Atopic dermatitis occurs most often in early childhood. The main reason for its occurrence in children can be called a family history (my mom or dad were manifestations Allergies due to poor diet, intoxication, metabolic disorders, disorders of the nervous and endocrine systems). But the disease can emerge into adulthood.
symptoms
Leading symptom of atopic dermatitis is severe itching. Skin, especially during the "dormant flow" (remission), characterized by dryness and flaking. The skin of the trunk and the extensor surfaces of the limbs covered shiny skin-colored plaques.
During the period of "dormant flow" only minimal manifestations of atopic dermatitis can be hardly scaly spots or cracks in the dock area of the ear lobe. Furthermore, such features can be perleches in the corners of the mouth (cheilitis), A median crack of the lower lip, as well as peeling and redness of the upper eyelid.
In the course of the disease (depending on the characteristics at different ages) conditionally three phases can be distinguished - infant, child and adult.
Atopic dermatitis in children
infant phase
The development of atopic dermatitis usually begins with 7-8 weeks of a child's life. Eruptions are located mainly on the face, affecting the skin of the cheeks and forehead. Gradually there are changes on the extensor surface of the lower legs, shoulders and upper arms. Often the affected skin of the buttocks and torso.
Children's stage
It starts after 18 months of age and continues until adolescence.
Cutaneous atopic dermatitis in children at an early stage of this phase is represented by red, edematous spots, prone to the formation of continuous lesions. As a result, raschesov the lesions covered with a crust. Rash located mainly in the elbow and popliteal folds on the side surfaces of the neck, upper chest, and hands. Over time, the majority of children skin is cleaned of rashes, and are affected only popliteal and elbow cgiby.
Photo: site of the Department of dermatology Tomsk Military Medical Institute
Atopic dermatitis in adults
The adult phase of atopic dermatitis occurs in adolescence. Particularly frequently affected torso, the neck, the forehead, the skin around the mouth, flexor surface of the forearm and wrist. In severe the skin can be affected throughout the body.
Observations indicate the role of heredity in the transmission of painful symptoms from parents to children. So, from the father-allergy symptoms of atopic dermatitis in the child develops in 40-50% of cases of mother - to 60-70%. If both parents are carriers of atopy, the development of disease incidence in the child is 80%. (Mazitov LP 2001).
In a certain number of children develop the latent allergy, which is implemented in the form of atopic dermatitis at the age of 19-20 years. Inherited not a disease but a set of genetic factors contributing to the formation of the body's allergy (Fedenko ES 2001).
In the formation of the disease is very important functional condition of the gastrointestinal tract. The risk of developing atopic dermatitis increases in non-compliance with a balanced diet of pregnant women, young infants who are bottle-fed.
So, the first year of life is often the cause of the disease are eggs, cow's milk protein, cereal.
During exacerbated by the development of intestinal dysbiosisIn connection with uncontrolled intake of antibiotics, hormones, presence of foci of chronic infections, allergic diseases (asthma, rhinitis), dismetabolic nephropathy, Parasites.
Atopic Dermatitis Treatment
An important trend in the treatment of atopic dermatitis is an optimal psycho-emotional environment. Please be aware that emotional stress can trigger itching.
Diet
First of all it is necessary to eliminate:
- meat and fish broth,
- grilled meat,
- chocolate, cocoa,
- citrus fruits (lemons, tangerines, oranges, grapefruit)
- strawberry, blackcurrant, melon,
- honey,
- pomegranates, nuts,
- mushrooms,
- fish spawn
- spices, meats,
- canned and other foods containing additives preservatives and dyes.
It is advisable to add to the diet of vegetable oil (sunflower, olive, etc.) To 30 g per day as a seasoning for salads. Assigned vitamin F-99 comprising the combination of linoleic and linolenic acids - high-dose (4 capsules, 2 times a day), or in medium (1-2 capsules 2 times a day). The drug is particularly effective in adults.
medication
It conducted strictly individually and can include tranquilizers, anti-allergic, antiinflammatory and detoxification agent.
It should be noted that in atopic dermatitis suggested a large number of methods and means (hormones, cytostatics, intal, allergoglobulin, specific desensitization, PUVA therapy, plasmapheresis, acupuncture, calorie restriction and et al.). However, the greatest importance in the practice of medicine, which have antipruritic effect - antihistamines and tranquilizers.
Antihistamine drugs are prescribed for relief of itching and swelling at the skin manifestations and atopic syndrome (asthma, rhinitis).
Applying daily antihistamines first generation drugs (suprastin, tavegil, diazolin, ferkarol), you must remember that the highly addictive developing them. Therefore, these drugs should be changed every 5-7 days. Penetrating through the bloodstream into the brain, the first-generation drugs cause a calming effect, so they should not be given students, drivers and all those who have an active lifestyle, as reduced concentration and impaired coordination movements.
Second Generation Drugs - loratodin (Claritin), astemizole, ebostin, cetirizine, fexofenadine.
Hormones are used is limited and common processes, as well as unbearable, excruciating itching, are not eliminated by other means. Hormones (better metipred or triamcinolone) are given a few days to remove the sharpness of attack with tapering.
When the distribution process and the phenomena of intoxication applies intensive therapy using intravenous means (gemodez, reopoligljukin, poliyonny solution, physiological solution and others.). Well established and hemosorbtion plasmapheresis (Special blood purification methods).
In the treatment of persistent atopic dermatitis very useful helper method can be light therapy. Ultraviolet light requires only 3-4 treatments per week and has few side effects.
Upon accession of infection used broad-spectrum antibiotics. Appointed by erythromycin, rondomitsin, vibramitsin for 6-7 days. In childhood, drugs tetracycline (tetracycline, doxycycline) are assigned to 9 years. Complication of herpes infection is an indication for Famvir or acyclovir in the age dosages.
In the treatment of complicated forms of atopic dermatitis should be included, especially in children, enzyme drugs (abomin, Festalum, mezim forte, panzinorm) and high eubiotiki (bifidumbakterin, baktisubtil, lineks et al.). Eubiotics best given as a result of microbial fecal bacteria overgrowth.
It has a good effect and purpose of antioxidants, especially Aevitum and Vetoron.
External treatment is carried out taking into account the severity of the inflammatory reaction, extent of the lesion, the age and related complications local infection.
In the acute stage, accompanied by weeping and crusts apply lotions containing anti-inflammatory, disinfectants (e.g., drilling fluid, camomile, tea). After removing the effects of acute inflammation are used creams, ointments and pastes containing zudouspokaivayuschie and anti-inflammatory agents (naftalan 2-10% oil, tar, 1-2%, 2-5% ichthyol, sulfur, etc.).
Widely used in the topical treatment received hormone drugs. These include tselestoderm (cream, ointment), tselestoderm with garamitsinom and triderm (cream, ointment), Elokim and advantan.
Prevention of exacerbations
The skin of patients with atopic dermatitis due to its dryness and increased permeability becomes sensitive to hydration. In this regard, the use of conventional varieties of toilet soap is not desirable. It is advisable to apply gentle soaps (such as Dove, Dial, Lowila, child, and so on. D.). Detergents, even in small amounts remaining on the freshly washed clothes and underwear, can also be irritating. Therefore, some authors recommend the use of "allergensvobodnye" washing powders (such as Tide Free) and repeated the laundry rinse cycle. Clothing should not be too tight. In addition, it is undesirable to carry woolens.
Pot able to irritate the skin of the patient, and therefore require more frequent change of the laundry.
A specific value for the prevention of atopic dermatitis has a microclimate in the house. Thus, the temperature and humidity in the room should be comfortable possibilities (constant temperature of 20-24 ° C and 45-55% humidity).
Patients are also recommended for swimming lessons. At the same time, however, you must keep in mind that chlorine-containing compounds and other antiseptics used for disinfection of the swimming pool, can cause skin irritation. Typically, in order to remove this effect, it is sufficient to take classes after a light shower.
To eliminate dry skin in atopic dermatitis need to use nourishing and softening means being applied to the skin must be often enough that the skin remains soft during the entire day. Also required skin treatment and nutrient emollients after showering, and before walking in windy and cold weather - protective creams and ointments.
Correction comorbidities include inspection, identification and treatment of chronic lesions infections, parasitic infections, dysbiosis, restoration of cortical and autonomic neurodynamics violations.
Forecast
Prediction of atopic dermatitis and quality of life largely depends on receiving them credible Knowledge about the causes of skin rash, itching, from the thorough implementation of all recommendations of the doctor and prevention.
The main directions of the prevention of atopic dermatitis - is the observance of the diet, especially for pregnant women and nursing mothers, breast-feeding children. Particular attention should be paid to limiting the impact of inhaled allergens, reducing the exposure to chemical means in daily life, the prevention of colds and infectious diseases caused by assignment antibiotics. When a landmark preventive treatment is recommended spa treatment in the Crimea, on the Black Sea coast of the Caucasus and the Mediterranean.
