Atopic  dermatitis (AD) is a diagnosis  with precise criteria  described  by Hanifin & Rajka. A differential diagnosis  should be considered at  the  discrepancy of  the  symptoms or torpid  eczema.  The  list  of  diseases  is genetic  syndromes with  the impaired epidermal barrier, metabolic diseases,  skin infections, psoriasis and others. Skin infections in the diagnostic search should be considered the first  time.

The basis of therapy allergic eczema is the elimination of allergenic and non-allergenic triggers, topical steroids and inhibitors calcineurin with uses of emollients  in the skincare  process. This therapy is sufficient for most patients.

Systemic therapy of dermatitis consists of short courses of steroids (up to 1 week) with the ineffectiveness of external preparation. If long-term therapy is necessary, it is proposed to consider the possibility of prescribing  dupilumab and cyclosporin A. Antihistamines can be considered as a drug for stopping itching in the early days  of the disease. With  a sufficient effect of external anti-inflammatory drugs, the use of antihistamines is not required.

Exclusion  of  culpable  food  allergens  leads  to rapid  remission  of  the disease.  Non-specific hypoallergenic diets  reduce  the quality of life  of patients and  should  not be used for a long time. The main  formula for feeding children  with  allergies to cow's milk protein  is extensively hydrolysed formula. The amino  acid-based formula is reserved  for severe cases.

During the period of remission, it is important to provide  skincare and regular use of emollients, as well as a complex  to eliminate  causative allergens from  the patient’s environment.

Specific immunotherapy can be recommended for patients with a proven  role of the allergen in the development of exacerbation  AD and with a combination of eczema  with allergic rhinoconjunctivitis and asthma.

Atopic  dermatitis (AD) significantly reduces the quality of life of patients. Skin lesions, itching, and sleep dysfunction lead to impaired social adaptation and work performance.

Systemic immunosuppressants are used for  the treatment of  severe AD.  The use of  antihistamines and  antileukotrienes in the  monotherapy or the  combination with  topical  steroids  is not  recommended and  not  effective for  treatment AD.  This group of medicine drugs applied  in the cases of the сo-morbidity with allergic rhinitis, food  allergy and asthma.

If it is necessary to use systemic drugs for the treatment of severe dermatitis, the appointment of biological therapy (anti-IL4Rα) is recommended from  the  12  years.  Dupilumab has  a high-efficiency profile  (LIBERTY and  ADOL study): by 12–16 weeks  in children,  about  80%  of  patients have  an EASI  index  halved,  about  half  of  patients report  a decrease  in EASI<75% of the initial values. Dupilumab in recommended doses-200 mg (≤60 kg; ≤18 years) or 300 mg 2 times a month relieves skin lesions, itching and significantly improves  the quality of life of patients. Serological markers of allergic inflammation (IgE, periostin,  chemokine CCL17) are reduced  during  treatment.

Clinical studies  (CHRONOS) showed no serious side effects and a decrease in the frequency of skin infections and herpetic eczema  when using dupilumab, but a slight increase  in the frequency of non-severe respiratory diseases  and conjunctivitis. Conjunctivitis was not the cause of drug withdrawal according  to research data.  When  co-morbidity dermatitis and asthma, dupilumab reduces the number  of exacerbations of both diseases.

Other  monoclonal antibodies (omalizumab, reslizumab, mepolizumab, benralizumab) are not effective for therapy allergic eczema.

Cyclosporin at a dose of 2.5–5 mg/kg/day has comparable effectiveness with dupilumab in the 2 weeks of administration. Then cyclosporin's results get worse. Systemic side effects limit the use of cyclosporine for more than  8 weeks. Oral steroids can be prescribed  in a short course for severe exacerbations (0.5–1 mg/kg/day, ≈ 1 week). Dupilumab is the drug of choice for systemic treatment of dermatitis in patients ≥12 years. The long-term safety-effectiveness profile  of dupilumab is better than  any  other systemic treatment. The drug is used for any  phenotype of dermatitis, independently of the increase  in serum IgE.

Chronic renal failure (CRF) remains  an important problem in childhood.  We have studied patients with chronic kidney disease (CKD) at the 3–5 stages at the stages of conservative treatment, dialysis  therapy and kidney transplantation (n=72). The main  reason for development is defined CRF in children  — CAKUT-syndrome. The main  clinical-anamnestic features at different stages of CKD are shown. Clinical-immunological correlations  were carried out, hypoimmune state of both cellular and humoral  links of immunity was detected in CRF.