medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2023-183medsovet-7684Research ArticleДЕРМАТОЛОГИЯDERMATOLOGYСложная задача в педиатрии: сочетание атопического дерматита и витилигоA challenge in paediatrics: concurrent atopic dermatitis and vitiligohttps://orcid.org/0000-0002-3235-6461СмолкинаО. Ю.SmolkinaO. Yu.

Смолкина Ольга Юрьевна - младший научный сотрудник, ЦТП ФХФ РАН; врач-дерматовенеролог, НККЦ аллергологии и иммунологии.

109029, Москва, ул. Средняя Калитниковская, д. 30; 117513, Москва, ул. Островитянова, д. 6

Olga Yu. Smolkina - Junior Researcher, Center for Theoretical Problems of Physicochemical Pharmacology of the Russian Academy of Sciences; Dermatovenerologist, Scientific and Clinical Consulting Center of Allergology and Immunology.

30, Srednyaya Kalitnikovskaya St., Moscow, 109029; 6, Ostrovityanov St., Moscow, 117513

https://orcid.org/0000-0003-1876-0713КрасниковаВ. Н.KrasnikovaV. N.

Красникова Виктория Николаевна - врач - детский дерматолог.

127473, Москва, ул. Селезневская, д. 20

Viktoriia N. Krasnikova - Pediatric Dermatologist, Moscow Scientific and Practical Center for Dermatovenereology and Cosmetology.

20, Seleznevskaya St., Moscow, 127473

https://orcid.org/0000-0002-6583-0318КорсунскаяИ. М.KorsunskayaI. M.

Корсунская Ирина Марковна – доктор медицинских наук, профессор, заведующая лабораторией.

109029, Москва, ул. Средняя Калитниковская, д. 30

Irina M. Korsunskaya - Dr. Sci. (Med.), Professor, Head of the Laboratory, Center for Theoretical Problems of Physicochemical Pharmacology of the Russian Academy of Sciences.

30, Srednyaya Kalitnikovskaya St., Moscow, 109029

marykor@bk.ruЦентр теоретических проблем физико-химической фармакологии Российской академии наук; Научно-клинический консультативный центр аллергологии и иммунологииРоссияCenter for Theoretical Problems of Physicochemical Pharmacology of the Russian Academy of Sciences; Scientific and Clinical Consulting Center of Allergology and ImmunologyRussian FederationМосковский научно-практический центр дерматовенерологии и косметологииРоссияMoscow Scientific and Practical Center for Dermatovenereology and CosmetologyRussian FederationЦентр теоретических проблем физико-химической фармакологии Российской академии наукРоссияCenter for Theoretical Problems of Physicochemical Pharmacology of the Russian Academy of SciencesRussian Federation202327072023012151155Copyright © Смолкина О.Ю., Красникова В.Н., Корсунская И.М., 20232023Смолкина О.Ю., Красникова В.Н., Корсунская И.М.Smolkina O.Y., Krasnikova V.N., Korsunskaya I.M.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/7684

Атопический дерматит - один из самых распространенных дерматозов во всем мире. Известно, что он часто может сочетаться со множеством аутоиммунных заболеваний. Одной из таких коморбидностей является витилиго. Это сочетание чаще всего встречается именно в детской практике, поскольку для обоих заболеваний характерен ранний дебют. Показано, что раннее начало витилиго и большая площадь поражения кожи связаны с более высокими шансами развития атопического дерматита. Патогенез витилиго характеризуется измененным иммунным ответом, также присутствуют генетические факторы. Показано, что некоторые из этих механизмов являются общими с патогенезом атопического дерматита, но требуется дальнейшее изучение. Считается, что ключевым моментом в развитии витилиго является окислительный стресс, вызывающий разрушение меланоцитов. В связи с этим пациентам с витилиго рекомендуется использование фотозащитных средств. На сегодняшний день изучение влияния видимого света на кожу - весьма актуальный вопрос, в частности, внимание уделяется синему свету (400-500 нм). Исследования демонстрируют, что именно эта длина волны оказывает более выраженное негативное влияние на кожу. Однако научные данные противоречивы, так как излучение этого спектра применяется в терапии различных дерматозов, в т. ч. атопического дерматита. Таким образом, сочетание витилиго и атопического дерматита накладывает определенные ограничения на выбор терапии, средств ухода и фотозащиты. Средство фотопротекции для таких сложных пациентов должно защищать кожу от воздействия как можно более широкого спектра солнечного излучения и при этом не содержать в составе потенциально аллергенных компонентов, способных ухудшить течение атопического дерматита.

Atopic dermatitis is one of the most common dermatoses globally. It has been established that it can often be associated with a variety of autoimmune diseases. Vitiligo is one of such comorbidities. This concurrent combination is most often found in paediatric practice, as an early onset is typical for both diseases. Early onset of vitiligo and involvement of a larger area of skin have been shown to be associated with higher odds of atopic dermatitis. The pathogenesis of vitiligo is characterized by altered immune responses, and genetic factors also counts. It has been shown that some of these mechanisms are shared with the pathogenesis of atopic dermatitis, but the issue warrants further study. Oxidative stress triggering melanocytes destruction is believed to be a key factor in the development of vitiligo. In this regard, patients with vitiligo are advised to use photoprotective agents. Today, the study of effects of visible light on the skin is a very topical issue, specifically, particular attention is paid to blue light (400-500 nm). Studies show that it is this wavelength that has a more pronounced negative effect on the skin. However, research findings are contradictory, as this spectrum radiation is used in the treatment of various dermatoses, including atopic dermatitis. Thus, the concurrent vitiligo and atopic dermatitis place certain restrictions on the choice of therapy, care products and photoprotective agents. A photoprotective agent for such difficult patients should protect the skin from exposure to as wide solar radiation spectrum as possible and at the same time not contain potentially allergenic components that can aggravate the course of atopic dermatitis.

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