vspВопросы современной педиатрииCurrent Pediatrics1682-55271682-5535Издательство «ПедиатрЪ»10.15690/vsp.v15i6.1655vsp-1696Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWСовременные представления о патогенезе и принципах наружной терапии атопического дерматита у детейCurrent Views on the Pathogenesis and Principles of External Treatment of Atopic Dermatitis in Childrenhttps://orcid.org/0000-0003-2252-8570МурашкинН. Н.MurashkinNikolay N.

доктор медицинских наук, заведующий отделением дерматологии НЦЗД, профессор кафедры педиатрии и детской ревматологии 1 МГМУ им. И.М. Сеченова Адрес: 119991, Москва, Ломоносовский пр-т, д. 2, стр. 1, тел.: +7 (499) 134-08-89

Moscow, Russian Federation

m_nn2001@mail.ruhttps://orcid.org/0000-0002-6034-8231МатерикинА. И.MaterikinAlexander I.

Москва, Российская Федерация

Moscow, Russian Federation

https://orcid.org/0000-0002-8232-8936АмбарчянЭ. Т.AmbarchyanEduard T.

Москва, Российская Федерация

Moscow, Russian Federation

https://orcid.org/0000-0002-4107-4642ЕпишевР. В.EpishevRoman V.

Москва, Российская Федерация

Moscow, Russian Federation

Научный центр здоровья детей Первый Московский государственный медицинский университет им. И.М. СеченоваРоссияScientific Center of Children’s Health Sechenov First Moscow State Medical UniversityRussian FederationНаучный центр здоровья детейРоссияScientific Center of Children’s HealthRussian Federation201629122016156584589Copyright © Мурашкин Н.Н., Материкин А.И., Амбарчян Э.Т., Епишев Р.В., 20162016Мурашкин Н.Н., Материкин А.И., Амбарчян Э.Т., Епишев Р.В.Murashkin N.N., Materikin A.I., Ambarchyan E.T., Epishev R.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vsp.spr-journal.ru/jour/article/view/1696

статье анализируются современные данные о патогенезе атопического дерматита. Обсуждается роль нарушения структуры дермального барьера в развитии пищевой аллергии, приводятся результаты, подтверждающие теорию чрескожной сенсибилизации к аллергенам наряду с наследственными и экзогенными факторами. Современная локальная терапия атопического дерматита с использованием топических глюкокортикостероидов (тГКС), направленная на уменьшение выраженности симптомов заболевания, зачастую сопряжена с риском развития осложнений. Приводятся данные об эффективном использовании топических ингибиторов кальциневрина (тИК) в качестве средств, нивелирующих побочные эффекты тГКС. Продемонстрированы результаты возможного применения пимекролимуса в виде 1% крема с целью постепенной отмены тГКС при долгосрочном использовании. Представлены данные обзоров и метаанализов за последнее десятилетие, демонстрирующие, что не существует никаких доказательств того, что использование тИК связано с повышенным риском развития лимфомы. Авторами сделан вывод, что пимекролимус в виде 1% крема является оптимальным средством топической терапии у детей с легкой и среднетяжелой формой заболевания, а также препаратом для проактивной терапии атопического дерматита в течение длительного периода времени с целью предотвращения обострений.

The article analyzes the current data on the pathogenesis of atopic dermatitis. It discusses the role of the damaged dermal barrier structure in the development of food allergies and presents the results confirming the theory of transdermal sensibilisation to allergens in addition to hereditary and exogenous factors. Current local treatment of atopic dermatitis using topical glucocorticosteroids (tGCs) aimed at reducing the severity of symptoms is often associated with the risk of complications. The data on the effective use of topical calcineurin inhibitors (TCI) to eliminate the side effects of tGCs are presented. The results of the possible use of pimecrolimus in the form of 1% cream for gradual withdrawal of tGCs in the long-term use are shown. The data of reviews and meta-analyses for the last decade are given showing that there is no evidence that the use of TIC is associated with an increased risk of lymphoma. The authors conclude that pimecrolimus in the form of 1% cream is the best medication for topical therapy in children with mild and moderate form of the disease. It is also considered the best preparation for the proactive treatment of atopic dermatitis in the long period of time in order to prevent recurrences.

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The authors declare that there are no conflicts of interest present.