KEY STAGES OF MANAGEMENT DIAGNOSIS, TREATMENT AND PREVENTION OF ATOPIC DERMATITIS IN CHILDREN DEPENDING ON THE SEVERITY

Abstract

SUMMARY. Acute dermatitis is one of the most common skin diseases, affecting up to 20 % of children and 1–3 % of adults in most countries of the world. The mechanisms underlying the change of the skin microbiome have great importance in the development of atopic dermatitis and need to be further studied. Exacerbation of doctors’ attention to the problem of atopic dermatitis is that it is an allergic disease that develops in people with a genetic predisposition to atopy, has a recurrent course, age-related clinical manifestations, and is characterized by elevated levels of general and specific Ig E in serum. Typical clinical manifestations of AD are eczematous and lichenoid rashes which arise because of hypersensitivity to specific (allergic) and non-specific triggers.

The urgency of the problem of the skin microbiome violation during atopic dermatitis consists in the processes of synthesis of anti-microbial peptides. 

Кeratinocytes with a help of anti-microbial peptides perform a barrier function. On the change of the skin, microbiome keratinocytes respond to the production of anti-microbial peptides, which in turn are the initiators of inflammatory processes.

The aim – to study peculiarities of diagnostic management, treatment, and prevention of atopic dermatitis depending on the severity in children of early age.

Materials and Methods. The work was carried out in the Lviv City Children’s Clinical Hospital. The study involved the main group, which contains the 48 children aged 1 to 14 years with the prodations of different severity of atopic dermatitis and 27 healthy children aged 1 to 14 years without any chronic diseases (control group).

Results. 75 children aged 1 to 14 years were examined, among them 34 (45 %) boys and 41 (55 %) girls. Сhildren were divided by the age: From 1 to 2 years – 22 (29 %), from 3 to 6 years – 25 (33 %) and from 7 to 10 years – 11 (15 %), from 11 to 14 years – 17 (23 %).All children who had the manifestations of AD were distributed by prodations (depending on the SCORAD index): Children with light prodations – 19 (40 %), middle prodations – 17 (35 %) and heavy prodations – 12 (25 %).As a result of the study, a relationship between the level of IgE in the blood raw material and the severity of the AD manifestations in the age of 1–14 years has been established. The analysis showed that the IgE level was well higher in children with a difficult severity of AD compared to its indicators in children with a slight passing (p<0.05) of the main group.

Conclusions. The results of our research confirm the presence of correlation (r = – 0,48; p<0.05) between the level of IgE in the blood raw material and the severity of the AD manifestations in children aged 1 to 14 years of the main group. The IgE level was well higher in children with difficult severity of AD compared to its indicators in children with a slight passing (p<0.05) of the main group and may correlate with the overall severity of AD according to the SCORAD scale and the intensity of clinical manifestations.The results of our research compare with the literature, which confirm the correlation between the growth of atopic dermatitis in children and the level of IgE in the blood raw material. Our research shows that it is very important to apply a differentiated approach to treatment of AD according to the current protocols and taking into account the IgE level in the blood raw material.