Preview

Current Pediatrics

Advanced search

SPECIAL CHARACTERISTICS OF TREATMENT OF SEVERE ATOPIC DERMATITIS IN CHILDREN

https://doi.org/10.15690/vsp.v12i4.740

Abstract

The article analyzes modern data on risk factors of severe course of atopic dermatitis in children: the role of alimentary and inhalant allergens, cutaneous infections, allergic reactions to drugs used in the treatment of disease. The most important questions of differential diagnosis of atopic dermatitis in children and the distinctive features of the illness, which may be mistaken for atopic dermatitis (primary immunodeficiencies, keratosis pilaris, psoriasis, enteropatic acrodermatitis; cutaneous bacterial and fungal infections, and drug-induced contact dermatitis to topical creams and ointments) are discussed. Treatment of atopic dermatitis is based on modern approaches and includes recommendations on the use of emolents, anti-inflammatory drugs (topical glucocorticoids) and calcineurin inhibitors. The article provides indications and contraindications to the administration of anti-inflammatory drugs. Special recommendations for use of cleansers and emolents at all degrees of severity of atopic dermatitis, which helps reduce the risk of side effects of topical corticosteroids, complications such as cutaneous infections and helps to maintain remission of disease are given. The importance of training programs patients is emphasized. Compliance of patients and/or their parents contributes to the achievement of the desired effect of the treatment of atopic dermatitis, which will improve the patients’ quality of life.

About the Author

D. Sh. Macharadze
Peoples’ Friendship University of Russia, Moscow
Russian Federation
Macharadze Dali Shotaevna, PhD, professor of the Department of Allergology and Immunopathology


References

1. . Arkwright P., Motala C., Subramanian H., Spergel J., Schnei der L., Wollenberg A. Management of difficult-to-treat atopic dermatitis. J. Allergy Clin. Immunology. 2013; 1: 142–151.

2. Akdis C., Akdis M., Bieber T. et al. Diagnosis and treatment of atopic dermatitis in children and adults: European Academy of Allergology and Clinical Immunology/American Academy of Allergy, Asthma and Immunology/PRACTALLConsensus Report. J. Allergy Clin. Immunol. 2006; 118: 152–169.

3. Darabi K., Hostetler S., Bechtel M., Zirwas M. The role of Malassezia in atopic dermatitis affecting the head and neck of adults. J. Am. Acad. Dermatol. 2009; 60: 125–136.

4. Cork M., Britton J., Butler L. et al. Comparison of parental knowledge, therapy utilization and severity of atopic eczema before and after explanation and demonstration of topical therapies by a specialist dermatology nurse. Brit. J. Dermatol. 2003; 149: 582–589.

5. Karlberg A., Bergstrom M., Borje A. et al. Allergic contact dermatitis-formation, structural requirements, and reactivity of skin sensitizers. Chem. Res. Toxicol. 2008; 21: 53–69.

6. Corazza M., Mantovani L., Maranini C. Contact sensitization to corticosteroids: increased risk in long term dermatoses. Eur. J. Dermatol. 2000; 10: 533–535.

7. Breuer K., Haussler S., Kapp A., Werfel T. Staphylococcus aureus: colonizing features and influence of an antibacterial treatment in adults with atopic dermatitis. Brit. J. Dermatol. 2002; 147: 55–61.

8. Wollenberg A., Wetzel S., Burgdorf W., Haas J. Viral infections in atopic dermatitis: pathogenic aspects and clinical management. J. Allergy Clin. Immunol. 2003; 112: 667–674.

9. Bergmann M., Caubet J.-Ch., Boguniewicz M., Eigenmann Ph. Evaluation of food allergy in patients with atopic dermatitis. J. Allergy Clin. Immunology. 2013; 1: 22–28.

10. Macharadze D.Sh. Lechashhii vrach — Practicing Doctor. 2013; 5: 24–30.

11. Bath-Hextall F., Delamere F., Williams H. Dietary exclusions for established atopic eczema. Cochr. Database Syst. Rev. 2008; 1: CD005203.

12. Tupker R., De Monchy J., Coenraads P. Induction of atopic dermatitis by inhalation of house dust mite. J. Allergy Clin. Immunol. 1996; 97: 1064–1070.

13. Macharadze D.Sh. Atopicheskii dermatit: sovremennye metody diagnostiki i terapii. Uch.-metod. Pos [Atopic Dermatitis: Current Diagnosis and Therapy Techniques. Guideline]. Moscow, Liniya-Print, 2011. 75 p.


Review

For citations:


Macharadze D.Sh. SPECIAL CHARACTERISTICS OF TREATMENT OF SEVERE ATOPIC DERMATITIS IN CHILDREN. Current Pediatrics. 2013;12(4):130-135. (In Russ.) https://doi.org/10.15690/vsp.v12i4.740

Views: 944


ISSN 1682-5527 (Print)
ISSN 1682-5535 (Online)