Atopic  eczema (atopic dermatitis, AD) — chronic recurrent  inflammation of the skin, arising as a result of a violation of the epidermal barrier and  entailing its further dysfunction. Maximum development atopic  dermatitis reaches  on the background of predisposition to IgE-mediated hypersensitivity, implemented in sensitization to surrounding allergens.

The diagnosis  of  atopic  eczema  is clinical.  An  obligatory clinical  symptom is itching  in combination with  3 other criteria: typical morphology and distribution; a history of atopy; chronically xerosis; AD debut  up to 2 years. The phase of the disease and the severity of skin lesions are of practical  importance for clarifying the stage AD. Changes  characteristic of different phases can be observed  simultaneously. Morphological and age-related classifications of AD are conditional and have little effect on the therapeutic strategy. Clinical variants of AD (allergic and non-allergic) are a single nosological form that requires  common  approaches to therapy. The prevalence of AD  is greatest  in children  a 1-st  year  of life  (up  to 30%) and significantly decreases  in adolescence.

Point and inherited mutations in genes (for  example, filaggrin) are a key point  in the pathogenesis of AD. Immune disorders are not limited  to IgE-dependent reactions  and occur with the participation of many cytokines (IL-4, IL-5,  IL-13, IL-25, IL-31, TSLP). Bacteria and fungi act as infectious agents  or superantigens for lymphocytes.

Food allergies are detected in 30–40% of children with AD causing aggravation of the disease. The children in the first year dominated by sensitization to food  allergens: milk, eggs, cereals, fish. An allergological examination using skin prick tests or specific IgE is informative and necessary, but the presence  of sensitization should  be clarified using an elimination-provocation  test with this product.

Food anaphylaxis is a severe life-threatening reaction  to food.  In recent years, there has been an increase  in the number  of such reactions.  The ability to recognize  the symptoms of food  anaphylaxis surrounding a sick person by people is the key to a saved  life.  This article on the basis of modern  data  on epidemiology, etiology  and pathogenesis of food  anaphylaxis discusses the problems  that  are currently in the diagnosis  and  treatment of children  with  food  anaphylaxis, suggests  ways  to solve them.

Questions of early detection of tuberculosis infection in children with rheumatoid arthritis  (RA) are of particular relevance when  prescribing  basic therapy with genetically engineered biological  drugs (GEBD). At the same time, all of them  are at twice the risk of tuberculosis, both for the disease  itself  and for the treatment used. The article presents  the results of a survey  of  121  children  aged  1 to 7 years.  Two  groups  were formed:  the  first  group  (main group)  included 53 patients with rheumatoid arthritis,  and the second (comparison group)  — 68 children without rheumatoid arthritis. A comparative analysis of the data  from  the annual Mantoux test was carried out, an additional test with Diaskintest was conducted for differential  diagnosis  of vaccine  and infectious allergies, and risk factors for tuberculosis were studied.

In children  with  JIA, an ineffective BCG  vaccination is more often observed,  the  size of  the  scar significantly differs in smaller sizes. When  evaluating the samples,  low sensitivity to tuberculin in the Mantoux test with 2 TE prevails  over moderate  and  high compared with  the control  group.  In a comparative analysis of  tuberculosis risk factors, social factors were almost the same (37.7%—32.3%, respectively).

The use of Diaskintest excludes active  tuberculosis infection in case of negative results, expanding the possibilities  for prescribing GEBD  in children  with RA.