Pruritus is one of the main clinical manifestations of atopic dermatitis, and it significantly reduces the quality of life of patients in childhood. Scientific images on its pathophysiological basis have now undergone significant changes. The histamine exceptional role in pruritus development was confounded, as well as data on immune system involvement in its maintenance was given. This article presents current data on differential approaches to pruritus management depending on its etiopathogenetic characteristics. The role of dermocosmetics in restoration of the skin barrier as the first stage prevention of pruritus in atopic dermatitis was considered. The results of clinical studies showing efficacy of topical agents (innovative component with anti-pruritic action — STIMU-TEX) application are presented.

The article analyzes the most significant genodermatoses associated with a high risk of allergic reactions that may occur in the practice of a dermatologist and pediatrician, such as ichthyosis and ichthyosiform dermatoses, Netherton syndrome and other ichthyosiform erythroderma, peeling skin syndrome, SAM syndrome, as well as congenital bullous epidermolysis. The article also describes in detail the pathogenetic aspects of transcutaneous sensitization, the development of food allergies and the listed above genodermatoses, two illustrative clinical cases are given.

Background. The PEWS (Pediatric Early Warning Score) is always used for prognosis of critical incidents in children at hospital. However, recording of various vital deviations may be advantageous. In this regard, it is relevant to study their prognostic value for risk of mortality estimation. Objective. The aim of the study was to estimate the frequency of vitals deviations from reference ranges in patients with low and high risk of mortality. Methods. We have studied medical records of patients aged from 1 month to 17 years old hospitalized in intensive care unit (ICU). Mortality prediction was counted with PIM3 score. Low and high risk of mortality groups were created due to the results of cluster analysis. The low risk group was made up of patients with mortality prediction rate < 37%, high risk group > 57%. Heart rate, respiratory rate, oxygen saturation in arterial blood, body temperature, systolic and diastolic blood pressure and deviations of all these values from reference ranges on presentation to ICU and further daily (every 2 hours) during the first 5 days (or less in case if the patient was transferred from the ICU earlier) were analysed. Results. Medical records of 66 patients (including 10 (15%) with a high risk of mortality) have been studied. The low and high risk groups were comparable by sex, age, spectrum of diseases, length of patient stay in the ICU. The lethal outcome in ICU was registered in two cases: both patients with high risk of mortality (> 50%) due to PIM3 score. The frequency of vitals deviations from reference ranges on presentation to ICU and in the following 5 days (except for HR on the first day) in risk groups did not differ statistically. Conclusion. Registration of only vitals deviations from reference ranges in the child during first 5 days in ICU does not allow us to predict high risk of mortality measured by PIM3 score.

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