Maintenance of remission and prevention of disease flares in children with atopic dermatitis. Position paper of the Association of Children's Allergists and Immunologists of Russia


Cite item

Full Text

Abstract

Since atopic dermatitis is a chronic disease with recurrent course having a significant negative effect on the quality of life of patients and their families the important attention in clinical practice should be given to measures aimed to maintaining of disease remission and flares prevention. Key measures are: systematic rational skin care, exclusion of the impact of allergenic and non-allergenic triggers, timely use of topical anti-inflammatory drugs at first sign of an exacerbation. The goal achievement is possible only through close interaction with parents of children suffering from atopic dermatitis, patient’s therapeutic education and their active involvement into disease control process.

Full Text

Restricted Access

About the authors

Yury S. Smolkin

Association of Children's Allergists and Immunologists of Russia; Academy Postgraduate Education of the Federal Research Center for Specialized Types of Medical Assistance and Medical Technologies

Email: smolkin@alerg.ru

Natalia B. Migacheva

Samara State Medical University

Olga Yu. Smolkina

Scientific Clinical Consultative Center of Allergology and Immunology

References

  1. Балаболкин И.И., Булгакова В.А., Елисеева Т.И. Атопический дерматит у детей. М.: Медицинское информационное агентство, 2018.
  2. Torres T, Ferreira EO, GonHalo M et al. Update on Atopic Dermatitis. Acta Medica Portuguesa 2019; 32 (9): 606-13.
  3. Альбанова В.И., Пампура А.Н. Атопический дерматит. М.: ГЭОТАР-Медиа, 2016.
  4. Drucker AM. Atopic dermatitis: Burden of illness, quality of life, and associated complications. Allergy Asthma Proceed 2017; 38 (1): 3-8.
  5. Атопический дерматит у детей: обновление 2019 (на правах руководства). Согласительный документ Ассоциации детских аллергологов и иммунологов России. М.: АДАИР, 2019; Самара: Полиграфическое объединение «Стандарт», 2019.
  6. Eichenfield LF, Ahluwalia J, Waldman A et al. Current guidelines for the evaluation and management of atopic dermatitis: A comparison of the Joint Task Force Practice Parameter and American Academy of Dermatology guidelines. J Allergy Clin Immunol 2017; 139 (4): 49-57.
  7. Wollenberg A, Barbarot S, Bieber T et al; European Dermatology Forum (EDF), the European Academy of Dermatology and Venereology (EADV), the European Academy of Allergy and Clinical Immunology (EAACI), the European Task Force on Atopic Dermatitis (ETFAD), European Federation of Allergy and Airways Diseases Patients’ Associations (EFA), the European Society for Dermatology and Psychiatry (ESDaP), the European Society of Pediatric Dermatology (ESPD), Global Allergy and Asthma European Network (GA2LEN) and the European Union of Medical Specialists (UEMS). Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part II. J Eur Acad Dermatol Venerol 2018; 32 (6): 850-78.
  8. Pickett K, Frampton G, Loveman E. Education to improve quality of life of people with chronic inflammatory skin conditions: a systematic review of the evidence. Br J Dermatol 2016; 174 (6): 1228-41.
  9. Sy W, Lamb AJ. Atopic Dermatitis Disease Education. Adv Exp Med Biol 2017; 1027: 179-84.
  10. Cork MJ, Britton J, Butler L et al. Comparison of parent knowledge, therapy utilization and severity of atopic eczema before and after explanation and demonstration of topical therapies by a specialist dermatology nurse. Br J Dermatol 2003; 149: 582-9.
  11. Teasdale E, Muller I, Santer M. Carers’ views of topical-corticosteroid use in childhood eczema: a qualitative study of online discussion forums. Br J Dermatol 2017; 176 (6): 1500-7.
  12. Lindh JD, Bradley M. Clinical Effectiveness of Moisturizers in Atopic Dermatitis and Related Disorders: A Systematic Review. Am J Clin Dermatol 2015; 16 (5): 341-59.
  13. Santer M, Muller I, Yardley L et al. Parents' and carers' views about emollients for childhood eczema: qualitative interview study. BMJ Open 2016; 6 (8): e011887.
  14. Gore C, Johnson RJ, Caress AL et al. The information needs and preferred roles in treatment decisionmaking of parents caring for infants with atopic dermatitis: a qualitative study. Allergy 2005 60 (7): 938-43.
  15. Giam YC, Hebert AA, Dizon MV et al. A review on the role of moisturizers for atopic dermatitis. Asia Pac Allergy 2016; 6 (2): 120-8.
  16. Lindh JD, Bradley M. Clinical Effectiveness of Moisturizers in Atopic Dermatitis and Related Disorders: A Systematic Review. Am J Clin Dermatol 2015; 16 (5): 341-59.
  17. Akerstrom U, Reitamo S, Langeland T et al. Comparison of Moisturizing Creams for the Prevention of Atopic Dermatitis Relapse: a Randomized Double-blind Controlled Multicentre Clinical Trial. Acta Derm Venereol 2015; 95: 587-92.
  18. Lynde CW. Moisturizers: What they are and how they work. Skin Therapy Lett 2001; 6 (13): 3-5.
  19. Loden M. The clinical benefit of moisturizers. J Eur Academy Dermatol Venereol 2005; 19: 672-88.
  20. Breternitz M, Kowatzki D, Langenauer M et al. Placebo-controlled, double-blind, randomized, prospective study of a glycerol-based emollient on eczematous skin in atopic dermatitis: biophysical and clinical evaluation. Skin Pharmacol Physiol 2008; 21 (1): 39-45.
  21. Chiang C, Eichenfield LF. Quantitative assessment of combination bathing and moisturizing regimens on skin hydration in atopic dermatitis. Pediatr Dermatol 2009; 26: 273-8.
  22. Norrlid H, Hjalte F, Lundqvist A et al. Cost-effectiveness of Maintenance Treatment with a Barrier-strengthening Moisturizing Cream in Patients with Atopic Dermatitis in Finland, Norway and Sweden. Acta Derm Venereol 2016; 96 (2): 173-6.
  23. Mason JM, Carr J, Buckley C et al. Improved emollient use reduces atopic eczema symptoms and is cost neutral in infants: before-and-after evaluation of a multifaceted educational support programme. BMC Dermatol 2013; 16 (13): 7.
  24. Varothai S, Nitayavardhana S, Kulthanan K. Moisturizers for patients with atopic dermatitis. Asian Pac J Allergy Immunol 2013; 31: 91-8.
  25. Sethi A, Kaur T, Malhotra SK, ML. Moisturizers: The Slippery Road. Indian J Dermatol 2016; 61 (3): 279-87.
  26. Tichota DM, Silva AC, Sousa Lobo JM, Amaral MH. Design, characterization, and clinical evaluation of argan oil nanostructured lipid carriers to improve skin hydration. Int J Nanomedicine 2014; 11 (9): 3855-64.
  27. Hon KL, Tsang YC, Pong NH et al. Patient acceptability, efficacy, and skin biophysiology of a cream and cleanser containing lipid complex with shea butter extract versus a ceramide product for eczema. Hong Kong Med J 2015; 21 (5): 417-25.
  28. Seite S, Zelenkova H, Martin R, Fierer N. Using a specific emollient to manage skin microbiome dysbiosis. JAAD 2016; 74 (5): 89-94.
  29. Мингалиев Р.А., Кудрявцева А.В. Атопический дерматит у детей как мультифак-ториальное заболевание, причины возникновения и особенности лечения. Аллергология и иммунология в педиатрии. 2017; 1: 8-14. [Mingaliev R.A., Kudriavtseva A.V. Atopicheskii dermatit u detei kak mul'tifaktori-al'noe zabolevanie, prichiny vozniknoveniia i osobennosti lecheniia. Allergologiia i immunologiia v pediatrii. 2017; 1: 8-14 (in Russian).]
  30. Lim NR, Lohman ME, Lio PA. The Role of Elimination Diets in Atopic Dermatitis-A Comprehensive Review. Pediatric Dermatology 2017; 34 (5): 516-27.
  31. Galli E, Neri I, Ricci G et al. Consensus Conference on Clinical Management of pediatric Atopic Dermatitis. Ital J Pediatr 2016; 2: 26-42.
  32. Stein SL, Cifu AS. Management of Atopic Dermatitis. JAMA 2016; 12 (14): 1510-1.
  33. Badina L, Barbi E, Berti I et al. The dietary paradox in food allergy: yesterday’s mistakes, today’s evidence and lessons for tomorrow. Cur Pharmaceutical Design 2012; 18 (35): 5782-7.
  34. Campana R, Dzoro S, Mittermann I et al. Molecular aspects of allergens in atopic dermatitis. Curr Opin Allergy Clin Immunol 2017; 17 (4): 269-77.
  35. Johansson EK, Bergstrom A, Kull I et al. IgE sensitization in relation to preschool eczema and filaggrin mutation. J Allergy Clin Immunol 2017; 140 (6): 1572-9.
  36. Leung DY, Boguniewicz M, Howell MD et al. New insights into atopic dermatitis. J Clin Investigation 2004; 113: 651-7.
  37. Das A, Panda S. Use of Topical Corticosteroids in Dermatology: An Evidence-based Approach. Indian J Dermatol 2017; 62 (3): 237-50.
  38. Sidbury R, Tom WL, Bergman JN et al. Guidelines of care for the management of atopic dermatitis: section 4. prevention of disease flares and use of adjunctive therapies and approaches. J Am Acad Dermatol 2014; 71: 1218-33.
  39. Fukuie T, Hirakawa S, Narita M et al. Potential preventive effects of proactive therapy on sensitization in moderate to severe childhood atopic dermatitis: A randomized, investigator-blinded, controlled study. J Dermatol 2016; 43 (11): 1283-92.
  40. Приказ Минздрава России от 07.06.2018 №321н «Об утверждении перечней медицинских показаний и противопоказаний для санаторно-курортного лечения». http://www.garant.ru/products/ipo/prime/doc/71879402/#ixzz5Qak8NB83
  41. Погонченкова И.В., Рассулова МА., Хан МА. и др. Современные технологии медицинской реабилитации детей с атопическим дерматитом. Доктор.Ру. 2016; 12 (129; Ч. 2): 44-7.
  42. Ring J, Mohrenschlager M, Weidinger S. Molecular genetics of atopic eczema. Chem Immunol Allergy 2012; 96: 24-9.
  43. Kezis S, Kemperman PM, Koster ES et al. Loss-of-function mutations in the fillag-grin gene lead to reduce level of natural moisturizing factor in the stratum corneum. J Invest Dermatol 2008; 128: 2117-9.
  44. Drucker AM, Wang AR, Li WQ et al. The Burden of Atopic Dermatitis: Summary of a Report for the National Eczema Association. J Invest Dermatol 2017; 137 (1): 26-30.
  45. Конова О.М., Дмитриенко Е.Г., Давыдова И.В., Сахарова Е.В. Аромафитованны -эффективный метод гидротерапии в комплексном восстановительном лечении детей с различными болезнями. Вопросы современной педиатрии. 2014;13 (4): 78-82.
  46. Козулин Е.Е., Коулин Е.А. Фитоминеральная корнеотерапия в реабилитации детей с атопическим дерматитом. Дальневосточный мед. журн. 2015; 2: 58-61.
  47. Козулин Е.Е., Коулин Е.А. Дальневосточные фитоминеральные препараты в предетерминированной реабилитации больных с атопическим дерматитом. Дальневосточный мед. журн. 2018; 1: 77-80.
  48. Giacomino MI, de Michele DF. Is mud an antiinflammatory? Anales Medicina Interna 2007; 24 (7): 352-3.
  49. Spilioti E, Vargiami M, Letsiou S et al. Biological properties of mud exstracts from various spa resorts. Environ Geochem Health 2017; 39: 821-33.
  50. Fioravanti A, Cantarini L, Guidelli GM, Galeazzi M. Mechanisms of action of spa therapies in rheumatic diseases: What scientific evidence is there? Rheumatol Int 2011; 31 (1): 1-8.

Copyright (c) 2020 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 74329 от 19.11.2018 г.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies