Recognizing secondary infection in patients with atopic dermatitis: Head & neck atopic dermatitis
https://doi.org/10.21518/ms2025-055
Abstract
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.
Keywords
Supporting agencies: The article was published with support from Bayer
About the Authors
O. B. Tamrazova
Peoples’ Friendship University of Russia named after Patrice Lumumba;
Bashlyaeva City Children’s Clinical Hospital
Russian Federation
Russian Federation
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
A. V. Tamrazova
Central State Medical Academy of Department for Presidential Affairs of the Russian Federation
Russian Federation
Russian Federation
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
G. A. Novik
Saint Petersburg State Pediatric Medical University
Russian Federation
Russian Federation
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
M. V. Zhdanova
Saint Petersburg State Pediatric Medical University
Russian Federation
Russian Federation
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
A. S. Stadnikova
Bashlyaeva City Children’s Clinical Hospital
Russian Federation
Russian Federation
Antonina S. Stadnikova, Cand. Sci. (Med.), Dermatovenerologist
28, Geroev Panfilovtsev St., Moscow, 125373
A. G. Sukhotina
Bashlyaeva City Children’s Clinical Hospital
Russian Federation
Russian Federation
Aleksandra G. Sukhotina, Dermatovenerologist
28, Geroev Panfilovtsev St., Moscow, 125373
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For citations:
Tamrazova OB, Tamrazova AV, Novik GA, Zhdanova MV, Stadnikova AS, Sukhotina AG. Recognizing secondary infection in patients with atopic dermatitis: Head & neck atopic dermatitis. Meditsinskiy sovet = Medical Council. 2025;(2):42-48. (In Russ.) https://doi.org/10.21518/ms2025-055
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