Symptoms of exacerbation of atopic dermatitis. Treatment methods for atopic dermatitis

Content

Skin pathologies of an allergic nature cause internal discomfort and cosmetic defects to the patient. Treatment of dermatitis in adults is possible with official medications and folk remedies against all skin manifestations of the disease. The approach to health problems is comprehensive. Initially identify the main allergen and eliminate pathogenic factor. Then you can use ointments as prescribed for atopic dermatitis in adults.

How to treat dermatitis in adults

The disease is of an allergic nature, so any treatment begins with a diet and complete exclusion of the potential allergen and additional use of antihistamines. The doctor carefully studies the external symptoms of dermatitis and recommends undergoing a clinical and laboratory examination to clarify the form of the disease and the characteristics of intensive care. With dermatitis, the patient's appearance leaves much to be desired, so it is recommended to act immediately.

Treatment of atopic dermatitis in adults

Dermatitis is a consequence of intoxication of the body, so its treatment in adult patients and children must be comprehensive. Doctors suppress the effect of the allergen with antihistamines, but taking them orally is sometimes not enough to completely heal. Here are the medications that need to be included in the treatment of dermatitis in adults:

1. Antihistamines for dermatitis: Claritin, Fenistil, Suprastin, L-Cet, Cetrin, Zirtec, Telfast, Loratadine.
2. Non-hormonal ointments: Protopic, Eplan, Fenistil, Elidel, Losterin, Destin, Thymogen, Naftaderm, Videstim, Isis.
3. Hormonal ointments for the effective treatment of complicated forms of dermatitis in adults: Elokom, Akriderm, Celestoderm.
4. Local antiseptics for relieving symptoms of inflammation in adults: Lincomycin and Erythromycin ointment, Celestoderm.
5. Antibiotics for oral use for complications of dermatitis: Rovamycin, Doxycycline, Sumamed, Zitrolide, Erythromycin.
6. Probiotics: Bifidobacterin, Linex, Lactobacterin, Acipol to restore intestinal microflora in adults with dermatitis.

Photodermatitis

The main irritant in this clinical picture is the sun's rays and the body's increased sensitivity to them. After infection, the skin will look heterogeneous, bumpy, and the patient experiences an acute sensation of itching, burning, and complains of increased swelling of the inflamed skin. The following medications are recommended as effective treatment:

1. To eliminate the provoking factor, it is recommended to use products with methyluracil or zinc.
2. For productive restoration of damaged dermis, Panthenol spray is prescribed externally to pathological lesions.
3. To strengthen weakened immunity, vitamins of groups C, E, A, B and preparations with x content are appropriate.

Treatment of contact dermatitis

Photodermatitis is atypical form contact dermatitis, which is associated with direct interaction with a provoking factor from environment. The main task of the patient is to exclude contact with the irritant, remove it with medication external symptoms diseases, eliminate their dependence in the future. Your doctor may prescribe the following medications:

1. Corticosteroids: Advantan, Elokom, Lokoid creams.
2. Antihistamines: Cetrin, Erius, Claritin, Zyrtec.
3. Local antiseptics: Burov's liquid.

Seborrheic dermatitis

When oily scales appear on the head, which periodically itch and itch, seborrheic dermatitis is suspected. This is a consequence of increased activity in the body of a yeast fungus that feeds on sebum. Seborrheic dermatitis predominates in children in the first days of life, extremely rarely in adults. Foci of pathology in adults are observed on the eyelids, in all folds of the skin.

To quickly recover from seborrheic dermatitis, the characteristic scales should be treated daily olive oil so that they disappear quickly and painlessly. Additionally, it is recommended to review your diet and exclude fatty, spicy and smoked foods from your daily diet. You can use special medicated shampoos to moisturize dry skin that is prone to flaking.

Treatment of allergic dermatitis

If the skin is damaged, there is a suspicion of an allergic reaction of the body. This is one of the forms of dermatitis in adults, which, to eliminate pathological process requires a review of daily nutrition. Synthetic components in food, semi-finished products and preservatives should be completely removed from the daily menu, since more often they become the same irritants. Therapeutic nutrition includes plant foods as a source of antioxidants and natural fiber.

Food dermatitis in adults

This form of dermatitis is chronic, and the patient goes into the category of eternal “allergy sufferers”. To maintain general health, it is necessary to regularly perform therapeutic and preventive measures. The components of the dishes must be hypoallergenic, otherwise the characteristic rash in different parts of the dermis will bother the patient more and more often. Allergens are often red vegetables and fruits, processed foods and preservatives, citrus fruits and berries.

How to treat toxicoderma

Proper treatment of dermatitis begins with the productive elimination of a dangerous allergen that entered the body with food or through Airways with further distribution through the systemic circulation. In addition, infection with a toxic substance can occur through injection. For productive treatment, a definitely hypoallergenic diet and vitamin intake are required. There is a permanent intensive care regimen for adults, which in practice includes the following areas:

• home use of cleansing enemas for the productive removal of intoxication products;
• internal intake of enterosorbents, diuretics, which also remove toxins from the blood and other biological fluids;
• administration of a solution of sodium thiosulfate, calcium chloride intravenously in order to strengthen weakened immunity;
• taking antihistamines orally: Cetirizine, Tavegil, Loratadine, Claritin, Chloropyramine;
• use of glucocorticosteroids in the form of Prednisolone and its derivatives in severe clinical situations.

How to treat dermatitis on the body in an adult

If the disease is detected at an early stage, the use of antihistamines internally and externally is quite sufficient treatment. In complicated clinical pictures with the appearance of purulent wounds and exudative rashes, oral antibiotics in the form of tablets and the use of external corticosteroids are necessary. If signs of dermatitis are preceded by increased activity fungal infection, treatment should include antifungal agents.

Drug treatment

The attending physician decides whether to take hormones or antibiotics, based on the characteristics of the clinical picture. If there are no complications, the adult patient is prescribed antihistamines orally. These are tablets Claritin, Loratadine, Cetrin, Suprastin, Fenistil, L-Cet, Tavegil and others. The course of intensive therapy varies between 7-14 days and is adjusted by the doctor on an individual basis. If one allergy medicine is not suitable, it must be replaced, taking into account the body's compatibility with the active components.

Additionally, pay attention to representatives of the following pharmacological groups:

• sorbents: Enterosgel, activated carbon;
• probiotics: Linex, Bifidumbacterin, Hilak Forte;
• antibiotics: Rovamycin, Doxycycline, Sumamed, Zitrolide, Erythromycin;
• antiviral drugs: Acyclovir, Famvir, Valtrex, Alpizarin;
• multivitamin complexes for dermatitis.

Local treatment

Dermatitis appears not only on the face; the presence of a characteristic rash is possible on the back, buttocks and other parts of the body. If taking pills kills a pathogenic infection from the inside, then the external use of creams and ointments helps to effectively eliminate a cosmetic defect, reduce the intensity of unpleasant sensations, and completely eliminate discomfort from your daily life. Here are the medications doctors prescribe for the treatment of dermatitis in adults:

• anti-inflammatory drugs: Elokom, Diprosalik or Akriderm;
• local remedies for skin regeneration: Solcoseryl, D-panthenol, Bepanten;
• corticosteroid drugs: Elokom, Afloderm, Lokoid, Advantan.
• antifungal agents: Triderm, Pimafucort;
• local antibiotics: erythromycin ointment;
• antimicrobial compounds: Fukortsin;
• local antiseptics.

Homeopathy

Use of drugs plant origin appropriate as part of complex treatment, since they independent use for adults it gives rather mediocre results. For dermatitis, positive dynamics are provided by herbal remedies with chamomile, string, lemon balm and St. John's wort. Medicines such as calendula-based ointment, medicinal chamomile extract, evening primrose ether, and stinging nettle have proven themselves well.

Physiotherapeutic procedures

To speed up the treatment of dermatitis in adults, it is necessary to undergo a course of special procedures in a hospital setting. Such sessions are prescribed by the attending physician, who also stipulates the number of procedures to achieve the desired effect. Here's what every potential allergy sufferer needs to know:

1. Electrophoresis with intal, diphenhydramine, calcium chloride reduces the feeling of itching of the skin and relieves swelling.
2. Ultraviolet irradiation of the skin to relax the nervous system and eliminate unpleasant symptoms of dermatitis.
3. Applications with paraffin or ozokerite to prevent massive peeling of overdried dermis.
4. Electrosleep with instability of the nervous system and pronounced signs of chronic insomnia in dermatitis in adults.

Treatment of dermatitis in adults with folk remedies

The disease can be eliminated using alternative methods, but at an early stage of the pathological process. Treatment of dermatitis is successful if the foci of pathology are regularly treated with decoctions of chamomile, stinging nettle, and string. The composition is being prepared classical method– 1 tbsp. l. raw materials per glass of water, but the amount of the finished medicine depends on the abundance of foci of pathology. An adult should perform home procedures daily, supplementing them with official methods.

Diet

The main goal is to eliminate allergens from the daily menu. For dermatitis in adults and not only food should be hypoallergenic. In order to promptly identify the irritant, during the next attack of dermatitis, for successful treatment, it is recommended to take a blood test to study the pathogenic flora. The daily menu should contain plant fiber, natural antioxidants, and natural vitamins.

Thank you

The site provides background 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!

How to treat atopic dermatitis?

Treatment atopic dermatitis Regardless of the severity of the disease, it must be comprehensive. This means that not the disease itself should be treated, but also the cause that led to it. For example, if atopic dermatitis is also accompanied by dysfunction of the gastrointestinal tract, then it is necessary to treat both of these diseases simultaneously.

The basic principles of treatment of atopic dermatitis are as follows:

• V acute period diseases is carried out intensive therapy, including hormonal and other drugs;
• during the period of subsidence of the disease, supportive treatment is recommended, which includes vitamins, physiotherapy, sorbents;
• during the period of remission, immunotherapy is prescribed;
• During all periods of the disease, a hypoallergenic diet is recommended.

Based on these principles, it is clear that for each period of the disease certain medications are needed. Thus, corticosteroids and antibiotics are prescribed during the acute period of the disease, and vitamins and immunomodulators - during the period of subsidence of the disease.

List of drugs prescribed during various periods of illness

The main principle of treating atopic dermatitis is diet. A proper diet during all periods of illness is the key to a quick recovery. Refusal of allergenic foods is the most important and at the same time difficult rule of diet therapy. It is especially difficult to comply with this recommendation for those patients who have not taken samples to determine a specific food causative agent of allergic reactions. Such people should adhere to a nonspecific diet, which means avoiding all traditional allergen foods. If allergy tests have been carried out, the patient is shown a specific diet, which involves avoiding a specific product.

Creams and emollients for atopic dermatitis

The use of creams, lotions and emollients in the treatment of atopic dermatitis is an integral part of therapy. External therapy (that is, the use of external medications) is often the only procedure during the period of subsidence of the disease. The following forms of external agents are distinguished: creams, lotions, aerosols, emollients (oily ointment base). The choice of one form or another depends on the stage of the atopic process. Thus, in the acute stage of the atopic process, lotions and creams are prescribed, in the subacute and chronic stages (when dryness predominates) - emollients. Also, if it is predominantly affected hairy part scalp - lotions are used, if the skin is smooth - then creams. During the day it is better to use lotions and aerosols, in the evening hours - creams and emollients.

The tactics for using creams and other external agents depends on the extent of the skin process. The choice of one remedy or another depends on the form of atopic dermatitis. As a rule, creams containing corticosteroids are used, which are also called local (or external) glucocorticosteroids. Today, most doctors prefer two external glucocorticosteroids - methylprednisolone and mometasone. The first drug is known as advantan, the second - under the name elocom. These two products are highly effective, and most importantly, safe and have minimal side effects. Both products are available in the form of creams and lotions.

If an infection is added to existing skin changes (as often happens especially in children), then combination drugs containing antibiotics. Such drugs include triderm, hyoxysone, sofradex.
In addition to the "traditional" hormonal drugs, used in the treatment of atopic dermatitis, other, non-hormonal agents are also used. These are antihistamines and immunosuppressive external agents. The first includes fenistil, the second - elidel.

List of external agents used in the treatment of atopic dermatitis

Name	Release form	How is it used?
Elokom	cream; ointment; lotion.	Apply a thin layer to the affected skin once a day. The duration of use depends on the extent of the skin process, but, as a rule, does not exceed 10 days.
Advantan	ointment; cream; emulsion.	Apply a thin layer and rub into the affected skin with light movements. The duration of treatment for adults is from 10 to 12 weeks, for children - up to 4 weeks.
Triderm	ointment; cream.	Rub gently into the affected skin and surrounding tissue twice a day. The duration of treatment should not exceed 4 weeks.
Fenistil	gel; emulsion; drops.	The gel or emulsion is applied to the affected areas 2 - 3 times a day. If intense itching is present, then drops are prescribed in parallel.
Elidel	cream.	Apply a thin layer of cream to the affected areas of the skin twice a day. After application, rub the cream into the skin with light movements.

Lipikar for atopic dermatitis

Lipikar creams and lotions are long-term topical products. These are cosmetics from La Roche-Posay, which are adapted for use in patients with atopic dermatitis. The products in this cosmetic line intensively moisturize the skin. As you know, the skin of people suffering from atopic dermatitis is characterized by increased dryness and flaking. Shea butter, which is included in most products from this line, slows down the process of dehydration (moisture loss) of the skin. Lipikar creams and lotions also contain allantoin, thermal water and squalene. This composition restores the damaged lipid membrane of the skin, relieves swelling and irritation of the skin.

In addition to Lipikar, Bepanthen, Atoderm, and Atopalm creams are used. Bepanthen cream can be used during pregnancy and even in infants. It is effective in healing scratches and shallow wounds, and also stimulates skin regeneration. Available in the form of cream, ointment and lotion.

Vaccinations for atopic dermatitis

Atopic dermatitis is not a contraindication for routine vaccination. Therefore, DPT, BCG, polio, hepatitis B, and rubella vaccines are routinely administered. At the same time, it is known that the vaccine can stimulate an exacerbation of the process. Therefore, it is recommended to administer the vaccine during the period of remission of atopic dermatitis. Vaccination should be carried out according to the vaccination calendar and only in immunization rooms. Before it is carried out, it is recommended to prescribe antihistamines for prophylactic purposes. Drug therapy is carried out 4–5 days before vaccination and for 5 days after it. Drugs of choice in in this case is ketotifen and loratadine.

Diet for atopic dermatitis

Diet therapy for atopic dermatitis is one of the main methods of treatment, which allows you to prolong the period of remission and improve the patient’s condition. The main rule of the diet is to avoid foods that can act as allergy triggers. In addition, nutrition should provide the body with the necessary resources to fight this disease.

The main provisions of the diet for atopic dermatitis are as follows:

• exclusion of food allergens;
• avoidance of foods that promote the release of histamine;
• reducing the amount of gluten-containing foods;
• inclusion of products for fast healing skin;
• improving the functionality of the digestive tract.

These rules are identical for all categories of patients, except infants (children whose age does not exceed 1 year). There are separate nutritional recommendations for infants.

Elimination of food allergens

Products that can trigger the development of an allergic reaction are present in all groups of food products. It is necessary to exclude allergenic foods in their pure form from the diet, as well as dishes for which they were used. To avoid a deficiency of nutrients, food allergens must be replaced with other products that are full of nutrients.

Food allergens and products that should replace them

Name	Allergens	Alternative
Meat	duck; goose; game; chicken.	rabbit; turkey; veal; beef.
Fish	trout; salmon; pink salmon; mackerel.	zander; cod; pollock.
Seafood	caviar; oysters; mussels; squid.	You can eat cod caviar and liver in limited quantities.
Bee products	propolis; beebread ( tightly compressed flower pollen).	Natural honey can be replaced with an analogue of artificial origin.
			Tincture	Low blood pressure, reduced heart rate.
Drugs to strengthen the immune system			Increased excitability of the nervous system, heart rhythm disturbances.
		Tincture	Increased arterial pressure, tendency to depression, anxiety.
	Rose hip		Ulcer, gastritis, tendency to thrombosis.
	Antihistamines			Varicose veins, impaired blood clotting.
				Compress	There are no contraindications for herbal medicines for external use other than individual intolerance to the main component.
				Compress
Antiseptic external agents

Prevention of atopic dermatitis

Prevention of atopic dermatitis is the most important element in the complex of therapeutic measures for this disease. The chronic, recurrent (wavy) course of atopic dermatitis and knowledge of pathogenesis made it possible to formulate the basic principles of prevention. Depending on the time of implementation and the goals pursued, the prevention of atopic dermatitis can be primary or secondary.

Primary prevention

The goal of primary prevention is to prevent disease in individuals who are at increased risk. Considering that atopic dermatitis is one of the most common childhood diseases, the issue of prevention among children is especially relevant. Among the factors predisposing to the development of atopic dermatitis, one of the main ones is heredity. Therefore, primary prevention is of great importance for children whose parents (one or both) have a history of this disease. Preventive measures it is necessary to begin taking measures in the antenatal (intrauterine) period and continue after the birth of the child.

Prevention in the antenatal period
Measures for antenatal prevention of atopic dermatitis are as follows:

• Hypoallergenic diet. A pregnant woman should exclude from her diet all traditional food allergens, which include eggs, milk, bee products, and nuts.
• Balanced diet. Despite the restrictions on the menu, the diet of a woman carrying a child should be varied and contain sufficient amounts of carbohydrates, proteins and fats. As experts note, a diet in which carbohydrate foods predominate especially increases the likelihood of developing atopic dermatitis in a child.
• Adequate treatment of gestosis(complications of pregnancy, which are manifested by edema and other problems). The deterioration of a pregnant woman's condition increases the permeability of the placenta, resulting in the fetus being exposed to allergens. This increases the chance that the child will have atopic dermatitis.
• Many medications contribute to allergization of the fetus and, as a result, the development of atopic dermatitis. Most often, allergy triggers are antibiotics of the penicillin group (nafcillin, oxacillin, ampicillin).
• Control of household chemicals used. Laundry powders and other household products contain aggressive allergens that enter the female body through the respiratory system and can cause fetal sensitization. Therefore, during pregnancy it is recommended to use hypoallergenic household chemicals.

Prevention after birth
After the birth of a child, his diet should be hypoallergenic for a year, since the immature immune system and intestinal microflora cannot give a “worthy response” food allergens. If breast milk is available, breastfeeding is recommended to continue for at least six months, and during this period the nursing woman should follow a diet that excludes allergenic foods. If breast milk is not available, the baby should be fed with special infant formula.
The first foods for complementary feeding should be hypoallergenic vegetables and fruits (apples, zucchini), meat (turkey, rabbit).

Gradually, allergenic foods should be introduced into the children's diet, recording the child's body's reaction to such food in a special diary. You should start with cow's milk and chicken. They should be administered after the child reaches one year of age, during the period of remission of atopic dermatitis. By the second year of life you can include in children's menu eggs, to the third - honey, fish.

Secondary prevention of atopic dermatitis

Secondary prevention measures are relevant for those patients who have already encountered atopic dermatitis. The goal of such prevention is to prolong the period of remission of the disease, and in case of exacerbation of the disease, to reduce symptoms.

Secondary prevention measures for this disease are:

• organization of hypoallergenic living conditions;
• adequate skin care;
• control of consumption of food allergens;
• preventive (preliminary) drug therapy.

Organization of hypoallergenic living conditions
The exacerbation of atopic dermatitis is facilitated by such a common factor in everyday life as dust. Household dust includes mites (saprophytes), skin particles from people and pets. Each of these components negatively affects the well-being of a patient with this disease. Therefore, prevention of this disorder involves organizing activities aimed at combating dust.
The main sources of dust in everyday life are bedding, textiles, upholstered furniture, bookcases and carpets. For preventive purposes, you should choose hypoallergenic items,, if possible, refuse to use some items and provide appropriate care for all household items.

Measures for organizing hypoallergenic living conditions are as follows:

• Sleeping area. People with atopic dermatitis are recommended to use pillows and blankets with synthetic filling. You should also avoid woolen rugs and blankets, as they provide a favorable environment for ticks. Bed linen should be changed for new ones twice a week, and boiled when washing. It is recommended to take blankets, mattresses and pillows to special disinfection chambers or treat them with anti-mite drugs. An effective measure for atopic dermatitis is special plastic cases for mattresses and pillows.
• Carpeting. It is recommended not to use carpets in the room where the patient lives. If it is not possible to refuse carpeting, preference should be given to products made from synthetic fibers with short pile. The best option are carpets made of nylon, acrylic, polyester. Carpets should be replaced with new ones every 5-6 years. They should be cleaned every 2 weeks using anti-tick products (Doctor Al, easy air, ADS spray).
• Cushioned furniture. The upholstery of upholstered furniture and the materials used as fillers are places where large amounts of dust accumulate. For atopic dermatitis, it is recommended to replace sofas with beds, and soft chairs with ordinary chairs or benches.
• Bookcases and shelves. Books not only accumulate a large amount of dust, but also develop mold, which contributes to the exacerbation of atopic dermatitis. Therefore, you should avoid the presence of bookcases and shelves in the room where a person with this disease lives. If this is not possible, books should be kept in furniture with closing doors.
• Textile products. Instead of curtains and other textiles for windows, it is recommended to use blinds made of polymer materials. In spring, summer and autumn, protective nets should be installed on windows to prevent dust, pollen, and poplar fluff from entering the room. Tablecloths, decorative napkins and other textiles should be used in minimal quantities.

In the room where a person suffering from atopic dermatitis lives, wet cleaning should be carried out daily using hypoallergenic household products. In the evening and in rainy weather, you need to ventilate the room, and in the hot season, keep the windows and doors closed. For support optimal mode humidity, it is recommended to use humidifiers.
Mold is one of the common factors that can worsen the condition of a person with atopic dermatitis. Therefore, in areas with high humidity (bathroom, kitchen), hoods should be installed and cleaning should be carried out monthly using products that prevent the growth of mold microorganisms.

Adequate skin care
The skin with atopic dermatitis is characterized by increased vulnerability, which contributes to irritation and inflammation even during remission. Therefore, people with this disease need to provide proper skin care. Proper care increases the barrier functions of the skin, which helps reduce the symptoms of the disease during periods of exacerbation.

Skin care measures for atopic dermatitis are as follows:

• Cleansing. To implement personal hygiene procedures for this disease, it is recommended to use special products that do not contain aggressive components (alcohol, fragrances, alkali, preservatives). The best option is hypoallergenic preparations specially designed for skin care with atopic dermatitis. The most common brands of specialized products are bioderma, ducray, avene.
• Hydration. During the day, it is recommended to moisturize the skin with special aerosols based on thermal water. Such products are present in the line of many manufacturers of pharmaceutical cosmetics (products intended for the care of problem skin). Among the most famous brands include uriage, vichy, noreva. Before going to bed, the skin should be treated with a moisturizer or compresses made from natural aloe and potato juices.
• Nutrition. Skin nourishing products are used after water procedures before bedtime. In the cold season, the systematic use of such products should be increased to 2–3 times a day. Creams with a fatty texture containing natural oils can be used to nourish the skin. You can increase the effectiveness of such a cream if you add fat-soluble vitamins A and E (sold in pharmacies). Can also nourish the skin natural oils(coconut, olive, almond).

During skin care procedures, you should refrain from using too hot and/or chlorinated water and harsh washcloths. The duration of any water procedure should not exceed 15–20 minutes, after which the moisture should be blotted with a soft towel.

Controlling food allergen intake
Patients who have undergone allergy tests, during which a specific allergy trigger has been identified, should follow a specific diet. This diet involves avoiding food allergens and dishes that contain them. For people whose allergen has not been determined, a nonspecific hypoallergenic diet is indicated, which implies the exclusion of all obligate (traditional) foods that provoke allergies.

One of the effective measures to control the body’s reaction to food is a food diary. Before you start keeping a diary, you should follow a strict hypoallergenic diet for several days. Then you gradually need to introduce allergenic foods into the diet, recording the body’s reaction.

Preventive (preliminary) drug therapy

Taking special medications before a predicted exacerbation of the disease inhibits the development of allergic reactions. For prevention, pharmacological drugs with antihistamine action are used, the type and pattern of consumption of which is determined by the doctor. Also, in order to increase the body's resistance to allergens, folk remedies can be used.

A prerequisite for the prevention of atopic dermatitis is strengthening the immune system. For this, various vitamin-mineral complexes and herbal immunomodulators can be used.

Before use, you should consult a specialist.

According to medical statistics, over the past decade the prevalence has increased significantly skin pathologies. One of the most common reasons for visiting a dermatologist is atopic dermatitis, the symptoms of which manifest themselves to one degree or another in 80% of children under school age. As patients grow older, signs of the disease disappear in 60% of cases; in the remaining patients, dermatitis becomes chronic. Clinical course The disease in adults is characterized by its specificity, which requires a special approach to treatment.

What is atopic dermatitis

The occurrence of an allergic reaction in a person is preceded by sensitization (acquisition of increased sensitivity) of the body by a certain allergen. The reasons that provoke the process of sensitization are varied - from non-compliance with hygiene standards to genetic predisposition. If disturbances in the mechanism of the immune response are congenital features, the term “atopy” is used in relation to them.

The hereditary form of allergy has several manifestations, one of which is dermatitis - an inflammatory skin lesion with eczematous signs. The specific features of atopic dermatitis (or atopic eczema syndrome) include the following facts:

• development is associated with genetic predisposition;
• chronic nature of the course;
• tendency to relapse;
• clear seasonality of manifestation (the manifestation of severe symptoms of the disease after a latent period occurs in the winter);
• clinical manifestations depend on the age of the patient;
• morphological manifestations are exudative rashes with lichenification (sharp thickening of the skin in the area where the rash appears, increased severity of its pattern, changes in pigmentation);
• the development of dermatitis occurs in childhood (a synonym for the disease is diathesis), after which either complete clinical recovery can occur, or the disease remains for life (a synonym for atopic dermatitis in adults is neurodermatitis or diffuse neurodermatitis);
• a constant symptom characteristic of all stages of the development of the disease (children and adults) is paroxysmal itching.

Atopic eczema syndrome is of two types in terms of prevalence and severity: moderate (focal rashes) and severe (extensive skin lesions). If left untreated, the skin disease can lead to serious complications - damage to the skin by pyogenic bacteria (pyoderma), viruses or fungi. Inherited hyperreactivity of the skin (increased sensitivity) acts as a predisposing endogenous factor to the development of pathology, but potentiation of the appearance allergic manifestations due to a number of exogenous reasons.

Development factors

Pathophysical changes in the skin that occur during periods of exacerbation of atypical dermatitis are caused by natural allergic reactions of the body of immediate type. Consecutive changes in the internal biological environment (formation, release of skin-sensitizing antibodies and tissue reaction to the processes that have occurred) have their own genetically determined characteristics.

The main factor determining the implementation of hereditary atopy in the form of atopic eczema is the tendency to hyperreactivity of the skin, the risk of inheritance of which is:

• up to 20% – if both parents are healthy;
• 40–50% – if one of the parents has atopy (atopy is transmitted from the father in 40–50% of cases, from the mother in 60–70%);
• 60–80% – if both parents suffer from hyperreactivity.

The presence of a predisposition to the disease alone does not lead to the appearance of clinical signs of allergic dermatosis - this requires the presence of other exogenous causes. Manifestations of diffuse neurodermatitis can occur under the influence of the following factors:

• Contact with allergens. The most common substances that can have an allergenic effect are dust and mites contained in it, tobacco smoke, plant pollen, food products, medicinal substances (usually antibiotics of the penicillin group, antimicrobials, local anesthetics), physiological secretions of insects (cockroaches, ticks), hair and skin particles of pets, chemical products (washing powders, cosmetics, etc.), mold fungi.
• Sedentary lifestyle. This factor indirectly influences the triggering of the mechanism for the development of an allergic reaction. Physical inactivity leads to a decrease in the level of oxygen saturation of the body (hypoxia), which causes disruption of the functioning of internal organs and systems and increases the tendency of the immune system to sensitization.
• Moral and biological violations. Psycho-emotional overload, frequent nervous breakdowns, fear, anxiety and excitement also often act as causes of allergic dermatitis.
• Instability of thermal parameters. The development of the disease can be triggered by temperature changes, changes in climate zones, and exposure to strong winds.
• Aggressive impact of the technogenic environment. The deterioration of the environmental situation and the use of chemical products in everyday life create the preconditions for changes in the internal environment by disrupting the functioning of the endocrine glands and nervous system.
• Impaired functionality of the gastrointestinal tract. This factor can influence both the development of neurodermatitis and act as a catalyzing factor in the manifestation of the disease.

Features of the course in adults

Under the influence of allergens or other potentiating factors for the development of atopic eczema, a chain is started in the body inflammatory reactions, resulting in the formation of a cellular infiltrate at the site of inflammation. The affected cells begin to secrete mediators (biologically active substances, transmitters of nerve impulses), hormone-like substances (cycotins) and immunoglobulin E, ensuring self-maintenance of inflammation. The processes occurring inside the body are reflected in specific symptoms.

Due to the presence of differences in the functioning of organs and systems in children and adults, the clinical manifestations of atopic dermatitis in different age groups of patients differ. Characteristic symptoms of the disease in persons over 13 years of age (the stage of development of the disease is defined as “adult” if the patient’s age is over 13 years) are:

• prurigo (pruritus) – severe itching that can appear even with minimal rashes, the sensation intensifies with sweating;
• dry skin – occurs due to a lack of natural moisturizing factors, which leads to disruption of the formation of the lipid layer and dehydration of the epidermis;
• the appearance of a blistering rash - typical places for localization of rashes are the face, neck, armpits, popliteal and elbow bends, groin area, scalp, area under the earlobes;
• swelling of the affected surfaces;
• hyperemia, darkening and thickening of the skin in places where the rash is localized (occurs in later stages of the disease);
• anxiety-depressive state, caused both by a reaction to a deterioration in the quality of life and by the development functional disorders central nervous system resulting from pathological changes in organism;
• increased susceptibility to infectious agents;
• follicular hyperkeratosis - in adult patients, as a result of neurodermatitis, keratinization of the skin surface of the lateral surfaces of the shoulders, elbows, and forearms may occur (looks like “goose bumps”);
• the appearance of cracks on the heels, bald spots in the occipital region - manifestations are typical for older people;
• peeling of the skin of the feet, madarosis (excessive loss of eyelashes and eyebrows) - a consequence of dysfunction thyroid gland, which are caused both by the allergic process itself and by the hormonal therapy undertaken.

Treatment of atopic dermatitis in adults

After diagnostics confirming the diagnosis of “atopic dermatitis” and identification of allergens that provoke the disease, a dermatologist prescribes a treatment regimen. To determine the optimal therapeutic methods Specialists in the following specialized areas may be involved:

• gastroenterologist;
• otolaryngologist;
• allergist;
• therapist;
• psychotherapist;
• neurologist;
• endocrinologist

Before starting treatment there is a need to carry out full examination the body in order to detect concomitant pathologies and assess the functionality of all organs and systems. Based on all the measures taken, treatment tactics are determined, the basis of which is control of the symptoms of atopic eczema. It is very difficult to achieve complete recovery in an adult patient with diffuse neurodermatitis, so the main goals of therapy are:

• elimination or reduction of the severity of external symptoms;
• treatment of background pathologies that aggravate the course of dermatosis (bronchial asthma, hay fever);
• preventing the disease from reaching a severe stage;
• restoration of the structural and functional structure of the affected skin.

The methods used to achieve treatment goals are prescribed to adult patients on an individual basis, taking into account the characteristics of the body and the clinical picture of the disease. Complex therapy may include the following methods:

• medicinal (using external and systemic agents);
• physiotherapeutic (physical or physico-chemical effects on the affected surface);
• psychotherapeutic (to prevent the development of neuroses or psychoses against the background of illness, electrosleep, hypnosis and, in agreement with a psychoneurologist, medications);
• resort therapy (sanatorium-resort treatment);
• therapeutic and prophylactic diet (to restore intestinal microflora), hypoallergenic diet therapy;
• herbal medicine (the use of traditional medicine recipes in mandatory agreed with the attending physician).

Acute period

The goal of treatment of neurodermatitis during the acute phase is to quickly relieve key symptoms and normalize the patient’s condition. The basis of therapeutic measures during exacerbation of the disease are medications from the group of topical corticosteroids (Prednisolone, Triamsinolone, Sinalar). For atopic eczema of moderate severity, corticosteroids of mild and moderate activity are used, for severe disease and large areas of damage - high activity. Drugs of this pharmacological class are prescribed in short courses.

At the acute stage of neurodermatitis, it is advisable to prescribe intravenous antihistamines (sodium thiosulfate solution or calcium gluconate). If there is exudation, it is recommended to use antiseptic lotions (Fukortsin, methylene blue solution, etc.). If the course of the disease is complicated by a secondary infection, antibacterial agents are prescribed systemic action(Erythromycin, Leukomycin). To potentiate the effectiveness of the treatment, the therapeutic course can be supplemented with immunomodulators (Levamisole, Thymus extract).

Remission period

During the latent phase of atopic dermatitis, treatment measures are aimed at preventing exacerbations. Due to the allergic nature of neurodermatitis, the main preventive measure is compliance with a treatment and prophylactic regimen, which is aimed at limiting the patient’s contact with potential allergens. At the stage of remission, drug therapy also plays an important role in ensuring the maximum duration of the asymptomatic period of the disease.

The drugs used to maintain a stable condition of the patient belong to the third generation of antihistamines, which can be taken continuously for six months. If there is a connection between the exacerbation of the disease and emotional stress, taking psychotropic medications in small or moderate doses is indicated. To prevent the appearance of symptoms of neurodermatitis, it is recommended to carry out therapy with sorbents, after which a course of drugs that normalize the intestinal flora (pre-, pro-, synbiotics, bacteriophages, enzymes) is prescribed.

For weakened adult patients whose disease occurs in a moderate to severe form, the use of anabolic steroids (Nerobol, Retabolil), which correct the effect of corticosteroids on the body, is indicated. At all stages and forms of dermatosis, the use of vitamin and mineral complexes is recommended. Depending on the patient’s condition, a course of mono- or multivitamin therapy is carried out. Vitamin supplements are often prescribed for short term in dosages significantly exceeding normal physiological needs.

Drug treatment

Treatment protocols for atopic eczema in adult patients include a large number of medications, but antihistamines and tranquilizers are of greatest practical importance. Medicines of other groups are prescribed taking into account the prevalence of the inflammatory process, the presence of complications and concomitant pathologies. The range of drugs used during the treatment of neurodermatitis may include the following pharmacological groups:

• antimicrobial (usually local action);
• cytostatics (antitumor);
• anti-inflammatory drugs of nonspecific action;
• membrane stabilizers;
• antimediators;
• psychotropics and desensitizers (tranquilizers, antipsychotics, antidepressants, alpha-blockers, M-anticholinergics);
• antimycotics;
• immunocorrectors (immunostimulants, immunosuppressors), adaptogens;
• enterosorbents;
• drugs to normalize intestinal function (bacteriophages, prebiotics, probiotics, synbiotics, enzymes, hepatoprotectors);
• vitamins, multivitamin complexes;
• glucocorticosteroids;
• reducing agents (ointments, creams, patches for resorption of infiltrates);
• keratolytics (soften skin seals).

Glucocorticosteroids

Drugs belonging to the group of glucocorticosteroids (GCS) are artificially synthesized analogues of natural steroid hormones produced by the adrenal cortex. GCS have a multifactorial effect on the body, being simultaneously desensitizing, anti-inflammatory, antiallergic, antitoxic, antiproliferative and immunosuppressive agents.

For the treatment of atopic eczema in adults, internal and external forms of GCS are used. To non-external hormonal agents for intramuscular injection refers to Betamethasone, injections of which are prescribed in a course with a frequency of use of 1 time every 2 weeks. The most frequently prescribed tablet medications in this group are Prednisolone, Metypred, Triamcinolone. For external use, the treatment regimen may include Laticort (hydrocortisone-based cream), Advantan ointment (methylprednisolone) and Afloderm cream (alclomethasone)

The use of GCS for the treatment of allergic dermatoses is due to their mechanism of action, which is to mediate the body's adaptive capabilities to external stress factors. Indications for the prescription of glucocorticosteroids are unbearable itching during the exacerbation phase of the disease (external forms) and lack of effect from the treatment (systemic corticosteroids). During remission, GCS can be used in the form of ointments to achieve an occlusive effect (blocking the release of pathogenic exudate).

Antihistamines

The drugs of first choice in the treatment of neurodermatitis are antihistamines 2nd and 3rd generations. To this pharmacological group include drugs that can block histamine neurotransmitter receptors and inhibit their potentiating effects. When treating allergic pathologies, H1 blockers are used, which are represented by 4 generations of drugs:

• 1st generation – Clemastine, Atarax;
• 2nd generation – Loratadine, Cetirizine;
• 3rd and 4th generation – Levocetirizine, Desloratadine.

Antihistamines for atopic dermatitis in adults have a pronounced antiallergic effect, effectively eliminating the key symptoms of the disease (redness, itching, swelling). 2nd and 3rd generation antihistamines are more effective than 1st generation drugs, are less likely to cause side effects and have reduced cardiotoxicity. During the treatment of the chronic form of the disease, H1-blockers in tablets are prescribed; in the acute phase, the medicine can be administered intravenously.

Immunosuppressants of the macrolide class

Basic therapy prescribed to adult patients after relief of the acute process includes external agents, which include immunosuppressants. Drugs in this group, unlike steroids, are non-hormonal drugs. The most well-known representatives of the macrolide class of immunosuppressants are tacrolimus (Protopic) and pimecrolimus (Elidel), the targets of which are T-lymphocytes and mast cells of the skin.

According to the results of a comparative analysis of the clinical effectiveness of immunosuppressive drugs for topical use with GCS of low and moderate activity, it was found that the use of tacrolimus and pimecrolimus in the face and neck area is more effective and safe than GCS. Using macrolide class drugs 2 times a week for a year increases the remission period by 3 times.

Moisturizers

Dermatological practice involves the widespread use of local therapy, which can be etiological, symptomatic or pathogenetic in nature. In the treatment of dermatitis in adult patients, reducing agents play an important role, restoring the structure and functionality of the skin. Dry skin is not only a symptom of neurodermatitis, but also a factor that supports inflammatory processes. Constant itching resulting from excessive dryness causes nervous disorders that interfere with the treatment process.

Reducing the dryness of the epidermis and accelerating the healing process is an important stage of therapy during remission, the purpose of which is to prolong the asymptomatic period of the disease. To achieve this task, moisturizing creams, ointments, gels, emulsions, lotions based on lanolin or thermal water are used. The choice of dosage form depends on the severity and localization of the inflammatory process:

• ointments – have pronounced nutritional properties, are prescribed in the presence of infiltration (ichthyol ointment);
• creams - ointment bases, which additionally have a cooling effect and have a gentle effect on the skin (Aisida cream, Atoderm);
• gels - high-molecular mixtures that keep low-molecular compounds (water, alcohols) from spreading (Solcoseryl);
• emulsions, solutions, aerosols - use is advisable during the acute stage of the disease, which is accompanied by exudation and weeping.

Tablets for atopic dermatitis in adults

The basis of systemic treatment of atopy in adults is drugs in tablet form. Due to the variety of factors influencing the development and course of the disease, the list of drugs for the treatment of neurodermatitis is extensive. All medications are prescribed exclusively by a doctor, based on the clinicopathological etiology of the disease. The main groups of medications in the form of tablets that can be used to treat atopic eczema are:

• membrane stabilizers;
• antihistamines;
• psycholeptics (sedatives).

Membrane stabilizing drugs

In diseases of an allergic or inflammatory nature, cell membranes are primarily damaged. Favorable conditions for the functioning of receptors built into the membrane are provided by the lipid component, which is especially vulnerable to the action of pathogens. The effectiveness of therapy for diffuse neurodermatitis depends on the degree of protection of the cellular structure, and therefore the complex of therapeutic measures should include membrane-stabilizing drugs that restore cell integrity.

During the treatment of allergic dermatosis, patients may be prescribed the following membrane stabilizers:

Name	Mechanism of action	Method of administration
Suprastin	The main active ingredient (chloropyramine) has an antihistamine effect by blocking H1-histamine receptors and may have a weak hypnotic effect.	The daily dose for adults is 3-4 tablets (75-100 mg), taken with meals. The duration of the treatment course is determined individually, on average it is 5–7 days.
Clemastine	H1-histamine blocker, in case of atopy, prevents the development of allergic symptoms, has a calming effect, relieves itching and swelling.	Tablets should be taken morning and evening, 1 piece, maximum daily dose– 6 tables.
Sodium cromoglycate	Reduces the severity of allergic manifestations and the inflammatory process by stabilizing the mast cell membrane (the release of histamine and inflammatory mediators is slowed down).
Ketotifen	Suppresses the development of allergy symptoms by inhibiting the release of inflammatory and allergic mediators.	The tablets are taken before meals twice a day. The recommended daily dosage is 2 mg. If necessary, the dose can be increased to 4 mg.

Sedatives

Psycholeptics (sedatives, sedatives) are prescribed for atopic dermatitis if a connection between the exacerbation of the disease and stress factors has been identified. Drugs in this group are also indicated in the case of psycho-emotional disorders that arise against the background of neurodermatitis. The calming effect is achieved due to the regulating influence of the active components of psycholeptics on nervous system. During the treatment of adult patients, the following sedative medications may be used:

Name	Mechanism of action	Method of administration
Grandaxin (Tofisopam)	The anxiolytic has a general calming effect, normalizes the emotional background, and reduces the level of anxiety.	The medicine is prescribed to adults 3-6 tablets per day, the daily dose must be divided into 3 doses.
Bellataminal	Relieves itching in neurodermatitis, prevents the development of depression and anxiety.	Take 1 tablet after meals. three times a day. The duration of the course is from 2 to 4 weeks.
	Psycholeptic of plant origin, has a pronounced antispasmodic and calming effect, eliminates symptoms of anxiety and irritability.	Adults should take 2-3 tablets 2 or 3 times a day (maximum daily dose 12 tablets). The duration of the continuous course should not exceed 1.5–2 months.
Diazepam	The sedative effect manifests itself in the relief of anxiety, nervous tension, anti-panic effect.	Depending on the severity of nervous tension, you should take from 1 to 3 tablets per day. The course continues until the emotional state improves.
Amitriptyline	An antidepressant with an analgesic effect, reduces restlessness, anxiety, agitation (nervous agitation).	The tablets should be swallowed whole immediately after meals. The recommended daily dosage for neurodermatitis is 2 tablets. (after 2 weeks you can increase to 4 tablets).

Drugs to normalize intestinal function

In order to speed up the healing process for atopic dermatitis, it is necessary to cure dysbiosis (violation of the ratio of beneficial and pathogenic bacteria inhabiting the intestines), which is often a provoking factor for exacerbation of the disease. The first stage of restoring normal intestinal microflora is detoxification, which is carried out using agents that can adsorb substances harmful to the body (Polysorb, Enterosgel).

The next stage after cleansing should be the restoration of the normal functioning of the gastrointestinal tract, which is achieved through the use of medications that improve intestinal microflora:

Name	Mechanism of action	Method of administration
	It has pronounced enveloping properties due to which it enhances the barrier functions of the mucous membrane, increases its resistance to irritants, adsorbs and removes toxic substances from the body.	Dissolve the contents of 1 sachet in 0.5 cups of water. Take the suspension after meals 3 times a day. The duration of the course is determined individually.
Preparations containing Lignin (Lactofiltrum, Polyphepan)	Regulation of the balance of intestinal microflora, adsorption and elimination of exogenous, endogenous toxins and allergens, increasing nonspecific immunity.	Take the sachet 1 hour before meals, after dissolving it in a small amount of water. The frequency of doses for adults is 2–4 times a day, the course duration is 2–4 weeks.
Bifidumbacterin	Normalization of the digestive tract, prevention of dysbacteriosis.	1 bottle (5 doses) 2-3 times a day with meals or 20-40 minutes before. before eating, course – 10–14 days.
Hilak forte	Regulation of the composition of intestinal microflora, regeneration of epithelial cells of the intestinal walls.	The daily dose is 9.9 ml (180 drops). It is recommended to take 40–60 drops diluted with liquid (except milk) three times a day with meals.

Hyposensitizing agents

There are two main ways of influencing the immunological phase of an allergic reaction - complete limitation of contact with the allergen and specific desensitization (reduction of the body's hypersensitivity). The first method is preferable, but due to a number of factors it is difficult to implement (it is not always possible to identify the allergen or completely eliminate contact with it).

The method of specific desensitization in practice gives satisfactory results and is used during an exacerbation of atopic eczema or in the absence of data on the cause of the allergic reaction. Specific hyposensitizing therapy is associated with a risk of exacerbation of the disease, so it is combined with nonspecific hyposensitizing antihistamines.

Hyposensitizers reduce the body's sensitivity to irritants by inhibiting the immunological mechanism of allergy development. The basis of drugs in this group are histamine antagonists (calcium preparations, sodium thiosulfate, corticosteroids, etc.), injections of which are often used during the acute phase of neurodermatitis to achieve a rapid antiallergic effect.

Calcium gluconate

The development of allergic reactions is often accompanied by hypocalcemia, resulting in increased permeability vascular walls, and the allergen enters the bloodstream faster. Calcium in the form of gluconate is a source of calcium ions, which are involved in the transmission of nerve impulses and prevent the release of histamine. During exacerbation of atopic eczema medicinal solution 1 ampoule (10 ml) is administered intravenously over 5–7 days. Before administration, the contents of the ampoule should be warmed to body temperature.

Sodium thiosulfate

The sodium salt and thiosulfuric acid is used in the treatment of neurodermatitis in order to achieve a detoxification effect. The drug is available in the form of a solution for intravenous injections. After introduction into the body, the substance is distributed in the extracellular fluid and forms non-toxic compounds with cyanides, facilitating their elimination. The medicine is prescribed for severe itching to minimize allergic manifestations of dermatitis. The duration of the course is 5 days, during which adult patients are administered 1–2 ampoules (5–10 ml) of sodium thiosulfate.

Prednisolone

To achieve maximum anti-inflammatory and immunosuppressive effect during the acute phase of the disease, the systemic glucocorticosteroid Prednisolone is used. The mechanism of action of the drug is due to the ability of the active substance to bind to specific receptors in the cellular cytoplasm and inhibit the synthesis of mediators of an immediate allergic reaction.

The immunosuppressive effect is ensured by potentiation of lymphopenia (decreased lymphocytes) and involution (decreased mass) of lymphoid tissue. In case of exacerbation of severe allergic dermatosis, intravenous or intramuscular injections of Prednisolone are prescribed at a dosage of 1–2 mg per 1 kg of the patient’s body weight. The course lasts no more than 5 days

External therapy

Local treatment of atopy is aimed at eliminating the cause and symptoms of dermatitis. To achieve these tasks, a large arsenal of external medications is used. From the right choice The success of therapy depends on the active components and dosage form of the medicine. During the treatment of atopic eczema, adult patients can be prescribed the following medications, which can be purchased in city pharmacies:

Pharmacological group	Drugs	Mechanism of action	Mode of application	Price range, rub.
Corticosteroids	Hydrocortisone (Laticort, Lokoid)	Relieves inflammation, inhibits allergic processes, eliminates swelling and itching. The ointment has a cumulative effect.	Apply to wound surfaces 2-3 times a day for 6-20 days. For limited areas of inflammation, it is recommended to use occlusive dressings.
	Dermovate	Cream and ointment based on clobetasol propionate. Eliminates inflammatory processes, reduces exudation, has antiallergic and antipruritic effects.	Lubricate the affected area every morning and evening until the desired effect is achieved. The duration of the course should not exceed 4 weeks.
		Inhibits the release of allergic reaction mediators, has an antiexudative and antipruritic effect.	To eliminate peeling in case of increased dryness of the skin, ointment should be used (applied once a day); with active exudation, a cream should be used (1 time/day). For lesions on the scalp, it is recommended to use lotion, which is rubbed into the skin until completely absorbed.
	Afloderm	Prevents the expansion of capillaries, thereby slowing down the development of edema. Has immunosuppressive and anti-inflammatory effects.	Apply cream (suitable for sensitive areas) or ointment to inflamed areas 2-3 times a day until the symptoms of the disease disappear.
Macrolides		Inhibits the synthesis and release of protein phosphatase (inflammatory mediator), which stops the development of the inflammatory process and reduces the severity of histopathological changes (disturbances in the intercellular connections of the epidermis).	The cream should be used at the first sign of exacerbation of dermatitis. Apply twice a day and rub into the skin until completely absorbed. Continuous use can be carried out for no more than 6 weeks.
Antihistamines	Fenistil gel	Reduces severity skin itching, eliminates irritation, blocks H1-histamine receptors and reduces capillary permeability.	The gel is applied externally 2–4 times a day.
Emollients and moisturizers	Ichthyol ointment	The therapeutic effect is due to the presence of sulfur-containing compounds in the composition, which contribute to pain relief, softening and removal of infiltrates, potentiation of the process of tissue regeneration, local constriction of blood vessels, due to which the production of purulent secretion is reduced.	The ointment is applied in a thin layer to the affected areas of the skin and distributed evenly (no need to rub in); the layer should be so thick that there are no gaps left. A sterile bandage is applied over the ointment, which should be changed after 8 hours. The course is 10–14 days.
		Accelerates the process of epithelization, has a moisturizing effect on all layers of the epidermis.	Apply the cream to dry areas of the skin once a day, if necessary, you can increase the number of applications.
	Trickzera	Softens very dry skin, increases its elasticity, restores the lipid barrier.	Apply to previously cleansed dry skin 2-3 times a day.
		Helps correct skin dryness and reduce hypersensitivity.	The cream is applied twice a day, the skin should be pre-prepared (cleansed and moisturized).
		Has a calming effect on irritated skin, restores the lipid layer.	Apply the cream daily with gentle movements to the skin of the body and face.
	Topicrem	Moisturizing the upper layers of the epidermis, eliminating the feeling of “tightness” due to the formation of a moist film on the surface of the skin.	Apply daily after hygiene procedures.
Wound healing drugs	Silver sulfathiazole (Argosulfan)	It has a bactericidal effect, helps accelerate the healing process and epithelization of wounds.	Apply a layer of 2–3 mm to the wound surface in the morning and evening. You can treat with cream in an open or closed way (applying the product under a bandage).
	Solcoseryl	Wound healing effect, acceleration of regenerative processes, increased collagen synthesis.	Apply to the wound surface pre-treated with an antiseptic 2-3 times a day (used only for weeping wounds without crusts).
	Actovegin	Treatment of wounds at all stages of the disease (gel is used at the initial stage of wound formation, cream is indicated for wet wounds, ointment is optimally used for long-term therapy of dry wound surfaces).	Apply to a wound cleaned of exudate, pus, etc. The product is applied 2-3 times a day in an open or closed way.
	Methyluracil ointment	Accelerates the process of cell formation, activates humoral and cellular immunity, stimulates repair (correction of cell damage due to exposure to pathogens).	Apply to damaged areas 2–4 times a day, duration of use should not exceed 2 weeks.

Antibacterial ointments for secondary infection

When intensively scratching itchy skin, the integrity of its surface is disrupted, which facilitates the penetration of infectious agents from the environment into the inner layers of the epidermis. Pathogens cause irritation and itching, completing the “atopic skin cycle” (where symptoms of dermatitis become factors in its development). In order to break the vicious circle, it is necessary to stop the development of secondary infection. For this purpose, external antibacterial agents are prescribed, such as:

1. Levomekol (cost from 102 rubles) - has a multifactorial effect due to the combined composition, which includes an antibiotic (chloramphenicol) and an immunostimulant (methyluracil). Levomekol for dermatitis helps relieve inflammation by inhibiting protein synthesis in pathogen cells and accelerates the process of tissue regeneration by accelerating the exchange of nucleic acids. The ointment should be applied to sterile napkins that are applied to the wound surface. The dressings should be changed daily until the wound is completely clean.
2. Erythromycin (cost from 80 rubles) - an ointment based on erythromycin (the first antibiotic of the macrolide class). The antibacterial effect consists of disrupting peptide bonds between amino acid molecules and disrupting the protein synthesis of pathogenic cells. Along with the bacteriostatic effect, a bactericidal effect may appear (with increasing dose). The medicine should be applied to the affected skin 2-3 times a day for 1.5-2 months.
3. Dioxidin (cost from 414 rubles) is an antibacterial agent, a derivative of quinoxaline, that can have a bactericidal effect on those strains of microorganisms that are insensitive to other types of antibiotics. Treatment of wounds with dermatitis with ointment accelerates the process of marginal epithelization and reparative regeneration. The medicine should be applied in a thin layer once a day; the duration of therapy for adult patients is no more than 3 weeks.

Physiotherapeutic procedures

The frequent use of various methods of physiotherapy in the practice of treating diffuse neurodermatitis in adults indicates their high effectiveness. When prescribing physical procedures, the indications and contraindications of specific types of exposure to physical factors are taken into account. The most common methods of physical treatment for dermatosis are:

1. Phototherapy is dosed irradiation of affected areas of the skin with ultraviolet rays, thereby suppressing local cellular immunity.
2. Phototherapy is the effect of bright light from artificial sources (lasers, diodes, fluorescent lamps) on the body of a patient who has previously consumed a photosensitizing substance (psoralen or ammifurin).
3. Acupuncture – stimulation of biologically active points general action(at the acute stage of the disease) and local (during treatment of subacute and chronic forms), corresponding to the localization of the inflammatory process.
4. Electrotherapy - the action of dynamic currents on the paravertebral ganglia (autonomous nerve nodes located along the spine) gives a sedative effect.
5. Hyperbaric oxygenation is the saturation of tissues with pure oxygen under high pressure, which leads to an improvement in the rheological properties of blood and acceleration of the process of tissue regeneration.
6. Electrosleep - electrical stimulation of parts of the brain helps to inhibit those structures whose excessive activity can provoke the development of neurodermatitis.
7. Paraffin therapy is a heat treatment method that involves heating tissue in areas of lichenification using paraffin. The purpose of the procedure is to moisturize the affected skin and increase its elasticity.
8. Electrophoresis - through intranasal administration medicinal substances(Diphenhydramine, Novocaine) with the help of electric current, a direct effect is exerted on the vessels and autonomic parts of the nervous system through the mucous membrane of the nasal cavity.

Vitamins

Degradation of the skin often accompanies hypovitaminosis, so vitamin support for the body is of great importance in the treatment of dermatological diseases. Therapy for neurodermatitis at the stage of remission is supplemented with vitamin and microelement complexes. The main vitamins that accelerate the healing process in atopy are:

• retinol (vitamin A) - drugs Tigazon, Neotigazon for diffuse neurodermatitis are used for a long time and in high dosages;
• B vitamins (thiamine, riboflavin, cyanocobalamin, pyridoxine, nicotinic acid) - used in isolation or as part of vitamin-mineral complexes;
• ascorbic acid - during the acute phase, taking mega-doses of vitamin C is indicated;
• vitamin D3 – prescribed in combination with calcium salts;
• tocopherol – the effectiveness of therapy increases when combining vitamin E and retinol (Aevit);
• zinc preparations - internal administration of zinc-containing preparations (Zincteral) enhances the effect of external agents used to care for affected tissues;
• multivitamin complexes - indicated for use in chronic dermatoses (Centrum, Oligovit).

Folk remedies

Traditional therapy for dermatitis can, in agreement with the doctor, be supplemented with non-traditional methods. Products made according to traditional medicine recipes can provide additional support to an organism weakened by disease and the action of highly active medicinal substances. To relieve the main symptoms of neurodermatitis, herbal remedies can be taken orally (decoctions, infusions) or used externally (ointments, lotions, compresses, lotions).

Before starting self-medication using traditional methods, it is necessary to agree with your doctor on the feasibility and safety of using certain medicinal herbs. Due to the effect they provide, the following methods of home therapy are very popular among patients with atopic eczema:

• oat decoction (taken orally for 1 month);
• potato compresses;
• ointments based on herbal ingredients;
• decoctions of medicinal herbs that have anti-inflammatory and antipruritic effects;
• alcohol tinctures;
• herbal baths.

Raw potato compress

Traditional recipes for getting rid of allergic dermatosis based on potatoes are safe to use and easy to prepare. The tubers of this vegetable consist of 75% water, which determines its moisturizing and softening effect on the skin. To prepare the medicinal composition, you should peel fresh raw potatoes and chop them using non-metallic tools. The potato mass should be wrapped in gauze, squeezed out and applied to the affected surface overnight. Procedures are performed until the skin condition improves.

Antipruritic ointment made from chamomile and fireweed

You can get rid of severe itching, which is the main symptom that bothers patients, using an antipruritic ointment based on fireweed (fireweed) and chamomile. This herbal medicine can only be used on open areas of the body. To achieve a sustainable effect, it is necessary to carry out the procedure for a month, applying the ointment 3-4 times a day. If necessary, the course continues after a week's break. The components necessary for preparing the antipruritic composition should be prepared in advance. The recipe includes the following ingredients:

• chamomile (flowers);
• fireweed;
• decoction of hay dust (0.5 cups of hay dust per 1.5 cups of water);
• butter (1 tbsp);
• glycerol.

Chamomile and fireweed flowers should be crushed and mixed in equal proportions. 1 tbsp. l. Pour the mixture with 4 cups of water and bring to a boil. After boiling, the broth is covered with a lid and boiled for 5 minutes, then a decoction of hay dust and butter are added to it. The resulting mass should be cooked over low heat until it reaches a homogeneous consistency. The last step in preparing the ointment is adding glycerin in a ratio of 1 to 1. After cooling, the product is stored in the refrigerator.

Herbal decoction for oral administration

Along with traditional medicine for external use, decoctions for oral use have a good healing effect. The main components of the herbal drink are tree peony grass, motherwort, nettle, valerian root and mint. The decoction has a calming effect, helps strengthen the immune system and improves metabolic processes in the body. In order to prepare a healing drink, mix 50 g of ingredients, pour 1.5 liters of boiling water and leave for 1 hour.

The course of herbal medicine should last 20–30 days, during which the drink is prepared daily and drunk throughout the day. During the entire period of using the decoction, you should not take baths with hot or cold water(recommended temperature is 36–40 degrees). After water procedures, it is necessary to lubricate the wounds with emollient compounds.

Sanatorium-resort treatment of dermatitis in adults

Carrying out spa therapy as part of the complex treatment of allergic dermatitis in adult patients increases the overall effectiveness of therapy. This method is only indicated during remission. The direction of sanatorium-resort treatment is assigned to the patient, taking into account all indications and possible contraindications. The following procedures can be performed during spa therapy:

• peloidotherapy (mud baths or applications);
• thalassotherapy (treatment using all factors formed in the marine climate - water, algae, seafood, etc.);
• balneotherapy (use of the healing properties of mineral waters - showering, irrigation, drinking, intestinal lavage, etc.);
• heliotherapy (solar therapy, sunbathing);
• climatotherapy (staying in a dry, warm climate zone for more than 2 months ensures long-term remission, more than 3 years - complete recovery).

Diet therapy

An important stage in the course of treatment for atopy is drawing up hypoallergenic diet, the main task of which is to prevent allergens and histamine liberators (products that stimulate the release of histamine) from entering the patient’s body. If using laboratory diagnostics a specific product has been identified that has caused sensitization of the body - a specific exclusion diet is prescribed (exclusion of products containing the identified substances).

In the absence of data on specific allergen and during the acute phase of the disease, a nonspecific elimination diet is indicated. Foods that must be excluded from the diet in all cases of atopic eczema during relapse are:

• spicy, fried, pickled, extracted (dry mixtures) foods;
• pickles;
• smoked meats;
• citrus;
• Tea coffee;
• chocolate;
• milk;
• chicken eggs;
• jam;
• chicken, goose, duck meat;
• seafood;
• fatty fish;
• red fruits and vegetables;

In addition to avoiding foods with a high level of allergenicity, patients are advised to follow a number of dietary rules, the implementation of which will help achieve sustainable remission of atopy:

• inclusion in the diet of foods containing all the necessary vitamins and minerals;
• ensuring the supply of substances that accelerate regeneration processes (sunflower oil, olive oil, corn, flax);
• reducing the consumption of gluten (protein amino acids found in cereal products);
• maintaining normal functioning of the liver and intestines (exclude alcohol, fatty foods, consume more fiber);
• short-term fasting under medical supervision;
• Maintaining water balance (drink at least 2 liters of water daily);
• monitoring the body’s reactions to consumed foods (keeping a food diary).

To determine the most likely food allergens, it is necessary to monitor and record reactions that occur in response to the consumption of a particular product. Guidelines for keeping records are as follows:

• Before starting a diary, you must abstain from food for 1 day (you are allowed to drink clean water, unsweetened tea);
• introduce foods into the diet gradually (first dairy, then eggs, meat, fish, vegetables and citrus fruits);
• describe in detail the composition of the dishes consumed (ingredients, quantity, time of intake, method of preparation);
• record all body reactions, indicating the time of their occurrence and severity.

Video

Found an error in the text?
Select it, press Ctrl + Enter and we will fix everything!

Atopic dermatitis– chronic inflammatory disease allergic nature, the main signs 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 diet 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. An allergen (any product that causes an allergic reaction in a particular person) entering the body cannot be processed in the intestines, and the liver, in turn, 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 in 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

The following factors can cause atopic dermatitis:

- consumption of highly allergenic foods 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 seasonal pattern – 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 of 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 ones 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. The main feature of these products is the content 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 we 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 They use two types of drugs - enterosorbents and drugs to normalize 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 toxicity 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 in a job where you are constantly exposed to stress, think about whether there is perhaps an opportunity to change this job? 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.

Atopic dermatitis in children is an inflammatory skin disease that occurs against the background of increased sensitivity of the body to contact and food allergens. The pathology manifests itself as itching, skin rashes, crust formation and other symptoms. Atopic dermatitis is predominantly encountered by young children, which makes the disease quite dangerous for their fragile bodies.

To diagnose atopic dermatitis in children, an analysis is performed skin tests, specific IgE and other procedures. If the diagnosis is confirmed, physiotherapy is prescribed, therapeutic nutrition and the use of medications (systemic and local). It also turns out that the child psychological help to enhance the therapeutic effect.

Description of the pathology

Atopic dermatitis in children is a chronic disease of an allergic nature. In medicine, there are other names for this pathology - diffuse neurodermatitis, atopic dermatitis syndrome and atopic eczema. But all this is one and the same disease, the occurrence of which is determined by such factors as negative environmental influences and genetic predisposition.

Note! Symptoms of atopic dermatitis are often encountered by young patients, so the disease should be considered in pediatric practice. According to statistics, recently, representatives of the children's population have predominantly encountered dermatological diseases of a chronic nature.

Causes

Genetics is far from the only factor that can trigger the development of dermatitis in children. There are other reasons:

• diseases of the gastrointestinal tract;
• non-compliance with the diet (the child eats too often or too much);
• the body's reaction to some food;
• exposure to cosmetics or household chemicals with which the child came into contact;
• allergy to lactose.

If during pregnancy the mother often used harmful products, which contain potential allergens, then atopic dermatitis can occur in a newborn baby. Self-healing, as statistics show, occurs in approximately 50% of clinical cases. The second half of children are forced to suffer from signs of pathology for many years.

Risk factors for the development of atopic dermatitis (AD) in children

Classification

In medicine, there are several types of diseases that manifest themselves in different age categories:

• erythematous-squamous dermatitis. Occurs in children under 2 years of age, accompanied by excoriation, increased dry skin, itching and papular rash;
• eczematous dermatitis. This type of dermatitis is diagnosed mainly in children under 6 years of age. Eczematous atopic dermatitis is accompanied by severe itching, papular-vesicular rash and swelling of the skin;
• lichenoid dermatitis. A common form of pathology, which is most often encountered by school-aged patients. In addition to standard symptoms, such as itching of the skin, swelling and hardening of the affected areas of the skin appears;
• pruriginous dermatitis. Manifests itself in the form of numerous papules and excoriation. A prurigo-like type of atopic dermatitis is diagnosed in adolescents and older children.

Ignoring the disease can lead to unpleasant consequences Therefore, if suspicious symptoms appear in a child, you should contact your pediatrician as soon as possible.

Stages of occurrence

Doctors divide 4 main stages:

• initial. Accompanied by swelling of the affected areas of the skin;
• expressed. Additional symptoms appear, for example, skin rashes, peeling. The expressed stage of the pathology can be chronic or acute;
• remission. Gradual reduction in the severity of symptoms until their complete elimination. The duration of this period can range from 4-6 months to several years;
• recovery. If relapses have not been observed for more than 5 years, then he can be considered clinically healthy.

On a note! Correct determination of the stage of atopic dermatitis is an important step in diagnostic examination, because this factor influences the choice of therapeutic course.

Characteristic symptoms

Regardless of the type of pathology or the age of the patient, dermatitis is accompanied by the following symptoms:

• inflammation of the skin, causing severe itching. The patient begins to uncontrollably scratch all the affected areas of the skin;
• redness of thinner areas of the skin (neck, knee and elbow joints);
• pustular formations on the skin and acne.

The most dangerous sign of atopic dermatitis in children is itching, because it forces the sick child to intensively scratch the affected area, which causes small wounds to appear. Through them, various bacteria penetrate the body, provoking the development of a secondary infection.

Will the symptoms of dermatitis go away with age?

In most cases, approximately 60-70%, the signs of atopic dermatitis in children disappear over time, but in the rest, the disease persists in the child and accompanies him throughout his life, periodically renewing. The severity of the pathology directly depends on the period of its occurrence, therefore, with early onset, dermatitis is especially severe.

Doctors say that if, in parallel with atopic dermatitis, children develop another allergic disease, for example, bronchial asthma or hay fever, the symptoms will appear almost constantly, which will significantly worsen the patient’s quality of life.

Diagnostic features

At the first suspicious signs of atopic dermatitis in children, the child should be immediately taken to a doctor for examination. Diagnosis is carried out by an allergist and pediatric dermatologist. During the examination, the general condition of the patient’s skin (dermatographism, degree of dryness and moisture), the localization of the rash, the intensity of the signs of pathology, as well as the area of ​​the affected area of ​​the skin are assessed.

For the ruling accurate diagnosis A visual examination alone will not be enough, so the doctor prescribes additional procedures:

• coprogram (laboratory stool analysis for helminthiasis and dysbacteriosis);
• general urine analysis;
• general and biochemical analysis blood;
• identification of possible allergens using provocative (through the nasal mucosa) or skin scarification (through a small scratch on the skin) tests.

Note! During diagnosis, it is important to distinguish childhood atopic dermatitis from other diseases, for example, pityriasis rosea, psoriasis, microbial eczema or seborrheic dermatitis. Only after differentiation will the doctor be able to prescribe an appropriate course of therapy.

Treatment methods

The main goal of therapy for atopic dermatitis in children is to desensitize the body, limit provoking factors, eliminate symptoms and prevent the development of serious complications or exacerbations of the pathology. Complex therapy should include taking medications (the use of local and systemic drugs), following a special diet, as well as traditional medicine.

Pharmacy drugs

To relieve the symptoms of atopic dermatitis, the child may be prescribed the following groups of drugs:

• antihistamines – have antipruritic properties. Such products as “Zodak”, “Cetrin” and “Finistil” are used;
• antibiotics - prescribed in cases where the disease is accompanied by a bacterial infection (Differin, Levomikol, Bactroban and others);
• antimycotics and antivirals are required when diagnosing additional infections. If a viral infection occurs, the doctor may prescribe Gossypol or Alpizarin, and if a fungal infection develops, Nizoral, Pimafucin, Candide, etc. are used;
• immunomodulators - used for atopic dermatitis, if signs of immune deficiency have been added to the symptoms of the pathology. These are potent drugs, so only the attending physician should select them;
• drugs to normalize the functioning of the gastrointestinal tract;
• Glucocorticosteroids are steroid hormones designed to eliminate pronounced symptoms of dermatitis. They are used in rare cases due to the large number of contraindications and side effects.

To speed up the regenerative functions of the body and restore affected areas of the skin, the doctor may prescribe special ointments that stimulate regeneration. The most effective drug is Panthenol.

Nutrition

A well-known doctor works hard on the topic of treating atopic dermatitis in children. Komarovsky, who devoted many years to this issue. He recommends organizing meals when the child’s diagnosis is confirmed (see). This will speed up the healing process and prevent recurrence of the disease.

To do this, you need to follow a few simple rules on nutrition:

• do not overfeed the child, because this will lead to disruption of metabolic functions, which is fraught not only with obesity, but also with the development of skin diseases;
• Reduce the fat content of breast milk if possible. To do this, a nursing mother must also follow a special diet, do not overeat fatty foods and drink enough fluids;
• When feeding a baby, you need to make a small hole in the nipple, thereby slowing down this process. This manipulation promotes normal digestion of food.

Also Komarovsky advises maintaining the room temperature no more than 20C. This will reduce the level of sweating in the child.

Folk remedies

If the disease was diagnosed in a child over 3 years old, then many parents use traditional medicine as therapy, which are in no way inferior in effectiveness to synthetic drugs. But before using them, you should definitely consult with your doctor.

Table. ethnoscience for atopic dermatitis in children.

Product name	Application
	Pour 1 liter of boiling water over 3 tbsp. l. chamomile flowers and leave in a closed thermos for 2-3 hours. Use the finished product to wipe your baby's skin after bath procedures.
	Grind the currant shoots (necessarily young ones) and, placing them in a thermos, pour boiling water over them and leave for 2 hours. Strain the product through cheesecloth and give it to your child to drink throughout the day.
	A simple and at the same time effective anti-inflammatory agent used in the treatment of atopic dermatitis. Squeeze the juice from several potatoes and apply it to the affected areas of the skin. An hour after application, the juice should be washed off with warm water.
	Mix 4 tbsp in one bowl. l. butter and 1 tbsp. l. St. John's wort juice. Heat ingredients over low heat, stirring occasionally. Place the mixture in the refrigerator for storage. Apply the ointment to the affected areas 2 times a day.
	To prepare the decoction, pour 500 ml of boiling water into 3 tbsp. l. chopped plant and cook over low heat for 30 minutes. After this, the medicine should infuse for 2 hours. The finished decoction should be taken 1 tbsp. l. 3-4 times a day. The duration of the treatment course is 3 weeks.

Application homeopathic remedies helps normalize the gastrointestinal tract, and also restores the child’s immune and nervous system.

Many doctors recommend supplementing traditional treatment methods hyperbaric oxygen therapy, reflexology and phototherapy methods. This will speed up the recovery process, strengthen the child’s body and reduce the likelihood of re-development of the pathology.

Often, when diagnosing atopic dermatitis, children require the help of not only a dermatologist, but also a psychologist.

Possible complications

Incorrect or untimely treatment of atopic dermatitis in children can lead to the development of serious complications, which, in turn, are divided into systemic and local. Systemic complications include:

• psychological disorder;
• hives;
• bronchial asthma;
• allergic form of conjunctivitis and rhinitis;
• the development of lymphadenopathy - a pathology that is accompanied by enlargement of the lymph nodes.

TO local complications atopic dermatitis in children include:

• lichenification of the skin;
• development viral infection(as a rule, patients develop herpetic or papillomatous lesions);
• candidiasis, dermatophytosis and other fungal infections;
• infectious inflammation accompanied by pyoderma.

To avoid such complications, the disease must be treated in a timely manner, so at the first suspicious symptoms, the child should be shown to a doctor as soon as possible.

Prevention measures

To prevent your child from encountering unpleasant symptoms of atopic dermatitis in the future, the following recommendations should be followed:

• ventilate the children's room, maintain a cool climate;
• take your child for walks regularly fresh air, preferably not on city streets, but in nature;
• maintain a drinking regime, especially in the summer;
• Monitor your baby’s diet – it should contain a sufficient amount of nutrients;
• Don't overdo it with hygiene. Too frequent bathing procedures can harm the baby’s skin by disrupting its protective lipid barrier;
• Buy clothes made exclusively from natural materials that are comfortable and do not restrict movement. experts recommend giving preference to cotton products;
• Use only “baby” laundry detergent.

Atopic dermatitis in children is a serious skin disease, requiring increased attention. The disease can periodically disappear and then appear again, so only timely therapy and preventive measures will get rid of dermatitis forever.

Video - 10 rules for treating atopic dermatitis in children