Atopic dermatitis in children

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 are compelled to be observed by an allergist for life. Only 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.

The only exact cause of the disease is unknown to scientists. 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 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. Typically, these forms of diseases are typical for babies with many chronic diseases.

All provoking factors that trigger a cascade of allergic reactions can be divided into several etiological categories:

Ingestion of food allergens. One of the most common forms of the disease. The first cases can occur in babies as early as six months of age. At this time, new products are added to the baby's diet - as complementary foods. In older children, citrus fruits, chocolate and seafood become active allergens. All tropical fruits can also cause manifestations of atopic dermatitis.
Inhalation of plant pollen and blossom allergy. The peak incidence occurs by the age of 6-8 years. Usually babies have a severe runny nose with profuse discharge, breathing is impaired, their eyes are watery and redden. In 20% of children, skin rashes and severe itching join these symptoms.
Long-term use of antibacterial drugs that have an adverse effect on the child's digestive system. 80% of immunity is formed in the intestines. Beneficial bacteria help fight foreign microflora and strengthen immunity. With prolonged use of antibiotics, pronounced dysbiosis and irritable bowel syndrome are formed. The disturbed microflora prevents the removal of allergens from the body, provoking exacerbation of atopic diseases.
Household dust, as well as animal hair or fluff. In more rare cases, the development of atopic dermatitis upon contact with textiles in which mites live. Sleeping on feather pillows can "give" babies not joyful and pleasant dreams, but strong itchy skin rashes.
Switching from breastfeeding to formula. Many babies with lactose intolerance may experience manifestations of lactase deficiency, and with a genetic predisposition, atopic dermatitis. There are cases of allergic skin diseases due to the introduction of mixtures that contain traces of nuts or soybeans.
All diseases that weaken the child's immune system. Children who often have colds are more susceptible to the development of atopic dermatitis. If the baby is sick with colds 3-4 times a year, then mom should definitely show the child to the allergist-immunologist. In children with frequent illnesses, constant stress on the immune system can lead to the development of allergic reactions.
Contact with chemical allergens. For a baby with individual intolerance or a tendency to allergic reactions, almost all chemical compounds can act as a chemical trigger. The largest number of cases of atopic dermatitis was observed upon contact with household chemicals. Allergic contact reactions to shampoos and personal care products are also common. The more aromatic additives in the product, the higher the risk of developing adverse symptoms in the baby.
Various parasitic diseases. Very often babies with atopic dermatitis are treated symptomatically, forgetting to establish the root cause of the disease. In babies under 5 years old, worms and various parasites are often the culprits of the disease. Living in the intestines or other internal organs, they release toxic substances that negatively affect the immune system. Such toxins contribute to the development of the inflammatory process in all layers of the skin.
Decreased immunity against the backdrop of unfavorable ecology. Children who live in cities are much more likely to suffer from atopic dermatitis than their rural peers. Many scientists attribute this to a weakening of immunity against the background of daily exposure to adverse environmental factors. Industrial pollution of air and water, huge amounts of car emissions negatively affect the immune system of the baby. The body is contaminated with various chemical elements. These factors gradually reduce the child's immunity and can cause severe allergic reactions.
Chronic diseases. Babies who have various pathologies of internal organs are also susceptible to the development of atopic dermatitis. At risk are children with chronic diseases of the digestive and respiratory systems. A child's weakened immunity cannot fight several diseases at once.
Bacterial infections. Recently, scientists have observed a strong link between staphylococcal infection and the subsequent development of atopic dermatitis. During laboratory tests, in more than 90% of cases, pathogenic staphylococcus was detected on damaged skin areas. This microorganism has a pronounced toxic effect on skin cells, enhances the inflammatory process and contributes to the emergence of new exacerbations of the disease.

Stages 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:

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 release 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 exposure, emit a huge amount of protective antibodies.
Development of immune inflammation. The activated lymphocytes, which have recognized the foreign agent, begin to release huge amounts 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.
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 the allergen appear after 48-72 hours. If the provoking factor re-enters the body, then the period before the onset of symptoms can be reduced from several hours to a day.
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.
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 lack 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.

Age

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. It usually lasts until adolescence. This form of the disease is characterized by pronounced itching, as well as drying of the skin. Skin elements can be varied. Various vesicular eruptions, filled with transparent contents, often appear.
Teenage version. It can develop up to the age of eighteen. This form proceeds with the appearance of severe itching in 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 as large 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 stay clean are the inside 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 of a small amount of skin rashes during exacerbations. Usually these are single vesicular elements. This option is characterized by the appearance of moderate itching, there is a slight edema, 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, the liquid 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. 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 epithelialize rather poorly.

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 damaged skin, can introduce additional infection and worsen 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. Thus there is a change in the structure and structure of the skin. It becomes denser, the architecture of collagen and elastin fibers is disrupted.
The child is not feeling well. Severe itching causes severe anxiety in the baby. Babies 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 the 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. The areas where weeping sores were located usually heal, but become less dense to the touch. Crusts may form on 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 long 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 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 the norm 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 determining 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.

Only a pediatric allergist-immunologist can conduct allergic tests. 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. You should not be afraid of such cuts. They are too small to be a threat of infection or suppuration.

After applying special incisions, 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 may occur. 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 any 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, 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 comes down to the determination of 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 a foreign agent from the body and eliminate inflammation.

A serological test is an important diagnostic test in identifying provoking factors that can provoke an allergic reaction. It has a fairly high specificity (95-98%) and informational content. The disadvantage of research is the high cost. Usually, the price for identifying 10 different allergens 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 therapeutic, 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 the period of 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. Children prone to allergies may develop acute contact dermatitis... 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 discomforting symptoms of atopic dermatitis. The choice of drugs is carried out, focusing on the skin manifestations that have arisen with 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 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. Eit 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, they can introduce additional infection and aggravate the course of the disease. When the secondary bacterial flora is attached, the inflammation increases markedly, 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 sufficiently 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. Normalization of the protective function of the intestines also helps to restore immunity... 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. Compliance with a hypoallergenic diet is worth throughout life.
Complete elimination of possible provoking allergens from household use. 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

Medical 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 can 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. In 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 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 help 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 by the 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.
Drugs 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 must be hydrated. 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. ThenOnly 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 food products.

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 prohibited.
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 sweetscontaining cocoa beans.
Candy and sweet sodawhich 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 babies to strengthen their immunity. 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. 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 kids. You can add grated cucumber to dishes. Vegetables are an excellent source of insoluble dietary fiber. They are also needed for the formation of healthy gut microflora.
Fruit. 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.
Sufficient amount of liquid. To remove the 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 trace elements enter the child's body, therefore, the introduction of such substances from the outside is required. Synthetic complexes are becoming 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. 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, the level of histamine decreases during sleep. This substance is formed during an acute inflammatory reaction and causes severe itching. Decreasing the concentration of histamine can reduce this adverse symptom. This brings the baby some relief.

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 if mild, 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, during a stay in a 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 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 wellness 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 experience certain complications of the disease.

The most common in 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 increases noticeably, 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 antibiotics. In severe cases of the bacterial process - emergency hospitalization in a hospital.
Atrophic phenomena on the skin or its pronounced thinning. Commonly encountered 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 examination. Doctors-experts will study all the child's medical documentation 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 a 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. Clean pillows 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. Such 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 flowering. 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 in 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. Children's 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 very often occurs 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 baby's quality of life.

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