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  • Atopic dermatitis in children and adults - Causes, symptoms and treatment. MF.

    Atopic dermatitis is one of the most common and severe allergic diseases, and the most common allergic skin lesion. The statistics indicate that the incidence of atopic dermatitis is more than 12%( that is, of 100 people, 12 suffer from atopic dermatitis).Despite the huge step forward made in this field in recent years, the treatment of atopic dermatitis is a rather complex problem and requires the joint work of a doctor, patient and family members.

    Atopic dermatitis is a chronic, genetically determined, allergic skin inflammation characterized by a typical clinical picture( typical symptoms).The leading clinical symptom of atopic dermatitis, found in all age groups, is itchy skin.
    Atopic dermatitis in the vast majority of the first time manifested in children aged 6 to 12 months. Less than 1 year to 5 years. For the first time the disease, corresponding to the symptoms of atopic dermatitis, was described in 1844.

    Atopic dermatitis can now hide under the names of eczema, neurodermatitis. Sometimes it is mistakenly called an allergic dermatitis or diathesis.

    Causes of atopic dermatitis.

    Atopic dermatitis is a disease that develops by the immediate-type hypersensitivity mechanism( IgE-dependent immune response).This is one of the most common mechanisms of allergy development. Its main feature is the rapid reaction of the immune system to the incoming allergen( from the moment of receipt of the allergen before the onset of symptoms, minutes pass, less often hours).

    An important role in the development of atopic dermatitis is played by weighed heredity, that is, among the closest relatives one can almost always find a person with an allergic disease. Most often, allergic mood is transmitted through the maternal line. Recent studies indicate that this polygenic disease, that is, for the development of allergic inflammation, there are about 20 genes located on several chromosomes.

    But in order for the allergic predisposition to develop into an allergic disease, in particular, into atopic dermatitis, the impact of a number of external factors is necessary. The main trigger points are: toxicoses of pregnant women, especially those developing late in life, smoking and drinking alcohol by the mother during pregnancy, infectious diseases in the mother during pregnancy. A major role in the development of allergic diseases in children is played by the pathology of the gastrointestinal tract, in particular, intestinal dysbacteriosis, insufficient duration or complete absence of breastfeeding, early introduction of complementary foods, introduction to the diet of products not corresponding to age, and inappropriate antibiotic prescription, etc..

    The negative role of frequent infectious diseases in a child, the presence of foci of chronic infection including parasitic infection is proved.

    A number of studies conducted in Europe and the US have shown that atopic dermatitis is more common in families with a higher standard of living. There are several theories with which this may be related, but they have not yet come to a common opinion.

    Among the allergens that cause the development of atopic dermatitis, the most important are food( allergy to various foods).Less common are clinical( various varieties of house dust mites, house dust, library dust, feather pillows) and epidermal( wool and animal dander, bird feathers, fish food, etc.) allergens. Allergy to pollen of plants, as the cause of atopic dermatitis, is extremely rare.

    Symptoms of atopic dermatitis with photos of

    Currently, the following diagnostic criteria for atopic dermatitis are identified:

    1) early onset of the disease( before the age of two years),
    2) presence of allergic diseases in immediate relatives,
    3) common dry skin,
    4)localization of skin rashes in the area of ​​the flexural surfaces of the hands and feet,
    5) the presence of itching.

    If four of their five criteria are found, the diagnosis of atopic dermatitis can be considered practically proven.

    Symptoms of atopic dermatitis differ depending on the age of the patient. Thus, three variants of the clinical course of atopic dermatitis are distinguished: infant form, pediatric form, adolescent-adult form.

    Infant form of atopic dermatitis( diathesis).Symptoms of atopic dermatitis in newborns and infants.

    The infant form of atopic dermatitis is noted at the age of 2 years. Inflammatory elements appear on the skin of the child as red spots, localized mainly on the face in the forehead and cheeks. Such rashes on the skin in people called diathesis , although in fact diathesis - this is atopic dermatitis.

    The disease is characterized by acute current, wetness, swelling, crusting. Perhaps the emergence of foci of inflammation in other areas: in the shins, buttocks, scalp of the child. Periods of bright exacerbation, accompanied by wetting, are replaced by a subacute stage, characterized by papular elements( papule is a cutaneous element that rises above the skin like a tubercle) against a background of hyperemic( reddened) skin.

    On the photo the infant form of atopic dermatitis

    Pediatric form of atopic dermatitis, symptoms.

    During exacerbation of atopic dermatitis, skin elements( red spots, papules) are located mainly in the area of ​​skin folds, on the flexural surfaces of the elbows and knee joints, and behind the ears. The skin becomes dry, there is peeling, lichenization( on the dry skin there is a clearly expressed, intensified cutaneous pattern).The child appears, so-called, "atopic face": a dull skin color, increased pigmentation around the eyes, an additional cutaneous fold of the lower eyelid. Outside exacerbation marked dryness of the skin. Skin can crack, especially in the area of ​​the back surfaces of hands, fingers.

    In the photo: Atopic dermatitis. Children's uniform. The patient is 3 years old.

    Adolescent-adult form of atopic dermatitis, symptoms.

    Skin lesion in atopic dermatitis is common, permanent. Changes are noted on the skin of the face, neck, chest, back, neck. Skin is dry, common lichenization, traces of scratching. There may be cracks in the hands and feet. Exacerbations of atopic dermatitis, manifested by reddening of the skin, are noted rarely.

    In the photo, atopic dermatitis in a teenager is 15 years old( dry skin, peeling).

    In the photo: atopic dermatitis. The adult form.

    In case of infection, fungal lesions, pustules, greenish crusts may appear.

    In the photo: Atopic dermatitis. Infant form. Secondary infection.

    Depending on the degree of severity, a mild, moderate and severe course of atopic dermatitis is isolated.

    Symptoms of chronic atopic dermatitis

    People with atopic dermatitis are characterized by thickening of the skin and strengthening of the skin pattern, painful cracks in the skin, especially on the palms and soles, hyperpigmentation of the eyelids( darker skin color on the eyelids).

    • Symptom of "winter foot" - hyperemia and moderate infiltration of soles, peeling, cracks.

    • Symptom Morgan( Denier-Morgan, folds of Denier-Morgan) - deep wrinkles on the lower eyelids in children.

    • The symptom of "polished nails" is the disappearance of longitudinal striation and the characteristic appearance of the nail, due to permanent combing of the skin.

    • The symptom of the "fur hat" is the dystrophy of the hair of the occipital region.

    • Pseudo-Hertog's symptom is the temporary disappearance of the hair, first in the outer third, and then in other parts of the eyebrows in some patients.

    What tests should I take if I suspect atopic dermatitis?

    Atopic dermatitis is in the sphere of interest of two medical specialties: a doctor of an allergist-immunologist and dermatologist. Taking into account the high prevalence of this problem among children, according to modern medical standards, a mild form of atopic dermatitis can be treated by a pediatrician, but it's best to try to get to a narrow specialist.

    The diagnosis of atopic dermatitis is based on the characteristic clinical symptoms and data obtained after questioning the patient or his parents( if the patient himself does not speak properly).

    A patient who has been diagnosed with atopic dermatitis for the first time should undergo an in-depth examination that reveals the factors that trigger the exacerbation of the disease and underlie its development.

    The examination of the gastrointestinal tract is mandatory. Recommended tests: analysis of feces for dysbiosis and coprogram, ultrasound of the abdominal cavity. It is necessary to identify or eliminate parasitic diseases. To do this, the analysis of feces for eggs of the worm is performed( but this is not very informative), the blood test for antibodies( proteins produced by the immune system on the fact of the presence of infection in the body) to the main parasites: toxocaram, toxoplasma, ascarids, lamblia, etc.

    The endocrinologist is recommended for the purpose of excluding the concomitant pathology of the endocrine system.

    If the rashes are persistent and localized strictly in certain areas, then a consultation of a neurologist or orthopedist( and better both) is necessary, since concomitant pathology of the spine is possible.

    With increased excitability of the child - consultation of the neurologist is obligatory.

    It is mandatory to conduct an allergic examination aimed at identifying those substances that directly cause the development of an allergic disease.

    Taking into account that atopic dermatitis is a disease that occurs with skin lesions, the only acceptable method of diagnosis is the delivery of a blood test for IgE-specific( specific immunoglobulin E, produced for specific allergens).First of all, they donate blood for food allergens. In patients older than three years, it is advisable to donate blood to household and epidermal allergens.

    In case of infection, cultures of the inflammation released from the foci are microflora and fungi, as well as sensitivity to antibiotics.

    Sometimes a skin biopsy( take a small area of ​​skin for analysis) to clarify the nature of the inflammatory process. But this method of research is conducted quite rarely and only on strict indications, for example, if it is suspected of skin lymphoma.

    If the exacerbations of atopic dermatitis coincide in time or begin immediately after a cold disease - it is advisable to take a blood test for an immunogram. This will help to identify possible malfunctions with the immune system.

    In general, when building a screening program, the doctor should imagine that atopic dermatitis is not only an allergic disease. In its occurrence, the nervous and endocrine system can participate. Almost always there are malfunctions in other organs and systems of the body. And if these provoking and aggravating factors are not found, then it will be extremely difficult to transfer the child into a state of persistent and prolonged remission( recovery).It is in the search for and elimination of the cause of atopic dermatitis that the main task of the attending physician is, and not in the appointment of only creams and tablets for the removal of the symptoms of the disease.

    Treatment of atopic dermatitis

    Treatment of atopic dermatitis should be prescribed by a specialist only after an accurate diagnosis. Do not start treatment yourself when symptoms of atopic dermatitis occur. Similar symptoms can occur in a number of very serious diseases, and inadequate treatment tactics can be a threat to the life of the patient, especially the patient-child. Never by yourself increase the duration of the recommended medications, even if they help and cope well with the symptoms of the disease, and there's no time to go to the doctor. Even the most harmless creams with banal vitamins have side effects that can manifest themselves if the tactics of treatment are not observed.

    General principles of treatment of atopic dermatitis:

    • Elimination of allergen, hypoallergenic diet;
    • antihistamines( relieve itching)( erius, tavegil, suprastin, ketotifen, claritin, feksadine, loratodine, telphase, etc);
    • detoxifying agents( cleansing)( enterosgel, polyphepan, activated carbon, sodium thiosulfate, etc.)
    • hyposensitizing( calcium gluconate, sodium thiosulfate);
    • corticosteroids( anti-inflammatory effect)( elokom, lokoid, tselestoderm, acryderm, synaflan, diprosalik, belosalik, etc.);
    • antiseptics( fucarcin, brilliant green, methylene blue, etc.)
    • sedative( soothing)( glycine, persene, various soothing herbs, valerian, peony, etc.);
    • enzymes( for pancreatic function disorders)( creon, mezim, pancreatin, etc.);
    • antibacterial agents( with infection)( ointments, celestoderm with geramicin, Lorinden C, lincomycin ointment, sumamed tablets, zitrolide, doxycycline, erythromycin, zanocin, rovamycin, etc.);
    • eubiotics( with intestinal dysbacteriosis)( linex, probiophore, etc.);
    • when attached to the fungal component, and bacterial( externally: triderm, aceridum GK, etc.);
    • with the addition of a viral infection( acyclovir, valtrex, famvir, alpisarin, etc.).
    • When suspected of Kaposi's eczema or other viral infections, antiviral agents are prescribed. When infection - antibiotics( to which the causative agent is sensitive).When wetting in the acute stage, wet-drying bandages or corticosteroid aerosols.

    The therapeutic tactics for acute exacerbation of atopic dermatitis and exacerbation vary considerably.

    Treatment of exacerbation of atopic dermatitis

    Treatment of exacerbation of atopic dermatitis consists of the complex application of the following groups of drugs:

    1) Topical glucocorticosteroids. The most commonly used group of drugs for external use, used to relieve the symptoms of exacerbation. The drugs have a number of side effects and contraindications, so they can only be used as prescribed by the doctor. It is preferable to use the latest generation of drugs that do not contain fluoride in their structure. Their security profile is much higher. Examples: Advantan, afloderm, elakom, etc. Topical glucocorticosteroids are available in the form of ointments, creams, emulsions, oily ointment, lotions. It is not recommended to use drugs of this group for more than 7-10 consecutive days. The instruction of some preparations implies the possibility of their appointment up to 1 month, but this should still be avoided. It is recommended gradual elimination of topical glucocorticosteroids. For example, the main part of the treatment course you apply ointment on the entire affected area. Then apply it by dashed method, every day, leaving the distance between the strokes a little more.

    Another variant of gradual cancellation is the day, apply the cream, and the day you give the skin to rest, using non-hormonal therapeutic agents.

    It should also be remembered that no external cucumber corticosteroids can be applied to the skin of the eyelids in the immediate vicinity of the eyes, as this can lead to the development of glaucoma and cataract.

    2) Combined preparations. Preparations of this group contain a combination of glucocorticosteroids, antibiotics and antifungal drugs. Drugs of this pharmacological group are used if infection is attached to allergic inflammation in atopic dermatitis. Examples: triderm cream, pimafukort, etc.

    3) Preparations with active zinc. This means for external use( ointment, cream).Some experts regard it as an alternative to local glucocorticosteroids. Duration of treatment should be necessarily controlled by a doctor, preferably with experience with these drugs, so it is possible to develop chronic dermatoses of another, not allergic, origin.

    4) Antihistamines. Preference should be given to second- and third-generation drugs. The average duration of treatment ten days. Although there are treatment regimens that provide for a long( at least three months) use of third-generation drugs. Examples: zirtek, erius.

    5) Pimecrolimus derivatives. This group includes the drug elide. A relatively new group of drugs used to relieve the symptoms of exacerbation. The effectiveness is not inferior to the local glucocorticosteroids and, according to the research conducted by the company, the researchers have much greater safety. Disadvantages of the drug: high cost, small clinical experience of its use.

    6) Sorbents. Carrying out detoxification therapy with sorbents is a necessary component in the treatment of exacerbations of most allergic diseases. Examples of drugs: lactofiltrum, enterosgel, filter, etc. The drugs are prescribed two to three times a day for the average age-related dosage for 7-14 days.

    7) Glucocorticosteroids. Preparations for oral administration are prescribed only in severe forms of atopic dermatitis. Dosages and duration of treatment are determined by the physician. Examples of drugs: metipred, prednisolone.

    8) Cytotoxic drugs. Can be used only in severe forms of atopic dermatitis, resistant to all other methods of treatment. Dosages and duration of treatment are determined by the physician. Treatment is carried out in a hospital.

    Treatment of atopic dermatitis without exacerbation.

    Atopic dermatitis is a chronic disease requiring long-term treatment even beyond the symptoms of exacerbation.

    Currently, much attention is paid to the use in this period of medical cosmetics. In connection with the presence of allergic inflammation, even lethargic without external clinical manifestations, the skin properties change. Violated its permeability and humidity. And the goal of regular use of vitaminized cosmetics is to restore the damaged properties of the skin. Examples of drugs related to medicinal cosmetics: radevit, bipanten, pantoderm, locobeise ripa, etc.

    In addition, the treatment of accompanying, identified during the examination of the patient, is being treated. The work of the gastrointestinal tract is corrected, the work of the nervous system is normalized, etc. The nature of the events is selected individually, depending on the specific results of the analyzes.

    Thus, it is not enough simply to relieve the exacerbation of atopic dermatitis, it is necessary to identify and eliminate the factors that caused the development of the disease or causing its aggravation. Only in this case it is possible to stop the progression of allergy, to bring atopic dermatitis to the stage of remission, and then completely to get rid of it.

    Folk remedies for atopic dermatitis

    In folk medicine, there are a number of methods that are actively used by patients with atopic dermatitis. So, for mild forms of the disease, a good effect is provided by baths with decoctions of medicinal herbs, such as chamomile and string.

    Children can recommend baths with soothing herbs, such as oregano, hops, valerian, motherwort. To make a bath, take 2 tablespoons of herbs, pour 1 cup of boiling water and insist for at least 10 minutes. The resulting broth is added to the baby bath.

    Still, allergists to folk medicine are rather cautious, since allergic patients often have individual allergic reactions to "folk" recipes.

    Treatment of atopic dermatitis in pregnancy.

    Atopic dermatitis does not manifest itself for the first time during pregnancy. The disease always begins in early childhood.

    There are some features on the treatment of an already existing disease in women during pregnancy. With care, select moisturizing cosmetics to soften the skin outside the exacerbation. A number of vitaminized creams, for example, a fairly popular Radevit cream, pregnancy is a contraindication.

    Principles of treatment during an exacerbation of atopic dermatitis during pregnancy practically do not differ from those of the rest of the population. If there is a need for local hormone therapy or prescription of antihistamines, then it is preferable to use the drugs of the latest generation, which has more safety( Advantan, elac, lokoid).

    The focus should be on creating a hypoallergenic environment.

    There is no adverse effect of atopic dermatitis on the fetus. Although the toxic effect on the baby is still possible, but only with the use of drugs prohibited for this period of the woman's life.

    Recommendations for the treatment of atopic dermatitis:

    • Wear cotton clothes. The skin must breathe. Clothing made of wool or synthetics will intensify irritation and itching.
    • Requires frequent wet cleaning and ventilation of the room. A minimum of carpets and upholstered furniture - a minimum of dust.
    • Bedding is better to use with synthetic filler, without fluff, feather.
    • Wash only with warm water, including hands.
    • After washing, do not rub the skin, but gently pat the towel.
    • Be sure to use moisturizers after the shower. Means for skin care should be neutral, without perfumes and dyes.
    • Timely treatment of all chronic diseases, courses of vasoconstrictive medications, sedatives( especially before significant events, eg examinations, weddings, etc.), hardening, vitamins, to exclude allergic products even during the resolution of rashes.

    Features of diet, diet and lifestyle with atopic dermatitis

    Creating a special hypoallergenic, that is, devoid of allergens, the environment, dieting is an essential component of the treatment of atopic dermatitis. Without observing these recommendations, the effectiveness of treatment of the disease is significantly reduced.

    Let's start with building a hypoallergenic environment. In fact, it is the observance of a special way of life. The goal is to eliminate the factors that can irritate the skin and thereby provoke exacerbations of atopic dermatitis.

    It is recommended to avoid exposure to extremes in temperature and humidity. The recommended humidity in the room is about 40%.Dry clothes should be outside the living room.

    It is also preferable to avoid intense physical activity or factors that increase sweating and itching. For the same reason, it is not recommended to participate in sports, as it causes active sweating and is accompanied by a close contact of the skin with clothing. If possible, avoid stressful situations( as far as possible).It is not recommended to wear coarse clothing, especially wool, synthetics, animal fur. New clothes should be stretched before the toe. When washing clothes and bedding use the minimum amount of conditioner for laundry, after which the laundry should be rinsed additionally. Do not use alcohol-containing personal care products.

    In the kitchen will have to put the hood. In the bedroom it will be nice to install an air purifier. In the hot season, use the air conditioner with a filter at the outlet.

    Bed linen is changed 1-2 times a week. It is necessary to eliminate sources of accumulation of dust and mold. TV, computer, home appliances from the bedroom of the patient should be removed. Easy wet cleaning is carried out once a day, general cleaning at least once a week. Use vacuum cleaners with good filters( the best ones with HEPA filters).With a confirmed allergy to the house dust mite, once every 3-6 months, treat the apartment with acaricide( killing mites) drugs, for example, Allergoff.

    You can not smoke in the house. This refers to family members. The patient can not smoke anywhere: neither in the house, nor in the street.

    Great attention is paid to water procedures. You can not use ordinary soap, it is better to use shower oil or therapeutic shampoo( for example, shampoos of the friderm series).After showering, always lubricate the skin with moisturizers.

    Nail to the patient to cut as short as possible to avoid involuntary skin damage in case of exacerbation of the disease and the occurrence of skin itching.

    You can not sunbathe with atopic dermatitis .Long exposure to the sun is a common mistake. Right after that there will be a slight improvement, which parents usually notice and seek, but then there is almost always a strong exacerbation of the disease.

    You can not comb and rub your skin, no funds will not be effective if you comb out lesions.

    Be sure to consult your doctor about compliance with the principles of hypoallergenic life. Suggested recommendations on our website can be supplemented depending on those allergens that you( or your child) react to.

    Hypoallergenic diet for atopic dermatitis:

    You also need to adhere to a special diet. During an exacerbation the diet should be observed especially rigidly, without exacerbation it can be expanded a little, not to cause at the child any neurosis-like condition because of that "all it is impossible for him".

    Excluded from atopic dermatitis products:

    The use of citrus fruits, nuts, seafood, fish, chocolate, coffee, mustard, spices, mayonnaise, tomatoes, eggplant, red pepper, milk, eggs, mushrooms, sausages, sausages, carbonated drinks, strawberries, strawberries, watermelons, pineapples, honey. Categorically prohibited alcohol.

    Allowed for atopic dermatitis products:

    You can eat boiled beef;cereals and vegetable soups;vegetarian soups;olive oil;sunflower oil;boiled potatoes;porridge of buckwheat, rice, oatmeal;lactic acid products;cucumbers;parsley;dill;apples are baked;tea;sugar;bran or whole grain bread;compote from apples or from dried fruits( except raisins);bio-yogurt without additives;one-day curd;yogurt.

    Atopic dermatitis in children

    Atopic dermatitis is a disease that begins precisely in early childhood. Most often in the period from 6 to 12 months. Atopic dermatitis in children in common people is called " Diathesis ", in medicine the concept of diathesis is not present, there is the concept of infant stage of atopic dermatitis .

    The clinical picture( symptoms with photos) of infant and pediatric forms of atopic dermatitis is described in detail in the Symptoms of Atopic Dermatitis. The smaller the age of the child, the more pronounced it is for exudation( wetting).

    In the photo a child with atopic dermatitis

    The nature of the activities aimed at creating a hypoallergenic environment around the child does not differ from those for adults and is described in detail above.

    Special attention in children is paid to the restoration of disturbed skin properties by the constant use of moisturizing cosmetics. Apply it should be 3-4 times a day, sometimes and more often.

    Very important is the longest( at least 6 months) preservation of breastfeeding. But at the same time, mom should not eat foods that can cause an aggravation of allergies( see the diet in the section on nutrition and lifestyle with atopic dermatitis).

    It is important to bathe correctly the child of the first year of life, especially the newborn. Do not use soap. It is better to use medical shampoos. For example, shampoo friederm with zinc during an exacerbation and a friderm balance out exacerbation. Before bathing, one shampoo cap should be added to the bath with water. After bathing, you can not rub the baby with a towel - it irritates the skin. It is better to lightly soak the skin with a towel or let it dry yourself.

    The actual problem is the vaccination of a child with atopic dermatitis. The very fact of the presence of the disease is not an excuse to refuse vaccinations, but vaccination is possible only in the stage of persistent remission of the disease( at least 2-3 months).It is compulsory to take antihistamines 7 days before vaccination on the day of vaccination and 3-5 days after vaccination. You can not administer several vaccines on the same day. If several vaccinations are already missed, then vaccination should begin with less allergenic vaccines. Properly compile an individual vaccination calendar will help you your doctor( allergist-immunologist or pediatrician).

    Complications of atopic dermatitis and prognosis of recovery

    Prognosis for life is favorable. However, skin lesions, especially in adolescence, can contribute to social disadaptation of the patient.
    Atopic dermatitis is a chronic allergic skin disorder. In case of adequate treatment, elimination of risk factors in most patients, there is a stable remission and subsequently the diagnosis can be withdrawn. But since the diagnosis of atopic dermatitis is a reflection of the general allergic mood( atopic constitution), in the majority of these patients( more than 40%), other allergic diseases, most often associated with airway damage( allergic rhinitis, atopic bronchial asthma), may develop in the future. Such progression of allergic mood and the change of allergic diseases from less severe to more serious in medical literature was called atopic march.

    In case of severe disease and / or inadequate treatment, non-observance of a special way of life - the disease continues in adolescence and in adults.

    The most common complications of atopic dermatitis are the attachment of bacterial infection( pyoderma) and skin atrophy( most often due to unreasonably long use of local glucocorticosteroid preparations).Constant scratching of the skin with atopic dermatitis leads to a violation of its protective, barrier properties, which contributes to the attachment of infection due to microbial and fungal flora.

    Pyoderma is characterized by the appearance of pustules on the skin, which gradually dry up and crusts form. Eruptions can be located on the body, and arms, and legs, and on the scalp. This can be accompanied by a violation of the general state of the person, the temperature may rise.

    Another frequent complication of atopic dermatitis is a viral infection. On the skin bubbles with transparent contents are formed. The causative agent is the herpes simplex virus, the one that causes a "cold" on the lips. Usually, rashes are located in the area of ​​inflammatory foci, but can involve healthy skin, as well as affect the mucous membranes( oral cavity, throat, genitalia and conjunctiva).Especially frequent localization of the rash is the skin of the face( around the mouth, lips, nose wings, on the cheeks, ears, eyelids).

    A common complication of atopic dermatitis is fungal( most often candidal) lesions. In adults, skin is more often affected( especially skin folds), nails, scalp, feet, brushes;and in children - the oral mucosa, the so-called thrush( there is a "curdled" coating, can be accompanied by soreness, redness).Sometimes the bacterial and fungal lesions are combined together.

    Prevention of atopic dermatitis

    There are no measures to prevent the development of atopic dermatitis. The only really working recommendation is the longest( at least 6 months), the preservation of breastfeeding. Some authors recommend the exclusion of cow milk from the diet of children under 1 year, if the family has a patient with an allergic disease.

    With the already manifested disease, preventive measures are reduced to eliminating the cause-significant allergen( the allergen causing the allergy) from the environment, observing the general principles of the diet, creating a hypoallergenic way of life and conducting adequate treatment.

    Answers to frequently asked questions about atopic dermatitis:

    Why do I have to follow a diet with a baby with atopic dermatitis?

    The diet should exclude products directly to which the allergy develops, and products containing a large amount of histamine. Histamine is one of the most important participants in an allergic disease. Absorbed in the intestine, it strengthens the existing allergic process. The use of foods rich in histamine in patients with allergic diseases can be compared with throwing firewood on a fire.

    Can atopic dermatitis be completely cured?

    Modern medical methods allow in most cases to transfer the disease into a state of remission in the child. In this case, during the transition period, the disease can completely disappear. In the old medical literature, this was called "to develop a disease."
    But for this to happen, a long joint work of the doctor and patient is necessary.

    I have atopic dermatitis, what is the probability of transferring it to my child?

    The probability of transmission of "allergic mood" from the father is about 15-20%, from the mother about 40%, if both parents are ill 70%.But in order for this attitude to evolve into a disease, a combination of a number of external factors is necessary. Therefore, the real probability is less. Consult your doctor about preventive measures.

    the doctor the allergist-immunologist, km. Mayorov RV