What is atopic dermatitis and how can it be cured quickly? Methods and means for the treatment of dermatitis in adults Atopic dermatitis in the adult stage how to treat

Comprehensive treatment includes a number of mandatory measures - physiotherapy, diets, drug treatment, and prevention.

Given the pathogenesis of the disease, treatment methods should be aimed at achieving long-term remission, as well as skin restoration.

The reasons

I single out external and internal causes of the development of dermatitis.

Internal factors:

1. genetic predisposition. Atopic dermatitis is more likely to occur in those whose relatives or parents have a predisposition to allergies. But this does not mean that dermatitis will definitely be inherited;
2. metabolic disorders in the skin. Any violation in the protective function of the skin leads to the fact that it becomes more susceptible;
3. skin reaction to external stimuli. In some people, the immune system reacts instantly to many substances;

External factors:

1. stress. Overwork of the body leads to disruption of the immune system;
2. environmental exposure to the skin contributes to the occurrence of atopic dermatitis;
3. excessive physical activity;
4. food products. Improper nutrition of pregnant mothers will lead to the fact that dermatitis will occur not only in them, but also in the child;
5. environment. Doctors say that excessive toxins in the air can trigger the onset of the disease;

Development mechanism

The mechanism of development is reduced to disruption of the immune system.

The ingestion of allergy pathogens leads to the onset of an inflammatory process of an allergic nature.

Antibodies begin to be produced in the blood, which gradually accumulate in the skin. The protective function of the skin is impaired. That is why the further inflammatory process concerns the skin.

The main symptoms of manifestation

One of the main manifestations is a feeling of severe itching.

It can be different - barely felt, intense, capable of causing depression and sleep disturbance.

The skin is flaky, lichenification appears. If treatment measures are not taken in time, the skin will begin to coarsen, dryness, ulcers will appear.

It is possible the appearance of secondary infections that will cause swelling, purulent discharge.

Treatment options for atopic dermatitis in adults

Atopic dermatitis is an insidious skin disease. In the fight against nm, people will pour both traditional methods of treatment and non-traditional ones. Traditional methods of treatment in adults consist of various complex measures.

Some of them can be done while at home:

1. diet. It is prescribed by a doctor, after examination. Patients need it in the acute form of the disease;
2. medical- the use of drugs to relieve inflammatory processes;
3. physiotherapy. Doctors say that this is one of the safest methods of treatment. The immune system is restored, inflammation on the skin recedes;

Non-traditional methods include treatment with tinctures based on herbal preparations.

The exacerbation of the disease is always associated with exposure to allergens, which is why there are recommendations that are important to follow:

• try to completely limit contact with the irritant;
• do not keep pets in the room where the patient lives;
• make sure that the skin is not dry;
• use hypoallergenic cosmetics;

A dermatologist will probably prescribe ointments and drugs. Be sure to take them as directed. At the slightest suspicion of dermatitis, go to the doctor.

medicines

Treatment of atopic dermatitis begins only after examination by a specialist. He will prescribe a number of medications, taking into account age, individual tolerance, and the nature of the disease.

Self-medication is dangerous and can cause complications.

For therapy, antihistamines are prescribed:

• Zodak;
• Diazolin;
• Narkom.

Desensitizing agents will help reduce itching. Drugs will reduce the level of sensitivity to allergens - calcium gluconate, sodium thiosulfate.

Soothing drugs are prescribed that can normalize the functioning of the nervous system - motherwort, valerian. For more severe disorders - Diazepam.

In most cases, atopic dermatitis is accompanied by inflammatory processes, as well as diseases of the digestive system.

In order to restore the normal microflora, you need to take medications such as:

1. enzymes - festal;
2. sorbents - enterosgel;
3. probiotics - dufalac;

To improve metabolism and normalize the functioning of the immune system, it is necessary to take vitamins regularly.

Exacerbated forms of the disease, as described above, require physiotherapy.

Means for external use

Funds used externally are aimed at the following:

• reduce or completely eliminate itching;
• restore the skin;
• soften the skin;
• restore protective properties;

Topical preparations - external glucocorticoids, topical immunosuppressants.

Almost all drugs of this type are produced in the form of creams, lotions, ointments.

Fenistal gel is a multifunctional remedy. Cares for damaged skin, moisturizes it.

A few hours after application, the first effect will be felt. They need to be used at least 4 times a day.

Zinc ointment is a caring and anti-inflammatory agent. Safe for children and pregnant women. Treatment in adults with ointment can be lengthy.

She struggles with dermatitis for a month, until the signs disappear completely. This is the only ointment that can be used independently without a doctor's appointment.

folk recipes

As practice shows, the treatment of atopic dermatitis with folk remedies in adults is quite effective.

After all, the disease does not bring life threat and is not incurable. It is unlikely that anyone will like inflammation on the skin, which not only itch, but also interfere with work.

In order to get rid of this unpleasant ailment, folk recipes were “invented”.

It is worth paying attention that they can treat not only adults, but also children.

1. lotion. To prepare it, you need to take a glass of boiled water and st. a spoonful of medicinal veronica. Pour boiling water over the grass and insist for 3 hours. Then strain and treat the skin in the affected areas 5-6 times a day. The lotion is safe, has no side effects;
2. compress. You can prepare this folk remedy at home. The only thing you need for this is a fresh raw potato. Wash it, clean it, and grate it. Squeeze the resulting mass from the water and wrap in gauze. Apply a compress at night to sore spots;
3. antipruritic ointment. In addition to redness on the skin, dermatitis also causes another discomfort - constant itching. In order to remove it, you can prepare an ointment. For this you will need: 1 tbsp. a spoonful of butter, glycerin, 2 tbsp. pre-boiled hay dust, 4 tbsp. water, chamomile, fireweed. In a container, mix fireweed and chamomile, bring to a boil and cook over low heat for 5 minutes. Add oil and dust, cook until the mass takes on a thick consistency. Keep the ointment in the refrigerator. Lubricate the skin 4 times a day;

Drug Overview

A number of drugs are used to treat atopic dermatitis.

Their doctor prescribes, unauthorized admission is prohibited, in order to avoid complications:

• tavegil- available in the form of tablets, syrup. Relieves itching, eliminates swelling. Taken as prescribed by a doctor;
• fenistil- drops for oral administration. According to the doctor's prescription, it can be given to children starting from one month. Side effects include drowsiness;
• fenisti - gel. It is used for severe skin itching. It does not need to be applied to the skin in a thick layer. It is strictly forbidden to give to children on their own;
• lomilal- comes in the form of a suspension and tablets. It has an anti-inflammatory effect. You can take pills from the age of 12.

Home therapy rules

Atopic dermatitis can develop at any age, regardless of gender. Despite the fact that this is not an infectious disease, there is still discomfort from it. While at home, you can try to relieve itching and the initial signs of the disease.

For this, there are certain means:

1. Aloe Vera Gel. You can buy it at a pharmacy, without a doctor's prescription. The cold effect of the drug relieves itching. If such a plant grows at home, you can cut the leaves and get a fresh gel.
2. oil therapy. This is the best option for treating atopic dermatitis at home. To do this, you can take - castor oil, coconut, almond. It has a calming and healing effect.
3. Salt. It is good for relieving itching and inflammation. Take a cup of salt, dissolve in a liter of warm water. Moisten the affected areas for 15 minutes.

Principles of therapy in children

For the treatment of atopic dermatitis in children, a number of measures must be taken. The main attention should be paid to the restoration of the outer layers of the skin. To do this, you need to use moisturizing cosmetics 3-4 times a day.

If the disease has affected the baby, then it is important to keep breastfeeding as long as possible. At the same time, the mother’s nutrition should be correct, not any allergic products.

You need to bathe the child every day, without the use of soap. Buy medicated shampoos. After bathing, do not rub the skin, blot with a towel and let it dry on its own.

Vaccination of a child with atopic dermatitis is a problem today. After all, the mere fact of having a disease is not a reason to refuse vaccinations.

But the nuance is that they can only be put in the period of remission.

It is mandatory to take antihistamines, but only those prescribed by the attending physician.

Treatment of atopic dermatitis in children is not difficult. With the timely treatment of mothers to the hospital, you can get rid of the disease as quickly as possible.

Preventive methods

To treat the disease, as well as to prevent its recurrence, several rules must be observed:

1. food. Exclude from the diet foods that can provoke allergies - chocolate, nuts, citrus, eggs;
2. skin care. It is important not just to use creams and moisturize the skin. It is also necessary to take water procedures correctly. Add decoctions of medicinal herbs to them. Do not wipe the skin dry, but let it dry on its own;
3. do not keep pets at home;
4. use hypoallergenic products.

Unfortunately, there is no single cure for the disease. But even these simple rules will delay the onset of remission.

When to See a Doctor

You should consult a doctor in the following cases:

• the symptoms are so disturbing that it is impossible to sleep peacefully;
• soreness of the skin;
• ulcers appeared on the skin, yellow color;
• all attempts at skin care do not bring results;

If you observe these symptoms, even if not in significant numbers, go to the doctor. This will help specialists quickly identify the source of the allergy, prescribe medications.

And you, in turn, will quickly return to your usual way of life, without unnecessary discomfort.

According to medical statistics, over the past decade, the prevalence of skin pathologies has increased significantly. One of the most common reasons for visiting a dermatologist is atopic dermatitis, the symptoms of which manifest themselves to some extent in 80% of preschool children. As patients grow older, the signs of the disease disappear in 60% of cases, in the rest of the patients, dermatitis becomes chronic. The clinical course of the disease in adults is distinguished by its specificity, which requires a special approach to treatment.

What is atopic dermatitis

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

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

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

According to the degree of prevalence and severity of the course, atopic eczema syndrome can be of two types: moderate (focal rashes) and severe (extensive skin lesions). If left untreated, a skin disease can lead to serious complications - damage to the skin by pyogenic bacteria (pyoderma), viruses or fungi. Inherited hyperreactivity of the skin (hypersensitivity) is a predisposing endogenous factor to the development of pathology, but the potentiation of the appearance of allergic manifestations is due to a number of exogenous causes.

Development factors

Pathophysical changes in the skin that occur during periods of exacerbation of atypical dermatitis are due to natural allergic reactions of the body of an immediate type. Successive changes in the internal biological environment (formation, release of skin-sensitizing antibodies and tissue response to the processes that have taken place) have their own genetically determined features.

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

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

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

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

Features of the course in adults

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

Due to the differences in the functioning of organs and systems in children and adults, the clinical manifestations of atopic dermatitis in different age groups of patients differ. The characteristic symptoms of the disease in persons older than 13 years (the stage of development of the disease is defined as "adult" if the patient's age is more than 13 years) are:

• prurigo (prurigo) - severe itching, which can appear even with minimal rashes, the sensations are aggravated by sweating;
• dryness of the skin - occurs due to a lack of natural moisturizing factors, which leads to a violation of the formation of the lipid layer and dehydration of the epidermis;
• the appearance of a blistering rash - typical places of localization of rashes are the face, neck, armpits, popliteal and elbow folds, groin, scalp, area under the earlobes;
• swelling of the affected surfaces;
• hyperemia, darkening and thickening of the skin in the localization of the rash (occurs in the later stages of the disease);
• anxiety-depressive state, caused both by a reaction to a deterioration in the quality of life and the development of functional disorders of the central nervous system that occurred as a result of pathological changes in the body;
• increased susceptibility to infectious agents;
• follicular hyperkeratosis - in adult patients, due to neurodermatitis, keratinization of the skin surface of the lateral surfaces of the shoulders, elbows, forearms (looks like "goosebumps");
• the appearance of cracks on the heels, bald spots in the occipital region - manifestations are characteristic of the elderly;
• peeling of the skin of the feet, madarosis (excessive loss of eyelashes and eyebrows) is a consequence of thyroid dysfunction, which are caused both by the allergic process itself and by the hormone therapy being undertaken.

Treatment of atopic dermatitis in adults

After a diagnosis confirming the diagnosis of "atopic dermatitis" and the identification of disease-provoking allergens, a dermatologist prescribes a treatment regimen. To determine the optimal therapeutic methods, specialists in the following specialized areas can be involved:

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

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

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

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

• medication (with the use of external and systemic agents);
• physiotherapeutic (physical or physico-chemical effect on the affected surface);
• psychotherapeutic (to prevent the development of neurosis or psychosis against the background of a disease, electrosleep, hypnosis and, in agreement with a neuropsychiatrist, drugs are used);
• balneotherapy (health resort treatment);
• therapeutic and prophylactic diet (to restore the intestinal microflora), hypoallergenic diet therapy;
• herbal medicine (the use of traditional medicine recipes must be agreed with the attending physician).

Acute period

The goal of the treatment of neurodermatitis during the acute phase is the rapid removal of key symptoms and the normalization of the patient's condition. The basis of therapeutic measures during an exacerbation of the disease is medications of the group of topical corticosteroids (Prednisolone, Triamcinolone, Sinalar). With atopic eczema of moderate severity, corticosteroids of mild and moderate activity are used, with severe disease and extensive areas of damage - high. Drugs of this pharmacological class are prescribed in short courses.

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

Remission period

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

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

For debilitated adult patients in whom the disease proceeds in moderate to severe form, anabolics (Nerobol, Retabolil) are indicated, which correct the effect of corticosteroids on the body. At all stages and forms of dermatosis, the use of vitamin and mineral complexes is recommended. Depending on the patient's condition, a course of mono- or multivitamin therapy is carried out. Fortified supplements are often prescribed for short periods at doses that are well in excess of normal physiological requirements.

Medical treatment

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

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

Glucocorticosteroids

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

For the treatment of atopic eczema in adults, internal and external forms of corticosteroids are used. Non-external hormonal agents for intramuscular administration include Betamethasone, injections of which are prescribed in a course with a frequency of use 1 time in 2 weeks. The most commonly prescribed tablet drugs in this group are Prednisolone, Metipred, Triamcinolone. For external use, the treatment regimen may include Laticort (hydrocortisone-based cream), Advantan ointment (methylprednisolone) and Afloderm cream (alclomethasone)

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

Antihistamines

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

• 1st generation - Clemastin, Atarax;
• 2nd generation - Loratadin, Cetirizine;
• 3rd and 4th generation - Levocetirizine, Desloratadine.

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

macrolide immunosuppressive agents

The basic therapy prescribed for adult patients after the relief of an acute process includes external agents, which include immunosuppressants. The drugs of this group, unlike steroids, are non-hormonal drugs. The best known macrolide immunosuppressants are tacrolimus (Protopic) and pimecrolimus (Elidel), which target T-lymphocytes and skin mast cells.

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

Moisturizers

Dermatological practice provides for the widespread use of local therapy, which can be etiological, symptomatic or pathogenetic. In the treatment of dermatitis in adult patients, reducing agents play an important role, restoring the structure and functionality of the skin. Dry skin is not only a symptom of neurodermatitis, but also a factor supporting inflammatory processes. Constant itching, which occurs due to excessive dryness, causes nervous disorders that impede the treatment process.

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

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

Tablets for atopic dermatitis in adults

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

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

Membrane stabilizing drugs

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

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

Sedatives

Psycholeptics (sedatives, sedatives) are prescribed for atopic dermatitis, if a connection between the exacerbation of the disease and stress factors is revealed. The drugs of this group are also shown in the case of psycho-emotional disorders that have arisen against the background of neurodermatitis. The calming effect is achieved due to the regulatory influence of the active components of psycholeptics on the nervous system. During the treatment of adult patients, the following sedative drugs can be used:

Preparations for the normalization of bowel function

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

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

Hyposensitizing agents

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

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

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

calcium gluconate

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

Sodium thiosulfate

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

Prednisolone

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

The immunosuppressive effect is provided by potentiation of lymphopenia (decrease in lymphocytes) and involution (weight loss) of lymphoid tissue. With an exacerbation of severe allergic dermatosis, intravenous or intramuscular injections of Prednisolone are prescribed at a dosage of 1–2 mg per 1 kg of the patient's body weight. The course lasts no more than 5 days

External Therapy

Topical treatment of atopy is aimed at eliminating the cause and symptoms of dermatitis. To implement these tasks, a large arsenal of external medications is used. The success of therapy depends on the correct choice of active components and the dosage form of medicines. During the treatment of atopic eczema, adult patients may be prescribed the following medications, which can be bought at pharmacies in the city:

Antibacterial ointments for secondary infection

With intensive scratching of itchy skin, the integrity of its surface is disturbed, which contributes to the penetration of infectious agents from the environment into the inner layers of the epidermis. Pathogens cause irritation and itching, closing the "atopic skin cycle" (when the symptoms of dermatitis become factors in its development). In order to break the vicious circle, it is necessary to stop the development of a secondary infection. For this purpose, antibacterial agents of external action are prescribed, such as:

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

Physiotherapy procedures

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

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

vitamins

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

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

Folk remedies

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

Before starting self-treatment using alternative methods, it is necessary to agree with the doctor on the appropriateness and safety of using certain medicinal herbs. Due to the effect, the following methods of home therapy are very popular in patients with atopic eczema:

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

Raw potato compress

Folk recipes for getting rid of allergic dermatosis based on potatoes are safe to use and easy to prepare. The tubers of this vegetable are 75% water, which causes its moisturizing and softening effect on the skin. To prepare a medicinal composition, fresh raw potatoes should be peeled and chopped using non-metallic tools. The potato mass should be wrapped in gauze, squeezed and applied overnight to the affected surface. The procedures are performed until the skin condition improves.

Antipruritic ointment from chamomile and fireweed

You can get rid of severe itching, which is the main symptom that disturbs patients, with the help of an antipruritic ointment based on willow-herb (fireweed) and chamomile. You can use this herbal remedy only on open areas of the body. To achieve a sustainable effect, it is necessary to perform the procedure for a month, applying the ointment 3-4 times a day. If necessary, the course continues after a week break. The components necessary for the preparation of the antipruritic composition should be prepared in advance. The recipe includes the following ingredients:

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

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

Herbal decoction for oral administration

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

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

Spa treatment of dermatitis in adults

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

• pelotherapy (mud baths or applications);
• thalassotherapy (treatment using all the factors that are formed in the conditions of the marine climate - water, algae, seafood, etc.);
• balneotherapy (using the healing properties of mineral waters - showers, irrigation, drinking, bowel lavage, etc.);
• heliotherapy (sun therapy, sunbathing);
• climatotherapy (staying in a dry warm climatic zone for more than 2 months provides a long-term remission, more than 3 years - a complete recovery).

diet therapy

An important step in the course of treatment of atopy is the preparation of a hypoallergenic diet, the main task of which is to exclude allergens and histamine liberators (products that stimulate the release of histamine) from entering the patient's body. If, with the help of laboratory diagnostics, a specific product is identified that caused the sensitization of the body, a specific elimination diet is prescribed (exclusion of products containing identified substances).

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

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

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

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

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

• before starting a diary, it is necessary to refrain from food for 1 day (it is allowed to drink clean water, unsweetened tea);
• introduce foods into the diet gradually (first dairy, then eggs, meat, fish, vegetables and citrus fruits);
• describe in detail the composition of the dishes used (ingredients, quantity, time of admission, method of preparation);
• record all reactions of the body with an indication of the time of their occurrence and the degree of severity.

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The term "atopy" refers to a genetically determined predisposition to a number of allergic diseases and their combination, arising in response to contact with certain environmental allergens. These diseases include chronic atopic dermatitis, also called atopic eczema/dermatitis syndrome and atopic eczema.

Atopic dermatitis is a chronic atopic inflammatory skin disease that develops mainly from early childhood and proceeds with exacerbations in response to low doses of specific and nonspecific stimuli and allergens, characterized by age-related features of the localization and nature of the foci, accompanied by severe itching of the skin and leading a sick person to emotional and physical maladjustment.

Causes of atopic dermatitis

Atopic dermatitis develops in 80% of children whose mother and father suffer from this disease; if only one of the parents - 56%; in the presence of a disease in one of the parents, and the second has a pathology of the respiratory organs of allergic etiology - almost 60%.

Some authors are inclined to believe that allergic predisposition is the result of a complex of various genetic disorders. For example, the importance of congenital insufficiency of the enzymatic system of the digestive tract has been proven, which leads to incomplete splitting of incoming products. Violation of the motility of the intestines and gallbladder, the development of dysbacteriosis, scratching and mechanical damage to the epidermis contribute to the formation of autoantigens and autosensitization.

The result of all this is:

• the assimilation of food components that are unusual for the body;
• the formation of toxic substances and antigens;
• dysfunction of the endocrine and immune systems, receptors of the central and peripheral nervous system;
• the production of autoantibodies with the development of the process of autoaggression and damage to the body's own tissue cells, that is, immunoglobulins are formed that play a major role in the development of an atopic allergic reaction of an immediate or delayed type.

With age, the importance of food allergens is increasingly minimized. The defeat of the skin, becoming an independent chronic process, gradually acquires relative independence from food antigens, the mechanisms of the response change, and exacerbation of atopic dermatitis occurs already under the influence of:

• household allergens - house dust, fragrances, sanitary household products;
• chemical allergens - soaps, perfumes, cosmetics;
• physical skin irritants - coarse woolen or synthetic fabric;
• viral, fungal and bacterial allergens, etc.

Another theory is based on the assumption of such innate features of the skin structure as insufficient content of the structural protein filaggrin in it, which interacts with keratins and other proteins, as well as a decrease in lipid synthesis. For this reason, the formation of the epidermal barrier is disrupted, which leads to easy penetration of allergens and infectious agents through the epidermal layer. In addition, it is assumed that there is a genetic predisposition to the excessive synthesis of immunoglobulins responsible for immediate allergic reactions.

Atopic dermatitis in adults can be a continuation of the disease from childhood , late manifestation of a latent (latently, without clinical symptoms) of an ongoing disease or late implementation of a genetically determined pathology (in almost 50% of adult patients).

Relapses of the disease occur as a result of the interaction of genetic and provoking factors. The latter include:

• unfavorable ecology and excessive dryness of the air;
• endocrine, metabolic and immune disorders;
• acute infectious diseases and foci of chronic infection in the body;
• complications during pregnancy and the immediate postpartum period, smoking during pregnancy;
• prolonged and repetitive psychological stress and stressful conditions, shift work, long-term sleep disorders, etc.

In many patients, self-treatment of allergic dermatitis with folk remedies leads to a pronounced exacerbation, most of which are prepared on the basis of medicinal plants. This is due to the fact that they are usually used without taking into account the stage and prevalence of the process, the age of the patient and allergic predisposition.

The active components of these products, which have antipruritic and anti-inflammatory effects, are not purified from accompanying elements, many of them have allergenic properties or individual intolerance, contain tanning and drying substances (instead of the necessary moisturizers).

In addition, self-prepared preparations often contain natural unrefined vegetable oils and/or animal fats that close the skin pores, which leads to an inflammatory reaction, infection and suppuration, etc.

Thus, theories about the genetic cause and the immune mechanism of the development of atopic dermatitis are the main ones. The assumption of the presence of other mechanisms for the implementation of the disease has long been only a subject of discussion.

Video: How to find the cause of allergic dermatitis

Clinical course

There is no generally accepted classification of atopic dermatitis and objective laboratory and instrumental methods for diagnosing the disease. The diagnosis is based mainly on clinical manifestations - typical morphological changes in the skin and their localization.

Depending on age, the following stages of the disease are distinguished:

• infantile, developing at the age of 1.5 months and up to two years; among all patients with atopic dermatitis, this stage is 75%;
• children (at 2 - 10 years of age) - up to 20%;
• adult (after 18 years) - about 5%; the onset of the disease is possible before the age of 55, especially among men, but, as a rule, this is already an exacerbation of the disease that began in childhood or infancy.

In accordance with the clinical course and morphological manifestations, there are:

1. The initial stage, developing in childhood. It manifests itself with such early signs as limited redness and swelling of the skin of the cheeks and buttocks, which are accompanied by slight peeling and the formation of yellow crusts. In half of the children with atopic dermatitis on the head, in the area of ​​\u200b\u200bthe large fontanel, fatty small dandruff flakes form, as with.
2. The stage of exacerbation, consisting of two phases - severe and moderate clinical manifestations. It is characterized by severe itching, the presence of erythema (redness), small vesicles with serous contents (vesicles), erosions, crusts, peeling, scratching.
3. The stage of incomplete or complete remission, in which the symptoms of the disease disappear, respectively, partially or completely.
4. The stage of clinical (!) Recovery is the absence of symptoms of the disease for 3-7 years (depending on the severity of its course).

The existing conditional classification also includes an assessment of the prevalence and severity of the disease. The prevalence of dermatitis is determined by the area of ​​the lesion:

• up to 10% - limited dermatitis;
• from 10 to 50% - common dermatitis;
• over 50% - diffuse dermatitis.

The severity of atopic dermatitis:

1. Mild - skin lesions are local in nature, relapses occur no more than 2 times in 1 year, the duration of remissions is 8-10 months.
2. Average - widespread dermatitis, aggravated up to 3-4 times within 1 year, remissions last for 2-3 months. The nature of the course is rather persistent, difficult to correct with drugs.
3. Severe course - damage to the skin is widespread or diffuse, often leading to a severe general condition. Treatment of atopic dermatitis in such cases requires the use of intensive care. The number of exacerbations within 1 year is up to 5 or more with remissions of 1-1.5 months or without them at all.

The nature of the course of atopic dermatitis in pregnant women cannot be predicted. Sometimes, against the background of moderate depression of immunity, there is an improvement (24-25%) or there are no changes (24%). At the same time, 60% of pregnant women experience deterioration, most of them - for up to 20 weeks. Deterioration is manifested by physiological or pathological metabolic and endocrine changes and is accompanied by changes in the skin, hair, nails.

It is also suggested that increased levels of progesterone and some other hormones during pregnancy lead to increased skin sensitivity and itching. Of no small importance are the increase in vascular permeability, the increase in the permeability of the lipid barrier of the skin in the area of ​​the back surface of the hands and the flexor surface of the forearm, psycho-emotional instability, preeclampsia of pregnancy, impaired functioning of the digestive organs, as a result of which there is a slowdown in the removal of toxins from the body.

Symptoms of atopic dermatitis

It is customary to distinguish between major (major) and minor (minor) symptoms. For the diagnosis of atopic dermatitis, the simultaneous presence of any three main and three auxiliary signs is necessary.

The main symptoms include:

1. The presence of itching of the skin, present even with minimal skin manifestations.
2. The characteristic morphological picture of the elements and their location on the body are dry skin, localization (often) in symmetrical zones on the arms and legs in the area of ​​the flexion surface of the joints. In places of defeat there are spotty and papular rashes covered with scales. They are also located on the flexion surfaces of the joints, on the face, neck, shoulder blades, shoulder girdle, as well as on the legs and arms - on their outer surface and in the area of ​​the outer surface of the fingers.
3. The presence of other allergic diseases in the patient himself or his relatives, for example, atopic bronchial asthma (in 30-40%).
4. The chronic nature of the course of the disease (with or without relapses).

Auxiliary criteria (most common):

• the onset of the disease at an early age (up to 2 years);
• fungal and frequent purulent and herpetic skin lesions;
• positive reactions to allergen testing, increased blood levels of general and specific antibodies;
• drug and / and food allergy, occurring in an immediate or delayed (up to 2 days) type;
• Quincke's edema, recurrent rhinitis and/or conjunctivitis (80%).
• reinforced skin pattern on the palms and feet;
• whitish spots on the face and shoulder girdle;
• excessive dryness of the skin (xerosis) and its peeling;
• itching of the skin with increased sweating;
• inadequate reaction of skin vessels to mechanical irritation (white dermographism);
• dark periorbital circles;
• eczematous skin changes around the nipples;
• poor tolerance to wool products, degreasers and other chemicals and other less significant symptoms.

Characteristic for adults are frequent relapses of atopic dermatitis under the influence of many external factors, moderate and severe course. The disease can gradually move into a more or less long-term remission, but almost always the skin tends to itching, excessive peeling and inflammation.

Atopic dermatitis on the face in adults is localized in the periorbital zone, on the lips, in the region of the wings of the nose, eyebrows (with hair loss). In addition, the favorite localization of the disease is in the natural folds of the skin on the neck, on the back surface of the hands, feet, fingers and toes, and flexion surfaces in the joints.

The main diagnostic criteria for skin manifestations of the disease in adults:

1. Severe itching in areas of localization.
2. Skin thickening.
3. Dryness, peeling and weeping.
4. Strengthening the picture.
5. Papular rashes, eventually transforming into plaques.
6. Detachment of significant limited areas of the skin (in the elderly).

Unlike children, exacerbations usually occur after neuro-emotional overstrain and stressful situations, exacerbations of other chronic diseases, and taking any medications.

Skin lesions are often complicated by lymphadenitis, especially inguinal, cervical and axillary, purulent folliculitis and furunculosis, skin lesions with herpes virus and papillomaviruses, fungal infection. Often develop blanching, softening and loosening of the lips with the formation of transverse cracks (cheilitis), conjunctivitis, periodontal disease and stomatitis, pallor of the skin in the eyelids, nose and lips (due to impaired capillary contractility), depression.

With increasing age, the foci become localized, the skin becomes thick and rough, and more flaky.

Video: Atopic dermatitis rules of life

How to treat atopic dermatitis

The goals of therapeutic intervention are:

• maximum reduction in the severity of symptoms;
• ensuring long-term control over the course of the disease by preventing relapses or reducing their severity;
• change in the natural course of the pathological process.

In adult patients with atopic dermatitis, unlike children, only complex treatment is always carried out, based on the removal or reduction of the effect of provoking factors, as well as on the prevention and suppression of allergic reactions and the inflammatory processes caused by them in the skin. It includes:

1. Elimination measures, that is, to prevent the entry into the body and the removal from it of factors of an allergenic or non-allergenic nature that increase inflammation or cause an exacerbation of the disease. In particular, most patients should take vitamins with caution, especially “C” and “B” groups, which cause allergic reactions in many. Preliminary carrying out of various diagnostic tests and other researches on identification of allergens is necessary.
2. Proper medical and cosmetic care aimed at improving the barrier function of the skin.
3. The use of external anti-inflammatory therapy, which provides for getting rid of itching, treatment of secondary infection and restoration of the damaged epithelial layer.
4. Treatment of concomitant diseases - foci of chronic infection in the body; allergic rhinitis and conjunctivitis, bronchial asthma; diseases and dysfunctions of the digestive organs (especially the pancreas, liver and gallbladder); complications of dermatitis, for example, neuropsychiatric disorders.

Video about the treatment of atopic dermatitis

Of great importance is the background on which treatment should be carried out - this is an individually selected diet for atopic dermatitis of an elimination nature. It is based on the exclusion from the diet of products:

• causing allergies;
• not being allergens for a particular patient, but containing biologically active substances (histamine) that provoke or intensify allergic reactions - histamine carriers; these include substances that are part of strawberries and strawberries, soybeans and cocoa, tomatoes, hazelnuts;
• having the ability to release histamine from the cells of the digestive tract (histaminoliberins), contained in citrus fruit juice, wheat bran, coffee beans, cow's milk.

Therapeutic and cosmetic skin care consists in the use of a daily shower for 20 minutes with a water temperature of about 37 ° C in the absence of a purulent or fungal infection, moisturizing and emollients - an oil bath with the addition of moisturizing ingredients, cosmetic moisturizing spray, lotion, ointment, cream. They have indifferent properties and are able to reduce inflammation and itching by maintaining skin moisture and retaining corticosteroids in it. Moisturizing creams and ointments in the absence of wetting) are more effective than spray and lotion in helping to restore the hydrolipidic layer of the skin.

How to relieve itching of the skin, which often acquires painful forms, especially at night? The basis is systemic and topical antihistamines, since histamine plays a crucial role in the development of this heavy sensation. With simultaneous sleep disturbance, first-generation antihistamines are recommended in the form of injections or tablets (Diphenhydramine, Suprastin, Clemastin, Tavegil), which also have a moderate sedative effect.

However, for long-term basic therapy, it is more effective and more convenient (1 time per day) for the treatment of local and general allergic reactions and itching (2nd generation) - Cetirizine, Loratadine or (better) their new derivative metabolites - Levocetirizine, Desloratadine. Of the antihistamines, Fenistil is also widely used in drops, capsules and in the form of a gel for external use.

Local treatment of atopic dermatitis also includes the use of systemic and local preparations containing corticosteroids (hydrocortoison, fluticasone, triamcinolone, clobetasol), which have antiallergic, decongestant, anti-inflammatory and antipruritic properties. Their disadvantage is the formation of conditions for the development of a secondary (staphylococcal, fungal) infection, as well as a contraindication to long-term use.

Second-line drugs (after corticosteroids) include non-hormonal local immunomodulators - calcineurin inhibitors (tacrolimus and pimecrolimus), which suppress the synthesis and release of cellular cytokines that are involved in the formation of the inflammatory process. The impact of these drugs helps prevent hyperemia, swelling and itching.

In addition, according to indications, non-hormonal anti-inflammatory, antibacterial, antifungal or combined drugs are used. One of the popular remedies with anti-inflammatory, moisturizing and regenerative properties is Bepanten in the form of an ointment or cream, as well as Bepanten-plus, which additionally includes the antiseptic chlorhexidine.

It is important not only to eliminate subjective symptoms, but also to actively moisturize and soften the affected areas, as well as restore the damaged epidermal barrier. If you do not reduce the dryness of the skin, it will not be possible to eliminate scratching, cracks, infection and exacerbation of the disease. Moisturizers include preparations containing urea, lactic acid, mucopolysaccharides, hyaluronic acid, glycerol.

Emollients are various emollients. Emollients in atopic dermatitis are the main external, not only symptomatic, but also pathogenetically directed means of influencing the disease.

They are various fats and fat-like substances that can be fixed in the stratum corneum. As a result of its occlusion, fluid retention and natural hydration occur. Penetrating within 6 hours deeper into the stratum corneum, they replenish lipids in it. One of these preparations is a multicomponent emulsion (for baths) and cream "Emolium P triactive", containing:

• paraffin oil, shea butter and macadamia oils, restoring the water-lipid mantle on the surface of the skin;
• hyaluronic acid, glycerin and urea, which are able to bind and retain water, moisturizing the skin well;
• allantoin, corn and rapeseed oils, softening and relieving itching and inflammation.

The current approach to the choice of atopic dermatitis treatment is recommended by the International Medical Consensus on Atopic Dermatitis. These recommendations take into account the severity of the course of the disease and are based on the principle of "steps":

1. Stage I, characterized only by dry skin - removal of irritants, application of moisturizers and emollients.
2. Stage II - minor or moderate signs of atopic dermatitis - topical corticosteroids with mild or moderate activity and/or calcineurin inhibitors.
3. Stage III - moderate or sufficiently pronounced symptoms of the disease - corticosteroids of medium and high activity until the development of the process stops, after which - calcineurin inhibitors.
4. Stage IV, which is a severe degree of the disease, not amenable to the above groups of drugs - the use of systemic immunosuppressants and phototherapy.

Atopic dermatitis in each person is characterized by the peculiarities of the course and diagnosis and requires an individual approach in the choice of treatment, taking into account the prevalence, forms, stage and severity of the disease.

Almost every mother can meet with atopic dermatitis in a baby. This disease often appears from the first days after birth and occurs throughout life. Babies who are diagnosed with atopic dermatitis are forced to be observed by an allergist for life. Only correct knowledge about this disease will help to control the course of the disease.

What it is?

Scientists have identified a number of genes that code for a predisposition to the perception of various substances. These genes cause an increased susceptibility of the body to various foreign components. As a rule, several family members can have such a predisposition at once.

Atopic dermatitis develops as a result of an acute response of the immune system to the entry of a trigger factor. This reaction is accompanied by severe skin and systemic manifestations. Various substances and allergens can act as trigger or provoking agents. The peculiarity of the individual reaction depends on the genetic predisposition and the initial level of the immune system.

Causes

A severe allergic reaction, manifested by the appearance of a rash or other skin elements, does not occur in all children. Currently, scientists identify more than a thousand different causes that can lead to the appearance of atopic dermatitis. . In most cases, provoking agents are chemicals.

The only exact cause of the disease is unknown to scientists. This is due to the individual encoding of genes in each human body. It has been established that when a specific trigger hits, the risk of developing atopic dermatitis in the presence of a specific genetic predisposition is more than 95-98%.

Canadian scientific studies have shown a statistically significant relationship between the presence of stressful situations and exacerbations of the disease. After strong psycho-emotional or physical stress, the risk of new exacerbations of the disease increases by 12-15%.

Among the possible causes, some scientists note the presence of skin pathologies. If the integrity of the skin is violated, allergens get into the children's body much easier and trigger a whole cascade of inflammatory reactions. With the development of diseases, periods of exacerbations are replaced by remissions. As a result of a long illness, the structure of the skin changes. It can also affect the likelihood of disease progression.

Provoking factors

Atopic dermatitis can be caused by many factors. All triggers can be divided into several categories. Most provoking agents enter the body from outside. They account for over 80% of cases. Internal provoking factors are much less common. Typically, these forms of diseases are typical for babies with many chronic diseases.

All provoking factors that trigger the cascade of allergic reactions can be divided into several etiological categories:

Stages of disease development

Unfortunately, atopic dermatitis is a chronic disease. In the presence of individual sensitivity and genetic predisposition to various provoking factors, a new exacerbation of the disease can occur at any age. Like any chronic disease, atopic dermatitis goes through several successive stages in its development:

1. Primary contact with the allergen. In this case, when a provoking agent enters, the cells of the immune system are activated. Lymphocytes, which are designed to recognize substances foreign to the body, are activated and emit a huge amount of biologically active substances. Subsequently, when the same trigger hits, the inflammation proceeds much more strongly. This property is due to cellular memory. The cells of the immune system “remember” the antigens of a substance foreign to the body and, when hit again, throw out a huge amount of protective antibodies.
2. development of immune inflammation. Activated lymphocytes that have recognized a foreign agent begin to release a huge amount of interleukins. These protein substances have a pronounced biologically active effect. It is with them that the development of all adverse clinical symptoms and manifestations is usually associated. This reaction is positive. It is designed to limit inflammation and prevent damage to vital organs. The body wants to limit inflammation to just the skin, protecting the brain and heart.
3. Development of classic manifestations of the disease. During this period, the inflammatory process reaches such strength that the first adverse symptoms of the disease begin to appear. As a rule, they last 7-14 days. The most acute manifestations upon initial contact with the allergen appear after 48-72 hours. If the provoking factor enters the body repeatedly, then the period before the onset of symptoms can be reduced from several hours to a day.
4. Subsidence of exacerbation and transition to a chronic form. During this period, the amount of toxic substances that are formed during an allergic reaction decreases. The immune system calms down and goes into "sleep" mode. The subsidence of the process can last up to 2-3 weeks. At this time, there are only residual skin manifestations: dryness, slight peeling, slight redness. After the acute period of the disease subsides, the skin clears up and takes on a normal appearance.
5. Remission. During this period, the child practically does not care about anything. The kid leads a normal life. The child is in excellent health. The skin changes slightly. In some cases, crusts or patches of dry skin may form at the folds.

The development of the disease implies a sequential alternation of several stages. After a period of exacerbation, remission occurs. The duration of this period largely depends on the condition of the baby and the absence of exposure to provoking factors. With any change in the level of immunity or inflammation, remission can quickly turn into an exacerbation.

Classification

To date, doctors in their work use several different categories at once, which allow them to clarify the diagnosis. Such classifications include the distribution of various variants and forms of the disease - depending on the stage of the inflammatory process, its duration, as well as the severity of the general condition of the child.

The various forms of atopic dermatitis can be divided into several broad categories.

Phase of disease development

• Start. Corresponds to the primary contact of the cells of the immune system with a provoking factor.
• Development of clinical manifestations. During this period, all the main manifestations of the disease characteristic of the acute period develop.
• Subsidence of exacerbation. Disappearance of unpleasant symptoms, improvement of the general condition of the baby.

Age

• Infant version. It develops in children up to two years of age. It usually proceeds with the appearance of red itchy spots. Such rashes are quite large. This option is also characterized by pronounced swelling of the buttocks, arms and legs of the baby. The skin on the body is very thin. Numerous white scales can form on the head, which are easily rejected.
• Children's option. It usually goes on until adolescence. This form of the disease is characterized by severe itching, as well as drying of the skin. Skin elements can be varied. Often there are various vesicular rashes filled with transparent contents.
• Teenage option. May develop before the age of eighteen. This form occurs with the appearance of severe itching on damaged areas of the skin. The disease proceeds with a change in periods of exacerbation and remission. This leads to the formation of dense crusts and areas with severe lichenification. The appearance of vesicles does not always occur. Much more often, skin rashes appear as extensive areas of erythema.

The extent of the inflammatory process

• Option with limited areas. Damage to the skin in such cases is no more than five percent of the entire surface of the skin.
• Option with common elements. It occurs when there are lesions that capture up to a quarter of the entire surface of the skin.
• Variant with diffuse changes. An extremely unfavorable form of the disease. In this case, there are numerous damage to the skin. The only areas that remain clean are the inner surface of the palms and the area on the face near the nose and above the upper lip. This variant of atopic dermatitis causes severe unbearable itching. Numerous scratch marks appear on the skin.

General state change

• Relatively easy flow. It implies the occurrence during exacerbations of a small number of skin rashes. Usually these are single vesicular elements. This option is characterized by the appearance of moderate itching, there is a slight swelling, as well as dry skin. The course of the disease is usually well controlled. Remission periods are usually long.
• Moderate form. With this variant of the disease, a large number of various vesicular formations filled with serous fluid appear in various parts of the body. When the vesicles break, the liquid expires, weeping ulcers form. As a rule, the condition of the baby worsens. The child constantly combs itchy elements. The condition may also be complicated by the addition of a secondary bacterial infection.
• Severe flow. It is typical for babies with a low level of immunity. The child looks terrible. Skin elements appear almost everywhere: on the face, on the arms and legs, cover the buttocks, stomach. Numerous vesicles, torn, contribute to the development of strong weeping wounds, which are poorly epithelialized.

Main symptoms and signs

Atopic dermatitis is manifested by numerous symptoms that cause severe discomfort to the baby. The severity of the manifestations of the disease depends on a combination of many factors. With a mild course of the disease, the symptoms appear to a lesser extent. If the child's allergic predisposition is sufficiently pronounced, then the immune response to the provoking factor will be very strong.

During an exacerbation, dermatitis is manifested by the following characteristic features:

• Marked itching. He worries the child throughout the day. Decreases somewhat at night. Toddlers, combing damaged areas of the skin, can bring an additional infection and cause a worsening of the course of the disease. The use of antihistamines helps to somewhat reduce the manifestation of this uncomfortable symptom.
• The appearance of erythematous spots. Numerous bright red spots begin to form on the skin. With a mild course of the disease, skin rashes can appear only in limited areas of the body. They often occur on the back, abdomen, or arms. Affected skin acquires a characteristic "fiery" color. To the touch it becomes hot, somewhat compacted.
• The appearance of dryness. It is also one of the most common symptoms of atopic dermatitis. The longer the disease proceeds, the more pronounced this manifestation becomes. This is due to a violation of the water-lipid composition of the skin (due to a long-term inflammatory process). The structure of the skin layers is disturbed, which contributes to a change in its quality. The skin becomes very dry to the touch and becomes thinner.
• Various skin rashes. Atopic dermatitis is characterized by a variety of different manifestations. In most cases, the disease is manifested by the appearance of vesicular elements. As a rule, they contain serous fluid inside. In more rare cases, papular elements occur or various crusts appear. Such rashes most often occur in all folds of the skin. Very often they appear in the cubital fossa, under the knees, and can also occur behind the ears or on the cheeks.
• The phenomena of lichenification. This symptom appears already quite late. It occurs with constant scratching, in the presence of damaged areas of the skin. In this case, there is a change in the structure and structure of the skin. It becomes denser, the architecture of collagen and elastin fibers is disturbed.
• Poor health of the child. Severe itching causes the baby expressed anxiety. Babies are more naughty, often crying. In severe cases, the disease may even refuse to eat. Older children are characterized by increased excitability - and even somewhat aggressive behavior. Sleep is disturbed.

After the acute process subsides, a period of remission begins. All the symptoms that were characteristic during the exacerbation are replaced by others. The duration of remission can depend on many different factors. With a favorable course of the disease, such periods can even last several years.

The following symptoms are characteristic of the period of remission of atopic dermatitis:

• Changing the structure of the skin. Some areas of the skin become thickened, while others become thinner. This is due to changes in the structure and structure of the skin layers. The areas where the weeping ulcers were located usually heal, but become less dense to the touch. Crusts may form on healed wounds.
• Traces of scratches. They occur in almost all babies with atopic dermatitis. Most pronounced in children with frequent exacerbations of the disease. Usually appear as narrow stripes of white or reddish color. Cover the entire surface of the body. In large quantities can be seen on the arms or cheeks of the baby.
• Change in skin pattern. With a long-term inflammatory process that occurs with this disease, the architecture of the skin structure changes. Areas of hyperpigmentation appear.
• Severe dryness of the skin and the appearance of areas with peeling. This symptom is typical in the very first days after the exacerbation subsides. The skin becomes very dry. Numerous scales may appear on the scalp and on the folds of the arms. They are easily rejected during washing or when touched.
• With a long course of the disease, severe dryness and peeling around the red border of the lips may appear. Often this is a manifestation of atopic cheilitis. This condition does not require special treatment - other than the use of soft lip balms approved for use in children. In some cases, atopic cheilitis resolves on its own, without the use of additional funds.

Diagnostics

Ancillary laboratory and instrumental tests will help identify the specific allergen that contributes to the symptoms of atopic dermatitis.

General blood analysis

An increase in the level of leukocytes above the norm indicates the presence of an inflammatory process in the body. Severe eosinophilia (an increase in the number of eosinophils) indicates the presence of an allergic nature of the disease. All allergies proceed with the acceleration of ESR in the acute period of the disease.

The leukocyte formula helps doctors understand the stage of the inflammatory process. An increase in the level of peripheral lymphocytes also speaks in favor of the allergic nature of the disease.

Biochemical research

For analysis, a little venous blood is taken from the baby. With this analysis, you can see the function of the liver and kidneys. An increase in the level of transaminases may indicate the involvement of liver cells in the systemic process. In some cases, there is also an increase in the level of bilirubin.

Kidney damage can be assessed by measuring urea or creatinine. With a long course of the disease, these indicators can change several times. If the level of creatitine changes, be sure to show the child to a nephrologist. He will help you choose the right tactics for further treatment of the baby.

Quantitative determination of immunoglobulin E

This substance is the main protein substrate that the cells of the immune system secrete in response to allergens entering the body. In a healthy baby, the level of immunoglobulin E remains normal throughout life. Children with atopic diseases are characterized by an increased content of this substance in the blood serum.

The material for the study is venous blood. The analysis is ready, as a rule, in 1-2 days. During an exacerbation of the disease, the level of immunoglobulin E is many times higher than normal. An increase in the rate of more than 165 IU / ml may indicate the presence of atopy. During remission, the level of immunoglobulin E decreases slightly. However, for quite a long time it can remain somewhat elevated.

Special allergy tests

This method is the classic way to determine allergens in immunology. It has been used in pediatrics for over a hundred years. The method is quite simple and informative. Such provocative tests are carried out for kids over four years old. Younger children may give false positive results during the test. This is largely due to the peculiarities of the functioning of the immune system at this age.

Only a pediatric allergist-immunologist can conduct allergy tests. Most often they are carried out in the conditions of allergy clinics or in private centers.

The survey usually takes no more than an hour. The baby is made small incisions on the skin with a special sharp scalpel. There is no need to be afraid of such cuts. They are too small to become a threat of infection or suppuration.

After applying special notches, the doctor applies diagnostic solutions of allergens. Substances are applied in strong dilution. This minimizes the risk of a possible violent allergic reaction. Such diagnostic solutions can be applied in several ways. Usually drip is selected.

Today, the application method is widely used. It does not require additional notches. With this method of applying the allergen, the diagnostic solution is pre-applied to the material. The doctor simply sticks it on the child's skin and after a while evaluates the result.

Usually the result is estimated in 5-15 minutes. This time depends on the initial diagnostic solution that is used in the study. If the baby has an allergic predisposition or a pronounced sensitivity to a particular allergen, then after a specified time, redness (and even skin manifestations) will appear at the application site. They may be papules or vesicles.

The undoubted disadvantage of such a test is its low specificity.. If the baby has very sensitive and delicate skin, then various false positive reactions can be observed. Under the influence of any chemical provocateur, too delicate skin can react excessively sharply. In such cases, it is impossible to speak about the unequivocal presence of an allergy.

If it is impossible to unambiguously assess the presence of individual allergic sensitivity to a particular allergen, doctors use additional serological studies.

Determination of specific antibodies

These studies are considered the most modern among all methods for diagnosing atopic diseases. They began to be used quite recently, but showed excellent results in the diagnosis of allergic diseases. The test does not require any notches or incisions in the skin. The material for the study is venous blood.

The analysis period is usually from three days to several weeks. It depends on the amount of allergens tested. For the convenience of young patients, modern laboratories immediately determine a whole line of allergens that are similar in antigenic structure. This allows not only to accurately establish one provoking factor, but also to identify all cross-allergens that can also provoke an exacerbation.

The essence of the method is to determine the specific antibodies that are formed in the body after allergens enter it. They are protein molecules that are very sensitive to various foreign agents. With any contact with the allergen, the cells of the immune system throw out a huge amount of antibodies. Such a protective reaction is designed to quickly eliminate the foreign agent from the body and eliminate inflammation.

The serological test is an important diagnostic test in establishing provoking factors that can trigger an allergic reaction. It has a fairly high specificity (95-98%) and information content. The disadvantage of research is the high cost. Usually, for the determination of 10 different allergens, the price is 5000-6000 rubles.

Before conducting any serological tests, it is important to remember about the preparation for the studies. All such tests are best done during remission. This will minimize false positive results. Before conducting the study, it is better to adhere to a therapeutic hypoallergenic diet. It is better to cancel all antihistamine and desensitizing drugs a couple of days before the study.

Principles of basic treatment

Therapy of atopic dermatitis is divided into several stages: during the period of exacerbation and remission. Separation of treatment allows you to cope with the various symptoms that occur at different periods of the course of the disease. With a long development of the disease, drug therapy also changes. This is largely due to changes in the architecture and structure of the skin.

During an exacerbation

• Elimination of the provocative factor. It is an important condition for the successful treatment of the disease. Often in infants there is a contact form of atopic dermatitis. It appears when wearing diapers that are not suitable for a particular child. A piece of tissue that is closely adjacent to the baby's genitals can be saturated with various antiseptic agents. Children who are prone to allergization may experience acute contact dermatitis. . In this case, it is better to abandon this brand of diapers and change them to others.
• The use of drug therapy. Today, the pharmaceutical industry offers a huge selection of different products that help to cope with the uncomfortable symptoms of atopic dermatitis. The choice of drugs is carried out, focusing on the skin manifestations that occurred during this exacerbation. Most often, various hormonal and anti-inflammatory ointments, creams, gels, as well as various powders or talkers are used.
• Compliance with a hypoallergenic diet. During the period of exacerbation, doctors prescribe the most rigid medical nutrition. Such a diet includes an abundance of permitted protein foods and cereals with the almost complete exclusion of a variety of fruits and vegetables. Only green plants can be used.
• In severe cases of the disease - elimination of systemic manifestations. In such cases, hormonal preparations in the form of injections or tablets may be prescribed. With severe itching, which brings severe suffering to the baby, tablet forms of antihistamines are prescribed. E it may be "Suprastin", "Fenistil" and others. They are prescribed for a long time: from several days and even up to a month.
• Compliance with the rules of personal hygiene. Moms should monitor the cleanliness and length of nails in babies. With severe itching, children scratch the inflamed skin strongly. If there is dirt under the nails, then they can bring an additional infection and aggravate the course of the disease. When the secondary bacterial flora is attached, the inflammation increases markedly, signs of suppuration may appear.
• Compliance with the daily routine. For the proper functioning of the immune system, babies need mandatory rest. During the day, children should sleep for at least ten hours. This time is required by the body to maintain a good ability to fight inflammation, it gives strength to fight the allergen.

During remission

• The use of drug therapy for damaged areas of the skin. After the acute process subsides, a variety of crusts and peeling remain on the skin. To eliminate the consequences of the inflammatory process, ointments and creams with a fairly oily texture are perfect. Such preparations penetrate well into all layers of the skin and eliminate severe dryness. To eliminate crusts or scales on the scalp, various ointments are used that have a keratolytic effect.
• Strengthening immunity. For babies weakened after an acute period of illness, restoring the strength of the immune system is an important stage in rehabilitation. Children with atopic diseases do not need to stay at home all the time. Sterile conditions are absolutely useless for them.

Active walks and games in the fresh air will strengthen the immune system and add health. Normalization of the protective function of the intestine also helps to restore immunity. Preparations enriched with useful lacto- and bifidobacteria restore the disturbed microflora. "Liveo baby", "Bifidumbacterin" help the intestines to work fully and strengthen the immune system.

• Regular adherence to a hypoallergenic diet. A child who has a tendency to allergic diseases or atopic dermatitis must definitely eat only permitted foods. All food that contains possible allergenic components is completely excluded from the baby's diet. Follow a hypoallergenic diet for the rest of your life.
• Complete exclusion from household use of possible provoking allergens. For babies who are prone to atopic dermatitis, feather-based pillows or blankets should not be used. It is better to give preference to other natural and synthetic materials on a hypoallergenic basis. Pillows should be dry-cleaned at least twice a year. This will get rid of household mites, which often live in such products and can cause allergic reactions.

Drug therapy

Drug treatment plays a significant role in eliminating the adverse symptoms of atopic dermatitis. The choice of a drug directly depends on which manifestation needs to be eliminated. In the treatment of the disease, both cutaneous forms and systemic administration of injections and tablets are used.

Local treatment

• Anti-inflammatory ointments, creams and suspensions (talkers). They include " Tsindol", "Elidel", "Triderm", "Ketotifen and many other means. These drugs have an anti-inflammatory effect and help to cope with inflammation. Many funds are combined. Antibiotics may be included in their composition in small concentrations. Such drugs are usually well tolerated and do not cause systemic side effects. They are prescribed, as a rule, 2-3 times a day and for a period of 10-14 days. With a more severe course of the disease, they can be used for a long time, until the adverse symptoms of the disease are completely eliminated.
• Hormonal ointments. They are used for long-term illnesses. You should not be afraid of the use of such drugs. The content of glucocorticosteroid hormones in them is quite small. Such drugs simply cannot cause systemic side effects. Most topical preparations contain beclomethasone or prednisolone in small concentrations. In the treatment, you can use the Advantan, Elocom ointments and many others approved for pediatric practice.
• Desensitizing drugs. Doctors often prescribe antihistamines to relieve severe itching. It can be Suprastin, as well as Fenistil, drugs based on desloratadine. Many of the drugs are used for children older than two years. These remedies allow you to eliminate severe inflammation and cope with debilitating itching. Such drugs are prescribed in a course of 10-14 days.

Tablet forms can also be used for a month or more after the elimination of adverse symptoms of exacerbation. Calcium gluconate can be used to relieve itching. It helps to eliminate the moderate manifestation of this unfavorable symptom.

• Cell membrane stimulators. They have a mechanism of action similar to that of antihistamines. They are used in pediatric practice relatively recently. They are well tolerated by children. There are practically no side effects from the use. Ketotifen is often prescribed. This drug is used for babies older than three years. Appointed by the course for 2-3 months. The plan is chosen by the attending physician. For proper discontinuation of the drug, a gradual decrease in dosage is required.
• Medicines that support the immune system. Often, babies with atopic dermatitis are advised to maintain a good condition of the intestinal microflora. For this, various preparations containing live bifidobacteria or lactobacilli are prescribed. These drugs should be used in courses: 2-3 times a year. To remove toxic products from the body, enterosorbents are used: Polysorb, activated carbon tablets, Enterosgel.

Are water treatments allowed?

In order for the skin to remain sufficiently hydrated during an exacerbation of atopic dermatitis, it must be moisturized. Even during the period of acute manifestations of the baby's illness, you can bathe. It is not recommended to wash the child in the bath. This can increase itching and lead to additional overdrying of the skin. It is better to give preference to a simple hygienic shower.

To reduce itching on the head, you can use special medicated shampoos. Such products have a physiological neutral pH and do not cause irritation.

Hygiene procedures can be carried out daily. After that, it is necessary to treat the skin with therapeutic ointments or creams. This will further moisturize damaged skin and eliminate the adverse manifestations of atopy.

For very young children, when bathing, you can add a decoction of celandine. To prepare it, take 2-3 tablespoons of crushed leaves, pour them with a liter of boiling water. It should be insisted for 3-4 hours. A glass of the resulting broth is added to the bath when bathing the baby. You can bathe a child with wormwood or infusion of succession. These herbs have a beneficial effect on the skin and help prevent infection of wounds that occur during an exacerbation.

What to eat?

Therapeutic nutrition in atopic dermatitis is very important for the treatment of the disease. That Only adherence to a diet throughout life will prevent frequent exacerbations of the disease. This is especially important for babies who have severe food allergies to various foods.

Especially for babies with atopic dermatitis and allergic diseases, pediatricians have developed a separate nutrition system.

It completely eliminates provocative foods that have strong antigenic properties and can cause allergies.

The following foods should be completely excluded from the baby's diet:

• All tropical fruits and vegetables. Most of the berries are red or burgundy in color. Citrus fruits are also banned.
• Seafood and fish that live in the ocean. River fish is added to the diet gradually. It is necessary to monitor the reaction of the child to the introduction of a new product.
• Chocolate products and other sweets containing cocoa beans.
• Candies and sweet sodas, which contain many chemical dyes and food additives.

The following foods must be included in the diet of a baby with atopic dermatitis:

• High in protein. Perfect for: lean poultry, veal, fresh beef, and rabbit meat. Dairy products must be included in the child's diet. A large amount of the right protein, combined with beneficial bifidobacteria, will help kids strengthen their immunity. At each meal, it is better to add some specific allowed protein product.
• Cereals or cereals. They can be a great addition or side dish. They help to provide the body with energy and give new strength to fight the disease. It is better to alternate different cereals. They contain a large amount of B vitamins, as well as zinc and selenium. These substances have a positive effect on the skin and even promote its healing.
• Green vegetables. During the period of subsiding exacerbation, you can add potatoes and some carrots. Boiled cauliflower (or broccoli) is an excellent side dish for very young children. You can add grated cucumber to dishes. Vegetables are an excellent source of insoluble dietary fiber. They are also needed for the formation of a healthy intestinal microflora.
• Fruit. Usually, apples and garden pears are recommended for Russian kids. In these fruits, the content of antigenic components is much lower than in tropical fruits. In the acute period, the use of such products should be somewhat reduced. Fruits contain a large amount of natural sugars. This can adversely affect the restoration of the cellular structure of the skin and somewhat impair the functioning of leukocytes.
• Sufficient liquid. To remove the decay products that are formed in the body during the inflammatory process, water is required. . You can drink plain boiled water. It is also acceptable to use fruit drinks or compotes prepared from dried garden apples or pears. Berry drinks are best excluded until the remission period.
• The use of vitamins. During the period of a strict diet, which is necessary during an exacerbation, too few useful microelements enter the child's body, so the introduction of such substances from the outside is required. Synthetic complexes are an excellent source of various vitamins. They contain a combination of useful trace elements necessary for the growth and development of the baby. Currently, vitamin preparations are available in the form of chewable tablets, syrup or caramel. Such vitamins will bring joy to the child, and will also help restore the deficiency of useful trace elements in the body.

How to organize the daily routine?

Toddlers with atopic diseases are very important to follow the correct routine . The daily routine must necessarily include daytime sleep. It is better to spend at least 3-4 hours on it. During such a rest, the nervous and immune systems are restored. The child has new strength to fight the disease.

Night sleep should be at least 8-9 hours. For babies in the first year of life - even up to 12. As a rule, during sleep, the level of histamine decreases. This substance is formed during an acute inflammatory reaction and causes severe itching. Reducing the concentration of histamine can reduce this adverse symptom. This brings some relief to the baby.

In the acute period of the disease, active games are noticeably reduced. Exhausting itching brings babies severe discomfort. With the elimination of adverse symptoms against the background of ongoing treatment, children begin to feel much better and return to their usual way of life. During the acute period of the disease, it is better to limit active physical activity. Kids need to rest more, try to get enough sleep.

Opportunities for spa treatment

The long course of the disease often becomes chronic. Symptoms that occur during an exacerbation are best treated in a hospital setting, and in mild cases, at home. .

The remission of the disease is an excellent time for specialized treatment in sanatoriums or health centers.

Various methods of physiotherapy have a positive effect on the course of the disease. For babies with a long-term illness, various methods of ultrasound treatment, magnetic and light therapy, as well as inductothermic methods are used. Usually, during a stay in a wellness center, the baby is prescribed several different methods at once, in courses of 10-14 days. In some cases, the appointment of a longer treatment, up to three weeks, is indicated.

Therapy in the sanatorium has a very pronounced clinical effect. With the regular passage of such balneological treatment, the number of exacerbations of the disease is significantly reduced. In children who undergo therapy at sea, immunity is noticeably strengthened. Sea ions have a positive effect on the functioning of the cells of the immune system, and also heal the skin.

Doctors recommend that children with atopic dermatitis undergo spa treatment at least once a year. It is better to do this when the exacerbation subsides or during the period of remission. The duration of the tour can be 14-21 days. It is better to choose sanatoriums that are located in close proximity to the sea, or specialized health centers that provide medical services for babies with atopy and allergic skin diseases.

Complications

At the initial stage, the disease usually proceeds without pronounced adverse effects. After several exacerbations and the use of numerous drugs, the child may experience certain complications of the disease.

The most common in atopic dermatitis are:

• Various suppurations(as a result of the addition of a secondary bacterial infection). Staphylococcal and streptococcal flora are widespread. Usually, a baby can bring germs while scratching itchy elements. After that, after a few hours, inflammation noticeably increases, pus appears.
• Very often weeping wounds become infected. Even a small amount of the pathogen is enough to start a bacterial infection process. These cases require immediate medical advice and antibiotics. In severe cases of the bacterial process - emergency hospitalization in a hospital.
• Atrophic phenomena on the skin or its pronounced thinning. Usually occur as side effects after long-term use of corticosteroid ointments. Some children may have alternative options. Instead of areas with thin skin, dense crusts (or even scabs) form. In such conditions, the appointment of hormones is canceled and they are switched to other drugs. During the period of such a cancellation, immunomodulatory agents are prescribed for babies, which allow normalizing the impaired function of the child's immune system.

Is there a disability?

Usually for babies with atopic dermatitis, the establishment of a disability is not mandatory. With a mild course of the disease and sufficient control of the onset of a persistent loss of functions, there is no. With this variant of the disease, doctors recommend the treatment of exacerbations in a polyclinic, with the obligatory control of an immunologist.

Adolescents and young people who have a history of a long course of the disease and numerous hospitalizations for the treatment of exacerbations may apply to the ITU for examination. Doctors-experts will study all the medical records of the child and identify the presence or absence of disabling signs. If a child has signs of a permanent loss of function, then a disability group can be established for him. Usually the third.

Prevention of exacerbations

Preventive measures help prevent acute manifestations of the disease and control the course of the disease. When it comes to babies with atopic dermatitis, you should always remember about prevention. Avoiding contact with the precipitating factor helps reduce the risk of a possible flare-up.

To avoid the appearance of adverse symptoms and the acute stage of the disease, you should:

• Be sure to follow a hypoallergenic diet. All foods with strong allergenic properties are completely excluded from the baby's diet. Only neutral dishes that do not contain allergens are allowed. Meals should be taken several times a day, in small portions. Be sure to include a complete protein (in sufficient quantity for the child's body).
• Use only hypoallergenic materials. All pillows, bedding, and clothing should be made of synthetic materials with low allergenic properties. It is better not to wear products made of natural silk or wool. Pillows should be cleaned at least once or twice a year. The duvet should also be professionally dry-cleaned.
• Toys, dishes and cutlery belonging to the child are processed in warm water using special liquids that do not contain aggressive chemicals. These products usually have a label stating that they are hypoallergenic and cannot cause allergic reactions. For children with atopic dermatitis, it is better to use household chemicals that are approved for use from the first days after birth.
• The use of antihistamines before flowering plants. Especially necessary for babies with allergic reactions to pollen. Antihistamines in prophylactic doses will reduce the likelihood of a severe allergic reaction. The disease can pass in a more erased form.
• Strengthening immunity. Proper nutrition with enough fiber and vitamins, active outdoor games will be excellent ways to restore and activate the immune system. Babies with atopic dermatitis should also not avoid hardening and water procedures. Such techniques have a positive effect on the immune system, as well as improve mood and normalize sleep.
• Prolonged breastfeeding. Scientists from many countries have proven that protective antibodies enter the body of an infant along with mother's milk. This allows you to protect the children's body from various infectious pathologies and reduce the risk of developing possible allergic reactions. Breast milk also contributes to the normalization of the baby's intestinal microflora and helps to strengthen the immune system.
• Compliance with hygiene rules. Children's rooms of babies who are prone to allergic reactions should be cleaned much more often. Achieving completely sterile conditions is not at all necessary. Much more important is just a clean and freshly washed floor. Be sure to ventilate the room. This improves air exchange in the children's room and even helps to reduce the concentration of pathogenic microbes in the air.
• Regular walks in the fresh air. Sufficient insolation has a positive effect on the immune system. The sun's rays stimulate the nervous system, and also contribute to the normalization of hormonal levels. For babies, outdoor activities are very important. They help restore immunity.

Atopic dermatitis is very common in children of all ages. The course of the disease in most cases becomes chronic. Regular monitoring, preventive measures, as well as timely and competent treatment of exacerbations will help control the development of the disease and improve the quality of life of the baby.

Forget about hormonal ointments, a hypoallergenic diet, mountains of pills and special skin care. Get treated for atopic dermatitis in 2019 with ALT and enjoy the remission of the disease!

Atopic dermatitis (obsolete) neurodermatitis) is a chronic allergic inflammation of the skin. The disease is manifested by characteristic rashes in the form of persistent or transient redness, increased dryness, thickening of the skin with elements of weeping and peeling.

As a rule, skin lesions are common, but skin lesions on the face, arms and hands are most irritating to the patient. Eruptions of a local type, for example, on the head or legs, usually persist during a period of relative remission.

In severe forms of the course of dermatitis, in addition to superficial changes in the skin, a persistent lesion of the subcutaneous tissue occurs. The skin takes on the form of a shell that binds the entire body. Excruciating skin itching does not stop even in a dream.

The disease affects not only adults, but also children. In children, atopic dermatitis usually begins at an early age and occurs later in only 2-5% of cases.

In childhood, in the case of a severe course of the disease, the so-called “atopic march” may develop, when allergic rhinitis and bronchial asthma join the disease.

Atopic dermatitis is a non-conscription diagnosis (according to Decree of the Government of the Russian Federation of February 25, 2003 No. 123), therefore, in young people of military age, it is a kind of lifesaver from military service.

In adults, atopic dermatitis usually has a chronic form with periods of exacerbations provoked by dietary disorders, stress and adverse effects on the body. One has only to drink alcohol, eat a chocolate bar or stand behind the wheel in a traffic jam, as the manifestations of allergic dermatitis remind of themselves - a rash, itching and skin lesions appear.

With a systematic violation of the diet, severe skin lesions, weeping can occur, which, combined with itching, turns the life of an allergic person into a real nightmare - undermined working capacity and social activity, depression occurs, etc. And when complications come to an allergic person in the form of fungal skin lesions, a vicious circle arises.

It does not happen that atopic dermatitis goes away on its own or as a result of symptomatic treatment. It is important to understand that external treatment of the skin and the use of antihistamines is only an effect on the symptoms of the disease!

Therefore, if you are in an unsuccessful attempt to cure atopic dermatitis, you are still wasting your time and money on:

• Hormonal ointments (Elocom, Advantan, etc.);
• Non-hormonal creams (Elidel, etc.);
• Various "folk remedies" and home treatment;
• Expensive tablets in bulk (Suprastin, Ketotifen, Telfast, Kestin, Loratadin, Zirtek, Erius, etc.);
• Shampoos, oils and medicated lotions.

It is worth saying to yourself: "Stop!"

The only way to cure the cause of atopic dermatitis in 2019 is autolymphocytotherapy! Alt has no alternative.

Help yourself and your loved ones cure atopic dermatitis, tell your friends and acquaintances about this method, they will be grateful to you!

Problems of a patient with atopic dermatitis

Get rid of atopic dermatitis and restore healthy skin is possible with the help of ALT!

"Autolymphocytotherapy" (abbreviated as ALT) has been widely used in the treatment of patients with various forms of allergic diseases for over 20 years, the method was first patented in 1992.

Autolymphocyte therapy is the only treatment for the cause of atopic dermatitis!

Children are treated by the method "Autolymphocytotherapy" after 5 years.

The "Autolymphocytotherapy" method, in addition to the treatment of "atopic dermatitis", is widely used for: urticaria, Quincke's edema, bronchial asthma, allergic rhinitis, hay fever, food allergies, allergies to household allergens, to pets, allergies to cold and ultraviolet rays (photodermatitis) .

Treatment with ALT is possible even in severe cases, when the patient is simultaneously observed, for example, atopic dermatitis and asthma.

ALT METHOD ELIMINATES INCREASED SENSITIVITY OF THE ORGANISM TO SEVERAL ALLERGENS AT ONCE, DIFFERING FAVORITELY FROM ASIT.

The essence of the "ALT" method is to use your own immune cells - lymphocytes to restore the normal function of the immune system and reduce the body's sensitivity to various allergens.

Autolymphocytotherapy is carried out on an outpatient basis, in an allergological office by appointment and under the supervision of an allergist-immunologist. Lymphocytes are isolated from a small amount of the patient's venous blood under sterile laboratory conditions.

The isolated lymphocytes are injected subcutaneously into the lateral surface of the shoulder. Before each procedure, the patient is examined in order to individually prescribe the dose of the administered autovaccine. In addition to its own lymphocytes and saline, the autovaccine does not contain any drugs. Treatment regimens, the number and frequency of administered immune cells depend on the severity of the disease. Autolymphocytes are administered in gradually increasing doses with an interval between injections of 2 to 6 days. Course of treatment: 6-8 procedures.

Normalization of the functions of the immune system and a decrease in the body's sensitivity to allergens occurs gradually. The expansion of the hypoallergenic diet is carried out within 1-2 months. Cancellation of supportive symptomatic therapy is also carried out gradually under the supervision of an allergist. The patient is given the opportunity of 3 free repeated consultations within 6 months of observation after the end of the course of treatment using the Autolymphocytotherapy method.

The effectiveness of treatment is determined by the individual characteristics of the immune system. This process to a certain extent depends on the patient's compliance with the allergist's recommendations during the period of treatment and rehabilitation. With a high IgE level, a patient with atopic dermatitis will most likely have to undergo two courses of treatment with ALT.

Video about the treatment of atopic dermatitis with ALT (About the most important, May 10, 2016)

The plot about the treatment of atopic dermatitis begins at 27:45.

And one more story about the treatment of neurodermatitis (About the most important thing, 03/21/2017). Watch from the 30:00 mark

You can familiarize yourself with possible contraindications on our website.

Ask a question to a specialist

The effectiveness of autolymphocytotherapy in the treatment of atopic dermatitis

When evaluating the long-term results of treatment, the effectiveness of the method is confirmed by the duration of remission:

• Remission for more than 5 years - in 88% of cases
• Remission for a period of 1 to 5 years - in 8% of patients
• Remission less than a year was observed - in 4% of patients

Benefits of treating disease with ALT

We treat the cause of the disease, not its symptoms

Minimum contraindications

No hospitalization or separation from work required

The course of treatment is only 3-4 weeks

1 procedure takes only 1-2 hours

Possible treatment in the absence of persistent remissions

Autolymphocytotherapy can be combined with any symptomatic treatment

THE METHOD IS AUTHORIZED BY THE FEDERAL SERVICE FOR SUPERVISION IN THE SPHERE OF HEALTH

How much does atopic dermatitis treatment cost?

When undergoing treatment for atopic dermatitis in Moscow, the cost of 1 procedure is 3700 rubles. The cost of a course of subcutaneous autolymphocytotherapy (6-8 procedures), respectively, is 22 200-29 600 rubles.

After a course of ALT, 3 free consultations are held by an allergist within 6 months of observation. If it is necessary to repeat the course of treatment for patients diagnosed with atopic dermatitis, an individual system of discounts is provided.

Primary allergological examination and diagnosis is carried out in accordance with the standards of the Department of Health. Previous examinations and tests for IgE and allergens performed in other medical institutions are taken into account.

You can donate blood for IgE and allergens at all medical centers where autolymphocytotherapy is done.

Allergist-immunologist Logina Nadezhda Yurievna will receive you in Moscow on a weekday

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