medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2026-098medsovet-9951Research ArticleЗАБОЛЕВАНИЯ КОЖИDERMAL DISEASESКомбинированная терапия кандидозов кожи у пациентов с сопутствующей системной патологиейCombination therapy of cutaneous candidiasis in patients with concomitant systemic pathologyhttps://orcid.org/0000-0002-4401-3722КовалеваЮ. С.KovalevaJu. S.

Ковалева Юлия Сергеевна, д.м.н., заведующая кафедрой дерматовенерологии, косметологии и иммунологии 

656038, Алтайский край, Барнаул, проспект Ленина, д. 40

Julia S. Kovaleva, Dr. Sci. (Med.), Head of the Department of Dermatovenereology, Cosmetology and Immunology 

40, Lenin Ave., Barnaul, Altai Region, 656038

julia_jsk@mail.ruhttps://orcid.org/0000-0002-1774-0334ЗяблицкаяН. К.ZyablitskayaN. K.

Зяблицкая Надежда Константиновна, к.м.н., доцент кафедры дерматовенерологии, косметологии и иммунологии 

656038, Алтайский край, Барнаул, проспект Ленина, д. 40

Nadezhda K. Zyablitskaya, Cand. Sci. (Med.), Associate Professor of the Department of Dermatovenereology, Cosmetology and Immunology 

40, Lenin Ave., Barnaul, Altai Region, 656038

oceann7@yandex.ruhttps://orcid.org/0000-0003-0665-709XОробейМ. В.OrobeiM. V.

Оробей Мария Владимировна, к.м.н., доцент кафедры дерматовенерологии, косметологии и иммунологии 

656038, Алтайский край, Барнаул, проспект Ленина, д. 40

Mariia V. Orobei, Cand. Sci. (Med.), Associate Professor of the Department of Dermatovenereology, Cosmetology and Immunology 

40, Lenin Ave., Barnaul, Altai Region, 656038

orobei77@mail.ruhttps://orcid.org/0009-0004-3396-732XГольцовР. Е.GoltsovR. E.

Гольцов Роман Евгеньевич, ассистент кафедры дерматовенерологии, косметологии и иммунологии 

656038, Алтайский край, Барнаул, проспект Ленина, д. 40

Roman E. Goltsov, Assistant of the Department of Dermatovenereology, Cosmetology and Immunology 

40, Lenin Ave., Barnaul, Altai Region, 656038

roma03-94@mail.ruhttps://orcid.org/0009-0003-5630-0336СавельеваП. Д.SavelyevaP. D.

Савельева Полина Дмитриевна, студент 

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Polina D. Savelyeva, Student 

8, Bldg. 2, Trubetskaya St., Moscow, 119991

savelyevapolly@mail.ruАлтайский государственный медицинский университетРоссияAltai State Medical UniversityRussian FederationПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian Federation202616042026028090Copyright © Ковалева Ю.С., Зяблицкая Н.К., Оробей М.В., Гольцов Р.Е., Савельева П.Д., 20262026Ковалева Ю.С., Зяблицкая Н.К., Оробей М.В., Гольцов Р.Е., Савельева П.Д.Kovaleva J.S., Zyablitskaya N.K., Orobei M.V., Goltsov R.E., Savelyeva P.D.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/9951

Грибы рода Candida, являясь частью нормальной микробиоты человека, при нарушении целостности кожного барьера и сбоях в работе иммунной системы способны трансформироваться в патогенную форму. Некоторые штаммы Candida способны модулировать иммунный ответ, подавляя продукцию провоспалительных цитокинов и индуцируя дифференцировку Т-хелперов в сторону Th2-ответа, что способствует хронизации воспаления. В статье подробно рассмотрены экзогенные и эндогенные факторы риска. Особый акцент сделан на коморбидности: представлены современные данные о роли Candida spp. в усугублении течения атопического дерматита и псориаза. Авторами представлены клинические случаи лечения кандидоза у пациентов с отягощенным анамнезом. Первый случай: мужчина, 19 лет, с жалобами на болезненность, покраснение и отек в области околоногтевого валика, изменение цвета и структуры ногтевой пластины. Диагноз «Кандидоз околоногтевого валика. Онихомикоз». Была назначена терапия 2%-ным кремом сертаконазол, через 4 нед. – клинический регресс воспаления, частичное восстановление структуры ногтевой пластины. Второй случай: мужчина, 37 лет, с жалобами на выраженный зуд, жжение и покраснение в паховых складках. Диагноз «Кандидозное интертриго паховых складок, ассоциированное с антибиотикотерапией, на фоне ожирения». Назначена ступенчатая терапия: 0,05%-ный клотримазол + 0,1%- ный гентамицин + 1%-ный бетаметазон в течение 7 дней, затем 2%-ный крем сертаконазол в течение 2 нед. Через 3 нед. терапии – регресс высыпаний с формированием поствоспалительной гиперпигментации. Третий случай: женщина, 58 лет, с жалобами на интенсивный зуд, жжение, болезненность и мокнутие в складке живота в течение 3 нед. Хронические заболевания в анамнезе. Диагноз «Кандидозное интертриго». Назначена ступенчатая терапия: 0,05%-ный клотримазол + 0,1%-ный гентамицин + 1%-ный бетаметазон в течение 7 дней, затем 2%-ный крем сертаконазол в течение 2 нед. После трехнедельного курса лечения – регресс воспаления. Контрольная микроскопия соскобов кожи во всех случаях – отрицательная.

Candida fungus is an integral part of the normal human microbiome, but disruption of skin integrity and malperformance of immune function can transform it into a pathogenic form. Some Candida strains are capable of modulating the immune response through suppressing the production of proinflammatory cytokines and inducing T-helper differentiation toward a Th2 response, which contributes to the chronification of inflammation. In this article, we take a detailed look at exogenous and endogenous risk factors. Particular focus has been placed on comorbidities: the present-date knowledge on the role of Candida spp. in exacerbating the course of atopic dermatitis and psoriasis is provided. The authors presented clinical case reports of candidiasis treatment in patients with aggravated histories. Case report 1: a 19-year-old man with complaints of pain, redness, and swelling in the periungual fold area combined with changes in the color and texture of the nail plate. Diagnosis: Periungual fold candidiasis. Onychomycosis. Treatment with 2% sertaconazole cream was prescribed. After 4 weeks, clinical regression of the inflammation process and partial restoration of the nail plate structure was observed. Case report 2: a 37-year-old man with complaints of severe itching, burning, and redness in the groin folds. Diagnosis: Candidal intertrigo of the groin folds associated with antibiotic therapy due to obesity. The prescribed stepwise therapy included: 0.05% clotrimazole + 0.1% gentamicin + 1% betamethasone for 7 days, then 2% sertaconazole cream for 2 weeks. After a three-week therapy, the rash regressed and post-inflammatory hyperpigmentation developed in a patient. Case report 3: a 58-year-old woman with complains of intense itching, burning, pain, and oozing in the abdominal fold within 3 weeks. The patient's medical history told a story of chronic illness. Diagnosis: Candidal intertrigo. The prescribed stepwise therapy included: 0.05% clotrimazole + 0.1% gentamicin + 1% betamethasone for 7 days, then 2% sertaconazole cream for 2 weeks. After a three-week course of treatment, the inflammation regressed. In all cases, skin scrapings showed negative follow-up microscopic examination results.

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