Атопічний дерматит: сучасний стан проблеми в Україні і світі

Abstract

Introduction. Social and environmental disasters in recent years have induced an increase in morbidity, which poses a threat to the health and life of the population not only in Ukraine but also in the world. Among the most common skin diseases is atopic dermatitis (AD), a chronic recurrent disease characterized by skin inflammation, disruption of the epidermal barrier, and, as a result, a decrease in the skin’s ability to retain moisture. Today general practitioners are usually the first to encounter this pathology, and they must assess self level of competence in a particular case and provide the necessary medical care or justify a referral to a dermatologist. The aim. To carry out an analytical review of domestic and foreign literature on the problem of atopic dermatitis (AD), methods of diagnosis and personalized approach to the treatment of this disease and to substantiate further directions of necessary scientific research to improve appropriate medical care. Materials and methods. A search, synthesis and analysis of world and national scientific publications on a personalized approach to the diagnosis and treatment of atopic dermatitis were conducted. A systematic approach, bibliosemantic method and method of structural and logical analysis were applied. Results and discussion. AD occurs with a frequency of up to 20 % among children and up to 10 % among adults in European countries. In Ukraine, as of 2020, the prevalence of AD among the pediatric population ranges from 9.0 to 28.5 %. The study of the complex pathogenesis of the disease, where genetic factors, immune dysregulation and epidermal barrier disorders play a key role, has allowed scientists to identify endotypes and phenotypes of AD, which has become an important step in the development of personalized therapy for patients with AD. It was biological drugs (blockers of IL-4 and IL-13 and JK-inhibitors) that made a breakthrough in the treatment of severe AD. Another promising direction in the treatment of AD is the use of probiotics, as it is known that in patients with AD there is a decrease in the number of commensal bacterial skin flora and colonization of the skin with S. aureus. Conclusions. Thus, the incidence of atopic dermatitis, which is characterized by a complex etiopathogenesis, is increasing every year in the population of Ukraine and the world. The medical and social significance of AD opens up new challenges for the search for new approaches to the management of patients with AD. In recent years, biologic therapies have been actively introduced into medical practice, opening up new opportunities for personalized management of patients with severe forms of AD. As for the treatment of mild and moderate forms of AD, the issue is still relevant, given the problem of corticophobia in society. That is why at this stage, attention to the treatment and prevention approach should be more focused, and treatment methods with high efficacy and low side effect profile should be a priority. The literature review revealed that the problem remains relevant, despite the large number of studies on the etiology, pathogenesis and treatment of AD, which substantiates promising areas for the development and application of methods of modern effective personalized treatment of AD.