In recent years, the number of people suffering from allergies has grown steadily. Such a response of the body to stimuli becomes rampant.Often, children develop allergic dermatitis, which over time can become chronic. Many parents do not know what can trigger the onset of the disease.

For any manifestation of allergies, seek medical attention. Allergic dermatitis does not go away by itself, the patient needs the right treatment.

• indigestion due to diseases of the gastrointestinal tract, dysbiosis;
• poor nutrition (early introduction of complementary foods, inclusion of highly allergenic foods, citrus fruits in the diet);
• the use of low-quality children's cosmetics and hygiene products;
• wearing clothes made of synthetic fabrics with the addition of dyes;
• taking medications;
• infections of bacterial etiology;
• reaction to chemically active substances (alkali, acid);
• radiation effect, temperature change, mechanical impact;

Allergic dermatitis in children develops according to the standard pattern. A person is in constant contact with an allergen that has a negative effect on the skin. A rash gradually begins to manifest, it can be localized anywhere on the body.

Several factors increase the risk of developing allergic dermatitis. Many of the sick are constantly faced with potential allergens:

• cosmetics;
• chemicals;
• medicines;
• toxicodendron plants;
• with animal hair.

Types and symptoms of allergic dermatitis

A rash on the skin may be accompanied by a slight swelling in the affected area. Quite often, pimples are filled with a clear liquid, and then burst, causing the wound to get wet. After a while, a dense crust forms on this area of ​​the skin, as you can see in the photo below.

Often, an allergic reaction is accompanied by characteristic symptoms, which helps doctors diagnose and begin treatment without delay. If the parents do not pay attention to the child's complaints, the allergy will turn into a chronic form up to the formation of eczema on the skin.

Experts conditionally divide allergic dermatitis into 3 types - infant, child and adolescent:

• The first occurs in newborn babies. Dermatitis appears immediately after birth and accompanies a child up to 3 years of age. The rash in this case affects the folds of the arms, legs and face. Often, allergies spread throughout the body, this condition is caused by the stage of acquaintance with a new food or the eruption of milk teeth.

• Children's dermatitis occurs in children aged 3 to 12 years. Irritation affects the facial region, neck, and can be localized in the folds of the arms and legs. Often, the rash is itchy, there are small swelling and cracks. After scratching, the wounds heal and crust over.
• During adolescence, a distinctive feature of allergic dermatitis is the spread of rashes throughout the body. There is no specific localization, acne can occur on any part of the skin and disappear on its own.

Quite often, allergies become chronic. Over a long period of life, dermatitis can be in remission, the disease will return periodically.

Typical localization of childhood eczema

The common symptoms of the disease include the appearance of small red pimples. Irritation is accompanied by itching, cracks form in the affected area, often weeping sores. With an exacerbation of the disease, the symptoms intensify, the itching makes the patient scratch the skin.

Allergic dermatitis in a child does not always appear in those places where there is constant contact with the allergen. More often in children and adults, rashes are localized in the groin, on the buttocks, arms, face and neck.

Allergic dermatitis can become chronic

Rash on the face

In some patients, the rash is accompanied by coughing, watery eyes, and nasal congestion. Sometimes the allergy does not bother the child at all, but sometimes the baby's condition worsens, he needs help.

In most cases, diathesis is caused by food products, with which a child prone to allergic reactions gets to know for the first time. Flavors, dyes, and some fruits and vegetables can provoke skin rashes. It is not uncommon for children to develop a rash after contact with plants or animals. Allergy symptoms usually appear within half an hour.

Parents can use emollient creams at home, which, once applied, reduce itching and provide some relief. Often, facial allergies provoke laryngeal edema (we recommend reading :). If the child's airways are blocked, he may suffocate. It is important to identify the allergen as soon as possible and try to protect the child from contact with it.

Cheek diathesis caused by food allergens

Spots on hands

Hands are the most common site for allergic dermatitis. On contact with an allergen, whether it be household chemicals or cosmetics, redness appears on the palms. The child experiences discomfort, the hands itch, the skin becomes tight and flakes.

Hand allergies are often caused by insect bites. Unbearable itching makes the child scratch the inflamed area, which only aggravates his condition. Often, redness and rashes on the hands appear due to the consumption of sweets, coffee or cocoa, as well as after taking medications. Usually, the rash is localized on the back of the palms.

Changes in the weather can also affect your baby's health. The skin of the hands, unprotected from wind and frost, reacts to external stimuli with redness, swelling and itching. Special hand creams and warm gloves or mittens that can protect the skin from the vagaries of the weather will help to correct the situation.

Allergy to the feet

Most of the irritation occurs in the thighs, calves and lower legs. Often, the rash is localized under the knees. Allergic reactions can occur on the feet. In this place, pimples of irregular shape, pustules appear, and the inflamed skin swells.

An allergic rash on the legs leads to severe discomfort and limited mobility

Red itchy patches and blisters cause a lot of inconvenience and lead to limited mobility. When a rash appears on a child's legs, you need to try to alleviate the child's condition as quickly as possible.

Stages of dermatitis

The doctor, evaluating the condition of the patient suffering from allergies, first of all tries to determine the stage of the disease. On the basis of the conclusions made, the question of the choice of treatment tactics is being decided. In total, there are 4 stages of allergic dermatitis:

1. The initial one is accompanied by hyperemia, swelling of the skin, peeling. If you start treating diathesis in children in time, you can soon forget about all the unpleasant symptoms forever. At the same time, improper treatment or lack of it leads to the development of the next stage.
2. The expressed stage of the disease proceeds in a chronic and acute form. The rash leads to the formation of crusts and scales at the site of inflammation.
3. The remission stage leads to a decrease or disappearance of all unpleasant allergy symptoms. This period can last for weeks and sometimes years.
4. In the stage of clinical recovery, all manifestations of atopic dermatitis completely disappear for several years.

Diagnosis of the disease

The doctor will not prescribe treatment until he identifies the nature of the rash, their localization and the period of exacerbation. Laboratory tests help diagnose the disease:

• clinical analysis of blood and urine;
• immunological and serological analysis;
• histological tissue analysis;
• biopsy;
• transcript of analyzes for allergens.

The results obtained make it possible to identify the cause of the development of an allergic reaction in a patient. The doctor prescribes appropriate therapy. If you follow all medical recommendations, the specialist will be able to predict the timing of the onset of remission.

How to treat allergic dermatitis at home?

Knowing which allergen leads to rashes, you need to try to protect the child from contact with him. If certain foods cause allergies, they should not be present in the baby's menu.

The child must be protected from sources of allergies: create the most comfortable conditions, excluding any external irritants

Often, allergies occur in children when exposed to external stimuli. The main task of parents of sensitive babies is to maintain cleanliness in the house and a certain humidity in the air. Pets should be given into good hands, and carpets and feather pillows should be disposed of forever.

Features of therapy for babies up to a year

A mild form of allergy does not require hospitalization. Allergy-prone infants should be transferred to a hypoallergenic diet. It is recommended to use sparing antihistamines prescribed from birth - Fenistil gel and drops, or from six months - Zyrtec drops.

Diathesis recedes with age, but not all babies are so lucky (we recommend reading :). Sometimes a persistent allergy develops, leading to asthma. If the treatment does not give the desired results, there is no positive dynamics, and other diseases develop against the background of allergic reactions, then the attending physician will suggest that the mother and child go to the hospital.

The advanced form of the disease is treated with glucocorticoids. Antibiotics will help get rid of pustules on the skin. Vitamin and mineral complexes will help improve the health of children under one year old.

Oral medications

Many drugs can improve the patient's condition. They relieve allergy symptoms by reducing inflammation and itching. Antihistamines are often prescribed to treat allergic dermatitis. First-generation drugs have a sedative effect.

Experts prefer modern medicines such as:

• Cetrin;
• Zyrtek;
• Erius;
• Zodak.

Antihistamines of the 2nd and 3rd generation do not cause drowsiness and addiction. To achieve a clinical effect, such drugs must be taken over a long period of time. The dosage and course of treatment are determined by the doctor on an individual basis.

Often, irritation and itching cause children to scratch their wounds - this is an open gateway to infection. Antiseptics help fight microorganisms. There are several effective drugs in the form of a solution for external use that can cope with staphylococci and streptococci:

• Chlorhexidine;
• Miramistin;
• Fukaseptol;
• Fukortsin.

Immunomodulators have proven their effectiveness in combating allergies. They are prescribed after consultation with an allergist, when the disease is severe. It is necessary to treat allergies with such drugs with caution, especially for those who have someone close to them in their family suffers from autoimmune diseases. Interference with the immune processes in a child's body can lead to serious consequences.

Use of topical preparations

• If the rash is insignificant, weakly expressed, it is more advisable to use non-hormonal preparations: Fenistil, Keratolan, Radevit, etc.
• If the allergy is in a pronounced stage, irritation affects large areas of the body, the doctor may recommend hormonal ointments (Sinaflan, Akriderm, etc.).
• In some cases, glucocorticosteroid drugs help to relieve an allergic reaction to the skin. This group of drugs includes Advantan, Afloderm and Lokoid.

To make the affected areas heal faster, you can use ointments that accelerate tissue regeneration:

• Dexpanthenol;
• Bepanten;
• Actovegin.

Physiotherapy

Physical therapy can help a child with allergic dermatitis recover faster. As a rule, physiotherapy methods are applied to patients who are in a hospital setting. The following physiotherapy procedures are considered the most effective:

• laser therapy;
• electrosleep;
• PUVA therapy;
• hydrotherapy;
• mud therapy;
• reflexology;
• ultraviolet irradiation.

Treatment with folk remedies

The list of medicinal herbs allowed for allergies is small. For therapy, succession, periwinkle, celandine, hops, etc. are suitable. To prepare a herbal decoction, you will need 3 tablespoons of dried and crushed plants and 1 liter of boiling water. The herb is poured with hot water and infused for 4 hours. The resulting broth is used to lubricate the inflamed areas of the skin or make lotions.

However, you need to be careful: the body of children prone to allergic reactions can respond with an increase in symptoms to treatment with folk remedies.

For a soda bath, you will need 1 liter of boiling water and 1 tablespoon of baking soda. Soda must be completely dissolved in water. It is necessary to follow the dosage exactly, otherwise after the procedure there will be a feeling of dry skin.

Diet features

Atopic dermatitis requires adherence to a special diet. The child's menu should include hypoallergenic foods. The baby's diet should be balanced. Severe restrictions on food will lead to disruption of its growth and development.

If the baby has an intolerance to cow's milk protein, then it is transferred to special mixtures developed taking into account the individual characteristics of children suffering from allergies. If the baby is breastfed, the mother should also take care of her nutrition. If possible, you need to limit yourself in the use of sweet, starchy and salty foods. It is advisable to avoid foods such as: honey, nuts, citrus fruits, strawberries, chocolate and condiments.

Since the beginning of the introduction of complementary foods, many babies suffer from food allergic dermatitis, so it is necessary to get acquainted with new products very carefully.

Oatmeal or semolina porridge, as well as foods containing gluten, can be a source of allergies. It is better to use zucchini or cauliflower as the first complementary food. Then you can introduce your baby to dairy-free cereals. When the child is 7-8 months old, you can offer him turkey or rabbit meat.

Compliance with certain rules of life

Allergic dermatitis is accompanied by skin lesions, so parents should know how to properly care for the child's skin. Experts recommend adhering to the following rules of life:

• The air in the children's room should be humid.
• Contact with animals and plants should be avoided as much as possible.
• It is necessary to monitor the cleanliness of the house. Wet cleaning should be done on a regular basis. The use of chemicals is not allowed.
• It is required to select hypoallergenic hygiene products.
• It is necessary to choose clothes made from natural materials. Woolen products should not come into contact with the skin.

Why is allergic dermatitis dangerous?

Allergies cannot be ignored. Without starting treatment for allergic dermatitis, parents increase the chances of their child developing bronchial asthma. The number of skin rashes is gradually decreasing, but this does not mean victory over allergies, but about the transformation of the disease into a new form.

- a complex of inflammatory and allergic skin reactions arising in response to the effects of various irritants. Dermatitis in children is manifested by erythema of various areas of the skin, itching, the presence of a rash or scales, a change in the sensitivity of inflamed skin areas, and a deterioration in general well-being. Diagnosis of dermatitis in children and its form is based on visual examination data, analyzes of scrapings from the affected skin surface, immunological and biochemical examinations. Treatment of dermatitis in children involves eliminating contact with the irritant that caused the reaction, treating the affected skin areas, taking antihistamines, immunomodulatory, sedatives.

General information

Dermatitis in children is a local or widespread inflammation of the skin of a child, which develops as a result of direct or indirect exposure to factors of a biological, physical or chemical nature. In pediatric dermatology and pediatrics, dermatitis accounts for 25-57% of all skin diseases. In children, atopic, seborrheic, contact and diaper dermatitis are most common. As a rule, dermatitis in children manifests itself in the first year of life, and in preschool and school age they develop for the first time relatively rarely. Starting in early childhood, dermatitis can acquire a recurrent course and lead to a decrease in the child's social adaptation.

Dermatitis causes

Dermatitis symptoms in children

Symptoms of atopic dermatitis

Usually manifests in the first half of life; less often it develops in preschool, school or adolescence. Skin rashes with atopic dermatitis in children can be represented by persistent hyperemia or transient erythema, dryness and scaling of the skin, or a weeping papular-vesicular rash on an erythematous background. The characteristic signs of atopic dermatitis in children include the symmetry of skin lesions on the face, extremities, flexor surfaces of the joints; itching of varying intensity. Quite often, with atopic dermatitis in children, folding (hyperlinearity) of the palms and soles is found; follicular hyperkeratosis of the elbows, forearms, shoulders; white dermographism, scratching of the skin, pyoderma, hyperpigmentation of the eyelids ("allergic glow"), cheilitis, urticaria, keratoconus, recurrent conjunctivitis, etc.

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

Symptoms of seborrheic dermatitis

This type of dermatitis occurs in about 10% of children in the first 3 months of life and completely stops by 2-4 years. The first manifestations of seborrheic dermatitis in a child may appear as early as 2-3 weeks of life. At the same time, grayish pityriasis scales (gneiss) are formed on the scalp, which, merging, turn into a continuous greasy crust. Gneiss can spread to the skin of the forehead, eyebrows, behind the ear; sometimes maculopapular rashes, covered with scales on the periphery, are found in the natural folds of the trunk and limbs.

The distinctive features of seborrheic dermatitis in children are the minimal severity of itching, the absence of exudation (the scales are greasy, but dry). When the crusts are forcibly removed, brightly flushed skin is exposed; in this case, it can get wet and easily become infected.

Diaper dermatitis symptoms

Diaper dermatitis is characterized by irritation of the skin of the gluteal region, inner thighs, perineum, lower back, abdomen, i.e., skin areas in contact with wet and contaminated diapers, diapers, and sliders. Diaper dermatitis occurs in 35-50% of infants, more often it develops in girls aged 6 to 12 months.

According to the severity of clinical manifestations, 3 degrees of diaper dermatitis are distinguished. With mild manifestations of dermatitis in children, there is moderate skin hyperemia, a mild rash and maceration of the skin in places of typical localization. Diaper dermatitis of moderate severity is characterized by the formation of papules, pustules and infiltrates on irritated areas of the skin. Severe diaper dermatitis in children occurs with the opening of the vesicles, the formation of areas of wetness and erosion, and extensive drainage infiltrates.

The development of diaper dermatitis affects the general well-being of children: they become restless, often cry, sleep poorly, since the inflamed skin areas are itchy, and touching them causes discomfort and pain. In girls, diaper dermatitis can lead to vulvitis.

Symptoms of contact dermatitis in children

Manifestations arise directly on the area of ​​the skin with which any irritant came into contact. The main signs of contact dermatitis in children include edematous hyperemia of the skin with sharp boundaries, severe itching, burning, soreness, blistering, the opening of which leads to the formation of weeping erosive areas.

Contact dermatitis in children can be acute or chronic. The acute phase begins immediately after contact with the stimulus and ends soon after the end of the exposure. The chronic course of dermatitis in children acquires after frequent repeated exposure to an aggressive factor.

Diagnostics

The appearance of any rash on the child's skin requires careful evaluation by a pediatrician, pediatric dermatologist, pediatric allergist-immunologist, and sometimes a pediatric infectious disease specialist. In case of suspicion of dermatitis in children, a thorough history collection, examination of the skin, clinical and laboratory examination is carried out.

In the diagnosis of atopic dermatitis in children, an important role is played by the detection of eosinophilia in the blood, an increased level of total IgE, allergen-specific IgE and IgG by ELISA, RAST, RIST, MAST; the presence of positive skin tests or provocative tests with allergens.

In the presence of a secondary infection, a bacteriological examination of smears is carried out; to detect pathogenic fungi, scraping from smooth skin is studied. As part of the examination of children with dermatitis, it is important to study the coprogram, feces for dysbiosis and helminth eggs, and an ultrasound of the abdominal organs. Sometimes with a purpose differential diagnosis a skin biopsy is performed.

During the examination, it is important to clarify the causes and form of dermatitis in children, as well as to exclude the presence of immunodeficiency diseases (Wiskott-Aldrich syndrome, hyperimmunoglobulinemia E), lichen pink, microbial eczema, scabies, ichthyosis, psoriasis, and skin lymphoma.

Treatment of dermatitis in children

The implementation of an integrated approach to the treatment of atopic dermatitis in children includes reducing or eliminating contact with an allergen, choosing the correct diet, drug therapy, and allergen-specific immunotherapy. Systemic pharmacotherapy involves the use of antihistamines, NSAIDs, enterosorbents, enzymes, vitamin preparations; in severe dermatitis in children - glucocorticoids. For relief of exacerbations of atopic dermatitis in children, hemosorption is also used.

Topical therapy is aimed at eliminating inflammation and dryness of the skin, restoring the barrier properties of the skin and preventing secondary infection. It includes the external use of corticosteroid ointments, non-steroidal hydrolipid creams, disinfecting liquids, lotions, and wet-drying dressings. With atopic dermatitis in children, non-pharmacological methods of treatment have proven themselves well: reflexotherapy, hyperbaric oxygenation, inductothermy, magnetotherapy, light therapy. With forms of atopic dermatitis resistant to traditional therapy, PUVA therapy can be used in children.

The basis for the treatment of seborrheic dermatitis is the proper organization of care for the affected skin with the help of special antifungal shampoos and creams. Children are prescribed to wash their heads with dermatological shampoos with ketoconazole, ciclopirox, tar, etc.), which have fungistatic, fungicidal, kerato-regulating and anti-inflammatory and action. After that, mineral or olive oil is applied to the scalp. To cleanse the areas of seborrhea on smooth skin, special gels are used, after which the skin is lubricated with a dermatological cream. On average, the course of therapy for seborrheic dermatitis in children lasts about 6 weeks.

In the treatment of diaper dermatitis in children, the main role is assigned to the organization of proper hygienic care: frequent change of diapers and diapers, washing the child after each act of urination and defecation, taking air and herbal baths. The affected areas of the child's skin should be thoroughly dried, treated with powders and hygiene medicinal products containing panthenol, dexpanthenol, piroctone olamine, etc.). Avoid prescribing topical corticosteroids in the treatment of diaper dermatitis in children. Contact dermatitis therapy involves the elimination of exposure to the skin of aggressive substances. To relieve inflammation, zinc-based pastes, lanolin-based ointments, powders, and herbal decoctions are used.

Prophylaxis

For any form of dermatitis in children, general measures are important: hardening procedures, proper care of baby skin, use of high-quality baby cosmetics and hypoallergenic hygiene products, wearing clothes made from natural materials, etc. It is necessary to change diapers every 4 hours (or immediately after a bowel movement) , avoidance of prolonged skin contact with secretions. Correction of the diet, normalization of the gastrointestinal tract is important.

In children with atopic dermatitis, avoid contact with household and food allergens. Long-term courses contribute to the prolongation of remission.

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 have to be monitored by an allergist for life. Only the correct knowledge about this disease will help to control the course of the disease.

What it is?

Any manifestations of atopic dermatitis are associated with allergic reactions. This disease has a predominantly genetic predisposition.

Scientists have identified a number of genes that code for a predisposition to the perception of various substances. These genes determine the 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 ingestion of a trigger factor. This reaction is accompanied by severe cutaneous and systemic manifestations. Various substances and allergens can act as triggering or provoking agents. The peculiarity of the individual reaction depends on the genetic predisposition and the initial level of the immune system.

Causes of occurrence

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, the provoking agents are chemicals.

Scientists do not know the only exact cause of the disease. This is due to the individual coding of genes in each human body. It has been found that when a specific trigger is hit, 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 activity 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 are much easier to get into children's organism and trigger a whole cascade of inflammatory reactions. With the development of diseases, periods of exacerbations are replaced by remission. As a result of prolonged illness, the structure of the skin changes. It can also affect the likelihood of disease progression.

Provoking factors

Numerous factors can trigger atopic dermatitis. All triggers can be divided into several categories. Most of the provoking agents enter the body from the outside. They account for more than 80% of disease cases. Internal provoking factors are much less common. Usually, these forms of diseases are typical for babies with many chronic diseases.

Stages of development of the disease

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 manifest itself at any age. Like any chronic disease, atopic dermatitis goes through several successive stages in its development:

1. Primary contact with an 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 "memorize" the antigens of a substance foreign to the body and, upon repeated contact, emit a huge amount of protective antibodies.
2. Development of immune inflammation. The activated lymphocytes, which have recognized the 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 unfavorable 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 only on the skin, protecting the brain and heart.
3. The development of the classic manifestations of the disease. During this period, the inflammatory process reaches such strength that the first unfavorable symptoms of the disease begin to appear. They usually last 7-14 days. Most acute manifestations upon initial contact with an allergen, they appear after 48-72 hours. If the provoking factor enters the body again, then the period before the onset of symptoms can be reduced from several hours to a day.
4. Abatement 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 subsiding 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 is cleansed and takes on a normal appearance.
5. Remission. During this period, the child is practically not worried about anything. The kid leads a normal life. The child's health is excellent. The skin changes slightly. In some cases, crusting or dry patches of 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 be replaced by an exacerbation.

Classification

Today, doctors in their work use several different categories at once, which make it possible 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.

Disease development phase

• Start. Corresponds to the primary contact of 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.
• Subside exacerbation... Disappearance of unpleasant symptoms, improvement of the general condition of the baby.

• Infant option. It develops in babies up to two years old. It usually proceeds with the appearance of red itchy spots. Such rashes are large enough. This option is also characterized by pronounced swelling of the baby's buttocks, arms and legs. The skin on the trunk becomes very thin. Numerous white scales can form on the head, which are easily rejected.
• Children's option. As a rule, it proceeds until adolescence. This form of the disease is characterized by severe itching, as well as desiccation of the skin. Skin elements can be varied. Often there are various vesicular eruptions filled with transparent contents.
• Teenage version. It can develop up to the age of eighteen. This form proceeds with the appearance of severe itching on the 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 of severe lichenification. The appearance of vesicles is not always found. Much more often, skin rashes appear in the form of extensive areas of erythema.

Extensiveness of the inflammatory process

• Limited area option. Damage to the skin in such cases is no more than five percent of the entire skin surface.
• Option with common elements. It occurs when there are lesions that cover 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, numerous damage to the skin is noted. 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 scratching marks appear on the skin.

Change in general condition

• Relatively easy course. It implies the occurrence during exacerbations of a small amount 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. The periods of remission 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 out, the fluid flows out, weeping ulcers form. As a rule, the baby's condition worsens. The child is constantly combing itchy elements. The condition may also be complicated by the addition of a secondary bacterial infection.
• Heavy current. It is typical for babies with a low level of immunity. The child looks terrible. Skin elements appear almost everywhere: on the face, arms and legs, cover the buttocks, abdomen. Numerous vesicles, ruptured, contribute to the development of severe weeping wounds, which are poorly epithelized.

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, symptoms appear to a lesser extent. If the child's allergic predisposition is quite pronounced, then the immune response to the provoking factor will be very strong.

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

• Severe itching. He worries the child throughout the day. Decreases somewhat at night. Babies, scratching the damaged areas of the skin, can introduce 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 on limited areas of the body. They often occur on the back, abdomen, or arms. The affected skin acquires a characteristic "fiery" color. To the touch, it becomes hot, somewhat compacted.
• Dryness appears. It is also one of the most common symptoms of atopic dermatitis. The longer the disease lasts, the more pronounced this manifestation becomes. This is due to a violation of the water-lipid composition of the skin (due to a prolonged inflammatory process). The structure of the layers of the skin 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 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.
• Lichenification phenomena. This sign appears late enough. It occurs with constant scratching, in the presence of damaged skin areas. 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 disrupted.
• Poor health of the child. Severe itching causes severe anxiety in the baby. Kids are more capricious, often cry. With a severe course of the disease, they 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 symptoms that were characteristic during an 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.

For the period of remission of atopic dermatitis, the following symptoms are characteristic:

• Changes in the structure of the skin. Some areas of the skin become hardened, while others become thinner. This is due to changes in the structure and structure of the skin layers. Weeping sores tend to heal, but feel less dense to the touch. Crusts may form on the healed wounds.
• Scratching marks. Found in almost all babies with atopic dermatitis. Most pronounced in babies with frequent exacerbations of the disease. Usually they appear as narrow stripes of white or reddish color. Cover the entire body surface. A large number can be seen on the arms or cheeks of the baby.
• Change in skin pattern. With a prolonged inflammatory process that occurs with this disease, the architecture of the structure of the skin changes. Areas of hyperpigmentation appear.
• Severe dryness of the skin and the appearance of areas with flaking... This symptom is characteristic 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 prolonged course of the disease, severe dryness and flaking around the red border of the lips may appear. This is often a manifestation of atopic cheilitis. This state does not require special treatment- other than the use of mild lip balms approved for use in children. In some cases, atopic cheilitis goes away on its own, without the use of additional funds.

Diagnostics

To identify the specific allergen that contributes to the onset of symptoms of atopic dermatitis, auxiliary laboratory and instrumental tests will help.

General blood analysis

An increase in the level of leukocytes above normal 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 occur with accelerated ESR in the acute period of the disease.

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

Biochemical research

For the analysis, a little venous blood is taken from the baby. With this test, 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, an increase in the level of bilirubin also occurs.

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

Quantification of immunoglobulin E

This substance is the main protein substrate that the cells of the immune system release 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 increased content of this substance in the blood serum.

The material for research 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 the norm. An increase in the index of more than 165 IU / ml may indicate the presence of atopy. During remission, the level of immunoglobulin E decreases slightly. However, for a fairly long time, it can remain somewhat elevated.

Special allergy tests

This method is the classic method for the determination of 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. Kids over early age 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.

Allergy tests can only be performed by a pediatric allergist-immunologist. Most often they are carried out in the conditions of allergy rooms of polyclinics or in private centers.

The research takes, as a rule, no more than an hour. The baby is made small incisions on the skin with a special sharp scalpel. Do not be afraid of such cuts. They are too small to be a threat of infection or suppuration.

After applying special notches, the doctor applies diagnostic solutions of allergens. The substances are applied in a strong dilution. This minimizes the risk of a possible violent allergic reaction. Such diagnostic solutions can be applied in several ways. Drip is usually chosen.

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

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

The unconditional 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 overreact. In such cases, it is impossible to speak of an unambiguous presence of an allergy.

If it is impossible to unambiguously assess the presence of individual allergic sensitivity to a specific 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 have shown excellent results in the diagnosis of allergic diseases. The test does not require scoring or cuts in the skin. The material for research is venous blood.

The analysis usually takes from three days to several weeks. It depends on the number 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 an allergen, the cells of the immune system release a huge amount of antibodies. Such defensive reaction is designed to quickly eliminate a foreign agent from the body and eliminate inflammation.

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

Before performing any serological tests, it is important to remember to prepare for the research. All such tests are best done during remission. This will minimize false positives. It is best to follow a medicated hypoallergenic diet before undertaking a study. It is better to cancel all antihistamines and desensitizing drugs a couple of days before the study.

Basic treatment principles

Therapy of atopic dermatitis is divided into several stages: during exacerbation and remission. Separation of treatment allows you to cope with different symptoms that occur at different periods of the course of the disease. With prolonged 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. The area of ​​tissue that is closely adjacent to the baby's genitals can be impregnated with various antiseptic agents. Acute contact dermatitis may occur in babies prone to allergies ... 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 can help cope with the uncomfortable symptoms of atopic dermatitis. The choice of drugs is carried out, focusing on the skin manifestations that have arisen during this exacerbation. The most commonly used are various hormonal and anti-inflammatory ointments, creams, gels, as well as various powders or talkers.
• Compliance with a hypoallergenic diet. During an exacerbation, doctors prescribe the most stringent health food... Such a diet includes an abundance of permitted protein foods and cereals with 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 drugs may be prescribed in the form of injections or tablets. With severe itching, which brings severe suffering to the baby, tablet forms of antihistamines are prescribed. NS it can be "Suprastin", "Fenistil" and others. They are prescribed for a long time: from several days or even up to a month.
• Compliance with the rules of personal hygiene. Mothers should keep their babies' nails clean and long. With severe itching, children strongly scratch the inflamed skin. If there is dirt under the nails, then they can introduce additional infection and aggravate the course of the disease. When the secondary bacterial flora is attached, the inflammation increases markedly, and signs of suppuration may appear.
• Compliance with the regime of the day. For the immune system to function properly, babies need rest. During the day, children should sleep at least ten hours. This time is required for 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 skin areas. After the acute process subsides, various crusts and peeling remain on the skin. To eliminate the effects of the inflammatory process, ointments and creams with a rather 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 the immune system. 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 be 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. The normalization of the protective function of the intestines also helps to restore the immune system. The 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 should definitely eat only approved foods. All food that contains possible allergenic components is completely excluded from the baby's diet. It is worth following a hypoallergenic diet throughout life.
• Complete exclusion from household use of possible provoking allergens. For babies who are prone to atopic dermatitis, do not use feather pillows or blankets. It is better to give preference to other natural and synthetic materials on a hypoallergenic basis. Pillows should be dry-cleaned at least 2 times a year. This will get rid of household mites that 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)... These include " Tsindol "," Elidel "," Triderm "," Ketotifen"And many other means. These drugs are anti-inflammatory and can help fight inflammation. Many remedies are combined. They may include antibiotics in low concentrations. These drugs are usually well tolerated and do not cause systemic side effects... They are appointed, as a rule, 2-3 times a day and for a period of 10-14 days. With a more severe course of the disease, it can be used for a long time, until the unfavorable symptoms of the disease are completely eliminated.
• Hormonal ointments. They are used for a long course of the disease. You should not be afraid of using such drugs. The content of glucocorticosteroid hormones in them is quite small. Such drugs simply cannot cause side effects of a systemic nature. Most topical preparations contain low concentrations of beclomethasone or prednisolone. In the treatment, you can use the ointments "Advantan", "Elokom" and many others approved for pediatric practice.
• Desensitizing drugs. Often, doctors prescribe antihistamines to eliminate severe itching. It can be "Suprastin", as well as "Fenistil", preparations based on desloratadine. Many of the drugs are used for children over two years of age. These remedies allow you to eliminate severe inflammation and cope with debilitating itching. Such drugs are prescribed for a course of 10-14 days.

Tablet forms can also be used for a month or more from the moment the adverse symptoms of exacerbation are eliminated. Calcium gluconate can be used to relieve itching. It helps to eliminate the mild manifestation of this adverse symptom.

• Cell membrane stimulants. They have a mechanism of action that is similar to that of antihistamines. They are used in children's practice relatively recently. They are well tolerated by children. There are practically no side effects from the use. Ketotifen is often prescribed. This medication is used for babies over three years old. Appointed as a course for 2-3 months. The scheme is chosen by the attending physician. For the correct withdrawal of the drug, a gradual reduction in dosage is required.
• Preparations that support immunity. Often, babies with atopic dermatitis are advised to maintain good intestinal microflora. For this, various preparations are prescribed containing live bifidobacteria or lactobacilli. Such medicines 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 is imperative to moisturize it. Even during the period of acute manifestations of the disease, the baby can be bathed. Bathing your baby is not recommended. This can contribute to increased itching and lead to additional dryness of the skin. Better to give preference to a simple hygienic shower.

Special medicated shampoos can be used to relieve itchy scalp. These products have a physiologically neutral pH and do not cause irritation.

Hygiene procedures can be performed daily. After that, it is imperative to process the skin medicinal ointments or creams. This will additionally moisturize damaged skin and eliminate the adverse manifestations of atopy.

For very young children, when bathing, you can add celandine broth. For its preparation, 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 the baby is bathing. You can bathe the child with wormwood or infusion of a series. These herbs have a beneficial effect on the skin and help prevent infection of wounds that occur during an exacerbation.

What to eat?

Nutritional therapy for 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 berries are red or burgundy. 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 child's reaction to the introduction of a new product.
• Chocolates and other sweets containing cocoa beans.
• Candy and sugary soda which contain many chemical dyes and food additives.

The nutrition of a baby with atopic dermatitis must include the following foods:

• High in protein. Perfect for: lean poultry, veal, fresh beef, and rabbit. The child's diet should definitely include dairy products... A large amount of the right protein, combined with beneficial bifidobacteria, will help to strengthen the immune system of babies. It is best to add a specific approved protein product at each meal.
• 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 between 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 exacerbation subsiding, you can add potatoes and a little 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 to form healthy gut microflora.
• Fruits. Usually apples and garden pears are recommended for Russian kids. The content of antigenic components in these fruits is much lower than in tropical fruits. In the acute period, the use of such products should be somewhat reduced. Fruits are high in natural sugars. This can negatively affect the restoration of the cellular structure of the skin and somewhat impair the work of leukocytes.
• Adequate amount of liquid. To remove decay products that are formed in the body during the inflammatory process, water is required. ... You can drink ordinary boiled water. It is also permissible to use fruit drinks or compotes, prepared from dried garden apples or pears. It is better to exclude berry drinks until the period of remission.
• Vitamin intake. During the period of a strict diet, which is necessary during an exacerbation, too few useful microelements enter the child's body, therefore, the introduction of such substances from the outside is required. Synthetic complexes become an excellent source of various vitamins. They contain a combination of beneficial 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 beneficial trace elements in the body.

How to properly organize the daily routine?

It is very important for babies with atopic diseases 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 this rest, the nervous and immune systems are restored. The child gains new strength to fight the disease.

A night's 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. A decrease in 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. The debilitating itching brings great discomfort to babies. With the elimination of adverse symptoms against the background of the 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 should get more rest, try to get enough sleep.

Possibilities of 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 case of a mild course - at home .

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

Various physiotherapy methods 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 inductothermal methods are used. Usually, while staying in the 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 is indicated, for a period of up to three weeks.

Therapy in a sanatorium has a very pronounced clinical effect. With the regular passage of such balneological treatment, the number of exacerbations of the disease is noticeably reduced. Babies who are undergoing therapy at sea noticeably strengthen their immunity. Sea ions have a positive effect on the functioning of the cells of the immune system, as well as 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 remission. The duration of the voucher can be 14-21 days. It is better to choose sanatoriums that are located in the immediate vicinity of the sea, or specialized health centers that provide medical services for babies with atopy and allergic skin diseases.

Complications

On initial stage the disease usually proceeds without pronounced adverse consequences. After several exacerbations and the use of numerous drugs, the child may develop certain complications of the disease.

The most common cases of atopic dermatitis are:

• Various suppurations(as a result of the attachment of a secondary bacterial infection). Staphylococcal and streptococcal flora are widespread. Usually, the baby can bring in germs while combing itchy elements. After that, after a few hours, inflammation noticeably increases, pus appears.
• Weeping wounds very often become infected. Even a small amount of the pathogen is enough to start a bacterial infectious process. These cases require immediate medical advice and antibiotic prescription. In case of a severe course of the bacterial process, emergency hospitalization in a hospital.
• Atrophic phenomena on the skin or its pronounced thinning. Commonly seen as side effects after prolonged use of corticosteroid ointments. Some children may have alternatives. Instead of areas of thinning skin, dense crusts (or even scabs) form. In such conditions, hormones are canceled and switched to other drugs. During the period of such a cancellation, babies are prescribed immunomodulatory agents that allow them to normalize the impaired function of the child's immune system.

Is a disability established?

Usually, for babies with atopic dermatitis, it is not necessary to establish a disability. With a mild course of the disease and sufficient control of the onset of persistent loss of function, there is no. With this variant of the disease, doctors recommend the treatment of exacerbations in a polyclinic, with the obligatory supervision 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 can turn to the ITU for an examination. Doctors-experts will study all medical records the child and reveal the presence or absence of disabling signs. If a child has signs of persistent loss of function, then he may be assigned a disability group. As a rule, the third.

Prevention of exacerbations

Preventive measures help prevent acute illness and control the course of the illness. When it comes to babies with atopic dermatitis, you should always remember about prevention. Avoiding contact with the provoking 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. It is imperative to include a complete protein (in an amount sufficient for a 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. The pillows should be cleaned at least once or twice a year. The blanket should also be taken to a professional dry cleaner.
• Toys, dishes and cutlery belonging to a child are processed in warm water using special liquids that do not contain aggressive chemicals. These products are usually labeled as 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 the onset of 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 the immune system. Eating a healthy diet with enough fiber and vitamins, and active outdoor play are great ways to rebuild and revitalize your immune system. Babies with atopic dermatitis should also not avoid tempering and water treatments. Such techniques have a positive effect on immunity, as well as improve mood and normalize sleep.
• Long-term breastfeeding. Scientists from many countries have proven that protective antibodies enter the infant's body along with breast milk. This allows you to protect the child's body from various infectious pathologies and reduce the risk of developing possible allergic reactions. Breast milk also helps to normalize the baby's intestinal microflora and helps to strengthen the immune system.
• Compliance with the rules of hygiene. Nursery rooms for babies who are prone to allergic reactions should be cleaned 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 nursery and even helps to reduce the concentration of pathogenic microbes in the air.
• Regular walks in the fresh air. Sufficient sun exposure 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. Outdoor walks are very important for babies. They help restore immunity.

Atopic dermatitis is very common in babies of different 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.

For more details, see the program of Dr. Komarovsky.

Atopic dermatitis is a skin rash that occurs as a result of an allergic reaction of the body. Children of different age categories are at risk.

The main symptoms of the disease are dryness, inflammation of the surface of the skin, burning, itching, the appearance of scales, spots, skin seals.

Various factors affect the appearance of dermatitis: improper skin care, nutrition, heredity, the presence of chronic diseases, malfunctions of the digestive system. If atopic dermatitis persists, you should consult your doctor. He will help to establish the cause of the disease, prescribe an effective course of treatment.

Treatment of atopic dermatitis

The disease occurs due to the high sensitivity of immunity to provoking environmental factors. As a result, small rashes appear on the skin on the folds of the arms, legs, armpits, on the abdomen, head, torso, and on the face. The disease requires an integrated approach to treatment, especially when the dermatitis persists and becomes chronic.

Treatment of the disease consists in prescribing:

• anti-inflammatory, antibacterial, antiallergenic drugs, immunomodulators;
• special skin care products;
• exclusion of possible allergens from food, personal hygiene products, clothing.

External therapy is highly effective. It consists in eliminating inflammation, relieving symptoms and manifestations of the disease.

Disease therapy is aimed at:

• removing inflammation on the surface of the skin;
• normalization of water metabolism of the skin, improvement of its functioning, structure;
• treatment of chronic diseases;
• elimination of infection;
• prevention of dermatitis.

When the first signs of the disease appear, you should immediately contact a specialist. Lack of treatment can lead to the development of bronchial asthma, allergic rhinitis.

Elimination of allergens

One of the first steps that must be taken when dermatitis is detected is getting rid of all allergens, including food.

Atopic dermatitis is characterized by a high sensitivity of immunity to various environmental factors. To alleviate the patient's condition, and to speed up the healing process, the elimination of provoking factors will help.

Irritants include:

1. Food. Experts recommend excluding eggs, milk, food additives, spices, salty, fatty, smoked foods, sweets, hot sauces, soda, peanuts, soy from the daily menu.

You should also avoid eating foods that are highly allergenic: honey, chocolate, cocoa.

The daily diet should be made taking into account the intolerance of the body to certain foods.

1. Inhaled allergens. Dermatitis can be caused by pet hair, food mites, mold, dust, and cigarette smoke.
2. Chemical substances. The disease can occur under the influence of fragrances and chemical compounds that are in: soap, shampoos, powder, air fresheners, detergents and cleaners, fabric rinse, decorative cosmetics.

People with a high threshold for allergic sensitivity should avoid contact with these irritants. In everyday life, use hypoallergenic products and materials.

Nutrition for illness

Atopic dermatitis can go away with the adherence to an anti-allergenic diet. It consists in the exclusion from the daily diet of foods that can cause skin rashes.

In case of illness, preference should be given to cereals: buckwheat, millet. They are a source of fiber, trace elements and vitamins. Before cooking, the cereal should be soaked for several hours in clean water, seasoned with a small amount of vegetable oil. You can eat a variety of vegetables: potatoes, cabbage, onions. As well as dietary meat, beef.

When the disease is observed in young children, it is better to choose an anti-allergenic food for feeding. Don't overfeed your baby. Portions should be small, liquid consistency. The frequency of eating should be at least 4-5 times a day. During an exacerbation of the disease, do not introduce new foods into complementary foods, monitor the work of the gastrointestinal tract.

clothing

The development of the disease is influenced by the composition and quality of clothing and textile materials. If atopic dermatitis persists, it is necessary to avoid materials that can exacerbate the disease: wool, synthetics.

Use a small amount of liquid detergent for washing. Then rinse thoroughly in clean water without using rinse aid, fabric softener.

Allergens include not only food, but also clothing and vitamins and medications that the patient may have taken before.

1. Clothing should be comfortable, spacious, not clinging to the body, not restricting or hindering movement.
2. The fabric should be natural, not hindering the evaporation of moisture and the flow of air.
3. Change towels daily, bed linen at least once a week.
4. The number of items of clothing should be suitable for the weather conditions. Don't dress your child too warmly.
5. When choosing a fabric, it is advisable to give preference to materials of natural shades that do not contain many chemical dyes.

Microclimate

An unfavorable microclimate in a living room can cause the development of the disease.

Sharp temperature drops, air humidity lead to increased sweating, can provoke dry skin, aggravate the manifestations of the disease.

The optimum room temperature is 20-21˚С. To maintain the required temperature regime in winter and summer, it is recommended to install an air conditioner, an adjustable heating system, and air humidifiers.

Room humidity should be within 60-70%. It is recommended to carry out regular airing, quartzing, wet cleaning. You also need to remove objects from the room that can accumulate household dust: carpets, books, soft toys.

Bathing rules

The condition of the skin and the development of the disease is influenced by the method of cleansing the skin, using cosmetics, washcloths, brushes.

1. In case of illness, it is not recommended to abuse taking a hot bath. Water for water treatment must be purified, boiled, warm, free of chlorine or other chemical elements.
2. In bathing water, you can add substances that have antibacterial, healing and anti-inflammatory properties: a decoction of celandine, chamomile, sea salt, a weak solution of manganese.
3. With atopic dermatitis, it is not recommended to use shower gels, bath foams. The shampoo should be baby and free from dyes and fragrances. The frequency of using shampoos should not exceed 1 time per week.
4. The bathing time is 20 minutes.
5. It is not recommended to use washcloths or brushes to cleanse the skin. They can damage the surface of the skin and cause inflammation.
6. During the period of exacerbation of the disease, the damaged areas need to get wet soft cloth, do not rub or rub the skin. Then apply an emollient body cream.
7. It is not recommended to visit public bathing areas: swimming pools, saunas, baths.

Prevention measures

Prevention of atopic dermatitis consists in excluding the influence of a possible allergen on the body, following the rules healthy eating, personal hygiene.

Proper nutrition, care, adherence to all doctor's prescriptions will help the patient get rid of the disease faster.

During pregnancy and in the first months of life while breastfeeding, excessive drug treatment should be avoided. The presence of drugs in the blood can lead to the transition to artificial feeding of the child and the activation of the synthesis of immunoglobulin.

During the period of breastfeeding, the mother must strictly adhere to the diet.

When a child enters the risk zone for the development of the disease, it is necessary to follow the rules for caring for the baby's skin, normalizing the digestive system.

It is not recommended to completely protect the child from the influence of provoking factors. It is necessary to create conditions under which the body of the newborn will gradually be able to adapt to the effects of any allergens: gradually introduce new foods into the diet, use detergents, and cosmetic substances.

When the first signs of atopic dermatitis appear, you should immediately seek the advice of a specialist. He, taking into account the type of skin, the stage of the disease, the age of the patient, the provoking factor, will prescribe a course of therapy. Untimely treatment or lack of it can lead to the development of serious complications and chronic diseases.

I'll tell you what, we live in Brussels, I, like a proper mom, after reading books, ran to the doctor at 6 months old, I say, they say that my child has “diathesis”, I could not find such a word in the dictionary, so I began to explain.

So, diathesis is not a bit allergy at all, because if only the cheeks turn red, and in other places everything is clean, it cannot be so with allergies.

ok, the cheeks turn red, under the knees, too, moreover, it is exacerbated in winter and during the period, and the period of snot.

we went to the doctor again

atopic dermatitis, according to European doctors, does not require diet and exclusion of products, requires a permanent cream during exacerbation and that's it.

an allergy is another matter, if you have allergens, then this cannot be called hell

Atopic dermatitis (also called eczema, diathesis, neurodermatitis) is a chronic, recurrent disease. This means that the disease is constantly present in the human body, although outwardly it can manifest itself only during an exacerbation. Symptoms of atopic dermatitis include dryness, skin inflammation, and intense itching.

Many people without atopic dermatitis treat it as a simple rash, but for millions of children and their caregivers, atopic dermatitis is a chronic disease that interferes with fulfilling their lives. At times, the manifestations of atopic dermatitis can be so slight that nothing is outwardly noticeable. However, the disease is often so severe that it interferes with sleep, going to work or school, and doing your usual activities.

Atopic dermatitis is not contagious - it cannot spread from person to person. Many children with atopic dermatitis are confused by the appearance of their skin, constant itching and continuous, sometimes involuntary scratching. It is obvious that atopic dermatitis is not life threatening, but there is no doubt that this disease significantly affects the quality of life.

Influence of heredity Atopic dermatitis is a common hereditary disease. If both parents are sick with atopic dermatitis, then with a probability of 80% the disease will be transmitted to their child. Moreover, in recent years, the spread of atopic dermatitis among members of the same family has become more and more frequent. In 90% of people, atopic dermatitis is diagnosed within the first five years of life. Symptoms may subside or even disappear as they get older, but in many people, symptoms of atopic dermatitis persist throughout their lives. In addition, the development of atopic dermatitis is often accompanied by allergies and / or asthma.

Atopic dermatitis is a common disease that often occurs in young children and is often inherited among members of the same family.

Does your child have atopic dermatitis? Signs or symptoms of atopic dermatitis include:

• Persistent dry skin;
• Regular inflammation of the skin, accompanied by itching;
• The appearance of thickenings, spots, scales in certain areas of the skin;
• The diagnosis of atopic dermatitis is more likely if the patient's relatives have allergic rhinitis or asthma.

The only way to be sure your child has atopic dermatitis is to consult a doctor. However, if your child is diagnosed with atopic dermatitis, do not despair - the correct treatment will help control the course of this disease.

It is important to remember: Exacerbations of atopic dermatitis are a consequence of the increased sensitivity of the skin's immune cells, which react to certain provoking factors.

Where do the signs of atopic dermatitis appear? During exacerbations of atopic dermatitis, there is a tendency to repeated damage to the same parts of the body, however, depending on the age of the child, the place of manifestation of the symptoms of the disease may change.

Atopic dermatitis pattern In young children, signs of atopic dermatitis usually appear on the face, elbows, or knees, and possibly elsewhere on the body.

In older children and adults, the rash is more common in the popliteal areas, on the inner surfaces of the elbows, on the side of the neck, on the wrists, ankles, hands and face.

During exacerbations of atopic dermatitis, there is a tendency to re-damage the same parts of the body.

It is important to remember: Atopic dermatitis (also called eczema, diathesis, neurodermatitis) is a chronic, recurrent condition. External manifestations of the disease can appear and disappear depending on exacerbations. Atopic dermatitis is not contagious.

Skin care Since atopic dermatitis is a chronic condition, you need to take constant care of your baby's skin. Some of the most important guidelines to follow are:

• The main rule is not to let your baby's skin get too dry.
• Make sure your child's room is not too hot to sweat as little as possible while sleeping.
• Avoid showers or baths that are too hot, and stay in water for too long. Take a bath or shower for no longer than 10 minutes at a water temperature no higher than 38 ° C.
• Avoid applying soap to areas of skin affected by atopic dermatitis or dry skin as much as possible. It is recommended to use special non-soap cleansers instead of soap.
• Do not rub on wet skin - dry it by blotting and patting the skin with a soft towel.
• Within 3 minutes after bathing, apply a moisturizer to your skin to keep moisture in your skin.
• Use only cleansers and moisturizers recommended by your doctor. Avoid perfumes and try not to use fabric softeners when washing.
• If possible, avoid contact with woollens.
• If itching is interfering with sleep, you can soothe your skin with a cool, moist terry cloth compress.
• Provide nannies and other caregivers with all the information about your child's special bathing conditions and the need for moisturizers.

Provoking factors The immune cells of the skin of people with atopic dermatitis have increased sensitivity. Exacerbations of atopic dermatitis are the reaction of these cells to certain provoking factors. Identifying and eliminating these factors helps to alleviate the condition of people suffering from this disease.

Allergens People with a predisposition to atopic dermatitis often develop or worsen the disease because of an allergic reaction to certain food (milk, wheat, peanuts) or inhalation allergens (dust mites, molds, pet hair). Watch out for any allergens that could potentially cause or worsen atopic dermatitis. In addition, you need to consult a doctor who will help you compile a list of allergens that are dangerous specifically for your child.

Irritants People with atopic dermatitis should avoid contact with chemicals that can irritate the skin. In addition to the quite obvious ones - for example, pesticides, dyes, etc. - Potential irritants also include alcohol, soap, fragrances and astringents. In addition, such chemicals can be found in cosmetics, cleaning products, detergents, air fresheners, toilet paper, fabric rinses, and the like. It is enough to remember this, carefully study the labels and eliminate these irritants in time to reduce the number of exacerbations. In addition, it must be remembered: the use of hypoallergenic products does not protect patients with atopic dermatitis from exacerbations. The term "hypoallergenic" means a product that is incapable of causing a skin reaction in healthy people. Skin prone to the development of atopic dermatitis has increased sensitivity, so even hypoallergenic products can cause an exacerbation of the disease.

Temperature and Humidity Abrupt changes in temperature and humidity lead to excessive dryness of the skin or increased sweating, which causes an exacerbation of atopic dermatitis or worsens its course. To avoid this, it is necessary to maintain a stable, moderate temperature and humidity indoors. For these purposes, it is best to use an air conditioner (in summer) and a humidifier (in winter). In addition, it is necessary to constantly use moisturizers that will allow the skin to maintain an optimal level of moisture.

Clothing Even something as simple as clothing affects the course of atopic dermatitis. People suffering from this disease need to avoid tissues that can cause itching, such as wool. It is recommended to wear soft fabrics such as cotton - this greatly reduces the likelihood of skin irritation. All new items, linen and towels should be washed thoroughly with a small amount of liquid detergent. After washing, all items must be rinsed as many times as possible to remove soap residues. At the same time, try not to use fabric softeners - the substances they contain often cause skin irritation.

It is necessary to identify and eliminate these provoking factors - among them may be chemical irritants, sudden changes in temperature and humidity, clothing fabric, as well as food and inhalation allergens.

Treatment Only a doctor can provide an accurate diagnosis for your child and select the appropriate treatment program.

As a rule, first of all, he will advise you to eliminate all the factors that provoke an exacerbation of the disease. However, this may not be enough.

Atopic dermatitis cannot be completely cured, but there are medications that can relieve or eliminate itching, reduce redness and help your skin look healthy, and control the disease by reducing the impact of atopic dermatitis on your life.

During a survey of patients with atopic dermatitis and their parents, 65% of respondents noted that it is very important for them or their children to keep their skin healthy and clean. At the same time, 65% of parents also "want their children to receive the most effective preventive treatment."

Moisturizers The first step in skin care is the daily use of moisturizers to keep the skin from drying out. Most often, these products are available in the form of creams. In some mild cases of atopic dermatitis, regular use of moisturizers may be sufficient to control the condition. Some moisturizers, especially oily ones, may not be to your baby's liking. However, remember to apply these remedies daily, even if the skin does not have the outward manifestations of atopic dermatitis.

Topical corticosteroids Corticosteroid ("steroid") creams and ointments can quickly reduce redness and relieve itching of inflamed skin, especially in severe flare-ups. Generally, corticosteroid medications should be prescribed by a doctor.

Steroids can quickly reduce the appearance of the disease, but such drugs are not intended for long-term use. Typically, the recommended duration of steroid use is limited to two weeks. Longer use of these drugs can lead to side effects such as thinning of the skin. To reduce the risk, your child's doctor should recommend the weakest steroid that will help the patient. However, remember that even mild steroids should not be used to treat a child for an extended period of time.

New treatments There is a new treatment for atopic dermatitis, nonsteroidal drugs known as topical calcineurin inhibitors (TICs). This method of dealing with atopic dermatitis has only recently begun to be applied. TECs not only help reduce redness and itching of inflamed skin, but they can also provide long-term control of the disease.

Topical calcineurin inhibitors can eliminate the immediate symptoms of the disease during an exacerbation, and such drugs can be used for a much longer time than steroids. In addition, TEC drugs provide a longer remission (period of time without exacerbations) and better control of atopic dermatitis. In Russia, this class of drugs is represented by the drug ELIDEL (Pimecrolimus 1%).

Itching Drugs Antihistamines may also be given to relieve itching caused by flare-ups of atopic dermatitis. However, some of these drugs cause drowsiness. At night, it can help improve sleep, however, during the day, when the person is at work or school, the use of any sedative drug should be avoided.

Antibiotics Patients with atopic dermatitis are more susceptible to infectious skin diseases than other people. When a bacterial infection occurs, antibiotics are prescribed to kill the bacteria that cause the infection. However, overuse of antibiotics can reduce the effectiveness of such treatment - over time, bacteria become less susceptible to drugs. If you use drugs to treat atopic dermatitis when your child first has symptoms of the disease, you can reduce the risk of skin infections and avoid the use of antibiotics.

It is important to remember: Only a doctor can diagnose atopic dermatitis and recommend an appropriate treatment program.

Psychology of a Child The psychology of a child with atopic dermatitis is very complex. In modern dermatology, the opinion is quite common that there is an inverse somatopsychic component of any skin disease. It lies in the fact that a cosmetic defect, already unnerving a person, can also cause him psychological trauma.

The ridicule of comrades, the pity of close friends, and itch-phobia worsen the condition of not only the child, but often also the adult patient. Experts emphasize that if the emotional factor is not taken into account in the treatment of a skin disease, then in 40% of cases, therapeutic assistance will be ineffective.

As a rule, exacerbations of atopic dermatitis are accompanied by various types of depression, which the child cannot cope with on his own. The help of a professional psychologist is often required, but often loving parents and relatives can support the child and help him in difficult periods of his life:

• Show your child that you understand the severity of his situation, but believe in his ability to overcome all difficulties and cope with the disease.
• Tell teachers and other school staff that your child has atopic dermatitis. Ask them to support your child during flare-ups.
• Tell your child that atopic dermatitis is not contagious and that the disease is more likely to disappear as they get older.
• Take good care of your child. Try to maintain a good mood and be optimistic in his presence at all times.
• Create an atmosphere in the home that will make your child feel comfortable. May he feel joy returning home every day. For a child, a home is a support in life, a place where he can hide from adversity and difficulties.
• Don't be afraid to tell your child how much you love and need him. It is very important for children to hear these words and to feel the participation of their parents in their lives. Go with your child to the cinema, circus, theaters, try to find common interests for you and your child.
• Being ashamed of their appearance, the child may abandon their usual activities - for example, sports. Explain to him that this is wrong, and go to training with him. Let the child feel that even during periods of exacerbation of his illness, he can still enjoy life.
• In no case limit the child's contacts with peers. On the contrary, in every possible way encourage his desire to communicate. Invite his friends to visit, get to know them.
• Relieve the child from overprotection. Any baby needs a certain degree of freedom. And it is perfectly normal if he periodically has a desire to be alone.
• The course of atopic dermatitis can worsen during times of stress, to which children are exposed much more than adults. Follow a specific bathing regimen and use moisturizers and medications. This will help improve the well-being of the child.

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 have to be monitored by an allergist for life. Only the correct knowledge about this disease will help to control the course of the disease.

What it is?

Any manifestations of atopic dermatitis are associated with allergic reactions. This disease has a predominantly genetic predisposition.

Scientists have identified a number of genes that code for a predisposition to the perception of various substances. These genes determine the 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 ingestion of a trigger factor. This reaction is accompanied by severe cutaneous and systemic manifestations. Various substances and allergens can act as triggering or provoking agents. The peculiarity of the individual reaction depends on the genetic predisposition and the initial level of the immune system.

Causes of occurrence

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, the provoking agents are chemicals.

Scientists do not know the only exact cause of the disease. This is due to the individual coding of genes in each human body. It has been found that when a specific trigger is hit, 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 psychoemotional or physical exertion, the risk of new exacerbations of the disease increases by 12-15%.

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

Provoking factors

Numerous factors can trigger atopic dermatitis. All triggers can be divided into several categories. Most of the provoking agents enter the body from the outside. They account for more than 80% of disease cases. Internal provoking factors are much less common. Usually, these forms of diseases are typical for babies with many chronic diseases.

Stages of development of the disease

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 manifest itself at any age. Like any chronic disease, atopic dermatitis goes through several successive stages in its development:

1. Primary contact with an 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 "memorize" the antigens of a substance foreign to the body and, upon repeated contact, emit a huge amount of protective antibodies.
2. Development of immune inflammation. The activated lymphocytes, which have recognized the 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 unfavorable 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 only on the skin, protecting the brain and heart.
3. The development of the classic manifestations of the disease. During this period, the inflammatory process reaches such strength that the first unfavorable symptoms of the disease begin to appear. They usually last 7-14 days. The most acute manifestations during initial contact with an allergen appear after 48-72 hours. If the provoking factor enters the body again, then the period before the onset of symptoms can be reduced from several hours to a day.
4. Abatement 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 subsiding 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 is cleansed and takes on a normal appearance.
5. Remission. During this period, the child is practically not worried about anything. The kid leads a normal life. The child's health is excellent. The skin changes slightly. In some cases, crusting or dry patches of 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 be replaced by an exacerbation.

Classification

Today, doctors in their work use several different categories at once, which make it possible 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.

Disease development phase

• Start. Corresponds to the primary contact of 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.
• Subside exacerbation... Disappearance of unpleasant symptoms, improvement of the general condition of the baby.

• Infant option. It develops in babies up to two years old. It usually proceeds with the appearance of red itchy spots. Such rashes are large enough. This option is also characterized by pronounced swelling of the baby's buttocks, arms and legs. The skin on the trunk becomes very thin. Numerous white scales can form on the head, which are easily rejected.
• Children's option. As a rule, it proceeds until adolescence. This form of the disease is characterized by severe itching, as well as desiccation of the skin. Skin elements can be varied. Often there are various vesicular eruptions filled with transparent contents.
• Teenage version. It can develop up to the age of eighteen. This form proceeds with the appearance of severe itching on the 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 of severe lichenification. The appearance of vesicles is not always found. Much more often, skin rashes appear in the form of extensive areas of erythema.

Extensiveness of the inflammatory process

• Limited area option. Damage to the skin in such cases is no more than five percent of the entire skin surface.
• Option with common elements. It occurs when there are lesions that cover 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, numerous damage to the skin is noted. 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 scratching marks appear on the skin.

Change in general condition

• Relatively easy course. It implies the occurrence during exacerbations of a small amount 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. The periods of remission 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 out, the fluid flows out, weeping ulcers form. As a rule, the baby's condition worsens. The child is constantly combing itchy elements. The condition may also be complicated by the addition of a secondary bacterial infection.
• Heavy current. It is typical for babies with a low level of immunity. The child looks terrible. Skin elements appear almost everywhere: on the face, arms and legs, cover the buttocks, abdomen. Numerous vesicles, ruptured, contribute to the development of severe weeping wounds, which are poorly epithelized.

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, symptoms appear to a lesser extent. If the child's allergic predisposition is quite pronounced, then the immune response to the provoking factor will be very strong.

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

• Severe itching. He worries the child throughout the day. Decreases somewhat at night. Babies, scratching the damaged areas of the skin, can introduce 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 on limited areas of the body. They often occur on the back, abdomen, or arms. The affected skin acquires a characteristic "fiery" color. To the touch, it becomes hot, somewhat compacted.
• Dryness appears. It is also one of the most common symptoms of atopic dermatitis. The longer the disease lasts, the more pronounced this manifestation becomes. This is due to a violation of the water-lipid composition of the skin (due to a prolonged inflammatory process). The structure of the layers of the skin 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 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.
• Lichenification phenomena. This sign appears late enough. It occurs with constant scratching, in the presence of damaged skin areas. 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 disrupted.
• Poor health of the child. Severe itching causes severe anxiety in the baby. Kids are more capricious, often cry. With a severe course of the disease, they 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 symptoms that were characteristic during an 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.

For the period of remission of atopic dermatitis, the following symptoms are characteristic:

• Changes in the structure of the skin. Some areas of the skin become hardened, while others become thinner. This is due to changes in the structure and structure of the skin layers. Weeping sores tend to heal, but feel less dense to the touch. Crusts may form on the healed wounds.
• Scratching marks. Found in almost all babies with atopic dermatitis. Most pronounced in babies with frequent exacerbations of the disease. Usually they appear as narrow stripes of white or reddish color. Cover the entire body surface. A large number can be seen on the arms or cheeks of the baby.
• Change in skin pattern. With a prolonged inflammatory process that occurs with this disease, the architecture of the structure of the skin changes. Areas of hyperpigmentation appear.
• Severe dryness of the skin and the appearance of areas with flaking... This symptom is characteristic 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 prolonged course of the disease, severe dryness and flaking around the red border of the lips may appear. This is often a manifestation of atopic cheilitis. This condition does not require special treatment - other than the use of mild lip balms that are approved for use in children. In some cases, atopic cheilitis goes away on its own, without the use of additional funds.

Diagnostics

To identify the specific allergen that contributes to the onset of symptoms of atopic dermatitis, auxiliary laboratory and instrumental tests will help.

General blood analysis

An increase in the level of leukocytes above normal 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 occur with accelerated ESR in the acute period of the disease.

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

Biochemical research

For the analysis, a little venous blood is taken from the baby. With this test, 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, an increase in the level of bilirubin also occurs.

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

Quantification of immunoglobulin E

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

The material for research 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 the norm. An increase in the index of more than 165 IU / ml may indicate the presence of atopy. During remission, the level of immunoglobulin E decreases slightly. However, for a fairly long time, it can remain somewhat elevated.

Special allergy tests

This method is the classic method for the determination of 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.

Allergy tests can only be performed by a pediatric allergist-immunologist. Most often they are carried out in the conditions of allergy rooms of polyclinics or in private centers.

The research takes, as a rule, no more than an hour. The baby is made small incisions on the skin with a special sharp scalpel. Do not be afraid of such cuts. They are too small to be a threat of infection or suppuration.

After applying special notches, the doctor applies diagnostic solutions of allergens. The substances are applied in a strong dilution. This minimizes the risk of a possible violent allergic reaction. Such diagnostic solutions can be applied in several ways. Drip is usually chosen.

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

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

The unconditional 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 overreact. In such cases, it is impossible to speak of an unambiguous presence of an allergy.

If it is impossible to unambiguously assess the presence of individual allergic sensitivity to a specific 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 have shown excellent results in the diagnosis of allergic diseases. The test does not require scoring or cuts in the skin. The material for research is venous blood.

The analysis usually takes from three days to several weeks. It depends on the number 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 an allergen, the cells of the immune system release a huge amount of antibodies. Such a protective reaction is designed to quickly eliminate the foreign agent from the body and eliminate inflammation.

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

Before performing any serological tests, it is important to remember to prepare for the research. All such tests are best done during remission. This will minimize false positives. It is best to follow a medicated hypoallergenic diet before undertaking a study. It is better to cancel all antihistamines and desensitizing drugs a couple of days before the study.

Basic treatment principles

Therapy of atopic dermatitis is divided into several stages: during exacerbation and remission. Separation of treatment allows you to cope with different symptoms that occur at different periods of the course of the disease. With prolonged 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. The area of ​​tissue that is closely adjacent to the baby's genitals can be impregnated with various antiseptic agents. Acute contact dermatitis may occur in babies prone to allergies ... 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 can help cope with the uncomfortable symptoms of atopic dermatitis. The choice of drugs is carried out, focusing on the skin manifestations that have arisen during this exacerbation. The most commonly used are various hormonal and anti-inflammatory ointments, creams, gels, as well as various powders or talkers.
• Compliance with a hypoallergenic diet. During the period of exacerbation, doctors prescribe the most severe medical nutrition. Such a diet includes an abundance of permitted protein foods and cereals with 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 drugs may be prescribed in the form of injections or tablets. With severe itching, which brings severe suffering to the baby, tablet forms of antihistamines are prescribed. NS it can be "Suprastin", "Fenistil" and others. They are prescribed for a long time: from several days or even up to a month.
• Compliance with the rules of personal hygiene. Mothers should keep their babies' nails clean and long. With severe itching, children strongly scratch the inflamed skin. If there is dirt under the nails, then they can introduce additional infection and aggravate the course of the disease. When the secondary bacterial flora is attached, the inflammation increases markedly, and signs of suppuration may appear.
• Compliance with the regime of the day. For the immune system to function properly, babies need rest. During the day, children should sleep at least ten hours. This time is required for 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 skin areas. After the acute process subsides, various crusts and peeling remain on the skin. To eliminate the effects of the inflammatory process, ointments and creams with a rather 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 the immune system. 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 be 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. The normalization of the protective function of the intestines also helps to restore the immune system. The 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 should definitely eat only approved foods. All food that contains possible allergenic components is completely excluded from the baby's diet. It is worth following a hypoallergenic diet throughout life.
• Complete exclusion from household use of possible provoking allergens. For babies who are prone to atopic dermatitis, do not use feather pillows or blankets. It is better to give preference to other natural and synthetic materials on a hypoallergenic basis. Pillows should be dry-cleaned at least 2 times a year. This will get rid of household mites that 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)... These include " Tsindol "," Elidel "," Triderm "," Ketotifen"And many other means. These drugs are anti-inflammatory and can help fight inflammation. Many remedies are combined. They may include antibiotics in low concentrations. These drugs are usually well tolerated and do not cause systemic side effects. They are appointed, as a rule, 2-3 times a day and for a period of 10-14 days. With a more severe course of the disease, it can be used for a long time, until the unfavorable symptoms of the disease are completely eliminated.
• Hormonal ointments. They are used for a long course of the disease. You should not be afraid of using such drugs. The content of glucocorticosteroid hormones in them is quite small. Such drugs simply cannot cause side effects of a systemic nature. Most topical preparations contain low concentrations of beclomethasone or prednisolone. In the treatment, you can use the ointments "Advantan", "Elokom" and many others approved for pediatric practice.
• Desensitizing drugs. Often, doctors prescribe antihistamines to eliminate severe itching. It can be "Suprastin", as well as "Fenistil", preparations based on desloratadine. Many of the drugs are used for children over two years of age. These remedies allow you to eliminate severe inflammation and cope with debilitating itching. Such drugs are prescribed for a course of 10-14 days.

Tablet forms can also be used for a month or more from the moment the adverse symptoms of exacerbation are eliminated. Calcium gluconate can be used to relieve itching. It helps to eliminate the mild manifestation of this adverse symptom.

• Cell membrane stimulants. They have a mechanism of action that is similar to that of antihistamines. They are used in children's practice relatively recently. They are well tolerated by children. There are practically no side effects from the use. Ketotifen is often prescribed. This medication is used for babies over three years old. Appointed as a course for 2-3 months. The scheme is chosen by the attending physician. For the correct withdrawal of the drug, a gradual reduction in dosage is required.
• Preparations that support immunity. Often, babies with atopic dermatitis are advised to maintain good intestinal microflora. For this, various preparations are prescribed containing live bifidobacteria or lactobacilli. Such medicines 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 is imperative to moisturize it. Even during the period of acute manifestations of the disease, the baby can be bathed. Bathing your baby is not recommended. This can contribute to increased itching and lead to additional dryness of the skin. Better to give preference to a simple hygienic shower.

Special medicated shampoos can be used to relieve itchy scalp. These products have a physiologically neutral pH and do not cause irritation.

Hygiene procedures can be performed daily. After that, it is imperative to treat the skin with medicinal ointments or creams. This will additionally moisturize damaged skin and eliminate the adverse manifestations of atopy.

For very young children, when bathing, you can add celandine broth. For its preparation, 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 the baby is bathing. You can bathe the child with wormwood or infusion of a series. These herbs have a beneficial effect on the skin and help prevent infection of wounds that occur during an exacerbation.

What to eat?

Nutritional therapy for 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 berries are red or burgundy. 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 child's reaction to the introduction of a new product.
• Chocolates and other sweets containing cocoa beans.
• Candy and sugary soda which contain many chemical dyes and food additives.

The nutrition of a baby with atopic dermatitis must include the following foods:

• High in protein. Perfect for: lean poultry, veal, fresh beef, and rabbit. Fermented milk products should be included in the child's diet. A large amount of the right protein, combined with beneficial bifidobacteria, will help to strengthen the immune system of babies. It is best to add a specific approved protein product at each meal.
• 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 between 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 exacerbation subsiding, you can add potatoes and a little 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 to form healthy gut microflora.
• Fruits. Usually apples and garden pears are recommended for Russian kids. The content of antigenic components in these fruits is much lower than in tropical fruits. In the acute period, the use of such products should be somewhat reduced. Fruits are high in natural sugars. This can negatively affect the restoration of the cellular structure of the skin and somewhat impair the work of leukocytes.
• Adequate amount of liquid. To remove decay products that are formed in the body during the inflammatory process, water is required. ... You can drink ordinary boiled water. It is also permissible to use fruit drinks or compotes, prepared from dried garden apples or pears. It is better to exclude berry drinks until the period of remission.
• Vitamin intake. During the period of a strict diet, which is necessary during an exacerbation, too few useful microelements enter the child's body, therefore, the introduction of such substances from the outside is required. Synthetic complexes become an excellent source of various vitamins. They contain a combination of beneficial 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 beneficial trace elements in the body.

How to properly organize the daily routine?

It is very important for babies with atopic diseases 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 this rest, the nervous and immune systems are restored. The child gains new strength to fight the disease.

A night's 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. A decrease in 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. The debilitating itching brings great discomfort to babies. With the elimination of adverse symptoms against the background of the 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 should get more rest, try to get enough sleep.

Possibilities of 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 case of a mild course - at home .

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

Various physiotherapy methods 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 inductothermal methods are used. Usually, while staying in the 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 is indicated, for a period of up to three weeks.

Therapy in a sanatorium has a very pronounced clinical effect. With the regular passage of such balneological treatment, the number of exacerbations of the disease is noticeably reduced. Babies who are undergoing therapy at sea noticeably strengthen their immunity. Sea ions have a positive effect on the functioning of the cells of the immune system, as well as 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 remission. The duration of the voucher can be 14-21 days. It is better to choose sanatoriums that are located in the immediate vicinity of 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 consequences. After several exacerbations and the use of numerous drugs, the child may develop certain complications of the disease.

The most common cases of atopic dermatitis are:

• Various suppurations(as a result of the attachment of a secondary bacterial infection). Staphylococcal and streptococcal flora are widespread. Usually, the baby can bring in germs while combing itchy elements. After that, after a few hours, inflammation noticeably increases, pus appears.
• Weeping wounds very often become infected. Even a small amount of the pathogen is enough to start a bacterial infectious process. These cases require immediate medical advice and antibiotic prescription. In case of a severe course of the bacterial process, emergency hospitalization in a hospital.
• Atrophic phenomena on the skin or its pronounced thinning. Commonly seen as side effects after prolonged use of corticosteroid ointments. Some children may have alternatives. Instead of areas of thinning skin, dense crusts (or even scabs) form. In such conditions, hormones are canceled and switched to other drugs. During the period of such a cancellation, babies are prescribed immunomodulatory agents that allow them to normalize the impaired function of the child's immune system.

Is a disability established?

Usually, for babies with atopic dermatitis, it is not necessary to establish a disability. With a mild course of the disease and sufficient control of the onset of persistent loss of function, there is no. With this variant of the disease, doctors recommend the treatment of exacerbations in a polyclinic, with the obligatory supervision 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 can turn to the ITU for an examination. Medical experts will examine all of the child's medical records and identify the presence or absence of disabling signs. If a child has signs of persistent loss of function, then he may be assigned a disability group. As a rule, the third.

Prevention of exacerbations

Preventive measures help prevent acute illness and control the course of the illness. When it comes to babies with atopic dermatitis, you should always remember about prevention. Avoiding contact with the provoking 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. It is imperative to include a complete protein (in an amount sufficient for a 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. The pillows should be cleaned at least once or twice a year. The blanket should also be taken to a professional dry cleaner.
• Toys, dishes and cutlery belonging to a child are processed in warm water using special liquids that do not contain aggressive chemicals. These products are usually labeled as 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 the onset of 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 the immune system. Eating a healthy diet with enough fiber and vitamins, and active outdoor play are great ways to rebuild and revitalize your immune system. Babies with atopic dermatitis should also not avoid tempering and water treatments. Such techniques have a positive effect on immunity, as well as improve mood and normalize sleep.
• Long-term breastfeeding. Scientists from many countries have proven that protective antibodies enter the infant's body along with breast milk. This allows you to protect the child's body from various infectious pathologies and reduce the risk of developing possible allergic reactions. Breast milk also helps to normalize the baby's intestinal microflora and helps to strengthen the immune system.
• Compliance with the rules of hygiene. Nursery rooms for babies who are prone to allergic reactions should be cleaned 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 nursery and even helps to reduce the concentration of pathogenic microbes in the air.
• Regular walks in the fresh air. Sufficient sun exposure 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. Outdoor walks are very important for babies. They help restore immunity.

Atopic dermatitis is very common in babies of different 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.

For more details, see the program of Dr. Komarovsky.

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

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

Causes of atopic dermatitis

In addition to the genetic disposition, the prerequisites for atopic dermatitis in infants can be:

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

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

Atopic dermatitis in older children (at the age of 2-3 years) can manifest itself against the background of psychoemotional stress, passive smoking, excessive physical exertion, poor ecology in the place of residence, and frequent infectious diseases. The same factors provoke an exacerbation of eczema in the chronic course of the disease.

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

The main signs of the disease

Symptoms of atopic dermatitis in infants:

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

In difficult cases, it is not only the scalp that suffers. There may be atopic dermatitis on the arms, neck, legs, buttocks. Sometimes irritation is accompanied by pyoderma - small pustules, combing which the child can get a secondary infection, expressed in difficult healing wounds.

In the process of growing up, if the disease cannot be stopped, the signs are modified or supplemented. So, if the baby is already 1 year old, it is possible that the skin pattern and the appearance of dry, flaky foci of compacted skin under the knees, in the folds of the elbows, on the wrists, feet and neck are possible. At 2 years old, almost half of the children, with appropriate treatment, get rid of the disease. But some babies suffer even after two years: the infantile stage of the disease passes into the childhood stage, and then into the adolescent stage. Painful areas are hidden in skin folds or localized on the palms and feet. Exacerbations occur in the winter, and the disease does not manifest itself in the summer.

Atopic dermatitis in a teenager

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

Clinical presentation and diagnosis of the disease

It is important to differentiate atopic dermatitis in children from other skin diseases. After all, the symptoms can be similar to the manifestations of scabies, pink lichen, psoriasis, microbial eczema or seborrheic dermatitis.

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

Mild form of atopic dermatitis in a child

Moderate atopic dermatitis with secondary infected scratching wounds

Severe atopic dermatitis in children

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

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

Allergic disease therapy

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

Experienced doctors who know how to cure atopic dermatitis believe that only complex therapy... It includes proper nutrition, clear control of the surrounding space, taking pharmaceuticals and physiotherapy. You may need the help of not only an allergist and dermatologist, but also a nutritionist, gastroenterologist, otolaryngologist, psychotherapist and neurologist.

Diet for atopic dermatitis in children

Diet therapy is extremely necessary: ​​it is food allergens that can give a violent cutaneous response. In the first place - products from cow's milk. If a "milk" allergy is detected in an "artificial", mixtures with soy substitutes will be preferable for him: "Alsoy", "Nutrilak soya", "Frisosoy" and others.

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

In difficult cases, the doctor can prescribe a complete hydrolyzate, such as Neocate, together with Creon 10000 therapy.

For complementary foods, you cannot choose foods with a high sensitizing activity, for example, citrus fruits, nuts, honey, strawberries.

Subsequently, when drawing up a diet, it should be borne in mind that when a reaction to milk protein is a real allergy to beef. The body of the crumbs, which does not perceive mold fungi, will give a violent response to yeast products - from bread to kefir.

The diet for atopic dermatitis in children involves a special menu. Broths, mayonnaise, marinades, pickles, frying, food containing dyes and preservatives are not recommended.

A sample menu for this disease:

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

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

Drinking water should be chosen artesian or non-carbonated mineral. It should be at least 1.5 liters per day so that toxins can be freely excreted in the urine.

The doctor may also prescribe fish oil to strengthen the baby's immune system and strengthen the cell membranes.

Control of the surrounding space

The well-known pediatrician Komarovsky is sure that with atopic dermatitis in children, the main thing is to exclude the effect of irritating factors on the skin. This requires:

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

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

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

Essential emollients

How is atopic dermatitis treated? In acute conditions, a physician may prescribe corticosteroids for external use. Compositions for softening and moisturizing are needed constantly. Emollients are ideal for atopic dermatitis in children.

Here is a list of the most popular remedies:

• Lokobase Lipikrem. The same company produces another cream for atopic dermatitis in children - Lokobase Ripea. In the first case, the active ingredient is liquid paraffin, which softens the skin. In the second - ceramides, cholesterol and polyunsaturated fatty acids, which contribute to the regeneration of the skin.
• A series of Topikrem products for the care of atopic children. The lipid-replenishing balm and Ultra Rish gel, which cleanses the skin, are suitable for babies.
• Milk or cream "A-Derma" is a good prophylactic agent that moisturizes and protects the skin.
• The Stelatopia series from the Mustela manufacturer. These are creams, emulsions and bathing compositions that soften the epidermis and help regenerate it.
• Lipikar balm. It contains lipid-replenishing karite and canola oils, glycine to relieve itching and wound healing thermal water. In addition, the pharmaceutical laboratory La Roche-Posay has created the Lipikar Surgra, Lipikar Sindet, and Lipikar Bath Oil hygiene products suitable for babies with atopic dermatitis.

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

Systemic pharmaceutical treatment

Systemic therapy is sometimes necessary. The course may include:

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

Therapy for allergic dermatitis is carried out on an outpatient basis. But with a serious skin lesion, the baby is shown hospitalization.

Treatment with folk remedies and physiotherapy

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

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

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

Birch tar ointments also have a healing effect on inflammation.

Sanatorium treatment and physiotherapy procedures are very useful for atopic children. In case of remission, pearl, sodium chloride, hydrogen sulfide, iodine-bromine baths, mud therapy are suitable. With a vivid manifestation of symptoms - electrosleep, magnetotherapy, carbon baths, relaxing procedures.

Prevention of atopic dermatitis in children should begin when the fetus develops in the mother's abdomen. It aims to reduce antigenic stress. In the first three months, it is vital for the baby breast milk for the formation of the immune system. In the future, mom and baby should eat right, avoid stress and negative environmental influences.

• Antihistamines for children: an overview of the most effective
• Urticaria in children: symptoms, causes and treatment
• Bronchial asthma: causes, signs and treatment in children

Remember that only a doctor can make a correct diagnosis, do not self-medicate without consulting and making a diagnosis by a qualified doctor. Be healthy!

taken from INNA's diary, from babyblog.

We were at the reception with a dermatologist at the CDC for Pediatric Dermatology on Bochkova Street. What was advised there ??????? Advantan for rashes in courses of 7-10 days. yes Emolium cream for dry skin. AND EVERYTHING ……… However, it did not work. I understood that Advantan is harmful, it can only be used in extreme cases, because it's a hormone after all !!! ..

Atopic dermatitis usually begins due to a lack of enzymes for the breakdown of food, or due to disruption of the intestines in which antiallergens are produced, which is very related to each other

Here are the treatment regimens according to which we treated the lack of enzymes in the pancreas and liver,
pancreatin 1tab 3 times a day with meals
liv 52 1/2 tab 3 times a day
3 weeks
for fasting before meals 2 tablets of activated carbon are diluted in a small amount of water
course 3 weeks

after that 1 month enterosgel, an absorbent that normalizes intestinal activity, relieves intoxication, and it is allergens if you are atopic ...

it is very important to drink clean water without chlorine….

Creon and Essentiale forte course 21 DAYS

Ketotifen has a good effect, in addition to all the actions that new antihistamines have, it not only lowers histamine but also stabilizes cells ...

always when you are taking antihistamines, you must stop them gradually Reducing the dosage, otherwise you can provoke an exacerbation
ketotifen in severe cases can be drunk for 3 months
scheme for a month 1/2 tablet 2 weeks in the morning and in the evening
1/4 tablet morning and evening 2 weeks
1/4 tablet at night only
and then every other day so that the body adapts to work without antihistamines
drank (zirtek, paralzin, suprastin, loratadin, claritin ... and many others) - this is not a way out of the situation, this is help to relieve itching but not
treatment…

If you do not tolerate milk and casein, then you will have to restore the intestinal flora with acidophilic bacteria, courses for 1 month and then a break, and so on for a year, no Linex and lactulose. In this case, Lacidophilus, Bifoval (not sweet), Enterojermine, etc. are suitable for you.

You can order in the pharmacy sodium thiosulfate medicine to relieve intoxication

Vitamin A in drops without E, if the skin is severely affected, you can drink calcium but not for long.

Here are ointments and creams that have helped us in different situations.

methyluracil ointment is a regenerator, but the skin does not breathe well under it

The ointments that Elidel helped us but cannot be smeared for a long time is not hormonal, but it is better not to use it for a long time
a month and then there should be a break
ointment based on Naftalan oil, course 1.5 months
Trickzera and Cold Cream Aven also have a good effect.
cheap cream in the pharmacy The rescuer for children moisturizes well, the rescuer for children with silver heals but dries the skin !!!
Borough plus green only! Heals and disinfects the skin, as everything clings to such skin. several times a month
desirable.
The chanterelle is children. the cream in pharmacies also moisturizes well but tingles on the wounds

Cooked birch tar heals well and restores, you just need to be prepared to ensure that the clothes that

you will use it further, it was not a pity. in pharmacies where medicines are prepared, you can buy refined tar, lanolin and petroleum jelly
1 tablespoon lanolin
1 jar of petroleum jelly
+100 g of tar, prepare everything in a water bath until smooth and allow to cool
lubricate in the morning and evening
it is better to rinse off to brew birch buds or cinquefoil, some are helped by boiled currant leaves or branches that did not suit us,
steam oat straw, but after each herb, even the one that suits you, rinse with plain water
cinquefoil and viburnum branches approached us

Now we smear Lokobase Ripea good cream really helps to restore the skin, I add a drop of olive oil to

moisten in areas where it is still dry
we continue to drink viburnum ...

It is necessary to be tested for celiac disease - this is a syndrome of not digesting food, if it is, then you have the key to the causes of your dermatitis!

An examination for helminths (blood test from a vein) is mandatory, because they eat up all the useful flora inside, populating the body

pathogenic bacteria that cause allergies, metabolic disorders, dysbiosis, rashes, etc. not surprising
that we subsequently suffer from all these diseases

their action, etc.
helminths and they are the culprits of our intoxication of the body, their larvae can get in with poor-quality water, with poorly washed greens,
vegetables and it is enough for children after the neighbor's dog in the elevator or to walk near the house, touch with their hands and put it in their mouths ...
so hormone therapy began not to help, but only to aggravate the situation

I am not an adherent of any method of treatment, we just reached the edge when the child did not get up anymore

and before that there were hospitals, paid clinics, etc. resorts, diets to this problem we must look for ways from the inside, we came to these analyzes in 4 years
May God grant you that your path to the answer is much shorter than ours!

Atopic dermatitis is an inflammatory allergic skin disease caused by allergens and toxins, its other name is children's eczema. Atopic dermatitis in children in the first years of life is more likely a congenital disease than an acquired one, since the hereditary factor is determining in the mechanism of its occurrence and often children, in addition to dermatitis, suffer from other allergic manifestations - food allergies, hay fever, allergic rhinitis, allergic conjunctivitis, bronchial asthma... Taking into account age, doctors distinguish 3 forms of the disease:

• Infant from 0 to 3 years old;
• Children from 3-7 years old;
• Teenage

In babies up to 6 months old, the disease appears in 45% of cases. In the first year of life, 60% of children suffer from allergies, after 5 years - 20% of children. Treatment of atopic dermatitis in children presents serious difficulties for doctors, since it is chronic, recurrent in nature and is combined with other concomitant diseases.

Causes of atopic dermatitis in a child

The main cause of atopic dermatitis in children is a combination of genetic predisposition to allergic manifestations in combination with unfavorable environmental factors. If both parents show signs of hypersensitivity to any irritants, then their children have a risk of atopic dermatitis is 80%, with atopic dermatitis in 1 of the parents, the child may suffer from atopy in 40% of cases.

Food allergy

The manifestation of atopic dermatitis in the first days (months) of a child's life is primarily promoted by food allergies. It can be triggered by a woman's malnutrition during pregnancy and during breastfeeding (abuse of highly allergenic foods), overfeeding the baby, a woman's refusal to breastfeed, and early introduction of complementary foods. And also appear in case of a violation of the function of the digestive system in a baby, with viral and infectious diseases.

Heavy pregnancy

Health problems in a woman while carrying a child (threat of termination of pregnancy, exacerbation of chronic diseases, infectious diseases, intrauterine infection in the fetus, fetal hypoxia) - can also influence the formation of the child's tendency to allergies, atopy.

Accompanying illnesses

Most often, atopic dermatitis occurs in children with concomitant gastrointestinal diseases:

• intestinal dysbiosis,
• enterocolitis (symptoms and treatment),
• gastritis,
• worm infestations (see pinworms in children - symptoms, treatment, worms in children, roundworms - symptoms and treatment).

Other allergens

In addition to food, other household allergens such as inhalation irritants (pollen, dust, house mites, household chemicals, especially washing powders, rinses, chlorine-containing cleaners, air fresheners), contact allergens (baby care products, some creams, wet wipes cause dermatitis in babies), drugs, act as provocateurs of atopic dermatitis.

An interesting fact: scientists from Italy conducted large-scale studies in families of the USA, Europe, Japan, having established that if there is a dog in the house, the risk of allergic reactions and atopic dermatitis in a child is reduced by 25%. It is believed that the modern child's lack of maximum contact with infectious agents, leads to disruption of immune processes during the maturation of the protective functions of the body, including the development of allergic reactions. And having dogs walking outside and bringing infection into your home encourages the natural process of getting to know germs (see Dogs Reduce the Risk of Atopy in Children).

What other factors influence the development of the disease or its exacerbation?

• Recurrence of childhood atopic dermatitis is caused by stress, psychoemotional overexertion, nervous overexcitation
• Secondhand smoke affects the general health of the child and skin condition, including
• General unfavorable environmental situation - a high content of toxic substances in the air, emitted by transport, industrial facilities, an abundance of chemicalized food products, an increased background radiation in some areas, an intense electromagnetic field in large cities
• Seasonal weather changes that increase the risk of infectious diseases and stress the immune system
• Exercise with excessive sweating

Atopic forms of dermatitis occur due to any of the above reasons or in combination with one another, the more combinations, the more complex the form of manifestation.

With the development of atopic dermatitis in children, the treatment should be comprehensive, therefore, consultation of several specialists is required - a dermatologist, allergist, nutritionist, gastroenterologist, ENT doctor, neuropsychiatrist.

What are the signs of atopic dermatitis?

Signs of the disease in children under one year old include: severe itching, skin eczema affecting many parts of the body, mainly the face, neck, hairy part heads, extensor surfaces, buttocks. In older children and adolescents, the disease manifests itself as skin lesions in the groin area, armpits, on the surface of the bends of the legs and arms, as well as around the mouth, eyes, and on the neck - the disease worsens in the cold season.

Symptoms of atopic dermatitis in a child from the onset of the disease can manifest themselves with seborrheic scales, accompanied by increased sebum secretion, the appearance of yellow crusts and peeling in the area of ​​eyebrows, ears, fontanelle, on the head, redness on the face, mainly on the cheeks with the appearance of keratinized skin and cracks with constant itching , burning, scratching.

All symptoms are accompanied by weight loss, restless sleep of the baby. Often the disease makes itself felt in the first weeks of a child's life. Sometimes atopic dermatitis is accompanied by pyoderma (pustular skin lesions). The main symptoms of the disease are as follows:

• Unbearable itching, burning, worse at night.
• Nodular eruptions - microvesicles and serous papules
• Wetness of a reddened spot
• When opened, erosions, crusts, peeling of the skin are formed
• Redness of some parts of the face
• Painful cracks in the area of ​​redness
• Dry skin with a mass of scaly scales
• Diathesis - red cheeks, chin, forehead
• Pustular lesions of the skin

For the chronic form of atopic dermatitis, characteristic manifestations are considered to be an increase in the skin pattern, thickening of the skin, the appearance of cracks, scratching, pigmentation of the eyelid skin. With chronic atopic dermatitis, its typical symptoms develop:

• Redness and puffiness of the foot, peeling and cracks in the skin are a symptom of a winter foot.
• Deep wrinkles in large numbers on the lower eyelids in children are a symptom of Morgan
• Thinning hair at the back of the head is a symptom of a fur hat.

It is necessary to take into account, analyze the occurrence of the disease, its course, the degree of damage to the skin, as well as heredity. Usually, in adults, atopic dermatitis is identified with diffuse neurodermatitis, sometimes it can also be observed in children. The clinical picture depends on the age category of the child, and is characterized by its own peculiarity in each period of life.

For children under one year old, dermatitis can occur in the form of:

• Seborrheic type - manifested by the appearance of scales on the baby's head in the first weeks of his life (see seborrheic dermatitis on the face in adults, treatment).
• Nummular type - characterized by the appearance of specks covered with crusts, appears at the age of 2-6 months. This type is localized on the limbs, buttocks and cheeks of the child.

By the age of 2 years, 50% of children have manifestations disappear. In the remaining half of the children, skin lesions are localized in the folds. A separate form of lesion of the soles (juvenile palmar-plantar dermatosis) and palms is noted. With this form, seasonality plays an important role - the complete absence of symptoms of the disease in the summer, and exacerbation in winter.

Atopic dermatitis in infants and older children should be distinguished from other skin conditions such as psoriasis (see causes of psoriasis in children), scabies (see symptoms and treatment of scabies), seborrheic dermatitis, microbial eczema, lichen rosacea (see treatment of pink lichen), contact allergic dermatitis, immunodeficiency state.

Stages of development of atopic dermatitis

Determination of the stage, phase and period of the onset of the disease is important in deciding questions about the treatment tactics for a short or long-term program. There are 4 stages of the disease:

• The initial stage - develops in children with exudative-catarrhal type of constitution. At this stage, hyperemia, swelling of the skin of the cheeks, peeling are characteristic. This stage, when treatment is started on time with a hypoallergenic diet, is reversible. With inadequate and untimely treatment, it can move to the next (pronounced) stage.
• Expressed stage - goes through a chronic and acute phase of development. The chronic phase is characterized by a succession of skin eruptions. An acute phase is manifested by microvesiculation with the development of scales and crusts in the future.
• Remission stage - during remission, symptoms decrease or disappear altogether. This stage can last from several weeks to several years.
• The stage of clinical recovery - at this stage, there are no symptoms from 3-7 years, depending on the severity of the disease.

Treatment of atopic dermatitis

In severe cases of atopic dermatitis in children, treatment requires the use of topical corticosteroid drugs, in conjunction with emollients. This will quickly resolve symptoms. Moisturizers and emollients are used at any time of the disease. The goal of the treatment is as follows:

• Change in the course of the disease
• Reducing the degree of exacerbation
• Long-term disease control

An indication for hospitalization of a child may be an exacerbation of the disease, as a result of which the general condition is disturbed, recurrent infections, and the ineffectiveness of the therapy.

Non-drug treatment consists of measures aimed at minimizing or eliminating the action of factors that provoked an exacerbation of the disease: contact, food, inhalation, chemical irritants, increased sweating, stress, environmental factors, infections and microbial contamination, violation of the epidermis (hydrolipid layer).

Drug treatment of atopic dermatitis in children is prescribed taking into account the period, stage and form of the disease. The age of the child, the area of ​​the affected skin and the involvement of other organs during the course of the disease are also important. Distinguish between means for external use and systemic action. Pharmacological preparations of systemic action, used in combination, or in the form of mototherapy, including the following groups of medicines:

Antihistamines

There is insufficient evidence to date of the effectiveness of antihistamines for the treatment of atopic dermatitis in children. Sedative drugs (suprastin, tavegil) are prescribed for significant sleep problems due to persistent itching, as well as in combination with urticaria (see symptoms and treatment of urticaria) or concomitant allergic rhinoconjunctivitis.

Among antihistamines for allergies today, the most preferred are drugs of the 2nd and 3rd generation, such as Cetrin (instructions for use), Eodak, Zyrtec, Erius - these drugs have a prolonged effect, do not cause drowsiness, addiction and are considered the most effective and safe, produced as in the form of tablets, and in the form of syrups, solutions, drops (see the list of all tablets for allergies). The clinical effect of the use of these drugs is felt after a month, so the course of treatment should be at least 3-4 months.

However, for the treatment of atopic dermatitis, the effectiveness of antihistamines without sedation has not yet been proven and the need for their use is determined by the doctor in each clinical case. Also, the effectiveness in atopic dermatitis of oral administration of cromoglycic acid and ketotifen has not been proven.

Antibiotics

The use of systemic antibiotics is justified only when bacterial infection of the skin is confirmed; prolonged use of antibacterial drugs is not permissible. Antibiotics and antiseptics are prescribed externally when the skin is infected with streptococci and staphylococci:

• Antiseptic solutions - Miramistin, Chlorhexidine, Fukaseptol, hydrogen peroxide, brilliant green alcohol solution 1-2% fucorcin
• Antibiotics - Bactroban ointment (mupirocin), Fucidin (fusidic acid), Levosin (chloramphenicol, sulfadimethoxin, methyluracil), neomycin, gentamycin, erythromycin, lincomycin ointments, Levomicol (levomycin + methyluracil)
• Xeroform, dermatol, furacilin ointments
• Argosulfan, Sulfargin, Dermazin
• Dioxidine ointment

They need to be applied 1-2 times a day. In the case of severe pyoderma, additional systemic antibiotics are prescribed (see 11 rules on how to take antibiotics correctly). Before antibiotic treatment, it is recommended to first determine the sensitivity of microflora to most of the known drugs.

Systemic immunomodulatory therapy

Uncomplicated course of atopic dermatitis does not require the use of immunomodulators. Only after a thorough diagnosis, an allegrollog-immunologist can prescribe immunomodulators in combination with standard local therapy if the symptoms of dermatitis are combined with signs of immune deficiency.

The danger of using immunostimulants and immunomodulators in children is that if the closest relatives have any autoimmune diseases (insulin-dependent diabetes mellitus, rheumatoid arthritis, Sjogren's syndrome, diffuse toxic goiter, multiple sclerosis, vitiligo, myasthenia gravis, systemic lupus erythematosus and lupus erythematosus). ) even a single use of immunomodulators can cause the debut of an autoimmune disease in a child. Therefore, in the presence of a hereditary disposition of the child to autoimmune diseases, it is not worth interfering with the immune processes, since this may result in hyperactivation of the immune system with the launch of immune aggression against healthy organs and tissues.

Vitamins and phytopreparations

Vitamins B15, B6 contribute to an increase in the effectiveness of treatment, due to which the process of restoration of functions, the liver cortex and adrenal glands is accelerated and the repair processes in the skin are accelerated. The resistance of membranes to toxic substances increases, lipid oxidation is regulated, and the immune system is stimulated. However, a child with a tendency to allergies has some vitamin complexes or certain vitamins, as well as phytopreparations ( medicinal herbs, decoctions, infusions) can cause a violent allergic reaction, therefore, the use of vitamins and herbal medicines should be treated with great caution.

Medicines that restore the digestive tract

Drugs that restore or improve the activity of the gastrointestinal tract are indicated in the subacute and acute periods of the disease, taking into account the identification of changes in the functioning of the digestive system. They are used to improve digestion, correct impaired functions, these are Panzinorm, Pancreatin, Creon, Digestal, Enzistal, Festal, as well as choleretic drugs and hepatoprotectors: Gepabene, rosehip extract, Allochol, corn silk extract, Hofitol, Leaf 52, Essale Forte. Duration of treatment is 2 weeks.

Antifungal and antiviral drugs

When the skin is affected by fungal infections, external antifungal agents in the form of creams: clotrimazole (Candide), natamycin (Pimafucin, Pimafukort), ketoconazole (Mycozoral, Nizoral), isoconazole (Travocort, Travogen). When joining a herpes infection, antiviral drugs(see the list of antiviral and antifungal ointments for stomatitis).

Remediation of foci of infection

It should be remembered about the treatment of concomitant diseases, the purpose of which is to sanitize the foci of infection - in the genitourinary system, biliary tract, intestines, ENT organs, and the oral cavity. Depending on the phase of the disease, antibacterial, keratoplastic, anti-inflammatory, keratolytic skin care preparations are used.

Anti-inflammatory drugs for external use are divided into 2 groups: containing glucocorticoids and non-hormonal drugs.

Glucocorticoids are effective in chronic and acute forms of the disease in children. As a prophylaxis, such creams are not used, moreover, glucocorticosteroid ointments and creams should be used strictly as prescribed by a doctor, in short courses, followed by a gradual withdrawal of the drug (see the list of all hormonal ointments in the article for psoriasis ointments).

The danger of prolonged and uncontrolled use of such funds lies in the development of systemic side effects, suppression of the function of the adrenal cortex, a decrease in local and general immunity, the development of skin atrophy, thinning, dry skin, the appearance of secondary infectious skin lesions, etc. dispense with, you should know the rules for their application:

• These funds are divided into: strong, moderate and weak activity. For the treatment of atopic dermatitis in children, you should start with the most weakly concentrated hormonal drugs. It is possible to increase the concentration only if the previous remedy is ineffective and only as directed by a doctor.
• Any hormonal ointments are used in short courses, then a break is made and the dose of the drug is reduced.
• Abrupt cessation of use worsens the condition and causes a relapse of the disease.
• First of the treatment, a pure cream is used, and when it is smoothly canceled, the required volume of cream or ointment is mixed 1/1 with baby cream, after 2 days of such use, the concentration is still reduced, already 2 parts of a baby with 1 part of a hormonal cream, after 2 days 3 parts of a baby 1 part of the hormonal.
• If you have to use local hormonal agents for a long time, you need to change the drug, which includes another hormone.
• To eliminate puffiness - the cream is used at night, to eliminate plaque - in the morning.

Non-hormonal - With minor manifestations of dermatitis, antihistamines are prescribed (Finistil gel 0.1%, Gistan, see the review of allergy creams for children). A cream is also prescribed - Vitamin F 99, Elidel, Radevit (see creams and ointments for dermatitis in children).

• Burov's fluid - aluminum acetate
• We see Radevit - fat-soluble vitamins
• ASD paste and ointment
• Zinc ointments and pastes - Tsindol, Desitin
• Birch tar
• Ichthyol ointment
• Naftaderm - liniment of Naftalan oil
• Fenistil gel
• Keratolan ointment - urea
• NSAIDs (see pain ointments)

Treatment with creams and ointments with healing properties is also effective for atopic dermatitis, they enhance tissue regeneration and trophism:

• Dexpanthenol - creams and sprays Panthenol, Bepanten
• Gel Curiosin (Zinc hyaluronate)
• Solcoseryl, Actovegin - ointments and creams, gels with calf blood hemoderivative
• Methyluracil ointment (also an immunostimulant)
• Radevit, Videstim (retinol palmitate, that is, vitamin A)
• Cream "Forest Power" with Floralizin is a very effective cream for any skin diseases - eczema, dermatitis, psoriasis, herpes, for dry and cracked skin. In the composition of floralisin - a complex of natural biologically active substances - it is an extract from the mycelium of fungi, contains enzymes with collagenase activity, vitamins, minerals, phospholipids. Ingredients: floralisin, petroleum jelly, pentol, perfume, sorbic acid.

Among the immunomodulators, cream-gel can be distinguished Timogen, its use is possible only as directed by a doctor.

Diet in the treatment of atopic dermatitis in children

Compliance with the diet during treatment plays an important role, especially in infants. Based on the prognosis of the disease, products containing the allergen must be excluded. In the first year of life, children may be sensitive to cow's milk proteins, eggs, gluten, grains, nuts, citrus fruits (see citrus allergy symptoms). In case of allergy to cow's milk, you can use soy mixtures: Frisosoy, Nutrilak soy, Alsoy.

At allergic reactions for soy proteins and in severe forms of food allergies, you need to use hypoallergenic mixtures: Pregestimil, Nutramigen, Alfare (Nestlé).

The introduction of each new product into food should be agreed with the doctor, no more than 1 product per day and in small portions. It is necessary to exclude foods that cause allergies in children if their intolerance is confirmed (you can take a blood test for a specific allergen).

Physiotherapy

It is indicated in the acute and remission period of the disease and includes:

• In the acute period - electrosleep, the use of a magnetic field, carbon baths;
• During remission - mud therapy, balneotherapy.

Complete recovery, based on clinical data, occurs in 17-30% of patients, the rest of the children suffer from this disease throughout their lives.

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We treat atopic dermatitis in children wisely. The opinion of Dr. Komarovsky. Causes, symptoms and treatment with folk remedies.

A pink-cheeked smiling baby is the most common picture on packages of baby food, cereals, mashed potatoes. According to manufacturers, this is how it should look healthy child... Practicing pediatricians and attentive mothers disagree with this "statement".

Pink spots on the face and body of the child, which appeared for no apparent reason, indicate an allergy. Redness of the skin may be accompanied by peeling, the appearance of bubbles. Doctors call this disease atopic dermatitis (other variants of the name are allergic dermatitis, children's eczema).

Photo of atopic dermatitis in Maxim. There are many terrible photos on the Internet, in fact, everything does not look so scary, with us, of course, he was not in the most terrible form. In the photographs, for clarity, I increased the contrast.

Diathesis and atopic dermatitis

The popular name for atopic dermatitis "diathesis" is not entirely correct. Diathesis, according to European doctors, is a tendency to any diseases, a genetic predisposition to them, which arises from the influence of external or hereditary factors. Diathesis itself does not require any treatment. How can a predisposition to something be treated? This is the same individual feature of the body as physique, height, hair or eye color. And the appearance of red flaky spots, bubbles on the body of a child is a very specific disease - allergic dermatitis, it requires a very specific treatment.

Causes of allergies

Allergy is usually called an unusual reaction of the body to an irritant. Such an irritant is a foreign protein. It enters the body, "forcing" the body to produce antibodies to neutralize it.

There is another variant of the body's reaction. Substances that cannot cause allergies enter the bloodstream, where they combine with blood proteins and, in this form, the protein provokes the body's response.

Allergies more often occur in children of the first year of life. This is explained by the general immaturity of the digestive system... The food that the baby eats breaks down into separate elements in the stomach and is absorbed in this form. Due to the immaturity of the digestive system, some elements may not break down into simpler ones that are familiar to the body and are perceived as foreign. Another reaction is also possible: the child's body can theoretically break down protein, but so much has been received that there are not enough digestive enzymes that can do this. For example, the mother knows that the child is not allergic to cow's milk, but before that the baby drank 100 grams of it and there was no reaction, but now he drank 150 grams and covered with red spots. This is evidence that the baby there were not enough enzymes to break down protein.

In theory, everything is very simple: the child ate something wrong - the body reacted. In practice, all efforts of parents are “directed” to the search for a “prohibited” product and its exclusion from the child's diet, but these measures are not always effective.

Causes of allergic dermatitis

The mechanism of allergic dermatitis is simple: some substances (foreign or poorly digested) are absorbed into the bloodstream, then excreted in the urine, then get on the skin, causing redness and rash.

The cause of atopic dermatitis in a child is digestion, but it's not just the foods that the baby eats. Pediatricians say that starving and thin children almost never have dermatitis. With a decrease in the load on the intestines and stomach, the rashes are significantly reduced or disappear altogether. In simple terms, the child should not overeat.

Here are some simple calculations. A 1 month old baby needs approximately 100 ml of formula or breast milk per feeding. The signal of saturation arrives at the brain with a delay of 15 minutes. When the baby receives breast milk, he eats 90-95% of this amount in 7-10 minutes, the missing 5-10% will be eaten by the child in those 5-8 minutes until the signal of satiety is sent to the brain. The baby himself regulates his needs, it is impossible to overfeed. With artificial feeding, the child eats the same 100 ml in 5 minutes, but does not feel satiety, so he will “demand” more. Caring parents (or grandparents), believing that the baby is growing and he needs to eat more, will offer him another mixture, and then they will wonder why suddenly the crumbs turned red and itched their cheeks. And the explanation is simple - the child is overfed, his stomach will not cope with the stress, the food will stagnate, rot, the decay products will enter the bloodstream, then they will be excreted by the body with sweat, and will fall on the skin, which will turn red (under the influence of external factors).

The function of neutralizing excess food residues is taken over by the liver, which in young children is not yet fully functional. The activity of the liver is individual for each baby, therefore:

not everyone has allergic dermatitis;

allergic dermatitis outgrows most children.

For atopic dermatitis to occur in a child, the following conditions must be met.

1. Harmful substances must get from the intestines into the circulatory system.
2. These substances should come out with sweat.
3. There must be something in the environment that will react with sweat on the baby's skin and cause irritation.

Accordingly, in order to combat the manifestations of allergic dermatitis, it is necessary to reduce the absorption of harmful substances into the blood, reduce the sweating of the child, and eliminate skin contact with external irritants that cause dermatitis. Everything in order.

How to reduce the absorption of harmful substances into the blood

1. Normalize stools. Constipation, hard feces interfere with bowel function. Intestinal problems in the mother (with breastfeeding) can also interfere with the child's digestion. To normalize the digestive system, you can use (after consulting a doctor) Duphalac, candles with glycerin.
2. No need to overload digestive system the child with enzymes, if not necessary.
3. Don't overfeed your baby. Those food debris that the child's body is unable to digest are retained in the intestines, creating an excellent environment for bacteria to multiply.
4. Slow down the eating process. This will help avoid overfeeding. Make a smaller hole in the nipple, interrupt while feeding. Do not forget that the saturation signal passes within 10-15 minutes.
5. When breastfeeding, a mother can reduce the fat content of her milk. To do this, you need to eat low-fat cottage cheese, kefir with a minimum percentage of liquid, drink more water, try to sweat less. We'll have to give up lard, fatty broths, butter, sour cream.
6. Eliminate sweets. Sweets increase allergies. Moreover, we are talking not only about sweets and chocolate. Even sweet syrup can increase redness and itching. The fact is that sugar enhances the processes of decay of undigested food residues in the stomach and intestines, increasing the amount of harmful substances.
7. Replace the mixture with a hypoallergenic one. In such a mixture, the amount of protein is reduced or it is broken down. The child's body reacts to such a mixture in a different way, without reddening of the cheeks, but these mixtures are much more expensive than their counterparts.

How to reduce sweating

1. Maintain a constant temperature regime in the child's room no higher than 20 degrees (ideally - 18).
2. Maintain humidity at 60%. You can increase the humidity in “old-fashioned” ways: buy an aquarium, put a basin of water, wash the floor more often. You can control humidity with a humidifier. Try to walk more, ventilate the room more often.
3. Use a minimum amount of clothing, do not overheat the child.
4. Do not restrict fluid intake.

How to eliminate skin contact with external irritants

1. Chlorine in water and detergents. If the child is prone to allergic dermatitis, it makes sense to install water filters.
2. Wash baby clothes with hypoallergenic powder. After washing, be sure to rinse in clean water. There is an easier way - after washing and rinsing, immerse the laundry in very hot water for a few seconds - the chlorine will evaporate. The bed linen of the child and parents (if the sleep is shared) should be subjected to the same treatment.
3. Buy light (preferably white) clothing made from natural fabrics (cotton, linen). It is not at all necessary to change the entire wardrobe; you need to replace the clothes that are in direct contact with children's skin with natural ones.
4. Use baby shampoo and soap when bathing no more than once a week, as they wash off the protective film covering the baby's skin.
5. Buy toys from well-known manufacturers of food-grade plastic. They will cost more than their counterparts, but the child is guaranteed not to have a rash, like from plastic of an incomprehensible production. For a while, you should forget about soft toys.

Medicines

It should be understood that there is no ideal pill for the treatment of atopic dermatitis. Treatment consists in the implementation of the above points.

You can reduce the absorption of harmful substances with smecta, lactulose, sorbents.

The effect of antihistamines (tavegil, suprastin) may be the opposite: they dry the skin, antihistamine gels, la-kree ointments, fenistil (if there is a strong oud) can help, but it is worth remembering that they only act on the external manifestations of allergic dermatitis, positive the effect will be temporary if the lifestyle does not change.

In difficult cases, the doctor prescribes hormonal drugs.

Personal experience

Faced with this problem, I searched for reliable information for a long time, read medical forums, consulted with doctors and friends. In this article I tried to explain everything that I could find for you in an accessible way. The recommendations of Dr. Komarovsky specifically in this problem helped us a lot.

We have atopic dermatitis after two intestinal infections. Allergens were all eliminated from the diet, but redness and dryness did not go away, every evening it was sprinkled on: cheeks, arms and legs. We began to sleep very badly at night.

For reference, but ne for self-medication!

Treatment prescribed by a gastroenterologist (head of the children's city hospital, candidate of medical sciences):

• for the intestines: enterol 1 capsule 2 times a day - 10 days;
• after enterol, the tank sits baby 1 capsule 1 time per day - 1 month;
• outwardly (our skin did not itch) Elidel 2 times a day smear dry plaques until complete recovery (1-1.5 months);
• moisturizing the skin: Lipikar AR cream after bathing, bathing Lipikar oil.

Examinations: ultrasound of the digestive system, general analysis of feces.

The diet is very strict, we are 1.5 years old.

Servings no more than 200 gr. All boiled or steamed.

Breakfast dairy-free porridge;

Dinner soup, vegetables with lean meat or porridge with meat; white or green vegetables;

Afternoon snack unsweetened curd without additives, only green apples from fruits;

Dinner vegetables, cereals;

Before bedtime kefirchik;

Crackers made of sweets))

Diet until the skin is completely clear, then gradually introduce new foods.