Place of anti-histamine in therapy of itching skin of children

ALLERGOLOGY AND IMMUNOLOGY IN PEDIATRICS | REVIEW​

Volume 66 • Issue 3 • September 2021, pp. 4-16

Received: 08.09.2021 | Publication date: 30.09.2021

S.S. Masalskiy1,3, Yu.S. Smolkin1,2,3

1 Association Pediatric Allergist and Immunologist Russia, Moscow, Russia;​
2 Academy postgraduate education «Federal State Budget Founding Federal Research and Clinical Center of specialized types of health care and medical technology of the Federal Medical and Biological Agency», Moscow, Russia;
3 «Scientific-Clinical Consultative Center of Allergology and Immunology», Ltd, Moscow, Russia

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Abstract

Itching is a frequent condition at a doctor’s appointment of any speciality. A quarter of patients complain of itching of various etiology. In real practice, H1-histamine receptor blockers are prescribed for itching in the first place. The article considers a complex of diseases accompanied by itching of the skin. The itching is a reflex. The classification contains a lot of forms:local and systemic; prurigogenic, neuropathic and psychogenic. Itching has no stable pathogenesis and can be provoked by various conditions. The main types of sensory neurons are opiate and 5-HT-receptors. Urticaria and food allergy are associated with irritation of the skin receptors with histamine and other mast cell mediators. In these cases, antihistamines are the drug of choice regardless of the aetiology of urticaria. In atopic dermatitis, the itching has a complex aetiology: transepidermal water loss, chronic inflammation of the skin with the participation of many cells, secondary hyperinervation of the skin with the formation of a pathological activity focus in the brain. This requires a comprehensive approach to therapy. Xerosisis overcome by the use of emollients and rational skincare. The presence of exacerbation makes it necessary to prescribe topical steroids or calcineurin inhibitors for an acute period s. In the case of the addition of psychogenic itching, antiserotonin 5-HT-blockers drugs, hydroxyzine can be considered. H1-receptor blockers do not affect the intensity of skin lesions in dermatitis, but some molecules can reduce the itching. Quifenadine is the antihistamine dug of the second generation. It can be used in the treatment of allergic itching dermatoses. The rapid onset of action allows you to reach the maximum concentration in the tissues within 1 hour, activate monooxidase and neutralise histamine in the tissue. Quifenadine absence a sedative effect and no respiratory depression.Instructions for the use of the medicinal product can increase the dose by 1,5–2 times.It makes the drug useful for the treatment of manifestations of food allergies and urticaria. The dual antihistamine and antiserotonin action allow the successful use of quifenadine in the acute period of atopic dermatitis, especially provoked by contact with an allergen.

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Citation

Masalskiy SS, Smolkin YuS. Place of anti-histamine in therapy of itching skin of children. Allergology and Immunology in Pediatrics. 2021;3(66):4–16. (In Russ.) https://doi.org/10.53529/2500-1175-2021-3-4-16

For correspondence:

Sergey S. Masalskiy

Candidate of Science, APAIR Secretary, Physician

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