Allergic contact dermatitis in children: the most common causes

December 3, 2020

Contact dermatitis is an inflammation of the skin in an area that has come into contact with an irritating substance or environmental factor. Children under 12 years of age are most susceptible to the disease. The point is the structural features of children's skin and the weakness of its protective mechanisms. The disease manifests itself in any area that has been in contact with the irritant, but more often on the face, arms, neck, and groin area.

If the provoking agent is recognized in time and the child is protected from it, the inflammation is well treated and the symptoms quickly pass. When the cause is difficult to identify or parents do not consult a doctor on time, the course of the disease becomes more severe.

Contact dermatitis occurs:

• simple - local irritation by some factor;
• allergic.

The second option will appear when the child has an increased sensitivity to this substance. The first interaction with it is outwardly unnoticeable, but chemicals are formed in the skin that bind to immune cells - T-lymphocytes. Immune cells remember the stimulus. Upon repeated contact, which can occur after a long time, T-lymphocytes trigger an allergic reaction and cause skin symptoms.

What is atopic dermatitis

Atopic dermatitis is a chronic skin disease characterized by a relapsing course.
Babies with atopic dermatitis are bothered by itching and dry skin. Foci of inflammation can be located throughout the body, but they especially “love” children’s cheeks and folds, as well as the area under the diaper. Statistics indicate that atopic dermatitis occurs in every fifth baby [1]. Why is he dangerous? Lack of treatment can lead to the development of severe forms of atopic dermatitis, the spread of inflammation and the atopic march. In this condition, the disease begins to “march” through the child’s body, provoking the appearance or exacerbation of concomitant diseases. In 20-43% of cases, the development of bronchial asthma is possible, and twice as often - allergic rhinitis or eczema [2].

In addition, disruption of the hydrolipid barrier that occurs with atopic dermatitis in children can cause a secondary infection. Unfortunately, atopic dermatitis cannot be “outgrown.”

Stages of childhood vitiligo

The disease in children has the same stages of development as in adults:

• Initial. First, one small spot appears, which may not increase in size for a long time and is a single spot.
• Progressive. It is characterized by the appearance of a large number of new spots over several weeks and an increase in the size of old ones.
• Repigmentation. This stage is diagnosed if no new foci of the disease have appeared for several months, and existing spots darken, do not grow, and in some places completely disappear.

Parents should know that vitiligo is prone to recurrence. If you manage to completely get rid of the signs of the disease, it may return after some time.

Symptoms of atopic dermatitis in children

According to recent studies [3], in 45% of babies, atopic dermatitis debuts between the ages of two and six months. In 60% of patients during the first year of life.

With atopic dermatitis in children, clinical symptoms and localization of inflammation largely depend on age. There are infant (up to one and a half years), child (from one and a half years to puberty) and adult phases. The following symptoms are common to all phases:

1. Severe dryness of the skin (xerosis), which cannot be treated with regular baby cream .
2. Redness and inflammation on the skin (especially symmetrical ones).
3. Itching, causing severe discomfort to the child.
4. Recurrent course (alternating periods of remissions and exacerbations). Moreover, in the cold season, deterioration is more often observed, and in the warm season, improvement is observed.

According to the nature of the course, acute and chronic stages of atopic dermatitis are distinguished, which are expressed by different signs (symptoms):

● Acute stage. Rough red spots (erythema), nodular rashes (papules), swelling, and crusts (including weeping) may appear on the baby's skin.

● Chronic stage. Accompanied by lichenification (thickening of the skin), cracks on the soles and palms, scratching, and increased pigmentation of the skin of the eyelids.

White spots on the skin: photodermatitis

04.10.2021

What to do if white spots appear legs , chest Will this really stay forever?

White spots on the body, especially in the indicated places, are a manifestation, that is, a symptom of a particular disease. Very rarely, in individual cases, spots are an independent disease. It is important to know whether pigmentation appeared on its own, or whether it is a consequence of past rashes, vesicles, papules, pimples , etc. This is a very important point, one might say that it is key in making a diagnosis. A correct diagnosis guarantees correct treatment.

In most cases, the described spots on the skin are a manifestation of the so-called “sun allergy”, or more precisely, photodermatitis. This allergy does not mean that if you go out into the sun you will always get spots. Photodermatitis is caused by the fact that ultraviolet rays react with certain substances on the skin or in the skin, forming spots. Very often, the spots are preceded by a rash, or “pimples,” but it happens that just spots appear, which can be either white or any other color.

Photodermatitis is divided into exogenous and endogenous. Accordingly, exogenous dermatitis is a reaction of ultraviolet radiation with carcinogenic substances on the surface of the skin. Such substances include cosmetics (deodorants, creams, ointments, perfumes, lipsticks, etc.), pollen, and other substances released by the environment.

As a remark, you can make the following: The most carcinogenic substances found in perfumes and most often causing photodermatitis include: Eosin, para-aminebenzoic acid, retinoids, essential oils, salicylic acid, mercury preparations, phenol. Also, spots of this type can appear after cosmetic procedures ( peeling , tattooing, etc.)

Endogenous photodermatitis is caused by an ultraviolet reaction, or by ultraviolet reaction products in the skin itself. Especially often, photodermatitis manifests itself in diseases of the liver , gastrointestinal tract, and endocrine system .

You need to understand whatever dermatitis or other disease is, it is primarily an allergic reaction , against the background of decreased immunity .

If your problem appeared in the spring, when the sun begins to shine more and warmer, and all the plants begin to turn green and bloom, then we can assume that this is an allergic reaction . Moreover, the stains appeared in those places that are covered with clothing in winter, and become exposed with the arrival of warm weather.

Whatever the reason, be sure to consult a dermatologist and allergist . It is rare to achieve a quick positive result by simply adjusting your lifestyle, although this is extremely important.

You need to take a number of antihistamines, use special ointments, creams or gels, and apply special cosmetic procedures.

We hope our answer helped you and you will soon solve your problem. We wish you and your loved ones all the best.

Published in Dermatology Premium Clinic

Causes of atopic dermatitis in children

Atopic dermatitis can be considered a hereditary disease, because the most important role in its occurrence is played by a genetic factor [3]:

• In 80% of children, it occurs if both parents have or have had atopic dermatitis.
• In more than 50% of children - if at least one of the parents was sick, especially the mother (this doubles the risk of transmitting the disease “by inheritance”).

Some prenatal factors can also provoke atopic dermatitis in a baby: for example, poor nutrition of the expectant mother, contact with toxic substances, infections suffered during pregnancy, as well as bad habits and stress.

In addition, atopic dermatitis more often develops in babies who suffered oxygen deprivation during childbirth, were born prematurely and were bottle-fed (perinatal factors).

Diagnosis of atopic dermatitis in children

For a long time it was believed that atopic dermatitis in children is predominantly an allergic disease. However, it has now been proven that this is, first of all, a disease with dysfunction of the epidermis! And food allergies are detected only in 30-40% of children with atopic dermatitis.

The symptoms of atopic dermatitis are almost always influenced by certain environmental triggers. This could be chlorinated or “hard” water, soap, contact with an allergen, unfavorable climate and even stress. Another common trigger is bacteria that enter the skin through a damaged epidermal barrier.

Only a doctor (pediatrician, dermatologist, allergist) can make a diagnosis of “atopic dermatitis in children”! It takes into account the presence of external signs of disease and itching, as well as hereditary factors. Laboratory tests may be prescribed for children to carry out diagnostics. For example:

• General detailed (clinical) blood test.
• Biochemical general therapeutic blood test.
• General (clinical) urine analysis.
• Study of the level of total immunoglobulin E in the blood.
• Skin testing with allergens.
• Skin biopsy.

Treatment of atopic dermatitis in children

In modern medicine, there are three degrees of severity of atopic dermatitis in children:

1. Easy. The child responds well to treatment, remission can last more than 10 months, the itching is minor, the redness is slight. Exacerbations occur no more than twice a year.
2. Medium-heavy. Exacerbations occur 3-4 times a year, and periods of remission are reduced to 2-3 months. The therapy gives less pronounced results, the redness “stubbornly” returns.
3. Heavy. Long-term exacerbations are interrupted by short periods of remission - up to one and a half months. Treatment helps little or for a short period of time; the baby’s behavior is greatly affected by itching [4].

At all stages of atopic dermatitis, pediatricians and dermatologists recommend emollients - cosmetic skin care products. They moisturize the skin and help restore the level of lipids - the most important structural components. During periods of exacerbation, emollients can be applied frequently and generously.

Pay attention to the composition; it is advisable that emollients are not addictive. Their main tasks are to help the skin produce its own lipids, providing effective hydration and softening. In addition, the constant use of emollients prolongs periods of remission and alleviates the symptoms of atopic dermatitis.

The Mustela Stelatopia line of cosmetics will help restore skin comfort for a long time! Stelatopia emollients are effective at all stages of atopic dermatitis , incl. at its first signs - increased dryness of the skin.

Studies have confirmed that the use of Stelatopia emollient cream can reduce the likelihood of developing atopic dermatitis by 51% ! [6]

Treatment (use of hormonal drugs) for atopic dermatitis in children can only be prescribed by a doctor, taking into account age, symptoms, concomitant diseases and test results. Self-medication can be dangerous!

• For external therapy for moderate and severe degrees of atopic dermatitis, topical glucocorticosteroids, topical calcineurin inhibitors and others are used.
• In case of mild disease, the use of Stelatopia Emollient Cream reduces the severity of inflammation after 32 hours, due to the presence of sunflower oil in the distillate [5].
• In systemic therapy, the drugs dupilumab, cyclosporine, glucocorticosteroids and others are used orally or in injection forms.
• To relieve itching - clemastine, hifenadine, cetirizine, chloropyramine, levocetirizine and others. The use of Stelatopia emollient cream as a cosmetic skin care product reduces the severity of itching in 80% of cases [7].
• Physiotherapy treatment may include phototherapy. Sometimes, in the treatment of atopic dermatitis, diet therapy, acupuncture, plasmapheresis and some other methods may be prescribed.

Treatment methods

Basically, the treatment of childhood vitiligo is aimed at restoring metabolism in the child’s body, since most often it is metabolic disorders that become the cause that affects the insufficient production of skin pigment. For treatment to bring positive results, it is advisable to use an integrated approach.

Symptomatic therapy

Its main goal is the maximum restoration of the lost pigment formation function. For this use:

• Local application of corticosteroids.
• Photosensitizing agents that restore normal pigmentation in affected areas of the body.
• In the case of a generalized type of disease, photochemotherapy is used.
• Herbal medicines.
• Ultraviolet treatment (its plus is safe for children over 3 years old)

To make the cosmetic defect less noticeable, skin whitening procedures are performed to reduce the contrast between healthy and depigmented skin.

Drug treatment

The following groups of medications are used for drug therapy:

• Glucocorticoids.
• Antioxidants.
• Immunomodulatory agents.
• Photosensitizing hormonal drugs.
• Multivitamin complex.

Surgery

The main methods of this treatment:

• Autoplasty (affected skin is replaced with healthy skin).
• Transplantation of own or donor melanocytes.
• Transplantation of cultured epidermis.
• Application of tissue genetic engineering.

Such actions are carried out only in extreme cases, since there is a high probability of rejection or suppuration of the transplanted tissue.

It is possible to cure leukoderma, but the final result will primarily be influenced by timely diagnosis of the disease and a well-chosen course of therapy.

Prevention of atopic dermatitis in children

For atopic dermatitis, primary, secondary and tertiary preventive measures are distinguished.

Primary prevention

is aimed at preventing the occurrence of atopic dermatitis in children.

Recommended:

• Expectant mothers with a tendency to allergic reactions should exclude allergenic foods from their diet.
• Introducing complementary foods to babies begins at four months of age.
• Pregnant women and newborns at risk should take probiotics containing lactobacilli.
• Practice breastfeeding whenever possible.
• Eliminate exposure of your baby to tobacco smoke.
• Maintain humidity levels and regularly ventilate the children's room.

Secondary prevention

is aimed at eliminating risk factors that, under certain conditions (stress, weakened immunity, etc.) can lead to the occurrence, exacerbation and relapse of atopic dermatitis.

Recommended:

• Regular consultations with specialists.
• Maintaining awareness of new research and drugs in the treatment of atopic dermatitis.

3.Tertiary prevention

is a set of measures aimed at preventing exacerbations or development of complications of atopic dermatitis.

Recommended:

• Avoid contact of the baby with provoking factors: soap (it dries the skin), clothes made of rough or synthetic fabrics, low-quality cosmetics, etc.
• Take care of your child's skin and apply emollients on a regular basis, including during periods of remission.

• Bath your baby daily using cosmetic cleansers for atopic skin.

[1] Isaac Steering Committee. (1998). Worldwide variation in prevalence of symptoms of asthma. The Lancet, 351, 1225-1235. (International Committee on Asthma and Allergy in Childhood 1998. Worldwide differences in the prevalence of asthma symptoms. The Lancet, 351, 1225-1235). [2] Studies Watson W., 2011, Larsen F.S., 2002, Draaisma E., 2015, ISAAC Steering Committee, 1998. (Studies Watson W., 2011, Larsen F.S., 2002, Draaisma E., 2015 International Committee on the study of asthma and allergies in childhood, 1998). [3] Clinical guidelines. Atopic dermatitis, 2021. [4] Atopic dermatitis: recommendations for practitioners. Russian national consensus document on atopic dermatitis. Ed. P.M. Khaitova, A.A. Kubanova. M.: Pharmacus Print, 2002. 192 p. [5] ODT and inflammation June 2010 [6] Scientific dossier “Atopic-prone skin: latest discoveries” [7] Test report “Stelatopia” emollient cream, self-assessment by users