Wednesday, February 3, 2016

Atopic dermatitis in children

Atopic dermatitis, often called eczema or atopic eczema, is a fairly common skin disease. What can I say, if it is found in about 10% of children worldwide. Despite the fact that there is a teenagers and an adult form of the disease, can reasonably be called atopic dermatitis "disease baby-faced." By the way, diathesis - another of its common and the more common name of the people.

The causes of atopic dermatitis

If we talk about the specific causes of atopic dermatitis, they remain to this day in the rank of versions and assumptions. In general, we can speak of a combination of hereditary and a number of other factors of everyday life, which act as the trigger button for atopic dermatitis.

The symptoms of atopic dermatitis in children

Period of occurrence

This kind of eczema is almost always develops within the first 5 years of life, most of all - until the child is 1 year old. Atopic dermatitis is rarely seen immediately after the birth of a baby: more likely its appearance later, after 6 weeks. Other rashes can occur at any time and go for a few days or weeks, but atopic dermatitis is coming for a long time and seriously. Periods of clinical exacerbations may be replaced by "ebb", but this disease has a marked tendency to recur.

Eruptions generated atopic dermatitis, unbearably itchy. The child can not control their unbridled desire to scratch, which ultimately leads to a natural skin damage.
Localization of lesions

In children rash emerges, primarily on the face or inner surface of the elbow and knee bends, i.e. in the places that are easily scratched. In principle, the rash can affect any area of ​​the skin. Sometimes red spots show through only the skin of hands. The rash on the scalp, feet or ears - other key locations for atopic dermatitis. However, one must bear in mind that has similar symptoms and a number of other diseases (e.g., seborrheic dermatitis).

The appearance of the rash
Atopic dermatitis on the inner surface of the knee bends.
This is perhaps the least significant criterion for the identification of atopic dermatitis in children: it is very different, it can be for each individual patient. Overall - it scratches and dry scaly skin. Sometimes the background of aggressive irrepressible scratching the skin infection is entered, and then it is covered by a yellow crust or small pustules. Constant damaging effect on the skin leads to its gradual coarsening.


The presence of family in the incidence of atopic eczema, asthma or hay fever may be more likely to persuade a doctor to the diagnosis of "atopic dermatitis."

What causes atopic dermatitis in children? Trigger factors

First of all, you must understand that atopic dermatitis is not contagious: it is not transmitted from person to person. Atopic skin inflammation is a result of the presence in the skin of the individual large number of so-called inflammatory cells (inflammatory cells) having hyperreactivity towards irritating factors. The task of scientists today is to establish the cause of hyperactivity. Patients with atopic dermatitis, asthma or hay fever are born with an excess of these cells. And if they will be affected by any of the following factors, they will not be able to just "switch off", as do the other cells:

    Dry skin. The main function of this natural protective barrier of our body - protective. We do not pay on skin problems absolutely no attention until she did not force us to do it his dry (read: vulnerability). Individuals with atopic dermatitis are endowed with abnormally dry skin. Other causes of dry skin - too frequent washing and neglect skin moisturizer;
    Irritants. It all chemical substances and natural origin, which can cause irritation and dryness of the skin;
    Stress. With regard to children is, by the way, is also true, as they also sometimes have to experience the frustration, anger or fear. By the way, atopic dermatitis itself - too much stress;
    Sweating. Most of the patients with atopic dermatitis notice that the rash covered when their throws in the heat. It can be physical activity, increased ambient temperature or too warm underwear;
    Infections. Staph infection - a fairly common phenomenon in children. Other infections that can cause atopic dermatitis - herpes and fungal (ringworm or athlete's foot);
    Allergens i.e. all the things that can cause an allergic reaction: pollen, animal dander, dust, food. Obviously, asthma and hay fever allergy-related easier by virtue of speed clinical signs. With slowly developing atopic dermatitis it is more complicated, but in some cases it also develops under the influence of allergens, such as food.

How to treat atopic dermatitis in children

It may seem trite, but the treatment of atopic dermatitis should start with a trip to the doctor. Neither of which Internet diagnosis there can be no question: it like symptoms can occur in a number of serious illnesses and untrue tactics of treatment can be very expensive. If you try to organize all the tools and methods for the treatment of atopic dermatitis in children, can get the following list:

    Local glucocorticoids in the form of creams, ointments, gels, emulsions, etc. (tselestoderm, sinaflana, betasalik). Removing inflammation, effective for acute exacerbations of the disease. The only thing - you can not use more than 7-10 days in a row because of the increased risk of side effects, with which, unfortunately, have these potent means;
    Combination medicaments which include corticosteroids, antibacterial and antifungal agents. Apply in the case of adherence to infection in allergic inflammation;
    Antihistamines (erius, ketotifen, Claritin, Telfast). Optimal use of drugs second and third generation, because they are much less likely to have the sedative effect. On average, a standard course of treatment is about 10 days;
    Derivative pimecrolimus. These modern drugs are used for the relief of acute symptoms. Compared with glucocorticoids have a greater safety (for example, at least to the manufacturer);
    Sorbents (Polyphepanum, activated charcoal). Used as part of combination therapy to detoxification;
    Antiseptics (fukartsin, "Zelenka");
    Soft sedatives (Persia, glycine, plant-based preparations of valerian, peony).

These drugs are used primarily during exacerbation of atopic dermatitis. When the disease is receding, the treatment significantly modified: emphasis on vitamin and cosmetic correction and concomitant diseases.

Hives: causes, symptoms, types, treatment

The term "urticaria" (aka urticaria) together under a group of diseases with similar clinical picture: itchy rash of blisters on the type, resembling a trace of burning nettle. Localization rash can be limited to any one part of the body or totally distributed throughout its surface. If the rash completely disappears for a time period not exceeding 6 weeks, then one speaks of acute urticaria. In more rare cases rash persists for years have chosen not wanting to leave the territory. In such cases, it leads to chronic hives.

Symptoms and types of hives
Symptoms of hives
Overriding clinical manifestations of urticaria - voldyreobraznaya rash, some elements of which may have a size from a couple of millimeters to a dozen centimeters in diameter. Skin rashes over time fade and disappear, but in their place, and often in an absolutely pristine parts of the body before there are new blisters, causing quite a significant itching and a burning desire to scratch.

Acute urticaria
In most cases, urticaria is a temporary phenomenon: suddenly appeared, it increases the severity of their presence within 8-12 hours, and 24-48 hours later, then gradually eroding.

Chronic urticaria
Another thing - chronic urticaria, manifestations of which are sometimes unpredictable. Typically, the clinical picture of this form urticaria can be represented as a sine wave, and is characterized by 6-12-week acute attacks, which are followed by periods of remission. The sharpening can be associated with exposure to certain triggers, which will be discussed below. Approximately 10% of patients with chronic urticaria are dominated by unpleasant symptoms during the time that lasts the disease. Clinical signs of chronic urticaria tend to get worse in the evening, which can cause problems falling asleep.
Urticaria vasculitis

It is not often, but, nevertheless, it happens that affects urticaria shallow blood vessels of the skin and cause an inflammation. In this case we speak about urticaria vasculitis (angina): it lasts more than 24 hours, and basic markers of disease - blisters - is quite painful to the touch and may leave a small scar. Urticaria vasculitis treatment requires not only an allergist and dermatologist.
Causes of urticaria

Urticaria caused massive local (s.c.) release of histamine and other mediators of inflammation, catalyzing the respective skin reactions.
Causes of acute urticaria

Factors that trigger chain reactions, causing an acute urticaria, about half of the cases remain unsolved. In general, those are:

  •     food allergy, such as peanuts, shrimp eggs or cheese;
  •     allergies to environmental factors (pollen, dust mites or chemical substances);
  •     latex allergy, which is characteristic for healthcare professionals;
  •     infection: from the banal to the SARS HIV;
  •     insect bites;
  •     emotional distress;
  •     side effects of certain medications, including antibiotics, NSAIDs, and antihistamines;
  •     physical factors such as mechanical or thermal effects on the skin, sunlight and water.

The causes of chronic urticaria
Chronic urticaria, many experts associated with autoimmune disorders in which the immune system begins to attack its own tissues, leading to the release of large amounts of histamine, thereby triggering skin reactions.

However, the real cause of chronic urticaria is not established yet. It is known that it may develop in combination with other autoimmune pathologies such as rheumatoid arthritis and systemic lupus erythematosus ("lupus").

Chronic urticaria, as, indeed, and severe, often begins under the influence of any trigger factors, such as the same stress, alcohol, caffeine, hot, squeezing the skin (eg - in tight clothes), certain nutritional supplements (salicylates, and others. ).

Treatment of urticaria
Treatment of acute urticaria

In most cases, urticaria not require any special treatment, because its symptoms are relatively mild and tested within a few days.

If the situation is not so optimistic, and signs of acute urticaria are more serious and do not want to pass, it's time to call for help antihistamines that blocking the effects of histamine, relieve itching and eliminate rashes. Here are just a few representatives of this group of drugs: cetirizine (allertek, Zyrtec, tsetrin), fexofenadine (Telfast, Rapid, feksofast, dinoks), loratadine (klarisens, lomilan, allergoferon, erius).

Modern antihistamines - this is not the relic diphenhydramine, causing drowsiness and sedation, though, lightly-irresponsible "cocktail" of alcohol, even ultra antihistamines may trigger a lowering of consciousness until his loss. If due to the symptoms of urticaria in a patient are present trouble falling asleep, in this case, you can kill two birds with appointing an antihistamine that promotes falling asleep: tavegil or Atarax.

But not by antihistamines alone ... In case of severe symptoms of the disease can be cut short by a short-term (3-5 days) receiving glucocorticoids, for example, this role can perform the same test of time prednisone. Preparations of this group suppress the immune system, and thus mitigate the symptoms of urticaria. Long-term use of glucocorticoids can cause side effects like plume of high blood pressure, glaucoma, cataracts and diabetes (or worsen during the last).
Treatment of chronic urticaria

As for the treatment of chronic urticaria, the situation is somewhat more complicated. It is possible to use the same antihistamines or glucocorticoids, taking them regularly and progressively increasing the dosage under medical supervision until the moment when the symptoms start to fade. Such a new antihistamine, as Spanish rupatadin (rupafin), well proven in the treatment of difficult flowing urticaria.

In the treatment of chronic urticaria, and this method is used, known as narrowband phototherapy. It is based on impact on a patient's skin high-intensity ultraviolet irradiation. To do this, several (2 to 5) times per week visit dedicated cabinet for completion of this procedure. Total for the improvement of the clinical picture may need about 20 of these sessions.

Leukotriene receptor antagonists (montelar, singular, ektalust, akolat) may help relieve redness and swelling of the skin. In the long term, they can serve as a good alternative to glucocorticoids, as not causing such unpleasant side effects.

Powerful drug cyclosporine (panimun Bioran, ekoral) has proven effective in the treatment of urticaria in 2/3 cases. Its operating principle is similar to that of glucocorticoids: cyclosporin eliminates the negative effects of the immune system. It should be noted that, as confirmed by the results of clinical trials, the longer used cyclosporin, the less its efficiency. Therefore, you should not use this medicine for more than 5 months, after which its effectiveness is only 25%.

And, of course, if you know the triggers that cause aggravation of urticaria in the individual patient, it is good to get out of their destructive influence. Factors provocateurs, like alcohol and caffeine can be easily erased from life. Since stress is more complicated, however, you should try to pry yourself from the clutches of making another step on the way to get rid of hives. In some cases, bad trigger relaxation techniques such as meditation or hypnosis, which can relieve stress and alleviate the symptoms of the disease.