medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2024-056medsovet-8126Research ArticleЗАБОЛЕВАНИЯ КОЖИDERMAL DISEASESТерапевтические возможности лечения и контроля рецидивирующего течения атопического дерматита тяжелой степени тяжестиTherapeutic potential of the treatment and control of severe recurrent atopic dermatitishttps://orcid.org/0000-0003-3261-6718ТамразоваО. Б.TamrazovaO. B.

Тамразова Ольга Борисовна - д.м.н., профессор кафедры дерматовенерологии с курсом косметологии факультета непрерывного медицинского образования Медицинского института, РУДН им. Патриса Лумумбы; руководитель центра аллергодерматозов, ДГКБ им. З.А. Башляевой.

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

Olga B. Tamrazova - Dr. Sci. (Med.), Professor of Department of Dermatovenerology with Cosmetology Course, Faculty of Continuing Medical Education, Institute of Medicine, Peoples’ Friendship University of Russia named after Patrice Lumumba; Head of Allergic Dermatoses Center, Bashlyaeva City Children’s Clinical Hospital.

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, ДГКБ им. З.А. Башляевой; ассистент кафедры дерматовенерологии с курсом косметологии факультета непрерывного медицинского образования Медицинского института, РУДН им. Патриса Лумумбы.

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

Antonina S. Stadnikova - Cand. Sci. (Med.), STD and Skin Physician, Bashlyaeva City Children’s Clinical Hospital; Teaching Assistant of Department of Dermatovenerology with Cosmetology Course, Faculty of Continuing Medical Education, Institute of Medicine, Peoples’ Friendship University of Russia named after Patrice Lumumba.

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

tonya-st@yandex.ruhttps://orcid.org/0000-0002-7571-5460НовикГ. А.NovikG. A.

Новик Геннадий Айзикович - д.м.н., профессор, заведующий кафедрой педиатрии имени профессора И.М. Воронцова.

194100, Санкт-Петербург, ул. Литовская, д. 2

Gennady A. Novik - Dr. Sci. (Med.), Professor, Head of Department of Children’s Diseases named after Professor I.M. Vorontsov, St Petersburg State Pediatric Medical University.

2, Litovskaya St., St Petersburg, 194100

ega_novik@mail.ruhttps://orcid.org/0000-0001-7394-6575СухотинаА. Г.SukhotinaA. G.

Сухотина Александра Геннадьевна - врач-дерматовенеролог, Детская городская клиническая больница имени З.А. Башляевой.

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

Aleksandra G. Sukhotina - STD and Skin Physician, Bashlyaeva City Children’s Clinical Hospital.

28, Geroev Panfilovtsev St., Moscow, 125373

aleksandra170697@mail.ruВоробьеваА. С.VorobevaA. S.

Воробьева Александра Сергеевна - к.м.н., заведующая педиатрическим отделением.

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

Alexandra S. Vorobeva - Cand. Sci. (Med.), Head of Paediatrics Department, Bashlyaeva City Children’s Clinical Hospital.

28, Geroev Panfilovtsev St., Moscow, 125373

dr.alexa@bk.ruhttps://orcid.org/0000-0003-4615-7356БаграмоваГ. Э.BagramovaG. E.

Баграмова Гаянэ Эрнстовна - д.м.н., профессор кафедры дерматовенерологии с курсом косметологии факультета непрерывного медицинского образования Медицинского института.

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

Gayane E. Bagramova - Dr. Sci. (Med.), Professor of Department of Dermatovenerology with Cosmetology Course, Faculty of Continuing Medical Education, Institute of Medicine, Peoples’ Friendship University of Russia named after Patrice Lumumba.

6, Miklukho-Maklai St., Moscow, 117198

bagramovaga@mail.ruhttps://orcid.org/0000-0001-7633-0338БезукладноваА. А.BezukladnovaA. A.

Безукладнова Анастасия Александровна - клинический ординатор кафедры дерматовенерологии с курсом косметологии факультета непрерывного медицинского образования Медицинского института.

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

Anastasia A. Bezukladnova - Clinical Resident of Department of Dermatovenerology with Cosmetology Course, Faculty of Continuing Medical Education, Institute of Medicine, Peoples’ Friendship University of Russia named after Patrice Lumumba.

6, Miklukho-Maklai St., Moscow, 117198

bezukladnova_n@mail.ruРоссийский университет дружбы народов имени Патриса Лумумбы; Детская городская клиническая больница имени З.А. БашляевойРоссияPeoples’ Friendship University of Russia named after Patrice Lumumba; Bashlyaeva City Children’s ClinicalRussian FederationСанкт-Петербургский государственный педиатрический медицинский университетРоссияSt Petersburg State Pediatric Medical UniversityRussian FederationДетская городская клиническая больница имени З.А. БашляевойРоссияBashlyaeva City Children’s ClinicalRussian FederationРоссийский университет дружбы народов имени Патриса ЛумумбыРоссияPeoples’ Friendship University of Russia named after Patrice LumumbaRussian Federation20240703202402816Copyright © Тамразова О.Б., Стадникова А.С., Новик Г.А., Сухотина А.Г., Воробьева А.С., Баграмова Г.Э., Безукладнова А.А., 20242024Тамразова О.Б., Стадникова А.С., Новик Г.А., Сухотина А.Г., Воробьева А.С., Баграмова Г.Э., Безукладнова А.А.Tamrazova O.B., Stadnikova A.S., Novik G.A., Sukhotina A.G., Vorobeva A.S., Bagramova G.E., Bezukladnova A.A.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/8126

Атопический дерматит – это наследственно обусловленное воспалительное заболевание кожи, свойственным характеристикам которого присуще наличие зуда, длительное повторяющееся течение и определенная эволютивная динамика. Атопический дерматит средней и тяжелой степени тяжести рассматривается как системное заболевание, которое утяжеляет течение сопутствующих патологий, в т. ч. сердечно-сосудистых, нервно-психических и злокачественных заболеваний. В данной статье представлены основные сведения о средней и тяжелой степени тяжести атопического дерматита, подробно разобраны статистические эпидемиологические и патогенетические данные, сделаны акценты на проблемах качества жизни больных. Известно, что еще несколько лет назад терапия средней и тяжелой степени атопического дерматита проводилась системными кортикостероидами и классическими иммуносупрессантами, но они имели ограниченную эффективность и не подходили для долгосрочного лечения из-за их профиля безопасности. В статье освещены разработки новых эффективных и удобных в применении методов лечения атопического дерматита, что привело к появлению селективных ингибиторов янус-киназ. В обзоре представлены основные механизмы действия селективных ингибиторов янус-киназ и их влияние на барьерную функцию кожи. Представлены данные исследований по доказанной эффективности с высокой безопасностью при лечении самого первого препарата из группы селективных ингибиторов – упадацитиниба. В статье авторы привели собственное клиническое наблюдение применения упадацитиниба у подростков с тяжелым течением атопического дерматита. Применение препарата упадацитиниб в описанных клинических случаях привело к уменьшению выраженности субъективных и объективных симптомов воспалительных заболеваний кожи.

Atopic dermatitis is a hereditary inflammatory skin disease characterized by pruritus, a long recurrent course and certain evolutionary dynamics. Atopic dermatitis of moderate and severe severity is considered a systemic disease that exacerbates the course of associated pathologies, including cardiovascular, neuropsychiatric, and malignant diseases. The current paper presents the essentials about moderate and severe severity atopic dermatitis, statistical epidemiologic and pathogenetic data is thoroughly processed, the issues of the quality of life of such patients are especially accentuated. It is known that a few years ago the therapy of moderate and severe atopic dermatitis was based on systemic corticosteroids and classical immunosuppressants, but they had limited efficacy and were not suitable for long-term treatment due to their safety profile. This article highlights the development of new effective and easy-to-use therapies for atopic dermatitis, which led to the emergence of selective Janus kinase inhibitors. The review presents the way selective inhibitors of Janus kinases works and their effect on the barrier function of the skin. The paper provides the research data on the very first drug from the group of selective inhibitors - upadacitinib, which proved its efficacy on a par with a high degree of safety. The authors presented their own clinical observation of the use of upadacitinib in adolescents with severe atopic dermatitis. The use of upadacitinib in the described clinical cases led to a decrease in the severity of subjective and objective symptoms of inflammatory skin diseases.

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