Tonus and Reactivity of the Autonomic Nervous System in Adults with Atopic Dermatitis

Atopic dermatitis is a genetically predisposed disease that has a chronic recurrent course with a certain age-related dynamics. This disease is clinically manifested by pruritus, papules and lichenification in combination with other signs of atopy. Atopic dermatitis is an extremely common dermatosis, often with a severe course. In the structure of skin diseases, the frequency of atopic dermatitis is from 20 to 40%. Atopic dermatitis is more often detected in young women. Atopic dermatitis occurs in people of different world contingents and all races. Over the past decades, its prevalence has increased. Different clinical manifestations in different age phases of atopic dermatitis create a mosaic of its clinical picture due to a variety of factors causing exacerbation and leading to the formation of the so-called atopic features with the expressed in many cases a psychosomatic component. The latter causes certain difficulties in treating patients with atopic dermatitis. According to the unanimous opinion of domestic and foreign researchers, the basis of the etiopathogenesis atopic dermatitis is the genetic predisposition to its development, which is realized through a variety of trigger mechanisms and factors. This predisposition is primarily related to the functioning of the immune system. It is mainly visualized by the reduction of T-suppression, which provides hyperactive T-helper cells and leads to hyperproduction of IgE antibodies. All this lies at the basis of forming the antigenic skin effect of the exogenous and endogenous origin to the inflammatory reaction of the immune type, with typical clinical characteristics. The purpose of the work was to determine the peculiarities of changes in the autonomic nervous system in adult patients with atopic dermatitis on the basis of A. M. Wein's study of vegetative dysfunction syndrome, its reactivity and tone according to local segmental dermographism. There were 80 patients with diabetes aged 18-45 under observation, among them: 32 (40%) men and 48 (60%) women. The control group consisted of 37 healthy people. The average severity was set in 52 patients, the severe course – in 28. Based on the analysis of A.M. Wein's questionnaires for patients with atopic dermatitis, it was 29 ± 4.2 points (in healthy people – 8 ± 2.2 points), more pronounced in female patients and in the severe course of dermatosis. In patients with affected skin, unlike the skin that was not affected, dermographism was slowed down or absent, which was mostly stagnant, white, swollen and widespread. More distinct skin changes to mechanical stimulation were in sick women with severe course of the disease. The other task was to determine the features of autonomic nervous system in adult patients with atopic dermatitis on the basis of studying the syndrome of autonomic dysfunctions (A. M. Wein), its reactivity and tone according to local, segmental dermographism. This study was performed during 2014-2018 on the basis of the results of anamnestic, complex clinical and functional and laboratory surveys on the basis of the Zaporizhzhya Regional Skin and Venereal Dispensary Municipal Institution of Zaporizhzhia District Council. The study involved 117 people, 80 of whom were the clinical core group, and 37 – the control group. Individuals who entered the clinical group had a verified diagnosis of “Atopic dermatitis (L20 according to ICD-10)”. The control group was made up of people with similar characteristics according to gender, age and social data, but who did not suffer from dermatological diseases. 24% of the studied patients with atopic dermatitis were inhabitants of rural areas, 76% – the inhabitants of the city. 22% of patients worked in agriculture, 54% were employees of industrial enterprises, 12% – workers of mental labor, 12% – without a specific kind of employment. The average age of patients was 31.0 ± 12.