Microbiological assessment of the effectiveness of standard therapy in atopic dermatitis

Background. Atopic dermatitis is an inflammatory skin disease characterized by recurrent lesions and intense pruritus. Nowadays there is a stepwise approach to the treatment of atopic dermatitis, which is defined by disease intensity and complications such as secondary skin infections. However, the current management of atopic dermatitis may not always lead to the expected outcome due to not only immune dysregulation of both adaptive and innate immunity but also imbalance of the skin microbiome. Aims. The aim of the study was to evaluate changes in the composition of the skin microbiome in both lesional and non-lesional skin in patients with atopic dermatitis during standard treatment. Materials and methods. Twenty patients with atopic dermatitis and twenty six healthy controls over 18 years old were included into the study. All microbiome samples were obtained from lesional and non-lesional skin sites of atopic dermatitis patients before and after therapy. Whereas samples from healthy controls were taken once from a flexor surface of the elbow. Species identification of clinical isolates were identified using MALDI Biotyper Sirius (Bruker Daltonics). Results. At baseline, the prevalence of S. aureus colonization among patients with atopic dermatitis was 34.20% in lesional skin and 32.50% in non-lesional skin. After treatment, there was a significant decrease in the prevalence of S. aureus carriage in both lesional and non-lesional skin areas (р 0.05). However, no significant difference was observed in the proportion of all other staphylococci (р 0.1). Interestingly, S. aureus was not found in healthy controls. Conclusions. The results of the study demonstrated the effectiveness of standard therapy for managing patients with atopic dermatitis as it had a positive impact on the skin microbial community and showed a decrease in S. aureus proportion after the treatment

New coronavirus infection (COVID-19): from the dermatologist’s view

Recently published data on the pathogenesis and cutaneous manifestations of a new coronavirus infection (COVID-19) are presented The most described lesions are urticarial, papulo-vesicular, erythematous rash, purpura, livedo-angiitis, as well as chilblains Eruptions mainly appear together with main COVID-19 symptoms or a few days later The treatment of new coronavirus infection may lead to a quick regression of skin lesions along with improvement of the general state of the patient The review also provides data on the fact that COVID-19 patients with severe psoriasis and atopic dermatitis receiving biologic therapy (guselkumab, ustekinumab, adalimumab, secukinumab, ixekizumab, etanercept, dupilumab) and phosphodiesterase-4 inhibitors experience mild or asymptomatic COVID-19 Moreover, such patients do not develop cutaneous manifestations of COVID-19 The specific COVID-19 treatment has not been developed yet We think that these findings might provide better understanding of mechanisms of action of biologic drugs in COVID-19 В обзоре представлены актуальные данные по вопросам патогенеза новой коронавирусной инфекции и ее кожных проявлений Так, авторами чаще всего описываются уртикарные, папуло-везикулезные, пятнистые высыпания, в том числе пурпура, ливедо-ангиит, а также высыпания по типу «обмороженных пальцев» Сыпь появляется одновременно с основными симптомами инфекции или через несколько дней после их манифестации Высыпания на коже относительно быстро регрессируют на фоне лечения новой коронавирусной инфекции и улучшения общего состояния пациента В статье также приводятся данные о том, что у больных с тяжелым псориазом и атопическим дерматитом, инфицированных COVID-19 и получающих биологическую терапию (гуселькумаб, устекинумаб, адалимумаб, секукинумаб, иксекизумаб, этанерцепт, дупилумаб) и ингибиторы фосфодиэстеразы-4, COVID-19 имеет более легкое или бессимптомное течение Кроме того, у этих пациентов не встречаются кожные проявления, характерные для COVID-19 В настоящий момент еще не разработано специфическое лечение новой коронавирусной инфекции, и полученные данные могут способствовать дальнейшему изучению механизмов действия биологических препаратов на COVID-1

Skin manifestations in patients with a new coronavirus infection: clinical cases

Clinical cases of cutaneous eruptions in patients with new coronavirus infection (COVID-19) are described. The authors conclude that predominant morphological eruptions in the form of macules, papules and weals are associated with COVID-19. As a rule, eruptions occur simultaneously with the onset of the first signs of the disease or several days later both in adult and children. The severity of COVID-19 does not generally correlate with the severity of skin clinical manifestations. The skin eruptions are most frequently difficult to attribute to a particular diagnosis, and they are often diagnosed as some kind of dermatosis. Skin eruptions regress quite shortly due to COVID-19 treatment and improvements in the patients’ general condition as well as the use of topical steroids, or even without treatment

Cutaneous manifestations of new coronavirus infection (COVID-19)

This article presents the recently published data on the pathogenesis and cutaneous manifestations of the new coronavirus infection (COVID-19). The main symptoms of COVID-19 have already been well studied. However, recently, some reports on cutaneous manifestations (urticaria, papulae and vesicles, erythematous rash, purpura, livedo-angiitis, eruptive angioma, chilblain-like rash, pityriasis rosea, erythema multiforme, and periorbital dyschromia) in patients with COVID-19 have been made. Moreover, the healthcare professionals using personal protective equipment more frequently may develop occupational dermatoses

Современные подходы к ведению пациентов с крапивницей

The Union of Pediatricians of Russia together with the Russian Association of Allergologists and Clinical Immunologists and the Russian Society of Dermatovenerologists and Cosmetologists have developed new clinical guidelines for the urticaria in adults and children. Urticaria is a common disease; its various clinical variants are diagnosed in 15–25% of people in the global population, and a quarter of all cases belongs to chronic urticaria. The prevalence of acute urticaria is 20%, and 2.1–6.7% in child population, whereas acute urticaria is more common in children than in adults. The prevalence of chronic urticaria in adults in the general population is 0.7 and 1.4%, and 1.1% in children under 15 years of age, according to the systematic review and meta-analysis, respectively. This article covers features of epidemiology, etiology, and pathogenesis of the disease with particular focus on differential diagnostic search. Guidelines on treatment and step-by-step therapy scheme (both based on principles of evidencebased medicine) for pediatric patients were presented. Clarification on the analysis of the therapy efficacy and the degree of disease activity was given.Союзом педиатров России совместно с Российской ассоциацией аллергологов и иммунологов и Российским обществом дерматовенерологов и косметологов (РОДВК) разработаны новые клинические рекомендации для диагноза «крапивница» для взрослых и детей. Крапивница является распространенным заболеванием: различные ее клинические варианты диагностируются у 15–25% людей в популяции, при этом четверть случаев приходится на хроническую крапивницу. Распространенность острой крапивницы составляет 20%, среди детского населения — 2,1–6,7%, при этом острая крапивница у детей встречается чаще, чем у взрослых. По данным систематического обзора и мета-анализа, хроническая крапивница у взрослых в общей популяции составляет 0,7 и 1,4% соответственно, у детей до 15 лет — до 1,1%. В статье рассматриваются особенности эпидемиологии, этиологии и патогенеза заболевания, особое внимание уделено вопросам дифференциально-диагностического поиска. Для пациентов детского возраста приведены рекомендации по лечению согласно принципам доказательной медицины и предложена ступенчатая схема терапии. Дано четкое разъяснение к проведению анализа эффективности терапии и оценки степени активности заболевания