Diathesis Peel a hard boiled egg. Free the shell from the film, dry it, and grind it into powder (in a mortar or coffee grinder). The resulting powder does not require precise dosage. If the child is small, take the powder at the tip of a knife. The older the child, the higher the dose.

Diathesis This disease affects the child’s skin, but its cause is considered to be a disruption of the digestive tract. Skin rashes usually appear after eating a particular food. Since the baby's main food is mother's milk, she

Exudative-catarrhal diathesis is a feature of the child’s body, which manifests itself in the form of a rash, most often on the cheeks, when consuming certain foods. This problem is usually called simply diathesis and is observed in most cases in babies under one year of age. You can get rid of this with proper care and diet adjustments.

What is pathology

This condition is not considered a pathology, but a hereditary predisposition to negative reactions of the body to its usual environment; symptoms are usually caused by diet.

Varying degrees of severity occur in 60% of children. Over the years, the number of cases of diathesis has increased significantly. This is associated with deteriorating food quality.

In some cases of diathesis, its transformation into bronchial asthma or eczema is observed. These are chronic diseases that need to be treated.

Causes

A child at any age can develop food allergies. This is due to the increased sensitivity of the body.

In babies under one year of age, food allergies are associated with physiological characteristics:

1. Reduced intestinal barrier functions. For this reason, some food components penetrate into the blood through the intestinal walls. They have a toxic effect on the body, exit through the skin and cause a rash.
2. Imperfection of the enzymatic system. Because of this, the process of digesting food does not occur well enough.
3. High sensitivity of immature body tissues to histamine. The production of this substance occurs in the human body, but it can also come from food.

During the first year of a child’s life, physiology improves and the functioning of all systems improves. This may help stop diathesis. Some children may suffer from allergies before the age of five.

Doctors consider this condition a pseudo-allergy, as it is associated with the characteristics of the body of children.

Allergic hypersensitivity can occur:

• if during labor the newborn suffered hypoxia;
• with intestinal dysbiosis;
• with early complementary feeding. If the child was introduced to new foods before six months of age;
• if the child’s diet is incorrectly prepared;
• if a nursing mother consumes foods that may cause allergies.

Increases the likelihood of developing an allergic reaction if a woman consumes harmful foods during pregnancy, as well as when she loses protein in the urine.

Hypersensitive reactions can be observed if the pregnancy proceeded with complications in the form of severe swelling, cramps, and high blood pressure.

Expert opinion

Allergist Yulia Borisovna Cherkashina

Education: Medical University named after. N.I. Pirogov, Moscow, 1998

The most important cause of exudative-catarrhal diathesis is considered to be a hereditary predisposition. If the problem occurs in one of your close relatives, it is often diagnosed in children.

Types and characteristic symptoms

Allergic diathesis can have different manifestations. It all depends on the individual characteristics of the child’s body.

In this condition, the appearance of:

1. Diaper rash in the folds of the neck, groin area, under the arms, behind the ears. In rare cases, they can form on the bends of the limbs.
2. Short behind the ears.
3. Wet diaper rash.
4. Red, hard, scaly spots on different parts of the body. This is a milk scab.
5. Gneiss formations. This phenomenon is represented by large scales of oily dandruff on the eyebrows and scalp.
6. Enlarged cervical lymph nodes.
7. Rash on the body.
8. Severe itching at the site of the rash.
9. Pale and dry areas of skin without a rash.
10. An increase in the size and brightness of spots during exposure to low temperatures.

The rash can cover the limbs, abdomen and back, sometimes spreading to the face.

Diathesis can occur in the form of:

1. Erythematous-papular rash. In this case, nodules appear on the surface of the skin, surrounded by red spots.
2. Erythema-vesicular rash. In this case, the spots on the skin will be light in color, around which there is erythema.

If the reaction lasts a long time, the crusts acquire a light yellow or golden color. The yellowing is caused by the tubercle bacillus. The wet crust and the skin underneath create ideal conditions for its reproduction. Because of this phenomenon, the problem is also known as scrofula.

If children are sensitive to certain foods, red spots and stripes may form on the tongue.

Children with allergies often develop colds and inflammation in the mucous membranes of the eyes, mouth and nasal cavity.

Milk eschar is a common occurrence in infants. It has a wavy flow. The development of the disease consists of the stage:

1. Latent. In this case, the problem is asymptomatic and the first signs appear.
2. Manifest. It is characterized by the formation of all the symptoms of diathesis.
3. Remissions. The severity of clinical manifestations decreases, the allergic reaction subsides.
4. Relapse. If a child has consumed an allergen product, been treated with antibacterial drugs, or under the influence of other factors, the condition may worsen.

Diagnostic methods

Exudative-catarrhal diathesis in children is diagnosed after collecting anamnesis, examination, and identifying complaints.

The mother should keep a food diary, in which she must indicate all the foods the child consumed, and whether a rash appeared after a certain food or not.

If a child drank milk, ate porridge, eggs, berries and a rash appeared, this indicates diathesis.

Usually, to make a diagnosis, it is enough for a doctor to examine the child, but in some cases, stool, blood, and skin tests may be performed.

Treatment

Since allergic diathesis in infants can be caused by various factors, there are no specific treatment methods. With the help of therapeutic measures, unpleasant manifestations of the disease are eliminated and favorable conditions are created for the development of the baby.

To get rid of the problem you need to:

1. Monitor home hygiene. Every day it is important to carry out wet cleaning, ventilate rooms, change bed linen, and use only clean towels.
2. Organize your daily routine correctly.
3. Make a diet according to age.
4. Walk outdoors regularly.

If a milk scab appears in a baby, treatment is carried out:

1. Antihistamines and antiallergic drugs.
2. Calcium supplements.
3. If there is severe itching that prevents the baby from sleeping normally, he is prescribed sedatives.
4. Vitamin products containing ascorbic acid, rutin, B6 and others.
5. Herbal medicine. Decoctions of St. John's wort, nettle, and string are prescribed.
6. Hormonal agents in severe cases.
7. Vegetable oil. It is used to lubricate areas of gneiss, after which the skin is washed with warm water and soap.
8. Zinc and sulfur ointment and fish oil are used to treat rough skin and rashes.
9. Therapeutic baths. Infusions of viburnum, oak bark, and chamomile are added to warm water.
10. Antibacterial drugs if an infectious process is detected.
    Magnesium sulfate solution if the baby suffers from constipation.

Nutrition plays an important role in therapy. Doctors recommend feeding children according to a schedule, avoiding overfeeding, with fresh foods rich in vitamins and microelements.

If the problem occurs in an infant, complementary feeding should be introduced no earlier than seven months. Vegetable puree is suitable as the first food. Formula-fed babies should be fed hypoallergenic formulas: hydrolyzed or soy.

It is important to replace milk with biolact, acidophilus milk, and kefir.

You need to completely avoid highly allergenic foods such as citrus fruits, tomatoes, bananas, cocoa, and red berries.

If a child suffers from diathesis and is fed breast milk, it is recommended to extend the feeding period. In this case, a woman should avoid allergens.

The problem has a favorable prognosis. In most cases, children recover completely from it. But in a small percentage of children, a transition to a chronic form is possible.

To avoid the problem, prevention should be carried out during pregnancy. A woman must follow the rules of a balanced diet, especially if cases of diathesis occur among close relatives.

After the baby is born, it is important to feed him breast milk for as long as possible and introduce additional foods according to his age.

If you protect your baby from exposure to factors during the first year of life, the risk of developing the disease will be minimal.

A good option would be to keep a food diary. Thanks to this, you can notice a negative reaction to a certain product in time.

– a constitutional anomaly, characterized by a tendency to infiltrative-desquamative skin changes, lymphoproliferation, insufficient immune response and lability of water-salt metabolism. Children experience the appearance of various skin elements (erythema, gneiss, strophulus, etc.), the nature of which is pseudo-allergic. Also characterized by excess weight, high susceptibility to acute respiratory viral infections, frequent inflammation of the mucous membranes (conjunctivitis, rhinitis, blepharitis). Diagnosis is based on a carefully collected history, clinical manifestations and test results. The treatment is complex, including desensitizing agents, zinc ointments and other drugs, and a large role is given to non-drug therapy.

General information

Exudative-catarrhal diathesis is not a disease, but a genetic predisposition to abnormal reactions to the usual environment, in particular food. To varying degrees, symptoms are observed in 40-60% of children. In recent years, there has been a significant increase in the number of cases of diathesis. Experts believe that this is largely due to cumulative prevalence, but changes in dietary culture compared to previous generations also play a role. Therefore, exudative-catarrhal diathesis continues to be a relevant topic for research in pediatrics. In addition, diathesis can mutate into eczema and bronchial asthma - chronic diseases that require constant monitoring and treatment.

Causes of exudative-catarrhal diathesis

Predisposing factors are pregnancy pathologies: toxicosis and gestosis, fetal hypoxia and toxic effects (taking antibiotics, etc.). Exudative-catarrhal diathesis is more likely to develop in mothers with a family history of allergic reactions and diseases, as well as cases of this constitutional anomaly in previous generations or in other children. Thus, a hereditary predisposition has been proven. Errors in the mother's diet during pregnancy play a certain role - consuming large amounts of sweet foods, chocolate, eggs and other allergenic foods.

An irrational diet of a child also increases the risk of developing exudative-catarrhal diathesis. This may be overfeeding, early introduction of complementary foods, insufficient natural feeding or irrational use of artificial formulas. Frequently ill children are more at risk of developing diathesis. Another predisposing factor is intestinal dysbiosis in children. The pathogenesis of exudative-catarrhal diathesis comes down to an atypical reaction of the body to its usual stimuli, while the type of reaction is also pathological, that is, there are disturbances in the components of the immune response.

Symptoms of exudative-catarrhal diathesis

Pathology usually develops in children 3-6 months old. In the premorbid period, attention is drawn to the child’s above-average weight and significant weight gain over the months. Such children look pale and pasty. One of the first symptoms of exudative-catarrhal diathesis is gneiss - seborrhea of ​​the scalp in children under one year of age. Diaper rash often forms in natural folds if care rules are followed. Various skin rashes are noted. In the youngest patients, erythema and redness of the skin of the cheeks is usually observed, followed by peeling ("milk eschar"), in older children - an itchy, finely nodular rash (strophulus).

Exudative-catarrhal diathesis is characterized by lability of water-salt metabolism. On the one hand, fluid is retained in the body, on the other hand, severe dehydration is possible in a short time. The cause of dehydration may be stool disorders, which are often found with this constitutional anomaly. Lymphoproliferative syndrome also occurs in the clinical picture. It is usually diagnosed in children older than one year and is manifested by enlarged lymph nodes, sometimes by hepatomegaly. Characterized by frequent and prolonged acute respiratory viral infections and the addition of bacterial complications. In addition, there is frequent infection of skin rashes due to scratching.

Exudative-catarrhal diathesis in children older than one year is manifested by conjunctivitis and blepharitis, which are difficult to treat. There is an enlargement of the tonsils and the formation of adenoids. There are also characteristic changes in the blood, in particular hypoproteinemia and dyslipidemia. It is worth noting that all of these symptoms occur in waves. They can be provoked by dietary disturbances, stressful situations, and concurrent diseases. Manifestations of exudative-catarrhal diathesis usually disappear by 2-3 years, but cases of development of bronchial asthma, eczema, etc. are possible.

Diagnosis and treatment of exudative-catarrhal diathesis

Diathesis can be suspected based on family history if the mother or other relatives also had manifestations of constitutional anomalies in childhood or currently have allergic diseases. The pediatrician must pay attention to the course of pregnancy, the mother’s diet, and the presence of any chronic diseases, for example, diabetes mellitus. Exudative-catarrhal diathesis often develops in children with a certain appearance; its features were discussed above. The diagnosis is confirmed based on the clinical picture. A biochemical blood test indicates impaired carbohydrate and fat metabolism, metabolic acidosis and an increase in IgE concentration.

The main role in therapy is played by adherence to a rational diet. This also applies to the mother, since one of the recommendations is breastfeeding, since breast milk is less allergenic than any of the artificial formulas. Milk, eggs, chocolate, fish and other highly allergenic foods are excluded from the diet, and easily digestible carbohydrates are limited. A later introduction of complementary foods for the child is indicated, with the first complementary foods being vegetables, not porridge. If the child is bottle-fed, hypoallergenic formulas (soy and hydrolyzed) are recommended.

The next important element of therapy is the regimen. Frequent exposure to fresh air softens the symptoms of exudative-catarrhal diathesis. Medicinal baths with herbs that have a calming effect (chamomile, string) are indicated. Local therapy also includes careful care of pathological skin elements (rash, erythema, diaper rash). As a rule, zinc ointments are prescribed. It is possible to use creams and ointments containing steroid hormones; such therapy is carried out in courses of 7-10 days to avoid addiction and the development of side effects. The therapy uses systemic desensitizing drugs, and, if indicated, antihistamines.

Forecast and prevention of exudative-catarrhal diathesis

The prognosis is favorable. More often, a complete cure is observed; transition to chronic allergic diseases occurs in 15-25% of cases. Primary prevention is carried out antenatally and consists of a rational diet of the mother during pregnancy, especially if there is a genetic predisposition. After the birth of a child (secondary prevention), a special role is given to the longest natural feeding and rational introduction of complementary foods. Excluding provoking factors in a child of the first year of life often reduces the risk of developing exudative-catarrhal diathesis to a minimum. Keeping a food diary helps, which allows you to promptly suspect an atypical reaction to certain foods.

Exudative-catarrhal diathesis (a type atopic dermatitis) occurs in children, less often in adults.

This is a disease has an allergic nature, it occurs due to individual intolerance to certain foods.

People often call it scrofula. Atopic dermatitis is caused by very small doses of allergenic substances, exudative diathesis is caused by large doses.

Exudative-catarrhal diathesis in children and adults: causes of occurrence

Allergic reactions to food occur in people of any age, but children suffer from hypersensitive reactions of the body much more often. In babies under one year of age, the causes of food allergies are physiological characteristics of the body:

• The infant's intestinal barrier functions are reduced. Some food components penetrate directly into the blood through the intestinal walls. They act as toxins in the body, are released through the skin and cause allergic skin reactions.
• The enzymatic systems of young children are imperfect. Poor digestion of food is the cause of diathesis.
• The tissues of a child’s body are highly sensitive to histamine. This organic compound is produced by the body itself and comes with certain foods.

By the age of one year, the baby’s physiology improves, the body’s systems gradually begin to function in the same way as in adults, and the diathesis goes away. Some babies have food allergies that persist. up to 3-5 years.

Reference. Doctors call childhood exudative-catarrhal diathesis pseudoallergy, since intolerance to a number of products is associated with the physiological characteristics of the child.

Development of allergic hypersensitivity contribute:

• hypoxia suffered by the child during childbirth;
• intestinal dysbiosis;
• early complementary feeding (at age up to 6 months);
• incorrect selection of products for children;
• the presence in the diet of a nursing mother of foods that cause allergies in the child.

Children are prone to allergies if the future mother didn't eat properly According to the test results, the woman had a loss of protein in her urine. The development of hypersensitive reactions is facilitated by complications of pregnancy, manifested by severe swelling, cramps, and high blood pressure in a pregnant woman.

The cause of exudative-catarrhal diathesis is family history. Diathesis occurs in children whose blood relatives themselves suffered from this disease in childhood. Parents of such children are often diagnosed with allergies, which require treatment. A fairly large percentage of parents are overweight and obese.

Could tuberculosis infection be the cause?

Atypical forms of cutaneous tuberculosis manifest themselves as nonspecific dermatoses that have all the symptoms of exudative diathesis.

Therefore, early diagnosis of tuberculosis and comprehensive treatment at an early stage of the disease are of great importance.

Tuberculosis weakens the immune system and changes the course of many reactions in the body, which is manifested by characteristic clinical signs.

In particular, exudative-catarrhal diathesis may indicate both progressive and active forms of tuberculosis.

Differences between exudative-catarrhal diathesis caused by tuberculosis and diathesis caused by other reasons

According to the manifestation of the clinical picture and the reasons that caused the hypersensitive reaction, they distinguish three types of diathesis. These are allergic (exudative, exudative-catarrhal) diathesis, neuro-arthritic and lymphatic-hypoplastic diathesis.

Symptoms of exudative-catarrhal diathesis

An allergic reaction to food manifests itself in different ways, depending on the individual characteristics of the body. With exudative-catarrhal diathesis observed:

• diaper rash in the cervical folds, in the groin, under the armpits, behind the ears, less often - in the popliteal areas and in the elbow bends;
• education wet crusts behind the ears, wet diaper rash;
• red, hard, scaly spots on cheeks(milk scab);
• red, often flaky, spots on other parts of the body(on the buttocks, chest, back, thighs, calves);
• gneiss formation(large scales of oily dandruff) on the crown of the head, along the hairline, on the eyebrows;
• moderate swollen lymph nodes on the neck;
• rash on the body(scrofula);
• severe itching in places where the rash is localized, under weeping crusts;
• skin unaffected by blemishes and diaper rash, pale, dry;
• spots on exposed areas of the body from exposure to cold and wind become brighter And increase in size.

The rash is located mainly on the stomach, back, legs and arms, but can spread to the face and neck. Distinguish two types of allergic rash:

• erythematous-papular rash, which is characterized by the formation of papules (nodules), around which erythema (red spot) is localized;
• erythema-vesicular rash (light dotted spots surrounded by erythema).

Photo 1. Erythema-vesicular rash on a man’s hand.

If an allergic reaction occurs over several days, crusts behind the ears, gneiss on the head, sometimes become light yellow, golden. Gives a yellow color tubercle stick, for which wet crusts and the skin underneath them provide a good breeding ground. Because of the yellowish crusts, allergic diathesis is popularly called scrofula.

With food allergies, characteristic light and reddish spots and stripes on the tongue are sometimes observed ( geographic language). Children with a hypersensitive reaction to food often suffer from colds, inflammatory diseases of the eyes, mucous membranes of the mouth and nose. They have constipation, which alternates with normal bowel movements and diarrhea.

Reference. Various manifestations of exudative-catarrhal diathesis are observed in 40-45% of children under the age of one year.

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Symptoms of neuro-arthritic diathesis

This disease occurs in children and adults. In young children, the symptoms are mild, so the disease is not diagnosed immediately. A complete clinical picture is formed at age seven or later. The causes of the disease are not reliably clear; its manifestation is greatly influenced by hereditary predisposition, abnormal metabolism, overeating or undereating, poor diet, and stressful situations. With this form of diathesis observed:

• uric acid metabolism disorder;
• high levels of ammonia in the body;
• allergic skin reactions (rash, itching).

Children suffering from neuro-arthritic diathesis have increased excitability. They are capricious and prone to causeless mood swings. Children experience nervous tics, causeless fluctuations in body temperature, abdominal pain, migraines, painful thinness, and sudden weakness. Many schoolchildren suffer from anorexia, they vomit after eating, and their breath constantly smells of acetone. Adults, on the contrary, gain excess weight and suffer from female obesity, in which excess fat tissue accumulates on the hips and buttocks.

Symptoms of lymphatic-hypoplastic diathesis

Externally, this form of diathesis manifests itself overweight, lack of mobility, blood circulation disorders, enlarged adenoids and tonsils. Patients often experience vomiting, muscle cramps, fever, and often have colds and inflammatory diseases. Lymph nodes with lymphatic-hypoplastic diathesis are enlarged. Cause of the disease- insufficient functioning of the thymus gland, which causes adrenal dysfunction.

External differences between tuberculous diathesis and other forms of diathesis, photo

With non-progressive tuberculosis, a complex of symptoms often appears, which is called scrofula. With scrofulosis the following are observed:

• decreased immunity;
• tendency to exudative-catarrhal diathesis;
• tendency to other allergic hypersensitive reactions on the skin and mucous membranes;
• tendency to colds and inflammatory diseases.

The course of exudative-catarrhal diathesis in tuberculosis has a number of features. Diathesis is progressing hard, doesn't disappear for a long time after identifying and eliminating the allergen. Allergic reactions (atopic dermatitis) occur due to small doses of the allergen.

Important! If exudative diathesis is long and severe, the doctor will suspect tuberculosis and refer the patient to see phthisiatrician. The patient is tested for tuberculosis, syphilis, fungal infections and diphtheria, since a number of symptoms of these diseases are similar to the symptoms of exudative-catarrhal diathesis.

Tuberculous diathesis, in addition to hypersensitive reactions on the skin and mucous membranes, is accompanied by other characteristic symptoms. In sick children observed:

• unhealthy fullness (pasty appearance);
• chronic, intractable runny nose;
• spots on the face (around the nose, ears, mouth, eyes) similar to eczema;
• swelling of the lips (the swelling of the upper lip is especially noticeable);
• nodular inflammation of the conjunctiva and cornea (phlyctenular conjunctivitis);
• photophobia;
• blepharospasms (involuntary contractions of the muscles around the eye);
• significant enlargement of the lymph nodes under the jaw and in the neck.

Attention! All forms of skin tuberculosis (ulcerative, warty, papulonecrotic tuberculosis, rosacea-like, lichenoid tuberculosis, tuberculous lupus, scrofuloderma, other skin manifestations of this disease) can be mistakenly taken for exudative-catarrhal diathesis.

Scrofuloderma (or tuberculous scrofula) occurs more often in adolescents and children. Deep under the skin, on the neck and chest, they form groups of dense nodules. The nodes enlarge, merge, begin to rise above the skin and become fused with it. The skin becomes burgundy, bluish-red, thin and breaks through with the formation of fistulas. A purulent white mass is released from the fistulas. In the process of treating tuberculosis with medications, scrofuloderma scars and disappears, but large areas with uneven, bumpy scars and adhesions remain on the body.

Photo 2. Enlarged cervical lymph nodes in a child with tuberculosis.

Treatment methods for tuberculous diathesis

If the cause of skin lesions is tuberculosis, the patient receives comprehensive treatment in the hospital. The goal of treatment is to suppress tuberculosis infection. When tuberculosis of internal organs is cured, the skin forms of the disease disappear.

Anti-tuberculosis drugs are prescribed for oral administration and injection: Isoniazid, Pyrazinamide, Phthivazid, Rifampicid, Ethionamide, Biormitsin, Streptomycin, other antibiotics. The course of treatment is long, it reaches up to six months. The drugs act on foci of infection in the lungs, bones, joints, lymph nodes, and on the skin of a sick person. They destroy Koch's bacillus and other infections.

The patient is advised to take drugs that restore immunity, drugs that have antioxidant properties. During treatment are prescribed antiallergic(antihistamines) drugs, drugs that improve blood microcirculation.

The patient needs vitamins: ascorbic acid, pyridoxine, thiamine, riboflavin and other B vitamins, vitamin D (this drug is contraindicated for tuberculous lesions in the lungs). Vitamins contribute to the normal course of metabolic processes; they are important for the normal functioning of all body systems.

One of the effective methods of treating nonspecific dermatitis and skin tuberculosis is exposure of skin to sunlight or rays of a quartz-mercury lamp(ultraviolet light). For tuberculous scrofula (scrofuloderma), irradiation is possible x-rays.

Diet- an important part of treatment. The diet of patients includes many easily digestible animal proteins, fats, milk, and other high-calorie foods ( therapeutic diet No. 11). Products that contribute to skin allergic reactions are excluded from the menu. When treating tuberculous scrofula, a diet with minimal salt content is prescribed.

Can exudative diathesis appear in adults?

Exudative-catarrhal diathesis can appear in adults if they have a tendency to allergic reactions to certain types of food, cosmetic ingredients, medications, household and industrial chemicals.

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