medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2022-024medsovet-7445Research ArticleДЕРМАТОЛОГИЯDERMATOLOGYРецидивирующее течение атопического дерматита: терапевтические возможности контроля за заболеванием и продление ремиссийThe recurrent course of atopic dermatitis: therapeutic options for management of disease and prolongation of remissionshttps://orcid.org/0000-0003-3261-6718ТамразоваО. Б.TamrazovaO. B.

Тамразова Ольга Борисовна, д.м.н., профессор кафедры дерматовенерологии, факультет повышения квалификации медицинских работников; врач-дерматовенеролог 

117198, Москва, ул. Миклухо- Маклая, д. 6125373, Москва, ул. Героев Панфиловцев, д. 28

Olga B. Tamrazova, Dr. Sci. (Med.), Professor of the Department of Dermatovenerology, Faculty of Advanced Training of Medical Workers; Dermatovenerologist 

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

anait_tamrazova@mail.ruhttps://orcid.org/0000-0003-3420-4442СтадниковаА. С.StadnikovaA. S.

Стадникова Антонина Сергеевна, к.м.н., врач-дерматовенеролог 

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

Antonina S. Stadnikova, Cand. Sci. (Med.), Dermatovenerologist 

28, Geroev Panfilovtsev St., Moscow, 125373

tonya-st@yandex.ruhttps://orcid.org/0000-0002-3004-6646ГлуховаЕ. А.GlukhovaE. A.

Глухова Евгения Александровна, врач-дерматовенеролог 

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

Evgeniia A. Glukhova, Dermatovenerologist 

28, Geroev Panfilovtsev St., Moscow, 125373

evgeniya.shmeleva1994@yandex.ruhttps://orcid.org/0000-0003-3278-4797ДубовецН. Ф.DubovetsN. F.

Дубовец Наталия Федоровна, врач-педиатр, заведующая приемным отделением 

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

Nataliya F. Dubovets, Pediatrician, Head of the Emergency Department 

28, Geroev Panfilovtsev St., Moscow, 125373

https://orcid.org/0000-0002-2425-9346ВоробьеваА. С.VorobevaA. S.

Воробьева Александра Сергеевна, к.м.н., врач-педиатр 

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

Alexandra S. Vorobeva, Cand. Sci. (Med.), Pediatrician 

28, Geroev Panfilovtsev St., Moscow, 125373

https://orcid.org/0000-0001-5717-7171РадченкоЕ. Р.RadchenkoE. R.

Радченко Елена Равильевна, врач-гастроэнтеролог 

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

Elena R. Radchenko, Gastroenterologist 

28, Geroev Panfilovtsev St., Moscow, 125373

elen.radchenko@list.ruРоссийский университет дружбы народов; Детская городская клиническая больница имени З.А. БашляевойРоссияPeoples’ Friendship University of Russia; Bashlyaeva City Children’s Clinical HospitalRussian FederationДетская городская клиническая больница имени З.А. БашляевойРоссияBashlyaeva City Children’s Clinical HospitalRussian Federation20231704202306193200Copyright © Тамразова О.Б., Стадникова А.С., Глухова Е.А., Дубовец Н.Ф., Воробьева А.С., Радченко Е.Р., 20232023Тамразова О.Б., Стадникова А.С., Глухова Е.А., Дубовец Н.Ф., Воробьева А.С., Радченко Е.Р.Tamrazova O.B., Stadnikova A.S., Glukhova E.A., Dubovets N.F., Vorobeva A.S., Radchenko E.R.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/7445

Атопический дерматит – распространенное воспалительное заболевание кожи, наиболее часто встречающееся среди детей. Заболевание характеризуется как хроническое, однако только 20% детей страдают тяжелой формой атопического дерматита, тогда как другие 80% к 8 годам достигают многолетней ремиссии. В статье представлены основные сведения об атопическом дерматите, включая статистические эпидемиологические данные, признаки тяжелого течения атопического дерматита, указаны критерии тяжести заболевания и основные аспекты ступенчатого подхода к терапии. Авторы уделили особое внимание факторам, ухудшающим течение атопического дерматита: роль аллергенов и провоцирующих факторов, вторичная инфекция, лекарственная гиперчувствительность, сочетанные заболевания, нарушение предписаний дерматолога. Несмотря на большой арсенал современных методов лечения, при длительном, упорном течении атопического дерматита может отсутствовать должный эффект от проводимой терапии, в связи с чем заболевание переходит в торпидное течение. Подобные клинические случаи требуют поиска новых терапевтических методов, в  частности применения ингибиторов янус-киназ. В статье авторы описали клинический пример: пациент К. 17 лет с жалобами на наличие распространенных высыпаний на коже туловища, сопровождаемых интенсивным зудом; пациент болен атопическим дерматитом с раннего детского возраста, кожный процесс носит рецидивирующий характер с чередованием периодов ремиссий и обострений около двух раз в год. Описано успешное применение ингибитора янус-киназ, способного снизить передачу сигналов от множества цитокинов, способствующих развитию признаков и симптомов заболевания, у пациента с атопическим дерматитом тяжелого рецидивирующего течения, у которого наблюдалась недостаточная эффективность терапии стандартными методами.

Atopic dermatitis is a common inflammatory skin disease, which is most frequently occurred in children. The disease is characterized as chronic, but only 20% of children have severe atopic dermatitis, while the other 80% achieve a long-term remission by the age of 8. The article summarizes the main details about atopic dermatitis, including statistical epidemiological data, signs of a severe course of atopic dermatitis, criteria for determining the severity of the disease and the main aspects of a stepwise approach to the therapy. The authors paid special attention to the factors worsening the course of atopic dermatitis: the role of allergens and provoking factors, secondary infection, drug hypersensitivity, concomitant diseases, breach of dermatologist’s prescriptions. Despite the large arsenal of modern therapeutic methods, the therapy of a long, persistent course of atopic dermatitis may not produce a proper effect, and this is the reason why the disease acquires a torpid course. Such clinical cases call for finding new therapeutic methods, in particular the use of Janus kinase inhibitors. In the article, the authors described a clinical case: a 17-year-old patient K. complained of widespread rashes on the skin of the trunk accompanied by intense itching; the patient had been suffering from atopic dermatitis since early childhood, the skin process had a recurrent character with alternating periods of remissions and exacerbations about 2 times a year. The case describes the successful use of Janus kinase inhibitor that was capable to reduce the signaling of many cytokines that contribute to the development of signs and symptoms of the disease, in a patient with severe relapsing atopic dermatitis, who showed insufficient efficacy of therapy with standard methods.

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