Atopic Dermatitis in Children: Differential Approach to the Choice of Treatment Strategy

The study considers advantages of differential approach to the treatment of children (Ch) with different immunopathogenetic phenotypes (IPGF) of atopic dermatitis (AD). It has been found that patients with non-IgE-mediated type of AtD was not sensitization to IgE to house dust mite allergens (HDMA) and was observed a decline in macrophage-phagocytic component of immune system (MPCIS). It was shown, that the IgE-mediated phenotype includes 3 forms of AtD: allergic form; mixed form (in combination with allergic rhinitis, asthma); immunocompromised form (ICF). Allergic and mixed have a proven sensitivity to non-eliminated HDMA, which promoted allergization and provoked the development of symptoms in the course of AtD, and in Ch with ICF of AtD a decrease in parameters of MPCIS (such as phagocytic number, phagocytic index). On the basis of immune system disorders (ISD), has been developed a different complex of immunotherapy (CIT). The developed algorithm of examination and diagnosis of patients with AtD allows the choice of an adequate CIT in accordance with IPGF based on detected of immune system disorders (ISD). Implementation of individual treatment allowed to reduce the risk of developing severe and chronic AD and to improve the quality of life of patients.