The most frequent contact allergens in children are metals, fragrances, preservatives, neomycin, rubber chemicals and more recently also colourings. Toys are another potentially source of hapten exposure in children, especially from toy-cosmetic products such as perfumes, lipstick and eye shadow. Clinical polymorphism of contact dermatitis to clothing may cause difficulties in diagnosing textile dermatitis. ACD because of haptens in shoes or shin guards should be considered in cases of persistent foot eruptions or sharply defined dermatitis on the lower legs. Topical treatment of ACD is associated with cutaneous sensitization, although the prevalence is not high.
#Ivoxel emulsja skin#
Factors that may influence the onset of sensitization in children are atopic dermatitis, skin barrier defects and intense or repetitive contact with allergens. The epidermal barrier is crucial for the development of sensitization and elicitation of ACD. Sensitization to contact allergens can start in early infancy.
We conclude that regarding pharmacotherapy of atopic eczema, there are considerable discrepancies between expert recommendations, scientific evidence for the effectiveness of recommended drugs, and the acceptable uses of the drugs as determined by the Summaries of Product Characteristics (SPC) that are in force in Poland.Īllergic Contact Dermatitis (ACD) in children is increasing. Further 75 products with active substances both recommended and effective were licensed for use in Poland, but not for AE. Thirty preparations for AE were reimbursed, including 19 recommended by experts and confirmed effective. Of these, clinical trials confirmed efficacy of active components of 36 topical or systemic calcineurin inhibitors and 19 topical glucocorticoid preparations. Among drugs recommended by experts for the treatment of AE, 484 medicinal products were licensed for use in Poland, including 89 with official indication for AE.
A systematic review of clinical trials was carried out, with their quality assessed using the GRADE tool. Expert recommendations for the treatment of AE were confronted with SPC of recommended drugs and their reimbursement scheme. The aim of the study was to analyze discrepancies between up-to-date expert guidelines for treating atopic eczema (AE), indications listed in SPC, reimbursement policy, and scientific evidence for the efficacy of recommended drugs. Prescriptions beyond SPC ('off-label') may be interpreted as 'medical experiments' with legal and financial liability resting solely with the doctor, the reimbursement is also denied. The Polish Physician's and Dentist's Profession Act and Polish Pharmaceutical Law oblige physicians to prescribing drugs strictly in line with the official indications listed in the Summaries of Product Characteristic (SPC).
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