The management of the pacients with the atopic dermatitis in children

Abstract

Introduction. Atopic dermatitis (AD) is a chronic, inflammatory skin condition which affects millions ofpeople worldwide. It is most commonly seen in children. In the Republic of Moldova the incidemce of AD inchildren is increasing from 11.9 in 2014 to 19.6 per 10,000 children in 2019. More and more children areaffected with this disease, which is why mothers should be properly informed about the impact of atopicdermatitis and the methods of its prevention. Aim of the study. To establish the clinical features and pharmacotherapeutic modalities of atopic dermatitis in children. Materials and methods. The analysis of 57 clinical cases of atopic dermatitis in children with duration of 2years was performed in ambulatory conditions. Results. Out of the group of 40 children with atopic dermatitis, to whom the diagnosis was established based on the Haniffin and Raika criteria, it was established that 17 (42.5%) belong to the extrinsic subtype of atopic dermatitis, and a number of 23 (57.5%) ) of patients belong to the intrinsic subtype. 11 cases with AD are associated with other allergic diseases (27%), respectively 8 are with allergic rhinitis (20%), and 3 with bronchial asthma (7.5%). Topical treatment is a compulsory and important part of complex DA therapy. The most used topical preparations were: creams with mometasone, clobetasol and fluticasone. Therapy with sedative and nonsedatav antihistamines (generations 1 and 2) presents basic therapy in atopic dermatitis in children. The most commonly used was I generation antihistamines such as: clemastine (26%), chloropyramine (42%) and ciproheptadine (32%), which are prescribed mainly in acute forms of AD. In subacute and chronic forms, second-generation antihistamines are usually used. The most commonly used drugs are: loratadine (64%), desloratadine (21%), cetirizine (28%) and levocetirizine (14%). Systemic antihistamine therapy, with both sedative and nonsedative effects, is the basic therapy for AD in children. The emollient remedies and contemporary curative cosmetics used are products from Bioderma, Avene, ISIS Pharma etc. They are used daily, not less than 2 times per day. It is administered as a whole with glucocorticoids and during the remission period, in the absence of the symptoms of the disease. Conclusions. The study determined that 42.5% of cases belong to the extrinsic subtype of atopic dermatitis, and 57.5% of patients belong to the intrinsic subtype. Ensuring adequate antiallergic management in combination with avoiding the adverse action of allergic factors contributes to reducing the incidence of atopic dermatitis morbidity in children.