Atopi̇k Dermati̇ti̇ Olan Çocuğun İzlemi̇ ve Toplumda Bakımı

Atopik dermatit (AD), alevlenme ve iyileşmeler ile seyreden, tekrarlayıcı, inflamatuvar kronik cilt hastalığıdır. AD’in klinik özellikleri arasında cilt kuruluğu, kaşıntı ve tekrarlayan egzamatöz deri lezyonları ön plandadır. AD tanısı alan çocukların semptom ve alevlenme tetikleyicileri, tedaviye uyumları, tedavi yanıtları ile gelişebilecek yan etkiler açısından yakın takibi gerekmektedir. Bu çocuklar ayrıca eşlik eden komorbiditeler, büyüme-gelişme ve beslenme gereksinimleri ile yaşam kaliteleri ve psikosomatik durumları açısından da takip altında olmalıdır. AD tanısıyla tedaviye başlanan çocukların izleminde hastalığın şiddetinin belirlenmesi, tedaviye yanıtının değerlendirilmesi ve tedavinin düzenlenmesi için önemlidir. AD tedavisinde başarısızlığın en önemli sebeplerinden biri çocuğun ve/veya ebeveynlerinin tedaviye uyum sorunudur. Çocuk ve ebeveynlerin, hastalığın doğal seyrini iyice öğrenmesi ve tedavinin uygulanabilmesi için gerekli eğitimi almaları, uyumu artırmak ve başarılı bir tedavi için gereklidir. Bütün çocuklarda olduğu gibi düzenli ve dengeli beslenmenin önerildiği AD’i olan çocuklarda, semptomlarla ilişkilendirilerek bazı besinlere karşı gereksiz ve uzun süreli eliminasyon diyetleri uygulanabilmekte, bu durum büyüme çağındaki bu çocuklarda beslenme bozukluklarına ve yetersizliklerine neden olmaktadır. Besin eliminasyon diyeti kararı mutlaka uzman bir hekim tarafından laboratuvar tetkiklerinin çocuğun kliniğiyle birlikte değerlendirilmesi sonrasında eğer uygun ise önerilmelidir. AD’li çocukların çocukluk çağı bağışıklama programlarının aksatılmadan uygulanması gereklidir. Güncel veriler doğrultusunda aşıların alerji ve AD görülme sıklığını arttırmadığı, hastalarda semptom artışına neden olmadığı bildirilmiştir. AD’nin çocuklar üzerindeki fiziksel, psikolojik ve sosyal etkileri sağlıklı yaşıtlarına göre okul yaşamlarının olumsuz yönde etkilenmesine neden olabilmektedir. Bu olumsuzlukların önüne geçilmesi için AD’li çocukların öğretmenlerine de hastalık ile ilişkili tedavinin uygulanması, diyetin düzenlenmesi ve tetikleyici faktörler açısından uygun çevre düzenlemesi ile ilgili bilgilendirmeler yapılmalıdır.

Anahtar Kelimeler: Atopik dermatit, çocuk, eğitim, izlem, tedavi

DOI :10.26650/B/CH32.2024.010.008 IUP :10.26650/B/CH32.2024.010.008 Tam Metin (PDF)

Follow-up and Community Care of the Child with Atopic Dermatitis

Sevgi Sipahi Çimen, Cevdet Özdemir

Atopic dermatitis (AD) is a recurrent, inflammatory chronic skin disease with exacerbations and remissions. Among the clinical features of AD, skin dryness, itching, and recurrent eczematous skin lesions are prominent. Children with AD should be followed in terms of symptoms and exacerbation triggers, adherence to treatment, treatment responses, and possible side effects of treatment. Patients with AD should be under control in terms of comorbidities, growth-development and nutritional requirements, quality of life, and psychosomatic status. The evaluation of the disease severity is essential for determining the response to treatment and planning of treatment. One of the most important reasons for failure of AD treatment is the patient’s and/or parents’ noncompliance to treatment. Education of patients and their parents about the natural course of the disease and treatment will improve compliance for a successful treatment. A regular and balanced diet is recommended in children with AD. Unnecessary and long-term elimination diets may cause nutritional deficiencies. The decision of an elimination diet should be initiated by specialists after the evaluation of laboratory tests together with the child’s clinical status. Children with AD may be involved in childhood immunization programs. In line with current data, immunizations do not increase the incidence of allergy and AD and do not cause an increase in symptoms in these patients. Physical, psychological, and social effects of AD on children can manifest in school life. Teachers of children with AD should also be educated about the treatment, triggering factors, and preventive measures,\ including diet.

Anahtar Kelimeler: Atopic dermatitis, child, education, follow-up, treatment

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Kroni̇k Hastalığı Olan Çocuğun İzlemi̇ ve Toplumda Bakımı

BÖLÜM

Atopi̇k Dermati̇ti̇ Olan Çocuğun İzlemi̇ ve Toplumda Bakımı

Follow-up and Community Care of the Child with Atopic Dermatitis

Referanslar

PAYLAŞ