Treatment of atopic dermatitis – This is always a topical issue in the practice of dermatologists. It is this pathology that belongs to the most common dermatological diseases, but despite this, there is still no universal method of treatment that could be a panacea for patients with atopic dermatitis. However, research in this direction is being actively conducted, and new methods of dealing with the problem are presented every year. It was about modern methods of treating atopic dermatitis in an exclusive interview for estet-portal.com that the candidate of medical sciences, associate professor of the Department of Skin and Venereal Diseases of the VNMU named after V.I. N.I. Pirogova, dermatovenerologist, universal dermatological clinic EuroDerm - Marina Anfilova.
How often do you experience atopic dermatitis in your practice?
Atopic dermatitis – a fairly widespread problem. Among the population, this disease occupies, on average, from 14 to 30%. Moreover, the highest prevalence is observed among children (on average, from 10 to 30%), and the pathology is less common among adults (from 4 to 10%). Atopic dermatitis is the most common I encounter in pediatric dermatology.
Almost every second patient who comes to me for an appointment with complaints of skin itching dryness and the presence of various variants of the rash, I diagnose atopic dermatitis.
In predicting atopic dermatitis, the hereditary factor is of great importance, because the development of pathology is based on a genetically determined defect in the immune response. If both parents are healthy – The risk of developing atopic dermatitis in a child is, on average, from 10 to 20%. If one of the parents is sick with atopic dermatitis, vasomotor rhinitis or bronchial asthma – this risk will be 10-40%, and if both parents are sick with one of the & nbsp; of the above diseases - the risk of developing atopic dermatitis in a child will already be from 40 to 80%.
What are the symptoms of atopic dermatitis that most concern patients?
In atopic dermatitis, patients will be bothered by the sensation of itching and the presence of a rash. If we are talking about manifestations of atopic dermatitis in early childhood – there are some peculiarities here. First of all, babies and their parents will be concerned about the presence of a rash on the flexion surfaces of the elbow joints, in the popliteal fossae, on the skin of the face, abdomen, buttocks, and even the anogenital zone. The rash equally worries patients at any time of the day. In addition, an important symptom that worries patients is dry skin. The mother of a sick child often says that his skin was dry right after birth. If an older patient, for example, a teenager, consults a doctor, he also notes that he always had a need to moisturize the skin after taking a shower or other water procedures. The problem of dry skin becomes especially relevant for patients with the onset of the cold season. Also, patients, especially younger ones, are concerned about increased sensitivity to certain foods. Parents note that when they give a child, for example, a chicken egg, grapes or citrus fruits – he has small papular elements on certain areas of the skin, which over time can either disappear on their own, after or without treatment, or spread over the skin. Older patients are disturbed by a localized rash that occurs on the palms, or on separate areas of the skin, for example, on the back of the neck, chest, back, in the anogenital region.
concerned about hypersensitivity to certain foods. Parents note that when they give a child, for example, a chicken egg, grapes or citrus fruits – he has small papular elements on certain areas of the skin, which over time can either disappear on their own, after or without treatment, or spread over the skin. Older patients are disturbed by a localized rash that occurs on the palms, or on separate areas of the skin, for example, on the back of the neck, chest, back, in the anogenital region.concerned about hypersensitivity to certain foods. Parents note that when they give a child, for example, a chicken egg, grapes or citrus fruits – he has small papular elements on certain areas of the skin, which over time can either disappear on their own, after or without treatment, or spread over the skin. Older patients are disturbed by a localized rash that occurs on the palms, or on separate areas of the skin, for example, on the back of the neck, chest, back, in the anogenital region.
which over time can either disappear on their own, with or without treatment, or spread through the skin. Older patients are disturbed by a localized rash that occurs on the palms, or on separate areas of the skin, for example, on the back of the neck, chest, back, in the anogenital region.which over time can either disappear on their own, with or without treatment, or spread through the skin. Older patients are disturbed by a localized rash that occurs on the palms, or on separate areas of the skin, for example, on the back of the neck, chest, back, in the anogenital region.
If we talk about the treatment of atopic dermatitis, what is fundamentally new that has appeared recently?
Fundamentally new, of course, are drugs for immunobiological therapy of atopic dermatitis, which can significantly improve the quality of life of patients with atopic dermatitis and prolong remission for a sufficiently long period of time. The targets for such therapy are interleukins 4, 13 and 31, thymico-stromal lymphopoietin, various types of phosphodiesterases and Janus kinase inhibitors. Of course, the development of these drugs are in different phases of clinical trials. But those studies that have already been published give very serious hope that we will be able to control the manifestations of atopic dermatitis quite well, and very difficult patients who need systemic treatment will be able to receive adequate therapy.
What do you consider to be the most important factor in the treatment of atopic dermatitis that determines the effectiveness of therapy?
In the treatment of atopic dermatitis, the most important factor, in my opinion, is, firstly, an adequate perception by the patient's parents of the disease itself, and a clear understanding of the tactics of its everyday management, which should be explained by an adequate, modern, thinking doctor dermatologist.
At the present stage, a lot of care points that patients with atopic dermatitis need have been revised.
With atopic dermatitis, dermatologists today allow bathing patients, and bathing as needed, as well as eating absolutely everything, in accordance with complementary foods, from a very early age. If the patient has no proven food allergy – there is no need to introduce a restrictive, so-called elimination diet. Patients pets are also allowed – cats and dogs. It is very important to inform the patient about the tactics of managing atopic dermatitis during an exacerbation of the disease, as well as for long-term control, that is, about the tactics of maintenance treatment. Indeed, now in our arsenal there are a lot of tools that allow us to ensure a long-term remission of atopic dermatitis. Patients must clearly understand why they are exacerbating the disease, and if some food agents are the provocateur, there is certainly a need for an elimination diet. If the patient's mother or the patient himself claims that he does not have a food allergy, and no products provoke an exacerbation of the rash, there is no need to limit the patient in anything. But we must also clearly understand that a patient with atopic dermatitis should not overeat, and should not get better. If the patient gets better – this may lead to deterioration of his condition. With regard to everyday moments, it is also very important how the patient will wash clothes, how he will clean the room where he lives and works, because, for example, the influence of dust mites on the provocation of bronchial asthma, vasomotor rhinitis and atopic dermatitis is quite large.
What novelties in the treatment of atopic dermatitis do you expect to appear in the near future?See also: The role of intestinal dysbacteriosis in the development of atopic dermatitisShare:
Add a comment