medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2024-099medsovet-8244Research ArticleДЕРМАТОЛОГИЯDERMATOLOGYФлашинг-реакции у детей с кожным мастоцитозомFlushing in children with cutaneous mastocytosishttps://orcid.org/0000-0002-0767-8821КасихинаЕ. И.KasikhinaE. I.

Касихина Елена Игоревна, к.м.н., врач-дерматовенеролог, Московский научно-практический центр дерматовенерологии и косметологии; доцент кафедры дерматовенерологии, аллергологии и косметологии Медицинского института, Российский университет дружбы народов имени Патриса Лумумбы

119071, Москва, Ленинский проспект, д. 17,

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

Elena I. Kasikhina, Cand. Sci. (Med.), Dermatologist, Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology; Associate Professor, Department of Dermatovenereology, Allergology and Cosmetology, Institute of Medicine, Peoples’ Friendship University of Russia named after Patrice Lumumba

17, Leninsky Ave., Moscow, 119071,

6, Miklukho-Maklai St., Moscow, 117198

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

Жукова Ольга Валентиновна, д.м.н., главный врач, Московский научно-практический центр дерматовенерологии и косметологии; профессор, заведующая кафедрой дерматовенерологии, аллергологии и косметологии Медицинского института, Российский университет дружбы народов имени Патриса Лумумбы

119071, Москва, Ленинский проспект, д. 17,

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

Olga V. Zhukova, Dr. Sci. (Med.), Chief Medical Officer, Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology; Professor, Head of the Department of Dermatovenereology Allergology and Cosmetology, Institute of Medicine, Peoples’ Friendship University of Russia named after Patrice Lumumba

17, Leninsky Ave., Moscow, 119071,

6, Miklukho-Maklai St., Moscow, 117198

klinderma@inbox.ruhttps://orcid.org/0000-0003-3386-1467ОстрецоваМ. Н.OstretsovaM. N.

Острецова Мария Николаевна, к.м.н., доцент кафедры дерматовенерологии, аллергологии и косметологии Медицинского института

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

Maria N. Ostretsova, Cand. Sci. (Med.), Associate Professor, Department of Dermatovenereology, Allergology and Cosmetology, Institute of Medicine

6, Miklukho-Maklai St., Moscow, 117198

ostretsova-mn@rudn.ruhttps://orcid.org/0000-0002-5788-4666КочетковМ. А.KochetkovM. A.

Кочетков Михаил Анатольевич, к.м.н., ведущий научный сотрудник

119071, Москва, Ленинский проспект, д. 17

Mikhail A. Kochetkov, Cand. Sci. (Med.), Leading Researcher

17, Leninsky Ave., Moscow, 119071

1012246@mail.ruhttps://orcid.org/0009-0002-1193-3247НадаА. Я.NadaA. Ya.

Нада Ахмед Яссер, аспирант кафедры дерматовенерологии, аллергологии и косметологии Медицинского института

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

Ahmed Yasser Nada, Postgraduate Student, Department of Dermatovenereology, Allergology and Cosmetology, Institute of Medicine

6, Miklukho-Maklai St., Moscow, 117198

ahmed_nada391@yahoo.comМосковский центр дерматовенерологии и косметологии; Российский университет дружбы народов имени Патриса ЛумумбыРоссияMoscow Scientific and Practical Center of Dermatovenereology and Cosmetology; Peoples’ Friendship University of Russia named after Patrice LumumbaRussian FederationРоссийский университет дружбы народов имени Патриса ЛумумбыРоссияPeoples’ Friendship University of Russia named after Patrice LumumbaRussian FederationМосковский центр дерматовенерологии и косметологииРоссияMoscow Scientific and Practical Center of Dermatovenereology and CosmetologyRussian Federation20241205202405240247Copyright © Касихина Е.И., Жукова О.В., Острецова М.Н., Кочетков М.А., Нада А.Я., 20242024Касихина Е.И., Жукова О.В., Острецова М.Н., Кочетков М.А., Нада А.Я.Kasikhina E.I., Zhukova O.V., Ostretsova M.N., Kochetkov M.A., Nada A.Y.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/8244Введение

Введение. Приливы крови (флашинги, флашинг-реакции) – это субъективное ощущение тепла, которое сопровождается покраснением кожи на любом участке тела, но преимущественно на лице, шее и верхней половины туловища. Эпизодические приливы с другими симптомами, связанными с медиаторами тучных клеток, могут наблюдаться у 30–50% детей с кожным мастоцитозом (КМ).

Цель

Цель. Провести анализ частоты встречаемости флашинг-реакций у детей с различными клиническими формами кожного мастоцитоза. Изучить уровни сывороточной триптазы у детей с флашинг-реакциями.

Материалы и методы

Материалы и методы. В исследование были включены данные 275 детей в возрасте от 6 мес. до 17 лет включительно, находившихся на амбулаторном лечении и наблюдении в ГБУЗ «Московский центр дерматовенерологии и косметологии» в период с марта 2022 г. по январь 2024 г. Концентрация триптазы в крови определялась методом иммунофлюоресценции на трехмерной пористой твердой фазе (технология ImmunoCAP, Pharmacia Diagnostics AB, Швеция). Дерматоскопическое исследование проводилось с использованием поляризационной и иммерсионной дерматоскопии с 20-кратным увеличением.

Результаты

Результаты. Флашинг-реакции регистрировались у 17,5% пациентов из 275 наблюдаемых детей с КМ. Уровень триптазы более 15 мкг/л определялся у 20,8% детей с приливами, выше 11,0 мкг/л – у 37,5%. Уровень триптазы выше 8,0 мкг/л отмечен у 22 (45,8%) пациентов. У 25,0% пациентов с приливами уровень триптазы не превышал 5 мкг/л. Выраженность сосудистого паттерна в очагах и видимо здоровой коже была характерна для пациентов с частыми и/или продолжительными флашингами и уровнем триптазы в диапазоне от 8,0 мкг/л и выше.

Выводы

Выводы. В Российской Федерации данное исследование впервые продемонстрировало распространенность флашингреакций в популяции детей с различными клиническими формами кожного мастоцитоза. Полученные результаты показали, что исследование уровня сывороточной триптазы необходимо проводить всем детям с флашинг-реакциями независимо от клинической формы мастоцитоза, в т. ч. с изолированными и множественными мастоцитомами кожи. Клинико-лабораторный и дерматоскопический мониторинг важен для разработки индивидуальной терапевтической тактики и профилактики медиаторных реакций и анафилаксии.

Introduction

Introduction. Flushing is a subjective feeling of warmth that is accompanied by redness of the skin on any part of the body, but mainly on the face, neck and upper trunk. Episodic flushing with other symptoms associated with mast cell mediators can be observed in 30–50% of children with cutaneous mastocytosis (CM).

Aim

Aim. To analyze the frequency of flushing in children with various clinical forms of cutaneous mastocytosis. To study serum tryptase levels in children with flushing.

Materials and methods

Materials and methods. The study included data from 275 children aged from 6 months to 17 years inclusive, who were undergoing outpatient treatment and observation at the Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology from March 2022 until January 2024. The concentration of tryptase in the blood was determined by immunofluo-rescence on a three-dimensional porous solid phase (ImmunoCAP technology, Pharmacia Diagnostics AB, Sweden). Polarization and immersion dermatoscopy with 20x magnification were performed.

Results

Results. Flushings were observed in 17.5% of patients out of 275 observed children with CM. The level of tryptase more than 15 µg/l was determined in 20.8% of children with flushing, above 11.0 µg/l – in 37.5%. Tryptase levels were higher than 8.0 µg/L in 22 (45.8%) patients. In 25.0% of patients with flushing, tryptase levels did not exceed 5 µg/L. The severity of the vascular pattern in lesions and apparently healthy skin was characteristic of patients with frequent or prolonged flushing and tryptase levels above 8.0 µg/L.

Conclusion

Conclusion. This study was the first in the Russian Federation to demonstrate the prevalence of flushing in children with various clinical forms of cutaneous mastocytosis. The results showed that the assessment of serum tryptase levels should be performed in all children with flushing, regardless of the clinical form of mastocytosis, including those with isolated and multiple skin mastocytomas. Clinical laboratory and dermatoscopic monitoring are important for the development of individual therapeutic tactics and prevention of mediator reactions and anaphylaxis.

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