Treatment of atopic dermatitis in young children. Non-steroidal anti-inflammatory means

Atopic dermatitis - this is an inflammatory allergic disease skin Pokrovwhich is caused by the effects of toxins and allergens, a more common name of the disease - children's eczema. In most cases, atopic dermatitis in children in the first years of life has rather innate the origin of the disease, and not acquired. This is explained by the fact that the determining factor of the mechanism of occurrence is heredity, quite often children, other than dermatitis, suffer from other allergic manifestations - polynosis, food allergies, allergic conjunctivitis, allergic rhinitis, bronchial asthma. According to age, the following forms of the disease are distinguished:

Infant - from birth to 3 years old.

Children's - from 3 to 7 years.

Teenage - from 7 years.

In children by age up to 6 months, the manifestation of the disease is observed in 45% of cases. In the first year of life, 60% of cases suffer from atopic dermatitis, after 5 years the disease is observed in 20% of cases. The process of treating atopic dermatitis in a child has serious difficulties. This is due to the chronic recurrent nature of the disease, which is often combined with concomitant diseases.

Causes of the appearance of atopic dermatitis in children

The main reason for the appearance of atopic dermatitis in the child is a genetic predisposition to allergic manifestations in aggregate with the influence of adverse environmental factors. The risk of appearances in children of atopic dermatitis, provided that both parents have allergic hypersensitivity, is 80%, if one of the parents of atopic dermatitis has the risk of atopic development in a child of 40%.

Food allergy

Food allergies contributes to the emergence of signs of atopic dermatitis in children of the first months of life. Its occurrence can provoke the wrong mother's nutrition during pregnancy or breastfeeding, refusal to breastfeeding, kid stubble, early introduction of dust. Also, the occurrence may be caused by viral-infectious diseases and violation of the functions of the gastrointestinal tract of the child.

• Heavy pregnancy

If in the process of nursing the child, the future mother has exacerbation of chronic diseases, the threat of pregnancy interruption, infectious diseases, fetal hypoxia or intrauterine fetal infection, these diseases may affect the appearance of a child of a tendency to allergies and atopy.

• Accompanying illnesses

Most often, atopia arises in children suffering from concomitant diseases of the gastrointestinal tract:

Enterocolitis.

Intestine dysbacteriosis.

Glisal invasions.

Gastritis.

• Other allergens

In addition to food products, ATOs of atopic dermatitis are the other household allergens: contact allergens (some creams, baby care products, wet wipes), inhalation stimuli (dust, pollen plants, homemade ticks, washing powders, chlorine-containing detergents, rinsers, air fresheners and other household chemicals) Also provocaters are drugs.

An interesting fact: during large-scale research in the families of Europe, Japan, the United States was established by scientists that the presence of a dog in the house reduces the risk of allergies and an atopy in a child by 25%. It is believed that it is the lack of contact with agents of infection leads to the development of violations when ripening in modern children protective functions The body (generating immunity). Such a feature is determining and in the case of allergic reactions. Going out of the above, the dog, bringing from the street to the microbic house, thereby introducing a child with them naturally.

Factors affecting the aggravation and development of the disease

The recurrence of atopic dermatitis in a child can be caused by stress, nervous exception, psycho-emotional overvoltage.

If the child succumbs to passive smoking, it loosens general health and skin condition in particular.

The adverse effect of the environment contaminated with toxic substances, car exhaust, industry waste, as well as a large number of chemist food, electromagnetic field of large cities, an increased radioactive background of some locality.

Seasonal weather factors - overvolting immunity and increasing the risk of infectious diseases.

Excessive physical exercisewho are accompanied by excessive sweating.

Any of the above-mentioned reasons can cause the development of atopic dermatitis, while the larger the combination of factors one with another, the more difficult the final form of atopy.

Therefore, in the development of atopy in children, the treatment process should be complex. Consultation is required for specialists - a dermatologist, a nutritionist, an allergist, a psychoneurologist, an ENT doctor, a gastroenterologist.

Signs of atopic dermatitis

Signs of atopic dermatitis in children in the first year of life are: a strong itching, eczema of skin, striking preferably face and neck, as well as extensive surfaces, miscellaneous Heads, buttocks. An older and adolescent children are primarily affected by the skin in the area of \u200b\u200bthe groin, the armpits, as well as on the colors and legs, around the eyes, mouth, on the neck, there is an aggravation of the disease in the winter (cold) time.

The beginning of a child's disease atopic dermatitis can manifest itself such symptoms: the appearance of seborrheic scales, which are accompanied by an increased development of the secret song hardware, the appearance of a yellow crust and peeling in the area of \u200b\u200bears, eyebrows, springs, redness of the face, mainly on the cheeks with the appearance of horny crusts and cracks in constant burning, itching and bumps.

Symptoms are accompanied by a violation of calm sleep and weight loss. Quite often, the manifestation of the disease occurs in the first days of the child's life. In some cases, atopia is accompanied by carpentry skin lesions (pyoderma).

The main symptoms of the disease:

Unbearable burning and itching, amplifying at night.

Nature rashes are serous papules and microwaves.

Moching the inflamed place.

Bubbles with liquid with an autopsy form crusts, erosion, peeling of the skin.

Large-scale redness of some parts of the face.

Cracks in the redness area, distinguished by soreness.

Diathesis is a red forehead, chin, cheeks.

Dry skin with the presence of sebuguum scales.

Piedlemia.

The chronic form of atopic dermatitis is distinguished by the manifestation of reinforced skin pattern, the appearance of cracks, mass thickening, the skin pigmentation.

Chronic atopic dermatitis has typical symptoms:

Woodness and redness of the foot, cracks and peeling of the skin is the so-called symptom of the winter foot.

A large number of deep wrinkles in the lower centuries at the kid is a symptom of Morgan.

Hair breakfast in the head of the head is a symptom of a fur hat.

It is important to take into account the factor in the occurrence of the disease, the degree of skin lesion, the nature of the course of the disease, heredity. Quite often, atopic dermatitis in an adult is identified with diffuse neurodermit, sometimes this disease is observed in children. The clinical picture directly depends on the age of the child and is characteristic of the characteristics of each period of time.

The age of the child	Manifestations of dermatitis	Typical localization
Up to six months	Erythema on the cheeks of the likeness of a dairy stamp, serous papulas and vesicles, erosion, peeling of the skin	Ears, forehead, cheeks, chin, hair, scalp, limbs
From six months to 1.5 years	Edema, redness, exudation (separation of liquid from small blood flow vessels during inflammation)	Mucous membrane gastroy respiratory tract, urinary tract (nose, eye, vulva, extreme flesh)
From 1.5 to 3 years	Skin seal, amplification of skin pattern, dry skin	Pages, elbow bends, less rare, neck, wrists
Older 3 years old	Ichthyosis, neurodermatitis	Fit fibers

Seborine type - characterized by the appearance of scales on the baby's head in the first weeks of life.In the first year of the child's life, dermatitis occurs in such types:

• Nummular type - manifests itself with the appearance of specks, which are covered with a crust, occurs between the ages of 2 to 6 months. Characterized localization on limbs, cheeks, buttocks.

Closer to 2 years of manifestation disappear in 50% of children. For the remaining 50%, the localization of skin lesions in the folds is characteristic. Stand out separate form Ladon lesions and soles (juvenile palm-sole dermatosis). This form has seasonal severity - the absence of symptoms of dermatosis in the summer and aggravation of the disease in winter.

Atopic dermatitis in infants and older children should not be identified with such skin diseases such as psoriasis, seborrheic dermatitis, scabies, microbial eczema, contact allergic dermatitis, pink deprived, immunodeficiency condition.

Atopic dermatitis, developmental stages

The determination of the period of occurrence, stage and phases of the disease has big influence On the tactics of the treatment of the disease, the program of which can be long-term and short-term. There are 4 stages of the disease:

The initial stage - begins to develop in children of an exudative-catarval constitution. For the stage, the swelling of the skin of the cheeks, hyperemia, peeling. This stage is timely treatment and holdingpophallergenic diet is reversible. If the treatment is assigned incorrectly or starting untimely, can go to the next step.

The pronounced stage is characterized by the passage of chronic and acute phase of development. Chronic phase Distinguished by a sequence of skin rashes. The acute phase is manifested by microwaves, as a result of which scales and crusts develop.

The remission is characterized by the fact that symptoms are reduced or disappeared at all. Remissance can continue both a few weeks and a few years.

The stage of clinical recovery is distinguished by a long lack of symptoms (from 3 to 7 years), it depends on the severity of the disease.

Treatment of atopic dermatitis

If the course of atopic dermatitis in the patient is quite difficult, local corticosteroid drugs are used to treat in combination with mitigating means. Such treatment contributes to the rapid elimination of symptoms. Mitigating and moisturizing means are applicable in any period of the disease. Main treaties:

Reduced exacerbation.

Change the flow of the disease.

Control of the disease for a long time.

The exacerbation of the disease with a violation of a general condition, the emergence of a recurrent infection, as well as the ineffectiveness of the appointed therapy, serve as an indication to hospitalization.

In the case of severe trendy dermatitis, a child has a child for treatment, the use of local corticosteroid drugs in a complex with mitigating agents is required. These measures will allow you to quickly eliminate the symptoms. Moisturizing I. mitigating funds Can be applied in any period of the disease. Treatment is to achieve the following goals:

Change the flow of the disease.

Reduced exacerbation.

Control of the disease for a long time.

The indication of the child's hospitalization can be the aggravation of the disease, as a result of which the general condition is disturbed, recurrent infections, the ineffectiveness of the therapy.

Non-drug treatment consists of measures aimed at reducing or eliminating acting factors that provoked the exacerbation of the disease: food, contact, chemical stimuli, inhalation, stress, increased sweating, microbial virgin and infection, environmental factors, impaired epidermis.

Medicase treatment is prescribed depending on the period, stage and form of atopic dermatitis in children. An important factor is also the age of a child, the scale of skin damage, involvement during the disease of other organs. There are means of system action and outdoor use. Pharmacological means of system action are prescribed in a complex or as monotherapy and include the following groups of drugs:

• Antihistamines.

Evidence that the treatment of atopic dermatitis in children with antihistamine drugs Effectively, not enough. Preparations of sedative action ("TAVEGIL", "Supratine") The doctor may prescribe with a sleep disorders, with constant toide, as well as in cases where the disease occurs in combination with the urticaria or allergic rhinconuncutitis.

Among antihistamine agents for the treatment of allergies, drugs relating to 2 and 3 generations are considered to be the most popular and preferred, namely: "Zirtek", "Edak", "Erius". These drugs are distinguished by a prolonged action and do not cause addiction and drowsiness, as well as are considered the safest and more efficient. Products are produced in the form of syrups, tablets, drops, solutions. The clinical effect of the use of drugs is observed month later, so for the course of treatment requires 3-4 months.

However, due to the fact that the effectiveness of antihistamine drugs that do not have a sedative effect has not been proven, the need to use drugs is determined by the doctor, depending on the characteristics of the course of the disease. The effectiveness of oral administration of ketotifen and croglycial acid is also proven and the effectiveness of oral administration in order to treat atopic dermatitis

• Antibiotics.

The use of systemic antibiotics is permissible only when confirming the presence of a bacterial skin infection, while long-term use antibacterial agents unacceptable. Antiseptics and antibiotics are prescribed externally in case of detection on the skin of staphylococcal and streptococcal infection:

Solutions-antiseptics - "chlorhexidine", "Miramistin", hydrogen peroxide, "Fukaceptol", diamond green, fuccin, alcohol solution 1-2%.

Antibiotics - Futsidin, Ointment "Baktorban", Neomycinovaya, "Levosin", Gentamicinic, Lincomicinic, Erythromycinovaya, "Levomikol" (methyluracyl + levomycin).

Dermatol, xeroform, furacinous ointment.

"Sulfargin", "Argosulfan", "Dermazin".

Dioxidine ointment.

Apply 1-2 times a day. If there is a pronounced pyodermy, systemic antibiotics are appointed. Before treatment with antibiotics, it is necessary to first check the microflora on the sensitivity to most drugs.

• Systemic immunomodulating therapy.

Immunomodulators do not require applications in the event of an uncomplicated flow of atopy. An immunologist allergist after diagnosis can assign immunomodulators, but only as auxiliary means in a complex with conventional dermatitis therapy if there are signs of immune failure.

The danger of using immunomodulators and immunostimulants in the treatment of children is that in case of close relatives of autoimmune diseases (rheumatoid arthritis, insulin-dependent diabetes, SHEGREEN syndrome, diffuse sclerosis, diffuse toxic goiter, Vitiligo, systemic red lupus, Miasthenia) Even a short intake of the immunomodulator may cause an autoimmune disease in a patient. Therefore, if there is hereditary location for autoimmune diseases, the immune system of the child should not be influenced by the influence of the child's immune system, given the possible hyperactivation of immune processes, which may result in immune aggression on healthy fabrics and organs.

• Vitamins and phytopreparations.

Taking vitamins B6, B15 increases the effectiveness of treatment. The process of restoring the functionality of adrenal and liver bark is accelerated, and also accelerates the reparation of the skin. The immune system is stimulated, the resistance of membranes to the effects of toxic substances is improved, lipid oxidation is regulated. However, the child may have an allergic reaction to complexes of vitamins or phytopreparations (champs, medicinal herbs, infusions), therefore the use of these groups of drugs should be carried out with extreme caution.

• Drugs that restore the operation of the gastrointestinal tract.

Preparations that improve and restoring the robot of the gastrointestinal tract are used in the acute and subacute period of the disease when changing the functioning of the digestive system. The use of drugs is aimed at improving the processes of digestion and the correction of the violated functions of the system, this is: "Pancreatin", "Panzinorm", "Creon", "Enzystal", "Digestal", "Festal", also apply hepatoprotectors and choleretic drugs, such as: " ALLOHOL ", Rosehip fruit extract," hepaben ", cornflower extract," Lifting 52 "," Hofitol "," Esssential Forte ". The duration of the course of treatment is 2 weeks.

• Antiviral and antifungal drugs.

In case of damage to the skin infections of fungal origin, antifungal drugs are used in the form of creams: "Natamycin" ("Pimafucher", "Pimafucin"), "Clotrimazole" ("Candid"), "Isokonazole" ("Herben", "Herbourt"), " Ketokonazole "(" Laughty "," Myxoral "). If the disease is joined by herpetic infection, antiviral drugs are applied.

• Sanitation of foci of infection.

Also, we should not forget about the treatment of diseases associated with atopic dermatitis, the purpose of which is to rehabilitate the foci of infection - in biliary tract, gOOD SYSTEM, ENT organs, intestines, oral cavity. Regardless of the phase of the disease, keratoplastic, antibacterial, anti-inflammatory, keratolytic drugs for skin care are used.

• Anti-inflammatory means for outdoor use are divided into 2 groups: non-immortal means and containing glucocorticoids.

* Glucocorticoids - Effective with acute and chronic forms of manifestation of atopic dermatitis in children. For prevention, these creams are not used, therapy with glucocorticosteroid creams and ointments are carried out only by appointment of a doctor in small courses, followed by a phased cancellation of the drug.

Long-term and uncontrolled use of such drugs is hazardous side effects, reduction of local immunity, oppression of the functions of the adrenal cortex, thinning and dryness of the skin, the development of secondary infectious lesions on the skin. If there is an acute need to apply such drugs, the following applications must be followed:

Funds are classified for: weak, moderate and strong activity. In the treatment of children's atopic dermatitis, it should be started with a weakly concentrated hormonal means. The concentration increases only in cases of the ineffectiveness of the composition of previous therapy and only on the recommendation of the doctor.

Hormonal ointments of any type are used only by short courses, followed by a break and reduced dose of the drug.

A sharp refusal to use the drug aggravates the patient's condition and causes recurrence of pathology.

The course of treatment begins with the use of a hormonal cream. In the process of smooth cancellation, ointment is mixed with children's cream in proportion 1/1. Two days later, the concentration is again reduced, 2 parts of the children's cream with 1 part of the glucocorticosteroid cream, another two days - 3 parts of the children's cream and 1 part of the hormonal drug.

With long-term use of the hormonal drug of local action, it is necessary to change the drug to the means containing another hormone.

The cream is used for the night to eliminate the swelling, the morning use of the cream is carried out to eliminate plaques.

Non-immalic drugs Used with minor manifestations of atopic dermatitis. Treatment is carried out by antihistamine: "Histan", "Phenolic gel" 0.1%. Also used creams: "Eliode", "Vitamin F99", "Radevit".

Aluminum acetate - Burov liquid.

Grease-soluble vitamins - Radevit, "Visenias".

ASD ointment and pasta.

Zinc pastes and ointments - Desitin, "Tsindol".

Ichthyolic ointment.

Birch tar.

The line of naphthalan oil is "naphtaderm".

Keratolan Ointment is urea.

"Phenolic Gel".

With atopic dermatitis, the treatment of ointments and creams with healing properties that enhance the trophy and tissue regeneration are also effective:

Dexapentol - sprays and creams "Bepanten", "Panthenol".

Gel "Kurizin".

"Aktovegin", "Salkoeril" - creams and ointments, gels containing hemoderivat calf blood.

Methyluracil ointment (is an immunostimulator).

"Vidests", "Radaev" (Vitamin A).

Cream "Power of the Forest" containing Floralizin, effective tool For treatment skin disease: eczema, psoriasis, dermatitis, herpes, to restore dry and cracking skin. Floraziline consists of a complex of biologically active natural substances - made of mushroom mycelium, which contains collagenase active enzymes, Minerals, phospholipids, vitamins. Composition: Floralized, pentol, vaseline, sorbic acid, fragrance.

Among the drugs of the immunomodulatory action, the cream-gel "Timogen" is allocated, applies only to the appointment of a specialist.

Diet in the treatment of children's atopic dermatitis

Diet plays an important role in the treatment of atopic dermatitis, especially for children on breastfeeding. According to the forecast of the disease, it is necessary to exclude products containing allergen. In the first year of the child's life, a special sensitivity can be observed for eggs, proteins of cow milk, cereal, gluten, nuts, citrus. If the child has an allergic reaction to the cow's milk, it is possible to replace it with soy mixtures: "Nutrilak Soy", "Friesosa", "Alsa".

In the presence of an allergic reaction to soy proteins, as well as in cases of severe food allergies It is recommended to use hypoallergenic mixtures: "Nutramgen", Prgestimil, Alfara.

If there is allergies on gluten (have 25% of children), it is necessary to use hypoallergenic cereals containing corn, rice, buckwheat - "Heinz", "Remedia", "Human", "Istra Nutrition".

The introduction of each new product in food is coordinated with the doctor, at the same time it is introduced no more than 1 product per day, small portions. If with the help of blood testing, the intolerance to the product containing an allergen was confirmed, it is necessary to exclude it from the diet.

Physiotherapy

Used in acute period Diseases and period of remission and consists of procedures:

• In the acute period - carbon baths, electrose, applying a magnetic field.
• During remission - balneotherapy, mud.

According to clinical sources, complete recovery is observed in 17-30% of patients, the rest of the patients suffers from atopic dermatitis throughout life.

Tips of Dr. Komarovsky here:

Unlike the pathologies of internal organs, the problems associated with skin cover are noticeable to the naked eye. One of such diseases is atopic dermatitis. He is characterized by the appearance of a specific rash, the skin itself becomes dry. This type of dermatitis is allergic nature and can develop in childhood. It is treated illness hard, delivering a person to physical and psychological discomfort.

What is atopic dermatitis?

Under dermatitis, the combination of a number of skin diseases, the development of which can be due to both external factors and internal problems in the body are due to both external factors and internal problems in the body. With any form of dermatitis, including atopic, there is a violation of the functions of the skin, homeostasis and the appearance of other pathological processes.

Recently, the degree of prevalence of atopic dermatitis has increased significantly. Deals occurs in 10-20% of residents of developed countries. Its flow has become more severe, it may be accompanied by other allergic pathologies. In 34% of cases, bronchial asthma is joined by the disease, in 25% - allergic rhinitis, 8% polynosis.

The disease can manifest itself on any part of the body: hands and palms, legs, face, neck, cheeks, back, or even in groin, in the form of a specific rash (we recommend reading :). It is a rash of bright red, which itchs, flakes, and in the future are covered with a thin crust, forming bubbles that grow into wet erosion. What the dermatitis in a child looks like, can be seen in the photo.

Due to incomplete formation and weak adaptation immune system Child K. environment It is children most of all exposed to atopic dermatitis, which is known as diathesis (we recommend reading :). At the age of 6 months, it is found in 60% of the kids, this indicator increases to 75%, and by 7 years, 80-90%.

Usually, symptoms of the disease are not for a small patient no danger, quickly pass, and with age completely disappear. If you do not respond to the sign in a timely manner and not to do with treatment, the disease will go into a chronic form that is not easy to therapy.

Causes of the disease in children

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Atopic dermatitis in children is developing due to genetic predisposition. According to statistics, if one of the parents came across such a problem, the probability of its appearance in the baby is 50%. When mom, and dad suffer from this disease, this value increases to 80%.

In addition to heredity, the provoking factor is the way of life of a woman during pregnancy. Bad habits, defective and unbalanced food of the future mother, reception medicinal preparations - Favorable conditions for the development of pathology in a newborn.

The main locations of the localization of atopic dermatitis

There are other reasons that contribute to the development of atopic dermatitis. Among them:

Having an allergic nature, dermatitis in children can be triggered by the following stimuli:

• dust;
• pollen, nectar or houseplants juice;
• plants-toxicodendrons, including ivy, oak, Sumy;
• citrus, chocolate, cow milk, eggs, honey, nuts, mushrooms, coffee, cocoa;
• medical preparations;
• vitamins (overdose);
• toothpaste, rinse or dental inventory.

Varieties and symptoms of children's atopic dermatitis

Atopic dermatitis is a complex disease that has several stages and varieties. For everybody separate type The ailments are characterized by their symptoms, however, there are a number of signs common to all dermatitis in children:

• erythema, or redness of the skin, characterized by the appearance of capillary meshs (we recommend reading :);
• strong itching, due to which the child becomes a capricious, nervous and sometimes aggressive;
• combing affected skin areas due to the high sensitivity of nerve endings;
• purulent wounds;
• peeling and dry skin caused by insufficient admission to lipid tissue and amino acids.

The table below shows the 3 main types of atopic dermatitis by the patient's age, accompanied by characteristic symptoms:

Skin atopy shape	Age, years	Symptoms
Infant	0-2	Education on skin bubbles that merge together and covered with a crust. The location of localization was visiting: arms and feet, face, groin, folds of legs, neck and wrists. Seborrhea Voloshogo Part of the Head (theme, Absorbing Arcs).
Children's	2-12	Peeling of the skin and its irritation, as a result of which the epidermis cracks. After the convergence of the rash in her place remains pigmentation.
Adult or chronic	Older 12.	The disease extends to almost all over the body, affecting palms and feet, delivering special discomfort. It is possible to loss of hair on the back of the head and the formation of folds under the eyes.

Stages of development of the disease

4 stages of the course of the disease are distinguished:

1. Primary. It is the result of allergies caused by food, clothing or air. Most of all its appearance is subject to low-life children with weakened immunity. It is characterized by dry, peeling and redness of individual skin sections.
2. Acute. Compared to the initial stage, the primary symptoms increase, to which the formation of crusts and cracks is joined.
3. Chronic. The foci of affected skin becomes extensive, the skin themselves are compacted, characterized by the appearance of wounded wounds.
4. Remission. Symptoms fully or partially disappears, a slight residual damage to the skin may be present. The disease is able to stretch for the period from one week to several months or years. Without the effects of provoking allergic reactions of factors, the likelihood of complete recovery is high.

Diagnostic methods

Diagnosis of atopic dermatitis is an important stage In the appointment of competent treatment.

Do not try to diagnose yourself, resorting to help photo from the Internet, and even more so treat atypical dermatitis in children. This should be engaged in specialists: a dermatologist, an allergist immunologist or pediatrician.

The doctor conducts a visual examination of the patient to assess the clinical picture, and collects information about the development of the disease through a child's survey and his parents. At this stage, the diagnosis on the description of the life of the baby can be understood that it became a provoking factor in the occurrence of dermatitis. Sometimes this happens enough.

Often requires a number of additional laboratory studies To clarify the diagnosis and establish the cause of the ailment:

1. General blood analysis.
2. Analysis on immunoglobulin. To do this, you need to pass blood from the vein. Increased level of immunoglobulin E speaks of possible allergies.
3. Immunogram. A kind of verification of the work of the immune system.
4. Analysis of urine. If protein is present in the urine, or increased the number of salts, this indicates the presence of kidney problems.
5. Blood biochemistry.
6. Analysis of the feces on the egg.
7. Uzi organs abdominal cavity. It is carried out in cases where there are suspicions for the presence of diseases of the gastrointestinal tract.
8. Skin biopsy. Determines the nature of the inflammatory process.
9. Coprogram and feces analysis on dysbacteriosis.

Features of the treatment of atopic dermatitis in a child

The treatment of atopic dermatitis is a long and time-consuming process, and it is necessary to approach it comprehensively. In addition to the dermatologist and pediatricians who are obliged to control the course of therapy, it may be necessary to participate other specialists of a narrow orientation, such as a gastroenterologist, neurologist or nutritionist.

According to statistics, the dermatitis is fully cured in 17-30% of cases. The rest of the patients remain with this problem for life. To overcome the disease, it is important not only to take medical preparations and smear the affected skin areas, it is necessary to ensure the proper living conditions and care of the baby, including its nutrition, hygiene and emotional stability.

Medical therapy

After removing the allergen, the use is shown medical preparationswhose action is aimed at combating the main symptom of dermatitis - itching. It is this unpleasant manifestation of the ailment that gives maximum discomfort and is fraught with complications due to combing. For these purposes, the doctor selects the course medicinal therapywhich may include tablets, syrups, ointments and creams, taking into account the characteristics of the course of the disease, age and individual features Child:

• Antihistamine preparations come to the fore: phenyatil, zyrtek, zoda, claritine, etc.
• For skin treatment, disinfecting and anti-face creams are used (atopic "soothing cream", topicrem, an emolium, gel phenyatil, etc.);
• If necessary, resort to help of hormonal ointments: eloc, advantan, etc. However, with a weak severity of symptoms, it is better to refuse to refuse treatment.
• Dysbacteriosis shows the reception of prebiotics to restore intestinal microflora. The most common drugs are Linex, lactobacterin, bifidumbacterin.
• Enterosorbents are appointed additionally: polysorb, lactofilter, enterosgel, etc. (more in the article :).
• Immunostimulating agents are used. They will support the work of the body's immune system, ensuring its necessary vitamins and minerals.

Physiotherapy

In addition to drug treatment, the complex therapy of atopic dermatitis includes physiotions that have proven themselves as sufficient effective method. Manipulations of this kind are applicable at two stages of the disease - in the sharp period and during remission. For each of these stages their physiotes are held. For an acute period, this is:

• carbon baths;
• electroscone;
• using a magnetic field.

Balneotherapy procedure

For the period of remissions, they carry out:

• balneotherapy;
• mud.

Homeopathic drugs

One of the options for treating atopic dermatitis is to use homeopathy. In the acute period, drainage funds are used, the choice of which depends on internal organWith which there are problems. For example, for the intestine, it is recommended to root or back-tier, for kidneys - Berberis, Solidago, Urcy.

Also an appointment homeopathic preparations During dermatitis is determined by the shape and character of the spindles on the skin:

• bubbles treat Cantaris;
• vesiculi - rus toxicodendron, arsenicum album, causticum;
• corks - antimonium in the tuper, calcarey carbonics, graphitis, lycoperation.

Folk remedies

Raw potatoes is a good helper with atopic dermatitis in children

Application folk remedies is also effective way Treatment of skin diseases, but pre-consultation with the doctor is obligatory. Usually, folk recipes for these purposes consist of one ingredient, which is safe and not able to cause allergies:

1. Raw potatoes. In crushed form, it should be squeezed and put the compress to the place of lesion, for example, the back, groin. It is better to do it in the dark day, and the vegetable is chopped by non-metallic instruments.
2. Raw pumpkin. A compress is made similar to potato.
3. Aloe juice. Apply a tampon on rash.
4. Sea salt, mangartan, infusions of therapeutic plants (turns and oak bark), grape leaves or starch. Used for bathing in the bath.
5. Green tea, burdock, nettle, clover and pear leaves - you can make antiseptic rods on the affected skin.

Hypoallergenic diet

A special position in the treatment of atopic dermatitis is occupied by food, namely, the adherence to a special diet. First of all, this concerns children who are still on artificial or breastfeeding. It is important to immediately exclude the infant to the infants that contain allergens provoking the disease. If the baby eats mother's milk, then the dietary food must stick a nursing woman.

In infants under the age of year, there may be increased sensitivity to some products:

• chicken eggs;
• cereals;
• protein cow milk;
• gluten;
• nuts;
• citrus;
• products with the addition of dyes.

If there is an alternative in the form of silent artificial mixtures based on soybean: soybean nutrilak, freousososa, Alsa. If the child has an allergic response to soy proteins, and in general, it is the food allergies that should go to hypoallergenic mixtures. These include: Nutramgen, Protection, Alfara.

About 25% of babies does not tolerate gluten. In such a situation, hypoallergenic cereals made from corn, rice or buckwheat are suitable. Among them, you can allocate: Heinz, Remedia, Human, Istra Nutrition.

Entering dust needs to be coordinated with a pediatrician. For example, fruit purees should not be introduced earlier than 10 months, and the introduction of such products like fish, fatty meat and milk, it is better to postpone up to 2 years. To this age, the sensitivity of the body to many allergens is reduced.

In the process of treatment of skin diseases in the diet may be present dairy products (kefir and small fatty cottage cheese) and meat: turkey, rabbit, chicken fillet. All dishes should be prepared for a couple or bake. Additionally, exotic fruits, pastries, sweets, canned and chocolate are excluded from the menu.

Possible complications

The main cause of the development of complications in atopic dermatitis is combing and injuring the affected skin areas. The result of the disorders of its integrity is a decrease in protective mechanisms and local immunity, which leads to the creation of favorable conditions for the reproduction of pathogenic bacteria and fungi.

Most complications can be divided into two groups: bacterial and secondary viral. The first group is more common, and its consequence is the development of pyodermia. To the symptoms of this dermatological disease relate:

• the appearance of guns, which, pouring, form a crust;
• increased body temperature;
• fast fatiguability;
• weakness and deterioration of the state.

The root cause of the occurrence of a complication of a viral nature is usually served by herpes virus. On the affected skin, bubbles are formed, inside of which there is a transparent liquid.

Under the atopic dermatitis, otherwise called the neurodermit, should be understood as an allergic skin reaction due to genetic violation immune response.

An important role in the development of atopic dermatitis in children is the insufficiently developed function of the gastrointestinal tract. It is the correction of genetics and the functionality of the gastrointestinal tract to be taken into account for prevention and treatment this disease.

Causes of atopic dermatitis in a child

Symptoms of atopic dermatitis in children provoked in an inadequate immune response to alien proteins against the background of genetic predisposition (neurodermatitis or other allergic reactions at the parents). The reason for this may be:

• excessive use of pregnant conditionally allergic products (cocoa, citrus, eggs, nuts, etc.) and the appearance of specific antibodies in the fetus;
• the immaturity of the gastrointestinal tract - intolerable protein fragments enter the blood, which is formed by sensitization;
• hypersensitivity of the skin and mucous membranes of the respiratory tract - the dry climate causes dry skin and mucous membranes, which provokes an increase in its sensitivity to allergens in the air, children's creams, clothes (see photo).

Once formed antibodies cause exacerbation of the disease, even without direct contact with sensitizing agents or product.

Stages of disease development

Atopic dermatitis U. baby Manifested only from 2 months. In the age criterion and specificity clinical manifestations The following stages of the disease are determined:

• 1 stage - infant neurodermit - observed up to 2 years, characterized by pronounced inflammation, mocking;
• 2 Stage - Children's Atopy - Fixed to the period of puberty, Papulas are formed against the background of amplifying dry skin;
• 3 Stage - Youth Neurodermatitis - manifestations for the first time appear in adolescents, and exacerbations can pursue a person and in adulthood, inflammatory reactions replace signs of liquidification and vascular skin disorders.

Symptoms of atopic dermatitis in children, photo

Tactics of treatment of atopic dermatitis in children directly depends on its symptoms and stage. IN different age Neurodermit gives a characteristic clinical picture.

1 Stage

Atopic dermatitis B. initial stage Manifested by pronounced inflammation of the skin. Characteristic localization - skin folds (diallos), forehead and cheekbones.

For this age period, bright hyperemia, swelling and fast-forming foci of mocking are characterized, which are then covered with dairy scabs.

Often inflammation applies to the scalp and neck. Strong itching can provoke bumps and suppuration of cracks. The kid has a dream, and the slightest discomfort causes anxiety. Often infant neurodermatitis is accompanied by a thrush in the mouth.

2 Stage

In a child under 10 years, the Neurodermitian foci is more often located in the skin folds behind the ears, on the delicate skin of the bending surface of the wrist and ankle, on the neck under the back.

At the same time, the pronounced dryness of the skin, expressing peeling, and impaired pigmentation (dark and bright skin sections).

Atopic face in a child: grayish dull skin, pigmented stains around the eyes, the addition of the lower eyelid. During this period, the child's condition can deteriorate with heavy allergic reactions - swelling of Queenka, bronchial asthma, urticule.

3 Stage

In adolescence, pathological changes of skin cover have signs of liquidation - focal thickening of the skin with a pronounced peeling, reinforced skin pattern.

Preferably modified sites are located on the face and neck, upper limbs. In severe cases, damage to the skin of the body is fixed.

Only an allergist after careful study of the anamnesis (identification of allergic reactions), conducting special allergic samples and child blood tests on antibodies can be made an accurate diagnosis and differentiate neurodermatitis from psoriasis, eczema and other skin diseases.

Although atopic dermatitis is chronic pathology, often with appropriate therapy, its symptoms disappear by the time of the cultivation of the body. However, sometimes the disease is manifested by exacerbations and in adulthood.

Therapeutic diagram with atopic dermatitis includes the exclusion of allergens, diet and complex drug impact.

Medical therapy

It is conducted by courses duration of 1-1.5 months and includes the use of the following tools:

• antihistamines;
• vitamins and zinc drugs;
• immusupenders, overwhelming the hyperactivity of immune cells;
• antibiotics (with an acceding infection);
• soothing;
• gastrointestinal preparations (normalization of the activity of the stomach, intestines, liver);
• corticosteroids (in severe cases, with frequent exacerbations).

Drug treatment is prescribed by a qualified dermatologist-an allergist, taking into account the peculiarities of the course of the disease and the state of the patient.

Exterior means

Their use is aimed at minimizing pathological skin manifestations:

• anti-inflammatory chatters;
• drinking agents and antiseptics - dotted at a mookantium at stage 1;
• moisturizing - with severe dryness of the skin in the 2 stages of the disease;
• external corticosteroids - hormonal cream with atopic dermatitis, as well as the inner intake of corticosteroids, is advisable only with the ineffectiveness of other means in the acute phase and continues not more than 1 week.

Physiotherapy

Especially effective with atopic dermatitis of phototherapy. Ultraviolet irradiation increases the effectiveness of the use of puva-therapy.

Also, bioresonance treatment is also prescribed, however, the effectiveness of this method is not conducted in the treatment of neurodermit.

Diet with atopic dermatitis in children

Diet up to the year

In this period, the kids can be given fruit puree and juices from pears, apples, currants. Safe among vegetables are zucchini, potatoes, different types of cabbage. In the course of feeding every week, only one new product should be introduced into the ration.

It is desirable to abandon the cow milk, giving preference to natural feeding and special children's mixtures that correspond to the child's age. From drinks can be given clean water, compote and weakly brewed tea.

Diet after year

The diet menu with atopic dermatitis at this age can be made more diverse, including various soups-mashed potatoes from vegetables, boiled lean meat (rabbit, turkey, veal), pumpkin, cucumbers, greens, rice, oatmeal, manna, buckwheat.

The choice of fruit is better to hold with the attending physician, since many of them are potential allergens. Vegetables must be treated thermally - they can be boiled, baked in the oven, cook for a pair.

Dairy products need to be removed from the diet, with the exception of a small amount of cottage cheese, home yogurt and sources. The menu should not have sausages and sausages, conservation, eggs, fat broths and roasted dishes, smoked, honey, bright fruits (red apples, strawberries, citrus fruits). After the study on the main allergen, the menu can be significantly expanded.

Dietary constraints concern not only children, but also the mother in the period of breastfeeding. In this case, all products that increase the content of histamine in the blood are excluded from the food:

• smoked
• nuts
• chocolate,
• marinada,
• eggs
• vinegar,
• yeast,
• products with chemical dyes and preservatives.

In the menu with atopic dermatitis must prevail:

• green apples
• cabbage and zucchini,
• non-fat meat
• cruises of sin, barley and corn.

Possible complications

Along with a cosmetic defect, atopic dermatitis may be complicated:

1. Long non-surging cracks;
2. Bacterial, fungal or viral infection: streptodermia, piederma, (including multicolored deprived), herpes;
3. (in babies);
4. Atopic march in 5-7 years - severe allergic pathologies -, in a child, etc.

• Observe the optimal air mode in the children's room - + 23 ° C, 60% humidity and more.
• Exception of allergenic things from the situation - carpets, feat pillows.
• Removal of mold in the bathroom (mold fungus - aggressive allergen).
• It is necessary for the lack of pets: cats / dogs, birds, fish (fish food are also allerged).
• Revision of washing powder, soap and detergents To exclude sensitization.
• Children's clothes are only cotton.
• Hypoallergenic care products for a child - Lanolin or baby soap without chemical flavors, neutral moisturizers of care.
• Preservation of the psychological rest of the child, the elimination of combs.
• Conducting vaccinations only a healthy baby.
• Treatment of helminthia and chronic tonsillitis.

- A complex of inflammatory-allergic skin reactions arising in response to the impact of various stimuli. Dermatitis in children manifests itself with erythema of various areas of the skin, itching, the presence of rashes or scales, changes in the sensitivity of the inflamed skin sections, the deterioration of general well-being. Diagnosis of dermatitis in children and its forms is based on the data of the visual inspection, analyzes of the scuffer from the affected surface of the skin, immunological and biochemical surveys. Treatment of dermatitis in children provides for the elimination of contact with the reaction with an irritant, treatment of affected skin, receiving antihistamine, immunomodulating, sedatives.

General

Dermatitis in children - local or common inflammation of the child's skin, developing due to direct or indirect effects of biological, physical factors or chemical nature. In children's dermatology and pediatrics, dermatitis constitute 25-57% of cases of all skin diseases. Children most often have atopic, seborrheic, contact and diaper dermatitis. As a rule, dermatitis in children are manifest in the first year of life, and in preschool and school age For the first time develop relatively rarely. Starting in early childhood, dermatitis can acquire a recurrent course and lead to a decrease in the social adaptation of the child.

Causes of dermatitis

Symptoms of dermatitis in children

Symptoms of atopic dermatitis

Usually manifests in the first half of life; Less often develops in preschool, school or adolescence. Skin rashes with atopic dermatitis in children can be represented by persistent hyperemia or transient erythema, dryness and peeling of the skin or a wet papular-vesiculous rash on a erythematous background. TO characteristic features Atopic dermatitis in children relate to the symmetry of skin lesions on the face, limbs, flexion surfaces of the joints; Itching of various intensity. Quite often, with atopic dermatitis in children, folding (hyperlinarity) of palms and soles are found in children; Follicular hyperkeratosis of elbows, forearms, shoulders; White dermographism, leather massacre, pyodermia, hyperpigmentation of the eyelid ("allergic radiance"), Haylit, urticaria, keratoconus, recurrent conjunctivitis, etc.

The natural course of the progression of atopic dermatitis in children in the absence of proper treatment may become the so-called "Atopic March" or atopic disease characterized by the addition of other allergic diseases: allergic conjunctivitis, allergic rhinitis, bronchial asthma.

Symptoms of seborrheic dermatitis

This type of dermatitis occurs about 10% of the children's first 3 months of life and completely stops by 2-4 years. The first manifestations of seborrheic dermatitis in a child may appear already on 2-3 weeks of life. At the same time, gray-sheltered heads (GNEIS) are formed on the heads of the head (GNEIS), which, merging, turn into a solid rig. GNius can spread to the skin of the forehead, eyebrows, the ear region; Sometimes fiddly papulese rashes, covered with scales on the periphery, are found in the natural folds of the body and limbs.

The distinguishing features of seborrheic dermatitis in children are the minimum severity of itching, the lack of exudation (silent, but dry). With violent lifting of the crusts, bright hyperemic leather is exposed; In this case, it can mock and easily infect.

Symptoms of diaper dermatitis

Diaper dermatitis is characterized by irritation of the skin of the berry region, internal surface Hungs, perineum, waist, belly, i.e., skin sites in contact with wet and contaminated diapers, diapers, sliders. Camping dermatitis occurs in 35-50% of the infants, more often develops from girls aged 6 to 12 months.

According to the degree of severity of clinical manifestations, there are 3 degrees of diaper dermatitis. With the light manifestations of dermatitis in children there are moderate skin hyperemia, neuro-pronounced rash and skin maceration in a typical localization places. The diaper dermatitis of the average severity is characterized by the formation of papules, empty and infiltrates on irritated areas of the skin. Heavy diaper dermatitis in children proceeds with the opening of bubbles, the formation of sections of the mock and erosion, extensive drain infiltrates.

Dammatit dermatitis Development affects the overall well-being of children: they become restless, often cry, sleep well, because the inflamed areas of the skin are strong, and touching them cause discomfort and pain. In girls, diaper dermatitis can lead to the development of vulvit.

Symptoms of contact dermatitis in children

Manifestations arise directly on the site of the skin, with whom some irritant comes into contact. The main signs of contact dermatitis in children include saline hyperemia with sharp boundaries, strong itching, burning, soreness, formation of blisters, the opening of which leads to the formation of wet erosive sections.

Contact dermatitis in children can take an acute or chronic course. The sharp phase occurs immediately after contact with the stimulus and stops shortly after the completion of the impact. Chronic flow dermatitis in children acquires after frequent re-exposure of the aggressive factor.

Diagnostics

The appearance of any rash on the skin of the child requires a careful assessment by a pediatrician, a children's dermatologist, a children's allergist-immunologist, sometimes a children's infectiousnessist. If the dermatitis suspicion of dermatitis in children is a thorough collection of anamnesis, the inspection of the skin, clinical and laboratory examination.

In the diagnosis of atopic dermatitis in children, the identification of eosinophilia, elevated levels of general IgE, allergenphecic IgE and IgG methods, Rast, Rist, Mast, plays an important role; the presence of positive skin or provocative tests with allergens.

In the presence of a secondary infection, a bacteriological study of smears is carried out; To detect pathogenic fungi, scraping with smooth skin is studied. In the framework of the examination of children with dermatitis, the study of the coprogram, feces on the dysbacteriosis and the eggs of helminths, carrying out ultrasound of the abdominal bodily organs. Sometimes a biopsy of the skin is performed with the purpose of differential diagnosis.

In the process of examination, it is important to clarify the causes and shape of dermatitis in children, as well as to eliminate the presence of immunodeficient diseases (Viscott-Oldrich syndrome, hyperimmunoglobulinemia E), pink deprivation, microbial eczema, scabies, ichthyosis, psoriasis, leaf lymphoma.

Treatment of dermatitis in children

Sales comprehensive approach The therapy of atopic dermatitis in children includes a decrease or exclusion of contact with an allergen, the correct selection of the diet, medical therapy., Allergen-specific immunotherapy. Systemic pharmacotherapy provides for the reception of antihistamine preparations, NSAIDs, enterosorbents, enzymes, vitamin preparations; In case of severe dermatitis in children - glucocorticoids. To relieve the exacerbations of atopic dermatitis in children, or hemosorption is used.

Topic therapy is aimed at eliminating the inflammation and dry skin, restoration of the barrier properties of the skin and the prevention of secondary infection. It includes the external use of corticosteroidal ointments, non-steroidal hydrolyphic creams, disinfecting fluids, lotions, humid drying bandages. With atopic dermatitis in children, neurmacological methods of treatment have proven wellness: reflexotherapy, hyperbaric oxygenation, inductothermia, magnetotherapy, light therapy. With traditional therapy, the forms of atopic dermatitis in children can be used by the PUVA-therapy.

The basis of the treatment of seborrheic dermatitis is the correct organization of the care of affected skin with the help of special antifungal shampoos and creams. Children are appointed washing head dermatological shampoos with ketoconazole cyclopiroks, tar and others), which have fungistatic, fungicidal, ceravatulating and anti-inflammatory and action. After that, mineral or head is applied on the scalp olive oil. To purify seborrhea plots on smooth skin, special gels are used, after which the skin is lubricated with dermatological cream. On average, the course of seborrheic dermatitis therapy lasts about 6 weeks.

In the treatment of diaper dermatitis in children, the main role is given to the organization of the right hygienic care: frequent change of diapers and diapers, toasting the child after each urination and defecation act, the adoption of air and herbal baths. The affected sections of the child's skin should be thoroughly dryed, to be treated with powders and medicinal means of hygiene containing panthenol, decantenol, Pyrochton Olamin, etc.). Topical corticosteroids should be avoided in the treatment of diaper dermatitis in children. Therapy of contact dermatitis implies the exclusion of impact on the skin of aggressive substances. Zinc-based pastes are used to remove inflammation, lanolin-based ointments, powders, grasses ragners.

Prevention

For any forms of dermatitis in children, general activities are important: hardening procedures, correct care For children's skin, the use of high-quality children's cosmetics and hygiene hypoallergenic products, wearing clothes from natural materials, etc. It is necessary to change diapers every 4 hours (or immediately after defecation), preventing the long-term contact of the skin with the discharge. Important Correction of dietary diet, normalization of the tract of the tract.

With atopic dermatitis, children should avoid contact with household and food allergens. Extension of remissions promote long-term courses

According to statistics, 20% of children around the world suffer from atopic dermatitis.

Atopic dermatitis is an allergic skin disease with hereditary predisposition, accompanied by itching and characterized by chronic recurrent flow.

Atopic dermatitis is still different in the eczema, babe and allergic dermatitis, etc. Parents are mainly such skin rashes Called diathesis. About the reasons, symptoms, diagnosis, methods for the treatment of aptopical dermatitis in children it will be in the article.

What causes atopic dermatitis in children: causes of illness

The main causes of atopic dermatitis:

• Heredity . Atopic dermatitis for kids up to a year - congenital. In his appearance, the main role is played healthy factor. In this case, the kids show other allergic reactions. 81% of children develop atopic dermatitis if their father and mother suffer from this disease. Allergic dermatitis occurs in 56% of children in the presence of eczema from one of the parents.
• Various food allergies provoked by the improper diet of the mother in the period of carrying the baby, non-compliance with the diet after birth, the absence of breastfeeding and early introduction of the feeding.
• Threats of pregnancy interruption, severe flow, Mom's disease during begging .
• Gastritis, dysbacteriosis, enterocolitis ,.
• Not food allergens : Wool left by pets (more often by cats), dust, household chemicals, medicines and others.

Atopic dermatitis arises for other reasons to which include:

• stress, emotional overvoltage, nervous overexcitation;
• second hand smoke;
• unfavorable environmental situation in the child's area;
• weather change (late autumn, early spring, when the risk of disease is especially great and the voltage of the entire immune system occurs);
• excessive sweating during exercise.

Doctor of Medical Sciences E. N. Volkov on the causes of the development of atopic dermatitis:

Atopic dermatitis is one of the most common diseases found in all countries, in persons of both sexes and in different age groups. According to numerous authors, the incidence varies from 6 to 20% per 1000 population; Women are more often sick (65%), less often - men (35%). The incidence of atopic dermatitis in residents of megalopolises is higher than the residents of the countryside. In children, atopic dermatitis is found in 1-4% of cases (up to 10-15%) among the entire population, while in adults in 0.2-0.5% of cases.

Atopic dermatitis is a polyethological disease with hereditary predisposition, and inheritance is polygenic in nature with the presence of a driving gene that determines the damage to the skin, and additional genes. It should be noted that inherited is not a disease as such, but a combination of genetic factors contributing to the formation of allergic pathology.

It is shown that atopic dermatitis develops in 81% of children if both parents suffer from this disease, and 56% - when only one parent is sick, and the risk increases if the mother is sick. In patients with atopic dermatitis, up to 28% of relatives suffer from respiratory speakers. In the study of twin steam, it was found that the frequency of atopic dermatitis in homozygous twins is 80%, and in heterozygous - 20%.

D. election of medical sciences G. I. Smirnova on factors causing atopic dermatitis in children:

The leading causal allergens with blood allergens are, especially in children of the first year of life (99% of cases). Essentially, food allergies are starting sensitization, against the background of which hypersensitivity to other allergens is formed by cross-reactions. Frequent food allergens according to our data are proteins of cow milk (84%), egg (91%), fish (52%), gluten (40%), beef (36%), bananas (32%), cereals (27%), soy (26%). However, the dominant role of food allergies is gradually decreasing with increasing the child, but the significance of aero allergens increases, first of all household (38%), epidermal (35%), pollen (32%), bacterial (20%) and fungal (15%) allergens.

The manifestation of atopic dermatitis in children - symptoms of diseases for kids up to 2 years, children 2-13 years old and teenagers in the table

There are infant (from birth to two years old), children's (from two to 13 years old), teenage (from 13 years old) Atopic dermatitis, which has its own characteristics in certain age periods.

Symptoms allergic dermatitis in children under 2 years old, 2-13 years old and adolescents

Children's age	How does atopic dermatitis manifest?
Kids from birth to 2 years	Dermatitis is localized on the face, colors and legs, can go to the body. Differermacy appear, scales are formed on the head. Blushing, covered with a crust, peel and buttocks and buttocks are peeling. The exacerbation of atopic dermatitis occurs during the introduction of dust and teething.
Children from 2 years and to adolescence	Rash on the bends of the limbs, neck, holes under the knees and elbows. The skin swells, cracks appear on the hands and soles of the legs. Also characteristic symptom It is a hyperpigmentation of the eyelid caused by constant itching and combing, characteristic folds appear under the lower eyelid.
Teenage age and older	Often, rashes disappear in adolescence, but the aggravation of atopic dermatitis is also possible. The number of affected sites is increasing: face, neck, elbow pits, skin is amazed around wrists, brushes, neckline, feet and fingers. The disease is accompanied by a strong itch, it is possible to attach a secondary infection.

At any age, the constant accompanying atopic dermatitis are skin rashes, dry skin, strong skin itch, thickening of the skin and peeling.

Diagnosis of atopic dermatitis in children: What surveys and analyzes need to go through?

Treatment of atopic dermatitis is engaged in several specialists at once: pediatrician, immunologist allergist and dermatologist , sometimes there is a need to appeal to doctors and other specialties (for example, endocrinologist, orthopedic, neurologist ).

When specifying the diagnosis, the tests are submitted. For the study, feces are used, blood, less often the gastric secret, scales from the skin and the intestinal mucosa.

Diagnosis of the disease includes collecting anamnesis (information obtained about the disease, living conditions, pathologies, transferred diseases, allergic reactions and other of the parents or the child), a number of analyzes and other surveys of the patient.

What tests pass to diagnose atopic dermatitis?

Additional diagnostic methods:

• Ultrasound abdominal cavity;
• blood chemistry;
• and urine.

Effective methods for the treatment of atopic dermatitis in infants

Non-media treatment

• First of all need to establish food baby . If you find crumbs on breastfeeding, his mom should closely, eliminating potentially dangerous products from its menu, eliminating its diet. In the event of atopic dermatitis, the kid-artificial should replace the milk mixture to soy. If atopic dermatitis originated when it is time to introduce new products to the kid's diet (luch), then they can be the cause of the disease. Therefore, at the time you need to stop the introduction into the kid's diet of these products.
• Mandatory is to maintain the proper temperature regime in the kid's room. , Frequent ventilation and daily wet cleaning The wash is also subject to all the toys of the child.
• From the baby's room you should remove carpets, books stored on open shelves, soft toy and Since many dust accumulates on these things, which can contribute to the development of dermatitis.
• Baby underwear should be washed , It is advisable to apply additional rinsing, kid's dishes worth soaking without detergents (even child).
• Preferably child wear clothes and cotton underwear.
• It is impossible to smoke with a child. If you have smokers with atopic dermatitis in the family, then the child's communication with them needs to be limited. Parents and other relatives need to smoke isolated from the kid.
• Bathtub can be bathed in warm water with the addition of grasses (Only with the permission of the doctor): nettle, burdock root, yarrow. It is impossible to bathe a baby with atopic dermatitis in water with a chamomile, a turn, oak bark and other herbs that have drying properties. After bathing, the baby can not be wiped, you just need to get into a towel and lubricate the skin with softening creams.
• Affected skin sections can not be so water During the day, it is better to remove pollution by hypoallergenic wet napkins.

Medicase treatment includes:

• the use of ointments and creams with glucocorticoids, which must be used only by appointment of a doctor;
• the use of drugs that contribute to the restoration of the protective barrier of the skin (for example, exopial lotion);
• use with a severe form of flowing atopic dermatitis of calcium preparations, antihistamines, antibiotics and immunomodulators.

How to treat atopic dermatitis in a child older than a year?

Treatment is assigned after accurate confirmation of the diagnosis. It is impossible to engage in the treatment of a child without consultation with a specialist, since a number of diseases can be similar symptoms, therefore, dealing with self-medication, you can harm the health of the child.

What non-drug methods are used to combat atopic dermatitis?

Non-media treatment It is to eliminate various factors that can contribute to the exacerbation of the disease: elimination of various food, household and contact allergens.

• It is impossible to use closed, tightly adjacent to the body synthetic clothing. It is better to wear a child in spacious cotton clothing, avoiding overheating.
• A special role is played by the length of nails. Be sure to shortly cut your nails to the child so that it cannot damage the skin when the skin has occurs in the skin lesions.
• From the children's room you need to withdraw all dust-collecting toys (soft toys), as well as all the toys having the smell. The rest you need to wash with children's soap.
• A diet has a beneficial effect on the course of the disease, the diet is formed for each child individually, given the history of the anamnesis and the results of allergic studies.
• Not last place in non-drug treatment Atopic dermatitis takes purity in the child's room, venting, compliance with the temperature regime. Be sure to change the baby and bed linen daily.
• In the bedroom of the child should not be household appliances (TV, computer). Wet cleaning in the room must be done daily, and the general one is once a week.
• Be sure to go more with the child, but ensure that clothes contact as little as possible with the body and did not rub.

Systemic medication treatment of allergic dermatitis appoints the doctor taking into account the stage and form of the disease.

In the treatment of atopic dermatitis use:

1. Antihistamines aimed at eliminating the action of allergen: zetrin, zoda, zyrtek, suprastin, Loratadine and others.
2. Detoxification drugs Cleansing the body: activated carbon, Enterosgel and others.
3. Antibacterial therapy and antiseptics: Antibiotics are written out when skin damage bacterial infection. First, the skin is treated with antiseptics (Miramistin, chlorhexidine), and after the antibiotic is applied: Mazi Bactroban, Levomikol, Furacin ointment and others.
4. Immunomodulators. If atopic dermatitis is combined with immune failure, the doctor allergist-immunologist can register immunomodulators: cyclosporine, levamizol, azathioprine and others.
5. Vitamins and phytopreparats: B (B15 and B6) vitamins and medicinal herbs.
6. Preparations aimed at restoring the work gastrointestinal : Mizim, Pancreatin, Festal and others.
7. Antifungal I. antiviral tools Assign in case of skin infection with fungi: Clotrimazole, pimafucine, microsyl and others. In case of layers herpetic infection Apply additional antiviral tools.
8. Creams and ointments with healing properties: Bepanten, Panthenol and others.

Prevention of exacerbations in atopic dermatitis in children

Parents must teach the child to properly care for their skin, use moisturizing agents and other local drugs, and also reduce contact with unfavorable factors External environment that can provoke an aggravation of the disease.

Prevention of exacerbations with atopic dermatitis is:

1. Diet and proper nutrition.
2. Secure environment for a child.
3. Use of soap and detergent with moisturizing effect. Water treatments It should be limited to wash in warm water no more than 10 minutes.
4. Wearing non-fitting cotton clothes without applying different dyes.
5. New clothes need to be erased and stroke in front of the sock.
6. When washing, you need to use the minimum amount of powder, air conditioner for linen, and also set the option - additional rinsing. Linen is better not in the house or apartment, but on the balcony or on the street.
7. As far as possible, in contact with allergens causing aggravation of the disease.
8. Fully follow the instructions of the doctor.

Children suffering from atopic dermatitis to avoid exacerbations, categorically impossible:

• use hygiene facilities containing alcohol;
• use antimicrobial drugs without a doctor's prescription;
• long to be in the sun;
• participate in sports competitions;
• long stay in water, take hot baths;
• during washing, use tough means (washcloths, but permissible to use washcloths from terry tissue).