medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2020-1-118-129medsovet-5548Research ArticleДЕРМАТОЛОГИЯDERMATOLOGYСовременный взгляд на этиопатогенез, клинические проявления и лечение пиодермий у детейCurrent views on etiopathogenesis, clinical manifestations and treatment of pyodermas in childrenhttps://orcid.org/0000-0003-3261-6718ТамразоваО. Б.TamrazovaO. B.

Тамразова Ольга Борисовна - доктор медицнских наук, профессор кафедры дерматовенерологии факультета повышения квалификации медицинских работников РУДН; врач-дерматовенеролог, ДГКБ им. З.А. Башляевой.

117198, Москва, ул. Миклухо-Маклая, д. 6; 125373, Москва, ул. Героев Панфиловцев, д. 28

Olga B. Tamrazova - Dr. of Sci. (Med), Professor of the Department of Dermatovenerology, Faculty of Advanced Training of medical workers, PFUR; dermatovenerologist, ChCCH named after Z.A. Bashlyaeva.

6, Miklukho-Maklaya St., Moscow, 117198; 28, Geroev Panfilovtsev St., Moscow, 125373

anait_tamrazova@mail.ruhttps://orcid.org/0000-0002-3004-6646ШмелеваЕ. А.ShmelevaE. A.

Шмелева Евгения Александровна - врач-ординатор кафедры дерматовенерологии факультета повышения квалификации медицинских работников.

117198, Москва, ул. Миклухо-Маклая, д. 6

Evgeniya A. Shmeleva - Resident of the Department of Dermatovenerology, Faculty of Advanced Training of medical workers.

6, Miklukho-Maklaya St., Moscow, 117198

evgeniya.shmeleva1994@yandex.ruhttps://orcid.org/0000-0002-7864-5090МироноваА. К.MironovaA. K.

Миронова Алена Константиновна - кандидат медицнских наук, заведующая центром восстановительного лечения детей до 3 лет.

125373, Москва, ул. Героев Панфиловцев, д. 28

Alena K. Mironova - Cand. of Sci. (Med), head of the Rehabilitation Centre for children under 3 years of age.

28, Geroev Panfilovtsev St., Moscow, 125373

lyona_85@mail.ruhttps://orcid.org/0000-0003-3278-4797ДубовецН. Ф.DubovetsN. F.

Дубовец Наталия Федоровна - врач-педиатр, заведующая приемным отделением.

Nataliya F. Dubovets - paediatrician, head of reception

28, Geroev Panfilovtsev St., Moscow, 125373

skorpionka_n@mail.ruРоссийский университет дружбы народов; Детская городская клиническая больница имени З.А. Башляевой Департамента здравоохранения города МосквыРоссияPeople’s Friendship University of Russia; Children’s City Clinical Hospital named after Z.A. BashlyaevaRussian FederationРоссийский университет дружбы народовРоссияPeople’s Friendship University of RussiaRussian FederationДетская городская клиническая больница имени З.А. Башляевой Департамента здравоохранения города МосквыРоссияChildren’s City Clinical Hospital named after Z.A. BashlyaevaRussian Federation20200803202001118129Copyright © Тамразова О.Б., Шмелева Е.А., Миронова А.К., Дубовец Н.Ф., 20202020Тамразова О.Б., Шмелева Е.А., Миронова А.К., Дубовец Н.Ф.Tamrazova O.B., Shmeleva E.A., Mironova A.K., Dubovets N.F.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/5548

Гнойничковое заболевание кожи, вызываемое гноеродными бактериями, - золотистым стафилококком и пиогенным стрептококком - пиодермия, относится к группе заболеваний междисциплинарного характера, т. к. встречается в практике врачей-терапевтов, инфекционистов, педиатров, хирургов и др. Пиодермии являются одним из наиболее распространенных дерматозов в России и за рубежом и составляют от 17 до 43% в общей структуре кожной патологии. Изменение реактивности макроорганизма, патогенность микроорганизмов и неблагоприятное влияние внешней среды определяют патогенетические механизмы развития пиодермий. В данной статье подробно рассмотрен каждый из перечисленных факторов развития инфекционного процесса на коже, клинические формы и осложнения. Наиболее часто в практике врача-педиатра встречаются пиодермии, вызванные S. aureus. На сегодняшний день клиническая картина стафилодермий у детей очень разнообразна и включает в себя как локализованные и распространенные формы, а также может характеризоваться генерализованным течением, угрожающим жизни пациента. Наиболее опасными формами пиодермий в педиатрической практике являются экс-фолиативный дерматит Риттера и стафилококковый синдром обожженной кожи. В данной статье описаны общие принципы диагностики и лечения пиодермий. Акцент сделан на описании антибактериальной терапии в условиях непрерывного роста антибиотикорезистентности. Учитывая высокую распространенность заболевания среди детского населения, подробно разобраны возрастные особенности и варианты течения гнойничковых заболеваний у данной группы пациентов.

Pyoderma - a pustular skin disease caused by pyogenic bacteria, - golden staphylococcus and pyogenic streptococcus [1], belongs to the group of diseases of interdisciplinary character, because it is found in the practice of therapists, infectious disease specialists, pediatricians, surgeons, and others. [2]. Pyodermas are one of the most widespread dermatoses in Russia and abroad, accounting for 17 to 43% of the total structure of skin pathology [3]. Changes in macroorganism reactivity, pathogenicity of microorganisms and unfavorable influence of environment determine pathogenetic mechanisms of pyodermas development. In this article, each of the listed factors for the development of the skin infection process, clinical forms and complications are considered in detail. Pyodermas caused by S. aureus are the most frequently encountered in the practice of a pediatrician. To date, the clinical picture of staphylodermia in children is very diverse and includes both localized and widespread forms, and may be characterized by a generalized flow threatening the life of the patient. The most dangerous forms of pyodermas in pediatric practice are Ritter’s exfoliating dermatitis and Staphylococcal scalded skin syndrome. This article describes the general principles of diagnosis and treatment of pyodermas. Emphasis is placed on the description of antibacterial therapy under conditions of continuous growth of antibiotic resistance. Taking into account the high prevalence of the disease among children, the age features and variants of the course of pustular diseases in this group of patients are analyzed in detail.

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The authors declare that there are no conflicts of interest present.