Atopic dermatitis in children
DOI:
https://doi.org/10.15574/PP.2025.1(101).117123Keywords:
atopic dermatitis, children, genetics, endotypes, allergic diseases, gut microbiotaAbstract
Aim: review of current data from scientific medical literature on the prevalence, genetic features, etiopathogenesis, approaches to diagnosis and treatment of atopic dermatitis in children.
Atopic dermatitis (AD) affects 15% to 20% of children and 5% to 20% of adolescents and is the most common chronic relapsing inflammatory skin disease in children with severe pruritus. In recent years, the incidence of AD has increased 2-3 times in industrialized countries and varies depending on the geographical region. The manifestation of AD is realized in the interaction of genetic and environmental factors. Mutations in the filaggrin gene lead to a violation of the skin barrier function and an increase in the transdermal transfer of allergens and are a significant genetic factor that contributes to the formation of both AD and AD combined with asthma in children. The severity of the course of AD depends on the intestinal microbiota, the presence of food sensitization, and food allergy. The diagnosis of AD is established on the basis of criteria Hanifin and Rajka (three main and three additional) and the British group of experts. According to the criteria of the British group, the presence of the main criterion (itching of the skin in the last 6 months) and three or more secondary criteria (onset of symptoms before the age of 2 years; damage to the flexural areas of the skin in the anamnesis; general dryness of the skin; other atopic diseases) is necessary to establish the diagnosis of AD in the anamnesis of the child or parents, siblings; dermatitis of flexural areas of the skin). Depending on the age of the child, there are baby (from birth to 2 years), childhood (2-12 years), and adolescent (from 12 years) forms of AD. For the treatment of AD in children, a step-by-step approach is used, which is based on the severity of the course of AD, using emollients, various strengths of topical glucocorticosteroids, calcineurin inhibitors, in case of a refractory course, systemic immunosuppressive therapy and biological drugs.
Conclusions. A timely diagnosis and individually selected treatment will allow parents and children to cope with the disease, avoid complications of AD and other psychosocial problems.
No conflict of interest was declared by the authors.
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