Eczema Causes and Atopic Dermatitis Risks: Genetics, Environment, and More

Doctors don’t know exactly what causes eczema. The most common type, atopic dermatitis, resembles an allergy. But the skin irritation is not an allergic reaction.

Causes of Eczema

Eczema is probably caused by a combination of things that may include:

• Genetics. A major risk factor is having relatives who have or had eczema, asthma, or seasonal allergies. A large percentage of children with severe eczema will later develop asthma or other allergies.
• Problems in the way your immune system works
• Mother’s age at time of birth. It’s not clear why, but children born to older women are more likely to develop eczema than children born to younger women.
• Environment. Children are more likely to get eczema if they are in higher social classes, live in urban areas with higher levels of pollution, or live in colder climates.
• Activities that make your skin more sensitive
• Defects in the skin barrier that allow moisture out and germs in
• Endocrine disorders such as thyroid disease

What Doesn’t Cause Eczema

Eczema is not contagious. You can’t catch eczema by coming in contact with someone who has it.

Eczema is not an allergic reaction. Even so, a large number of children who have eczema also have food allergies. That doesn’t mean that certain foods such as dairy, eggs, and nuts — common food allergy triggers in children with eczema — cause it or make it worse. Before removing particular foods from your child’s diet, talk with your doctor to be sure your child’s nutritional needs will be met.

Eczema Triggers

A trigger is not something that causes eczema. But it can cause it to flare or make a flare worse.

Skin irritants

The most common triggers are substances that irritate the skin. For instance, in many people with eczema, wool or man-made fibers that come in contact with the skin can trigger a flare.

Examples of other things that can irritate the skin include:

• Soaps and cleansers
• Perfume
• Makeup
• Dust and sand
• Chlorine
• Solvents
• Irritants in the environment
• Cigarette smoke

Continued

Infections or allergies

Flares can also be triggered by certain conditions that have an effect on the immune system. For instance, things that can trigger or worsen a flare include:

Continued

Stress has also been identified as a possible trigger.

Your environment

Actions and environments that cause the skin to dry out or become otherwise sensitive can trigger flares. Some examples include:

• Prolonged exposure to water
• Being too hot or too cold
• Sweating and then becoming chilled
• Taking baths or showers that are too hot or last too long
• Not using a skin lubricant after a bath
• Low humidity in the winter
• Living in a climate that is dry year-round

What’s the Connection Between Food and Eczema Flares in Kids?

Could diet be to blame for your child’s eczema?

It’s possible.

Up to 1 in 3 kids with eczema has a food allergy that could make symptoms worse. If you remove some choices, it could make a big difference.

But since finding food triggers is tricky — and eczema can have lots of other causes — don’t jump to conclusions. Work closely with an allergist.

Which Foods May Trigger Eczema?

When you have a food allergy, your body reacts to a harmless treat as if it’s a dangerous germ and attacks. Symptoms — like swelling — are side effects of your body’s defenses.

Eczema doesn’t seem to be an allergic condition, but reactions from food can make it worse in some kids. It’s more likely in babies and young children.

Some foods are more likely to bring symptoms. The common offenders are:

• Milk
• Eggs
• Peanuts
• Tree nuts
• Wheat
• Fish
• Shellfish
• Soy

While trigger foods can make eczema worse, experts don’t think they’re really the original cause. Instead, it seems to result from “leakiness” in the outer layer of skin that lets in irritants, germs, and allergens.

How to Find a Food Trigger

Some are obvious. If your child eats lobster for the first time and breaks out in hives 15 minutes later, it’s probably not hard to figure out.

But with eczema, it’s often tougher. Symptoms may not show up for days after you eat something. If you do find a trigger food and get rid of it, that may help. Still, it may not make the eczema go away. Remember, 2 out of 3 kids with eczema don’t have a food allergy at all.

That’s why working with a doctor is so important. They can guide you toward the real cause through tests like:

Elimination diets. If your doctor thinks a food may be harmful, they may ask you not to give it to your kid for 10 to 14 days. Watch to see if it makes a difference.

Food challenges. After you’ve taken a food out of your child’s diet, your pediatrician might want you to add a small amount back in to see if it causes symptoms. They may want to do this in the office, just in case your child has a reaction.

Continued

Skin testing. A doctor can take an extract of the food and use it to scratch the skin lightly. If the area swells up, that could be an allergic reaction. However, it’s not always accurate.

Blood tests. RAST — a radioallergosorbent test — can check for special cells in the blood that signal specific food allergies. Again, it’s not always accurate. Other lab tests can check for cells that trigger swelling.

Tracking down a food trigger can take patience and detective work.

Be methodical. Only eliminate one food at a time. If you ban dairy and gluten at the same time and symptoms get better, you won’t know which one made the difference. Use a food diary to keep track of what you get rid of, and the changes that brings.

Move slowly. A positive skin test isn’t reason enough to cut out a food. Lots of kids test positive for foods that don’t really cause symptoms. Plus, if you get rid of too many foods, you could cut out nutrients your child needs to grow and develop. So for their sake and yours, be sure before you take a food from your child’s diet permanently. Work with your doctor.

Keep using other treatments. Even if you find a trigger food, getting rid of it may not make the rash disappear. Stick with the other things your doctor recommends — like skin ointments, lotions, and medicines. Continue to steer clear other allergens like dust mites, pollen, or pet dander, too.

How do I treat and manage eyelid eczema?

Eyelid eczema is common and includes the areas around the eyelids, eyebrows and eyelashes. This is a challenging area to manage because the skin is thinner than other areas of the body, which make it more sensitive to treatment options. Other common areas for eczema to flare up are the hands and feet, as well as the inside of the elbows and behind the knees.

We recommend treatment with our natural oatmeal face mask with vitamin E and eczema moisturiser.

What is eyelid eczema?

Eyelid eczema is an inflammatory response involving the eyelid skin, usually caused by an eczema trigger.  This can make the eyelids itchy and red and constant rubbing can lead to swelling. Children with eczema around the eyes often experience eczema on other areas of the face, including the cheeks, forehead, nose and chin.

Why does my child have eczema around their eyes and on their eyelids?

Eczema around the eyes and on the eyelids is more common in children who also have asthma and hay fever. This is because their body is already highly sensitive to allergens in the environment that are usually harmless to other people.

It is important to get your diagnosis of eyelid eczema from your doctor to better understand causes and what treatment options are available.

What can I do to help eczema around the eyes and eyelids?

Avoiding contact with any known allergens is the first step to reducing the incidence of eczema around the eyes and eyelids, as well as keeping the area well moisturised and reducing inflammation.

Tips to minimise symptoms:

• Only touch eyelids with clean, rinsed hands
• Applying a cool compress to avoid rubbing and scratching
• Keep fingernails short to prevent extra damage if scratching occurs
• Use a skincare routine to ensure the entire body is nourished and hydrated
• Manage any diagnosed conditions such as hay fever and asthma with your doctor

There are a range of ointments and creams which can be used to treat this delicate area of the face. Sometimes light therapy is also considered as a treatment option. It is important to speak with your doctor about the treatment options suitable for your child.

This blog post was brought to you and your bub with love and care by Julia and the itchy baby co. team. x

Disclaimer: Information provided is of a general nature only and you should always consult your medical professional.

Eczema (Atopic Dermatitis) in an Infant or a Baby: Condition, Treatments, and Pictures for Parents – Overview

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32

Information for
InfantAdultChildTeen

caption goes here…

Images of Dermatitis, Atopic (Eczema)

Overview

Eczema, formally known as atopic dermatitis, is a common disorder in infants and is associated with dry and itchy patches of skin. Young children will often scratch at the dry skin, causing bleeding in the affected area. Eczema can occur on any part of the body and is most common on skin that is stretched often (eg, the back of elbows and front of knees).

Eczema is not contagious and it is not an infection, but prolonged scratching can allow bacteria to get through the skin and cause an infection. Some common triggers that cause eczema include:

• Heat and humidity
• Abrasive clothing
• Tobacco smoke and chemicals
• Some soaps and detergents

Who’s at risk?

Infants are more likely to have eczema if they have other allergies, such as to foods or milk, as well as seasonal allergies, or if they have other family members who were affected with eczema as an infant. Infants who have asthma are also more likely to have eczema.

Signs and Symptoms

The most common locations for eczema are, in general, the face, neck, in front of the elbows, behind the knees, and on the extremities. The first location in an infant is usually the cheek area.

• Thickened, scaly, pink to red bumps (papules) and slightly elevated lesions (plaques) are seen in these areas.
  • Mild eczema – few, scattered areas of involvement, which are easily treated with self-care measures
  • Moderate eczema – more extensive involvement, which is more difficult to control with self-care measures and may require prescription therapy
  • Severe eczema – diffuse involvement, which is difficult to treat even with prescription therapy
• Infants with eczema may have prominent involvement of the face, scalp, and the skin on the arms and legs overlying the elbows and knees.
• Areas with superimposed infection can develop thick crusts.
• People with darker skin frequently have extensive accentuation of the hair follicles and shininess without obvious thickened, raised areas.

Self-Care Guidelines

Maintaining healthy skin is very important for sufferers of eczema.

• Moisturizing skin-care routines are essential.
• Non-soap cleansers, such as Cetaphil®, or moisturizing soaps, such as Dove®, are recommended.
• Thick moisturizers, such as petroleum jelly, Aquaphor® ointment, Eucerin® cream, CeraVe® cream, and Cetaphil® cream, should be applied daily to damp skin after bathing.
• Attempt to minimize exposure to heat, humidity, detergents/soaps, abrasive clothing, chemicals, smoke, and stress.
• Fragrance-free laundry detergent may be beneficial.
• Keep the home air from getting too dry by using a humidifier or by setting out bowls of water, especially in the bedroom.

When to Seek Medical Care

See your child’s doctor or a dermatologist if there is a lack of response to self-care measures or the condition worsens or flares.

Treatments Your Physician May Prescribe

Topical or oral medications for eczema can include:

• Topical steroid creams or ointments may be prescribed to treat active areas of localized eczema. Lower-strength steroids may be used on the face, and medium- to high-strength steroids may be used on the trunk and extremities.
• Care should be taken when using topical steroids in skin folds and obstructed areas due to the risk of thinning (atrophy) of the skin.
• Steroid-sparing agents, such as topical tacrolimus or pimecrolimus, may be prescribed for milder disease or for certain areas of involvement, such as the face. These medications are not approved for children under the age of 2. These medications have a warning about the risk of malignancy.
• Oral antihistamines may be prescribed to decrease itching.
• If a superimposed infection is suspected, topical or oral antibiotics may be prescribed.
• In patients who have multiple areas of broken skin or a history of bacterial skin infections, dilute bleach baths may be prescribed.

Trusted Links

References

Bolognia, Jean L., ed. Dermatology, pp. 1999-2414. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick’s Dermatology in General Medicine. 6^th ed, pp.1180, 1188-1189. New York: McGraw-Hill, 2003.

Eczema (Atopic Dermatitis) in an Infant or a Baby: Condition, Treatments, and Pictures for Parents – Overview

51378
32

Information for
InfantAdultChildTeen

caption goes here…

Images of Dermatitis, Atopic (Eczema)

Overview

Eczema, formally known as atopic dermatitis, is a common disorder in infants and is associated with dry and itchy patches of skin. Young children will often scratch at the dry skin, causing bleeding in the affected area. Eczema can occur on any part of the body and is most common on skin that is stretched often (eg, the back of elbows and front of knees).

Eczema is not contagious and it is not an infection, but prolonged scratching can allow bacteria to get through the skin and cause an infection. Some common triggers that cause eczema include:

• Heat and humidity
• Abrasive clothing
• Tobacco smoke and chemicals
• Some soaps and detergents

Who’s at risk?

Infants are more likely to have eczema if they have other allergies, such as to foods or milk, as well as seasonal allergies, or if they have other family members who were affected with eczema as an infant. Infants who have asthma are also more likely to have eczema.

Signs and Symptoms

The most common locations for eczema are, in general, the face, neck, in front of the elbows, behind the knees, and on the extremities. The first location in an infant is usually the cheek area.

• Thickened, scaly, pink to red bumps (papules) and slightly elevated lesions (plaques) are seen in these areas.
  • Mild eczema – few, scattered areas of involvement, which are easily treated with self-care measures
  • Moderate eczema – more extensive involvement, which is more difficult to control with self-care measures and may require prescription therapy
  • Severe eczema – diffuse involvement, which is difficult to treat even with prescription therapy
• Infants with eczema may have prominent involvement of the face, scalp, and the skin on the arms and legs overlying the elbows and knees.
• Areas with superimposed infection can develop thick crusts.
• People with darker skin frequently have extensive accentuation of the hair follicles and shininess without obvious thickened, raised areas.

Self-Care Guidelines

Maintaining healthy skin is very important for sufferers of eczema.

• Moisturizing skin-care routines are essential.
• Non-soap cleansers, such as Cetaphil®, or moisturizing soaps, such as Dove®, are recommended.
• Thick moisturizers, such as petroleum jelly, Aquaphor® ointment, Eucerin® cream, CeraVe® cream, and Cetaphil® cream, should be applied daily to damp skin after bathing.
• Attempt to minimize exposure to heat, humidity, detergents/soaps, abrasive clothing, chemicals, smoke, and stress.
• Fragrance-free laundry detergent may be beneficial.
• Keep the home air from getting too dry by using a humidifier or by setting out bowls of water, especially in the bedroom.

When to Seek Medical Care

See your child’s doctor or a dermatologist if there is a lack of response to self-care measures or the condition worsens or flares.

Treatments Your Physician May Prescribe

Topical or oral medications for eczema can include:

• Topical steroid creams or ointments may be prescribed to treat active areas of localized eczema. Lower-strength steroids may be used on the face, and medium- to high-strength steroids may be used on the trunk and extremities.
• Care should be taken when using topical steroids in skin folds and obstructed areas due to the risk of thinning (atrophy) of the skin.
• Steroid-sparing agents, such as topical tacrolimus or pimecrolimus, may be prescribed for milder disease or for certain areas of involvement, such as the face. These medications are not approved for children under the age of 2. These medications have a warning about the risk of malignancy.
• Oral antihistamines may be prescribed to decrease itching.
• If a superimposed infection is suspected, topical or oral antibiotics may be prescribed.
• In patients who have multiple areas of broken skin or a history of bacterial skin infections, dilute bleach baths may be prescribed.

Trusted Links

References

Bolognia, Jean L., ed. Dermatology, pp.1999-2414. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick’s Dermatology in General Medicine. 6^th ed, pp.1180, 1188-1189. New York: McGraw-Hill, 2003.

Eczema and Food Allergy in Babies and Young Children

What is eczema?

The word eczema is used to describe a number of chronic skin disorders. Atopic dermatitis is the most common type of eczema, especially in babies and young children. In Canada, about 10 percent of infants and children have the atopic dermatitis form of eczema.

It is common for the word eczema to be used instead of atopic dermatitis. In this resource, the word eczema means atopic dermatitis.

What are the symptoms of eczema?

Eczema is a chronic condition which causes red, itchy areas on the skin. Sometimes the itching is very severe. When skin is scratched it can break open, ooze and then crust over. Symptoms of eczema can come and go. Babies with eczema often have it on their cheeks, forehead and scalp. Older children often have it on their hands, wrists, ankles, feet, and on the inside folds of their elbows and knees.

What causes eczema?

Some children are more prone to eczema due to differences in their skin and their immune systems:

1. Healthy skin acts as a barrier to prevent moisture from getting out and irritants from getting in. This barrier function of the skin does not work very well in children who are prone to eczema. Their skin does not hold moisture very well. As a result, their skin gets dry easily and allows irritants to get in more easily.
2. The immune system of children with eczema reacts more strongly to irritants than usual. When the immune system responds strongly to irritants, it makes the skin red and itchy.

When it is red and itchy, it is even harder for skin to be a good barrier, so it lets in even more irritants. This leads to a cycle of itching, scratching and more irritation, which makes eczema worse.

Eczema belongs to a group of allergic conditions including asthma, hay fever, and food allergy. Allergic conditions tend to run in families. Genetics has a major role in determining who will get eczema. Eczema is not caused by a single gene, rather many genes act together to increase the chance of eczema developing.

An example of one gene that has a role is called filaggrin (pronounced PHIL-a-GRIN). It is responsible for making the skin protein filaggrin. When this gene is not working properly, the barrier function of the skin does not work as well. Many, but not all, children with eczema have a problem with this particular gene.

Eczema usually starts in babies, but it can start at any age. Some children outgrow it, but it can also return later in life.

What is food allergy?

Food allergy results from an abnormal immune response to a food protein. Food proteins that can cause an allergic reaction are called food allergens. Children with food allergy will have an allergic reaction every time they eat the food to which they are allergic. Managing a food allergy involves avoiding the food that causes the allergic reaction. For more information about food allergy, look at: “Reducing Risk of Food Allergy in Your Baby” and “Severe Food Allergies in Children”. If you suspect your baby or child is reacting to a food, stop giving that food and talk to your child’s doctor. Your child’s doctor can refer your child to a pediatric allergist if help with a diagnosis and a treatment plan are needed. If you are concerned about your child’s nutrition, talk with a registered dietitian.

Can food allergy cause eczema?

Although food allergy is more common in children who have eczema, they are separate conditions.

Food allergy does not normally cause eczema, but having eczema may increase the chance that a food allergy develops. For a description of how eczema may increase the risk of food allergy, please refer to the section on the next page called: How can good eczema control help prevent food allergy?

What are the differences between the skin symptoms of food allergy and eczema?

An allergic reaction to a food typically happens quickly. Symptoms of an allergic reaction then go away, usually after several hours, as long as the food is not eaten again. Eczema is a chronic condition that does not go away quickly. Eczema tends to show up in predictable places, such as on the cheeks of young babies or elbow creases of older children. The places on the skin where symptoms of an allergic reaction to food appear are more unpredictable. Hives, redness and itching from an allergic reaction can show up just about anywhere on the body and even in different places each time the food is eaten.

Why is it important to control my child’s eczema?

When eczema is not well controlled, it can affect a child’s quality of life and health. It increases the chance of skin infections, and it can also be painful. Itching and scratching can be distressing for your child and for you as a parent to watch. Physical comfort, sleep, social interactions and self-image can all be affected. Good control allows your child to feel well and stay focused on childhood activities such as learning and playing.

Some new research shows there may be an additional benefit to keeping eczema under good control. Good control might help prevent food allergy. This is especially good news for parents who have babies and toddlers who are at increased risk for food allergy.

How can good eczema control help prevent food allergy?

Since healthy skin acts as a barrier, it also helps prevent substances like food allergens from getting into the body through the skin. Healthy skin helps protect the immune system from being exposed to food allergens. When your child’s eczema is under good control, your child’s skin is better at preventing food allergens from getting in.

New research suggests that when your child’s skin is scratched open, food allergens can get into the body more easily to make contact with the immune system. Direct contact between open skin and food, such as peanuts, may increase the chance that an allergy will develop to that food. The immune system may be more prone to developing a food allergy if the first exposures to the food are through scratched open skin.

The opposite may be true if the immune system is first introduced to the food by eating it. If the first exposure to a food is through the digestive tract, the immune system may more likely tolerate the food.

For more information about controlling eczema, please refer to the section on the next page called: How can I help control my child’s eczema?

What are other ways to help prevent food allergy?

Many health professionals now think there are two steps parents can take to help prevent food allergy.

1. Avoid unnecessary delays when introducing new solid foods to your baby.
2. If your baby tolerates a new food, continue to offer it regularly. “Regularly” means about once per week, or more often if you prefer. Offering foods regularly may remind the immune system to tolerate the foods rather than develop an allergy to them.

Health Canada recommends introducing solid foods to babies starting at six months of age. Babies with eczema should also be offered solid foods starting at six months.

You can introduce boneless fish, egg, peanuts, tree nuts, and sesame seeds in age appropriate forms starting at six months of age if you wish. Whole tree nuts and big globs of peanut butter are choking hazards. You can start by offering peanut, tree nut and sesame seed butters mixed into infant cereal.

When your baby is ready for finger foods, you can offer these foods spread thinly on small strips of toast. For more information about introducing solid foods to babies, see “Baby’s First Foods” and “Reducing Risk of Food Allergy in Your Baby”.

Since 2008, the American Academy of Pediatrics no longer recommends delaying the introduction of foods such as fish, eggs and foods that contain peanut protein beyond 4 to 6 months of age to babies at increased risk for allergy.

In 2000, it was thought that delaying the introduction of new foods into a baby’s diet decreased the chance of a food allergy. However, the delay may increase the chance that the first exposures to the food will be through skin that has been scratched open. Therefore, delaying the introduction of new foods may actually increase the chance that a food allergy will develop.

A few recent studies suggest introducing certain foods even before 4-6 months of age may help prevent food allergy, but more research is needed before this can be recommended. An example of a study currently being done is called the LEAP Study. LEAP stands for “Learning Early About Peanut Allergy”. For more information visit: www.leapstudy.com

How can I help control my child’s eczema?

Although eczema cannot be cured, three main steps can be taken to help control it:

1. Follow a daily bathing routine and apply moisturizer right after the bath to help moisturize your child’s skin.
2. Use skin medications to calm the immune response when needed.
3. Avoid contact with personal irritants

1. Keep skin moisturized

Keep your child’s skin well moisturized at all times. This helps improve the skin’s barrier function and helps break the cycle of irritation, which leads to itching and scratching. Even after skin has healed after an eczema flare-up, continue with the daily steps that keep skin well moisturized. This will help prevent new flare-ups.

Allow your child to soak in bath water every day. Soaking for about 10 minutes is best. Use lukewarm water not hot water.

Use mild soap and only on skin surfaces that need cleaning, such as underarms and the diaper area. Do not use strong soaps, which can be too drying. Use soap and shampoo at the end of the bath to prevent your child from soaking in products that cause skin to dry out. Wash skin gently. Scrubbing can irritate skin prone to eczema.

After the bath, gently pat your child dry and apply any medicated creams prescribed by your child’s doctor. Apply moisturizer within 3 minutes of the bath. The moisturizer helps to “lock-in” the water absorbed by the skin during the bath.

Applying moisturizer immediately after the bath is probably the single most important thing that you can do to help your child’s skin.

Always wash your hands before applying moisturizer. Apply moisturizer generously to all skin surfaces. Avoid rubbing. Use moisturizer after every bath, after hand washing and after swimming.

2. Use skin medications when needed

For some babies and children with eczema, daily bathing and moisturizing is not enough for good control. These children also need a medical treatment plan, which often includes medicated creams or ointments that calm the immune system in the skin and control irritation. Medical treatment plans also include instructions on how often and when to apply the cream or ointment.

There are a variety of skin medications available for eczema, each with a different strength. The strength of the medication prescribed should be right for the area of the body that needs medication. For example, a child may have one medication prescribed for the face and another one for the elbows and knees. Do not use the percent on the label to judge the strength of your child’s medication. Speak to your child’s doctor or pharmacist if you have questions about medication strength.

Follow the treatment plan provided by your child’s doctor, so your child gets the most possible benefit from the medication. It is especially important to follow your doctor’s advice about how much of the medication to apply, so you do not use too little or too much. Some doctors recommend applying a layer of medication to eczema patches every day for about two to four weeks. The medication is more effective if you apply it to skin immediately after the bath, while the skin is still damp.

The treatment plan may need to be adjusted from time to time, based on the severity of the eczema and the response to the skin medication. You may be the first to notice that the plan needs to be adjusted. Let your child’s doctor know if you think the plan needs adjustment.

3. Help your child avoid personal irritants

Some substances can irritate skin and start the cycle of itching and scratching. If you notice that your child’s eczema gets worse after being exposed to something, help your child avoid it. Irritants are not the same for all children. If a common trigger does not bother your child, there is no reason to avoid it. Here are some examples of possible triggers that can cause eczema flare-ups in some children.

Perfumes and fragrances, including the skin care and bathing products that contain them

Harsh soaps

Bath salts or bubble baths

Rough clothing, including wool fabrics

Temperature extremes, including hot and cold, dry air

Skin Infections

Children with eczema often have more bacteria on their skin. Even when it does not cause an infection, the bacteria can make the skin more irritated and can make the eczema worse, so keeping clean is important.

Babies and children with eczema are also prone to skin infections. Infections make the eczema even worse and need to be treated by a doctor. An oral antibiotic, antibiotic cream or very small amount of bleach added to bath water might be prescribed. Bleach should not be added to bath water without guidance from your child’s doctor. Signs of possible infection include: increased pain, tenderness or swelling, hot skin, fever, pus, or red streaks extending from the affected skin.

Stress

Emotional upset, frustration and embarrassment are stressful and can trigger itching that leads to more scratching in children with eczema. Help your child learn to cope with stressful events.

Environmental allergens

Environmental allergens include animal dander (skin flakes) and saliva, dust mites, pollens, and moulds. Children with eczema may also have environmental allergies. For these children, being exposed to these allergens may make the eczema worse. If your child is allergic to specific environmental allergens, reduce your child’s exposure to them when possible. 

Foods that are not allergens

Some foods that are not allergens can irritate inflamed skin through contact. To reduce irritation, avoid food contact with eczema when possible. You may apply ointment to your child’s skin before offering food to reduce skin contact. If food does make contact with your child’s inflamed skin, wash it off gently and re-apply moisturizer.

Foods that irritate eczema through contact do not cause any problems when they are eaten, unless your child also has a food allergy to them.

Many parents report foods such as tomato, strawberry and citrus fruits (such as oranges) irritate eczema. If your child’s eczema is not bothered by these foods continue to offer them to your child.

What else can I do to help control my child’s eczema?

• Keep your child’s finger nails short and clean. This can help prevent an infection if skin gets scratched
• Use unscented laundry products and avoid dryer sheets.
• Wash new clothes and remove tags before your child wears them.
• Dress your child in loose rather than tight clothes.
• If your child’s eczema is hard to keep well controlled, get help from health care providers who have expertise in eczema care.

What should I look for when selecting skin care products?

Choose soaps and moisturizers made for sensitive skin. Although there is no single group of products that are right for every child, generally, products with fewer ingredients are best. Expensive products are not always better. If you need help finding products for your child, ask your doctor or pharmacist.

Products for bathing

You do not need to add anything to your child’s bath water. Choose a gentle soap for cleaning skin. Avoid harsh products and those containing perfumes or fragrances.

Moisturizers

Choose a thick moisturizer without perfumes or fragrances. Thick products are more effective for moisturizing than thinner ones that pour easily. Thick moisturizers include creams and ointments, and these are usually available in jars or in tubes.

Moisturizers can be divided into three categories based on the amount of oil or grease in comparison to the amount of water present. These three groups are called ointments, creams and lotions. Ointments are just grease, and do not contain much water. They are usually very thick, clear and nearly colourless. Creams are usually a half-and-half mixture of oil (or grease) and water. They are typically too thick to pour, come in jars and often white in colour. Lotions are creams with much more water added. They are pourable or come with a pump dispenser, and they are normally white in colour.

Examples of product ingredients that help keep moisture locked in skin:

Petroleum jelly and petrolatum: These are greasy ingredients and very good at keeping moisture locked in the skin.

Silicone and dimethicone: These are non-greasy ingredients and also good at locking moisture in the skin. They feel silky to the touch and are added to many moisturizers.

Ceramides: These are moisture holding substances and naturally present in the skin. People with eczema lack normal amounts of ceramides in their skin. Applying ceramides to skin helps keep moisture locked in. Some newer moisturizers have ceramides added to them. Products made with ceramides may be more expensive than other moisturizers.

Resources

The EASE Program: www.eczemacanada.ca provides information and resources on eczema for Canadians.

Reducing Risk of Food Allergy in Your Baby: www.healthlinkbc.ca/healthy-eating/reducing-baby-food-allergy-risk

Baby’s First Foods: www.healthlinkbc.ca/healthlinkbc-files/babys-first-foods

Last updated: July 2011

Eczema Around the Eyes| National Eczema Society

Eyelid eczema is treated with emollients and mild topical steroids, prescribed by your doctor or other health professional. Generally, only mild topical steroids (0.5-1% hydrocortisone) are recommended for eyelid eczema, because strong topical steroids can cause thinning of the skin around the eye – an area where the skin is already thinner than on other parts of the body.

Mild topical steroids are safe to use as long as you follow your doctor’s instructions. Sometimes for a severe flare a stronger steroid may be prescribed (usually Eumovate, a moderate topical steroid) for a short treatment burst of around 5 days and then stepped down to a mild steroid. Anything more potent than a moderate topical steroid would only be prescribed by a dermatologist for use on the eyelids.

Topical calcineurin inhibitors (TCIs) – pimecrolimus (Elidel) or tacrolimus (Protopic) – are also prescribed for eyelid eczema. These are not steroids so there is no problem with them thinning the skin, though they can have some other side effects. These include photosensitivity, so as it is difficult to use sunscreen on the eyelids, they are best applied in the evening; or if applied in the day, a sun hat and sunglasses should be worn, especially from March to September.

TCIs are initially prescribed for 6 weeks and can also be used for long-term, twice-weekly maintenance treatment. It is common for TCIs to produce a burning and stinging sensation when first put on, but this usually subsides after a few days, so try to persevere.

We recommend that you keep facial skin care simple and use bland medical leave-on emollient to wash with, as well as applying it frequently as a moisturiser. You should definitely avoid washing your face with soap or using perfumed face creams. It is important not to use olive oil or aqueous cream on your eyelids as these are both known to damage the skin barrier in eczema. You can also use your emollient to remove eye make-up including mascara.

Eczema of the eye and eyelid

Eczema is an allergic skin disorder characterized by rash, burning and itching. Eczema is not contagious, but treatment should be started early. Causes anxiety due to a defect in aesthetics, especially when it comes to the eyes and eyelids. Most often, women are susceptible to this disease, since not all cosmetics are harmless.

It is rather difficult to immediately determine the causes of eczema, since the factors provoking the disease can be very different.These reasons can be divided into two groups:

– endogenous;

– exogenous.

Endogenous causes are:

1. congenital predisposition;
2. hormone imbalance;
3. metabolic disorders;
4. violation in the work of the gastrointestinal tract;
5. failures in the immune system.

Exogenous causes are:

1. allergy to dust, flowers, animal hair;
2. long enough medication;
3. detergents, household chemicals;
4. products;
5. cosmetics, both medicinal and decorative.

The skin around the eyes is very sensitive and is therefore primarily at risk of disease. At the first signs of the disease, make-up should be completely abandoned, all cases are individual and special treatment is prescribed for each.

A dermatologist must prescribe treatment.

In case of untimely treatment of the disease, thickening of the eyelid, loss of eyelashes and, in difficult cases, possible twisting of the eyelid in the other direction is possible.Wounds that occur with eczema need to be treated and disinfected.

Treatment is prescribed after identifying the causes of eczema. Effective remedies are antiallergic drugs:

– suprastin

– tavegil

– zyrtec

– lorantadine.

In cases of complications or deterioration of the patient’s well-being with eczema of the eyes and eyelids, hormonal preparations are prescribed.

One of the most important conditions for the treatment of eczema is the rejection of cosmetics for the entire course of treatment.You can wash your face with chamomile or string infusions.

Foods should also be excluded from the food intake:

– spicy, salty, smoked;

– coffee

– chocolate

– milk and cereals

– baked goods

– citrus

– red berries.

Allowed:

– steamed fish

– chicken without skin

– porridge on the water

– vegetable soups.

Prevention of eczema, mandatory identification of the allergen, as well as strengthening the immune system. Compulsory adherence to personal hygiene, the right choice of cosmetics, proper nutrition, rest and sleep.

90,000 Tips for Infant Eczema – Blog

Learn about the causes and treatment of eczema in young children.

In this Article:

What is eczema?

Eczema, or atopic dermatitis, is a widespread skin disorder that affects both adults and children.It is characterized by the appearance of red, itchy and itchy areas of the skin. It most commonly affects children, but it can also occur in adults. It is a chronic condition, but it tends to flare up intermittently, especially if some environmental factors, dietary patterns, or other variables contribute to it. There is currently no cure for eczema, but there are many treatment options that can help relieve itching and prevent future flare-ups.

Symptoms of eczema

Symptoms of eczema may not only include red, itchy skin, and the course of the disease may differ slightly from person to person. Some people experience dry skin, red, brown, or gray patches of skin, protruding blisters that leak fluid when scratched, and cracked or thickened skin.

Areas affected by eczema can be found on the hands, feet, ankles, wrists, neck, eyelids, and the inner surface of the flexion of the elbows and knees.In young children, eczema usually occurs on the face and scalp. Eczema can also get worse at certain times of the year. Symptoms often tend to get worse in dry, cold air in winter rather than warm, humid summer days. Using a household humidifier during winter can help prevent flare-ups of eczema.

Causes of eczema

Eczema is caused by damage to a gene that alters the skin’s ability to properly defend itself.Healthy skin is able to retain water in the body and protect it from bacteria and other irritants. Eczema is the result of the body’s overactive reaction when the immune system is triggered. Eczema is more common in families whose members have suffered from plant pollen allergies (“hay fever”) or asthma. This confirms the diagnosis that eczema is a reaction of the body’s activated immune system. Eczema is not contagious to other children and adults.

Eczema in children

Approximately 20 percent of young children are diagnosed with eczema, and many will outgrow the condition before they reach 2 years of age.Complications of eczema can manifest as asthma and hay fever, especially in children under the age of 13, skin infections, poor sleep quality due to itching, and other chronic skin conditions.

Red, delicate, scaly and even crusty or discharge skin affected by eczema is especially unpleasant for children, so the following factors should be avoided as much as possible. A rash can be caused or worsened by allergic reactions to substances such as pollen or cigarette smoke.A worsening condition of the rash can be caused by the diet of the baby or even the mother if the baby is breastfed.

However, such exacerbations are not typical for all types of eczema. Some of these are simply the immune response to the baby’s environment. Flare-ups of eczema can be caused by heat, certain chemicals in soaps, temperature changes, or even stress.

5 Ways to Treat Your Child’s Eczema

Visit the pediatrician with your child

If a child seems to have eczema or is suffering from similar symptoms, the first step is to see a pediatrician and get a doctor’s recommendation.Diaper rash is sometimes mistaken for eczema, so it’s best not to make any assumptions without listening to your doctor’s opinion.

Daily bathing

Experts and doctors recommend daily bathing as an easy way to help relieve rashes and other eczema symptoms. However, you should not use hot water, as it actually dries out the skin even more. Here are two types of home baths that can help relieve your child’s symptoms.

Brine bath

For a salt bath, pour warm water into the bathtub. Add about ⅛ cup of table salt for a baby bath or 1 cup of salt for half a bath for an older baby. Let your child sit in a warm salt bath for 10-20 minutes, then remove and towel dry. Apply an eczema cream or lotion immediately. This procedure should be done daily because the effects of salt baths on your baby’s skin can take up to 10 days.

Oatmeal bath

Combine ⅓ cup oatmeal (unscented instant, instant or slow cooked oatmeal) at the highest speed of your food processor or blender until a very fine, uniform powder is obtained. Place the homemade oatmeal in a tub filled with running water and stir the water with your hand to ensure that the oatmeal is evenly distributed.

Place your child in the bathtub for 15–20 minutes. After this time has elapsed, remove the baby from the bathroom and pat his skin with a soft towel.The oatmeal bath can be taken once or twice a day. You can also purchase ready-to-use oatmeal bath mixes. As with a salt bath, apply an eczema cream or lotion immediately after taking a bath.

It is recommended to wear clothes made of cotton and natural fabrics

Some fabrics can irritate baby’s skin. Recommends to wear clothes made of cotton and other natural fabrics, as well as use soft sheets and bedding made from these fabrics.Fabric softeners and laundry detergents should also be considered a potential source of irritation. We recommend using hypoallergenic, fragrance-free laundry detergents.

Put cotton mittens or socks on your child’s arms

If the child cannot help but itch or itch during sleep, wear cotton mittens or socks on the child’s arms. They can help prevent unnecessary damage to the skin. Cold compresses with a moisturizer can be applied to relieve itching during flare-ups.

Check baby for food allergies

If your child is still suffering from flare-ups of eczema or their environment is changing too often, it may be time to consider whether they may be sensitive to food allergies. The child’s doctor will be able to determine if the child’s diet is causing exacerbations of eczema, and will provide appropriate advice.

The most common allergies in children are foods such as cow’s milk, eggs, soy, wheat, peanuts and fish.If the baby is breastfed, foods should be taken out of the baby’s and the mother’s diet in turn to find out which foods are improving the baby’s eczema symptoms.

Children with eczema may benefit from switching to a hypoallergenic formula diet. However, you should not switch to a soy-based formula as it could potentially contain allergens as well. A food diary can be a very useful tool for finding a food that a child is sensitive to.Recording what a child has eaten and how their skin reacts over the course of several days can help determine the causes of flare-ups and foods to avoid.

Homemade cream for eczema

Many parents and professionals recommend homemade eczema cream or bathing to help treat particularly stubborn breakouts or aggressive flare-ups with natural ingredients.

The following is a popular homemade natural eczema cream that is safe for children.It requires a steamer, a glass jar with a screw lid, and a hand mixer.

Ingredients:

Instructions:

1. First, melt the shea butter and coconut oil in a double boiler until smooth and easy to mix.
2. Then you should add honey and wait for it to melt. When all ingredients are in a liquid mixed state, add lavender and tea tree oil to the mixture to ensure that they are mixed.
3. The mixture will harden at room temperature. It can be chilled in the refrigerator to speed up the hardening. After the solution has hardened for some time, it should be mixed by hand until it acquires the consistency of a homogeneous cream that can be applied by hand. It can be moved into a screw-top glass jar for storage at room temperature.

Use the mixture sparingly and in small amounts at first to test the skin’s reaction to it.Shea butter and coconut oil are great moisturizers. In addition, coconut oil contains high amounts of vitamin E with medicinal properties. Honey has natural antibacterial properties. Lavender and tea tree oil have healing properties and help soothe itchy skin.

This article was written by the iHerb Staff Writer.

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Allergic dermatoses in children – St. Petersburg State Budgetary Healthcare Institution “Dermatovenerologic Dispensary No. 4”

Of the allergic skin diseases (allergic dermatoses) in children, the most common are: atopic dermatitis, eczema, strofulus, neurodermatitis.

Atopic dermatitis is one of the most common allergic diseases, the prevalence of which varies widely, reaching high numbers in ecologically unfavorable areas.

Atopic dermatitis is an allergic disease with a hereditary predisposition, characterized by a chronic recurrent course, accompanied by itching, manifested by various rashes (redness, peeling, crusts, etc.)resulting from hypersensitivity to specific (allergenic) and nonspecific irritants (provoking factors). Provoking factors contribute to the development or exacerbation of atopic dermatitis. Most often it can be: contact allergens (perfumery, clothing accessories, etc.), inhalation allergens – animal hair, pollen, house dust, food, microbial and fungal microorganisms, climatic conditions, ecology, ENT diseases – organs, diseases of the gastrointestinal tract, psycho – emotional stress.Atopic dermatitis can occur alone or in combination with other allergic diseases (allergic rhinitis, bronchial asthma, etc.). The diagnosis of atopic dermatitis must be made by a dermatologist. There are many diagnostic criteria for atopic dermatitis. The diagnosis is made only if there are 3 main and 3 additional criteria. For a more detailed study of the disease and the identification of factors contributing to the development or exacerbation of the disease, it is necessary to conduct biochemical blood tests, an analysis for dysbiosis, the determination of immunoglobulin E in the blood serum, as well as consultations of narrow specialists according to indications.In the treatment of patients with atopic dermatitis, dynamic observation of the patient is required. The choice of treatment method is selected individually for each patient, taking into account the severity of the disease, age, concomitant diseases.

Eczema and neurodermatitis are also the most common dermatoses of childhood. Eczema most often develops against the background of allergic diathesis. More often, pediatricians, when the initial manifestations of eczema occur in a child, make such diagnoses as “exudative diathesis”, “allergic dermatitis”.Eczema begins at 3-6 months of age. The appearance of small bubbles on the background of reddening of the skin of the face is characteristic. Bubbles quickly open up and microerosions appear, areas of skin wetness, later yellow-brown crusts, scales and peeling are formed. All this can spread to the scalp, ears, limbs and trunk. The process on the skin is accompanied by severe itching, insomnia, and increased irritability. But if you start treating the child on time and correctly, eliminate contact with allergens and adjust the diet, then this leads to recovery.

At the age of 2-3 years, the transformation of eczema into neurodermatitis can occur, which can be localized or widespread. This disease is characterized by very severe itching. On the skin, scratching, lichenification, infiltration are clearly expressed, against a background of slight redness. There is a small amount of serous crusts. In children, the general condition is disturbed, they become capricious, irritable, sleep is disturbed. Localized neurodermatitis is characterized by the presence of lesions on the wrist joints, elbows, popliteal fossa.In the event of intercurrent diseases (acute respiratory infections, influenza, sinusitis, etc.), vaccination, improper external treatment, the localized form can turn into a common one. It is noted that neurodermatitis is often combined with damage to internal organs and disorders in many body systems.

Strofulus is a chronic recurrent allergic dermatosis developing against the background of allergic diathesis. Allergens (cow’s milk, eggs, fish, chocolate, citrus fruits), environmental allergens (plants, flowers, animals, house dust, fluff, etc.) are of great importance in the development of the stropulus.and toxic effects in infectious diseases with impaired functions of the liver, kidneys, helminthic invasions. With stropulus, specific rashes appear very similar to rashes with scabies, therefore it is very important to carefully differentiate these diseases in children.

When scratching a bacterial infection joins, therefore pustular diseases are frequent complications of allergic skin diseases.

Thus, in children with allergic dermatoses, it is necessary to conduct a comprehensive examination by a pediatric dermatologist, and, if necessary, with the participation of an immunologist, gastroenterologist and other specialists.Prevention and treatment of allergic dermatoses should be carried out constantly and purely individually for each child.

Buzyreva Lyudimila Valerievna

90,000 Honest Review | Dermacosmetics AHAVA Clineral X-Zem against eczema

Eczema …

A word familiar to many, but it is not customary to talk about it, although a rather high percentage of both adults and children suffer from various eczematous skin lesions. There are many types of this disease, the mechanism of development is similar to the mechanism of development of allergies, the provoking factor is primarily stress.

One of the most common types of eczema is dyshidrotic eczema or dyshidrosis

The disease is unpleasant, it does not respond well to therapy, the stages of remission are short-term, and during the period of exacerbation, the skin looks, to put it mildly, completely unsightly. Most eczematous lesions primarily affect the hands, since it is the skin of the hands that is most susceptible to aggressive environmental influences: sudden changes in temperature, dust, sweat, detergents, etc.

What dyshidrosis looks like through the eyes of an ordinary man in the street

subcutaneous vesicles filled with fluid appear on the lateral surfaces of the fingers and palms, their appearance is accompanied by itching, so the vesicles are often combed, burst and turn into ulcerated, weeping wounds.Since there can be many bubbles, the area of ​​ulcerated skin can be quite extensive. Such lesions heal for a long time, at first they get wet, then the skin in the healing sites remains dry for a long time.

In therapy, both medicinal and cosmetic preparations are used, in the moments of remission and after relieving an exacerbation, it is correct to use specialized cosmetics intended for skin prone to eczema.

This means Clineral X-ZEM hand cream from the Israeli brand Ahava, which creates care and dermacosmetics under the motto “balance between nature and science.”Dermacosmetics of this brand are developed with dermatologists and have passed clinical trials.

Package

Cardboard box containing a tube made of soft matte plastic with a flip-top lid and a leaflet with detailed information about the product, laconic color design, in a calm blue and white tones. The shape of the tube is ergonomic, fits well in the hand, soft plastic allows you to easily and accurately dispense the required amount of product. The lid is reliable and will not open unexpectedly: if you are prone to eczema, you need to apply the cream quite often, so the cream should tolerate travel well in the bag, without the risk of spoiling all its contents.Also, the tube protects the product from the penetration of dust and bacteria, since contact with the external environment is minimal.

Item

Light beige cream, dense, nourishing, rich, slightly oily texture. The aroma is pronounced, natural, floral with a slight citrus sourness; it remains a light weightless haze on the skin.

Application

Applies and spreads easily, due to its dense texture it takes time to fully absorb, leaves the skin feeling like a film, but not greasy and oily.Taking into account the rich composition and purpose of the product, the creation of a film is an inevitable property of the product for the performance of the declared actions: protection, creation of a barrier, retention of moisture in the skin, removal and prevention of irritation.

Due to the density and ease of distribution, consumption is minimal, 125 ml tubes will last for 4-6 months of daily use about 2-3 times a day, and given its fairly affordable price in the dermacosmetics segment, the purchase is the most profitable.

Impressions, result

My cream Clineral X-ZEM was used after relieving an exacerbation to moisturize healed eczematous lesions in dyshidrotic eczema and as a prophylactic agent at the time of remission.

Important! At the moment of exacerbation, when the vesicular vesicles have already opened, forming a weeping ulcerated surface, the use of moisturizers is not indicated, this is a stage of drug therapy under the supervision of a physician.

Itching relief

In dyshidrosis, itching is present at the stage of the vesicles, when they have not opened, and at the stage of healing of the ulcerated surface: the skin in the places of healing wounds is thin, stretched, overdried. Cream Clineral X-ZEM within 3-5 minutes already has a soothing effect and itching gradually disappears.

Moisturizing and nourishing

No matter what type of eczema you have to fight, general dryness of the skin is a mandatory attribute of the disease. The constant daily use of the cream improves the general condition of the skin, makes it soft and nourished, without places of inflammation and peeling, that is, it acts as an excellent prevention of the occurrence of provoking factors of the disease.

Protective, barrier action

The dense texture of the cream forms a protective film on the skin surface that protects against moisture, dust, bacteria.Eczema is paradoxical: it leads to dry skin, but external exposure to water is a provoking factor, so the presence of a protective film on the skin is mandatory. This film is palpable, you need to get used to it, but since the application of the product is comfortable, you very quickly cease to notice its presence.

Economy

Unfortunately, eczema is a disease that cannot be cured, the goal of treatment is to achieve remission. Specialized care products must be used continuously.Cream Clineral X-ZEM for one application requires a minimum amount – the size of a pea, so the tube will last for a long time, every ruble spent pays for itself. And due to the high quality of the product, you can forget about the problem of finding a suitable product for a long time and not worry about the condition of your skin, and stress, as you know, also provokes skin diseases)

High product quality and safety

When we are dealing not just with care cosmetics, but with dermatological cosmetics, which are aimed at eliminating signs of the disease, it is necessary to choose products with a name, TM AHAVA is a brand with a worldwide reputation that values ​​its reputation and guarantees quality, therefore, making a choice in benefit from the dermatological lines of this manufacturer, you can be sure of the quality and safety of products.

Skin – the largest organ of the human body

This is our shield against aggressive factors of the surrounding world, therefore taking care of it is a guarantee of health and beauty. Unfortunately, dermatological problems are familiar to most people, so the choice of care must be approached responsibly and sensibly. Cream TM AYAVA Clineral X-ZEM will suit even the most capricious skin, has no age-related contraindications, and its effectiveness and quality will satisfy the most demanding requirements.

Eczema

Contents:

Disease of eczema

Clinical picture

Atopic dermatitis

Psoriasis

Definition

Chronic erythematous-vesicular skin disease developing against the background of special changes in its reactivity.

Allocate:

Clinical picture

The disease begins acutely with edematous erythema, against the background of which microvesicles with a pinhead appear.They open up rather quickly, exposing micro-erosion. Some microvesicles dry out with the formation of crusts, in addition, pityriasis scales are formed. As a result of the gradual appearance of more and more new microvesicles, the lesion focus increases in size and acquires a polymorphic appearance associated with the evolutionary polymorphism of the vesicles. Itching is characteristic.

Eczema is characterized by a long and capricious course – an exacerbation of the process for no apparent reason. As the inflammatory phenomena subside, the disease passes into a chronic stage, characterized by congestive hyperemia, lack of wetness, infiltration and lichenification of the skin.

The following clinical types of eczema are distinguished:

• Plaque eczema
• Eczematid
• Dyshidrotic eczema
• Corneous eczema

Atopic dermatitis

and vesicular eruptions.

Clinical presentation: the disease begins in childhood.The first symptoms usually develop at 4-5 months of a child’s life and are characterized by erythematous-vesicular weeping elements that appear on the cheeks and quickly spread to the forehead, eyelids, and chin. The bubbles dry out, forming a layered serous crusts. In the future, the scalp, ears, extensor surfaces of the limbs are affected. The disease is accompanied by severe itching, secondary pyococcal lesions (impetigo, folliculitis) may appear against the background of scratching.With age, the severity of the disease decreases, erythematous-vesicular rashes are replaced by papular-pruriginous, and the process takes on the character of chronic inflammation. Bubbles and oozing appear only with pronounced exacerbations and relapses.

In this period, the lesions look like merging papules against the background of thickening, dryness and hardening of the skin (xerosis), as well as an increase in its pattern (lichenification). The skin acquires a dull shade and latent or rather pronounced peeling (acquired ichthyosis), areas of uneven hypo- and hyperpigmentation, as well as white dermographism.Pronounced excoriation is characteristic. The most common localization of the rash is the cubital and popliteal fossa, flexion surfaces of the limbs, the lateral surfaces of the neck, chest, wrists, and the back of the feet. There is a pallor of the skin of the face, accentuation and strengthening of the folds of the lower and upper eyelids (“Morgan folds”) develops around the eyes. Due to dryness, the skin of the palms is characterized by a large number of fine lines and folds.

Psoriasis

Definition: chronic inflammatory immune-dependent genodermatosis, transmitted in a dominant manner with incomplete penetrance, characterized by an increase in the proliferative activity of keratinocytes with impaired keratinization processes and the development of pathological processes in the skin, nails and joints.

Clinical picture: there are 4 types of psoriasis.

• Psoriasis vulgaris
• Psoriatic arthritis
• Psoriatic erythroderma
• Pustular psoriasis, which in turn is subdivided into generalized pustular psoriasis (Zumbusch type psoriasis) and pustular psoriasis of the palms and soles of the barbariasis (psoriasis)

  manifested by the appearance on various parts of the body, often symmetrically on the extensor surfaces of the upper and lower extremities, flat miliary papules of pink color, which grow along the periphery and gradually turn into larger – lenticular and nummular papules, as well as plaques, at the same time becoming covered with silvery, easily detachable scales …Papules and plaques in the process of peripheral growth can merge, forming bizarre shapes, and affect large areas of most of the body (diffuse psoriasis), and sometimes almost the entire skin (universal psoriasis). Subjective sensations are usually absent.

  When the scales are scraped, a “psoriatic triad” appears, consisting of three sequentially isolated symptoms:

  • stearin stain
  • terminal film
  • “blood dew” symptom

  Another important diagnostic test is the characteristic “isomorphic reaction”, or phenomenon Kebner, – the appearance of fresh rashes at the site of local skin damage by factors of a physical or chemical nature.

  The process of the course of psoriasis is characterized by three periods – progressive, stationary and a period of regression.

  In addition to the three periods, psoriasis vulgaris has two forms – winter and summer.
  Psoriasis vulgaris can affect any area of ​​the skin, but mainly those that are more likely to be traumatized (elbow and knee joints, extensor surfaces of the extremities). In these areas, after the resolution of the psoriatic rash for a long (several years) period, single (“duty”) plaques often remain.

  Phenylketonuria

  Phenylketonuria – a hereditary disorder of amino acid metabolism caused by a deficiency of liver enzymes involved in the metabolism of phenylalanine to tyrosine. Early signs of phenylketonuria are vomiting, lethargy or hyperactivity, moldy odor from urine and skin, delayed psychomotor development; typical late signs include oligophrenia, physical retardation, seizures, eczematous skin changes, etc.Screening of newborns for phenylketonuria is carried out in the maternity hospital; subsequent diagnostics include molecular genetic testing, determination of the concentration of phenylalanine in the blood, biochemical analysis of urine, EEG, MRI of the brain. Treatment of phenylketonuria consists in adherence to a special diet.

  General

  Phenylketonuria (Felling’s disease, phenylpyruvic oligophrenia) is a congenital, genetically determined pathology characterized by impaired hydroxylation of phenylalanine, accumulation of amino acids and its metabolites in physiological fluids and tissues, followed by severe damage to the central nervous system.Phenylketonuria was first described by A. Felling in 1934; occurs with a frequency of 1 in 10,000 newborns. In the neonatal period, phenylketonuria has no clinical manifestations, however, the intake of phenylalanine with food causes the manifestation of the disease already in the first half of life, and subsequently leads to severe developmental disorders of the child. That is why the presymptomatic detection of phenylketonuria in newborns is the most important task of neonatology, pediatrics and genetics.

  Causes of phenylketonuria

  Phenylketonuria is an autosomal recessive disorder.This means that for the development of clinical signs of phenylketonuria, the child must inherit one defective copy of the gene from both parents who are heterozygous carriers of the mutant gene.

  Most often, the development of phenylketonuria is caused by a mutation of the gene encoding the enzyme phenylalanine-4-hydroxylase and located on the long arm of chromosome 12 (locus 12q22-q24.1). This is the so-called classical type I phenylketonuria, accounting for 98% of all cases of the disease. Hyperphenylalaninemia can reach 30 mg% or more.If untreated, this variant of phenylketonuria is accompanied by profound mental retardation.

  In addition to the classical form, there are atypical variants of phenylketonuria, proceeding with the same clinical symptoms, but not amenable to correction by diet therapy. These include type II phenylketonuria (dehydropterin reductase deficiency), type III phenylketonuria (tetrahydrobiopterin deficiency), and other, more rare variants.

  The likelihood of having a child with phenylketonuria increases with the conclusion of closely related marriages.

  Pathogenesis of phenylketonuria

  The classic form of phenylketonuria is based on the deficiency of the enzyme phenylalanine-4-hydroxylase, which is involved in the conversion of phenylalanine to tyrosine in the mitochondria of hepatocytes. In turn, the tyrosine derivative tyramine is the initial product for the synthesis of catecholamines (adrenaline and norepinephrine), and diiodotyrosine is for the formation of thyroxine. In addition, the result of the metabolism of phenylalanine is the formation of the pigment melanin.

  Hereditary insufficiency of the enzyme phenylalayin-4-hydroxylase in phenylketonuria leads to a violation of the oxidation of phenylalanine supplied with food, as a result of which its concentration in the blood (phenylalaninemia) and cerebrospinal fluid increases significantly, and the level of tyrosine decreases accordingly. The excess content of phenylalanine is eliminated by increased urinary excretion of its metabolites – phenylpyruvic, phenyl lactic and phenylacetic acids.

  Impaired amino acid metabolism is accompanied by impaired myelination of nerve fibers, a decrease in the formation of neurotransmitters (dopamine, serotonin, etc.)), triggering the pathogenetic mechanisms of mental retardation and progressive dementia.

  Symptoms of phenylketonuria

  Newborns with phenylketonuria do not show clinical signs of the disease. Usually, the onset of phenylketonuria in children occurs at the age of 2-6 months. With the beginning of feeding, breast milk protein or its substitutes begins to enter the child’s body, which leads to the development of the first, nonspecific symptoms – lethargy, sometimes – anxiety and hyperexcitability, regurgitation, muscular dystonia, convulsive syndrome.One of the early pathognomonic signs of phenylketonuria is persistent vomiting, which is often mistakenly regarded as a manifestation of pyloric stenosis.

  By the second half of the year, the child’s lag in psychomotor development becomes noticeable. The child becomes less active, indifferent, ceases to recognize loved ones, does not try to sit down and stand on his feet. The abnormal composition of urine and sweat results in a characteristic “mouse” odor (moldy odor) emanating from the body. Peeling of the skin, dermatitis, eczema, scleroderma is often observed.

  Children with phenylketonuria who do not receive treatment have microcephaly, prognathia, later (after 1.5 years) teething, and enamel hypoplasia. There is a delay in speech development, and by 3-4 years deep oligophrenia (idiocy) and an almost complete absence of speech are revealed.

  Children with phenylketonuria have a dysplastic physique, often congenital heart defects, autonomic dysfunctions (sweating, acrocyanosis, arterial hypotension), and suffer from constipation.The phenotypic characteristics of children with phenylketonuria include fair skin, eyes and hair. A child with phenylketonuria is characterized by a specific “tailor’s” posture (upper and lower limbs bent at the joints), hand tremors, shaky, mincing gait, hyperkinesis.

  Clinical manifestations of type II phenylketonuria are characterized by severe mental retardation, increased excitability, convulsions, spastic tetraparesis, tendon hyperreflexia. The progression of the disease can lead to the death of a child at the age of 2 to 3 years.

  With type III phenylketonuria, a triad of signs develops: microcephaly, oligophrenia, spastic tetraparesis.

  Diagnosis of phenylketonuria

  Currently, the diagnosis of phenylketonuria (as well as galactosemia, congenital hypothyroidism, adrenogenital syndrome and cystic fibrosis) is included in the neonatal screening program for all newborns.

  A screening test is carried out on the 3-5th day of life of a full-term and 7th day of life of a premature baby by taking a sample of capillary blood on a special paper form.If hyperphenylalanemia is detected, more than 2.2 mg% of the child is referred to pediatric genetics for re-examination.

  To confirm the diagnosis of phenylketonuria, the concentration of phenylalanine and tyrosine in the blood is checked, the activity of liver enzymes (phenylalanine hydroxylase) is determined, a biochemical study of urine (determination of ketonic acids), metabolites of catecholamines in the urine, etc. is performed.

  A genetic defect in phenylketonuria can be detected even at the stage of pregnancy during invasive prenatal diagnosis of the fetus (chorionic biopsy, amniocentesis, cordocentesis).

  The differential diagnosis of phenylketonuria is carried out with intracranial birth trauma of newborns, intrauterine infections, and other disorders of amino acid metabolism.

  Treatment of phenylketonuria

  The fundamental factor in the treatment of phenylketonuria is adherence to a diet that limits the intake of protein into the body.It is recommended to start treatment with a phenylalanine concentration> 6 mg%. For infants, special mixtures have been developed – Afenilak, Lofenilak; for children over 1 year old – Tetrafen, Phenyl-free; over 8 years old – Maxamum-HR, etc. The basis of the diet is low-protein foods – fruits, vegetables, juices, protein hydrolysates and amino acid mixtures. Expansion of the diet is possible after 18 years of age due to an increase in tolerance to phenylalanine. In accordance with Russian legislation, the provision of medical nutrition to persons suffering from phenylketonuria should be carried out free of charge.

  Patients are prescribed the intake of mineral compounds, B vitamins, etc.; according to indications – nootropic drugs, anticonvulsants. In the complex therapy of phenylketonuria, general massage, exercise therapy, acupuncture are widely used.

  Children suffering from phenylketonuria are under the supervision of a local pediatrician and neuropsychiatric specialist; often need the help of a speech therapist and a speech pathologist. Careful monitoring of the neuropsychic status of children, control of the level of phenylalanine in the blood and electroencephalogram indicators is required.

  Atypical forms of phenylketonuria that cannot be treated with diet require the appointment of hepatoprotectors, anticonvulsants, replacement therapy with levodopa, 5-hydroxytryptophan.

  Prediction and prevention of phenylketonuria

  Conducting mass screening for phenylketonuria in the neonatal period allows organizing early diet therapy and preventing severe cerebral damage and liver dysfunction. With the early appointment of an elimination diet for classical phenylketonuria, the prognosis for the development of children is good.When treatment is started late, the prognosis for mental development is poor.

  Prevention of complications of phenylketonuria consists in mass screening of newborns, early appointment and long-term adherence to diet.

  In order to assess the risk of having a child with phenylketonuria, couples who already have a sick child, are consanguineous, and have relatives with this disease should undergo preliminary genetic counseling.Women with phenylketonuria planning a pregnancy should follow a strict diet before conception and during pregnancy to avoid an increase in the level of phenylalanine and its metabolites and impair the development of a genetically healthy fetus. The risk of having a child with phenylketonuria in parents who are carriers of the defective gene is 1: 4.

  90,000 Vaccinations can harm the health of our children – Rossiyskaya Gazeta

  Svetlana noticed something wrong in the evening, barely crossing the threshold of the apartment.His son’s eyes glittered suspiciously, and his cheeks blazed with fire. The thermometer stopped only at around 38.7. What was the matter, I realized only when, helping him, with the fire burning, throw off his shirt, I saw a hand. All of her, from the wrist to the shoulder, was like a strangely crimson cake that came up strongly.

  Immunity fee

  Everything is clear: vaccination! But what kind of impromptu? Shouldn’t have done it! Anyway, without warning. At his ten years old Ilyusha has a whole bunch of diagnoses.And each has the keyword “allergic”. Allergic bronchial asthma, allergic rhinosinusopathy, psoriasis.

  True, the nurse is new at the school since September. But she certainly knows how to read. There must be some kind of medical records. And then Svetlana for the first time thought: and the decision to make – not to get vaccinated, really should the nurse take? Only if there is a doctor at school, then it seems that this is some kind of invisible doctor. She had never seen him, and had never heard of him.Svetlana does not remember that he was in previous years. But in previous years, and similar “school-vaccination” impromptu did not happen.

  In the children’s clinic, everyone – from the nurse to the head of the department – was indignant and alarmed. The nurse called the school. Svetlana was alarmed by what she dropped in this conversation: “Well, at the age of 14 he needed to …” The doctor said that people like Ilyusha, if they do vaccinations, then only in the presence of an immunologist. But for the school nurse, the attending physician does not seem to be a decree.She demanded the appropriate piece of paper from the immunologist. This turned out to be more difficult. Ilyusha was observed at the Pediatrics Research Institute until last year. But then the services of his specialists became paid. There is no immunologist in the polyclinic. Ilyushka was sent “to the neighbors” – for a one-time consultation. And this “one-time” consultant, Svetlana, happily assured that the boy would perfectly endure all the injections provided for by the law without his intervention.

  And it was worth running so much! Maybe just write refusal after refusal? But, on the other hand, the son was given a vaccine to protect him from unpleasant infections.In diphtheria, as in asthma, the airways can be blocked. Complications hit the heart and kidneys. Tetanus seriously affects the nervous system. The gate for him is a wound surface. And the boy can do without wounds? Fever, hives, edema in response to vaccination are not uncommon these days. Only now Ilyusha has reached asthma. This, of course, will not be written in any medical record. But she saw: like a vaccine, so a new surprise. Is the immunity fee too high?

  Fatal side effects

  It turns out to be really high.The most compelling argument belongs, of course, to the English physician Edward Jenner, who lived two centuries ago. He believed that introducing a living infectious substance to healthy people (especially children) is very risky. That it is impossible to vaccinate children of the first weeks of life and people who are weak. He warned against smallpox vaccination (and then it was the only vaccine) against the background of not only an outbreak, but even the threat of an outbreak of any of the infections. And in general, he believed that vaccination should be carried out only in case of real danger, only by those who had contact with the sick person.

  Scientific works of just such a tonality have appeared both in our country and in the world since the middle of the last century. Seven years ago, scientists of the now renamed Peoples’ Friendship University of Russia L. Kuzmenko, N. Tyurin,

  D. Ovsyannikov published the results of twenty years of observation of a group of 122 children with the same difficult reaction as Ilya’s to the vaccine. These kids came to the attention of scientists when the youngest of them was three months old, and the oldest was eight years old. And they all completely “worked out” the lists of possible complications that vaccine manufacturers usually warn about.Encephalitis, obstructive bronchitis, pneumonia, pyelonephritis, bronchial asthma, anaphylactic shock, myocarditis, autoimmune hemolytic anemia, ARVI with croup syndrome … Allergic diseases developed in about a quarter of children. Among them there were those who had bronchial asthma for the first time, but in most of them the vaccine caused an exacerbation of an already existing disease.

  The vaccine, it turns out, first enhances the immune response, and then suppresses. In the phase of “depression” an infection can overcome the child.Scientists have identified two peaks in incidence after vaccinations: in the first three days and in the period from 10th to 30th days after vaccination. In about a third of children, an infection has joined the pathologies that sharply manifested after the introduction of the vaccine. It is known that the least stable immune system is in children during the first two years of life. But especially at the age of one to two. And here the four smallest were under the greatest blow. The associated infection caused croup syndrome in someone, purulent meningitis in someone…

  The youngest (he was only 9 months old) died on the 3rd day after the administration of the DPT vaccine, the oldest (15 months) left a week later. It turned out that their immune status (and not only them) was lowered even before vaccination: someone was unwell, someone was born that way.

  Scientists have been observing a group of these vulnerable children for twenty years. But even with such low-optimistic results, we considered it necessary to cite the monograph of our colleagues from Tomsk: “Phenomena that are delicately called vaccine side effects in medical use are nothing more than the visible part of the iceberg, the true size of which we are only beginning to guess.”

  How to vaccinate so as not to harm

  A summary of this work was something like this:

  Only healthy children should be vaccinated. Vaccinations earlier than 4 weeks after an illness (acute or chronic exacerbation) contributes to complications. (On many sites I have come across a recommendation to vaccinate the very next day after the temperature returns to normal!)

  Children with allergic diathesis, as well as hereditary burden of allergic and other immunopathological conditions, and any reaction to any of the vaccines in the history, need rehabilitation measures before vaccination (antihistamines within 7 to 10 days before vaccination and 3 days after it).(Svetlana, if you remember, could not do this – she was not warned about vaccination.)

  There are recommendations for preparing for vaccination of children against the background of a current allergic disease. (Just like Ilyusha.) But they seem to be especially for immunologists. So Ilyushin, the “outside consultant”, was wrong to disown patronage when vaccinating a child who might well react to this intervention with anaphylactic shock. (And, by the way, he took a risk. Among the sad Internet stories on the topic of vaccination was the story of one dad about how his son was vaccinated with ADSM in kindergarten, just like Ilyusha, out of the box.The boy died. The perpetrators were convicted.)

  There is also a clause in these conclusions that strongly recommends limiting the child’s contacts as much as possible within a month after vaccination in order to avoid the risk of joining an infectious disease reaction to vaccination. (Something I don’t remember!)

  And more. The need for vaccination against a particular infection is often justified by the severity of the disease from which the vaccine is being vaccinated and its complications. This scientific work proves that the difficult current period after the introduction of the vaccine gives rise to pathologies in the body that are even more severe than the complication of the infection.

  At the end of the work, the authors assure that, of course, all this should not in the least discredit the idea of ​​immunization, which has saved millions of people from the worst infections. On the contrary, it should serve as a stimulus for “optimizing immunoprophylaxis”, reducing its possible side effects.

  Quality vaccine

  But what can discredit an idea other than the idea itself? “In Russia, the mortality rate of children aged 0 to 5 years exceeds the same European indicator by 5.27 times.The number of practically healthy children dropped to 30 percent. Neuropsychiatric disorders are detected in 60 percent of school graduates. Indicators of mental illness in children and adolescents are twice as high as in adults, and have a steady upward trend. ”These are data from the Russian Academy of Medical Sciences.

  Of course, for many, a vaccine is not sugar. Life is not sugar for many. “There is a downward trend in the number of children with normal body weight. According to the criteria of the World Health Organization, 30 percent of the population in Russia is undernourished.At the same time, the most suffering group is children from 10 to 14 years old. “(Same source.) It turns out that only a third of our children can pass the post-vaccination period without any special troubles. The rest absolutely need medical support and increased attention of doctors both before and after administration. I remembered “Edward Jenner’s associates”, who believed that only a healthy person could tolerate vaccine administration without harm to health, and after a conversation with the Director of the Institute of Immunology of the FMBA RF, Academician of the Russian Academy of Sciences and RAMS Rakhim Khaitov.

  Rakhim Musaevich believes that immunization is absolutely necessary. And the introduction of a high-quality vaccine to a basically healthy person will really protect him from many troubles. But what is a quality vaccine?

  Rakhim Khaitov | Many of the vaccines used 20-30 years ago were harmful. It was a “compote” – microbes and many other ingredients suspended in aluminum hydroxide. These technologies are no longer used today. We have a new generation of vaccines – genetically engineered.They are very clean and drug-like.

  Russian newspaper | Is the entire National Vaccination Schedule covered?

  Khaitov | There are such vaccines in the National Calendar. In general, we have several dozen of them. But do you know how much time and money it takes to develop one vaccine? Thirty years and several billion dollars! Only it should be done anyway. Indeed, today, for example, it is unsafe to vaccinate against influenza with a “live” vaccine – even in an epidemiological sense.The virus introduced into the body will multiply, God forbid, it will meet the virus of the same bird flu (and our poultry houses are at risk) – a new and very dangerous strain for humans is ready.

  RG | But is vaccination with a “dead” vaccine in progress?

  Khaitov | A vaccine developed at our institute is recommended. She is genetically engineered – two proteins and an immunostimulant. Practically does not give complications. And this is important, because this year, for the first time, influenza vaccination was included in the vaccination calendar – for risk groups.

  RG | And in these groups there are small children. And, you know, not all of them can be called healthy. For ill health, there is often a decrease in the body’s defenses. And then there’s the vaccine. I know that with your active participation in the 1970s, a network of regional centers and laboratories of clinical immunology was created in the USSR. And you even created an immune map of the country. Is it possible in them to determine the immune status of children before vaccinations?

  Khaitov | These laboratories were created to assess the immune status of the population and the influence of adverse factors on it.But it is very difficult and expensive to determine the immune status of each child before vaccination. In addition, I do not see a special need for it for everyone. If there is an immunodeficiency, it necessarily manifests itself with any symptoms. And then this person will get to our clinic or he will be sent to one of our laboratories. When vaccinated, this condition is, of course, taken into account.

  RG | But there are “borderline states”. The disease has not yet developed into symptoms, but it is ripening – and then the vaccine.

  Khaitov | The decision on vaccination is made by the doctor. And he knows that only healthy children can be vaccinated. Because a vaccine given to a person in ill health can cause complications. Even the cleanest and most non-toxic. The doctor is legally responsible for the result of the vaccination. And the doctor will surely notice the illness.

  RG | Are you saying that the law purely automatically saves you from trouble?

  Khaitov | Today I read an interview with Gennady Onishchenko.And he said that doctors are very well aware of the extent of their responsibility for vaccination. After all, they introduce a biologically active substance.

  “Atopic March”

  Ilyusha once again gave an acute reaction to one of the modifications of the vaccine mentioned more than once in the material. Perhaps, it is precisely her that should not be introduced to such children? We asked about this from the head of the department of immunopathology in children of the clinic of the Institute of Immunology of the FMBA of Russia, Doctor of Medical Sciences Mikhail Yartsev.

  He has been treating children like Ilyusha for more than one year. And, as no one knows: bronchial asthma, the “amplitude” of reactions to vaccination in them is quite even, and therefore predictable. But Dr. Yartsev nevertheless makes a reservation: this is his view of the problem in principle. Had the boy Ilyusha been at his reception, to his mother, perhaps he would have said slightly different words.

  Head of the Department of Childhood Diseases, Moscow Medical Academy Sechenova, Professor Natalia Geppe, on the basis of long-term clinical observations, proved that many children come to bronchial asthma in stages.From atopic dermatitis through allergic rhinitis and bronchial obstruction. This “path of many” she called the “atopic march”.

  Like Dr. Yartsev, Natalya Geppe believes that children with bronchial asthma can be vaccinated only during a quiet period and always against the background of a course of treatment. And one more thing: such a child should be vaccinated only in the immunoprophylaxis office and in no case disappear from the doctor’s field of vision for the next forty minutes.

  So, leafing through Ilyushin’s map, comparing the dates of vaccinations, Ilya’s reactions to them in the records and in Svetlana’s stories, I saw this “atopic march” – from allergic dermatosis to moderate allergic bronchial asthma and psoriasis – with my own eyes.And the “rhythm beat off” planned vaccinations. The impetus for almost each of them at an early age was … a recipe for baby food. This was how one “unspoken order from above” was implemented.

  Then they started to postpone vaccinations – serious diagnoses started. But towards the end of this “folio” Ilyushkin I thought that this was not the only “unspoken order from above.” I leafed through it under the synchronous comments of Svetlana – about asthma attacks, about psoriasis “crusts” under the hair, about wheezing, which the doctor for some reason did not hear, and Svetlana heard with “naked ear” and the doctor confirmed them the next day.But on the pages of the map corresponding to these memories I saw: “the skin is clean”, sometimes “obstructive bronchitis”, but more often ARVI. Despite the fact that the treatment was prescribed for bronchial asthma, including inhalers. How could it be otherwise? Without them, Ilyukha would have become very bad. And all the diagnoses are “from Mr. Baranov.” I had to make a telephone “reconnaissance”. It turned out that the approach to Ilyushin’s peers with serious diagnoses was somewhat different than to those of his peers. Which is natural. Girls have not yet been called up in our country.

  And what happens? It is risky to refuse vaccinations. Not to refuse – too. Especially when universal immunization is very reminiscent of universal collectivization with its inherent “local excesses” to improve statistics. With “unspoken orders” circulating vertically and horizontally. Are these excesses born in the localities? I think the truth is, as always, in the middle. Last year “RG” – “Nedelya” wrote about a simple, “mediated” method of determining the immune status of a person that does not require expensive equipment.

  – Our nervous system is closely related to the immune system. Today, to understand whether the nerves are healthy, just a drop of blood is enough. And the more disorder in the nervous system, the more active enzymes of the cells of the immune system are in the blood. An increase in the activity of these enzymes is observed in the blood – it’s time to see a neurologist. And if there is a question about vaccination, then it is better to wait until these indicators return to normal, – this is how the head of the molecular biology laboratory of the Scientific Center for Mental Health of the Russian Academy of Medical Sciences, Doctor of Medical Sciences, Tatyana Klyushnik, told our readers about this method.

  Maybe this is just the way out? Especially if we add to the widespread introduction of this test the desire of the staff to fulfill the right of everyone, enshrined in the aforementioned federal law, to know contraindications to the drugs injected and possible complications. And, of course, the changing situation in school and preschool medicine.

  ATTENTION, PARENTS!

  Nurse’s Law

  So, the doctor must understand the extent of his responsibility. But I think the reader will agree with me: in the case of my colleague’s son, neither the doctor, nor the understanding of the measure of responsibility was observed.Who trains the staff to work in schools? Who is responsible for the level of their qualifications and, by and large, for their personal qualities? I asked these questions to the Deputy Head of the Epidemiological Surveillance Department of Rospotrebnadzor Galina Lazikova.

  Galina Lazikova | The question is not entirely for me, but I will answer: the medical staff of polyclinics work in schools.

  Russian newspaper | The work of school doctors is probably regulated by some document?

  Lazikova | School doctors are obliged to follow the Federal Law “On Immunoprophylaxis of Infectious Diseases”.According to this law, underage children can only be vaccinated with the consent of their parents or their substitutes. In relation to Ilyusha, the school nurse violated this very law.

  RG | Could she not have known about this law?

  Lazikova | Only specialists who have undergone additional training are allowed to immunize the population. A nurse cannot not know this law and this point of it – she simply would not be allowed to work.

  RG | But this nurse did not even know about Ilya’s asthma.Or did she follow the “maximum coverage” of schoolchildren with vaccinations? Although the instructions for this particular vaccine say: “There are no absolute contraindications.” In the law on immunization, I did not find a list of contraindications to vaccines.

  Lazikova | And you won’t. He’s not there. You are not surprised that there are no contraindications to drugs in the Law “On Medicines”? Each pharmacological preparation has a so-called pharmacological article. In it, in particular, the conditions of delivery and storage, instructions for use.Possible side effects and contraindications are also indicated there. You will find all this information in every vaccine box.

  RG | But suppose contraindications were ignored and this entailed tragic consequences.