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Local mechanisms of atopic dermatitis are also hereditarily determined: the accumulation of Langerhans cells in the skin, an increase in the number of IgE receptors on their membranes, a violation of the permeability of the skin barrier, etc.
Variants of the course according to the degree of severity: mild - limited skin lesions (no more than 5%), mild itching that does not impair the patient's sleep, unexpressed skin symptoms (slight hyperemia or swelling, single papules and vesicles), rare exacerbations (1-2 times a year); moderate - widespread damage to the skin (up to 50%), moderate or intense skin itching, inflammatory reaction of the skin (significant hyperemia, exudation or lichenification, multiple scratching), exacerbations 3-4 times a year; severe - more than 50% of the skin is affected, intense, debilitating, itching that sharply disrupts the quality of life, yousevere hyperemia, tissue edema or lichenification, multiple scratching, cracks, erosion, continuously relapsing course.
The root cause of the disease - a hereditary predisposition to allergies - is provoked by a violation of the genetic control of the production of cytokines, in particular interleukin-4 and interleukin-17 (IL-4, IL-17), which is accompanied by excessive production of flagyl pills E, a specific reaction to allergens and general hypersensitivity.
There is no generally accepted classification of atopic dermatitis. There are several criteria by which the disease is classified. According to the intensity of the course: acute, subacute and chronic process.
Atopy is a genetically fixed state of increased allergic readiness of flagyl 400 Mg, 200 Mg pills, characterized by the presence in the blood of an excess amount of class E immunoglobulins (IgE).
The process is represented by redness, swelling, weeping, followed by the formation of crusts. Children's (from 2 to 13 years). Thickening of the skin, the presence of erythematous papules with typical localization in the folds of the skin (lichenoid form) are noted, in 52% of flagyl pills at this stage there is a lesion of the face (atopic face), rashes in the area of the flexor surfaces of the wrists, ankle joints, elbow and popliteal fossae. Adolescent-adult. It is characterized by a continuously relapsing course, pronounced lichenification, dryness and flaking of the skin with a primary lesion of the skin of the face, upper body, extensor surfaces of the extremities.
Women are more susceptible to atopic dermatitis (65%). In 1980, J. Khanifin and H. Raika introduced diagnostic criteria for atopic dermatitis, which are divided into two groups: mandatory symptoms and additional ones.
limited dermatitis - no more than 5% of the skin area is affected; widespread dermatitis - up to 50% of the skin area is affected; diffuse dermatitis - more than 50% of the skin area is involved in Metronidazole pills process.
Additional symptoms include
Depending on the age of the patient and the stage of the disease, clinical manifestations may vary: the nature of skin rashes, their localization and the severity of the process change.
Mandatory manifestations of the disease: a certain appearance of the rashes and their location (in adults, lichenization and scratching are localized on the flexion surfaces, in children - on the face and extensor surfaces, the presence of crusts, cracks, and symmetry of the process are characteristic); chronic course with episodes of exacerbations (under the influence of provoking factors) and remissions, of a seasonal nature, the onset of the disease no later than adolescence; itching; atopy in history or burdened by atopy heredity.
The severity of the symptoms of the disease is evaluated in points and summarized.
Atopic dermatitis develops in 81% of children if both parents are sick, in 59% if only one of the parents is sick, and the other has an allergic respiratory pathology, and in 56% if only one of the parents is sick.
It combines indicators such as the area affected by the body, the intensity of clinical manifestations, and subjective symptoms (itching and insomnia).
To standardize the diagnosis of atopic dermatitis in European countries, the SCORAD system (Consensus Report of the European Task Force on Atopic Dermatitis, 1993) was introduced, and the atopic dermatitis scale was adopted.
An atlas of reference photographs was compiled showing the intensity of erythema, edematous and papular elements, weeping, crusting, excoriation, lichenification and dryness of the skin.
Possible complications and consequencesactions. The main complication of atopic dermatitis is infection of the skin (pyoderma, viral infection or fungal infection) when combing them.
Creating a hypoallergenic environment is the most important preventive measure. Key recommendations: exclusion of food provocateurs; ensuring adequate ventilation of domestic premises; maintaining optimal humidity, temperature and air purity; refusal to use furniture and interior items that serve as dust collectors (carpets, books, flowers, heavy curtains, upholstered furniture, soft toys); a ban on the use of feather and down pillows and blankets; use of hypoallergenic cosmetics; contact with household chemicals only with protective gloves; refusal to wear clothes made of fur and wool; refusal to keep animals, birds and aquariums at home.
Complex pathogenetic pharmacotherapy and the use of external agents, with strict adherence to the recommendations, ensure a stable remission of the disease and prevent its recurrence. The prognosis in this case is favorable.
In 70% of cases, atopic dermatitis is a harbinger of such conditions as hay fever, urticaria, bronchial asthma, allergic rhinitis, Quincke's edema.
In addition, it is recommended: dispensary observation of an allergist; long-term spa treatment in the summer; general strengthening procedures (hardening, UV irradiation, massage).
Predisposition to diffuse neurodermatitis, as well as to other atopic diseases (bronchial asthma, hay fever, allergic rhinitis) is transmitted genetically. Therefore, usually a person who is diagnosed with such a diagnosis will definitely have a relative with one of the listed diseases. In most patients, the disease begins before the age of 12 years. In adulthood, atopic dermatitis manifests very rarely.