Principles of treatment of contact allergic dermatitis: features associated with children and adolescents

Introduction. Contact allergic dermatitis (CAD) is known to be one of the most prevalent allergic diseases of skin, so its research is of a high interest. Besides clarification of modern approaches to the treatment of contact allergic dermatitis is undoubtedly of current interest. The increase in the growth of contact allergic dermatitis in children explains the relevance of solving the problem of treating the disease in this age group. Purpose of the lecture. The purpose of this lecture is to review modern approaches to the treatment of contact allergic dermatitis taking into account current clinical guidelines with an emphasis on childhood. Materials and Methods. This lecture presents consideration of modern principles of treatment of contact allergic dermatitis taking into account the specific features of pediatric practice. A non-systematic literature review was conducted. Pharmacological mechanisms of main medications used are discussed. Focus is based on rational skin therapy. Besides information is given about topical glucocorticosteroids and principles in choosing of concrete group and formulation of them. Also characteristics of topical calcineurin inhibitors are given, and their role in treatment of contact allergic dermatitis is explained. In addition, mechanism of the “vicious circle” during secondary infection and treatment tactics are described. Results. Increased prevalence of contact allergic dermatitis in children depends primarily on household contact with chemicals and metals, as well as on the use of topical medications. This should be taken into account in prescription of elimination regime. Choice of the class and the formulation of topical corticosteroids should be made differentially taking into account the age, structural features of the child’s skin, its sensitivity in different areas and the stage of the inflammatory process. Based on indications topical calcineurin inhibitors might be used in treatment of contact allergic dermatitis especially in pediatric practice. They are characterized by the absence of those side effects which are common during use of topical corticosteroids. Secondary infection which is quite often observed in CAD in childhood requires timely administration of antiseptics and combined topical medications containing corticosteroids, antibiotics and antifungal components. Conclusion. Contact allergic dermatitis has good prognosis in case of implementation of elimination measures, adherence to treatment algorithm in accordance with clinical guidelines and age-based characteristics.