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Significant assistance in the diagnosis is played by special methods of additional examination, which, however, require a special interpretation. Among them, the most important should be called a specific allergological examination, a study of the immune status, and an analysis of feces for dysbacteriosis. Other methods of examination are carried out depending on the associated diseases in the patient.
Specific allergological examination. Most patients with atopic dermatitis show sensitization to a wide range of tested allergens. Skin testing allows you to identify a suspected allergen and implement preventive measures. However, the involvement of the skin in the process does not always allow this examination to be carried out; difficulties may arise both in carrying out such reactions and in interpreting the results obtained.
In this regard, immunological studies have become widespread, allowing the blood test to determine sensitization to certain allergens.
Immunological examination. IgE antibodies. Serum IgE concentration is elevated in more than 80% of patients with atopic dermatitis and is more often higher than in patients with respiratory diseases. The degree of increase in total IgE correlates with the severity (prevalence) of skin disease.
However, high levels of IgE are determined in patients with atopic dermatitis, when the disease is in remission. PathogeneticThe role of total IgE in the inflammatory response remains unclear, since about 20% of patients with typical manifestations of atopic dermatitis have normal IgE levels. Thus, the determination of the serum level of total IgE helps in the diagnosis, but it cannot be fully guided in the diagnosis, prognosis and management of patients with atopic dermatitis.
PACT (radioallergosorbent test), MAST, ELISA methods for determining the content of specific IgE antibodies in vitro.
The study of cellular immunity makes it possible to differentiate the immune-dependent form of atopic dermatitis from the immuno-independent form and to conduct an in-depth additional examination in order to clarify the pathogenetic mechanism. Assessment of the immune status makes it possible to identify immunodeficiency states, to conduct controlled immunocorrective therapy. In a series of studies conducted by us, the existence of four clinical and immunological variants of the course of AD has been proved, which makes it possible to carry out immunocorrective therapy, taking into account the characteristics of the immune response of a particular patient.
When starting the treatment of atopic dermatitis, one should take into account the age stage, clinical manifestations and comorbidities. Clinical and laboratory examination of Cleocin allows you to establish the leading pathogenetic mechanism, identify risk factors, outline a plan of treatment and preventive measures. The plan must provide for the stages of course treatment, the change of drugs, fixing treatment and prevention of relapses.
In cases where atopic dermatitis is a manifestation of the atopic syndrome (accompanied by asthma, rhinitis, etc.) or is caused by dysfunction of Cleocin organs and systems, correction of identified comorbidities should be ensured. For example, in childhood, dysfunctions of the gastrointestinal tract play an important role, in puberty - endocrine dysfunctions, etc. Dietary therapy can bring significant improvement, including preventing severe exacerbations.