Nowadays, approximately 15-35% of the population are affected by allergic diseases, mainly those with genetic predisposition to allergies. Environmental and domestic factors, food, pollen, bacterial, fungal, and other allergens, climatogeographic and environmental living conditions, non-rational drug intake and other numerous factors play a key role in the development of allergic disorders.
Respiratory diseases rank number one among causes of morbidity in children and adolescents and number three among causes of death. This determines the importance of timely diagnosis and the ability to provide therapeutic and preventive care to children. Since diseases of the respiratory system are sometimes allergic in origin, they will be discussed in one chapter, rather than separately.
Atopic dermatitis
According to the Clinical Recommendations of the Ministry of Health of Russia (2020), atopic dermatitis (AD) is a multifactorial skin disease characterized by itching, chronic relapsing course, and age-related features of localization and morphology of lesions. In most cases, AD begins in infants with genetic predisposition, and continues into adulthood, often associated with genetic asthma, allergic rhinitis, conjunctivitis and other allergic diseases.
Atopic dermatitis is often the initial step in the so called atopic march.
Etiology and pathogenesis. In childhood, food allergy is of primary importance in patients with atopic dermatitis. In children of the 1st year of life, cow's milk protein is the causative allergen in 70-90% of cases. Such products as egg white, peanuts, nuts, soy, fish, seafood, wheat etc. are considered highly allergic (fig. 5.1, a). The spectrum of allergens expands with age: house dust, pollen from plants and trees, bacteria, viruses, fungi, etc. (fig. 5.1, b).