Exudative diathesis means “go out” in Latin. Major contributions in this problem investigation were made by M.S. Maslov, G.N. Speranski, J.F. Dombrovskaya, V.A. Tabolin and etc. It should be emphasized that M.S. Maslov has devoted 30 years of his life to the diathesis study. He identified eight varieties of it, out of which the most common are exudative, lymphohypoplastic, and neuro-arthritis ones.
The term “diathesis” in Greek means the predisposition of body reactivity form, characterized by specific reaction to conventional stimulants, liability to certain diseases, which represent a set of inherited and acquired properties of the body The concept of diathesis is inseparable from the concept of the body type. M.S. Maslov identifies the concepts “diathesis” and “abnormality of body type”. In 1905, A. Cherny described exudative diathesis in his own opinion. “Allergic diathesis” can be considered as a broader and more general term, as proposed by A.D. Ado and Kemmerer.
In the modern sense exudative diathesis is the ability of inheritance conventional to congenital and acquired properties of the body to response to certain external stimulus by hyperreaction from the skin and mucous membranes. Exudative diathesis is caused by genetic factors (genetic burden in 70-80% children), age peculiarities of digestive system and immunological protection, and environmental exposures.
Risk factors could be unfavorable conditions of intrauterine development, fetal hypoxia, perinatal affection of CNS, infectious diseases, massive medication therapy, and nature of infant feeding. Risk factors of exudative diathesis in children are dysbacteriosis and maternity gastrointestinal during pregnancy, gestosis, medicinal therapy during pregnancy, eating habits of the expectant mother and immature artificial feeding for the child. Often parents, or one of them, developed exudative diathesis in their childhood had. Factor contributing to clinical manifestation of diathesis are usually food proteins of cow's milk, as well as eggs, citrus fruits, strawberries, semolina and other cereals. Eggs, strawberries, lemons, bananas, chocolate and fish contain endogenous endogenic histamine liberators.
Exudative diathesis may occur in children who are on breastfeeding if their mothers intake foodstuff mentioned earlier Clinical symptoms of exudative diathesis sometimes start immediately or within a few days after birth, in many cases from 2 to 3 months of age. For exudative diathesis the triad symptom by M.S. Maslov is definitive: 1. Cradle caps on the hairy part of the head, the increased formation of seborrheic flakes peeling. Milk tetter - redness and peeling of the skin on the cheeks. 3. Intertrigo (diaper rush)- in the skin folds is consistent. The skin in this area is pale, and dry. These children are thin, with long eye lashes; their skin is thin and delicate, reminiscent of greenhouse fruit.
The increased tenderness of the mucous membranes is reflected in the strong and uneven epithalaxia tongue (geographic tongue), changes in the mucous membrane of the oral cavity (stomatitis). Hyperplasia of lymphoid tissue is also reported as clinical manifestation of exudative diathesis. Adenoides and tonsils, lymph nodes are enlarged, and rare do the liver and spleen. The exudative diathesis run is wavy, with acute conditions (exacerbation) due to dietary errors, including from mothers side if the child is on breastfeeding, but may be due to meteorological factors, and co-morbidities.
It is interesting to note the fact that during bronchial asthma exacerbation and other allergic diseases geographic pattern of the tongue is enhanced. Development of allergic reactions in these people is significantly co-related to inherited ability to produce antibodies- reagin of IgE class, when exposed to exogenous allergens (pollen, household dust, epidermal, medications).
Almost all children with diathesis develop allergic itching dermatosis as neurodermatitis, pruritus, weeping and dry eczema, false croup, bronchial asthma and other allergic inherited diseases.