{"id":10516,"date":"2008-01-04T11:10:20","date_gmt":"2008-01-04T09:10:20","guid":{"rendered":"https:\/\/www.synevo.ro\/afectiuni\/profil-eczemadermatita-atopica\/"},"modified":"2020-07-10T12:33:09","modified_gmt":"2020-07-10T09:33:09","slug":"profil-eczemadermatita-atopica","status":"publish","type":"synevo_diseases","link":"https:\/\/old.synevo.md\/ru\/afectiuni\/profil-eczemadermatita-atopica\/","title":{"rendered":"Profil eczem\u0103\/ dermatit\u0103 atopic\u0103"},"content":{"rendered":"<p style=\"text-align: justify;\"><span style=\"color: #00539f;\"><strong>Dermatita atopic\u0103<\/strong> <strong>(DA)<\/strong><\/span> cunoscut\u0103 \u015fi sub denumirea \u201cSindromul eczem\u0103\/dermatit\u0103 atopic\u0103\u201d (SEDA), este o afec\u0163iune inflamatorie cutanat\u0103 cronic\u0103, cu evolu\u0163ie ondulant\u0103, ce debuteaz\u0103 mai ales \u00een primul an de via\u0163\u0103, av\u00e2nd localiz\u0103ri \u015fi aspecte clinice diferite, \u00een func\u0163ie de v\u00e2rsta pacientului \u015fi de stadiul evolutiv al bolii. Reprezint\u0103 una din bolile atopice al\u0103turi de rinita alergic\u0103 \u015fi astmul bron\u015fic.<sup>1<\/sup><!--more--><br \/>Este cea mai r\u0103sp\u00e2ndit\u0103 afec\u0163iune cutanat\u0103 a sugarului \u015fi copilului mic, fiind \u00eent\u00e2lnit\u0103 la p\u00e2n\u0103 la 1\/5 din popula\u0163ia pediatric\u0103 \u015fi la aproximativ 1-3% din cea adult\u0103.<sup>2<\/sup><\/p>\n<hr \/>\n<p style=\"text-align: justify;\"><strong>Etiopatogenia <\/strong>dermatitei atopice nu este complet elucidat\u0103. \u00cen prezent se consider\u0103 c\u0103 apare pe fondul interconexiunii unor factori genetici, imunologici, de mediu \u015fi farmacologici, care fiecare \u00een parte, pe c\u0103i diferite, duce la modificarea permeabilit\u0103\u0163ii barierei cutanate, hiperreactivitate la stimuli inflamatori \u015fi r\u0103spuns imunologic anormal.<\/p>\n<p style=\"text-align: justify;\">\u00cen prezent este acceptat\u0103 o <strong>clasificare <\/strong>a dermatitei atopice \u00een DA pur\u0103 \u2013 f\u0103r\u0103 acuze respiratorii \u015fi DA mixt\u0103 \u2013 care asociaz\u0103 \u015fi manifest\u0103ri respiratorii ale atopiei.<\/p>\n<p style=\"text-align: justify;\">Dermatita atopic\u0103 pur\u0103 (numai cu manifest\u0103ri cutanate), poate fi intrinsec\u0103 &#8211; cu nivelul IgE normal (10-45% din cazuri) \u015fi extrinsec\u0103 \u2013 IgE totale crescute, IgE specifice crescute. DA extrinsec\u0103 are un debut al manifest\u0103rilor clinice caracteristic sub varsta de 20 ani, este exacerbat\u0103 de contactul cu alergeni specifici \u015fi prezint\u0103 niveluri crescute de IgE totale \u015fi specifice, IL-4 crescut\u0103. DA intrinsec\u0103 apare la adul\u0163i, cu niveluri ale IgE totale \u015fi specifice normale.<\/p>\n<p style=\"text-align: justify;\">O alt\u0103 clasificare a DA ca \u015fi sindrom este: DA alergic\u0103 IgE asociat\u0103 \u015fi non-IgE-asociat\u0103 (limfocit T-asociat\u0103); DA non-alergic\u0103.<sup>1<\/sup><\/p>\n<hr \/>\n<p style=\"text-align: justify;\"><strong>Clinic<\/strong>, dermatita atopic\u0103 se caracterizeaz\u0103 prin leziuni ca: eritem, exudat, escoria\u0163ii, usc\u0103ciune, lichenificare, distribuite pe g\u00e2t, m\u00e2ini, coate, picioare \u015fi trunchi. Tipul de leziuni prezente difer\u0103 \u00een func\u0163ie de v\u00e2rsta celui afectat, remarc\u00e2ndu-se mari varia\u0163ii individuale. La orice v\u00e2rst\u0103, cel mai sup\u0103r\u0103tor \u015fi constant simptom este pruritul; se consider\u0103 c\u0103 \u00een absen\u0163a acestuia, oricare din semnele enumerate pot caracteriza o alt\u0103 suferin\u0163\u0103 dermatologic\u0103, nefiind asociate dermatitei atopice.<\/p>\n<p style=\"text-align: justify;\">Tabloul clinic \u00eent\u00e2lnit \u00een dermatita atopic\u0103 este polimorf \u015fi este caracterizat de prezen\u0163a unui cumul de simptome \u015fi semne clinice asociate aleatoriu, diferen\u0163iate de Hanifin \u015fi Rajka, \u00een 1980, \u00een \u201ccriterii majore\u201d \u015fi \u201ccriterii minore\u201d, utile \u00een practic\u0103 pentru diagnostic.2 \u00cen lipsa unei analize de laborator care sa poat\u0103 constitui un marker al bolii, diagnosticul de DA se face \u00een principal clinic pe baza acestor criterii.<\/p>\n<p style=\"text-align: justify;\"><span style=\"color: #00539f;\"><strong>Principalii factori declan\u015fatori<\/strong><\/span> ai puseului de DA (\u201cflare factors\u201d) sunt infec\u0163iile, stress-ul, expunerea la alergeni, cre\u015fterea temperaturii ambientale, transpira\u0163ia \u015fi iritan\u0163ii de contact.<\/p>\n<p style=\"text-align: justify;\">Un rol important \u00een patogenia bolii (in majoritatea cazurilor de DA) \u00eel au hipersensibilitatea imediat\u0103 (IgE-mediat\u0103) \u015fi cea \u00eent\u00e2rziat\u0103 (limfocit T-mediat\u0103) la diver\u015fi alergeni alimentari, inhalatori (aeroalergeni) sau alergeni de contact. \u00cen acest context este evident\u0103 importan\u0163a investigatiilor alergologice. Recomand\u0103rile actuale sunt pentru pentru efectuarea acestor explor\u0103ri \u00een urma orientarii anamnestice, atunci c\u00e2nd se suspicioneaz\u0103 ca factori trigger alergeni alimentari, aeroalergeni sau alergeni de contact.<sup>1<\/sup><\/p>\n<p style=\"text-align: justify;\">Principalii <span style=\"color: #00539f;\"><strong>alergeni alimentari incrimina\u0163i \u00een DA<\/strong> <\/span>sunt laptele de vac\u0103, ou\u0103le, f\u0103ina de gr\u00e2u, soia \u015fi alunele. Manifest\u0103rile clinice dup\u0103 expunere constau at\u00e2t \u00een reac\u0163ii imediate (apari\u0163ie \u00een max. 2h) de tip urticarie, simptome respiratorii \u015fi gastro-intestinale, precum \u015fi reac\u0163ii \u00eent\u00e2rziate (ap\u0103rute la 2-48h p\u00e2n\u0103 la c\u00e2teva zile dup\u0103 ingestie) de tip eczema. Reac\u0163iile de hipersensibilitate imediat\u0103 pot fi puse \u00een eviden\u0163\u0103 prin teste \u201cin vivo\u201d \u015fi prin teste \u201cin vitro\u201d (IgE specifice serice, eliberare de histamin\u0103, teste de proliferare limfocitar\u0103). Reac\u0163iile de hipersensibilitate \u00eent\u00e2rziat\u0103 pot fi studiate prin patch test.<\/p>\n<p style=\"text-align: justify;\">\u00cen cazul suspicion\u0103rii alergiei declan\u015fate de aeroalergeni (\u00een special praful de cas\u0103, polen, p\u0103r de animale), explor\u0103rile alergologice de rutin\u0103 sunt testele \u201cin vivo\u201d \u015fi \u201cin vitro\u201d.<sup>1,3<\/sup><\/p>\n<p style=\"text-align: justify;\">Rolul sensibiliz\u0103rii de contact este frecvent subestimat. Alergenii de contact (metale, parfumurile, neomicina, lanolina) se pare c\u0103 pot fi incrimina\u0163i \u00een 41-64% dintre cazurile de DA. \u00cen acest caz, patch testele sunt utilizate la pacien\u0163ii cu DA, at\u00e2t copii c\u00e2t \u015fi adul\u0163i.<br \/>Importan\u0163a detect\u0103rii alergenului incriminat const\u0103 \u00een orientarea ulterioar\u0103 a terapiei de evitare.<sup>1<\/sup><\/p><div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-1 wp-block-columns-is-layout-flex\"><div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:33.33%\"><p><strong>Analize medicale disponibile \u00een laboratoarele Synevo:<\/strong><\/p><\/div>\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:66.66%\"><div class=\"synevo-shop-products\">\r\n    <div class=\"sysprod\">\r\n        \r\n        <div class=\"sysprod-products\">\r\n                    <\/div>\r\n        \r\n    <\/div>\r\n<\/div>\r\n\r\n<style>\r\n.synevo-shop-products {\r\n    padding: 24px 0;\r\n    margin: 24px 0;\r\n    border-radius: 10px;\r\n    background: #F6F7F9;\r\n}\r\n.synevo-shop-products .sysprod-product {\r\n    position: relative;\r\n    margin: 0 24px;\r\n    margin-bottom: 24px;\r\n    border-radius: 10px;\r\n    background: #fff;\r\n    display: flex;\r\n    flex-direction: row;\r\n    align-items: center;\r\n}\r\n.synevo-shop-products .sysprod-product:last-child {\r\n    margin-bottom: 0;\r\n}\r\n.synevo-shop-products .sysprod-product-title {\r\n    flex-grow: 1;\r\n    padding: 15px;\r\n    margin-left: 14px;\r\n    font-family: Poppins,sans-serif;\r\n    font-weight: 600;\r\n    font-size: 16px;\r\n    color: #29263F;\r\n}\r\n.synevo-shop-products .sysprod-product-price {\r\n    flex-shrink: 0;\r\n    font-family: Poppins,sans-serif;\r\n    font-weight: 600;\r\n    font-size: 18px;\r\n    color: #FDB813;\r\n}\r\n.synevo-shop-products .sysprod-product-addcart {\r\n    flex-shrink: 0;\r\n    position: relative;\r\n    width: 38px;\r\n    height: 38px;\r\n    margin-left: 24px;\r\n    margin-right: 24px;\r\n}\r\n.synevo-shop-products .sysprod-product-addcart .button {\r\n    top: unset;\r\n    right: unset;\r\n}\r\n<\/style><\/div><\/div><p><strong><small>Bibliografie<\/small><\/strong><small>1. Calin Giurcaneanu, Dermatita atopic\u0103-probleme de diagnostic, \u00een Alergologie \u015fi imunologie clinica, Vol.I, Nr.3\/2005.<\/small><small>2. Jeana Rodica Radu, Dermatita atopic\u0103 sau sindromul eczema\/dermatita atopic\u0103, \u00een Alergologie \u015fi imunologie clinica, Vol.I, Nr.3\/2005.<\/small><small>3. Darsow U, Lubbe J, Taieb A et al. for the European Task Force on Atopic Dermatitis. Position paper on diagnosis and treatment of atopic dermatitis, JEADV(2005) 19, 286-295.<\/small><\/p><hr class=\"wp-block-separator\"\/><p>Mai multe informa\u021bii despre teste:<\/p><ul class=\"wp-block-list\"><li><a href=\"\/shop\/f1-albus-de-ou\/\" class=\"rank-math-link\">Albu\u015f de ou<\/a><\/li><li><a href=\"\/shop\/f2-lapte-de-vaca\/\" class=\"rank-math-link\">Lapte de vac\u0103<\/a><\/li><li><a href=\"\/shop\/f4-grau\/\" class=\"rank-math-link\">Gr\u00e2u<\/a><\/li><li><a href=\"\/shop\/f14-soia\/\" class=\"rank-math-link\">Soia<\/a><\/li><li><a href=\"\/shop\/f3-peste-cod\/\" class=\"rank-math-link\">Pe\u015fte<\/a><\/li><li><a href=\"\/shop\/carne-amestec-fx73-porc-vita-pui\/\" class=\"rank-math-link\">Carne amestec (porc, vit\u0103, pui)<\/a><\/li><li><a href=\"\/shop\/d1-dermatophagoides-pteronyssinus\/\" class=\"rank-math-link\">Dermatophagoides pteronyssinus<\/a><\/li><li><a href=\"\/shop\/d2-dermatophagoides-farinae\/\" class=\"rank-math-link\">Dermatofagoides farinae<\/a><\/li><li>polen<\/li><li>p\u0103r animale<\/li><\/ul><p>vezi \u2013 Teste alergologice \u2018in vitro\u2019<\/p>","protected":false},"featured_media":0,"template":"","synevo_diseases_category":[902,892],"class_list":["post-10516","synevo_diseases","type-synevo_diseases","status-publish","hentry","synevo_diseases_category-teste-alergologie","synevo_diseases_category-dermato-venerologie"],"_links":{"self":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/synevo_diseases\/10516","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/synevo_diseases"}],"about":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/types\/synevo_diseases"}],"wp:attachment":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/media?parent=10516"}],"wp:term":[{"taxonomy":"synevo_diseases_category","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/synevo_diseases_category?post=10516"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}