Atopic dermatitis (diffuse neurodermatitis)

Atopic dermatitis (diffuse neurodermatitis) is a skin disease characterized by itching, lichenoid papules, lichenification and chronic recurrent course. Has a clear seasonal dependence: in the winter - exacerbations and relapses, in the summer - partial or complete remission. White dermographism is characteristic. Provocative role is played by food products (citrus fruits, sweets, smoked products, spicy foods, spirits), medicines (antibiotics, vitamins, sulfonamides, pyrazolone derivatives), grafts and other factors.

The etiology is unknown. At the heart of pathogenesis is the altered reactivity of the organism, caused by immune and non-immune mechanisms. Combinations are often combined with allergic rhinitis, asthma, hay fever or indication of their presence in the family history.

Symptoms, course. The disease can first appear in one of the three age phases - infant, child and adult, acquiring, as a rule, a persistent current. The clinical picture is determined by the age of the patient regardless of the time of onset of the disease. Phases are characterized by a gradual change in the localization of clinical manifestations, the weakening of acute inflammation and the formation and subsequent prevalence of lichenoid papules and foci of lichenification. In all phases, a strong, sometimes painful itching is disturbed. The infant phase covers the period from the 7th to 8th week of a child's life to 1.5-2 years. The disease is of acute, eczematous nature with the primary lesion of the facial skin (cheeks, forehead), although it can spread to other areas of the skin. In the childhood phase (up to pubertal age), lichenoid papules and foci of lichenification begin to predominate, localizing mainly on the lateral surfaces of the neck, upper chest, elbows and popliteal creases and brushes. The adult phase begins with pubertal age and, according to clinical symptoms, approaches eruptions in late childhood (lichenoid papules, foci of lichenification). Depending on the degree of involvement of the skin, limited, widespread and universal (erythroderma) forms are distinguished.

Treatment. Elimination of provoking factors, hypoallergenic diet, stupa regulation, antihistamine, sedative and immunocorrecting drugs, reflexotherapy, ultraviolet irradiation, selective phototherapy, photochemotherapy, local remedies (lotions, corticosteroid ointments, hot poultices, paraffin applications). In severe exacerbations, hospitalization with the use of infuionic therapy (haemodes, rheopolyglucin), hemosorption, plasmapheresis is indicated. The longest climatotherapy (staying for 2-3 years in a warm climatic zone, for example in the Crimea) is the most effective in the persistence of results.

Prevention provides for rational management of pregnancy and childbirth, a diet of a nursing mother and newborn, correction of the concomitant pathology, a long reception is obscured. Particular attention is paid to psychotherapy, social adaptation, vocational guidance, rational litany and other factors