1.manejo de la infeccion bacteriana en niños con dermatitis atopica

7/21/2019 1.Manejo de la infeccion bacteriana en nios con Dermatitis Atopica

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Lr. @rkmnosnf Afmzehz Fthrf

^hrvonof lh Lhriktfefak

Jfspotke Xmovhrsotkrof lh Nkrknks

^OITF^OF

LHSIK\FEFAOK THLOK\SONK

Ikmhbf lh ek om`hnnom cknthrokmk hm mofs nfm Lhriktotos Ktponk


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;. Omtrflunnom

;. Tktfamhsos

3. \rktkiohmtf

Ikmhbf lh ek Om`hnnom Cknthrokmk hm Mofs nfm Lhriktotos Ktponk


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Ahmtonfs

Omiumfeaonfs

Ckrrhrk Nutmhk

Keoihmtkrofs

Tsonfeaonfs Om`hnnofsfs

Kicohmtkehs

LHSIK\O\O^ K\FTONK. H\OFTK\FAHMOK


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Nfefmozknom Cknthrokmk Tohe ^kmk y Tknohmths nfm LK

Bfurmke f` Neomonke kml Lokamfston Shshkrnj. 34;> ^hpt, Pfe-1(?)2 ;?0:-;?14


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Om`hnnofmhs Poks rhsporktfroks Ketks

^. Kurhus hm Hnzhik 2 1:-;44 %

Tohe skmk lh LK 2 8;-;44 %

^ubhtfs mf ktponfs 2 3-38%

Tohe mf k`hntklk5 pohe k`hntklk

Km Crks Lhriktfe. 34417:3(;)21?-:8.

Lhriktotos Ktponk 2 Om`hnnom

Cknthrokmks


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^. Kurhus y LHSIK\O\O^ K\FTONK

@kntfr Karkvkmth


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^. Kurhus y Lhriktotos Ktponk

Pok Nfmtkiomknom


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;. Omtrflunnom

;. Tktfamhsos

3. \rktkiohmtf



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^. Kurhus hm Lhriktotos Ktponk

Trhlospfsonom Ahmtonk

Losùmnom lh Ckrrhrk Nutmhk

Nkicofs hm he ôsthik Omiumh Ommktf

Nkicofs hm he ôsthik Omiumh Klquorolf

@rhnuhmnok Om`hnnofmhs


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^. Kurhus y Lhriktotos Ktponk 2

Ckrrhrk Nutmhk


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ZHSF^O^

Kmfrikeolkl hm EpolfsNhrkiolks

Kuihmtf \HQe

Kethrknom @umnom lh ckrrhrk

CKSSHSK NX\KMHK HM

LHSIK\O\O^ K\FTONK


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Los`umnom CkrrhrkHpolrionk

Ikyfr Thmhtrknom lhKmtahmfs hm ek Tohe

Kntovknom Omiumh Nfmstkmth

Thrphtukr Om`ekiknom

lh ek Tohe

LK


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OMIXMOLKL

TFNF H^THN@ONK(OMMK\K)

IX_ H^THNO@ONK(KL[XOSOLK FKLKT\K\OPK)

MK\XSKE KS\O@ONOKE

KN\OPK / TK^OPK KN\OPK / TK^OPK

Troihrk emhk lhlh`hmsk nfmtrk eks

om`hnnofmhs

Shauhorf BS, Ephz N, Afmzehz ^, Ikrtmhz H. Omiumfefak Cofefak y pktfefak lhe sosthik omiumh. Hlotfroke Tkmkihronkmk. >hlonom

^.Kurhus hm Lhriktotos Ktponk


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Shnhptfrhs lh Shnfmfnoiohmtf lh Tktahmfs

Eks neueks lh ek omiumolkl ommktk rhnfmfnhm hstrunturksquh sfm nkrknthrstonks lh efs pktahmfs ionrfcokmfs y quh

mf hstm prhshmths hm eks neueks lh efs iki`hrfs

^osthik omiumotkrof ommktf

Shnhptfrhs lh rhnfmfnoiohmtf lh Tktrfmhs / Ifenueks(TSSs/TSIs)

TK\SFMH^ IFEHNXEKSH^ K^FNOKLF^ K TK\AHMF^

TKITs)

Shauhorf B, Ephz N, Afmzehz ^, Ikrtmhz H. Omiumfefak Cofefak y pktfefak lhe sosthik omiumh. Hlotfroke Tkmkihronkmk. >hlonom


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Shnhptfrhs lh rhnfmfnoiohmtf lh pktahmfs

Shnhptfrhs topf \FEE


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Ihlzjotfv, S7 Bkmhwky. Nj. M.H.B I 34447 > (8)2 >>:->


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HmLhriktotos Ktponk

Cohlhrikm \. Kntk Lhri Phmhrhfe 34407 :02 ??;4?

[uhrktomfnotf

NL

\ES

Tkrhl nheuekrcknthrokmk

Ihloklfrhsprfomèkiktfrofs

^. kurhus TKITs

(TKITs )

\ES eoakmlf

^. kurhussh umh k \ES3

Lhònohmnok \ES3

2

Ikyfr susnhptocoeolkl kom`hnnom

Trlolk tftke2

Hm`hrihlkl arkvh

Hm `kshs tkrlks2

Omèkiknom sfsthmolk

OE-0\M@


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Trurotf \rkuik ihnmonf

Trflunnom lh notfnomks yquoiofnomks prfomèkiktfroks

ShneutkiohmtfEhunfnotfs k pohe

Kntovknom lh ehunfnotfs

Omèkiknom nutmhk OE-;, OE-;:, \M@- , AI-N^@, \ÊT,NNE;1, NNE33, NNE31

NNE;, NNE;:,

NNE30, OE-;0

Nfefmozknom Cknthrokmk

Lh ek Tohe

OE-;>

\ÊT

OaH

O@M-

OE-;3

OE-;

Trfthksks

Jostkiomk

^trhss

\J;

OE->;

\J3

Nhe. \ ihifrok 2 Ka - Kehrahmfs

ûphrkmtahmfs Cknthrokmf

LHSIK\O\O^ K\FTONK

NL

Lh`hmsomks juikmks 3 ,>B Keehray Neom Oiiumfe 34407;;: 2;1:-:?


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Los`umnom CkrrhrkHpolrionk Ikyfr Thmhtrknom lhKmtahmfs hm ek Tohe

Kntovknom Omiumh Nfmstkmth

Thrphtukr Om`ekiknom

lh ek Tohe

LK

N `


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Nonef omèkiktfrof lh ek Lhriktotos Ktponk

Jfihy C, ^thomjf`` I, Suzongk \, Ehuma L. B Keehray Neom Oiiumfe 34407;;: 2;1:-:?

NNE;, NNE;:,NNE30

OE-;0

Nfefmozknomcknthrokmk lh ek pohe

OE-;>

\ÊT

OaH

O@M-

OE-;3

OE-;

TrfthksksJostkiomk

^trhss

\J;

OE->;

\J3

Nhe\ ihifrok 2 Ka-Kehrahmfs

NL- OaH kmtahmf hsphnònk

Trfluntfs cknthrokmfsûphrkmtahmfs

Trflunnom lh notfnomksprfomèki. y quoiofnomks

\rkuikihnmonf

Trurotf

Shneutkiohmtfehunfnotfs k

pohe

OE-;, \M@, AIN^@, OE-;:

\ÊT

NNE31, NNE;1, NNE33,

Kntovknomehunfnotkrok

Omèkiknom lh ek

pohe ktponk

OE-8

O@M


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Lhriktotos Ktponk

Ktfpon lhriktotos2 k loshksh nkushl cy ommkth oiiumh

lh`hnts6

Lh Chmhlhttf K, ht ke

B Omvhst Lhriktfe. 344? 7;3?(;)2;4


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Ktfpon lhriktotos2 k loshksh nkushl cy ommkth oiiumh lh`hnts6



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Ktfpon lhriktotos2 k loshksh nkushl cy ommkth oiiumh lh`hnts6


L toto Kt o


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Lhriktotos Ktponk

Ktfpon lhriktotos (KL) os k nfiifm njrfmon om`ekiiktfry sgom loshksh tjkt jks omnrhkshl om prhvkehmnh fvhr tjh

ekst jke` nhmtury. K arfwoma cfly f` hvolhmnh suaahsts tjkt tjhrh krh k vkrohty f` lh`hnts om tjh ommkth oiiumh

systhi tjkt nfeehntovhey k``hnt tjh lhvhefpihmt kml shvhroty f` KL. \jh rhluntofm om kmtoionrfcoke phptolhs,

loiomosjhl rhnruotihmt f` ommkth oiiumh nhees (TIMs, pLN, kml MG nhees) tf tjh sgom, hpotjheoke ckrrohr

losruptofm, kml \ES3 lh`hnts krh bust sfih f` tjh nrhloceh hxpekmktofms `fr KL pktohmtssusnhptocoeoty tf

pktjfahms sunj ks ^tkpjyefnfnnus kurhus, jhrphs soipehx vorus, kml vknnomok vorus.Ketjfuaj tjh `fnus `fr

shvhrke yhkrs jks chhm tf olhmto`y lh`hnts om tjh ommkth oiiumh systhi tjkt ioajt hxpekom KL pktohmts

susnhptocoeoty tf nutkmhfus pktjfahms, ot jks chnfih nehkr tjkt sfih ommkth oiiumh lh`hnts ioajt prfifth

om`ekiiktofm kml tjhrhcy kaarkvkth fr hvhm omlunh tjh lhvhefpihmt f` KL. Jhrh wh rhvohw tjh ommkth oiiumh

systhi, kml joajeoajt ikmy f` tjh pfthmtoke ommkth mhtwfrgs tjkt iky ch oipfrtkmt om KL pktohmts susnhptoceh tf

nutkmhfus pktjfahms.

^ K


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ûsnhptocoeolkl k Tktahmfs V

^. kurhus, PJ^,

Losùmnom Ckrrhrk Nutmhk

Shneutkiohmtf lh nhe. lhe ÔO k pohe 2 TIMs, LN, y MG

Shlunnom lh Tptolfs kmtoionrfcokmfs

Lh`hntfs hm \ES3

LHSIK\O\O^ K\FTONK2 ^. KurhusSH^XIHM


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^hnrhnom lh tfxomks

^uphrkmtoahmfs

Iksovk prfeo`hrknom lh neueks \

Trflunnom lh notfquomks

Om`ekiknom

^.kurhus


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Ahmtonfs

ôsthik lhOmiumolkl

Klquorolk

Ckrrhrk NutmhkTptolfs

Kmtoionrfcokmf

LHSIK\O\O^ K\FTONK2 ^. Kurhus

ôsthik lhOmiumolkl

Ommktk

ûphrkmtahmf


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;. Omtrflunnom

;. Tktfamhsos

3. \rktkiohmtf


urhus

y hrik s p nk


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^. Kurhus 2 @kntfr hxknhrckmth lh ek LK

Hxknhrck y ikmtohmh ek omèkiknofm hm LK

Ihbfrkmlf ek Omèkiknom 2 losiomuyh ^. Kurhus

Losiomuyh ^. Kurhus 2 Ihbfrk ek Omèkiknom

K = nfefmozknom ^. Kurhus =^hvhrolkl

BHKLP 34;3, 30, ;4


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^. Kurhus y LHSIK\O\O^ K\FTONK

@kntfr Karkvkmth

Ckmahrt ^, Ehvy I, Jhchrt KK. Cknthroke rhsostkmnh kml


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Ckmahrt ^, Ehvy I, Jhchrt KK. Cknthroke rhsostkmnh kml

oiphtoaf trhktihmt trhmls2 k rhvohw. Thloktr Lhriktfe

34;373?233 vhnhs /shikmk.Losiomuyh rhnurrhmnoks lh ^2Kurhus nukmlf sh nficomk nfm

Iuporfnom omtrkmkske

Ckf nfmJopfnefrotf

Mk

Trhvhmnom

\rktkiohmtf

Fcshrvknom Kutfrhsfeunom / Kutfomknueknom / Nfmtkaof

5 H`hntovfs quh Kmtocotonfs Trhsnrotfs\ponfsFvhr tjhNfumthr

KmtocotonfsFrkehs

Kmtocotonfs\ponfs

Shshrvkr pkrk nksfs shvhrfs lh oiptoafH`hntfs Klvhrsfs / Shsosthmnok Cknthrokmk

Ehsofmhs eoiotklks / ^fef ehsofmhs5 Shsosthmnok Cknthrokmk

Nfihmtkrofs

^ K L o o K o


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Kmtosptonfs

^. Kurhus y Lhriktotos Ktfponk

Njefrjhxolomh2 kmtosptonf

Cknthronolk y cknthrofsttonf 2 Arki + kml Arki- , ftrks\xonf2 Fnuekr y Folfs ( nrmhk , sfrlhrk y lhriktotos),

^gom Tjkriknfe Tjysofe. 3441734(3)21;-0. Hpuc 3440 Lhn ;.

Kmtoshpton h` onkny f` k efw-lfshl tfponke tronefskm/njefrjhxolomh nficomktofm

tjhrkpy om ktfpon lhriktotos.

Qfjerkc B;, Bfst A, Kchng L

;

Mfvhe ^floui Jypfnjefroth Nehkmshr ^jfws Neomonke;


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Mfvhe ^floui Jypfnjefroth Nehkmshr ^jfws NeomonkeShspfmsh kml Hxnheehmt Knnhptkcoeoty om tjh \rhktihmt f`

Ktfpon Lhriktotos.Nkotrofmk Sykm, ht ke Thl. Lhriktfe. >47> >4:>;8, 34;>

;

C l E b T t e


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Hxpeonkr efs Chmh`onofs lhe ckf hm kauk nfm Jopfnefrotf lh Mk

Eehmkr ek ckhrk nfm kauk thipeklk (;8; Ets)

Kklor ;34 iE lh MKFNE ke 0%

Ihznekr cohm

Ckf lh 8 k ;4 iomutfs 3- > vhnhs pfr shikmk

Hmbukakr cohm nfm kauk lhe tohipf

^hnkr som @rftkr

Jolrktkr

Hvotkr

Xsf som loeuor

Krhks hsnroklks kcohrtks

Kehraok ke Nefrf

Ckf lh Ehbk . Trftfnfef(Grkgfwsgo ht.ke)


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Hstulof rhtrfsphntovf y prfsphntovf ;: pknohmths, LK iflhrklk k shvhrk

^. kurhus + Tohe ehsofmke

Hxneusofm 2 om`hnnofmhs kntovks y usf lh kmtocoftonfs tfponf sostionf prhvoks3 shikmks .

Ahe lh ckf nfm jopfnefrotf lh Mk+

; k 3 iomutfs

> / shi x > shi

Ikmtohmhm \rktkiohmtf


Ktfpon Lhriktotos.

Ikthroke y Itflfs

H``onkny snfrhs `fr tjh prfsphntovh kml rhtrfsphntovh


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y p p p

nfjfrts kml tjh nficomhl arfup krh sjfwm

Momam pknohmth kihrot kmtocotonf frke lurkmth he hstulof

N to o T l


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Nuhstofmkrof k Tklrhs


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\x nfm Jopfnefrotf lh ^flof Loeuolf

Ihbfrk LK

Mf txonfs

Mf omlunh rhsosthmnok kmtoionrfcokmk

@ketkm Hstulofs


Ktfpon Lhriktotos.

Nfmneusofmhs


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Trfpohlklhs Fxolkmths

Tuhlh hxknhrckr ksik y nkuskr lhriktotos

@okcoeolkl 2 vkrokcehs hm prfluntfs lospfmocehs

Lhsnfipfsonom lh MkFNe nfm he tohipf

@rkakmnoks y ftrfs prfluntfs quionfs

Karkvkr he hnzhik.

Sohsafs

Ckf nfm Jopfnefrotf lh ^flof 2 MkFNe

K tocoto \ o3


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Kn. @usolonf 2 Omjocolfr smthsos prfthomks lh eks cknthroks

Hsphntrf 2 Arki + (^tkpjyefnfnnus y Nfrymhcknthroui ).

Iuporfnom2 omjocolfr osfehunye t-SMK somthtksk.

Hsphntrf 2 ^. kurhus kml ^. Tyfahmhs

Heoiomk \rkmspfrth mkske ^. kurhus .

Shsostkmnok 2 Kn. @usolonf y Iuporfnom

Kmtocotonfs \ponfs3


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;. Muhvk neksh lh kahmths kmtocknthrokmfs pehurfiutoeomks.

3. \ropeh iflf lh knnom2 ;omjoch ek smthsos lh prfthmks cknthrokmks

3 cefquhk omthrknnofmhs nfm he sotof T,

>. omjoch ek trkms`hrhmnok phptoloe.

Shsosthmnok pfnf prfckceh

>. Hxnhehmth kntovolkl ionrfcofeaonk 2

^. kurhus , IS^K y ^. Tyfahmhs


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K iuetonhmthr stuly om tjh Xmothl ^tkths rhpfrthl tjkt up tf 1:%

f` kee stkpjyefnfnnke-rhekthl sgom kml sf`t tossuh om`hntofms whrh

luh tf IS^K. \jh ihnK ahmh, wjonj afvhrms prfluntofm f` tjh

phmonoeeom comloma prfthom 3k, nfm`hrs rhsostkmnh. \jos prfthom

prhvhmts -ekntki kmtocknthrokes `rfi k``hntoma nhee wkee symtjhsos.

Shnhmt lktk jks sjfwm IS^K osfekths rhsostkmt tf iuetopeh

kahmts, omneuloma iuporfnom, hrytjrfiynom, neomlkiynom,

thtrknyneomh, sue`fmkiolhs, njefrkipjhmonfe, nhpjkefspfroms, kml

quomfefmhs .

^oevhrchra M, Cefng ^. Xmnfipeonkthl sgom kml sgom strunturh om`hntofms om

njoelrhm2 lokamfsos kml nurrhmt trhktihmt fptofms om tjh Xmothl ^tkths. Neom

Thloktr 344:7


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Om`hnnom Hxthmsk 2 Kmtocotonf frke

^. Kurhus

Kmtocotonfs pfr vok frke 2

Shsosthmnok k Thmonoeomk y Hrotrfionomk 2

;kEmhk2 Nh`kehxomk , Lonefxknoeomk

Kmtocotonf \ponf 2 Mkromks y Xks

KM\OIONSFCOKMF^

Kustrkeksokm Bfurmke f` Lhriktfefay (344:)


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^KIS 2 Neomlkionomk \I^.

Kifxonoeomk/kn.Nekvuemonf

@eufrfquomfefmkPkmnfionomk

Nuetovf y Kmtocofarkik

KM\OIONSFCOKMF^

Kustrkeksokm Bfurmke f` Lhriktfefay (344:)


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Nfefmozknom

Ps

Om`hnnom

^. Kurhus y Lhriktotos Ktponk

He pkphe lh ^. kurhus hm he hnnhik ktponf y eklo`hrhmnoknom hmtrh ek nfefmozknom lh ^. kurhus y ek

om`hnnom mf hst nekrk

^. Kurhus 2 `kntfr hxknhrckmth hm efs crfths lh LK


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^hnrhnom lh tfxomks

^uphrkmtoahmfs

Iksovk prfeo`hrknom lh neueks \

Trflunnom lh notfquomks

Om`ekiknom

^.kurhus. Nfefmozknom

Kmtocotonfs Frkehs y Lhriktotos Ktponk


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Ehuma L_I, Cohchr \. Ktfpon lhriktotos. Ekmnht. 344>7>0;2;8;-04.

He usf lh kmtocotonfs frkehs pkrk trktkr he hnnhik mf

om`hntklf mf sh ksfno nfm umk ihbfrk lh ek lhriktotos.

Kmtocotonfs Frkehs y Lhriktotos Ktponk

Mf sh rhnfiohmlk he usf lh kmtoionrfcokmfs sostionfs

pkrk ek lhsnfefmozknom pfr ^. kurhus

Shnfefmo knom Shsosthmnok Cknthrokmk k


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Bkpph X, ^njmunj K, Xthr Q. @rhquhmny f` shmsotozktofm tf kmtoionrfcokes om

pktohmts wotj ktfpon hnzhik nfipkrhl wotj mfmktfpon omlovolukes2 kmkeysos f` iuetonhmtrh survhoeekmnh lktk, ;??8-;???. Cr B Lhriktfe. 344>7;

Jky hvolhmnok lh quh ek pohe sh rhnfefmoz rpolkihmth

nukmlf he trktkiohmtf kmtoionrfcokmf nhsk.

Kmtoionrfcokmfs hm KL sh lhchm uskr nfm prhnkunom

pkrk rhlunor ek omnolhmnok lh ek rhsosthmnok cknthrokmk.

Shnfefmozknom y Shsosthmnok Cknthrokmk k

^.Kurhus hm LK


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Kuihmtf Trhvkehmnok lh Shsosthmnok ^. kurhus,

IS^K.

Fcbhtovf 2 Shlunor he Xsf lh Kmtocotonf ^ostionf

^. Kurhus y Lhriktotos Ktfponk

^oevhrchra M, Cefng ^. Xmnfipeonkthl sgom kml sgom strunturh om`hntofms om

njoelrhm2 lokamfsos kml nurrhmt trhktihmt fptofms om tjh Xmothl ^tkths. Neom

Thloktr 344:7


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Krnj Lhriktfe. 34437;>:2?>?-


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Mf hmnfmtrkrfm hvolhmnoks lh quh efs \x kmtohstkòefnnonks nfimihmth utoeozklfs sfm

nemonkihmth toehs hm phrsfmks nfm hnzhik quh mf hst om`hntklk nemonkihmth.

û usf nfmtomuklf lhch shr nuhstofmklf hm hstks sotuknofmhs, jkstk quh efs hstulofs

ihbfr y is ekraf pekzf iuhstrkm umk nekrk hvolhmnok lh chmhònof nemonf

f` ktfpon hnzhik2 km uplkthl Nfnjrkmh rhvohw. .Cktj-Jhxtkee @B, Cormoh KB, Skvhmsnrf`t BN, Qoeeokis JN. Cr B Lhriktfe.34;47;0>2;3---30.

Muhstrk Nfmluntk


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;. Nuetovf y Kmtocofarkik

3. Xsf lh Kmtocotonfs ^osthionfs pfr 0 lks

>. Kmtocotonf hm mkromks y uks


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Ckske

LHSIK\O\O^ K\FTONK 2

Crfth ^hvhrf


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Ckske


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Phmlkbhs Jihlfs + Nonefspfromk


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Ikmhbf Lh Ek Om`hnnom Cknthrokmk Hm Mofs Nfm Lhriktotos Ktponk


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^. Kurhus 2 Htofpktfahmok lh ek LK

Shsosthmnok y IS^K

Ckf Nfm Ehbk 2 \rkckbfs

\x Kmtohstk`oefnnnonf 2 Hnnhik Om`hntklf

Mf K\C hm Hnnhik Mf Om`hntklf


Nfmneusofmhs



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Nonefs Nfrtfs

\rktkiohmtf Kmtoom`ekiktfrof 2 5 ^. Kurhus

\rkckbfs lh Ikyfr Fcbhtovolkl

Nuetovf y Kmtocofarkik

Om`hnnom Hvolhmth y Nksfs ^hvhrfs


Nfmneusofmhs


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1.manejo de la infeccion bacteriana en niños con dermatitis atopica

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