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Introduction. The combination of atopic dermatitis (AD) with allergic contact dermatitis (ACD) or the occurrence of ACD on the background of atopic dermatitis is called the overlap syndrome. Studies have demonstrated several reasons why patients with AD have a similar or even increased risk of developing ACD compared to those without AD. Allergens and haptens are trigger factors in a group of patients with AD and ACD overlap syndrome. The aim of the study. To confirm the diagnosis of ACD in a group of patients with AD – diagnose the overlap syndrome and analyze which allergens and haptens were the trigger factors in this group. Materials and methods. To confirm IgE-dependent sensitization in atopic dermatitis, skin prick tests or determination of specific IgE in blood serum were performed. Skin patch tests (European series S-1000) were performed to determine the mechanisms of delayed-type hypersensitivity. Results. It was found that the highest specific weight of positive allergic reactions has been recorded in response to the following allergens: ticks, ticks/ambrosia, birch and mold. The absolute majority of patients demonstrated positive specific IgE-dependent sensitization to Dermatophagoides pteronyssinus and Dermatophagoides farinae – 24 (50%), in turn, on Ambrósia – 14 (29.2%), and on Alternaria alternata – 8 (16.7%). Also, the reaction was most often recorded to haptens: cobalt, nickel, formaldehyde, PPD, textile dyes. Deterioration of the clinical course and shortening of AD remission periods were observed due to the formation of ACD against the background of impaired skin barrier function and the presence of chronic immune inflammation. Conclusions. Patients with AD are more often diagnosed with ACD, which predictably worsens the course of AD. Patients with confirmed overlap syndrome "AD + ACD" most often show reactions to haptens: Cobalt, Nikel, Formaldehyde, PPD, Textile dye mix – and in the vast majority to 2 haptens or more in one patient.

Introduction. Social and environmental disasters in recent years have induced an increase in morbidity, which poses a threat to the health and life of the population not only in Ukraine but also in the world. Among the most common skin diseases is atopic dermatitis (AD), a chronic recurrent disease characterized by skin inflammation, disruption of the epidermal barrier, and, as a result, a decrease in the skin's ability to retain moisture. Today general practitioners are usually the first to encounter this pathology, and they must assess self level of competence in a particular case and provide the necessary medical care or justify a referral to a dermatologist. The aim. To carry out an analytical review of domestic and foreign literature on the problem of atopic dermatitis (AD), methods of diagnosis and personalized approach to the treatment of this disease and to substantiate further directions of necessary scientific research to improve appropriate medical care. Materials and methods. A search, synthesis and analysis of world and national scientific publications on a personalized approach to the diagnosis and treatment of atopic dermatitis were conducted. A systematic approach, bibliosemantic method and method of structural and logical analysis were applied. Results and discussion. AD occurs with a frequency of up to 20% among children and up to 10% among adults in European countries. In Ukraine, as of 2020, the prevalence of AD among the pediatric population ranges from 9.0 to 28.5%. The study of the complex pathogenesis of the disease, where genetic factors, immune dysregulation and epidermal barrier disorders play a key role, has allowed scientists to identify endotypes and phenotypes of AD, which has become an important step in the development of personalized therapy for patients with AD. It was biological drugs (blockers of IL-4 and IL-13 and JK-inhibitors) that made a breakthrough in the treatment of severe AD. Another promising direction in the treatment of AD is the use of probiotics, as it is known that in patients with AD there is a decrease in the number of commensal bacterial skin flora and colonization of the skin with S. aureus. Conclusions. Thus, the incidence of atopic dermatitis, which is characterized by a complex etiopathogenesis, is increasing every year in the population of Ukraine and the world. The medical and social significance of AD opens up new challenges for the search for new approaches to the management of patients with AD. In recent years, biologic therapies have been actively introduced into medical practice, opening up new opportunities for personalized management of patients with severe forms of AD. As for the treatment of mild and moderate forms of AD, the issue is still relevant, given the problem of corticophobia in society. That is why at this stage, attention to the treatment and prevention approach should be more focused, and treatment methods with high efficacy and low side effect profile should be a priority. The literature review revealed that the problem remains relevant, despite the large number of studies on the etiology, pathogenesis and treatment of AD, which substantiates promising areas for the development and application of methods of modern effective personalized treatment of AD.

Introduction: Atopic dermatitis (AD) is a chronic and refractory inflammatory skin disease characterized by relapsing eczematous and pruritic skin lesions. Understanding the specific gene expression patterns associated with AD is crucial for advancing diagnosis and targeted treatment development. Using bioinformatics methods, candidate genes and biological pathways involved in AD pathogenesis were identified based on gene expression profiles in the Gene Expression Omnibus (GEO) database. Materials and Methods: A comprehensive analysis of four pooled transcriptomic datasets obtained from the Gene Expression Omnibus (GEO) database were conducted. Differential gene expression analysis was performed using the GEO2R. The differentially expressed genes (DEGs) between lesion skin of AD patients and normal skin of individuals were analyzed using the Gene Ontology (GO) term enrichment analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway, and protein-protein interaction (PPI) network to explore the functional roles of these genes. Results: Among the patient-level gene expression datasets, we identified 133 shared DEGs, consisting of 48 upregulated genes and 85 downregulated genes. GO analyses revealed these DEGs to be significantly enriched in biological processes including inflammatory responses, cytokine-mediated signaling pathway. These DEGs were also enriched in the KEGG pathway, including viral protein interaction with cytokine and cytokine receptor, C-type lectin receptor signaling pathway, cytokine-cytokine receptor interaction, JAK-STAT signaling pathway, and Adipocytokine signaling pathway. Conclusion: By comparing with other studies using the same method, we found that in addition to the already confirmed pathways such as inflammatory response, different studies have found changes in different hub genes and metabolic pathways, which prompts us to develop individualized treatments for AD.

Introduction: Atopic dermatitis is an inflammatory disease which can significantly affect quality of life of patients. Especially severe forms of this disease are challenging to treat and for a long time forms of treatment have been limited. Because of that- it is crucial to find new ways of treatment which can be registered and impove moderate and severe dermatitis. Aim of study: Fundament purpose of this literature review is focusing on effectiveness, safety, side effects or different potential medical applications of Dupilumab. The main question, which is formulated in the title- is Dupilumab a chance for patients with moderate to severe atopic dermatitis? State of knowledge: Nowadays Dupilumab is well known drug and a lot of trials and analysis focus on efficacy, safety in treatment of moderate and severe dermatitis. The development of Dupilumab and different potential, clinical applications is also a chance for other groups of patients- for example patients with asthma, chronic rhinosinusitis with nasal polyps, eosinophilic esophagitis, prurigo nodularis. Conclusion: Dupilumab is definitely a relevant and essential element of treatment therapy for patients with moderate to severe atopic dermatitis. There were many analysis and researches which confirmed effectiveness, safety level and described Dupilumab impact on many different parameteres and scales focused on symptoms and life quality of patients during treatment with Dupilumab.

Atopic dermatitis is a chronic inflammatory disease with recurrent exacerbations, persistent itching, erythema, dry skin due to damage to the epidermal barrier, and staphylococcal infections. The causative factors are mutations in the gene encoding filaggrin, dysregulation of the immune system, changes in the skin microbiome and lipids in the stratum corneum and deficiency of antimicrobial peptides AMPs. The disease mainly affects children, causing a significant deterioration in the quality of life, and its first symptoms occur in approximately 90% before the age of 5. Lesions most often appear on the bends of elbows and knees, on the face and neck, but may also affect the skin of the entire body (erythroderma). The location of the eruptions depends on age. Atopic dermatitis is the result of complex genetic, epigenetic, environmental and immunological interactions with a coexisting epidermal barrier defect. The disease is diagnosed based on the Hanifin and Rajka criteria. Treatment of atopic dermatitis is symptomatic and selected individually. They include the elimination of provoking factors, care of the epidermal barrier, and anti-inflammatory and anti-pruritic therapy.

Introduction and purpose: Atopic dermatitis (AD) is chronic inflammatory skin disorder. It typically begins in infancy or childhood and might persist into adulthood. AD is characterized by dry, itchy, eczematous skin. The lesions can vary in intensification from mild to severe according to patient age or body region. AD requires ongoing management to control the symptoms. Skin manifestations along with the demand of treatment and care regimens significantly impact quality of life (QOL) in patients with AD. Individuals suffering from this condition are more prone to developing mental health disorders, which are often linked to emotional stress they experience. Exposure to stress exacerbates AD and stimulates skin changes, which in turn leads to intensification of treatment regimens. This cause-and-effect chain can be considered as a vicious circle mechanism. The aim of the review is to highlight the phenomenon by examining current literature on this topic in order to raise the awareness of healthcare professionals regarding this subject as well as implement appropriate and complete support for patients struggling with AD. A brief description of the state of knowledge: The pathophysiology of AD is multifactorial. Numerous studies explore the impact of stress on the deterioration of AD symptoms and delve into its pathogenic concepts. Simultaneously, researchers highlight increased psychological distress in AD patients, which surpass that observed in many other chronic conditions. Summary: Psychological factors play a significant role in AD. It demands considering mental health screening and support as a part of clinical practice, treating AD patients. Further research is necessary to provide efficient and comprehensive interventions.

Introduction and purpose. Atopic dermatitis (AD) is a common chronic inflammatory skin disease that affects many children and adults around the world. It has been also empirically known that some environmental factors such as exposure to the sun can be beneficial for patients with AD. The purpose of this literature review is to present positive impact, as well as challenges and risks of heliotherapy and phototherapy on patients suffering from AD. Material and methods. The article is a review of publications obtained from the PubMed database and published between 2017-2023. Based on the keywords "phototherapy" "heliotherapy"and "atopic dermatitis", 14 articles were selected. Finally, 1 meta-analysis and 3 observational studies were included in the rewiev. Brief description of the state of knowledge. People with AD have a compromised skin barrier, which favors infiltration by activated Th2 cells, and their cytokine, causing thickening of the skin. It makes management of AD challenging. It is known that most patients’ skin condition improves due to sun exposure. This is why an artificial UV radiation (UVR) is employed for the treatment. The idea is to administrate a non-ionizing radiation to the skin. Both sunlight and artificial light have a significant immunosuppressive effect on the skin. Summary. Phototherapy as well as heliotherapy improved skin condition of people suffering from AD. It was appreciable by the end of few weeks of studies and also afer 3 months, reflected by improvement in PO-SCORAD, VAS and DLQI scales. During some of the studies there have been incidents of side-effects. More research is necessary to define a long-term effect of this kind of treatment and the role of chronic and prolonged therapy of AD.

Vaccination against COVID-19 is the main global preventive measure in the fight against SARS-CoV-2. As the COVID-19 vaccine will be administered to billions of individuals worldwide during the pandemic, there exists a reasonable fear of severe adverse reactions requiring constant vigilance and careful treatment, particularly in individuals with a history of severe allergy. The aim of our study was to develop and implement an algorithm for the safe vaccination against COVID-19 in patients with pathology associated with hypersensitivity reactions. From January to June 2022, after signing the informed consent, 126 adult patients with relevant diseases in remission were included in a prospective single-center study. Complaints and case histories were collected from all patients, including comorbidity and medications received, anthropometric data were studied, a standard clinical examination was performed, tryptase in venous blood was measured, the level of control was additionally assessed in patients with asthma using the asthma control test and spirography. According to the results of the study, it was proven that vaccination against COVID-19 in patients with pathology associated with hypersensitivity reactions is safe, on condition of prior consultation with an allergist and performing vaccination in a medical institution. The algorithm developed for preparing for vaccination in the mentioned above persons consists of a careful collection of case history; assessment and, in case of absence – achieving control of the underlying disease; analysis and correction of therapy with temporary replacement of medications that are potential cofactors of anaphylaxis; determination of blood tryptase level. For safe vaccination in patients with severe allergic anamnesis, administration of 20 mg of desloratadine before each dose of the vaccine with observation after vaccination within 30 minutes is suggested.

Background. Children with atopic dermatitis may be at increased risk of developing dental caries. This problem is poorly understood and needs attention. The aim of this study was to investigate the oral health status of children and adolescents with atopic dermatitis. Materials and methods. One hundred children with atopic dermatitis aged 2 to 17 years, median of 6 [3.5; 10], and 103 children without atopic dermatitis, median age 7 [5; 12.5] years, were included in the study. Clinical parameters included age, sex, age of onset and severity of atopic dermatitis according to the SCORing AD index (SCORAD). Patients with at least one type of caries at any stage of progression (from white spots to carious lesions with pulpal damage) were included in the caries group. The risk of caries in the atopic dermatitis group and in healthy children, and the significance of the presence of asthma and allergic rhinitis for the development of caries were evaluated using the odds ratio (OR) with a 95% confidence interval (CI). Results were considered statistically significant at the p < 0.05 level. Results. Caries was detected in 46 % of children with atopic dermatitis and 22 % controls (OR = 2.9630, CI 1.6131–5.4424, p = 0.0005). In the group of allergic rhinitis, 24 patients were found to have caries, and among those without allergic rhinitis, 22 children had caries. It was found that patients with concomitant allergic rhinitis were significantly more likely to develop caries (OR = 3.4406, CI 1.4693–8.0563, p = 0.0044). No such significance was found depending on the presence of asthma (OR = 1.3986, CI 0.4913–3.9814, p = 0.5). Conclusions. Children with atopic dermatitis have a significantly higher risk of dental caries than healthy children. Based on the results of our study, clinicians should be aware of dental manifestations in patients with atopic dermatitis and recommend regular dental examinations for early caries detection.

Introduction. Atopic dermatitis is a common chronic relapsing inflammatory multifactorial skin disease. Staphylococcus aureus skin colonization increases during disease outbreaks and correlates with the severity of skin symptoms. Purpose - to evaluate the effectiveness of thyrothricin gel as an adjuvant therapy in the treatment of atopic dermatitis and the influence of polymorphisms of pattern recognition receptors on the achieving a therapeutic effect. Materials and methods. This study included patients with atopic dermatitis (n=37) aged 2-18 years from the Allergy Department of the Kyiv City Children’s Clinical Hospital No. 2. Patients were devided into two groups: a group that received thyrothricin gel on the affected skin areas 2 times a day for 7 days (the Group A) and a control group (the Group B) that received only basic symptomatic therapy. SCORAD (SCORing AD) and CDLQI (Children’s Quality of Life Index in Dermatology) scores were recorded before and after treatment, side effects were recorded during the study. Skin swabs were taken in the Group A before and after treatment. Genotyping of polymorphisms rs4696480 in the TLR2 gene, rs7309123 in the Dectin-1 gene were performed using polymerase chain reaction. Results. In both groups of children, improvement was observed in 7 days after treatment (p

Background. Atopic dermatitis is a chronic, relapsing eczema. Although atopic dermatitis occurs mainly in children, it greatly affects the life of the whole family. The purpose was to assess the quality of life of the families of children with atopic dermatitis and to study the correlation between the severity of atopic dermatitis and the quality of life of family members according to the Family Dermatology Life Quality Index (FDLQI) questionnaire. Materials and methods. The study included 104 patients with atopic dermatitis aged 6 months to 17 years (median of 6 [3; 9] years) who were treated at the Allergy Department of the Kyiv City Children’s Clinical Hospital 2. Clinical parameters included age, sex of the patients, disease duration and severity of atopic dermatitis. The latter was assessed by the SCORing for Atopic Dermatitis (SCORAD) tool. Spearman’s rank correlation index was used for analysis of correlation between FDLQI and SCORAD indicators. Р < 0.05 was considered statistically significant. Results. The quality of life of the family of 104 children with atopic dermatitis was assessed using the FDLQI questionnaire. Four parents (3.8 %) reported no impact of the disease on the family’s quality of life, 65 (62.5 %) — a mild effect, 34 (32.7 %) — a moderate impact, parents of 1 patient (1.0 %) noted a very large effect. The average FDLQI was 6.4 ± 2.8. There was a correlation between the FDLQI and the SCORAD severity index (Ro = 0.714, p < 0.01). In the subgroup of children under 4 years of age, a strong correlation between the FDLQI and the SCORAD was found (Ro = 0.789, p < 0.01). Child’s age and disease duration were not associated with the quality of life score (Ro = –0.011, p > 0.05 and Ro = 0.076, p > 0.05, respectively). In the subgroup of children aged 4–17 years, a strong positive correlation of FDLQI and the SCORAD was also determined (Ro = 0.714, p < 0.01). The age of the children and the duration of the disease were not related to the quality of life score (Ro = –0.011, p > 0.05 and Ro = –0.027, p > 0.05, respectively), although in the subgroup of younger children (4–7 years) we noted a tendency towards a greater influence of the disease on the family’s quality of life. Conclusion. In this study, most parents of children with atopic dermatitis reported a mild to moderate impact of the disease on their quality of life. The FDLQI of family members correlated with the severity of atopic dermatitis.

Introduction: Atopic dermatitis is a chronic, relapsing disease with a multifactoral etiology. The basic disorder of the atopic dermatitis is the disruption of the epidermal barrier. The family history of atopy is a high risk factor of the development of the disease. The clinical manifestations are heterogeneous and vary depending on patient’s age, disease duration and current disease activity according to the SCORAD scale. Objective: The aim of the review is to analyze the latest information on the characteristics, diagnosis and treatment of atopic dermatitis, including new biological medications. Methods and materials: The sources available in PubMed database have been analyzed using the keywords: „atopic dermatitis”, „epidermal barrier”, „SCORAD index”, „topical treatment”, „biological therapy”, „Janus kinase inhibitors”. Current state of knowledge: Atopic dermatitis is only treated symptomatically. The greatest therapeutic challenge is to reduce the pruritus which significantly impairs the quality of life. Topical corticosteroids may cause local side effects. The most severe cases of the disease require systemic treatment with immunosuppressants. Conclusions: The complex pathogenesis of atopic dermatitis is the object of research. Understanding the immunological mechanisms responsible for the development of the disease allows to introduce new therapeutic options. Previous studies have confirmed the effectiveness of biological medications in reducing disease activity, which is a chance to improve the quality of live of the patients suffering from atopic dermatitis.

The article discusses the phenomenon of allergic march, which is a progressive process of atopic disease development in allergic patients. The inflammatory process changes localization, causing various symptoms such as atopic dermatitis, food allergy, asthma, allergic rhinitis and eosinophilic esophagitis. Allergic march has a major impact on the development of asthma and allergic rhinitis. The diversity of allergic march trajectories is due to the interaction of genetic, environmental and psychosocial factors. Understanding these mechanisms is crucial to prevent effectively the progression of allergic diseases. The article also discusses the advantages of sublingual immunotherapy (SILT) in the treatment of allergic diseases. SILT shows safety profile and may be more acceptable treatment option for the patients comparing to the traditional subcutaneous immunotherapy (SCIT). There are evidence of the beneficial effects of SILT in reducing allergy symptoms and improving quality of life in allergic patients.

Vaccination against COVID-19 is the main global preventive measure in the fight against SARS-CoV-2. As the COVID-19 vaccine will be administered to billions of individuals worldwide during the pandemic, there exists a reasonable fear of severe adverse reactions requiring constant vigilance and careful treatment, particularly in individuals with a history of severe allergy. The aim of our study was to develop and implement an algorithm for the safe vaccination against COVID-19 in patients with pathology associated with hypersensitivity reactions. From January to June 2022, after signing the informed consent, 126 adult patients with relevant diseases in remission were included in a prospective single-center study. Complaints and case histories were collected from all patients, including comorbidity and medications received, anthropometric data were studied, a standard clinical examination was performed, tryptase in venous blood was measured, the level of control was additionally assessed in patients with asthma using the asthma control test and spirography. According to the results of the study, it was proven that vaccination against COVID-19 in patients with pathology associated with hypersensitivity reactions is safe, on condition of prior consultation with an allergist and performing vaccination in a medical institution. The algorithm developed for preparing for vaccination in the mentioned above persons consists of a careful collection of case history; assessment and, in case of absence – achieving control of the underlying disease; analysis and correction of therapy with temporary replacement of medications that are potential cofactors of anaphylaxis; determination of blood tryptase level. For safe vaccination in patients with severe allergic anamnesis, administration of 20 mg of desloratadine before each dose of the vaccine with observation after vaccination within 30 minutes is suggested. [ABSTRACT FROM AUTHOR]

Topicality. Up to 90% of patients with atopic dermatitis are colonized with S. aureus, with S. aureus predominance being unique to atopic dermatitis. TLR2 play a role in the presentation of S. aureus antigens in a course of atopic dermatits. Purpose - to investigate the association of rs4696480 polymorphism in TLR2 gene and S. aureus skin colonization. Materials and methods. The study included 101 patients with eczema and 84 healthy children. Skin swab cultures were taken. Subjects were classified as carriers if the cultures were positive, while those with culture found to be negative were classified as non-carriers. Genotyping for TLR2 rs4696480 was performed by using Real-time PCR. Results. We determined the prevalence of S. aureus carriage in a cohort study of atopic dermatitis patients in Ukraine. Skin culture for the presence of S. aureus was performed in 82 patients: 45.1% children had positive culture for S. aureus, 54.9% had a negative result. SCORing Atopic Dermatitis (SCORAD) index was significantly higher in S. aureus carriers (p0.05). AA genotype was significantly more frequent among S. aureus carriers (OR=2.745 (95% CI 0.865-8.708) for AT genotype, OR=7.000 (95% CI 1.852-26.462) for TT genotype. To our knowledge, the association of T16934A (rs4696480) and S. aureus colonization of lesion skin in children with atopic dermatitis have not been studied before. Conclusions. AA variant of TLR2 rs4696480 polymorphism predisposes to S. aureus colonization of skin in children with atopic dermatits. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the author.

A significant increase in the severity of clinical manifestations of various dermatoses accompanied by dry skin often increases the feeling of discomfort and itching of the skin, significantly reducing the patient's quality of life. This leads to the search for effective ways to correct the dryness of the skin and maintain the proper functioning of the epidermal barrier of the skin in various dermatoses. The aim of the study was to study the effect of using a combined emollient, which includes components of a classic emollient (with the inclusion of ceramides and substances with moisturizing and softening effects), as well as substances with antiseptic and fungistatic effects. The results of treatment of 100 patients with skin diseases and conditions accompanied by dry skin and itching were analyzed. The study group included patients with acne undergoing treatment with retinoids and external preparations with an irritating effect, patients with atopic dermatitis in remission, patients with seborrheic dermatitis, rosacea, follicular hyperkeratosis, and skin xerosis. Using the method of corneometry, the dynamics of changes in skin hydration during the use of a combined moisturizer and changes in the indicators of the dermatological index of the quality of life of patients were studied. The data obtained showed a pronounced increase in skin hydration in terms of corneometry after 2 weeks of using an emollient (by an average of 31.6 units or 160%), and after a month of observation, the changes amounted to 36.7 conv. units, i.e. increased by 185%, which proves the effectiveness of using Blue cap® foam to normalize skin hydration. The level of the dermatological index of quality of life during this period decreased from 9.9±0.2 to 7.2±0.2 points, i.e. by 2.7 points or 27%,what also indicates an improvement in the subjective attitude of patients and promotion quality of life of patients. In the course of the study, a significant improvement in skin hydration when using the combined Blue cap® foam to correct signs of skin xerosis was proven. In the case of dermatoses accompanied by itching associated with dry skin, a marked reduction in itching was noticed, as well as a significant improvement in the quality of life of the patient after a month of using the combined moisturizer.

Background. Atopic dermatitis is a common pruri­tic skin disease that causes a significant burden on patients, their families, and society. The purpose of this work was to evaluate the quality of life of children with atopic dermatitis and to study the correlation between the severity of atopic dermatitis and the quality of life according to the Children’s Dermatology Life Quality Index (CDLQI). Materials and methods. Patients with atopic dermatitis (n = 71) aged 4–17 years from the allergy department of the Kyiv City Children’s Clinical Hospital No. 2 were included in the study. The severity of atopic dermatitis was assessed by the SCORing Atopic Dermatitis (SCORAD) tool, and the quality of life — by the CDLQI. Spearman’s rank correlation coefficient was used for correlation analysis of the CDLQI and the SCORAD indicators. Correlation was considered probable at p < 0.05. Results. Atopic dermatitis had a small effect on the quality of life in 25.4 % patients, a moderate effect — in 40.8 %, a very large effect — in 19.7 %, and in 12.7 % of patients, atopic dermatitis caused an extremely large effect on the quality of life. Spearman’s correlation coefficient of severity indicators on the SCORAD and the CDLQI was Ro = 0.932; a correlation was found at the significance level of p < 0.01. When evaluating correlation indicators in subgroups of children by degree of severity, a difference was found: in patients with mild atopic dermatitis, there was no correlation (Ro = 0, p > 0.05), in contrast to the group with moderate to severe (Ro = 0.625, p < 0.01) and severe atopic dermatitis (Ro = 0.688, p = 0.01). The quality of life indicator had a positive correlation with the age of patients and duration of the disease, which may be related to a more severe course and a greater social and psychological burden for older children. Conclusions. The Ukrainian version of CDLQI is a reliable tool for asses­sing the quality of life of paediatric patients with atopic dermatitis.

Background. Atopic disorders (AtD), in particular atopic dermatitis (AD), have a complex genetic basis. There is reliable evidence for associations of thymic stromal lymphopoietin (rs_11466749 TSLP) and orsomucoid-1-like protein 3 (rs_7216389 ORMDL3) gene polymorphisms with the risk of developing mono- and polyorganic phenotypes of AtD in children. The aim of study: to determine associations between SNPs rs_11466749 TSLP and rs_7216389 ORMDL3 and the mono-organic phenotype of AD, to determine the risks of its occurrence with different variants of SNP data related to polyorganic phenotypes of AtD. Materials and methods. Two hundred and ninety-three children of the main group and 105 controls aged 3 to 18 years were recruited in the study. Patients of the main group had established diagnoses of AD, allergic rhinitis/conjunctivitis (AR/AC) and bronchial asthma (BA) in both mono- and multiorganic phenotypes, and the control group did not have AtD and suffered from the gastrointestinal diseases. All patients underwent buccal swab for genotyping the variants A/A, A/G and G/G rs_11466749 TSLP, C/T, C/C and T/T rs_7216389 ORMDL3 using standar­dized kits by the means of real-time polymerase chain reaction with restriction fragment length polymorphism (qPCR). Pearson’s χ2 test, Fisher’s exact test, Bravais-Pearson correlation coefficient (rb) and odds ratio with 95% confidence interval (CI) were used to achieve the stated study aim. The level of statistical significance was taken at p < 0.05, the trend was determined at p < 0.1. Results. The most frequent genotypes among those investigated within the mono-organic phenotype of AD are A/A and A/G rs_11466749 TSLP and C/T rs_7216389 ORMDL3. Genotype T/T rs_7216389 ORMDL3 has a significantly negative low association, and genotype A/G rs_11466749 TSLP — significantly direct medium association with mono-organic AD phenotype relative to polyorganic AD + AR/AC and AD + AR/AC + BA, respectively. There is a significantly reduced risk of developing mono-organic phenotype of AD compared to polyorganic phenotype of AD + AR/AC with the T/T rs_7216389 ORMDL3 genotype — 0.36 (95% CI 0.15–0.88). Related to the full polyorganic phenotype of AD + AR/AC + BA with the A/G rs_11466749 TSLP genotype, the risk of developing the AD phenotype is significantly increased to 5.81 times (95%CI 1.57–21.5). Conclusions. Carriers of A/A rs_11466749 TSLP, C/T and T/T rs_7216389 ­ORMDL3 genotypes have a higher risk of developing mono-organic AD phenotype than digestive disorders. Carriership of the A/G rs_11466749 TSLP genotype significantly increases the risk of the developing the mono-organic AD phenotype compared to the full polyorganic phenotype AD + AR/АC + BA, and of the T/T rs_7216389 ORMDL3 variant has a protective effect for the development of AD compared to the polyorganic phenotype AD + AR/AC.

The aim of the study The aim of this study was to assess the value of interventions aimed at improving the skin barrier and skin care products, as well as breastfeeding and early introduction of complementary foods, for the primary prevention of atopic dermatitis (AD) and food allergy in infants. Materials and methods We started a survey in the period from May 2022, which continues to this day. The survey was conducted with the help of Google forms and distributed on the Internet, as well as parents of children who applied for help at Kyiv children’s clinical hospital No. 2 and MC "Allergolog" were interviewed. The relationship between intervention methods and the development of AD and food allergy was determined using the odds ratio (OR) with a 95% confidence interval (CI). Results According to the survey data, 42,2% of children received moisturizing cream, parents of 16,5% of children reported using moisturizing oil for bathing the child, 12,4% of parents used less soap and bathed the child less often, 28,9% reported that they did not use none of these methods and means of care. AD occurred in 23,7% of children interviewed. The odds ratio for the moisturizing cream group was 68,6 (CI 3,9-1201,5), p=0,004, for the groups that used moisturizing oils for bathing – 8,9 (CI 0,4-197,6), p= 0,17, for the group where the intervention was a reduction in bathing and using soap – 7,1 (CI 0,3-186,0), p=0,24. 18,6% of respondents reported a reaction to food that occurred in the child within 2 hours after consumption. We have not found any role of emollients (OR=1,4, CI 0,4-4,9), p=0,56, moisturizing oils for bathing (OR=0,3, CI 0,03-2,6), p=0,27, and reduced use of soap and water (OR=1,4 (CI 0,3-7,2), p=0,66 for the development of food allergy. The duration of breastfeeding (more than 3 months) did not affect the risk of developing AD (OR = 0,1, CI 0,01-2,6), p = 0,19, or food allergy (OR = 1,3, CI 0,3-6,9), p=0,74. Also, the role of earlier introduction of supplementary food on the development of AD and food allergy was not shown: the OR for AD was 0,9 (CI 0,3-2,7), p=0,8, the OR for food allergy was 0,8 (CI 0,2- 2,9), p=0,76. Conclusions This study did not reveal the protective role of skin care products, breastfeeding, and early introduction of complementary foods for the development of AD and food allergies in children. A larger survey will allow us to study the effect of emollients and other preventive measures on the development of food allergies in a group of children with AD.

The peculiarity of the skin is that it acts not only as a place of synthesis of vitamin D, but also as an organ targeted for its biologically active form. The aim of our study was to analyze the level of vitamin D in patients with atopic dermatitis. There were examined 48 people aged between 18 to 55 years; they are residents of Vinnytsia and Vinnytsia region. Serum levels of vitamin D, total IgE and eosinophilic cationic protein (ECP) were determined in the subjects. The average level of vitamin D in the serum of patients with atopic dermatitis was 19.2 [11.3-25.4] ng/ml, which corresponded to a deficiency. Among those surveyed, vitamin D deficiency was found in 68.4±4.7% (n=26) while vitamin D insufficiency in 31.6±4.5% (n=12). The severe course of the disease prevailed among patients aged 18-40 years (63.33±8.79) % more than in the age group of 41 years and older, (36.67±8.8%, p

Background. Atopic dermatitis is one of the most common chronic inflammatory skin diseases. In atopic dermatitis, the diversity of the normal microflora decreases, so that the number of S. aureus prevails and the number of bacteria with antistaphylococcal activity decreases. The aim of this study was to evaluate the effectiveness of mupirocin 2% cream in the treatment of atopic dermatitis in children as an additional therapy, and the effect of the rs4696480 polymorphism in the TLR2 gene on the effectiveness of the treatment. Materials and methods. The study included patients with atopic dermatitis (n = 37), aged 1-18 years (7.9±4.9) from the Department of Allergy at Kyiv City Children Clinical Hospital №2. All children included in the study with atopic dermatitis had a positive S. aureus culture. Patients were randomized into two groups: a group receiving mupirocin 2% cream on the affected skin areas 2 times a day 10 days (group A) and a control group (group B). Children of the control group received only symptomatic therapy. The SCORAD score and CDLQI (children's dermatology life quality index) questionnaire score was recorded before and after the treatment, side effects were recorded during the study. Skin swab cultures were taken before and after treatment. Genotyping for TLR2 rs4696480 was performed by using Real-time PCR. This study was approved by the ethical committee of the O.Bogomolets National Medical University; all patients/ parents of the children gave an informed consent to participate. Statistical processing of the obtained data was carried out using the statistical package IBM SPSS Statistics Base (version 22) and the software EZR version 1.32 (graphical interface of the R environment (version 2.13.0). The difference in the effectiveness of therapy between the two subgroups and the influence of genotype on the effectiveness of therapy was determined using the Student criterion for parametric data (T) and Wilcoxon W-test for nonparametric data (W). The dynamics of indicators in each group before and after treatment were evaluated using the Wilcoxon T-test (T-W). Eeffectiveness of S. aureus eradication was estimated using the odds ratio (OR) with a 95% confidence interval (CI). Results were considered statistically significant at the level of p < 0.05. Results. In both groups of children, improvement was observed in 10 days after the treatment. In group A, the improvement in ΔSCORAD was found to be 13.8 (T-W=190.0, p

Background. Atopic dermatitis is a multifactorial di­sease in which the microbial products of Malassezia yeast may play a certain role in triggering the disease. Topical application of zinc pyrithione has an antifungal effect and can improve the course of disease. The aim of this study was to evaluate the effectiveness of zinc pyrithione in the treatment of atopic dermatitis in children by conducting a randomized clinical trial using zinc pyrithione as an adjunct therapy. Materials and methods. Sixty-two patients with atopic dermatitis were included in the study and randomly divided into two groups: 31 people received only traditional therapy, 31 — additional topical zinc pyrithione in the form of 0.2% cream. Disease severity was evaluated using the dynamics of SCORAD (SCORing Atopic Dermatitis) indicators. Specific IgE to Malassezia was analyzed in 31 patients of the main group. Results. The improvement on the SCORAD was 45 % (T-W=496.0, p < 0.001) in the group of children who received zinc pyrithione in addition to traditional therapy, in the control group — 35.2 % (T-W = 496.0, p < 0.001). Children receiving zinc pyrithione locally had statistically significantly better dynamics on the SCORAD than controls: the average value of ΔSCORAD in the main group was 17.9, in the control group — 12.6 (W = 782.5, p = 0.006). Specific IgE to Ma­lassezia mixture (m227) was evaluated in 31 children of the main group, among them 38.7 % had a positive result: 3 patients had class 1 sensitization; 1 — class 2; 4 — class 3; 4 children — class 5 of sensitization. Sensitization to Malassezia had not any impact on the effectiveness of treatment (W = 179.0, p = 0.597). Conclusions. This study demonstrated the effectiveness of a 3-week course of using zinc pyrithione in the treatment of atopic dermatitis as an adjunct therapy. Since the pathogenetic mechanism and interaction between Malassezia spp. and atopic dermatitis remain partially unclear, there is still a need for further research to understand the exact role of these organisms in the disease course and the role of antifungal drugs in the treatment of atopic dermatitis.

The prevalence of atopic dermatitis (AD) is growing rapidly among the population, treatment protocols need to be reviewed, taking into account evidence-based medicine data and the introduction of new drugs and new forms in the country's market. The aim of this study was to analyse the pharmaceutical component of treatment protocols in Ukraine, to conduct a comparative analysis of the list of medicines registered on the pharmaceutical market on 2022 (also in comparison with 2016). To determine the socio-economic affordability of TCGS for the treatment of AD at the regional level based on the availability ratio. The objects of the study were topical glucocorticosteroids (TGCS) preparations according to the State Register of Medicines of Ukraine and the online resource «Apteka online». Analysis methods: information analysis, content analysis, marketing analysis, systematization and generalization. The study of domestic protocols and the British recommendations for the treatment of AD showed that TGCS with evidence-based effectiveness are prescribed as first-line drugs, but domestic documents for the treatment of AD from 2016 need to be revised, taking into account actual evidence-based data. The results of this study of the TGCS assortment showed that as of February 1, 2022, there were 13 INN TGCS for the treatment of AD, corresponding to 104 trade names (TN) on the Ukrainian market. In 2016–2022, the assortment of TGKS increased in terms of TN by 10.6%, while imports grew by 16.1%, which indicates a positive trend in the segment. It was revealed that, compared with 2016, there is a negative trend of reducing the number of domestic producers of TCGS by 18.1%. Consequently, the share of imported TGCS preparations is 62.5%, which contributes to the growth of treatment costs. An analysis of the assortment of TKGS according to the dosage form of the release shows that the main share among domestic drugs is ointments for, and for imported drugs – cream, but very small amounts in the form of lotions, emulsions. It was found that two medicines are low available: methylprednisolone aceponate, bemethasone, medicines have an average availability: mometasone furoate, bemethasone (lotion). It was revealed that the majority of domestically produced drugs are available to patients. It has been established that the range of TGCS in the treatment of AD is import-dependent, 5 INNs are not available in domestic production. It has been substantiated that pharmacist should be aware of new TGCS, the features and duration of their administration in order to ensure good pharmaceutical care for the effective treatment of AD.

Background. Allergen-specific immunotherapy is the mainstay of treatment for inducing long-term immune and clinical tolerability of allergens in patients with IgE-mediated allergic diseases. The aim of this study was to investigate the role of sublingual immunotherapy (SLIT) as an adjunct treatment in children with atopic dermatitis sensitized to dust mites by conducting a randomized 18-month clinical trial with house dust mite extract or placebo. Materials and methods. The study included 26 children with atopic dermatitis who were sensitized to house dust mites. 12 patients received SLIT, and 14 controls received only symptomatic treatment. The activity of atopic dermatitis was assessed using the dynamics of SCORAD indicators and the СDLQI questionnaire. Results. After 18 months of treatment, the reduction in baseline SCORAD was 43.4 % in the SLIT group and 10.3 % in the placebo group (W = 104.0, p = 0.003). СDLQI also showed improvement in the SLIT treatment group (40.7 % in the SLIT group, no improvement was found in the control group, W = 106.5, p = 0.004). There were no significant differences in serum Der.p.-specific sIgE levels between the main and control groups 18 months after the start of treatment (p > 0.05). Conclusions. SLIT with dust mite extract can provide significant clinical efficacy among children with atopic dermatitis, as evidenced by a significant overall reduction in SCORAD scores and СDLQI questionnaire scores.

Introduction Probiotics are defined as "live microorganisms which when administered in adequate amounts confer a health benefit on the host" by the World Health Organization (WHO). Probiotics help to regulate innate and adaptive host immune responses by combating aggressive commensal bacteria and improving epithelial barrier function. Probiotics have shown positive results in the treatment of various inflammatory skin conditions. Aim of the study The aim of the study was to investigate the potential efficacy of probiotics in the treatment of dermatological diseases, such as acne vulgaris; atopic dermatitis; psoriasis. Materials and methods A search was conducted using PubMed and Google Scholar databases. Articles were searched in English using the following key words: probiotics; dermatology; acne vulgaris; eczema; atopic dermatitis; psoriasis. Results Probiotics reduced the amount of inflammatory acne lesions and the erythema index in acne vulgaris patients. Patients with atopic dermatitis who received probiotics also experienced an immediate and long-lasting improvement in their symptoms and skin quality. Individuals noticed enhanced skin smoothness and moisture, self-acceptance, and a decrease in the SCORAD index. It was also proven that oral probiotic supplementation successfully reduced psoriasis symptoms by lowering plasma levels of inflammatory markers such as IL-6, TNF-α, and CRP. Furthermore, the chance of psoriasis recurrence was reduced. Conclusion The reviewed literature indicates that probiotics may be helpful in treating skin conditions like psoriasis, atopic dermatitis, and acne vulgaris. Probiotics demonstrated encouraging results in the treatment of inflammatory skin conditions by altering the immune response as a result of modifying the gut microbiome.

Allergic diseases, which have a certain stage in their development from food allergy to bronchial asthma / allergic rhinitis, are much more common in children than in adults. The aim of this study was to analyze data on the prevalence and incidence of atopic dermatitis, bronchial asthma and allergic rhinitis as components of the allergic march, in children of Ukraine from 1994 to 2017 to determine the possible impact of adverse environmental factors on their development. During the same period, due to the influence of a number of factors, in particular environmental, there were significant changes in the structure of allergic diseases making up the stages of the allergic march due to an increase in the proportion of allergic rhinitis with the reduced one of asthma and atopic dermatitis. Within 24 years, the incidence of atopic dermatitis in children aged 0-6 years including, increased by 27.6%, in adolescents - by 40.5% and significantly decreased by 39.5% in children aged 7-14 years including. Most cases of allergic rhinitis and bronchial asthma were observed in schoolchildren (47.6 and 54.0%, respectively) with a slight decrease compared to 1994. In general, allergic diseases in recent years have become more common in children from 0 to 6 years and their detection has decreased in school-age children and adolescents. Over the past 24 years, in children of Ukraine a steady increase in the incidence and prevalence of allergic diseases that form an allergic march has been noted: the prevalence of bronchial asthma has increased by 69.3% and the incidence has increased by 22.9%; the prevalence of atopic dermatitis increased by 43.9% and the incidence increased by 8.3%; the prevalence of allergic rhinitis increased by 488.3% and the incidence of allergic rhinitis increased by 380.3%, with a predominance of detection of this pathology in children from regions with developed infrastructure and industry, where there are significant emissions of pollutants into the atmosphere, that have a direct moderate effect on the increase in the prevalence of bronchial asthma, the incidence and prevalence of allergic rhinitis in children.

Introduction The globe is currently experiencing a new pandemic due to the introduction of the SARS-CoV-2 strain of the human coronavirus. The virus infects people and causes COVID-19, a lung condition that can be fatal in susceptible people and is characterized by fever, pneumonia, and shortness of breath. The prevalence of hand eczema among healthcare professionals working in COVID-19 units has grown, and it has been linked to increased hand sanitation habits. Aim of the study The purpose of the study was to examine the prevalence of hand eczema as a consequence of more intensive hand hygiene among healthcare workers during COVID-19 pandemic. Materials and methods A search was conducted using PubMed and Google Scholar databases. Articles were searched in English using the following key words: hand eczema; hand dermatitis; atopic dermatitis; COVID-19; SARS-CoV-2. Results Healthcare workers developed hand eczema more frequently in COVID-19 outbreak. The risk of hand eczema was raised by frequent use of hand hygiene products, alcohol-based hand sanitizers, wearing gloves, previous atopic dermatitis history and female sex gender. Due to excessive hand hygiene the natural skin barrier function was impaired, leading to hand eczema. The use of preventive skincare products can lower the risk of hand eczema development. Conclusion Findings demonstrated positive correlation between hand eczema prevalence among healthcare professionals and COVID-19 pandemic. Hand washing and the use of disinfectants disrupt the natural skin barrier function, leading to allergic and irritating hand eczema. In order to continue practicing hand hygiene during the continuing pandemic, proper prevention strategies and education should be implemented.

Introduction: Atopic dermatitis (AD) is the most common chronic inflammatory skin disease. It is characterized by damaged epidermal barrier, skin dysbiosis and pruritus. It affects up to 20% of the population of developed countries. AD represents a heterogeneous condition belonging to the spectrum of atopic diseases. It occurs in the form of multiple phenotypes with varied pathogenesis requiring different therapeutic strategies. Aim of the study: To summarize the current state of knowledge on AD phenotypes and related therapeutic options. Methods and materials: A review of the literature available in PudMed and Google Scholar databases was conducted. The following keywords were used: "atopic dermatitis", "atopic dermatitis phenotypes", "atopic dermatitis current treatment". Results: There are many phenotypes of AD. However, due to the lack of a consistent classification system, identifying phenotypes is greatly hindered. It is possible to use the division of phenotypes into groups based on age, lesion topography, lesion morphology and patient ethnicity. Various drugs are available for the treatment of AD, but therapeutic strategies for specific phenotypes are sparse and insufficiently understood due to the problem of identifying phenotypes and the complexity of the endotypes behind them. Treatment of AD is not currently based on phenotype-specific targeted therapy. Conclusion: Development of personalized therapy for the treatment of AD requires additional research using uniform definitions of phenotypes and endotypes. It is necessary to create a classification system for AD phenotypes.

Dupilumab is a recombinant human monoclonal antibody of the IgG4 class. Its mechanism of action can most broadly be described as inhibition of interleukin 4 and 13-mediated signal transduction. These cytokines are the main drivers of inflammatory diseases such as atopic dermatitis (AD) and asthma. Currently, dupilumab is the subject of many studies and scientific articles. More and more papers are being written about the efficacy of this drug and the side effects. Based on publications from the PubMed database, we present selected cases of atopic dermatitis patients who experienced uncharacteristic and unclear hair-related changes, such as hair loss, growth and change in hair colour, after dupilumab administration.

Bacterial, allergic, parasitic and fungal skin lesions are much more common among children than among adult patients. The aim of this study was to analyze data on the prevalence and incidence of diseases of skin and subcutaneous tissue with allergic and non-allergic origin among children of Ukraine in period from 1994 to 2017. Our main purpose was to determine the possible impact of different adverse environmental factors on children`s growth, including radiation, connected with the Chernobyl disaster in 1986. Over the past 24 years Ukraine has witnessed a 10.3% increase in prevalence of diseases of skin and subcutaneous tissue among children and 8.6% raise of incidence rate with a predominance of detection of this pathology in children affected by the Chernobyl accident and children from areas of radiological control. We have found a direct influence of moderate strength on the connection between population-weighted effective dose of total human exposure (in millizieverts) in different regions of the country in the period of 1997-2011 and the incidence and prevalence of skin diseases among children aged 0-14 years, including 2011 (p

The goal of this study was to detect the risk of developing different atopic dermatitis (AD) phenotypes in children (isolated or combined with other comorbid atopic diseases (AtD)) depending on serum concentrations of cutaneous T-cell attracting chemokine (CTACK)/CCL27. The main group comprised 37 children aged 3 to 18 years old suffering from different AD phenotypes – isolated (18 patients) and combined with comorbid AtD – AR/ARC and/or bronchial asthma (21 patients). The control group comprised 47 children aged 3 to 18 years old, suffering from diseases of the gastrointestinal tract (GIT). Serum CTACK/CCL 27 concentrations were detected in all children. In the full main group, the average level of CTACK/CCL27 was significantly higher compared to the patients of the control group: 4403.6 pg/ml (95% CI: 3726.2; 5148.7, p

Vitamin D is an important substance that has a pleiotropic range of action in the human body. Its important role is to influence the cells of the immune system and regulate the body's inflammatory response. Many physiological processes at the immune level have been discovered to prove this. Vitamin D deficiency is common and results mainly from limited sun exposure at certain latitudes or from insufficient dietary supply. This likely increases the risk of many diseases, including autoimmune diseases. Numerous evidence shows that also in skin diseases such as AD or psoriasis, the level of calcitriol is of great importance, and its supplementation in the prevention and treatment of these diseases promotes frequent remissions and improves the clinical condition of patients. Therapy with high doses of vitamin D analogues can be effective and safe. The exact knowledge of the properties of this vitamin probably allows for its real and effective use in the treatment of skin diseases. However, numerous large-scale studies are still needed to more accurately determine the dosage, effects of this therapy and to use this preparation with certainty and the highest possible effectiveness in everyday medical practice.

Allergic diseases, which have a certain stage in their development from food allergy to bronchial asthma / allergic rhinitis, are much more common in children than in adults. The aim of this study was to analyze data on the prevalence and incidence of atopic dermatitis, bronchial asthma and allergic rhinitis as components of the allergic march, in children of Ukraine from 1994 to 2017 to determine the possible impact of adverse environmental factors on their development. During the same period, due to the influence of a number of factors, in particular environmental, there were significant changes in the structure of allergic diseases making up the stages of the allergic march due to an increase in the proportion of allergic rhinitis with the reduced one of asthma and atopic dermatitis. Within 24 years, the incidence of atopic dermatitis in children aged 0-6 years including, increased by 27.6%, in adolescents - by 40.5% and significantly decreased by 39.5% in children aged 7-14 years including. Most cases of allergic rhinitis and bronchial asthma were observed in schoolchildren (47.6 and 54.0%, respectively) with a slight decrease compared to 1994. In general, allergic diseases in recent years have become more common in children from 0 to 6 years and their detection has decreased in school-age children and adolescents. Over the past 24 years, in children of Ukraine a steady increase in the incidence and prevalence of allergic diseases that form an allergic march has been noted: the prevalence of bronchial asthma has increased by 69.3% and the incidence has increased by 22.9%; the prevalence of atopic dermatitis increased by 43.9% and the incidence increased by 8.3%; the prevalence of allergic rhinitis increased by 488.3% and the incidence of allergic rhinitis increased by 380.3%, with a predominance of detection of this pathology in children from regions with developed infrastructure and industry, where there are significant emissions of pollutants into the atmosphere, that have a direct moderate effect on the increase in the prevalence of bronchial asthma, the incidence and prevalence of allergic rhinitis in children. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) is a chronic recurrent inflammation of the skin with a prevalence 10-15% in children worldwide. The pathogenesis of AD is complex and insufficiently studied. Patients with AD are sensitive to viral, bacterial and fungal skin infections, because of the skin barrier function defection in an acute period. Irreversible changes of the skin barrier structure and transformation of the skin microbiota, excessive overgrowth of bacteria and fungi lead to chronization of AD. Early detection of the skin superinfection in AD may prevent chronization in early childhood. The purpose is to study the role of conditionally pathogenic fungal strains in the course of AD in children. Methods. 98 children with AD (age 3 months – 3 years) were. Transepidermal water loss, skin pH meas-urements and microbiological study were performed. Results. A group of 56 children among the 98 patients with AD had signs of a complicated course of AD due to rash and its localization, as well as the ineffective therapy with moisturizers, anti-inflammatory drugs and elimination diet, which is the first stage in the AD treatment according to the ICON recommendations. This rash was regarded as a possible fungal superinfection. 12 children out of the 56 had microbiologically confirmed contamination with fungi: Candida albicans (n = 6), Candida nonalbicans (n = 3), Hormodendrum compactum (n = 2), Aspergillus nidulans (n = 1). Detection of Spp. Malassezia did not give positive results. 89% of the children (n = 50) had verified changes of the skin pH (5.8). The patients with nontypical rash, changed pH ( 5.8) had an effective treatment with antifungul drugs and achieved remission in AD. Conclusion. Morphologically altered elements of moderate to severe rash should be regarded as a possible fungal super infection. Revealed changes in the skin pH and the background of altered clinical manifestations of AD (peeling spots with raised or scalloped edge, double contour, clear demarcated, cracks with blood secretion) should be regarded as activation of fungal microorganisms which is considered to be ethiotropically treated due to the guidelines.

Background. Searching for the fundamental pathogenic mechanisms of atopic dermatitis (AD) and improvement of options for prevention and treatment, increasing attention is paid to the state of trace elements supply of the child’s body. Particular role is given to zinc, which is one of the most versatile trace elements. The purpose was to study the features of atopic dermatitis in children depending on the serum content of zinc. Materials and me­thods. The paper presents the materials of clinical observation, clinical laboratory and instrumental examination of 168 children aged 7 to 18 years with AD. The control group consisted of 60 healthy children. The serum zinc content was determined by atomic absorption spectroscopy on a C-115-M1 spectrophotometer according to the instructions that are attached to the device. Results. More than half of children (55.6 %) had very low levels of zinc (0.35 ± 0.11 mg/l), while another 22.2 % had extremely low levels (0.12 ± 0.02 mg/l). Several features of AD clinical course were noted: more frequent episodes of acute respiratory infection, predominance of mode­rate and severe course with periorbital, perioral, perianal dermatitis, dystrophic changes and hyperkeratosis of the nails, increased hair brittleness, expressed skin dryness (2.31 ± 0.73 vs. 1.92 ± 0.69 points, p

Background. About 35 % of world population request for medical support for clinical allergy symptoms annually. Its first sign as usual is food allergy, which is diagnosed in early childhood and mainly manifests by atopic dermatitis. On the pages of special literature, the issues of terminology, clinical features and treatment of atopic dermatitis are debated a lot. In particular, the use of antihistamines for the treatment of this pathology in infants is interpreted ambiguously. The purpose is to presents our experience of using drug Fenokit. Materials and methods. The study group enrolled 50 children with atopic dermatitis (mild to moderate course) aged from 1 and 18 months old. Exclusion criteria were as follows: somatic and neurological diseases, a severe form of atopic dermatitis. The disease was monitored based on an assessment of the disease severity by the SCORAD index; severity of itching; the frequency of adverse events and side effects registered by the doctor; quality of life of patients. Results. The follow-up of children within a month revealed positive dynamics of clinical symptoms (decrease of SCORAD index from 29.2 to 3.5; itching regression from 6.4 to 0.3) and significant improvement of quality of life of patients (from 19.1 to 4.2). Four children dropped out of the study because they need additional drugs for treatment (topical corticosteroids). Three patients developed side effects (episodic nausea, irritability), but they did not require discontinuation of the drug. Conclusions. Antihistamine Fenokit makes it possible to control the manifestations of atopic dermatitis in infants effectively.

The objective of the study – to determine the comparative effectiveness of І-generation antihistamines and active metabolites of II-generation in treatment of patients with atopic dermatitis. Materials and methods. The study included 40 patients with atopic dermatitis. SCORAD scale was used for the assessment of the disease severity and Ukrainian translation of the Dermatology Life Quality Index – for the quality of life assessment. Patients were randomized into two groups that received I generation antihistamines and active metabolites of the II generation. Student's criterion or Wilcoxon criterion was used for statistical analyses. Normality of data distribution was verified using Shapiro–Wilk criterion.Results. A high ΔSCORAD (%) was observed in patients, who used I generation antihistamines. The significantly higher DLQI was in the group which used active metabolites of the II generation. ΔDLQI (%) was significantly lower in patients from the comparison group compared with individuals from the main group. Significant differences in neuroticism and state anxiety were obtained in patients from main and comparative groups with lower values in patients taking I generation antihistamines. In the group of patients before the start of treatment, the state of subdepression was noted, and in those of the main group there were no depressive symptoms at the end of the course of therapy. Conclusions. First-generation antihistamines are more effective in the treatment of atopic dermatitis compared to the active metabolites of second-generation, as evidenced by significant differences in SCORAD, ΔSCORAD (%), the severity of pruritus between groups of patients after completion of treatment. I-generation antihistamines indirectly have a positive effect on the quality of life, anxiety, depression and neuroticism, which explains the need for their priority choice in the treatment of atopic dermatitis.

Bacterial, allergic, parasitic and fungal skin lesions are much more common among children than among adult patients. The aim of this study was to analyze data on the prevalence and incidence of diseases of skin and subcutaneous tissue with allergic and non-allergic origin among children of Ukraine in period from 1994 to 2017. Our main purpose was to determine the possible impact of different adverse environmental factors on children`s growth, including radiation, connected with the Chernobyl disaster in 1986. Over the past 24 years Ukraine has witnessed a 10.3% increase in prevalence of diseases of skin and subcutaneous tissue among children and 8.6% raise of incidence rate with a predominance of detection of this pathology in children affected by the Chernobyl accident and children from areas of radiological control. We have found a direct influence of moderate strength on the connection between population-weighted effective dose of total human exposure (in millizieverts) in different regions of the country in the period of 1997-2011 and the incidence and prevalence of skin diseases among children aged 0-14 years, including 2011 (p<0.05).This fact may indicate the impact of this disaster on the occurrence and pathogenesis of skin diseases and its consequences among children. During the same period, due to the influence of a number of environmental factors, there was a significant transformation in the structure of skin diseases in children. We have witnessed double increasing of the proportion of allergic lesions of the skin and its elements. The prevalence of diseases of the skin and its elements in general has reached 28.7% against the corresponding reduction of skin infections. [ABSTRACT FROM AUTHOR]

Background. According to the European Academy of Allergy and Clinical Immunology, about 17.3 % of European population has food allergies throughout life. At the same time, an increased concentration of specific immunoglobulins E to food is determined in 12.2 % of children and adolescents and in 4.1 % of adults. Atopic dermatitis is a common chronic inflammatory skin disease affecting up to 20 % of children and 10 % of adults in developed countries. The purpose of our research was to study the efficacy of probiotics Lactiale for children and Lactiale baby in children with atopic dermatitis and food allergy. Materials and methods. We observed 97 children aged from 6 months to 9 years with atopic dermatitis and food allergy. They were divided into 2 groups. The main group consisted of 59 children who received probiotics Lactiale for children or Lactiale baby for 3 months. The control group consisted of 38 children who did not receive probiotic. They were given only general recommendations. Results. Food allergy and atopic dermatitis are one of the actual problems in modern pediatrics, because they occupy one of the dominant positions in the structure of young children diseases. It was found that the food allergy and atopic dermatitis were more severe in children of the main group, the symptoms of the disorder of the general condition and the indicators of scatological and bacteriological feces studies were significantly worse than in the children of the control group. But at the end of the study, there was a significantly better positive dynamics in the group, which additionally received probiotics Lactiale for children or Lactiale baby that testifies to its efficacy and the possibility of recommending its inclusion to the treatment regimens in allergic diseases, food allergies and atopic dermatitis in particular.

The article summarizes the data on atopic dermatitis problem in pediatric practice, in particular, the issues of its diagnosis and treatment are considered. Atopic dermatitis is the most common skin disease in children, which greatly reduces small patients quality of life. It is well known that this disease is the result of the complex interaction of defects in the barrier function of skin, immune dysregulation, and environmental and infectious agents. There are no specific diagnostic tests for atopic dermatitis. There is no pathognomonic laboratory biomarker for its diagnosis. One of the earliest and most recognized diagnostic criteria is the Hanifin and Rajka diagnostic criteria of 1980. The diagnosis is performed in the presence of three main criteria and three additional criteria. Approaches to its treatment and choice of effective and safe treatment method in childhood are particularly relevant in recent years. For children with atopic dermatitis, a differentiated, integrated approach to treatment is necessary. Successful treatment requires a multifaceted approach that involves teaching of the patient and care-takers, elimination diet in the event of a food allergy, optimal skin care, anti-inflammatory therapy with topical corticosteroids and/or topical calcineurin inhibitors, and treatment of skin infections. The main part of treatment is daily proper skin care. The use of moisturizers enhances the hydration of the skin. Emollients can reduce the inflammation and the severity of the disease. In addition, their use reduces the amount of anti-infectious agents to fight the disease.

Background. According to the data of numerous authors, the severity of atopic dermatitis (AD) strongly depends on the functional state of the digestive system. The purpose of the study is to analyze frequency and peculiarities of atopic dermatitis course in children with disorders in the biliary system. Materials and methods. A total of 168 children aged 1 to 18 years old with AD were studied. Diagnosis of AD in children was verified according to the diagnostic criteria of J.M. Hanifin and G. Rajka (1980). All patients and their parents were questioned using a survey record. General and specific IgE (pediatric panel) was determined. State of the biliary system was assessed using ultrasonography, biochemical parameters of blood serum. Statistical processing of research results was performed using standard algorithms of variation statistics. Results. According to the questionnaire results, the following risk factors for the development of AD in children and adolescents are found: burdened heredity (53.5 %), allergic manifestations during the 1st year of life (62.5 %), high IgE levels (52.3 %); factors causing exacerbation of AD (triggers): mixed allergens — 23.8 %, food allergens — 71.4 %, medicinal allergens — 17.8 %, household allergens — 5.9 %, pollen allergens — 3.4 %, temperature factor — 1.7 %, psychoemotional factor — 1.7 %, not specified — 24.6 %; artificial feeding from birth (13.1 %); the total duration of manifestation: up to a year — 11.3 %, from 1 to 5 years — 44.9 %, from 5 to 10 years — 23.8 %, more than 10 years — 20.3 %. The mean scoring value for SCORAD in patients with mild AD levels was 14.01 ± 0.63 points, with an average grade of AD of 31.04 ± 0.92 points, and in patients with severe degrees of 56.17 ± 5.23 points. The average score on the EASI scale in the examined patients aged 5 to 7 years was 8.67 ± 0.46 points. The elevated IgE level was registered in 52.3 %. The active survey and observation revealed the signs of functional disorder of the biliary tract in the majority of patients — 109 (64.8 ± 3.2 %) children. The ultrasound examination demonstrated gallbladder dysfunction in 45 (42.8 %) out of 109 children with complaints. Increase liver (up to 10 %) without changes in echostructure and echogenicity was observed in 26 (23.8 ± 0.8 %) children with AD. Conclusions. Given a high frequency of functional disorders of the biliary tract in children with AD, it is recommended to perform an ultrasound examination of the hepatobiliary system and to make the appropriate correction of the revealed violations in the complex treatment of AD on the basis of the obtained data.

Introduction. In case of weak or insufficient immune response, activation of chronic M. Epstein – I. Barr virus infection initiates different pathological disorders, one of which is allergy. Aim. To specify the features of patients with allergic diseases and to investigate clinical and laboratory peculiarities of chronic active M. Epstein – I. Barr virus infection course. Materials and methods. Totally, 298 patients, who were consulted at Lviv regional medical center of clinical immunology and allergology in 2016-2017 years with prior stratification by the presence of allergic symptoms, were examined randomly. All patients underwent clinical, laboratory and instrumental, specific allergy tests. Detection of herpes virus infections was performed by the results of molecular and genetic investigations. In general, the research involved 62 patients with verified allergic diseases, who were infected only with M. Epstein – I. Barr virus (33 (53.3 %) females and 29 (46.7 %) males aged 28.6 ± 2.4 years). The diseases were verified based on ARIA (2016), GINA (2016-2017) criteria and unified clinical protocol “Atopic dermatitis” (2016). Results. Allergic diseases constituted 20.08 %. Verified persistent allergic rhinitis as well as sensitization with house dust mites, grass and spring trees were the most common. Polysensitization was detected in 75.80 % of individuals, and hyper-IgE syndrome in 50.00 %. Chronic active M. Epstein – I. Barr virus infection was detected in 48.38 % of patients with allergic diseases (1st group). Clinical signs of allergopathy in patients of the 1st group were manifested by rhino-conjunctivitis, cutaneous syndrome (p < 0.05), transitory syndrome of expiratory breathlessness (p < 0.05) and hyper-IgE-syndrome, namely with reliably higher IgE content (p < 0.05) compared to the patients with chronic active M. Epstein – I. Barr virus infection in latent phase (2nd group). In patients of the 1st group, polysensitization and the presence of allergopathy in close relatives were more common (p < 0.05), indicating the probability of genetic predisposition to allergic diseases (p < 0.05). Conclusions. The results of investigation prove the influence of chronic active M. Epstein – I. Barr virus infection on the course of allergic diseases in adults, and indicate the applicability and perspectives of the research in this direction.

The article presents a literature review and our own experience in differential diagnosis of atopic dermatitis. Diagnostic difficulties were described on the example of the analysis of the observation of 57 children with atopic dermatitis (aged 1–5 years), and a diagnostic algorithm was offered that included three stages: clinical (detailed collection of complaints and anamnestic data), laboratory (general blood test, biochemical and coprological examination, determination of total IgE and specific IgE to gluten, and different milk fractions, serological biomarkers of celiac disease) and instrumental (skin test at the time of achieving the disease control and, if necessary, endoscopy with subsequent histological exa­mination of biopsy specimen of the small intestinal mucosa). Patients’ observation was conducted in the Lviv Municipal Children’s Allergology Center at the premises of the Non-Profit Commercial Enterprise “Lviv Municipal Children’s Clinical Hospital”. Children were examined at baseline and dynamically after 1, 2, and 3 months. Treatment effectiveness was evaluated based on the clinical symptoms, the nature and prevalence of rash, and severity of itching. The results of the study showed that in the study group, the following causes of resistance to treatment were detected in children with atopic dermatitis: 36.84 % — comorbid allergic diseases (71.43 % with uncontrolled course); 24.56 % — food allergy: 12.28 % — allergy to cow’s milk protein; 7.02 % — lactase insufficiency; 7.02 % — helminthiasis; 5.25 % — streptodermia; 3.51 % — allergy to gluten; 3.51 % — celiac disease; 3.51 % — scabies; 1.75 % — hypersensitivity to food additives (E102), and in 3.51 % of children, the cause was not identified (further research is being carried out). The need for an individual approach to the laboratory and instrumental algorithm for the diagnosis of atopic dermatitis has been described, and the results of a particular approach to diagnosis have been shown.

Background. In the structure of dermatological morbidity, the specific weight of atopic dermatitis (AD) is up to 20.0 %. The severity of AD correlates with the lesion of the gastrointestinal tract. In the opinion of almost all immunology and allergology specialists, allergen specific immunotherapy (ASIT) is the only method that is able to influence all links of the pathological process. The purpose was to determine the effectiveness of the ASIT in children with atopic dermatitis combined with the pathology of the upper gastrointestinal tract. Materials and methods. The paper presents data of clinical observation, clinical laboratory and instrumental examination of 168 children aged 7 to 18 years with AD combined with chronic gastroduodenitis (CGD). A comparative evaluation of the different treatment options was carried out in 50 children: the main group of 25 children with AD and CGD who, along with the traditional therapy as a part of outpatient treatment, underwent ASIT according to the standard schedule during the year, the comparison group consisted of 25 children with combined pathology who received standard therapy. Results. Clinical symptoms in children with CGD combined with AD were characterized by the presence of leading syndromes: pain (98.8 ± 8.9 % of patients), dyspepsia (91.6 ± 11.2 % of persons), intoxication (79.1 ± 7.2 % of patients) and cutaneous (100 %). In the group of children receiving ASIT, the mean levels of the Scoring Atopic Dermatitis index decreased by 61.8 % three months after treatment, and one year after the treatment — by 42.6 %. The corresponding indices in the comparison group decreased by 41.3 and 24.9 %, respectively (р < 0.05). The use of comprehensive treatment in children with AD and CGD reduced by 27.8 % the period of pain relief, by 14.0 % — of dyspepsia and by 25.0 % — of asthenovegetative syndromes. It was found that the relative risk of disease recurrence will decrease by 0.48 times (c2 = 3.96, p < 0.05) when this therapy is included in the treatment regimen. Conclusions. The clinical study demonstrated the positive effect of comprehensive treatment with the inclusion of ASIT on the clinical course of AD combined with CGD. The proposed comprehensive therapy was more effective than traditional treatment even in long-term follow-up.

The article presents modern information on the clini­cal application, effectiveness and safety of the first-generation H1-antihistamine — dimetindene maleate. A brief description of the drug is given, the main indicators of its pharmacokinetics and pharmacodynamics are described. The attention is focused on the main pharmacological mechanisms of the clinical effects of the drug. An analysis of the results of clinical studies using dimetindene maleate in allergic and infectious diseases of the skin in children has been carried out. A brief description is given of the drug Phenokit appeared on the pharmaceutical market of Ukraine, the main indications for its administration are substantiated.

Background. Allergic diseases (bronchial asthma, allergic rhinitis, atopic dermatitis, food allergy, acute urticaria, insect allergy) are disabling life-threatening conditions and are a cause of worldwide concern. Objective: to determine the prevalence of allergy symptoms in children and to evaluate the modern level of allergic diseases diagnosis in our country on the example of Kyiv region. Materials and methods. 1011 children from 4 age groups were surveyed: group I — 305 patients (aged 1 month — 4 years), group II — 254 children (6–7 years), group III — 254 persons (13–14 years), group IV — 198 children (15–17 years). Results. Quite high prevalence of bronchial asthma, allergic rhinitis, atopic dermatitis, food allergy, acute urticaria and insect allergy were received. At the same time, significantly low levels of diagnosing these diseases (e.g. asthma) were revealed. Despite the significant incidence of wheezing (more than 3 times in the past year of life), children from all age ca­tegories have reliably low diagnosis level of asthma (p = 0.000), especially those under 4 years of age. According to received results, the food allergy manifestations (i.e. acute urticaria and angioedema) are being detected more and more often in younger age. Conclusions. The level of diagnosing allergic diseases, particularly asthma, remains low in Ukraine, especially in children under 4 years.

The article presents the features of atopic dermatitis in children with concomitant metabolic disturbances of oxalic acid. The influence of metabolic shifts was evaluated by clinical presentation, morphofunctional parameters of the skin and the features of oxalic acid metabolites excretion. In this study, a high incidence of dysmetabolic changes was identified, their significance was determined by the involvement of different systems for oxalic acid products excretion. The increased concentration of oxalate in the urine and in the exhaled air condensate had irritant effect and is associated with the hereditary metabolic disorders, early manifestation of atopy symptoms and the intensity of skin itching, with moderate increase of immunoglobulin E level.

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Copyright of Zdorov'ye Rebenka is the property of Zaslavsky O.Yu and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)