Сучасні підходи до лікування пацієнтів з атопічним дерматитом

Abstract

Modern approaches to the treatment of patients with atopic dermatitis. Atopic dermatitis (AD), also known as atopic eczema, is a chronic, relapsing skin condition characterized by an inflammatory process that affects a significant percentage of children and adults. The pathogenesis of AD is multifactorial, involving genetic predispositions and immune system dysfunctions that heighten skin sensitivity to external triggers. Approximately 10–20% of children and 1–3% of adults suffer from AD, with symptoms often manifesting within the first year of life. The clinical presentation varies by age, with more chronic lesions and severe itching observed in older children and adults. In infants, the disease often presents as exudative lesions, while in older children and adults, it manifests as lichenified papules and plaques. Management of AD requires a comprehensive approach aimed at improving patients' quality of life and controlling symptoms. Key components of treatment include emollients to maintain skin barrier function, anti-itch therapies to minimize discomfort, and topical corticosteroids (TCS) to manage inflammation. The effective use of TCS is crucial, as they help to reduce inflammation and alleviate symptoms like erythema and pruritus. However, secondary bacterial infections, often from Staphylococcus aureus, complicate AD cases, necessitating the use of combined topical preparations that include corticosteroids and antibiotics. The effectiveness of a combined topical ointment, Cremgen, which contains fluocinolone (a potent corticosteroid) and gentamicin (an antibiotic). This combination offers a synergistic effect, improving clinical outcomes by reducing inflammation and controlling infections more effectively than monotherapy. The combined treatments represent a viable strategy for managing AD, highlighting the importance of further research to enhance therapeutic protocols and patient care.

Атопічний дерматит (АД), або синдром атопічної екземи/дерматиту (AEDS), що був запропонований Європейською академією алергології та клінічної імунології (European Academy of Allergy and Clinical Immunology, EAACI) у 2001 році як альтернативна назва, представляє собою хронічне рецидивуюче захворювання шкіри. Патогенез дерматоза є багатофакторним, де ключову роль відіграють як спадкові чинники, так і порушення імунної системи. Спадкові дефекти сприяють підвищеній чутливості шкіри до зовнішніх подразників, тоді як імунні збої провокують ненормальну реакцію організму на певні тригери, що зрештою веде до запального процесу.