temperature and humidity of the room in which a person lives. Thus, temperatures above 23 degrees and humidity below 60 percent negatively affect the condition of the skin. Such living conditions reduce the resistance (resistance) of the skin and trigger immune mechanisms. The situation is aggravated by the irrational use of synthetic detergents, which can enter the human body through the respiratory tract. Soap, shower gel and other hygiene products are irritating factors and contribute to the appearance of itching.

Stages of atopic dermatitis

It is customary to distinguish several stages in the development of atopic dermatitis. These stages or phases are characteristic of certain age intervals. Also, each phase has its own symptoms.

The phases of development of atopic dermatitis are:

• infant phase;
• child phase;
• adult phase.

Since the skin is an organ of the immune system, these phases are considered as features of the immune response at different age periods.

Infant phase of atopic dermatitis

This phase develops at the age of 3 – 5 months, rarely at 2 months. This early development of the disease is explained by the fact that, starting from 2 months, the child’s lymphoid tissue begins to function. Since this body tissue is a representative of the immune system, its functioning is associated with the onset of atopic dermatitis.

Skin lesions in the infant phase of atopic dermatitis differ from other phases. So, in this period the development of weeping eczema is characteristic. Red, weeping plaques appear on the skin, which quickly become crusted. In parallel with them, papules, vesicles and urticarial elements appear. Initially, the rashes are localized in the skin of the cheeks and forehead, without affecting the nasolabial triangle. Further skin changes affect the surface of the shoulders, forearms, and extensor surfaces of the lower leg. The skin of the buttocks and thighs is often affected. The danger in this phase is that infection can set in very quickly. Atopic dermatitis in the infantile phase is characterized by periodic exacerbations. Remissions are usually short-lived. The disease worsens during teething, the slightest intestinal disorder or a cold. Spontaneous cure is rare. As a rule, the disease moves into the next phase.

Childhood phase of atopic dermatitis
The childhood phase is characterized by a chronic inflammatory process of the skin. At this stage, the development of follicular papules and lichenoid lesions is characteristic. The rash most often affects the area of ​​the elbow and popliteal folds. The rash also affects the flexor surfaces of the wrist joints. In addition to the rashes typical of atopic dermatitis, so-called dyschromia also develops in this phase. They appear as flaky brown lesions.

The course of atopic dermatitis in this phase is also wavy with periodic exacerbations. Exacerbations occur in response to various provoking environmental factors. Relationship with food allergens during this period it decreases, but there is increased sensitization (sensitivity) to pollen allergens.

Adult phase of atopic dermatitis
The adult phase of atopic dermatitis coincides with puberty. This stage is characterized by the absence of weeping (eczematous) elements and the predominance of lichenoid foci. The eczematous component is added only during periods of exacerbation. The skin becomes dry, infiltrated rashes appear. The difference between this period is the change in the localization of the rash. So, if in childhood the rash predominates in the area of ​​​​the folds and rarely affects the face, then in the adult phase of atopic dermatitis it migrates to the skin of the face and neck. On the face, the nasolabial triangle becomes the affected area, which is also not typical for the previous stages. The rash can also cover the hands and upper body. During this period, the seasonality of the disease is also minimally expressed. Basically, atopic dermatitis worsens when exposed to various irritants.

Atopic dermatitis in children

Atopic dermatitis is a disease that begins in infancy. The first symptoms of the disease appear by 2–3 months. It is important to know that atopic dermatitis does not develop until 2 months. Almost all children with atopic dermatitis have a polyvalent allergy. The term "multivalent" means that an allergy develops to several allergens at the same time. The most common allergens are food, dust, and household allergens.

The first symptoms of atopic dermatitis in children are diaper rash. Initially, they appear under the arms, buttock folds, behind the ears and in other places. At the initial stage, diaper rash appears as reddened, slightly swollen areas of the skin. However, very quickly they move into the stage of weeping wounds. The wounds do not heal for a very long time and often become covered with wet crusts. Soon the skin on the baby’s cheeks also becomes chafing and red. The skin of the cheeks very quickly begins to peel off, as a result of which it becomes rough. Another important diagnostic symptom are milky crusts that form on the eyebrows and scalp of a child. Beginning at the age of 2–3 months, these signs reach their maximum development by 6 months. In the first year of life, atopic dermatitis goes away with virtually no remissions. In rare cases, atopic dermatitis begins at one year of age. In this case, it reaches its maximum development by 3–4 years.

Atopic dermatitis in infants

In children of the first year of life, that is, infants, there are two types of atopic dermatitis - seborrheic and nummular. The most common type of atopic dermatitis is seborrheic, which begins to appear from 8 to 9 weeks of life. It is characterized by the formation of small, yellowish scales in the scalp area. At the same time, in the area of ​​the baby’s folds, weeping and difficult-to-heal wounds are detected. The seborrheic type of atopic dermatitis is also called skin fold dermatitis. When an infection occurs, a complication such as erythroderma develops. In this case, the skin of the baby's face, chest and limbs becomes bright red. Erythroderma is accompanied by severe itching, as a result of which the baby becomes restless and constantly cries. Soon, hyperemia (redness of the skin) becomes generalized. The entire skin of the child becomes burgundy and covered with large-plate scales.

The nummular type of atopic dermatitis is less common and develops at the age of 4–6 months. It is characterized by the presence of spotted elements covered with crusts on the skin. These elements are localized mainly on the cheeks, buttocks, and limbs. Like the first type of atopic dermatitis, this form also often transforms into erythroderma.

Development of atopic dermatitis in children

In more than 50 percent of children suffering from atopic dermatitis in the first year of life, it goes away by 2–3 years of age. In other children, atopic dermatitis changes its character. First of all, the localization of the rash changes. Migration of atopic dermatitis into skin folds is observed. In some cases, dermatitis can take the form of palmoplantar dermatosis. As the name suggests, in this case, atopic dermatitis affects exclusively the palmar and plantar surfaces. At the age of 6 years, atopic dermatitis can be localized in the buttocks and inner thighs. This localization can persist until adolescence.

Atopic dermatitis in adults

As a rule, after puberty, atopic dermatitis can take an abortive form, that is, disappear. As you get older, exacerbations become less common, and remissions can drag on for several years. However, a strong psychotraumatic factor can again provoke an exacerbation of atopic dermatitis. Such factors may include severe somatic (physical) illnesses, stress at work, or family troubles. However, according to most authors, atopic dermatitis in people over 30–40 years of age is a very rare phenomenon.

Incidence of atopic dermatitis in different age groups

Symptoms of atopic dermatitis

The clinical picture of atopic dermatitis is very diverse. Symptoms depend on age, gender, environmental conditions and, importantly, on concomitant diseases. Exacerbations of atopic dermatitis coincide with certain age periods.

Age-related periods of exacerbation of atopic dermatitis include:

• infant and early childhood(up to 3 years)– this is the period of maximum exacerbation;
• age 7 – 8 years– associated with the start of school;
• age 12 – 14 years– period of puberty, exacerbation is caused by numerous metabolic changes in the body;
• 30 years- most often in women.

Also, exacerbations are often associated with seasonal changes (spring - autumn), pregnancy, stress. Almost all authors note a period of remission (disease subsidence) in the summer months. Exacerbations in the spring-summer period occur only in cases where atopic dermatitis develops against the background of hay fever or respiratory atopy.

Characteristic symptoms of atopic dermatitis are:

• rash;
• dryness and flaking.

Itching with atopic dermatitis

Itching is an integral sign of atopic dermatitis. Moreover, it can persist even when there are no other visible signs of dermatitis. The causes of itching are not fully understood. It is believed that it develops due to too dry skin. However, this does not fully explain the reasons for such intense itching.

Characteristics of itching in atopic dermatitis are:

• persistence – itching is present even when there are no other symptoms;
• intensity – the itching is very pronounced and persistent;
• persistence – itching responds poorly to medication;
• increased itching in the evening and at night;
• accompanied by scratching.

Persisting (being constantly present) for a long time, itching causes severe suffering to patients. Over time, it becomes the cause of insomnia and psycho-emotional discomfort. It also worsens the general condition and leads to the development of asthenic syndrome.

Dryness and flaking of the skin in atopic dermatitis

Due to the destruction of the natural lipid (fat) membrane of the epidermis, the skin of a patient suffering from dermatitis begins to lose moisture. The consequence of this is a decrease in skin elasticity, dryness and flaking. The development of lichenification zones is also characteristic. Lichenification zones are areas of dry and sharply thickened skin. In these areas, the process of hyperkeratosis occurs, that is, excessive keratinization of the skin.
Lichenoid lesions often form in the area of ​​folds - popliteal, ulnar.

What does skin look like with atopic dermatitis?

The way the skin looks with atopic dermatitis depends on the form of the disease. At the initial stages of the disease, the most common form is erythematous with signs of lichenification. Lichenification is the process of thickening the skin, which is characterized by an increase in its pattern and an increase in pigmentation. In the erythematous form of atopic dermatitis, the skin becomes dry and thickened. It is covered with numerous crusts and small-plate scales. These scales are located in large numbers on the elbows, sides of the neck, and popliteal fossae. In the infant and childhood phases, the skin looks swollen and hyperemic (reddened). In the purely lichenoid form, the skin is even more dry, swollen and has a pronounced skin pattern. The rash is represented by shiny papules, which merge in the center and only remain in small quantities at the periphery. These papules very quickly become covered with small scales. Due to painful itching, scratches, abrasions, and erosions often remain on the skin. Separately, foci of lichenification (thickened skin) are localized on the upper chest, back, and neck.

In the eczematous form of atopic dermatitis, the rashes are limited. They are represented by small blisters, papules, crusts, cracks, which, in turn, are located on flaky areas of the skin. Such limited areas are located on the hands, in the area of ​​the popliteal and elbow folds. In the prurigo-like form of atopic dermatitis, the rash mostly affects the skin of the face. In addition to the above forms of atopic dermatitis, there are also atypical forms. These include “invisible” atopic dermatitis and the urticarial form of atopic dermatitis. In the first case, the only symptom of the disease is intense itching. There are only traces of scratching on the skin, and no visible rashes are detected.

Both during exacerbation of the disease and during remission, the skin of a patient with atopic dermatitis is dry and flaky. In 2–5 percent of cases, ichthyosis is observed, which is characterized by the presence of numerous small scales. In 10–20 percent of cases, patients experience increased folding (hyperlinearity) of the palms. The skin of the body becomes covered with whitish, shiny papules. On the lateral surfaces of the shoulders, these papules are covered with horny scales. With age, there is increased pigmentation of the skin. Pigment spots, as a rule, are of a non-uniform color and are distinguished by their different colors. Reticular pigmentation, together with increased folding, can be localized on the anterior surface of the neck. This phenomenon gives the neck a dirty appearance (dirty neck symptom).

In patients with atopic dermatitis, whitish spots often appear on the face in the cheek area. In the remission stage, signs of the disease may be cheilitis, chronic seizures, cracks on the lips. An indirect sign of atopic dermatitis may be a sallow skin tone, pale facial skin, periorbital darkening (dark circles around the eyes).

Atopic dermatitis on the face

Manifestations of atopic dermatitis on the skin of the face are not always found. Skin changes affect the facial skin in the eczematous form of atopic dermatitis. In this case, erythroderma develops, which in young children affects mainly the cheeks, and in adults also the nasolabial triangle. Young children develop what is called a bloom on their cheeks. The skin becomes bright red, swollen, often with numerous cracks. Cracks and weeping wounds quickly become covered with yellowish crusts. The area of ​​the nasolabial triangle in children remains intact.

In adults, changes on the facial skin are of a different nature. The skin takes on an earthy tint and becomes pale. Spots appear on the cheeks of patients. In the remission stage, a sign of the disease may be cheilitis (inflammation of the red border of the lips).

Diagnosis of atopic dermatitis

Diagnosis of atopic dermatitis is based on patient complaints, objective examination data and laboratory data. At the appointment, the doctor should carefully question the patient about the onset of the disease and, if possible, about the family history. Data on the diseases of a brother or sister are of great diagnostic significance.

Medical examination for atopic

The doctor begins the examination with the patient's skin. It is important to examine not only the visible areas of the lesion, but also the entire skin. Often the elements of the rash are masked in folds, under the knees, on the elbows. Next, the dermatologist evaluates the nature of the rash, namely the location, number of rash elements, color, and so on.

Diagnostic criteria for atopic dermatitis are:

• Itching is an obligate (strict) sign of atopic dermatitis.
• Rashes – the nature and age at which the rashes first appeared is taken into account. Children are characterized by the development of erythema in the cheeks and upper half of the body, while in adults, foci of lichenification predominate (thickening of the skin, disturbed pigmentation). Also, after adolescence, dense, isolated papules begin to appear.
• Recurrent (wavy) course of the disease - with periodic exacerbations in the spring-autumn period and remissions in the summer.
• The presence of a concomitant atopic disease (for example, atopic asthma, allergic rhinitis) is an additional diagnostic criterion in favor of atopic dermatitis.
• The presence of a similar pathology among family members - that is, the hereditary nature of the disease.
• Increased dry skin (xeroderma).
• Increased pattern on the palms (atopic palms).

These signs are the most common in the clinic of atopic dermatitis.
However, there are also additional diagnostic criteria that also speak in favor of this disease.

Additional signs of atopic dermatitis are:

• frequent skin infections (for example, staphyloderma);
• recurrent conjunctivitis;
• cheilitis (inflammation of the mucous membrane of the lips);
• darkening of the skin around the eyes;
• increased pallor or, conversely, erythema (redness) of the face;
• increased folding of the neck skin;
• dirty neck symptom;
• the presence of an allergic reaction to medications;
• periodic seizures;
• geographical language.

Tests for atopic dermatitis

Objective diagnosis (i.e. examination) of atopic dermatitis is also complemented by laboratory data.

Laboratory signs of atopic dermatitis are:

• increased concentration of eosinophils in the blood (eosinophilia);
• the presence in the blood serum of specific antibodies to various allergens (for example, pollen, some foods);
• decreased level of CD3 lymphocytes;
• decrease in CD3/CD8 index;
• decreased phagocyte activity.

These laboratory findings should also be supported by skin allergy testing.

Severity of atopic dermatitis

Often atopic dermatitis is combined with damage to other organs in the form of atopic syndrome. Atopic syndrome is the presence of several pathologies at the same time, for example, atopic dermatitis and bronchial asthma or atopic dermatitis and intestinal pathology. This syndrome is always much more severe than isolated atopic dermatitis. In order to assess the severity of atopic syndrome, a European working group developed the SCORAD (Scoring Atopic Dermatitis) scale. This scale combines objective (signs visible to the doctor) and subjective (provided by the patient) criteria for atopic dermatitis. The main advantage of using the scale is the ability to assess the effectiveness of treatment.

The scale provides a score for six objective symptoms - erythema (redness), swelling, crusting/scale, excoriation/scratching, lichenification/flaking and dry skin.
The intensity of each of these signs is assessed on a 4-point scale:

• 0 - absence;
• 1 – weak;
• 2 – moderate;
• 3 – strong.

By summing these scores, the degree of activity of atopic dermatitis is calculated.

The degrees of activity of atopic dermatitis include:

• Maximum degree of activity equivalent to atopic erythroderma or widespread process. The intensity of the atopic process is most pronounced in the first age period of the disease.
• High degree of activity determined by widespread skin lesions.
• Moderate degree of activity characterized by a chronic inflammatory process, often localized.
• Minimum degree of activity includes localized skin lesions - in infants these are erythematous-squamous lesions on the cheeks, and in adults - local perioral (around the lips) lichenification and/or limited lichenoid lesions in the elbow and popliteal folds.

Before use, you should consult a specialist.

Complex treatment includes a number of mandatory measures - physiotherapy, diets, drug treatment, carrying out prevention.

Considering the pathogenesis of the disease, treatment methods should be aimed at achieving long-term remission, as well as skin restoration.

Causes

I distinguish external and internal causes of the development of dermatitis.

Internal factors:

1. genetic predisposition. Atopic dermatitis occurs more often in those whose relatives or parents have a predisposition to allergies. But this does not mean that dermatitis will definitely be inherited;
2. metabolic disorders in the skin. Any violation in the protective function of the skin leads to it becoming more susceptible;
3. skin reaction to external irritants. In some people, the immune system reacts instantly to many substances;

External factors:

1. stress. Overworking the body leads to disruption of the immune system;
2. environmental exposure to the skin contributes to the occurrence of atopic dermatitis;
3. excessive physical activity;
4. food products. Improper nutrition of pregnant mothers will lead to dermatitis not only in them, but also in the child;
5. environment. Doctors say that excessive toxins in the air can trigger the disease;

Development mechanism

The mechanism of development comes down to disruption of the immune system.

The entry of allergy pathogens into the body leads to the onset of inflammatory process allergic in nature.

Antibodies begin to be produced in the blood, which gradually accumulate in the skin. Protective function skin is broken. That is why the further inflammatory process concerns the skin.

Main symptoms of manifestation

One of the main manifestations is a feeling of severe itching.

It can be different - barely noticeable, intense, capable of causing depression and sleep disturbances.

The skin peels off and lichenification appears. If treatment measures are not taken in time, the skin will begin to harden, dryness and ulcers will appear.

It is possible that secondary infections may occur, causing swelling and purulent discharge.

Methods for treating atopic dermatitis in adults

Atopic dermatitis is an insidious skin disease. In the fight against nm, people will use both traditional and non-traditional methods of treatment. Traditional methods Treatments for adults consist of various complex measures.

Some of them can be done while at home:

1. diet. It is prescribed by a doctor after an examination. Patients need it in acute form of the disease;
2. medicinal- use of drugs to relieve inflammatory processes;
3. physiotherapy. Doctors say this is one of the safest treatments. The immune system is restored, inflammation on the skin recedes;

Non-traditional methods include treatment with herbal tinctures.

Exacerbation of the disease is always associated with exposure to allergens, which is why there are recommendations that are important to follow:

• try to completely limit contact with the irritant;
• do not keep pets in the premises where the patient lives;
• make sure that the skin is not dry;
• use hypoallergenic cosmetics;

A dermatologist will probably prescribe ointments and medications. Be sure to take them as recommended. If you have the slightest suspicion of dermatitis, go to the doctor.

Medicines

Treatment of atopic dermatitis begins only after examination by a specialist. He will prescribe a number of medications, taking into account age, individual tolerance, and the nature of the disease.

Self-medication is dangerous and can cause complications.

Antihistamines are prescribed for therapy:

• Zodak;
• Diazolin;
• Nalcom.

Desensitizing agents will help reduce itching. The drugs will reduce the level of sensitivity to allergens - calcium gluconate, sodium thiosulfate.

Sedative medications are prescribed that can normalize the functioning of the nervous system - motherwort, valerian. For more severe disorders - Diazepam.

In most cases, atopic dermatitis is accompanied by inflammatory processes, as well as diseases of the digestive system.

In order to restore normal microflora, you need to take medications such as:

1. enzymes - festal;
2. sorbents - enterosgel;
3. probiotics - duphalac;

To improve metabolism and normalize the immune system, you need to take vitamins regularly.

Exacerbated forms of the disease, as described above, require physical therapy.

Products for external use

Externally used products are aimed at the following:

• reduce or completely eliminate itching;
• restore skin;
• soften the skin;
• restore protective properties;

External preparations - external glucocorticoids, topical immunosuppressants.

Almost all medications of this type are produced in the form of creams, lotions, and ointments.

Fenistal gel is a multifunctional product. Cares for damaged skin, moisturizes it.

A few hours after application the first effect will be felt. You need to use it at least 4 times a day.

Zinc ointment is a caring and anti-inflammatory agent. Safe for children and pregnant women. Treatment with ointment in adults can be lengthy.

She fights dermatitis for a month, until the symptoms completely disappear. This is the only ointment that can be used independently without being prescribed by a doctor.

Folk recipes

As practice shows, treatment of atopic dermatitis with folk remedies in adults is quite effective.

After all, the disease is not life-threatening and is not incurable. It’s unlikely that anyone will like inflammation on the skin, which not only itches, but also interferes with work.

In order to get rid of this unpleasant illness, folk recipes were “invented”.

It is worth noting that they can treat not only adults, but also children.

1. lotion. To prepare it you need to take a glass boiled water and Art. a spoonful of medicinal veronica. Pour boiling water over the herb and leave for 3 hours. Then strain and treat the skin in affected areas 5-6 times a day. The lotion is safe and has no side effects;
2. compress. You can prepare this folk remedy at home. The only thing you need for this is fresh raw potatoes. Wash it, peel it, and grate it. Squeeze the resulting mass from the water and wrap it in gauze. Apply the compress to sore areas at night;
3. antipruritic ointment. In addition to redness on the skin, dermatitis also causes another discomfort - constant itching. In order to remove it, you can prepare an ointment. For this you will need: 1 tbsp. spoon of butter, glycerin, 2 tbsp. pre-boiled hay dust, 4 tbsp. water, chamomile, fireweed. Mix fireweed and chamomile in a container, bring to a boil and simmer over low heat for 5 minutes. Add butter and dust, cook until the mass takes on a thick consistency. The ointment should be stored in the refrigerator. Lubricate the skin 4 times a day;

Review of drugs

A number of medications are used to treat atopic dermatitis.

They are prescribed by a doctor; unauthorized use is prohibited, in order to avoid complications:

• tavegil- Available in the form of tablets and syrup. Relieves itching, eliminates swelling. Taken as prescribed by a doctor;
• fenistil- drops for oral administration. If prescribed by a doctor, it can be given to children starting from one month. Side effects include drowsiness;
• fenisti - gel. Used for severe skin itching. There is no need to apply a thick layer to the skin. It is strictly forbidden to give to children on their own;
• lomilal- comes in the form of a suspension and tablets. Has an anti-inflammatory effect. You can take the pills from the age of 12.

Rules for therapy at home

Atopic dermatitis can develop at any age, regardless of gender. Despite the fact that this is not an infectious disease, there is still discomfort from it. While at home, you can try to relieve itching and the initial signs of the disease.

There are certain means for this:

1. Aloe Vera Gel. You can buy it at a pharmacy without a doctor's prescription. The cold effect of the drug relieves itching. If such a plant grows at home, you can cut the leaves and get fresh gel.
2. Oil therapy. This the best option for the treatment of atopic dermatitis at home. To do this you can take - Castor oil, coconut, almond. It has a calming and healing effect.
3. Salt. It is good for relieving itching and inflammation. Take a cup of salt, dissolve it in a liter of warm water. Wet the affected areas for 15 minutes.

Principles of therapy in children

To carry out therapy for atopic dermatitis in children, a number of measures need to be taken. The main attention should be paid to restoring the outer layers of the skin. To do this, you need to use moisturizing cosmetics 3-4 times a day.

If the disease affects the baby, it is important to continue breastfeeding for as long as possible. At the same time, the mother’s diet should be correct, without any allergic foods.

You need to bathe your child every day, without using soap. Buy medicated shampoos. After swimming, do not rub your skin; pat dry with a towel and let it dry on its own.

Vaccination of a child with atopic dermatitis is a problem today. After all, the mere fact of having a disease is not a reason to refuse vaccinations.

But the nuance is that they can only be used during remission.

It is mandatory to take antihistamines, but only those prescribed by the attending physician.

Treatment of atopic dermatitis in children is not difficult. If mothers go to the hospital in a timely manner, they can get rid of the disease as quickly as possible.

Preventive methods

To treat the disease, as well as prevent its recurrence, several rules must be followed:

1. nutrition. Eliminate from the diet foods that can provoke allergies - chocolate, nuts, citrus, eggs;
2. skin care. It is important not just to use creams and moisturize the skin. Accept water treatments it also needs to be done correctly. Add decoctions of medicinal herbs to them. Do not wipe the skin dry, but let it dry on its own;
3. do not keep pets at home;
4. use hypoallergenic products.

Unfortunately, there is no single cure to combat the disease. But even these simple rules will delay the onset of remission.

When to see a doctor

You should consult a doctor in the following cases:

• the symptoms bother you so much that you can’t sleep peacefully;
• soreness of the skin;
• ulcers appeared on the skin, yellow in color;
• all attempts at skin care do not bring results;

If you observe these symptoms, even in significant quantities, go to the doctor. This will help specialists quickly identify the source of the allergy and prescribe medications.

And you, in turn, will quickly return to your normal lifestyle, without unnecessary discomfort.

Atopic dermatitis– chronic inflammatory disease of an allergic nature, the main symptoms of which are a skin rash of the exudative and/or lichenoid type, severe itching and seasonality. In winter and summer, exacerbations often occur, and symptoms intensify, but remissions, sometimes even complete, are common.

Atopic dermatitis is one of the types. Previously it had a different name - diffuse neurodermatitis.

To make the picture of the disease clearer, let’s look at the question: “ what is atopy?».

Atopy, or atopic diseases– the tendency of newborn children to allergic diseases, which is transmitted to infants through hereditary means. That is why the development of atopic dermatitis occurs in quite early age– 2-4 months, and one of the root causes is the incorrect lifestyle and nutrition of a pregnant woman. The expectant mother, especially in the last trimester of pregnancy, should try to refrain from consuming foods from the highly allergenic category - chocolate, citrus fruits, strawberries, etc.

Another factor without which the development of atopic dermatitis in a child is impossible is the infant’s incompletely formed immune and other systems, which at this age are not yet able to adequately fight allergens.

Due to the above features, atopic dermatitis often goes away by the age of 4, but there are cases when it accompanies a person throughout his life.

Secondary triggers for the development or exacerbation of atopic dermatitis can also be contact or respiratory allergens - dust, pollen, clothing, animals.

Atopic dermatitis. ICD

ICD-10: L20
ICD-9: 691.8

Development of atopic dermatitis

So, let’s summarize the beginning of the article and continue the topic with the question - “ How does atopic dermatitis develop?».

1 situation: An infant 2-3 months or 2 years old receives highly allergenic foods through mother's milk or other means. His gastrointestinal tract organs, immune system, etc. have not yet fully formed. Allergen (any product that causes allergic reaction) entering the body, cannot be processed in the intestines, in turn, the liver also cannot neutralize its adverse effects on the body. The kidneys also cannot remove it in any way. Thus, due to various biochemical processes in the body, this allergen is transformed into substances with the properties of antigens (substances foreign to the body). The body produces antibodies to suppress them. The rash that we can observe in a child with atopic dermatitis is the body’s reaction to foreign substances produced by the allergen.

Situation 2: A pregnant woman consumes large quantities of highly allergenic foods, or has been in contact with various substances that cause. The fetal body can also receive part of these products or substances that will be in the child’s body after birth. Further, when the baby eats or comes into contact with allergens that he was in contact with during the prenatal period, his body will react to this with a rash and other symptoms of atopic dermatitis.

Thus, we can come to the conclusion that atopic dermatitis is not a skin disease, but an internal reaction of the body to an allergen, transmitted hereditarily.

Causes of atopic dermatitis

Atopic dermatitis can be caused by the following factors:

- consumption of highly allergenic food products by a pregnant woman - citrus fruits, chocolate, red berries, alcoholic drinks;
- consumption of highly allergenic foods by the child himself;
- hereditary predisposition;
- fungal, viral and bacterial infections;
- weakened immune system;
— physical contact with the allergen: clothing, chemicals, building materials, medications;
— respiratory contact: dust, pollen, gases;
- non-compliance;
— ;
- sudden change of diet;
— uncomfortable temperature in the living room;
- emotional instability, psychological disorders, .

The main symptoms of atopic dermatitis are:

- severe itching;
- redness, red spots on the skin with unclear boundaries;
- rash on the body, sometimes dry, sometimes filled with liquid;
- weeping areas of skin, erosions, ulcers;
- dry skin, with further peeling;
- scales on the scalp, glued together with the secretion of the sebaceous glands.

Accompanying symptoms may include:

- coating on the tongue;
- respiratory diseases: false croup;
— ;
— ;
— , .

Atopic dermatitis most often appears on the following areas of the body: elbows, knees, neck, folds, dorsums of the feet and hands, forehead, temples.

Experts note that atopic dermatitis has a seasonality - symptoms worsen in winter and summer. Partial or complete remissions may also occur.

If the treatment of atopic dermatitis is not given due attention, this disease can develop into allergic rhinitis and other diseases of an allergic nature.

Complications of atopic dermatitis

• Viral infection;
• Fungal infection
• Pyoderma

Treatment for atopic dermatitis includes:

— preventing patient contact with the allergen;
- taking antiallergic drugs;
— relief of inflammatory processes on the skin;
— strengthening the immune system;
— diet correction;
— normalization of the work/rest regime;
- treatment of concomitant diseases.

Medicines against atopic dermatitis

Antiallergic drugs

Antihistamines are used to relieve the main symptoms - severe itching and rash. There are 3 generations of them. Each subsequent generation has improved characteristics - reduced addiction, a decrease in the number of side effects and an increase in the duration of the therapeutic effect.

First generation: “Dimetindene”, “Clemastine”, “Meclizine”;
Second generation: “Azelastine”, “Loratadine”, “Cetrizine”;
Third generation: Desloratadine, Levocetrizine, Sehifenadine.

It is better to take antihistamines before bedtime, because... many of them are sleepy.

Anti-inflammatory and antipruritic drugs

To stop inflammatory processes on the surface of the skin and relieve itching, anti-inflammatory and antipruritic agents are used.

The group of these drugs includes: glucocorticosteroid drugs, Burov's liquid, non-steroidal anti-inflammatory drugs (with sodium thiosulfate solution), silver nitrate, lead lotion, decoctions with infusions of string and other medicinal plants.

Remedies for infiltration and thickening of the skin

For these purposes, various creams, ointments and patches with a resolving effect are used, the bases of which are: tar, sulfur, naftalan oil, ichthyol. Such drugs begin to be used in small doses, gradually increasing the concentration active ingredients, or changing them to a stronger agent.

Means for softening and removing rough scales and crusts

Keratolytic ointments and creams, which also contain: acids (salicylic, lactic, fruit), urea and resorcinol, are used as a means to soften and remove hardened scales and crusts.

Hormonal drugs

Hormonal drugs are widely used, but strictly under the supervision of the attending physician, for all forms of dermatitis, especially the acute course of the disease. For weeping dermatitis, lotions and pastes are preferred; for dry dermatitis, creams, ointments and lotions with the addition of keratolytics are used.

The advantage of using hormonal agents is the rapid and powerful relief of inflammatory processes on the skin, relieving itching, as well as further restoration of the skin. The disadvantage is addiction and withdrawal symptoms.

Weak hormonal agents - hydrocortisone. They are used mainly to treat children or when the disease manifests itself on the face.

Medium-acting hormonal agents - glucocorticosteroids (Prednisolone, Fluocortolone). Used to treat all areas of the body.

Strong hormonal agents - Betamethasone, Halomethasone, Mometasone, Flumethasone. They are used for long-term dermatitis, as well as for lichenification of the skin.

For severe skin lesions, glucocorticosteroids are prescribed for 2-4 days, after which they switch to weaker hormonal drugs - medium intensity.

Remedies for chronic atopic dermatitis

During remission, as well as at the stage of chronic atopic dermatitis, it is recommended to externally use various lotions or baths that will help relieve itching, redness, reduce inflammation, and also speed up the healing and restoration of the skin.

Such remedies include: birch buds, speedwell, oak bark, borage, fireweed and chamomile flowers, basil, pear leaves.

Antibacterial and antifungal agents

When ( , etc.), i.e. When the skin is damaged, there is always a risk of various infections getting into the papules and vesicles - viruses, fungi, bacteria, which in many people complicate the already complex picture of the course of dermatitis. To prevent this, or at least minimize this possibility, antibacterial, antiviral or antifungal agents are used externally. These can be ointments, creams, and aerosols. Main feature of these products is the content in them of substances such as furacilin, boric acid, iodine solution, silver nitrate, ethacridine lactate, gentamicin, oxytetracycline and glucocorticoid.

Means for normalizing and improving the functioning of the digestive system

As you and I already know, dear readers, from the beginning of the article, atopic dermatitis is a complex disease, the basis of which lies inside the body, and externally it manifests itself in a video of the inflammatory process of the skin.

Doctors have established a connection between normalizing or improving the functioning of the digestive system and accelerating recovery from dermatitis.

Thus, for this result, two types of drugs are used - enterosorbents and drugs for normalizing intestinal microflora.

Enterosorbents. Designed to stop the activity of unfavorable microflora in the body and its rapid removal from the body. Also, these drugs help reduce the level of toxicoderma in the body. The most popular enterosorbents: “ Activated carbon", "Diosmectite", "Povidone".

Preparations for normalizing intestinal microflora. This can include the following agents: probiotics (Baktisubtil, Linex), prebiotics (Inulin, Lysozyme), synbiotics (Maltodofilus, Normoflorin), hepatoprotectors (ademetionine, beatine, glycyrrhizic acid), bacteriophages (coliproteus, pseudomonas), enzymes (pancreatin).

Preparations to strengthen the immune system and accelerate skin recovery

Lack of vitamins () and microelements in the body, metabolic disorders, disturbances in the functioning of the immune and digestive systems play some of the important roles in the development of not only atopic, but also other types of dermatitis.

We already know how to improve the functioning of the digestive system from the previous paragraph. An additional point that will have a beneficial effect on the entire body as a whole is an additional intake of minerals. The greatest emphasis should be placed on vitamins - or echinacea.

To speed up the process of skin restoration, anabolic drugs are used, which contain substances such as methandienone, methionine, nandrolone.

Normalization of the mental and nervous system

Violations of the work/rest/sleep regime, mental stress, weaken the immune system, making the entire body more susceptible to various diseases. If all these areas are not put in order, there is a risk of developing secondary diseases.

If you work at a job where you are constantly exposed to stress, think about it, perhaps there is an opportunity to change this work? Here it is fair to say that “Health is more valuable than money.”

To normalize the functioning of the nervous system, it is very important to get enough sleep. Scientists have found that a person needs from 6 to 8 hours of sleep to fully rest and recuperate. The best result is achieved if you go to bed at 21:00-22:00, and sleep will be uninterrupted.

Additionally, but after consultation with a doctor, the following drugs can be used to normalize the nervous system, especially during stress, and other disorders:

• sedative herbal medicines or agents;
• remedies for insomnia;
• antidepressants.

The correct menu or diet for atopic dermatitis is a necessary measure, without which treatment of dermatitis is virtually impossible.

The menu for dermatitis is aimed at:

- exclusion of highly allergenic foods from the diet;
— enriching the body with essential vitamins and minerals;
- normalization of the digestive system.

What not to eat if you have atopic dermatitis:

• red and orange fruits, berries, vegetables: strawberries, raspberries, etc.;
• citrus fruits: oranges, tangerines, pomelo, grapefruits, etc.;
• sweets: chocolate, cocoa, candies, lemonades;
• nuts, greens;
• fish;
• milk, dairy products;
• chicken eggs;
• smoked, spicy and fried foods;
• mayonnaise, ketchup, spices;
• alcoholic drinks.