Atopic dermatitis in children and adults

Atopic dermatitis symptoms Atopy is the hypersensitivity of the skin to the effects of environmental substances, in which there is an increased production of IgE and / or a violation of nonspecific reactivity.

One of the main problems of dermatology is atopic dermatitis, the incidence of which is much more common than other common dermatitis.

Children suffer from atopic dermatitis, but adults are also susceptible to this disease.

Causes

The cause of the development of an allergic reaction in the skin with atopic dermatitis in children and adults is the hyperreactivity of the organism in response to interaction with various substances. These substances are for the body of the patient allergens.

As an allergen can act pollen of plants, house dust, animal hair, various food products, household chemicals, etc. Isolate the air, contact and food path of penetration of the allergen into the body.

The leading causes of atopic dermatitis:

Hereditary predisposition. And in some relatives, the allergy can be expressed in rhinitis, conjunctivitis, in others with bronchial asthma and hay fever, and in others it is a specific reaction of the skin. That is why, as already mentioned, AD appears for the first time in a small child.
instagram viewer
Hypersensitivity to the skinto detergents, washing powder, with which things are washed, the type of clothing fabric.
Contact with allergens. The most diverse allergens can start the process, and often the rashes appear after a while. Naturally, allergens will be different for different people and can change during life.
Receptionsome medicinesEspecially antibiotics. These drugs kill not only the pathogenic bacteria, but also the beneficial microflora of the intestines, as a result of which their balance in the body is violated and the immunity of the child is reduced.
Frequentviral and infectious diseases- this leads to a decrease in the protective forces of man, resulting in the appearance of the first symptoms of dermatitis.

They contribute to the occurrence of dermatitis problems with the gastrointestinal tract, metabolic disorders, hormonal imbalance in the body. Atopic dermatitis can occur with periods of remission, the duration of which depends on compliance with the diet, the use of preventive measures.

Symptoms of atopic dermatitis

Atopic dermatitis, severe itching is the leading symptom of the disease. During the period of remission, the skin of the patients in the affected areas is dry and compacted, pink, mottled or cyanotic-red, often covered with scaly scales. The disease is characterized by a pronounced skin pattern, giving the skin a shagreen appearance.

The main symptoms of atopic dermatitis in adults include:

The presence of itching of the skin, which is present even with minimal skin manifestations.
The characteristic morphological picture of the elements and their location on the body is the dryness of the skin, localization (often) in the symmetrical zones on the arms and legs in the area of the flexural surface of the joints. In the lesions there are patchy and papular rashes, covered with scales. They are also placed on the flexural surfaces of the joints, on the face, neck, shoulder blades, shoulder girdle, and also on the legs and hands - on their outer surface and in the area of the outer surface of the fingers.
The presence of other diseases of an allergic nature in the patient or his relatives, for example, atopic bronchial asthma (in 30-40%). Chronic character of the course of the disease (with or without relapses).

Atopic dermatitis occurs with exacerbations and remissions. Exacerbations of skin manifestations can be caused by both a violation of the diet, and a sharp change of weather, concomitant diseases, dysbacteriosis, vaccination, etc. At the same time, a trip to the sea can significantly improve the skin condition.

Symptoms in children

Clinical manifestations of atopic dermatitis in children are:

skin peeling;
itching, which is worse at night;
the wetting of the brushed areas of the skin;
strengthening of the skin pattern in the lesions;
compaction of affected areas of the skin, coarsening.

After drying out the combs, these places are covered with brown crusts, which are unbearably itch, the child again combs them and starts all over again.

Atopic dermatitis: photos

What does atopic dermatitis look like in children and adults in the photo.

Diagnostics

Differential diagnosis of atopic dermatitis is always based on the collection of allergic anamnesis:

studying the history of development of skin lesion and family predisposition;
the presence of atopic respiratory diseases;
presence of concomitant skin diseases;
presence of risk factors (the course of pregnancy, childbirth, the type and nature of feeding, the presence of infections
in infancy, taking antibacterial drugs);
detection and detection of concomitant diseases;
intolerance to medications;
the definition of foci of focal infection.

In some cases, a complex of additional studies is required, consisting of determining the total amount of IgE, identifying allergen-specific IgE by means of radioallergosorbent test (RAST), allergy tests (prik test or patch test) and provocative tests with ingestion of possible food allergens. Sometimes there is a need to take crops for the presence of a viral or bacterial culture.

Differential diagnostics

Atopic dermatitis must be differentiated with the following diseases: limited neurodermatitis, lichen planus, Prerigo Gebra, mushroom mycosis, chronic eczema.

For limited neurodermatitis (depriving Vidal) is characterized by a lack of atopy in the anamnesis, the onset of the disease in the adult period of life; absence of dependence of exacerbations from the action of allergens; localized lesion; presence of three zones in the lesion: central lichenification, lichenoid papular eruptions and dyschromic zones; accompanying diseases precede skin rashes; the level of total IgE in the blood serum is normal; skin tests are negative.

Treatment of atopic dermatitis

When atopic dermatitis is diagnosed, how to treat the disease depends on the age phase, the severity of the clinic and the concomitant diseases.

First of all, the treatment is aimed at:

elimination of allergic factor;
desensitization (decrease in sensitivity to the allergen) of the organism
removal of itching;
detoxification (cleansing) of the body;
removal of inflammatory processes;
Correction of the revealed concomitant pathology;
prevention of recurrence of atopic dermatitis;
struggle against complications (when joining the infection);

For the treatment of atopic dermatitis in adults, different methods and medicines are used: diet therapy, PUVA therapy, acupuncture, plasmapheresis, specific hyposensitization, laser treatment, corticosteroids, allergoglobulin, cytostatics, intal, etc.

Also, you should stop eating citrus, coffee, chocolate, honey, chicken, fish, nuts and spices, as well as fatty and fried foods. The patient shows sour-milk products, cereals, boiled meat, various vegetable dishes.

Treatment of dysbacteriosis and diseases of the digestive tract

Often the development of dermatitis is associated with dysbiosis of the intestine, so the intake of various probiotics is also advisable - RioFlora Immunno, Bifidobacterin, Lactobacterin, Acipol and others

Possible additional cause of such dermatitis and dysbiosis, may be a digestive disorder, namely functions of the pancreas, with the appointment of enzyme preparations, such as Pancreatin, Creon, Mezim.

Non-hormonal ointments

Such creams and ointments have a very wide choice. These include - Protopic, Elidel, Eplan, Fenistil, Losterin, cream Timogen, Naftaderm, Videstim, Destin, Isida, etc.

Anti-inflammatory therapy for blood pressure

In the acute phase are appointed:

Antihistamines of the second generation (with additional anti-allergic properties - antimediator and membrane stabilizing (loratadine)) - 4-6 weeks. (There is an exacerbation of such drugs and various supplements in these drugs).
Antihistamines of the 1st generation at night (if a sedative effect is required) - 4-6 weeks. (There is an exacerbation of such drugs and various supplements in these drugs).
Lotions (tinctures of the bark of oak, 1% of r-tannin, r-rivanol 1: 1000, etc.), dyes (fukortsin, Kastelani liquid, 1-2% of the solution of methylene blue, etc.) - in the presence of exudation.
External glucocorticosteroids (Mometasone, cream, lotion) - 3-7 days.
Systemic glucocorticosteroids (in the absence of the effect of the therapy).

Atopic dermatitis has a wavy course: in 60% of children the symptoms completely disappear in time, while in others they remain or recur throughout life. The earlier the debut and the harder the disease, the higher the chance of its persistent flow, especially when combined with another allergic pathology.

Atopic dermatitis in children treatment: Komarovsky

The success of treating children's atopic dermatitis depends on the detection of an allergen or a provoking factor, and its elimination from the life of the child. Food, chemical, natural allergens should be removed from the child.

Even with minor manifestations of dermatitis, it is necessary to show the child to a specialist, and not rely on reviews on the Internet. The doctor can prescribe for the treatment of atopic dermatitis in children in severe cases pills or nyxes with antihistamines, ointment with corticosteroids, capable of quickly suppressing itching and inflammation.

In some cases, the doctor may prescribe treatment with ultraviolet (UV) radiation. And also prescribe a special diet for a child with atopic dermatitis and / or, if the baby is on breastfeeding, appoint a special diet for the mother.

On the video you can see the advice of Dr. Komarovsky, how to treat atopic dermatitis in children.

Features of food

In the period of remission, one should adhere to the basic rules of hypoallergenic diets. However, with severe exacerbations, reduce the food intake to a minimum. Often there is an individual intolerance, which can lead to a sharp deterioration in the disease. Sometimes it is advisable to follow a strict diet for a long time: from several months to two years.

There are products, the use of which should be minimized in dermatitis, strictly not recommended use - seafood, chocolate, citrus fruits, nuts, fish, coffee, mayonnaise, aubergines, mustard, spices, tomatoes, red pepper, milk, eggs, sausages, sausages, mushrooms, carbonated drinks, strawberries, strawberries, honey, watermelons, pineapples. Categorically prohibited alcohol.

People who suffer from the symptoms of atopic dermatitis, it is recommended to include in their diet products with a high content of saturated fatty acids. Unfortunately, such components in sufficient quantity can be found in seafood, which include to the main allergens, so they can replace vegetable oils, for example, olive and linseed. In addition, it is useful to use low-fat dairy products, the components of which allow maintaining a healthy intestinal microflora.

Prevention

The main directions of prevention of atopic dermatitis are compliance with the diet, especially for pregnant and lactating mothers, breast-feeding children. Particular attention should be paid to limiting the effects of inhaled allergens, reducing contact with chemical means in a life, the prevention of catarrhal and infectious diseases and the caused appointment of antibiotics.

With stage antiretrovisivnoy therapy recommended spa treatment in the Crimea, the Black Sea coast of the Caucasus and the Mediterranean.