Pruritus is one of the main clinical manifestations of atopic dermatitis, and it significantly reduces the quality of life of patients in childhood. Scientific images on its pathophysiological basis have now undergone significant changes. The histamine exceptional role in pruritus development was confounded, as well as data on immune system involvement in its maintenance was given. This article presents current data on differential approaches to pruritus management depending on its etiopathogenetic characteristics. The role of dermocosmetics in restoration of the skin barrier as the first stage prevention of pruritus in atopic dermatitis was considered. The results of clinical studies showing efficacy of topical agents (innovative component with anti-pruritic action — STIMU-TEX) application are presented.

Atopic dermatitis is a chronic inflammatory disease characterized by relapsing course, severe itching, erythema and dry skin due to skin barrier defects and staphylococcus infection. According to current guidelines for the treatment of atopic dermatitis (prepared by dermatological societies) the background therapy is prolonged application of emollients directly on the skin and its use during bathing. Clinical studies have shown that repeated administration of emollients moisturizes the skin, restores its barrier and normal functioning, and reduces the amount of glucocorticosteroids needed for atopic eczema therapy in infants, children and adults. The results of trials and long-term clinical practice have proven that emollients are safe and effective in patients with atopic dermatitis. This article presents the information based on the recent data concerning emollients: their characteristics, mode of action, role in atopic dermatitis treatment, and results of clinical trials conducted in such patients.

The article analyzes the most significant genodermatoses associated with a high risk of allergic reactions that may occur in the practice of a dermatologist and pediatrician, such as ichthyosis and ichthyosiform dermatoses, Netherton syndrome and other ichthyosiform erythroderma, peeling skin syndrome, SAM syndrome, as well as congenital bullous epidermolysis. The article also describes in detail the pathogenetic aspects of transcutaneous sensitization, the development of food allergies and the listed above genodermatoses, two illustrative clinical cases are given.

Атопический дерматит (АтД) является распространенным кожным заболеванием и оказывает серьезное влияние на качество жизни пациентов и их семей. В последние годы все чаще используется термин «чувствительная кожа», подразумевающий под собой независимый синдром с субъективными ощущениями (жжение, зуд, покалывание и др.), а также утолщением и сухостью кожи в ответ на факторы окружающей среды (биотические, абиотические и антропогенные), которые не вызывают таких симптомов среди здоровых людей. В статье описан патогенез АтД с ассоциированным ему синдромом чувствительной кожи, а также алгоритм их лечения. Проанализированы параметры эффективности и безопасности 1% крема пимекролимус у детей, в том числе при нанесении на участки чувствительной кожи.

Background. Malformations in epidermal barrier in children with atopic dermatitis (AD) can cause transcutaneous sensitization with further development of allergic diseases that can worsen the AD course and significantly reduces patients’ quality of life.Objective. The aim of the study was to determine the effect of topical treatment and maintenance therapy with pimecrolimus 1% cream (PIM) and topical glucocorticosteroids (tGCS) in infants with AD on reducing the risk of developing transcutaneous sensitization (due to the levels of specific IgE to the cow milk protein over time) and on reducing the disease severity (by the EASI scale).Methods. The study included children aged from 1 to 4 months with early manifestations of moderate and severe AD. The severity of AD was estimated via the EASI scale at start of observation, then at 6, 9 and 12 months of life. The class and level of specific IgE to cow milk proteins (CMP) were determined by the ImmunoCAP method at the point of enrolment and at the ages of 6 and 12 months. Statistical analysis of studied indicators dynamics and their comparison in research groups was carried out using multifactorial dispersion analysis.Results. The study included 36 patients. All patients have received standard tGCS therapy in combination with emollients (wet wrap) for 10 days. The maintenance therapy was prescribed in postacute period. It included topical calcineurin inhibitor PIM 2 times/day for 3 months, then double application (morning/evening) 3 times/week up to the age of 1 year old (group 1). Other group had maintenance therapy — tGCS2 times/week for 3 months, and then at AD aggravation (group 2). Group 1 has shown lower level of sensitization to CMP at the age of 6 and 12 months and more significant decrease in AD severity according to EASI scale compared to group 2.Conclusion. The treatment with PIM is effective in therapy of AD and prevention of transcutaneous sensitization in infants.