Microbial eczema: modern possibilities of consistent topical therapy

Abstract

At the present stage, there is an increase in the prevalence of allergic spectrum diseases. Epidemiological studies and the active introduction of genomic technologies in recent years have made it possible to accumulate data indicating the significant role of bacteria and fungi in the development of sensitization, which is one of the triggering and supporting factors for the course of microbial eczema. Dermatosis has a chronic relapsing course, in the formation of which delayed-type hypersensitivity, free-radical processes, and violations of the epidermal barrier play a significant role. A number of studies have noted the relationship between the development of microbial eczema and genetic factors, neuroendocrine and vegetative-vascular disorders. Features of etiopathogenesis and the recurrent nature of the course of microbial eczema necessitate an integrated approach to the management of patients with this dermatosis. Treatment of the disease includes elimination of the action of bacterial and fungal agents, anti-inflammatory therapy and restoration of the epidermal barrier. To suppress the infection, the appointment of antibacterial and antifungal drugs is indicated. However, their use as monotherapy in patients with eczema can provoke an exacerbation of the allergic process. In this regard, the article describes the current possibilities of using topical glucocorticosteroid drugs in combination with antibiotics and antimycotics. Attention is focused on ways to prevent complications and a staged approach to the management of patients with microbial eczema, the important components of which, after stopping the infectious process, are the suppression of inflammation and the restoration of the epidermal barrier. We present our own observations of patients with microbial eczema treated with preparations containing combinations of glucocorticosteroid with antibiotics and antimycotics, glucocorticosteroid with ceramides.