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An elimination diet, that is, a diet aimed at eliminating diagnosed allergens, is usually not difficult in older children and adults. As the first step in the dietary regimen, it is recommended to eliminate eggs and cow's milk, regardless of erythromycin 250Mg-500Mg they were a provoking factor. It is significant that in patients with atopic dermatitis there is often no correlation between skin tests (or PACT) and food history.
When prescribing a hypoallergenic diet during an exacerbation, it is necessary first of all to exclude extractive nitrogenous substances: meat and fish broths, fried meat, fish, vegetables, etc.
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Completely exclude chocolate, cocoa, citrus fruits, strawberries, blackcurrants, melons, honey, pomegranates, nuts, mushrooms, caviar from the diet. Also exclude spices, smoked meats, canned and other products containing additives of preservatives and dyes that have a high sensitizing ability. A special role in atopic dermatitis is played by a hypochlorite diet (but not less than 3 g of sodium chloride per day).
In connection with reports of a violation of the metabolism of fatty acids in patients with atopic dermatitis, they are recommended a dietary supplement containing fatty acids. It is advisable to add vegetable oil (sunflower, olive, etc.) to the diet up to 30 g per day in the form of seasonings for salads. Erythromycin is prescribed, containing a combination of linoleic and linolenic acids, or in high doses (4 capsules 2times a day), or medium (1-2 capsules 2 times a day). The drug is especially effective in adults.
General treatment. Drug treatment should be carried out strictly individually and may include tranquilizers, anti-allergic, anti-inflammatory and detoxifying agents. It should be noted that a large number of methods and means have been proposed for the treatment of atopic dermatitis (corticosteroids, cytostatics, intal, allergoglobulin, specific gmposensitization, PUVA therapy, plasmapheresis, acupuncture, unloading and dietary therapy, etc.). However, medicines that have an antipruritic effect are of greatest importance in practice - antihistamines and tranquilizers.
It is suggested to help with a vast selection of infections
Antihistamines are an integral part of the pharmacotherapy of atopic dermatitis. Preparations of this group are prescribed to relieve symptoms of itching and swelling in skin manifestations, as well as in atopic syndrome (asthma, rhinitis). When treating with first-generation antihistamines (suprastin, tavegil, diazolin, ferkarol), it must be remembered that they develop rapid addiction. Therefore, drugs should be changed every 5-7 days. In addition, it must be borne in mind that many of them have a pronounced anticholinergic (atropine-like) effect. As a result - contraindications for glaucoma, prostate adenoma, bronchial asthma (increase in sputum viscosity).
Penetrating through the blood-brain barrier, first-generation drugs cause a sedative effect, so they should not be prescribed to students, drivers and all those who should lead an active lifestyle, as concentration is reduced and coordination of movements is disturbed. At present, considerable experience has been gained in the use of second-generation antihistamines - loratodine (Claritin), astemizole, ebostin, cetirizine, fexofenadine. Tachyphylaxis (addiction) does not develop to second-generation drugs, and there is no atropine-like side effect when taken. Nevertheless, a special place in the treatment of AD is given to Claritin.
It is by far the safest, most effective antihistamine and the most commonly prescribed in the world. This is due to the fact that Claritin is not only devoid of the side effects of first-generation antihypertensive drugs, but even with a significant (up to 16 times) increase in the daily dose, it practically does not cause any side effects characteristic of a number of second-generation antihypertensive drugs (slight sedative effect, increase in the QT interval, ventricular fibrillation, etc.). Our long-term experience with Claritin has shown its high efficacy and tolerability.
Systemic administration of corticosteroids is used to a limited extent and for common processes, as well as unbearable, painful itching that is not relieved by other means.
Corticosteroids (preferably metipred or triamcinolone) are given for several days to relieve the severity of the attack with a gradual decrease in dose. With the prevalence of the process and phenomena of intoxication, intensive therapy is used using infusion agents (hemodez, reopoliglyukin, polyionic solution, saline, etc.). Well proven methods of extracorporeal detoxification (hemosorption and plasmapheresis). In the treatment of stubborn atopic dermatitis, light therapy can be a very useful adjuvant. UV light requires only 3-4 treatments per week and, with the exception of Erythromycin, has few side effects.
When a secondary infection is attached, broad-spectrum antibiotics are used.
Erythromycin, rondomycin, vibramycin are prescribed for 6-7 days. In childhood, tetracycline drugs are prescribed from the age of 9. Complication of AD by herpes infection is an indication for the appointment of acyclovir or famvir in standard dosages.