medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-073medsovet-8959Research ArticleТРИХОЛОГИЯTRICHOLOGYАктуальные возможности и стратегии лечения гнездной алопеции при коморбидности с атопическими заболеваниямиCurrent options and treatment strategies for alopecia ateata in comorbidity with atopic diseaseshttps://orcid.org/0000-0002-9578-5490ПотекаевН. Н.PotekaevN. N.

Потекаев Николай Николаевич, д.м.н., профессор, директор, Московский научно-практический центр дерматовенерологии и косметологии; 119071, Россия, Москва, Ленинский проспект, д. 17; заведующий кафедрой кожных болезней и косметологии факультета дополнительного профессионального образования, Российский национальный исследовательский медицинский университет имени Н.И. Пирогова

119071, Москва, Ленинский проспект, д. 17,

117997, Москва, ул. Островитянова, д. 1

Nikolay N. Potekaev, Dr. Sci. (Med.), Professor, Director, Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology of Moscow Health Department; Head of the Department of Skin Diseases and Cosmetology of the Faculty of Further Professional Education, Pirogov Russian National Research Medical University

17, Leninskiy Ave., Moscow, 119071,

1, Ostrovityanov St., Moscow, 117997

klinderma@mail.ruhttps://orcid.org/0000-0001-9643-0440ТерещенкоГ. П.TereshchenkoG. P.

Терещенко Галина Павловна, к.м.н., врач-дерматовенеролог, аллерголог-иммунолог, 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

Galina P. Tereshchenko, Cand. of Sci. (Med.), Associate Professor, Dermatologist, Allergologist-Immunologist, Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology; Department of Dermatovenereology Allergology and Cosmetology, Institute of Medicine, Peoples’ Friendship University of Russia named after Patrice Lumumba

17, Leninskiy Ave., Moscow, 119071,

6, Miklukho-Maklaya St., Moscow, 117198

gala_ter@mail.ruhttps://orcid.org/0000-0002-8097-2816ГуменнаяЭ. Р.GumennaiaE. R.

Гуменная Эльвира Равильевна, заведующая отделением дерматовенерологии

119071, Москва, Ленинский проспект, д. 17

Elvira R. Gumennaia, Head of the Department of Dermatovenerology

117, Leninsky Ave., Moscow, 119571

elvgumenny@mail.ruhttps://orcid.org/0000-0001-6890-2041БоткинаА. С.BotkinaA. S.

Боткина Александра Сергеевна, врач-дерматовенеролог

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

Alexandra S. Botkina, Dermatologist, Department of Dermatovenerology

117, Leninsky Ave., Moscow, 119571

botkina@gmail.comhttps://orcid.org/0000-0002-2569-6652СогомонянС. А.SoghomonyanS. A.

Согомонян Софи Арамаисовна, врач-ординатор кафедры дерматовенерологии, аллергологии и косметологии Медицинского института

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

Sofi A. Soghomonyan, Resident Doctor, Department of Dermatovenereology Allergology and Cosmetology, Institute of Medicine

6, Miklukho-Maklaya St., Moscow, 117198

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

Гаджигороева Аида Гусейхановна, д.м.н., руководитель научного отдела клинической дерматовенерологии и косметологии, 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

Aida G. Gadzhigoroeva, Dr. Sci. (Med.), Head of the Scientific Department of Clinical Dermatovenerology and Cosmetology, 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, Leninskiy Ave., Moscow, 119071,

6, Miklukho-Maklaya St., Moscow, 117198

aida2010@mail.ruМосковский центр дерматовенерологии и косметологии; Российский национальный исследовательский медицинский университет имени Н.И. ПироговаРоссияMoscow Scientific and Practical Center of Dermatovenereology and Cosmetology; Pirogov Russian National Research Medical UniversityRussian FederationМосковский 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 FederationРоссийская детская клиническая больницаРоссияRussian Children’s Clinical HospitalRussian FederationРоссийский университет дружбы народов имени Патриса ЛумумбыРоссияPeoples’ Friendship University of Russia named after Patrice LumumbaRussian FederationМосковский 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 Federation20253103202502143152Copyright © Потекаев Н.Н., Терещенко Г.П., Гуменная Э.Р., Боткина А.С., Согомонян С.А., Гаджигороева А.Г., 20252025Потекаев Н.Н., Терещенко Г.П., Гуменная Э.Р., Боткина А.С., Согомонян С.А., Гаджигороева А.Г.Potekaev N.N., Tereshchenko G.P., Gumennaia E.R., Botkina A.S., Soghomonyan S.A., Gadzhigoroeva 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/8959Введение

Введение. Гнездная алопеция (ГА), ассоциированная с атопическими заболеваниями (АЗ), характеризуется специфическими клинико-эпидемиологическими и иммунологическими особенностями, что позволяет выделить «атопический тип» ГА. В настоящее время существуют определенные методы лечения, которые могут быть эффективны как при ГА, так и при АЗ.

Цель

Цель. Оценить актуальные возможности лечения «атопического типа» ГА на основе литературных данных и клинического опыта.

Материалы и методы

Материалы и методы. Изучение публикаций, касающихся связи ГА с атопией, и методов лечения, оценка клиниколабораторных данных и результатов терапии пациентов с ГА и АЗ.

Результаты

Результаты. Проанализированы 78 публикаций и описаны два клинических наблюдения. В первом случае у пациентки, получающей дупилумаб, отмечен положительный эффект в отношении универсальной ГА, атопического дерматита (АтД) и бронхиальной астмы. У второго пациента с АтД и субтотальной ГА достигнута неполная ремиссия в результате комбинированной терапии, включающей УФБ 311 нм и антигистаминный препарат. Выделены определенные варианты лечения при коморбидности ГА и АЗ. В частности, фототерапия, применяемая при АтД, может способствовать восстановлению волос; антигистаминные препараты, используемые для купирования симптомов АЗ, также потенциально эффективны при ГА, особенно в активную стадию. При необходимости системной терапии ГА и АтД следует рассматривать пероральные ингибиторы JAK: барицитиниб, упадацитиниб и аброцитиниб. Дупилумаб может быть препаратом выбора при ГА в сочетании с тяжелым АтД и респираторными аллергозами, в т. ч. у пациентов младшего детского возраста.

Выводы

Выводы. Стратегия лечения пациентов с сочетанием ГА и АЗ должна быть направлена на снижение фармакологической нагрузки и улучшение качества жизни. Современные методы терапии позволяют выбрать тактику лечения с возможностью одновременного воздействия на общие механизмы патогенеза заболеваний с учетом тяжести патологий и возраста пациентов.

Introduction

Introduction. Alopecia areata (AA) associated with atopic diseases (AD) is characterized by specific clinical, epidemiological, and immunological features, allowing the identification of an “atopic type” of AA. Currently, certain treatment methods may be effective for both AA and AD.

Aim

Aim. To analyze current treatment options for “atopic” AA based on literature and clinical experience.

Materials and methods

Materials and methods. Review of publications concerning the connection between AA and atopy and treatment methods; assessment of clinical and laboratory data and treatment outcomes for patients with AA and AD.

Results

Results. Seventy-eight publications were analyzed, and two clinical cases were described. In the first case, a patient receiving dupilumab showed positive effects on universal AA, atopic dermatitis (AtD), and bronchial asthma. The second patient with AtD and subtotal AA achieved partial remission through combined therapy, including UVB 311 nm and antihistamines. Specific treatment options for comorbid AA and AD were identified. Notably, phototherapy used for AtD may aid in hair restoration; antihistamines used for AD symptoms are potentially effective for AA, particularly during active stage. For systemic therapy needs in AA and AtD, oral JAK inhibitors – baricitinib, upadacitinib, and abrocitinib – should be considered. Dupilumab may be the treatment of choice for AA with severe AtD and respiratory allergies, including in younger pediatric patients.

Conclusions

Conclusions. The treatment strategy for patients with concomitant AA and AD should focus on reducing pharmacological burden and improving quality of life. Modern therapeutic approaches provide options for addressing shared pathological mechanisms while considering diseases severity and patient age.

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