Поддержание ремиссии и профилактика обострений заболевания у детей с атопическим дерматитом. Позиционная статья Ассоциации детских аллергологов и иммунологов России
Поддержание ремиссии и профилактика обострений заболевания у детей с атопическим дерматитом. Позиционная статья Ассоциации детских аллергологов и иммунологов России
Смолкин Ю.С., Мигачева Н.Б., Смолкина О.Ю. Поддержание ремиссии и профилактика обострений заболевания у детей с атопическим дерматитом. Позиционная статья Ассоциации детских аллергологов и иммунологов России. Педиатрия. Consilium Medicum. 2020; 2: 38–45. DOI: 10.26442/26586630.2020.2.200149
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Аннотация
Атопический дерматит (АтД) является хроническим заболеванием с рецидивирующим течением и оказывает значительное негативное влияние на качество жизни пациентов и членов их семей. Важнейшее внимание в клинической практике должно уделяться мероприятиям, направленным на поддержание ремиссии заболевания и профилактику обострений. Ключевыми среди таких мероприятий являются: постоянный рациональный уход за кожей пациента в период ремиссии АтД, максимальное исключение воздействия аллергенных и неаллергенных триггеров, своевременное использование наружных противовоспалительных препаратов при первых признаках обострения заболевания. Достижение поставленных целей возможно только в ходе тесного взаимодействия врача с родителями детей, страдающих АтД, терапевтического обучения пациентов и активного вовлечения их в процесс контроля над течением заболевания.
Ключевые слова: атопический дерматит, себорейная кожа, уход за кожей при атопическом дерматите.
Key words: atopic dermatitis, seborrheic skin, skin care for atopic dermatitis.
Ключевые слова: атопический дерматит, себорейная кожа, уход за кожей при атопическом дерматите.
________________________________________________
Key words: atopic dermatitis, seborrheic skin, skin care for atopic dermatitis.
Список литературы
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[Balabolkin I.I., Bulgakova V.A., Eliseeva T.I. Atopic dermatitis in children. Moscow: Medical News Agency, 2018 (in Russian).]
2. Torres T, Ferreira EO, Gonçalo M et al. Update on Atopic Dermatitis. Acta Medica Portuguesa 2019; 32 (9): 606–13.
3. Альбанова В.И., Пампура А.Н. Атопический дерматит. М.: ГЭОТАР-Медиа, 2016.
[Albanova V.I., Pampura A.N. Atopic dermatitis. Moscow: GEOTAR-Media, 2016. (in Russian).]
4. Drucker AM. Atopic dermatitis: Burden of illness, quality of life, and associated complications. Allergy Asthma Proceed 2017; 38 (1): 3–8.
5. Атопический дерматит у детей: обновление 2019 (на правах руководства). Согласительный документ Ассоциации детских аллергологов и иммунологов России. М.: АДАИР, 2019; Cамара: Полиграфическое объединение «Стандарт», 2019.
[Atopic dermatitis in children: update 2019 (as a guide). Conciliation document of the Association of Children's Allergologists and Immunologists of Russia. Moscow: ADAIR, 2019; Samara: Printing Association “Standard”, 2019 (in Russian).]
6. Eichenfield LF, Ahluwalia J, Waldman A et al. Current guidelines for the evaluation and management of atopic dermatitis: A comparison of the Joint Task Force Practice Parameter and American Academy of Dermatology guidelines. J Allergy Clin Immunol 2017; 139 (4): 49–57.
7. Wollenberg A, Barbarot S, Bieber T et al; European Dermatology Forum (EDF), the European Academy of Dermatology and Venereology (EADV), the European Academy of Allergy and Clinical Immunology (EAACI), the European Task Force on Atopic Dermatitis (ETFAD), European Federation of Allergy and Airways Diseases Patients’ Associations (EFA), the European Society for Dermatology and Psychiatry (ESDaP), the European Society of Pediatric Dermatology (ESPD), Global Allergy and Asthma European Network (GA2LEN) and the European Union of Medical Specialists (UEMS). Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part II. J Eur Acad Dermatol Venerol 2018; 32 (6): 850–78.
8. Pickett K, Frampton G, Loveman E. Education to improve quality of life of people with chronic inflammatory skin conditions: a systematic review of the evidence. Br J Dermatol 2016; 174 (6): 1228–41.
9. Sy W, Lamb AJ. Atopic Dermatitis Disease Education. Adv Exp Med Biol 2017; 1027: 179–84.
10. Cork MJ, Britton J, Butler L et al. Comparison of parent knowledge, therapy utilization and severity of atopic eczema before and after explanation and demonstration of topical therapies by a specialist dermatology nurse. Br J Dermatol 2003; 149: 582–9.
11. Teasdale E, Muller I, Santer M. Carers’ views of topical-corticosteroid use in childhood eczema: a qualitative study of online discussion forums. Br J Dermatol 2017; 176 (6): 1500–7.
12. Lindh JD, Bradley M. Clinical Effectiveness of Moisturizers in Atopic Dermatitis and Related Disorders: A Systematic Review. Am J Clin Dermatol 2015; 16 (5): 341–59.
13. Santer M, Muller I, Yardley L et al. Parents' and carers' views about emollients for childhood eczema: qualitative interview study. BMJ Open 2016; 6 (8): e011887.
14. Gore C, Johnson RJ, Caress AL et al. The information needs and preferred roles in treatment decisionmaking of parents caring for infants with atopic dermatitis: a qualitative study. Allergy 2005; 60 (7): 938–43.
15. Giam YC, Hebert AA, Dizon MV et al. A review on the role of moisturizers for atopic dermatitis. Asia Pac Allergy 2016; 6 (2): 120–8.
16. Lindh JD, Bradley M. Clinical Effectiveness of Moisturizers in Atopic Dermatitis and Related Disorders: A Systematic Review. Am J Clin Dermatol 2015; 16 (5): 341–59.
17. Akerstrom U, Reitamo S, Langeland T et al. Comparison of Moisturizing Creams for the Prevention of Atopic Dermatitis Relapse: a Randomized Double-blind Controlled Multicentre Clinical Trial. Acta Derm Venereol 2015; 95: 587–92.
18. Lynde CW. Moisturizers: What they are and how they work. Skin Therapy Lett 2001; 6 (13): 3–5.
19. Loden M. The clinical benefit of moisturizers. J Eur Academy Dermatol Venereol 2005; 19: 672–88.
20. Breternitz M, Kowatzki D, Langenauer M et al. Placebo-controlled, double-blind, randomized, prospective study of a glycerol-based emollient on eczematous skin in atopic dermatitis: biophysical and clinical evaluation. Skin Pharmacol Physiol 2008; 21 (1): 39–45.
21. Chiang C, Eichenfield LF. Quantitative assessment of combination bathing and moisturizing regimens on skin hydration in atopic dermatitis. Pediatr Dermatol 2009; 26: 273–8.
22. Norrlid H, Hjalte F, Lundqvist A et al. Cost-effectiveness of Maintenance Treatment with a Barrier-strengthening Moisturizing Cream in Patients with Atopic Dermatitis in Finland, Norway and Sweden. Acta Derm Venereol 2016; 96 (2): 173–6.
23. Mason JM, Carr J, Buckley C et al. Improved emollient use reduces atopic eczema symptoms and is cost neutral in infants: before-and-after evaluation of a multifaceted educational support programme. BMC Dermatol 2013; 16 (13): 7.
24. Varothai S, Nitayavardhana S, Kulthanan K. Moisturizers for patients with atopic dermatitis. Asian Pac J Allergy Immunol 2013; 31: 91–8.
25. Sethi A, Kaur T, Malhotra SK, ML. Moisturizers: The Slippery Road. Indian J Dermatol 2016; 61 (3): 279–87.
26. Tichota DM, Silva AC, Sousa Lobo JM, Amaral MH. Design, characterization, and clinical evaluation of argan oil nanostructured lipid carriers to improve skin hydration. Int J Nanomedicine 2014; 11 (9): 3855–64.
27. Hon KL, Tsang YC, Pong NH et al. Patient acceptability, efficacy, and skin biophysiology of a cream and cleanser containing lipid complex with shea butter extract versus a ceramide product for eczema. Hong Kong Med J 2015; 21 (5): 417–25.
28. Seite S, Zelenkova H, Martin R, Fierer N. Using a specific emollient to manage skin microbiome dysbiosis. JAAD 2016; 74 (5): 89–94.
29. Мингалиев Р.А., Кудрявцева А.В. Атопический дерматит у детей как мультифакториальное заболевание, причины возникновения и особенности лечения. Аллергология и иммунология в педиатрии. 2017; 1: 8–14.
[Mingaliev R.A., Kudriavtseva A.V. Atopicheskii dermatit u detei kak mul'tifaktorial'noe zabolevanie, prichiny vozniknoveniia i osobennosti lecheniia. Allergologiia i immunologiia v pediatrii. 2017; 1: 8–14 (in Russian).]
30. Lim NR, Lohman ME, Lio PA. The Role of Elimination Diets in Atopic Dermatitis-A Comprehensive Review. Pediatric Dermatology 2017; 34 (5): 516–27.
31. Galli E, Neri I, Ricci G et al. Consensus Conference on Clinical Management of pediatric Atopic Dermatitis. Ital J Pediatr 2016; 2: 26–42.
32. Stein SL, Cifu AS. Management of Atopic Dermatitis. JAMA 2016; 12 (14): 1510–1.
33. Badina L, Barbi E, Berti I et al. The dietary paradox in food allergy: yesterday’s mistakes, today’s evidence and lessons for tomorrow. Cur Pharmaceutical Design 2012; 18 (35): 5782–7.
34. Campana R, Dzoro S, Mittermann I et al. Molecular aspects of allergens in atopic dermatitis. Curr Opin Allergy Clin Immunol 2017; 17 (4): 269–77.
35. Johansson EK, Bergstrom A, Kull I et al. IgE sensitization in relation to preschool eczema and filaggrin mutation. J Allergy Clin Immunol 2017; 140 (6): 1572–9.
36. Leung DY, Boguniewicz M, Howell MD et al. New insights into atopic dermatitis. J Clin Investigation 2004; 113: 651–7.
37. Das A, Panda S. Use of Topical Corticosteroids in Dermatology: An Evidence-based Approach. Indian J Dermatol 2017; 62 (3): 237–50.
38. Sidbury R, Tom WL, Bergman JN et al. Guidelines of care for the management of atopic dermatitis: section 4. prevention of disease flares and use of adjunctive therapies and approaches. J Am Acad Dermatol 2014; 71: 1218–33.
39. Fukuie T, Hirakawa S, Narita M et al. Potential preventive effects of proactive therapy on sensitization in moderate to severe childhood atopic dermatitis: A randomized, investigator-blinded, controlled study. J Dermatol 2016; 43 (11): 1283–92.
40. Приказ Минздрава России от 07.06.2018 №321н «Об утверждении перечней медицинских показаний и противопоказаний для санаторно-курортного лечения». http://www.garant.ru/products/ipo/prime/doc/71879402/#ixzz5Qak8NB83
[Prikaz Minzdrava Rossii ot 07.06.2018 №321n "Ob utverzhdenii perechnei meditsinskikh pokazanii i protivopokazanii dlia sanatorno-kurortnogo lecheniia'. http://www.garant.ru/products/ipo/prime/doc/71879402/#ixzz5Qak8NB83 (in Russian).]
41. Погонченкова И.В., Рассулова М.А., Хан М.А. и др. Современные технологии медицинской реабилитации детей с атопическим дерматитом. Доктор.Ру. 2016; 12 (129; Ч. 2): 44–7.
[Pogonchenkova I.V., Rassulova M.A., Khan M.A. i dr. Sovremennye tekhnologii meditsinskoi reabilitatsii detei s atopicheskim dermatitom. Doktor.Ru. 2016; 12 (129; Ch. 2): 44–7 (in Russian).]
42. Ring J, Mohrenschlager M, Weidinger S. Molecular genetics of atopic eczema. Chem Immunol Allergy 2012; 96: 24–9.
43. Kezis S, Kemperman PM, Koster ES et al. Loss-of-function mutations in the fillaggrin gene lead to reduce level of natural moisturizing factor in the stratum corneum. J Invest Dermatol 2008; 128: 2117–9.
44. Drucker AM, Wang AR, Li WQ et al. The Burden of Atopic Dermatitis: Summary of a Report for the National Eczema Association. J Invest Dermatol 2017; 137 (1): 26–30.
45. Конова О.М., Дмитриенко Е.Г., Давыдова И.В., Сахарова Е.В. Аромафитованны – эффективный метод гидротерапии в комплексном восстановительном лечении детей с различными болезнями. Вопросы современной педиатрии. 2014; 13 (4): 78–82.
[Konova O.M., Dmitrienko E.G., Davydova I.V., Sakharova E.V. Aromafitovanny – effektivnyi metod gidroterapii v kompleksnom vosstanovitel'nom lechenii detei s razlichnymi bolezniami. Voprosy sovremennoi pediatrii. 2014; 13 (4): 78–82 (in Russian).]
46. Козулин Е.Е., Коулин Е.А. Фитоминеральная корнеотерапия в реабилитации детей с атопическим дерматитом. Дальневосточный мед. журн. 2015; 2: 58–61.
[Kozulin E.E., Koulin E.A. Fitomineral'naia korneoterapiia v reabilitatsii detei s atopicheskim dermatitom. Dal'nevostochnyi med. zhurn. 2015; 2: 58–61 (in Russian).]
47. Козулин Е.Е., Коулин Е.А. Дальневосточные фитоминеральные препараты в предетерминированной реабилитации больных с атопическим дерматитом. Дальневосточный мед. журн. 2018; 1: 77–80.
[Kozulin E.E., Koulin E.A. Dal'nevostochnye fitomineral'nye preparaty v predeterminirovannoi reabilitatsii bol'nykh s atopicheskim dermatitom. Dal'nevostochnyi med. zhurn. 2018; 1: 77–80 (in Russian).]
48. Giacomino MI, de Michele DF. Is mud an antiinflammatory? Anales Medicina Interna 2007; 24 (7): 352–3.
49. Spilioti E, Vargiami M, Letsiou S et al. Biological properties of mud exstracts from various spa resorts. Environ Geochem Health 2017; 39: 821–33.
50. Fioravanti A, Cantarini L, Guidelli GM, Galeazzi M. Mechanisms of action of spa therapies in rheumatic diseases: What scientific evidence is there? Rheumatol Int 2011; 31 (1): 1–8.
2. Torres T, Ferreira EO, Gonçalo M et al. Update on Atopic Dermatitis. Acta Medica Portuguesa 2019; 32 (9): 606–13.
3. Albanova V.I., Pampura A.N. Atopic dermatitis. Moscow: GEOTAR-Media, 2016. (in Russian).
4. Drucker AM. Atopic dermatitis: Burden of illness, quality of life, and associated complications. Allergy Asthma Proceed 2017; 38 (1): 3–8.
5. Atopic dermatitis in children: update 2019 (as a guide). Conciliation document of the Association of Children's Allergologists and Immunologists of Russia. Moscow: ADAIR, 2019; Samara: Printing Association “Standard”, 2019 (in Russian).
6. Eichenfield LF, Ahluwalia J, Waldman A et al. Current guidelines for the evaluation and management of atopic dermatitis: A comparison of the Joint Task Force Practice Parameter and American Academy of Dermatology guidelines. J Allergy Clin Immunol 2017; 139 (4): 49–57.
7. Wollenberg A, Barbarot S, Bieber T et al; European Dermatology Forum (EDF), the European Academy of Dermatology and Venereology (EADV), the European Academy of Allergy and Clinical Immunology (EAACI), the European Task Force on Atopic Dermatitis (ETFAD), European Federation of Allergy and Airways Diseases Patients’ Associations (EFA), the European Society for Dermatology and Psychiatry (ESDaP), the European Society of Pediatric Dermatology (ESPD), Global Allergy and Asthma European Network (GA2LEN) and the European Union of Medical Specialists (UEMS). Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part II. J Eur Acad Dermatol Venerol 2018; 32 (6): 850–78.
8. Pickett K, Frampton G, Loveman E. Education to improve quality of life of people with chronic inflammatory skin conditions: a systematic review of the evidence. Br J Dermatol 2016; 174 (6): 1228–41.
9. Sy W, Lamb AJ. Atopic Dermatitis Disease Education. Adv Exp Med Biol 2017; 1027: 179–84.
10. Cork MJ, Britton J, Butler L et al. Comparison of parent knowledge, therapy utilization and severity of atopic eczema before and after explanation and demonstration of topical therapies by a specialist dermatology nurse. Br J Dermatol 2003; 149: 582–9.
11. Teasdale E, Muller I, Santer M. Carers’ views of topical-corticosteroid use in childhood eczema: a qualitative study of online discussion forums. Br J Dermatol 2017; 176 (6): 1500–7.
12. Lindh JD, Bradley M. Clinical Effectiveness of Moisturizers in Atopic Dermatitis and Related Disorders: A Systematic Review. Am J Clin Dermatol 2015; 16 (5): 341–59.
13. Santer M, Muller I, Yardley L et al. Parents' and carers' views about emollients for childhood eczema: qualitative interview study. BMJ Open 2016; 6 (8): e011887.
14. Gore C, Johnson RJ, Caress AL et al. The information needs and preferred roles in treatment decisionmaking of parents caring for infants with atopic dermatitis: a qualitative study. Allergy 2005; 60 (7): 938–43.
15. Giam YC, Hebert AA, Dizon MV et al. A review on the role of moisturizers for atopic dermatitis. Asia Pac Allergy 2016; 6 (2): 120–8.
16. Lindh JD, Bradley M. Clinical Effectiveness of Moisturizers in Atopic Dermatitis and Related Disorders: A Systematic Review. Am J Clin Dermatol 2015; 16 (5): 341–59.
17. Akerstrom U, Reitamo S, Langeland T et al. Comparison of Moisturizing Creams for the Prevention of Atopic Dermatitis Relapse: a Randomized Double-blind Controlled Multicentre Clinical Trial. Acta Derm Venereol 2015; 95: 587–92.
18. Lynde CW. Moisturizers: What they are and how they work. Skin Therapy Lett 2001; 6 (13): 3–5.
19. Loden M. The clinical benefit of moisturizers. J Eur Academy Dermatol Venereol 2005; 19: 672–88.
20. Breternitz M, Kowatzki D, Langenauer M et al. Placebo-controlled, double-blind, randomized, prospective study of a glycerol-based emollient on eczematous skin in atopic dermatitis: biophysical and clinical evaluation. Skin Pharmacol Physiol 2008; 21 (1): 39–45.
21. Chiang C, Eichenfield LF. Quantitative assessment of combination bathing and moisturizing regimens on skin hydration in atopic dermatitis. Pediatr Dermatol 2009; 26: 273–8.
22. Norrlid H, Hjalte F, Lundqvist A et al. Cost-effectiveness of Maintenance Treatment with a Barrier-strengthening Moisturizing Cream in Patients with Atopic Dermatitis in Finland, Norway and Sweden. Acta Derm Venereol 2016; 96 (2): 173–6.
23. Mason JM, Carr J, Buckley C et al. Improved emollient use reduces atopic eczema symptoms and is cost neutral in infants: before-and-after evaluation of a multifaceted educational support programme. BMC Dermatol 2013; 16 (13): 7.
24. Varothai S, Nitayavardhana S, Kulthanan K. Moisturizers for patients with atopic dermatitis. Asian Pac J Allergy Immunol 2013; 31: 91–8.
25. Sethi A, Kaur T, Malhotra SK, ML. Moisturizers: The Slippery Road. Indian J Dermatol 2016; 61 (3): 279–87.
26. Tichota DM, Silva AC, Sousa Lobo JM, Amaral MH. Design, characterization, and clinical evaluation of argan oil nanostructured lipid carriers to improve skin hydration. Int J Nanomedicine 2014; 11 (9): 3855–64.
27. Hon KL, Tsang YC, Pong NH et al. Patient acceptability, efficacy, and skin biophysiology of a cream and cleanser containing lipid complex with shea butter extract versus a ceramide product for eczema. Hong Kong Med J 2015; 21 (5): 417–25.
28. Seite S, Zelenkova H, Martin R, Fierer N. Using a specific emollient to manage skin microbiome dysbiosis. JAAD 2016; 74 (5): 89–94.
29. Mingaliev R.A., Kudriavtseva A.V. Atopicheskii dermatit u detei kak mul'tifaktorial'noe zabolevanie, prichiny vozniknoveniia i osobennosti lecheniia. Allergologiia i immunologiia v pediatrii. 2017; 1: 8–14 (in Russian).
30. Lim NR, Lohman ME, Lio PA. The Role of Elimination Diets in Atopic Dermatitis-A Comprehensive Review. Pediatric Dermatology 2017; 34 (5): 516–27.
31. Galli E, Neri I, Ricci G et al. Consensus Conference on Clinical Management of pediatric Atopic Dermatitis. Ital J Pediatr 2016; 2: 26–42.
32. Stein SL, Cifu AS. Management of Atopic Dermatitis. JAMA 2016; 12 (14): 1510–1.
33. Badina L, Barbi E, Berti I et al. The dietary paradox in food allergy: yesterday’s mistakes, today’s evidence and lessons for tomorrow. Cur Pharmaceutical Design 2012; 18 (35): 5782–7.
34. Campana R, Dzoro S, Mittermann I et al. Molecular aspects of allergens in atopic dermatitis. Curr Opin Allergy Clin Immunol 2017; 17 (4): 269–77.
35. Johansson EK, Bergstrom A, Kull I et al. IgE sensitization in relation to preschool eczema and filaggrin mutation. J Allergy Clin Immunol 2017; 140 (6): 1572–9.
36. Leung DY, Boguniewicz M, Howell MD et al. New insights into atopic dermatitis. J Clin Investigation 2004; 113: 651–7.
37. Das A, Panda S. Use of Topical Corticosteroids in Dermatology: An Evidence-based Approach. Indian J Dermatol 2017; 62 (3): 237–50.
38. Sidbury R, Tom WL, Bergman JN et al. Guidelines of care for the management of atopic dermatitis: section 4. prevention of disease flares and use of adjunctive therapies and approaches. J Am Acad Dermatol 2014; 71: 1218–33.
39. Fukuie T, Hirakawa S, Narita M et al. Potential preventive effects of proactive therapy on sensitization in moderate to severe childhood atopic dermatitis: A randomized, investigator-blinded, controlled study. J Dermatol 2016; 43 (11): 1283–92.
40. Prikaz Minzdrava Rossii ot 07.06.2018 №321n "Ob utverzhdenii perechnei meditsinskikh pokazanii i protivopokazanii dlia sanatorno-kurortnogo lecheniia'. http://www.garant.ru/products/ipo/prime/doc/71879402/#ixzz5Qak8NB83 (in Russian).
41. Pogonchenkova I.V., Rassulova M.A., Khan M.A. i dr. Sovremennye tekhnologii meditsinskoi reabilitatsii detei s atopicheskim dermatitom. Doktor.Ru. 2016; 12 (129; Ch. 2): 44–7 (in Russian).
42. Ring J, Mohrenschlager M, Weidinger S. Molecular genetics of atopic eczema. Chem Immunol Allergy 2012; 96: 24–9.
43. Kezis S, Kemperman PM, Koster ES et al. Loss-of-function mutations in the fillaggrin gene lead to reduce level of natural moisturizing factor in the stratum corneum. J Invest Dermatol 2008; 128: 2117–9.
44. Drucker AM, Wang AR, Li WQ et al. The Burden of Atopic Dermatitis: Summary of a Report for the National Eczema Association. J Invest Dermatol 2017; 137 (1): 26–30.
45. Konova O.M., Dmitrienko E.G., Davydova I.V., Sakharova E.V. Aromafitovanny – effektivnyi metod gidroterapii v kompleksnom vosstanovitel'nom lechenii detei s razlichnymi bolezniami. Voprosy sovremennoi pediatrii. 2014; 13 (4): 78–82 (in Russian).
46. Kozulin E.E., Koulin E.A. Fitomineral'naia korneoterapiia v reabilitatsii detei s atopicheskim dermatitom. Dal'nevostochnyi med. zhurn. 2015; 2: 58–61 (in Russian).
47. Kozulin E.E., Koulin E.A. Dal'nevostochnye fitomineral'nye preparaty v predeterminirovannoi reabilitatsii bol'nykh s atopicheskim dermatitom. Dal'nevostochnyi med. zhurn. 2018; 1: 77–80 (in Russian).
48. Giacomino MI, de Michele DF. Is mud an antiinflammatory? Anales Medicina Interna 2007; 24 (7): 352–3.
49. Spilioti E, Vargiami M, Letsiou S et al. Biological properties of mud exstracts from various spa resorts. Environ Geochem Health 2017; 39: 821–33.
50. Fioravanti A, Cantarini L, Guidelli GM, Galeazzi M. Mechanisms of action of spa therapies in rheumatic diseases: What scientific evidence is there? Rheumatol Int 2011; 31 (1): 1–8.
[Balabolkin I.I., Bulgakova V.A., Eliseeva T.I. Atopic dermatitis in children. Moscow: Medical News Agency, 2018 (in Russian).]
2. Torres T, Ferreira EO, Gonçalo M et al. Update on Atopic Dermatitis. Acta Medica Portuguesa 2019; 32 (9): 606–13.
3. Альбанова В.И., Пампура А.Н. Атопический дерматит. М.: ГЭОТАР-Медиа, 2016.
[Albanova V.I., Pampura A.N. Atopic dermatitis. Moscow: GEOTAR-Media, 2016. (in Russian).]
4. Drucker AM. Atopic dermatitis: Burden of illness, quality of life, and associated complications. Allergy Asthma Proceed 2017; 38 (1): 3–8.
5. Атопический дерматит у детей: обновление 2019 (на правах руководства). Согласительный документ Ассоциации детских аллергологов и иммунологов России. М.: АДАИР, 2019; Cамара: Полиграфическое объединение «Стандарт», 2019.
[Atopic dermatitis in children: update 2019 (as a guide). Conciliation document of the Association of Children's Allergologists and Immunologists of Russia. Moscow: ADAIR, 2019; Samara: Printing Association “Standard”, 2019 (in Russian).]
6. Eichenfield LF, Ahluwalia J, Waldman A et al. Current guidelines for the evaluation and management of atopic dermatitis: A comparison of the Joint Task Force Practice Parameter and American Academy of Dermatology guidelines. J Allergy Clin Immunol 2017; 139 (4): 49–57.
7. Wollenberg A, Barbarot S, Bieber T et al; European Dermatology Forum (EDF), the European Academy of Dermatology and Venereology (EADV), the European Academy of Allergy and Clinical Immunology (EAACI), the European Task Force on Atopic Dermatitis (ETFAD), European Federation of Allergy and Airways Diseases Patients’ Associations (EFA), the European Society for Dermatology and Psychiatry (ESDaP), the European Society of Pediatric Dermatology (ESPD), Global Allergy and Asthma European Network (GA2LEN) and the European Union of Medical Specialists (UEMS). Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part II. J Eur Acad Dermatol Venerol 2018; 32 (6): 850–78.
8. Pickett K, Frampton G, Loveman E. Education to improve quality of life of people with chronic inflammatory skin conditions: a systematic review of the evidence. Br J Dermatol 2016; 174 (6): 1228–41.
9. Sy W, Lamb AJ. Atopic Dermatitis Disease Education. Adv Exp Med Biol 2017; 1027: 179–84.
10. Cork MJ, Britton J, Butler L et al. Comparison of parent knowledge, therapy utilization and severity of atopic eczema before and after explanation and demonstration of topical therapies by a specialist dermatology nurse. Br J Dermatol 2003; 149: 582–9.
11. Teasdale E, Muller I, Santer M. Carers’ views of topical-corticosteroid use in childhood eczema: a qualitative study of online discussion forums. Br J Dermatol 2017; 176 (6): 1500–7.
12. Lindh JD, Bradley M. Clinical Effectiveness of Moisturizers in Atopic Dermatitis and Related Disorders: A Systematic Review. Am J Clin Dermatol 2015; 16 (5): 341–59.
13. Santer M, Muller I, Yardley L et al. Parents' and carers' views about emollients for childhood eczema: qualitative interview study. BMJ Open 2016; 6 (8): e011887.
14. Gore C, Johnson RJ, Caress AL et al. The information needs and preferred roles in treatment decisionmaking of parents caring for infants with atopic dermatitis: a qualitative study. Allergy 2005; 60 (7): 938–43.
15. Giam YC, Hebert AA, Dizon MV et al. A review on the role of moisturizers for atopic dermatitis. Asia Pac Allergy 2016; 6 (2): 120–8.
16. Lindh JD, Bradley M. Clinical Effectiveness of Moisturizers in Atopic Dermatitis and Related Disorders: A Systematic Review. Am J Clin Dermatol 2015; 16 (5): 341–59.
17. Akerstrom U, Reitamo S, Langeland T et al. Comparison of Moisturizing Creams for the Prevention of Atopic Dermatitis Relapse: a Randomized Double-blind Controlled Multicentre Clinical Trial. Acta Derm Venereol 2015; 95: 587–92.
18. Lynde CW. Moisturizers: What they are and how they work. Skin Therapy Lett 2001; 6 (13): 3–5.
19. Loden M. The clinical benefit of moisturizers. J Eur Academy Dermatol Venereol 2005; 19: 672–88.
20. Breternitz M, Kowatzki D, Langenauer M et al. Placebo-controlled, double-blind, randomized, prospective study of a glycerol-based emollient on eczematous skin in atopic dermatitis: biophysical and clinical evaluation. Skin Pharmacol Physiol 2008; 21 (1): 39–45.
21. Chiang C, Eichenfield LF. Quantitative assessment of combination bathing and moisturizing regimens on skin hydration in atopic dermatitis. Pediatr Dermatol 2009; 26: 273–8.
22. Norrlid H, Hjalte F, Lundqvist A et al. Cost-effectiveness of Maintenance Treatment with a Barrier-strengthening Moisturizing Cream in Patients with Atopic Dermatitis in Finland, Norway and Sweden. Acta Derm Venereol 2016; 96 (2): 173–6.
23. Mason JM, Carr J, Buckley C et al. Improved emollient use reduces atopic eczema symptoms and is cost neutral in infants: before-and-after evaluation of a multifaceted educational support programme. BMC Dermatol 2013; 16 (13): 7.
24. Varothai S, Nitayavardhana S, Kulthanan K. Moisturizers for patients with atopic dermatitis. Asian Pac J Allergy Immunol 2013; 31: 91–8.
25. Sethi A, Kaur T, Malhotra SK, ML. Moisturizers: The Slippery Road. Indian J Dermatol 2016; 61 (3): 279–87.
26. Tichota DM, Silva AC, Sousa Lobo JM, Amaral MH. Design, characterization, and clinical evaluation of argan oil nanostructured lipid carriers to improve skin hydration. Int J Nanomedicine 2014; 11 (9): 3855–64.
27. Hon KL, Tsang YC, Pong NH et al. Patient acceptability, efficacy, and skin biophysiology of a cream and cleanser containing lipid complex with shea butter extract versus a ceramide product for eczema. Hong Kong Med J 2015; 21 (5): 417–25.
28. Seite S, Zelenkova H, Martin R, Fierer N. Using a specific emollient to manage skin microbiome dysbiosis. JAAD 2016; 74 (5): 89–94.
29. Мингалиев Р.А., Кудрявцева А.В. Атопический дерматит у детей как мультифакториальное заболевание, причины возникновения и особенности лечения. Аллергология и иммунология в педиатрии. 2017; 1: 8–14.
[Mingaliev R.A., Kudriavtseva A.V. Atopicheskii dermatit u detei kak mul'tifaktorial'noe zabolevanie, prichiny vozniknoveniia i osobennosti lecheniia. Allergologiia i immunologiia v pediatrii. 2017; 1: 8–14 (in Russian).]
30. Lim NR, Lohman ME, Lio PA. The Role of Elimination Diets in Atopic Dermatitis-A Comprehensive Review. Pediatric Dermatology 2017; 34 (5): 516–27.
31. Galli E, Neri I, Ricci G et al. Consensus Conference on Clinical Management of pediatric Atopic Dermatitis. Ital J Pediatr 2016; 2: 26–42.
32. Stein SL, Cifu AS. Management of Atopic Dermatitis. JAMA 2016; 12 (14): 1510–1.
33. Badina L, Barbi E, Berti I et al. The dietary paradox in food allergy: yesterday’s mistakes, today’s evidence and lessons for tomorrow. Cur Pharmaceutical Design 2012; 18 (35): 5782–7.
34. Campana R, Dzoro S, Mittermann I et al. Molecular aspects of allergens in atopic dermatitis. Curr Opin Allergy Clin Immunol 2017; 17 (4): 269–77.
35. Johansson EK, Bergstrom A, Kull I et al. IgE sensitization in relation to preschool eczema and filaggrin mutation. J Allergy Clin Immunol 2017; 140 (6): 1572–9.
36. Leung DY, Boguniewicz M, Howell MD et al. New insights into atopic dermatitis. J Clin Investigation 2004; 113: 651–7.
37. Das A, Panda S. Use of Topical Corticosteroids in Dermatology: An Evidence-based Approach. Indian J Dermatol 2017; 62 (3): 237–50.
38. Sidbury R, Tom WL, Bergman JN et al. Guidelines of care for the management of atopic dermatitis: section 4. prevention of disease flares and use of adjunctive therapies and approaches. J Am Acad Dermatol 2014; 71: 1218–33.
39. Fukuie T, Hirakawa S, Narita M et al. Potential preventive effects of proactive therapy on sensitization in moderate to severe childhood atopic dermatitis: A randomized, investigator-blinded, controlled study. J Dermatol 2016; 43 (11): 1283–92.
40. Приказ Минздрава России от 07.06.2018 №321н «Об утверждении перечней медицинских показаний и противопоказаний для санаторно-курортного лечения». http://www.garant.ru/products/ipo/prime/doc/71879402/#ixzz5Qak8NB83
[Prikaz Minzdrava Rossii ot 07.06.2018 №321n "Ob utverzhdenii perechnei meditsinskikh pokazanii i protivopokazanii dlia sanatorno-kurortnogo lecheniia'. http://www.garant.ru/products/ipo/prime/doc/71879402/#ixzz5Qak8NB83 (in Russian).]
41. Погонченкова И.В., Рассулова М.А., Хан М.А. и др. Современные технологии медицинской реабилитации детей с атопическим дерматитом. Доктор.Ру. 2016; 12 (129; Ч. 2): 44–7.
[Pogonchenkova I.V., Rassulova M.A., Khan M.A. i dr. Sovremennye tekhnologii meditsinskoi reabilitatsii detei s atopicheskim dermatitom. Doktor.Ru. 2016; 12 (129; Ch. 2): 44–7 (in Russian).]
42. Ring J, Mohrenschlager M, Weidinger S. Molecular genetics of atopic eczema. Chem Immunol Allergy 2012; 96: 24–9.
43. Kezis S, Kemperman PM, Koster ES et al. Loss-of-function mutations in the fillaggrin gene lead to reduce level of natural moisturizing factor in the stratum corneum. J Invest Dermatol 2008; 128: 2117–9.
44. Drucker AM, Wang AR, Li WQ et al. The Burden of Atopic Dermatitis: Summary of a Report for the National Eczema Association. J Invest Dermatol 2017; 137 (1): 26–30.
45. Конова О.М., Дмитриенко Е.Г., Давыдова И.В., Сахарова Е.В. Аромафитованны – эффективный метод гидротерапии в комплексном восстановительном лечении детей с различными болезнями. Вопросы современной педиатрии. 2014; 13 (4): 78–82.
[Konova O.M., Dmitrienko E.G., Davydova I.V., Sakharova E.V. Aromafitovanny – effektivnyi metod gidroterapii v kompleksnom vosstanovitel'nom lechenii detei s razlichnymi bolezniami. Voprosy sovremennoi pediatrii. 2014; 13 (4): 78–82 (in Russian).]
46. Козулин Е.Е., Коулин Е.А. Фитоминеральная корнеотерапия в реабилитации детей с атопическим дерматитом. Дальневосточный мед. журн. 2015; 2: 58–61.
[Kozulin E.E., Koulin E.A. Fitomineral'naia korneoterapiia v reabilitatsii detei s atopicheskim dermatitom. Dal'nevostochnyi med. zhurn. 2015; 2: 58–61 (in Russian).]
47. Козулин Е.Е., Коулин Е.А. Дальневосточные фитоминеральные препараты в предетерминированной реабилитации больных с атопическим дерматитом. Дальневосточный мед. журн. 2018; 1: 77–80.
[Kozulin E.E., Koulin E.A. Dal'nevostochnye fitomineral'nye preparaty v predeterminirovannoi reabilitatsii bol'nykh s atopicheskim dermatitom. Dal'nevostochnyi med. zhurn. 2018; 1: 77–80 (in Russian).]
48. Giacomino MI, de Michele DF. Is mud an antiinflammatory? Anales Medicina Interna 2007; 24 (7): 352–3.
49. Spilioti E, Vargiami M, Letsiou S et al. Biological properties of mud exstracts from various spa resorts. Environ Geochem Health 2017; 39: 821–33.
50. Fioravanti A, Cantarini L, Guidelli GM, Galeazzi M. Mechanisms of action of spa therapies in rheumatic diseases: What scientific evidence is there? Rheumatol Int 2011; 31 (1): 1–8.
________________________________________________
2. Torres T, Ferreira EO, Gonçalo M et al. Update on Atopic Dermatitis. Acta Medica Portuguesa 2019; 32 (9): 606–13.
3. Albanova V.I., Pampura A.N. Atopic dermatitis. Moscow: GEOTAR-Media, 2016. (in Russian).
4. Drucker AM. Atopic dermatitis: Burden of illness, quality of life, and associated complications. Allergy Asthma Proceed 2017; 38 (1): 3–8.
5. Atopic dermatitis in children: update 2019 (as a guide). Conciliation document of the Association of Children's Allergologists and Immunologists of Russia. Moscow: ADAIR, 2019; Samara: Printing Association “Standard”, 2019 (in Russian).
6. Eichenfield LF, Ahluwalia J, Waldman A et al. Current guidelines for the evaluation and management of atopic dermatitis: A comparison of the Joint Task Force Practice Parameter and American Academy of Dermatology guidelines. J Allergy Clin Immunol 2017; 139 (4): 49–57.
7. Wollenberg A, Barbarot S, Bieber T et al; European Dermatology Forum (EDF), the European Academy of Dermatology and Venereology (EADV), the European Academy of Allergy and Clinical Immunology (EAACI), the European Task Force on Atopic Dermatitis (ETFAD), European Federation of Allergy and Airways Diseases Patients’ Associations (EFA), the European Society for Dermatology and Psychiatry (ESDaP), the European Society of Pediatric Dermatology (ESPD), Global Allergy and Asthma European Network (GA2LEN) and the European Union of Medical Specialists (UEMS). Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part II. J Eur Acad Dermatol Venerol 2018; 32 (6): 850–78.
8. Pickett K, Frampton G, Loveman E. Education to improve quality of life of people with chronic inflammatory skin conditions: a systematic review of the evidence. Br J Dermatol 2016; 174 (6): 1228–41.
9. Sy W, Lamb AJ. Atopic Dermatitis Disease Education. Adv Exp Med Biol 2017; 1027: 179–84.
10. Cork MJ, Britton J, Butler L et al. Comparison of parent knowledge, therapy utilization and severity of atopic eczema before and after explanation and demonstration of topical therapies by a specialist dermatology nurse. Br J Dermatol 2003; 149: 582–9.
11. Teasdale E, Muller I, Santer M. Carers’ views of topical-corticosteroid use in childhood eczema: a qualitative study of online discussion forums. Br J Dermatol 2017; 176 (6): 1500–7.
12. Lindh JD, Bradley M. Clinical Effectiveness of Moisturizers in Atopic Dermatitis and Related Disorders: A Systematic Review. Am J Clin Dermatol 2015; 16 (5): 341–59.
13. Santer M, Muller I, Yardley L et al. Parents' and carers' views about emollients for childhood eczema: qualitative interview study. BMJ Open 2016; 6 (8): e011887.
14. Gore C, Johnson RJ, Caress AL et al. The information needs and preferred roles in treatment decisionmaking of parents caring for infants with atopic dermatitis: a qualitative study. Allergy 2005; 60 (7): 938–43.
15. Giam YC, Hebert AA, Dizon MV et al. A review on the role of moisturizers for atopic dermatitis. Asia Pac Allergy 2016; 6 (2): 120–8.
16. Lindh JD, Bradley M. Clinical Effectiveness of Moisturizers in Atopic Dermatitis and Related Disorders: A Systematic Review. Am J Clin Dermatol 2015; 16 (5): 341–59.
17. Akerstrom U, Reitamo S, Langeland T et al. Comparison of Moisturizing Creams for the Prevention of Atopic Dermatitis Relapse: a Randomized Double-blind Controlled Multicentre Clinical Trial. Acta Derm Venereol 2015; 95: 587–92.
18. Lynde CW. Moisturizers: What they are and how they work. Skin Therapy Lett 2001; 6 (13): 3–5.
19. Loden M. The clinical benefit of moisturizers. J Eur Academy Dermatol Venereol 2005; 19: 672–88.
20. Breternitz M, Kowatzki D, Langenauer M et al. Placebo-controlled, double-blind, randomized, prospective study of a glycerol-based emollient on eczematous skin in atopic dermatitis: biophysical and clinical evaluation. Skin Pharmacol Physiol 2008; 21 (1): 39–45.
21. Chiang C, Eichenfield LF. Quantitative assessment of combination bathing and moisturizing regimens on skin hydration in atopic dermatitis. Pediatr Dermatol 2009; 26: 273–8.
22. Norrlid H, Hjalte F, Lundqvist A et al. Cost-effectiveness of Maintenance Treatment with a Barrier-strengthening Moisturizing Cream in Patients with Atopic Dermatitis in Finland, Norway and Sweden. Acta Derm Venereol 2016; 96 (2): 173–6.
23. Mason JM, Carr J, Buckley C et al. Improved emollient use reduces atopic eczema symptoms and is cost neutral in infants: before-and-after evaluation of a multifaceted educational support programme. BMC Dermatol 2013; 16 (13): 7.
24. Varothai S, Nitayavardhana S, Kulthanan K. Moisturizers for patients with atopic dermatitis. Asian Pac J Allergy Immunol 2013; 31: 91–8.
25. Sethi A, Kaur T, Malhotra SK, ML. Moisturizers: The Slippery Road. Indian J Dermatol 2016; 61 (3): 279–87.
26. Tichota DM, Silva AC, Sousa Lobo JM, Amaral MH. Design, characterization, and clinical evaluation of argan oil nanostructured lipid carriers to improve skin hydration. Int J Nanomedicine 2014; 11 (9): 3855–64.
27. Hon KL, Tsang YC, Pong NH et al. Patient acceptability, efficacy, and skin biophysiology of a cream and cleanser containing lipid complex with shea butter extract versus a ceramide product for eczema. Hong Kong Med J 2015; 21 (5): 417–25.
28. Seite S, Zelenkova H, Martin R, Fierer N. Using a specific emollient to manage skin microbiome dysbiosis. JAAD 2016; 74 (5): 89–94.
29. Mingaliev R.A., Kudriavtseva A.V. Atopicheskii dermatit u detei kak mul'tifaktorial'noe zabolevanie, prichiny vozniknoveniia i osobennosti lecheniia. Allergologiia i immunologiia v pediatrii. 2017; 1: 8–14 (in Russian).
30. Lim NR, Lohman ME, Lio PA. The Role of Elimination Diets in Atopic Dermatitis-A Comprehensive Review. Pediatric Dermatology 2017; 34 (5): 516–27.
31. Galli E, Neri I, Ricci G et al. Consensus Conference on Clinical Management of pediatric Atopic Dermatitis. Ital J Pediatr 2016; 2: 26–42.
32. Stein SL, Cifu AS. Management of Atopic Dermatitis. JAMA 2016; 12 (14): 1510–1.
33. Badina L, Barbi E, Berti I et al. The dietary paradox in food allergy: yesterday’s mistakes, today’s evidence and lessons for tomorrow. Cur Pharmaceutical Design 2012; 18 (35): 5782–7.
34. Campana R, Dzoro S, Mittermann I et al. Molecular aspects of allergens in atopic dermatitis. Curr Opin Allergy Clin Immunol 2017; 17 (4): 269–77.
35. Johansson EK, Bergstrom A, Kull I et al. IgE sensitization in relation to preschool eczema and filaggrin mutation. J Allergy Clin Immunol 2017; 140 (6): 1572–9.
36. Leung DY, Boguniewicz M, Howell MD et al. New insights into atopic dermatitis. J Clin Investigation 2004; 113: 651–7.
37. Das A, Panda S. Use of Topical Corticosteroids in Dermatology: An Evidence-based Approach. Indian J Dermatol 2017; 62 (3): 237–50.
38. Sidbury R, Tom WL, Bergman JN et al. Guidelines of care for the management of atopic dermatitis: section 4. prevention of disease flares and use of adjunctive therapies and approaches. J Am Acad Dermatol 2014; 71: 1218–33.
39. Fukuie T, Hirakawa S, Narita M et al. Potential preventive effects of proactive therapy on sensitization in moderate to severe childhood atopic dermatitis: A randomized, investigator-blinded, controlled study. J Dermatol 2016; 43 (11): 1283–92.
40. Prikaz Minzdrava Rossii ot 07.06.2018 №321n "Ob utverzhdenii perechnei meditsinskikh pokazanii i protivopokazanii dlia sanatorno-kurortnogo lecheniia'. http://www.garant.ru/products/ipo/prime/doc/71879402/#ixzz5Qak8NB83 (in Russian).
41. Pogonchenkova I.V., Rassulova M.A., Khan M.A. i dr. Sovremennye tekhnologii meditsinskoi reabilitatsii detei s atopicheskim dermatitom. Doktor.Ru. 2016; 12 (129; Ch. 2): 44–7 (in Russian).
42. Ring J, Mohrenschlager M, Weidinger S. Molecular genetics of atopic eczema. Chem Immunol Allergy 2012; 96: 24–9.
43. Kezis S, Kemperman PM, Koster ES et al. Loss-of-function mutations in the fillaggrin gene lead to reduce level of natural moisturizing factor in the stratum corneum. J Invest Dermatol 2008; 128: 2117–9.
44. Drucker AM, Wang AR, Li WQ et al. The Burden of Atopic Dermatitis: Summary of a Report for the National Eczema Association. J Invest Dermatol 2017; 137 (1): 26–30.
45. Konova O.M., Dmitrienko E.G., Davydova I.V., Sakharova E.V. Aromafitovanny – effektivnyi metod gidroterapii v kompleksnom vosstanovitel'nom lechenii detei s razlichnymi bolezniami. Voprosy sovremennoi pediatrii. 2014; 13 (4): 78–82 (in Russian).
46. Kozulin E.E., Koulin E.A. Fitomineral'naia korneoterapiia v reabilitatsii detei s atopicheskim dermatitom. Dal'nevostochnyi med. zhurn. 2015; 2: 58–61 (in Russian).
47. Kozulin E.E., Koulin E.A. Dal'nevostochnye fitomineral'nye preparaty v predeterminirovannoi reabilitatsii bol'nykh s atopicheskim dermatitom. Dal'nevostochnyi med. zhurn. 2018; 1: 77–80 (in Russian).
48. Giacomino MI, de Michele DF. Is mud an antiinflammatory? Anales Medicina Interna 2007; 24 (7): 352–3.
49. Spilioti E, Vargiami M, Letsiou S et al. Biological properties of mud exstracts from various spa resorts. Environ Geochem Health 2017; 39: 821–33.
50. Fioravanti A, Cantarini L, Guidelli GM, Galeazzi M. Mechanisms of action of spa therapies in rheumatic diseases: What scientific evidence is there? Rheumatol Int 2011; 31 (1): 1–8.
Авторы
Ю.С. Смолкин*1,2, Н.Б. Мигачева3, О.Ю. Смолкина4
1 Ассоциация детских аллергологов и иммунологов России, Москва, Россия;
2 Академия постдипломного образования ФГБУ «Федеральный научно-клинический центр специализированных видов медицинской помощи и медицинских технологий ФМБА России», Москва, Россия;
3 ФГБОУ ВО «Самарский государственный медицинский университет», Самара, Россия;
4 ООО «Научно-клинический консультативный центр аллергологии и иммунологии», Москва, Россия
*smolkin@alerg.ru
1 Association of Children's Allergists and Immunologists of Russia, Moscow, Russia;
2 Academy Postgraduate Education of the Federal Research Center for Specialized Types of Medical Assistance and Medical Technologies, Moscow, Russia;
3 Samara State Medical University, Samara, Russia;
4 Scientific Clinical Consultative Center of Allergology and Immunology, Moscow, Russia
*smolkin@alerg.ru
1 Ассоциация детских аллергологов и иммунологов России, Москва, Россия;
2 Академия постдипломного образования ФГБУ «Федеральный научно-клинический центр специализированных видов медицинской помощи и медицинских технологий ФМБА России», Москва, Россия;
3 ФГБОУ ВО «Самарский государственный медицинский университет», Самара, Россия;
4 ООО «Научно-клинический консультативный центр аллергологии и иммунологии», Москва, Россия
*smolkin@alerg.ru
________________________________________________
1 Association of Children's Allergists and Immunologists of Russia, Moscow, Russia;
2 Academy Postgraduate Education of the Federal Research Center for Specialized Types of Medical Assistance and Medical Technologies, Moscow, Russia;
3 Samara State Medical University, Samara, Russia;
4 Scientific Clinical Consultative Center of Allergology and Immunology, Moscow, Russia
*smolkin@alerg.ru
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