medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-055medsovet-8947Research ArticleЗАБОЛЕВАНИЯ КОЖИDERMAL DISEASESРаспознавание вторичной инфекции у пациентов с атопическим дерматитом лица и шеи (head and neck)Recognizing secondary infection in patients with atopic dermatitis: Head & neck atopic dermatitishttps://orcid.org/0000-0003-3261-6718ТамразоваО. Б.TamrazovaO. B.

Тамразова Ольга Борисовна, д.м.н., профессор РАН, профессор кафедры дерматовенерологии с курсом косметологии факультета непрерывного медицинского образования Медицинского института, Российский университет дружбы народов имени Патриса Лумумбы; руководитель направления детской дерматологии, Детская городская клиническая больница имени 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 the RAS, Professor of the Department of Dermatovenerology with a Cosmetology course at the Faculty of Continuing Medical Education of the Medical Institute, Peoples’ Friendship University of Russia named after Patrice Lumumba; Head of Pediatric Dermatology Department, Bashlyaeva City Children’s Clinical Hospital

6, Miklukho-Maklai St., Moscow, 117198,

28, Geroev Panfilovtsev St., Moscow, 125373

anait_tamrazova@mail.ruhttps://orcid.org/0000-0002-4672-697XТамразоваА. В.TamrazovaA. V.

Тамразова Анаит Вардановна, ассистент кафедры дерматовенерологии

121359, Москва, ул. Маршала Тимошенко, д. 19, стр. 1а

Anait V. Tamrazova, Assistant of the Department of Dermatovenerology and Cosmetology,: Central State Medical Academy of Department 

19, Bldg. 1а, Marshal Timoshenko St., Moscow, 150000

anaittamrazova@gmail.comhttps://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

2, Litovskaya St., St Petersburg, 194100

ga_novik@mail.ruhttps://orcid.org/0000-0001-7035-0100ЖдановаМ. В.ZhdanovaM. V.

Жданова Марина Владимировна, к.м.н., доцент, заведующая учебной частью кафедры педиатрии имени профессора И.М. Воронцова

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

Marina V. Zhdanova, Cand. Sci. (Med.), Associate Professor, Curriculum Director of Department of Children’s Diseases named after Professor I.M. Vorontsov

2, Litovskaya St., St Petersburg, 194100

zhdanova-marina@rambler.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/0000-0001-7394-6575СухотинаА. Г.SukhotinaA. G.

Сухотина Александра Геннадьевна, врач-дерматовенеролог

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

Aleksandra G. Sukhotina, Dermatovenerologist

28, Geroev Panfilovtsev St., Moscow, 125373

aleksandra170697@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 Clinical HospitalRussian FederationЦентральная государственная медицинская академия Управления делами Президента РФРоссияCentral State Medical Academy of Department for Presidential Affairs of the Russian FederationRussian FederationСанкт-Петербургский государственный педиатрический медицинский университетРоссияSaint Petersburg State Pediatric Medical UniversityRussian FederationДетская городская клиническая больница имени З.А. БашляевойРоссияBashlyaeva City Children’s Clinical HospitalRussian Federation202530032025024248Copyright © Тамразова О.Б., Тамразова А.В., Новик Г.А., Жданова М.В., Стадникова А.С., Сухотина А.Г., 20252025Тамразова О.Б., Тамразова А.В., Новик Г.А., Жданова М.В., Стадникова А.С., Сухотина А.Г.Tamrazova O.B., Tamrazova A.V., Novik G.A., Zhdanova M.V., Stadnikova A.S., Sukhotina A.G.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/8947

Атопический дерматит – это наследственно обусловленное хроническое заболевание кожи, которое характеризуется выраженным зудом, рецидивирующим течением и ассоциацией с другими заболеваниями атопической природы, а также многочисленными осложнениями, к которым относится присоединение вторичной инфекции. Дерматит головы и шеи (“head & neck atopic dermatitis”, или HNAD) – это особый фенотип атопического дерматита, который встречается у подростков и взрослых людей. Характерной особенностью HNAD является поражение участков кожи, богатых сальными железами (лицо, шея, верхняя треть груди и спины), что связано с активным участием грибов рода Malassezia в патогенезе дерматоза. Многофакторный патогенез HNAD, зачастую персистирующее течение, невозможность полной элиминации провоцирующего фактора, а также присоединение вторичной бактериальной инфекции на фоне зуда обуславливают необходимость комплексного подхода к терапии данного состояния и применения для купирования обострения комбинированных препаратов, содержащих глюкокортикостероид, антимикотик и антибиотик. В статье разбирается этиология, механизмы развития HNAD, клинические особенности, а также современные методы терапии, практическое применение которых продемонстрировано на клиническом примере: пациент 19 лет с жалобами на зудящие, шелушащиеся высыпания в области лица и шеи, существующие в течение 3 нед. На основе клинической картины был выставлен диагноз: «атопический дерматит лица и шеи». Учитывая многогранную причину состояния, а именно участие как выраженного иммунного ответа, характерного для АтД, активную колонизацию грибами рода Malassezia, а также «открытые ворота» для вторичной бактериальной инфекции в виде эрозий, патогенетически обоснованным было назначение топического глюкокортикостероида.

Atopic dermatitis is a hereditary chronic skin disease characterized by severe itching, recurrent course and association with other diseases of atopic nature, as well as numerous complications, which include the addition of a secondary infection. Head and neck atopic dermatitis (HNAD) is a special phenotype of atopic dermatitis that occurs in adolescents and adults. A characteristic feature of HNAD is the lesion of skin areas rich in sebaceous glands (face, neck, upper third of the chest and back), which is associated with the active participation of Malassezia fungi in the pathogenesis of the dermatosis. The multifactorial pathogenesis of HNAD, often persistent course, the impossibility of complete elimination of the provoking factor, as well as the addition of a secondary bacterial infection against the background of itching, necessitate a comprehensive approach to the treatment of this condition and the use of combination drugs containing a glucocorticosteroid, an antimycotic and an antibiotic to relieve exacerbations. The article examines the etiology, mechanisms of development of HNAD, clinical features, as well as modern methods of therapy, the practical application of which is demonstrated in a clinical example: patient, 19 years old, complaining of itchy, flaky rashes in the face and neck area, existing for 3 weeks. Based on the clinical picture, a diagnosis was made: atopic dermatitis of the face and neck. Given the multifaceted cause of the condition, namely the participation of both a pronounced immune response characteristic of AD, active colonization by Malassezia fungi, as well as open “gates” for secondary bacterial infection in the form of erosions, the prescription of a topical glucocorticosteroid was pathogenetically justified.

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