Features of pathogenesis of itch and anti0itch therapy in children with allergic dermatosis (literature review)

O. Mochulska
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Abstract

Allergic dermatoses are allergic skin diseases, the most common of which are: simple and allergic contact dermatitis, atopic dermatitis, various forms of eczema, acute and chronic allergic urticaria, Quincke's edema, toxicodermias, multiforme exudative erythema (Stevens–Johnson syndrome), acute epidermal necrolysis (Lyell's syndrome). The clinical course of all allergic dermatoses is accompanied by itch, although its severity varies depending on the nosology. An important focus of treatment of allergic dermatoses is to control of skin itch, as it is the leading symptom. According to the international program documents EAACI (European Academy of Allergy and Clinical Immunology), AAAAI (American Academy of Allergy, Asthma & Immunology), PRACТALL (Practical Allergology Consensus Report) in treatment of allergic dermatoses the leading place takes anti-itch therapy, which requires an individual approach and daily care of skin. Systemic anti-itch therapy includes using of the following drugs: antihistamines, glucocorticosteroids, membrane's stabilizators (kromons), leukotriene receptor antagonists, anti-IgE. External anti-itch therapy consists of local application of emollients, topical glucocorticosteroids, topical calcineurin inhibitors, topical anti-histamines, reparants and epithelializing medications. Purpose — to increase knowledge about features of etiopathogenetically-based anti-itch therapy of allergic dermatoses in children. Conclusions. Treatment of itch of allergic dermatoses is diverse, complex and multi-stage, requires an individual approach to each patient, and includes: environmental control to eliminate allergenic and non-allergenic factors, systemic and local pharmacotherapy, skin care. Modern anti-itch therapy of allergic dermatoses should be etiopathogenetic and affect on local and system mechanisms of allergic inflammation with itch, it should be differentiated according to the stage of the disease, the phase of inflammation and the severity of skin manifestations and to be based on the rational use of drugs. No conflict of interest was declared by the author. Key words: children, allergy, allergic dermatoses, itch, anti-itch therapy.
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过敏性皮肤病患儿瘙痒发病特点及抗痒治疗(文献复习)
过敏性皮肤病是过敏性皮肤病,其中最常见的有:单纯性过敏性接触性皮炎、特应性皮炎、各种形式的湿疹、急慢性过敏性荨麻疹、奎克氏水肿、毒副皮炎、多形性渗出性红斑(Stevens-Johnson综合征)、急性表皮坏死松解(Lyell综合征)。所有过敏性皮肤病的临床病程都伴有瘙痒,尽管其严重程度因病种而异。过敏性皮肤病的治疗重点是控制皮肤瘙痒,因为它是主要症状。根据国际项目文件EAACI(欧洲过敏与临床免疫学学会),AAAAI(美国过敏、哮喘与免疫学学会),PRACТALL(实用变态反应学共识报告)在治疗过敏性皮肤病中占主导地位的是抗痒疗法,这需要个体化的方法和日常的皮肤护理。全身抗痒治疗包括使用以下药物:抗组胺药、糖皮质激素、膜稳定剂(kromons)、白三烯受体拮抗剂、抗ige。外部抗痒治疗包括局部应用润肤剂,局部糖皮质激素,局部钙调磷酸酶抑制剂,局部抗组胺剂,修复剂和上皮化药物。目的:提高对儿童过敏性皮肤病的病因遗传学抗痒治疗特点的认识。结论。过敏性皮肤病瘙痒的治疗是多样、复杂和多阶段的,需要针对每个患者采取个体化的治疗方法,包括:环境控制以消除致敏性和非致敏性因素、全身和局部药物治疗、皮肤护理。现代对变应性皮肤病的抗痒治疗应是病原性的,并对伴有瘙痒的变应性炎症的局部和系统机制产生影响,应根据疾病分期、炎症期和皮肤表现的严重程度进行区分,并以合理用药为基础。作者未声明存在利益冲突。关键词:儿童,过敏,过敏性皮肤病,瘙痒,抗痒治疗。
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