Atopic dermatosis (neurodermatitis)
The term atopic (atopos-unusual, alien) is used to refer to a group of allergic diseases with a pronounced hereditary predisposition. Clinically, this is manifested by the characteristic location of the foci of skin lesions, their intense itching and development on the skin due to combing of secondary changes. Children's form of atopic dermatitis is often called childhood eczema, a disease in adults is usually called neurodermatitis.
Symptoms and course:The disease tends to increase, especially in young children. In them, it develops most often against the background of exudative diathesis associated with a congenital anomaly. An important role is played by intrauterine fetal sensitization due to the uniform nutrition of a pregnant woman with the daily use of a large number of products - allergens. It has been established that the most common ones are: cow's milk (up to 2-3 liters per day), chicken eggs, fish, cereals (especially wheat, oats, buckwheat), vegetables (tomatoes), fruits and berries (citrus fruits, grapes, strawberries, nuts). The predisposition to allergic diseases of the body of the unborn child is affected by the unfavorable course of pregnancy - toxicosis, infectious diseases, nervous experiences and stresses, irrational regimen. The development of skin manifestations in infants is often affected by the early introduction of complementary foods and artificial feeding. In older children, allergens can penetrate not only through the gastrointestinal tract, but also through the respiratory tract and skin. These are environmental substances - house dust, pollen of various plants and flowers, wool, smells of perfumes, paints, etc. With age, the manifestations of the disease tend to decrease. By 3-5 years, most children recover, but about a third of eczema passes into neurodermatitis. In the epidermis, the amount of fatty acids and wax is significantly reduced, sweating is reduced. The skin acquires a yellowish-gray color, becomes dry, rough, often peeling, hair - thin and dull.
An important role in the manifestation of neurodermatitis in adults is played by violations of the functional state of various parts of the nervous system. The duration of the disease is estimated in decades. Two forms of neurodermatitis are distinguished. With limited neutrodermatitis, the process is localized mainly on the neck, in the popliteal fossae, ulnar folds, and inguinal-femoral folds. With diffuse neurodermatitis, any part of the skin can be involved in the process. The affected surface is covered with scales, blood crusts and cracks. Skin nodules with a tendency to merge and form continuous infiltration are typical for both forms. As well as a sharp, sometimes unbearable itch with combs, often leaving small scars.
Quite often, neurodermatitis is complicated by pyococcal infection, often in the form of various strepto-staphyloderma. In children, the most serious complication is possible - herpetiform eczema of Kaloshi, resulting from infection with the herpes simplex virus.
Treatment:The disease is independently resolved in a dry, hot climate (Central Asia, Crimea). Of great importance is the normalization of the regime, rest, diet therapy, elimination of allergens and treatment of concomitant diseases. The appointment of general drugs (antihistamines, desensitizing, pyrogenic drugs, stimulants, vitamin therapy, physiotherapeutic methods of exposure, etc. External corticosteroid and tar ointments is recommended.
Prevention:If the expectant mother has allergic diseases, then during pregnancy it is necessary to follow a diet, limit the use of drugs, especially intravenous glucose infusion. A nursing mother should be on a strict diet with the exception of food allergens, and the baby should receive proper hygiene care (bathe only with baby soap, exclude washing of diapers and linen with synthetic powders, avoid wrapping, etc.). An individual approach to conducting preventive vaccinations, the introduction of blood products and some drugs that contribute to further allergization of the patient is required.