docruДоктор.РуTitle1727-23782713-2994ООО "ГК "РУСМЕДИКАЛ"10.31550/1727-2378-2022-21-7-41-44docru-106Research ArticleСтатьиФакторы риска развития прогрессирующего течения атопического дерматита у детей и подростковRisk Factors for the Development of a Progressive Course of Atopic Dermatitis in Children and Adolescentshttps://orcid.org/0000-0003-1758-5909СоболеваВ. А.SobolevaV. A.

Соболева Виктория Александровна — ассистент кафедры детских болезней Клинического института детского здоровья имени Н.Ф. Филатова; младший научный сотрудник лаборатории молекулярной иммунологии

119992, г. Москва, ул. Большая Пироговская, д. 19, стр. 1

19 Bolshaya Pirogovskaya Str., build. 1, Moscow, 119991

5a Maly Kazeny Lane, Moscow, 105064

vasoboleva@list.ruhttps://orcid.org/0000-0002-0363-6106КудрявцеваА. В.KudryavtsevaA. V.

Кудрявцева Ася Валерьевна — д. м. н., профессор кафедры детских болезней Клинического института детского здоровья имени Н.Ф. Филатова; ведущий научный сотрудник лаборатории иммунопатологии

119992, г. Москва, ул. Большая Пироговская, д. 19, стр. 1

19 Bolshaya Pirogovskaya Str., build. 1, Moscow, 119991

5a Maly Kazeny Lane, Moscow, 105064

kudassia@gmail.comhttps://orcid.org/0000-0003-1757-8389СвитичО. А.SvitichO. A.

Свитич Оксана Анатольевна — член-корреспондент РАН, д. м. н., профессор кафедры микробиологии, вирусологии и иммунологии имени академика А.А. Воробьёва Института общественного здоровья имени Ф.Ф. Эрисмана; директор

105064, г. Москва, Малый Казенный пер., д. 5а

19 Bolshaya Pirogovskaya Str., build. 1, Moscow, 119991

5a Maly Kazeny Lane, Moscow, 105064

svitichoa@yandex.ruhttps://orcid.org/0000-0003-0547-3686ГеппеН. А.GeppeN. A.

Геппе Наталья Анатольевна — д. м. н., профессор, заведующая кафедрой детских болезней Клинического института детского здоровья имени Н.Ф. Филатова

119991, г. Москва, ул. Большая Пироговская, д. 19, стр. 1

19 Bolshaya Pirogovskaya Str., build. 1, Moscow, 119991

geppe@mail.ruФГАОУ ВО «Первый Московский государственный медицинский университет имени И.М. Сеченова» Министерства здравоохранения Российской Федерации (Сеченовский Университет); ФГБНУ «Научно-исследовательский институт вакцин и сывороток имени И.И. Мечникова»РоссияFederal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University); Federal State Budgetary Scientific Institution “Research Institute of Vaccines and Serums them. I.I. Mechnikov”Russian FederationФГАОУ ВО «Первый Московский государственный медицинский университет имени И.М. Сеченова» Министерства здравоохранения Российской Федерации (Сеченовский Университет)РоссияFederal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)Russian Federation202216022025217ПЕДИАТРИЯ4144Copyright © Соболева В.А., Кудрявцева А.В., Свитич О.А., Геппе Н.А., 20252025Соболева В.А., Кудрявцева А.В., Свитич О.А., Геппе Н.А.Soboleva V.A., Kudryavtseva A.V., Svitich O.A., Geppe N.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://docru.elpub.ru/jour/article/view/106Цель исследования

Цель исследования: определить факторы риска развития прогрессирующего течения атопического дерматита (АтД) у детей и подростков.

Дизайн

Дизайн: наблюдательное поперечное проспективное исследование.

Материалы и методы

Материалы и методы. В исследование вошли 89 пациентов с АтД в возрасте от 2 месяцев до 17 лет. Верификация диагноза проводи лась по критериям Hanifin и Rajkа (1980), оценка выраженности изменений – по индексу SCORAD.

Результаты

Результаты. Чаще всего встречалась эритематосквамозная (ЭрС) форма АтД (n = 44; 49,4%), ЭрС форма с лихенизацией (ЭрСЛ) наблю далась у 28 (31,5%) детей, лихеноидная (Л) — у 17 (19,1%) (p < 0,05). Среднетяжелое и тяжелое течение АтД отмечено более чем в 50% случаев (p < 0,05). Показатели SCORAD были максимальными при Л форме (p < 0,05). Прогрессирующее течение заболевания чаще имело место у детей с наследственной отягощенностью по материнской линии, ранним дебютом, более коротким периодом грудного вскармливания. Увеличение продолжительности АтД влияло на риск возникновения Л форм.

Заключение

Заключение. Риск развития прогрессирующего течения АтД выше у детей с наследственной отягощенностью по материнской линии, ранним дебютом болезни на фоне непродолжительного грудного вскармливания. Клинические проявления атопического марша в основном представлены сезонным аллергическим ринитом, реже — бронхиальной астмой.

Study Objective

Study Objective: To determine the risk factors for the development of a progressive course of atopic dermatitis (AD) in children and adolescents.

Study Design

Study Design: Observational prospective cross-sectional study.

Materials and Methods

Materials and Methods. The study enrolled 89 outpatients with AD aged 2 months — 17 years. The diagnosis was verified based on Hanifin and Rajkа criteria (1980); skin disorders were assessed via SCORAD followed by statistical analysis. Family history, breastfeeding duration and symptoms manifestation were assessed.

Study Results

Study Results. Based on our results, compared to children with erythemato-squamous plaques with lichenization AD (ESPL) and lichenoid AD (L), children with erythemato-squamous plaques of AD (ESP) predominated (ESP vs. ESPL vs. L: 44 (50%) vs. 28 (31%) vs. 17 (19%) respectively (p < 0.05). Progressive AD was noticed in more than 50% (p < 0.05). SCORAD index was maximal in lichenoid AD (p < 0.05). Progressive AD is frequently accompanied with genetic predisposition on the mother’s side as well as early AD manifestation and shorter breastfeeding. Prolonged course of the disease influences the risks for lichenoid forms.

Conclusion

Conclusion. Risks for progressive course of AD is higher in children with genetic predisposition on the mother’s side, duration of breastfeeding with regard to early AD manifestation. Basically, clinical symptoms of the atopic march were related to seasonal allergic rhinitis, less often with asthma.

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