Atopic dermatitis - symptoms, causes and treatment of atopic dermatitis. Atopic dermatitis is now curable! Get rid of it with ALT! Atopic dermatitis is a chronic disease

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

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

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

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

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

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

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

Main signs of the disease

Symptoms of atopic dermatitis in infants:

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

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

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

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

Clinical picture and diagnosis of the disease

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

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

Mild form of atopic dermatitis in a child

Moderate atopic dermatitis with secondary infected wounds from scratching

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

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

Therapy for allergic disease

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

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

Diet for atopic dermatitis in children

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

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

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

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

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

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

Sample menu for this disease:

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

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

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

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

Environmental control

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

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

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

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

Necessary emollients

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

Here is a list of the most popular means:

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

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

Systemic pharmaceutical treatment

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

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

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

Treatment with folk remedies and physiotherapy

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

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

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

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

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

The concept of “atopy” as a predisposition of newborns to allergic diseases, transmitted hereditarily, was proposed in 1923 by American scientists A. Coca and R. Cooke.

This common allergic skin lesion, characterized by an inflammatory process, is atopic dermatitis . Over 12% of the population suffers from this non-contagious disease.

ICD-10

In the international classification, atopic dermatitis is defined as a skin disease of a chronic nature. He was assigned a code according to ICD-10 - L 20. The development of pathology is due to the special sensitivity of the body in response to certain irritating factors.

Atopic dermatitis (neurodermatitis) in adults (photo)

Causes

The disease is mainly caused by heredity.

Problems that activate the process of exacerbation of the disease

The course of the disease is recurrent, alternating with stages of remission. The following factors especially aggravate it:

• environmental and climatic anomalies;
• unbalanced diet;
• expansion of the range of allergic reagents;
• nervous overload;
• immune disorders;
• early feeding of infants.

Dermatitis worsens as a result of a reaction to allergens and irritants.

Symptoms

The main signs appear on the surface of the skin.

• irritation;
• severe itching;
• dryness.

When scratching, a secondary infection (viral or bacterial) develops.

Most common symptoms:

Secondary symptoms are physical, psychological, domestic, cosmetic, emotional discomfort and complexes.

Periods of the disease

Dermatitis occurs especially often in older infants (from 2-4 months to 1 year). Before the age of 5 years, dermatitis occurs, but less frequently.

Atopic dermatitis in children

The early development of the disease is explained by the predisposition of infants to allergic diseases.

Atopic dermatitis in children: photo

Prerequisites for early dermatitis:

• poor nutrition and lifestyle of the mother during pregnancy;
• the child’s immature immune system.

The disease often resolves by age 4, but occurs in adolescents and adults. Before the age of 5 years, 90% of the manifestations of the disease are recorded.

Atopic dermatitis in adults

Symptoms tend to subside with age. However, the disease may manifest itself and even occur for the first time in adolescents and adults. By the age of 15-17 years, the disease recedes on its own in 70% of cases. Only 30% flows into the adult form.

Clinical indicators in different phases:

The disease progresses differently, depending on the phase, cause, and other diseases.

Seasonal exacerbations occur in spring and autumn. Stages according to the nature of the course: acute, chronic.

Acute stage

Spots, papules, skin peeling, crusts and erosions. As the infection develops, pustular formations are observed.

Chronic stage

Thickening of the skin with a bright pattern, scratching, cracks, changes in pigmentation of the eyelids.

Diffuse neurodermatitis- one of the forms of dermatitis. It is also manifested by itching and rashes of an allergic nature. A secondary factor is disruptions in the functioning of the nervous system, aggravated by stressful situations.

Diagnostics

Activities to recognize the disease are carried out by specialists: dermatologist, allergist:

• monitoring the clinical picture;
• allergy tests;
• urine and stool tests.

Diagnostic studies use family history analysis. If necessary, the knowledge of other specialists is used: neuropsychiatrist, endocrinologist, otolaryngologist.

Treatment

Since symptoms differ between children and adults, treatment also differs. The process is quite complicated. The basis is diet, drug therapy, specific hyposensitization (reduction of general sensitivity to the allergen).

Main objectives of treatment

• elimination of the allergic factor;
• relieving inflammation and itching;
• cleansing the body of toxic substances;
• prevention of complications and relapses.

When treating, age, the presence of concomitant pathologies, and clinical severity are taken into account.

Treatment methods

Treatment methods are selected by the attending physician in combination. Most common:

• drug therapy;
• use of laser;
• photochemotherapy (PUVA);
• blood purification (plasmapheresis);
• measures to reduce susceptibility to the allergen (hyposensitization);
• exposure to needles (acupuncture);
• diet.

Diet therapy

It is designed to regulate nutrition, which helps improve the condition and helps prevent exacerbation. Firstly, food allergens are completely excluded. Milk and eggs are not recommended, even if tolerated.

At hypoallergenic diet completely excluded:

• fried meat and fish;
• vegetables, mushrooms;
• honey, chocolate;
• melon, citrus fruits;
• strawberries, black currants;
• canned food, spices, smoked meats.

Particularly important diet for atopic dermatitis in children . The following dishes should prevail on the menu:

Drug therapy

Includes different groups of drugs:

Local treatment

It takes into account the nature and prevalence of the pathology, age characteristics, complications, and other factors.

Effect of drugs : anti-inflammatory, decongestant, drying, antipruritic, disinfectant.

Forms : lotion, ointment, paste, cream.

Representatives : Losterine, Prednisolone, Flumethasone.

The use of emollients for atopic dermatitis in children

These are substances that soften and moisturize the skin, protecting it from irritants. Particularly effective in early childhood after bathing.

They are produced on the basis of hypoallergenic ingredients without the presence of harmful chemical compounds.

List of funds:

• A-Derma;
• Bioderma Atoderm;
• Topicrem;
• Oillan;
• Physiogel intensive;
• Dardia.

The use of emollients helps fight dryness, inflammation, and skin damage during manifestations of atopic dermatitis.

Atopic dermatitis on the face of a child (photo)

Conducted extensive research on the question of how to treat atopic dermatitis in children. Dr. Komarovsky . Among the important reasons, he highlights the child’s overeating, his intake of food in larger quantities than he is able to digest.

For pathologies in children, Komarovsky suggests treating in three directions:

1. Minimizing the entry of harmful substances from the intestines into the blood. Fighting constipation, dysbacteriosis, increasing meal times, reducing the concentration of infant formula, using activated charcoal, dosing sweets. The main thing is not to overeat.
2. Avoid skin contact with irritating factors. Boiling water before bathing, using children's washing powders, natural fabrics, bathing with soap no more than 2 times a week, taking care of the quality of toys.
3. Creating conditions to reduce children's sweating. Maintain temperature and humidity conditions, do not wrap yourself up excessively, and drink enough liquid.

Treatment with folk remedies

People practice decoctions for oral administration, means for local treatment, baths with special agents, and compresses.

Some folk recipes:

Also popular among people baths: coniferous, with chamomile and string, calendula, mint and other medicinal plants. It is practiced to add soda or starch to combat dryness.It is recommended to wash the skin on the face and other parts of the body daily in the morning with a 1:10 solution of vinegar and water.

Many folk remedies reduce symptoms and treatment becomes more effective.

Complications

They arise due to injury to the skin by scratching. Because of this, its protective properties are reduced, resulting in infections.

Types of complications

Helps avoid complications preventive measures.

Prevention
Starts before the baby is born.

Primary – prevention of dermatitis

Natural feeding, limiting medications, and following a diet are necessary.

Secondary – prevention of relapses, exacerbations

• exclusion of causes and provoking factors;
• compliance with the prescribed diet;
• taking preventive medications;
• skin hygiene.

Hygiene features

• do not wash with a washcloth every day;
• use hypoallergenic soap;
• prefer a warm shower to a hot one;
• blot with a towel rather than rub;
• moisturize the skin with special products;
• use clothes made from natural materials.

Complete recovery is considered to be the absence of symptoms for 3 to 7 years. The interval between the stages of exacerbations lasts from a month to several years.

If left untreated, there is a risk of developing bronchial asthma. It is necessary to carry out treatment under the supervision of a specialist.

Competent prevention and lifestyle protect against relapses. It is important to be attentive to your own body, follow a diet, and take care of the condition of your skin.

Video

is a chronic, non-contagious inflammatory skin lesion that occurs with periods of exacerbations and remissions. It manifests itself as dryness, increased skin irritation and severe itching. It causes physical and psychological discomfort, reduces the patient’s quality of life at home, family and work, and externally presents cosmetic defects. Continuous scratching of the skin leads to secondary infection. Diagnosis of atopic dermatitis is carried out by an allergist and dermatologist. Treatment is based on diet, general and local drug therapy, specific hyposensitization and physiotherapy.

General information

Atopic dermatitis is the most common dermatosis (skin disease), developing in early childhood and maintaining certain manifestations throughout life. Currently, the term “atopic dermatitis” refers to a hereditary, non-contagious, allergic skin disease of chronic relapsing course. The disease is the subject of supervision of specialists in the field of outpatient dermatology and allergology.

Synonyms for atopic dermatitis, also found in the literature, are the concepts of “atopic” or “constitutional eczema”, “exudative-catarrhal diathesis”, “neurodermatitis”, etc. The concept of “atopy”, first proposed by American researchers A. Coca and R. Cooke in 1923, implies a hereditary tendency to allergic manifestations in response to a particular irritant. In 1933, Wiese and Sulzberg coined the term “atopic dermatitis,” which is now generally accepted, to refer to hereditary allergic skin reactions.

Causes

The hereditary nature of atopic dermatitis determines the widespread prevalence of the disease among related family members. The presence of atopic hypersensitivity (allergic rhinitis, dermatitis, bronchial asthma, etc.) in parents or immediate relatives determines the likelihood of atopic dermatitis in children in 50% of cases. A history of atopic dermatitis in both parents increases the risk of transmitting the disease to the child by up to 80%. The vast majority of initial manifestations of atopic dermatitis occur in the first five years of life (90%) of children, of which 60% occur during infancy.

As the child continues to grow and develop, the symptoms of the disease may not bother or weaken, however, most people live with a diagnosis of atopic dermatitis all their lives. Atopic dermatitis is often accompanied by the development of bronchial asthma or allergies.

The widespread spread of the disease throughout the world is associated with problems common to most people: unfavorable environmental and climatic factors, dietary errors, neuropsychic overload, an increase in infectious diseases and the number of allergic agents. A certain role in the development of atopic dermatitis is played by disorders in the immune system of children, caused by a shortening of breastfeeding, early transfer to artificial feeding, maternal toxicosis during pregnancy, and poor nutrition of women during pregnancy and lactation.

Symptoms of atopic dermatitis

The initial signs of atopic dermatitis are usually observed in the first six months of life. This can be triggered by the introduction of complementary foods or transfer to artificial mixtures. By the age of 14-17, in almost 70% of people the disease goes away on its own, and in the remaining 30% it develops into an adult form. The disease can last for many years, worsening in the autumn-spring period and subsiding in the summer.

According to the nature of the course, acute and chronic stages of atopic dermatitis are distinguished.

The acute stage is manifested by red spots (erythema), nodular rashes (papules), peeling and swelling of the skin, the formation of areas of erosion, weeping and crusts. The addition of a secondary infection leads to the development of pustular lesions.

The chronic stage of atopic dermatitis is characterized by thickening of the skin (lichenification), pronounced skin patterns, cracks on the soles and palms, scratching, and increased pigmentation of the skin of the eyelids. In the chronic stage, symptoms typical of atopic dermatitis develop:

• Morgan's sign - multiple deep wrinkles in children on the lower eyelids
• Symptom of “fur hat” - weakening and thinning of hair on the back of the head
• Symptom of “polished nails” - shiny nails with worn edges due to constant scratching of the skin
• The symptom of “winter foot” is puffiness and hyperemia of the soles, cracks, peeling.

There are several phases in the development of atopic dermatitis: infant (first 1.5 years of life), childhood (from 1.5 years to puberty) and adult. Depending on the age dynamics, features of clinical symptoms and localization of skin manifestations are noted, however, the leading symptoms in all phases remain severe, constant or periodically occurring skin itching.

The infant and childhood phases of atopic dermatitis are characterized by the appearance on the skin of the face, limbs, and buttocks of areas of bright pink erythema, against which bubbles (vesicles) and areas of weeping appear, followed by the formation of crusts and scales.

In the adult phase, foci of erythema are pale pink in color with a pronounced skin pattern and papular rashes. They are localized mainly in the elbow and popliteal folds, on the face and neck. The skin is dry, rough, with cracks and areas of peeling.

In atopic dermatitis, focal, widespread or universal skin lesions occur. Areas of typical localization of rashes are the face (forehead, area around the mouth, near the eyes), skin of the neck, chest, back, flexor surfaces of the limbs, inguinal folds, buttocks. Plants, house dust, animal hair, mold, and dry fish food can aggravate the course of atopic dermatitis. Often atopic dermatitis is complicated by a viral, fungal or pyococcal infection, and is a background for the development of bronchial asthma, hay fever and other allergic diseases.

Complications

The main reason for the development of complications in atopic dermatitis is constant trauma to the skin as a result of scratching. Violation of the integrity of the skin leads to a decrease in its protective properties and contributes to the addition of a microbial or fungal infection.

The most common complication of atopic dermatitis is bacterial skin infections - pyoderma. They manifest themselves as pustular rashes on the body, limbs, and scalp, which dry out and form crusts. At the same time, general well-being often suffers, and body temperature rises.

The second most common complication of atopic dermatitis is viral skin infections. Their course is characterized by the formation of bubbles (vesicles) filled with clear liquid on the skin. The causative agent of viral skin infections is the herpes simplex virus. The face (skin around the lips, nose, ears, eyelids, cheeks), mucous membranes (conjunctiva of the eyes, oral cavity, throat, genitals) are most often affected.

Complications of atopic dermatitis are often fungal infections caused by yeast-like fungi. The affected areas in adults are often skin folds, nails, hands, feet, and scalp; in children, the oral mucosa (thrush). Often fungal and bacterial infections are observed together.

Treatment of atopic dermatitis

Treatment of atopic dermatitis is carried out taking into account the age phase, severity of the clinical picture, concomitant diseases and is aimed at:

• exclusion of allergic factor
• desensitization (reduced sensitivity to allergen) of the body
• itching relief
• detoxification (cleansing) of the body
• removal of inflammatory processes
• correction of identified concomitant pathology
• prevention of relapses of atopic dermatitis
• combating complications (if an infection occurs)

Various methods and medications are used to treat atopic dermatitis: diet therapy, PUVA therapy, acupuncture, specific hyposensitization, laser treatment, corticosteroids, allergoglobulin, cytostatics, sodium cromoglycate, etc.

Diet therapy

Regulating nutrition and following a diet can significantly improve the condition and prevent frequent and severe exacerbations of atopic dermatitis. During periods of exacerbation of atopic dermatitis, a hypoallergenic diet is prescribed. At the same time, fried fish, meat, vegetables, rich fish and meat broths, cocoa, chocolate, citrus fruits, black currants, strawberries, melon, honey, nuts, caviar, and mushrooms are removed from the diet. Products containing dyes and preservatives are also completely excluded: smoked meats, spices, canned food and other products. For atopic dermatitis, a hypochloride diet is indicated - limiting the amount of table salt consumed (however, not less than 3 g of NaCl per day).

In patients with atopic dermatitis, there is a violation of the synthesis of fatty acids, so diet therapy should include food supplements saturated with fatty acids: vegetable oils (olive, sunflower, soybean, corn, etc.), linoleic and linolenic acids (vitamin F-99).

Drug treatment

A significant disadvantage of first-generation antihistamines (mebhydrolin, clemastine, chloropyramine, hifenadine) is the rapidly developing addiction of the body. Therefore, these medications must be changed every week. The pronounced sedative effect, leading to a decrease in concentration and impaired coordination of movements, does not allow the use of first-generation drugs in the pharmacotherapy of people of certain professions (drivers, students, etc.). Due to the atropine-like side effects, a number of diseases are contraindications to the use of these drugs: glaucoma, bronchial asthma, prostate adenoma.

The use of second-generation antihistamines (loratadine, ebastine, astemizole, fexofenadine, cetirizine) is much safer in the treatment of atopic dermatitis in people with concomitant pathologies. They do not become addictive, and there are no atropine-like side effects. The most effective and safest antihistamine used to date in the treatment of atopic dermatitis is loratadine. It is well tolerated by patients and is most often used in dermatological practice for the treatment of atopy.

To alleviate the condition of patients with severe attacks of itching, drugs affecting the autonomic and central nervous systems (hypnotics, sedatives, tranquilizers) are prescribed. The use of corticosteroid drugs (methylprednisolone or triamcinolone) is indicated for limited and widespread skin lesions, as well as for severe, unbearable itching that is not relieved by other medications. Corticosteroids are prescribed for several days to relieve an acute attack and are discontinued with a gradual reduction in dose.

In severe cases of atopic dermatitis and severe symptoms of intoxication, intravenous infusion of infusion solutions is used: dextran, salts, saline, etc. In some cases, it is advisable to carry out hemosorption or plasmapheresis - methods of extracorporeal blood purification. With the development of purulent complications of atopic dermatitis, the use of broad-spectrum antibiotics in age-specific dosages is justified: erythromycin, doxycycline, metacycline for 7 days. When a herpes infection occurs, antiviral drugs are prescribed - acyclovir or famciclovir.

In case of recurrent complications (bacterial, viral, fungal infections), immunomodulators are prescribed: solusulfone, thymus preparations, sodium nucleinate, levamisole, inosine pranobex, etc. under the control of blood immunoglobulins.

External treatment

The choice of external therapy method depends on the nature of the inflammatory process, its prevalence, the age of the patient and the presence of complications. For acute manifestations of atopic dermatitis with weeping surfaces and crusts, disinfectant, drying and anti-inflammatory lotions (infusion of tea, chamomile, Burov's liquid) are prescribed. When stopping an acute inflammatory process, pastes and ointments with antipruritic and anti-inflammatory components are used (ichthyol 2-5%, tar 1-2%, naftalan oil 2-10%, sulfur, etc.). The leading drugs for external therapy of atopic dermatitis remain corticosteroid ointments and creams. They have antihistamine, anti-inflammatory, antipruritic and decongestant effects.

Light treatment of atopic dermatitis is an auxiliary method and is used when the disease is persistent. Ultraviolet irradiation procedures are carried out 3-4 times a week and practically do not cause adverse reactions (except for erythema).

Prevention

There are two types of prevention of atopic dermatitis: primary, aimed at preventing its occurrence, and secondary, anti-relapse prevention. Measures for the primary prevention of atopic dermatitis should begin during the period of intrauterine development of the child, long before his birth. A special role during this period is played by toxicosis of the pregnant woman, taking medications, and occupational and food allergens.

Particular attention to the prevention of atopic dermatitis should be paid in the first year of a child’s life. During this period, it is important to avoid excessive medication and artificial feeding, so as not to create a favorable background for the body’s hypersensitivity to various allergic agents. Following a diet during this period is no less important for a nursing woman.

Secondary prevention aims to prevent exacerbations of atopic dermatitis, and, if they occur, to facilitate their course. Secondary prevention of atopic dermatitis includes correction of identified chronic diseases, exclusion of exposure to disease-provoking factors (biological, chemical, physical, mental), adherence to hypoallergenic and elimination diets, etc. Prophylactic use of desensitizing drugs (ketotifen, sodium cromoglycate) during periods of probable exacerbations (autumn, spring) allows you to avoid relapses. As anti-relapse measures for atopic dermatitis, treatment is indicated in the resorts of the Crimea, the Black Sea coast of the Caucasus and the Mediterranean.

Particular attention should be paid to daily skin care and the correct choice of underwear and clothing. When taking a daily shower, do not wash with hot water and a washcloth. It is advisable to use gentle hypoallergenic soaps (Dial, Dove, baby soap) and a warm shower, and then gently pat the skin with a soft towel without rubbing or injuring it. The skin should be constantly moisturized, nourished and protected from adverse factors (sun, wind, frost). Skin care products should be neutral and free of fragrances and dyes. In linen and clothing, preference should be given to soft natural fabrics that do not cause itching and irritation, and also use bedding with hypoallergenic fillings.

Forecast

Children suffer the most severe manifestations of atopic dermatitis; with age, the frequency of exacerbations, their duration and severity become less pronounced. Almost half of patients recover by the age of 13-14 years. Clinical recovery is considered a condition in which there are no symptoms of atopic dermatitis for 3–7 years.

Periods of remission in atopic dermatitis are accompanied by subsidence or disappearance of symptoms of the disease. The time interval between two exacerbations can range from several weeks to months and even years. Severe cases of atopic dermatitis occur with virtually no clear intervals, constantly relapsing.

The progression of atopic dermatitis significantly increases the risk of developing bronchial asthma, respiratory allergies and other diseases. For atopics, an extremely important point is the choice of professional field of activity. They are not suitable for professions that involve contact with detergents, water, fats, oils, chemicals, dust, animals and other irritants.

Unfortunately, it is impossible to completely protect yourself from the influence of the environment, stress, illness, etc., which means that there will always be factors that aggravate atopic dermatitis. However, careful attention to your body, knowledge of the peculiarities of the course of the disease, timely and active prevention can significantly reduce the manifestations of the disease, extend periods of remission for many years and improve the quality of life. And under no circumstances should you try to treat atopic dermatitis on your own. This can cause complicated variants of the course of the disease and serious consequences. Treatment of atopic dermatitis should be carried out

Treatment of atopic dermatitis is not a matter of one day. First of all, you need to establish the cause of the rash and the type of allergy, only then proceed to complex treatment. To get rid of atopic dermatitis, it is necessary to follow a diet that eliminates all possible allergens, cleanse the body of toxins, take antihistamines and, in addition, local treatment in areas of redness or rash. Treatment can be supplemented with sedatives and spa therapy.

Diet for the treatment of atopic dermatitis

A one hundred percent method of curing atopic dermatitis simply does not exist in nature. The disease often has a genetic predisposition, and one of the treatment options is to eliminate the causative agent of the disease. In this case, these are allergens. How to identify them?

• When introducing the first complementary foods to a baby with allergies, it is important to adhere to the progressive principle, maintain an interval between taking new foods, and record all the consequences, as well as their absence, in the child’s food diary.
• Atopic dermatitis can appear at any age, often after suffering from complex diseases and using antibiotics, as well as when the immune system is weakened. In this case, the anti-allergenic diet should be supplemented with yoghurts with beneficial bacteria to restore intestinal balance; you should not give up vitamins, the main thing is to identify safe products.
• If atopic dermatitis manifests itself, you need to avoid products included in the list of potential allergens. The leading positions belong to citrus fruits, cow's milk, chicken eggs, seafood and peanuts. A more accurate forecast regarding individual intolerance to foods can be given by special blood tests or allergen scrapers.
• A baby may develop rashes and itching even during breastfeeding, provided that the mother abuses allergenic foods. In this case, the child’s mother should go on an anti-allergenic diet.

After the allergy symptoms disappear, you can gradually introduce prohibited foods, but in minimal doses and not every day.

Removing toxins from the body with atopic dermatitis

Skin manifestations are only the outer part of the problem. In atopic dermatitis, both the gastrointestinal tract and the liver are out of balance. The culprit is toxins that need to be removed from the body. Enterosorbents and complex purification preparations are used.

• Enterosorbents. These drugs not only remove toxins from the body, but also reduce the load on the kidneys, liver and other organs that are involved in the detoxification process. Synthetic sorbents – Enterosgel, Sorbolong. Sorbents of natural origin - activated carbon and its analogues (Sorbex, White Coal, Karbolen), silicon-based preparations (Smecta, Atoxil), based on medicinal plants (Polyphepan, Lacto Filtrum).
• Complex cleansing preparations. Only preparations of plant origin are used based on birch and tansy leaves, stigmas and columns of corn, fennel, immortelle, and burdock.

After a course of cleansing the body, it would not be a bad idea to drink probiotics and other drugs that improve intestinal microflora (Bifidumbacterin, Mezim, Laminolact).

Taking antihistamines

These drugs are directed against the product of the allergic reaction – histamine. There are 1st, 2nd and 3rd generation antihistamines. These medications cannot completely rid the patient of the disease; their task is to alleviate the symptoms and relieve discomfort.

• Old generation drugs ( Ketotifen, Chloropyramine, Clemastine) . They are inconvenient because they must be taken several times a day, they are addictive and affect general behavior, they often cause drowsiness and it is not recommended to use them while driving. The advantage is the price.
• New generation drugs(Suprastin, Loratidin, Erius, ) . Speed ​​of action, minimal dosage, minimal side effects - these are the advantages of this type of drug.

Allergy medication is an important step in the treatment of atopic dermatitis, but be careful when choosing a drug. Antihistamines can cause allergies if one of the components is selected incorrectly or is intolerant. In this case, it is necessary to replace the drug.

Is it possible to cure atopic dermatitis with ointments?

It is not possible to cure dermatitis with ointments alone. Even the most potent remedy will only relieve the rash or redness for a few days. If the allergic reaction in the body progresses, dermatitis may appear elsewhere.

When deciding how to cure atopic dermatitis in a child, you can start with proven folk methods.

• Lotions with a decoction of chamomile, string, sage, rubbing problem areas with astringents, such as a decoction of oak bark.
• Grinders on an oil (for moistening) or zinc (for drying) basis.
• Zinc based pastes.
• Nourishing ointments with lanolin and petroleum jelly.
• Creams and gels have a lighter structure.
• Absorbable patches for thickened areas of skin.

Means for local treatment can relieve inflammation (Advantan, medicinal decoctions, Burov's liquid), fight infections (Triderm, Baktobarn, Furacilin, Boric acid), dissolve seals on the skin (Ichthyol, Methyluracil ointment), relieve itching and burning (Menthol, Camphor , Menovazin).

Sedatives in the fight against atopic dermatitis

Skin rashes can also appear as a result of nervous stress and anxiety. In this case, sedatives (Persen, tincture of valerian, motherwort) and relaxing procedures (pearl baths, hydromassage) would be appropriate.

Spa therapy

The method is effective and extremely useful. For allergy sufferers with dermatous manifestations of the disease, dry sea air and bathing in salty water are recommended. One of the ideal options is the resorts of the Azov region.

Usually people think about this disease in the spring and autumn, during the off-season. But now it’s winter, not winter, and that’s why outbreaks of atopic dermatitis are right here. This disease has many names: constitutional eczema... But the essence is the same: a hereditary, immune-allergic disease. Is it possible to get rid of the disease forever and how?

Strange manifestations of atopic dermatitis

Atopic dermatitis (from the Greek "atopos" - strange, wonderful) is a truly strange phenomenon. Sometimes an exacerbation is preceded by severe stress, and immediately the neck and arms become covered with eczema - an itchy, weeping crust, which is not so easy to get rid of. In addition to the neck and elbow bends of the arms, favorite places for localization of itchy crusts are the skin around the eyes, mouth (cheilitis), in the area of ​​the earlobes, and popliteal fossae. The area of ​​skin damage can be completely local.

Where else does atopic dermatitis live?

But atopic dermatitis, as a rule, is not limited to one skin. Often, skin lesions are accompanied by a respiratory syndrome, reminiscent in its manifestations of attacks of bronchial asthma. Often such patients (in childhood) are unsuccessfully treated for adenoids. Until the sufferer gets an appointment with... an allergist-dermatologist. Such combined forms of the disease have recently become more and more common, which most experts attribute to the deteriorating environmental situation.

When the disease appears

As a rule, the disease manifests itself in early childhood, but can also appear in adulthood, either fading or reappearing. Anything can serve as an impetus for an exacerbation: puberty (in childhood), emotional overload (for the same children, outbreaks of atopic dermatitis often coincide with the first entry into kindergarten and school). As well as taking antibiotics, eating disorders, etc. The disease is often seasonal. Spring and autumn for atopics are the most difficult time, which many experts associate with weather changes (autumn) and the flowering period of pollen-bearing plants (spring). Well, now that we have winter - not winter, but something like March, don’t be surprised if the disease manifests itself “in all its glory”

Atopic dermatitis is a multifactorial disease

However, despite the similarity of development mechanisms, atopic dermatitis is not a purely allergic disease, as it might seem at first glance. This disease is multifactorial. Atopic dermatitis may be based on hereditary weakness of the endocrine, nervous and/or immune systems. Everyone has their own Achilles heel, which only an experienced doctor can determine. Along with a visual examination and analysis of the patient’s complaints, a specific allergological examination, a study of the immune status, a stool test for dysbacteriosis, etc. helps to reveal the truth.

How to treat atopic dermatitis

The success of treatment, which is purely individual in each specific case, depends on the competent actions of the doctor. Some are helped by long-acting antihistamines, others by hormonal drugs (in the form of ointments or sprays for respiratory manifestations of the disease), others by immunostimulants or, conversely, immunosuppressants that suppress excessive activity of the immune system. And for some, the only salvation from exacerbations of the disease is moving to another climate zone with a dry, warm climate. It has been noticed that sun rays suppress the activity of complexes that form the atopic reaction. The main method of physiotherapy for atopic dermatitis is based on the same principle - selective phototherapy, which looks like a solarium. Only in contrast to this popular cosmetic procedure, phototherapy uses mid-wave (UVB) and long-wave (UVA) ultraviolet rays, which have a milder effect . In especially severe cases, when eczema covers the entire body, they resort to a more serious version of this procedure, using photosensitizers (substances that enhance the effects of ultraviolet rays) . Fortunately, such situations rarely arise.

How not to start the disease

The sooner you start fighting the disease, the better. Without adequate treatment, atopic dermatitis is fraught with quite serious consequences, ranging from infection of skin areas affected by eczema to the development of bronchial asthma. Often people suffering from atopic dermatitis contract new diseases. Losing its protective functions, their skin becomes especially vulnerable to molluscum contagiosum, flat warts, fungal and other skin infections. Psychological disorders and neuroses often occur against the background of atopic dermatitis. In this case, you cannot do without modern antidepressants, which are prescribed not only to adults, but also to children.

How to learn to live with illness

Unfortunately, it is impossible to completely get rid of atopic dermatitis. In some cases, the disease may seem to “fall asleep”, but then flare up again. You need to learn to live with this disease. How? Trying to lead a measured lifestyle, avoiding stressful situations, traveling to the south every year (to a hot, dry climate), and in the off-season to a sanatorium. Outside of an exacerbation, the entire range of sanatorium-resort procedures (with the exception of mud applications) is useful. Acupuncture, electrophoresis with diphenhydramine, novocaine also have a good preventive and therapeutic effect for atopic dermatitis.

Diet is secondary

But following a diet for atopic dermatitis, as a rule, is of a secondary nature. Patients and their loved ones (if we are talking about a child) usually know themselves which foods they should avoid. True, you need to eat often and in small portions, trying to ensure that your diet contains foods that promote good digestion (constipation is a frequent companion to this disease).

How important it is to avoid self-medication

Recently, self-medication has become very common. In the case of atopic dermatitis, this can have fatal consequences. Especially when it comes to hormonal drugs. If they are used inadequately and if they are abruptly discontinued, you can get an even greater exacerbation of the disease than before taking them. Not to mention the serious side effects of such therapy, which only a doctor can prescribe. The leading doctor for patients with atopic dermatitis should be a dermatologist, interacting with an allergist and other specialists (neurologist, gastroenterologist).

Start your treatment in your apartment

Often the source of torment for the patient is in... his own apartment:

Try to keep it clean, especially if there are animals in the house. In this case, you cannot do without frequent wet cleaning. Prevent mold from forming in the kitchen and bathroom. Try to reduce contact with household products. Remove carpets from walls and floors, and thick curtains from windows; do not pile up books or keep them in glass cabinets.