medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2019-17-156-167medsovet-4728Research ArticleДЕРМАТОЛОГИЯDERMATOLOGYСовременные подходы к наружной терапии чувствительных участков кожи при атопическом дерматите у детей: фокус на топические ингибиторы кальциневринаModern approaches to external therapy of sensitive skin area in atopic dermatitis in children: focus on topical calcineurin inhibitorshttps://orcid.org/0000-0003-2954-8996СаверскаяЕ. Н.SaverskayaE. N.

Саверская Елена Николаевна, доктор медицинских наук, профессор кафедры фармации

125080, Москва, Волоколамское шоссе, д. 11

Elena N. Saverskaya, Dr. of Sci. (Med.), Professor, Chair for Pharmacy

11 Volokolamskoe shosse, Moscow, 125080

l.saverskaya@mail.ruМедицинский институт непрерывного образования, Московский государственный университет пищевых производствРоссияMedical Institute of Continuing Education, Moscow State University of Food ProductionRussian Federation201924112019017156167Copyright © Саверская Е.Н., 20192019Саверская Е.Н.Saverskaya E.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/4728

Атопический дерматит представляет собой актуальную проблему для педиатров, дерматологов и аллергологов ввиду высокой распространенности в детской популяции, хронического рецидивирующего течения и сложностей выбора тактики местной терапии. В обзорной статье приводятся данные о распространенности и особенностях клинических проявлений атопического дерматита в различные возрастные периоды. Подробно рассматриваются структурно-функциональные и иммунологические особенности кожного барьера в норме и при данной патологии. Сделаны акценты на проблемах качества жизни, комплаентности и стероидофобии пациентов с атопическим дерматитом. Особое внимание уделено концепции чувствительной кожи, определению этого понятия и локализации чувствительных участков кожи на поверхности тела. Освещены подходы к тактике выбора наружной терапии согласно Европейским рекомендациям по лечению атопического дерматита 2018 г. Представлен современный практический алгоритм назначения местных противовоспалительных препаратов (топические глюкокортикостероиды, топические ингибиторы кальциневрина) с учетом тяжести клинических проявлений заболевания и областей нанесения (участки чувствительной кожи / другие участки тела). Приведены доказательства эффективности и безопасности топических ингибиторов кальциневрина, в частности пимекролимуса, при лечении пациентов с легкой и умеренной степенью тяжести атопического дерматита, особенно в участках чувствительной кожи.

Due to high prevalence in the pediatric population, chronic recurrent course and difficulties in choosing the local therapy, atopic dermatitis is an urgent problem for pediatricians, dermatologists and allergists. The review presents data on the prevalence and features of the clinical manifestations of atopic dermatitis in various age periods. The authors consider structural, functional and immunological features of the skin barrier are considered in detail under normal and under pathological conditions. They emphasize the problems of quality of life, compliance and steroidophobia of patients with atopic dermatitis. Particular attention is paid to the concept of sensitive skin, the definition of this concept and the localization of sensitive skin area on the surface of the body. The article describes approaches to the method of choosing external therapy according to the European guidelines for the treatment of atopic dermatitis in 2018. It presents a modern practical algorithm for prescribing local anti-inflammatory drugs (topical glucocorticosteroids, topical calcineurin inhibitors) taking into account the severity of the clinical manifestations of the disease and the areas of application (sensitive skin areas/other parts of the body). The authors provide evidence of the efficacy and safety of topical calcineurin inhibitors, in particular pimecrolimus, in the treatment of patients with mild to moderate severity of atopic dermatitis, especially in sensitive skin areas.

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The authors declare that there are no conflicts of interest present.