medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2023-271medsovet-7768Research ArticleТРИХОЛОГИЯTRICHOLOGYЭффективность узкополосной средневолновой терапии 311нм при лечении пациентов с гнездной алопецией, ассоциированной с атопическим дерматитомEfficacy of therapy with 311nm narrow-band UVB 311nm in the treatment of patients with alopecia areata associated with atopic dermatitishttps://orcid.org/0000-0001-9643-0440ТерещенкоГ. П.TereshchenkoG. P.

Терещенко Галина Павловна, к.м.н., заведующая консультативно-диагностическим центром, 119071, Москва, Ленинский проспект, д. 17;

доцент кафедры дерматовенерологии, аллергологии и косметологии медицинского института, 117198, Москва, ул. Миклухо-Маклая, д. 6

Galina P. Tereshchenko, Cand. Sci. (Med.), Head of the Consultative and Diagnostic Center, 17, Leninskiy Ave., Moscow, 119071;

Associate Professor of the Department of Dermatovenerology, Allergology and Cosmetology at the Medical Institute, 6, Miklukho-Maklai St., Moscow, 117198

gala_ter@mail.ruhttps://orcid.org/0000-0002-9578-5490ПотекаевН. Н.PotekaevN. N.

Потекаев Николай Николаевич, д.м.н., профессор, заведующий кафедрой кожных болезней и косметологии факультета дополнительного профессионального образования, 117997, Москва, ул. Островитянова, д. 1;

директор, 119071, Москва, Ленинский проспект, д. 17

Nikolay N. Potekaev, Dr. Sci. (Med.), Professor, Head of the Department of Skin Diseases and Cosmetology of the Faculty of Further Professional Education, 1, Ostrovityanov St., Moscow, 117997;

Director, 17, Leninskiy Ave., Moscow, 119071

klinderma@mail.ruhttps://orcid.org/0000-0003-0489-0576ГаджигороеваА. Г.GadzhigoroevaA. G.

Гаджигороева Аида Гусейхановна, д.м.н., президент ассоциации «Профессиональное общество трихологов», действительный член Европейского общества исследования волос, главный врач клиники эстетической медицины «Институт красивых волос»; руководитель научного отдела клинической дерматовенерологии и косметологии,

119071, Москва, Ленинский проспект, д. 17

Aida G. Gadzhigoroeva, Dr. Sci. (Med.), President of the Association “Professional Society of Trichologists”, Full Member of the European Hair Research Society, Chief Doctor of the Aesthetic Medicine Clinic “Institute of Beautiful Hair”; Head of the Scientific Department of Clinical Dermatovenerology and Cosmetology,

17, Leninskiy Ave., Moscow, 119071

aida2010@mail.ruhttps://orcid.org/0000-0001-5723-6573ЖуковаО. В.ZhukovaO. V.

Жукова Ольга Валентиновна, д.м.н., профессор, заведующая кафедрой дерматовенерологии, аллергологии и косметологии медицинскогоинститута, 117198, Москва, ул. Миклухо-Маклая, д. 6;

главный врач, 119071, Москва, Ленинский проспект, д. 17

Olga V. Zhukova, Dr. Sci. (Med.), Professor, Head of the Department of Dermatovenerology, Allergology and Cosmetology of the Medical Institute, 6, Miklukho-Maklai St., Moscow, 117198;

Chief Doctor, 17, Leninskiy Ave., Moscow, 119071

klinderma@inbox.ruАндреенкоО. Н.AndreenkoO. N.

Андреенко Ольга Николаевна, врач-дерматовенеролог, Российская детская клиническая больница,

119571, Москва, Ленинский проспект, д. 117

Olga N. Andreenko, Dermatovenerologist, Russian Children’s Clinical Hospital,

119571, Moscow, Leninskiy Ave., 117

on_andreenko@mail.ruМосковский научно-практический центр дерматовенерологии и косметологии; Российский университет дружбы народовРоссияMoscow Scientific and Practical Center of Dermatovenereology and Cosmetology; Peoples’ Friendship University of RussiaRussian FederationРоссийский национальный исследовательский медицинский университет имени Н.И. Пирогова; Московский научно-практический центр дерматовенерологии и косметологииРоссияPirogov Russian National Research Medical University; Moscow Scientific and Practical Center of Dermatovenereology and CosmetologyRussian FederationМосковский научно-практический центр дерматовенерологии и косметологииРоссияMoscow Scientific and Practical Center of Dermatovenereology and CosmetologyRussian FederationРоссийский университет дружбы народов; Московский научнопрактический центр дерматовенерологии и косметологииРоссияPeoples’ Friendship University of Russia; Moscow Scientific and Practical Center of Dermatovenereology and CosmetologyRussian FederationРоссийский национальный исследовательский медицинский университет имени Н.И. ПироговаРоссияPirogov National Medical Research UniversityRussian Federation20232809202301498104Copyright © Терещенко Г.П., Потекаев Н.Н., Гаджигороева А.Г., Жукова О.В., Андреенко О.Н., 20232023Терещенко Г.П., Потекаев Н.Н., Гаджигороева А.Г., Жукова О.В., Андреенко О.Н.Tereshchenko G.P., Potekaev N.N., Gadzhigoroeva A.G., Zhukova O.V., Andreenko O.N.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/7768Введение

Введение. Атопический дерматит  (АтД) относится к  коморбидным заболеваниям при гнездной алопеции  (ГА), влияющим на  риск развития, тяжесть алопеции и  на  иммунологический профиль перифолликулярного воспалительного процесса. Узкополосная средневолновая фототерапия с длиной волны 311 нм (УФБ 311 нм), успешно применяемая при АтД, рассматривается как метод лечения ГА с ограниченной эффективностью, но может способствовать регрессу ГА при комбинированной терапии. Противовоспалительное действие в сочетании с относительной безопасностью делают актуальным изучение возможности применения этого метода в лечении ГА у детей.

Цель

Цель. Оценить эффективность УФБ 311 нм в комплексной терапии пациентов детского возраста с сочетанными заболеваниями: ГА и АтД.

Материалы и методы

Материалы и методы. Проведено открытое когортное сравнительное исследование при участии 49 пациентов 5–12 лет (средний возраст 7,4 ± 0,38 года) с разными клиническими формами ГА. В группу 1 вошли 22 пациента с сопутствующим АтД, группу 2  составили 27  человек без АтД. Все пациенты получали стандартную терапию ГА топическим ГКС; пациентам 1-й группы также был проведен курс общей УФБ 311 нм по показаниям для лечения АтД. Ответ на  лечение оценивался через 3 мес. и считался положительным при возобновлении роста волос более чем на 30%.

Результаты

Результаты. В  группе 1  наблюдалось достоверное преобладание пациентов, ответивших на  лечение  (77%), в  сравнении с группой 2 – 48% (OR 3,7; ДИ [1,05; 12,8] р = 0,045); среднее процентное значение индекса SALT в группе 1 уменьшилось на 46% от исходного, в группе 2 – на 26,6%; при сравнении групп по проценту регресса ГА p = 0,027.

Выводы

Выводы. При комбинированном лечении ГА, включающем УФБ 311 нм, наблюдается тенденция к более интенсивному восстановлению волос. УФБ 311 нм можно рассматривать как дополнительную опцию в лечении ГА, ассоциированной с АтД.

Introduction

Introduction. Atopic dermatitis (AD) is among a comorbid conditions in alopecia areata (AA), that influence the risk of development, severity of AA and the immunologic profile of the perifollicular inflammatory process. Narrowband UVB-311 nm, which has been successfully used in AD, is considered as a treatment for AA with limited efficacy, but may contribute to AA regression when combined with other therapies. The anti-inflammatory effect combined with the relative safety make it relevant to study the possibility of using this method in the treatment of AA in children.

Aim

Aim. To evaluate the efficacy of NB-UVB 311 nm in the complex therapy of pediatric patients with coexisting diseases: AA and AD.

Materials and methods

Materials and methods. We conducted an open cohort comparative study with 49 patients 5–12 years old (mean age 7.4 ± 0.38 y.o.) with different clinical forms of AA. Group 1 included 22 patients with concomitant AD, group 2 consisted of 27 patients without AD. All patients received standard therapy of AA with topical glucocorticosteroids; patients of the first group also received a course of total NB-UVB 311 nm for the treatment of AD. The response to treatment was evaluated after 3 months and was considered as positive when hair regrowth was more than 30%.

Results

Results. In group 1 there was a significant predominance of patients who responded to treatment (77%) compared to group 2 – 48% (OR 3.7; CI [1.05;12.8] p = 0.045); the mean percentage value of SALT index in group 1 decreased by 46% from baseline values, in group 2 – by 26.6%; when comparing the groups by the percentage of alopecia regression p = 0.027.

Conclusions

Conclusions. Combined treatment of AA including NB-UVB 311 nm, contributes to the tendency to more intensive hair regrowth. NB-UVB 311 nm can be considered as an additional option in the treatment of AA, associated with AD.

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