Exacerbation Of Atopic Dermatitis Research Articles

A Consensus on Staphylococcus aureus Exacerbated Atopic Dermatitis and the Need for a Novel Treatment.

The skin microbiome is essential for skin barrier function because it inhibits pathogen colonization, and decreased microbiome diversity correlates with increased Staphylococcus aureus (S. aureus) burden and atopic dermatitis (AD) severity. Managing S. aureuss-driven AD in clinical practice remains problematic due to complications such as AD exacerbation, impetigo, abscesses, and invasive infections. This project used a modified Delphi process comprising face-to-face discussions followed by a blinded vote to define 5 final consensus statements. A panel of 6 pediatric dermatologists developed a consensus on S. aureus-driven AD exacerbation, challenges in current treatments for AD with secondary bacterial infections, and new developments to improve patient care and outcomes. The panel's 5 consensus statements provide recommendations for dermatologists, pediatricians, and healthcare providers treating patients with secondary infected AD. These recommendations underscore the importance of recognizing and managing S. aureus skin infection in AD clinical practice and promoting antibiotic stewardship to mitigate resistance. The panel defined a significant unmet need for a single topical AD therapy effective against all symptoms, including pruritus, S. aureus-driven AD exacerbation, infection, and inflammation, across AD severity levels. J Drugs Dermatol. 2024;23(10):825-832. doi:10.36849/JDD.8240.

The Impact of Air Pollution on Atopic Dermatitis. Literature review

Introduction and purpose The rising level of air pollution is currently a serious worldwide problem. Airborne pollutants, such as PM, O3, CO, NOx, SO₂, and heavy metals, negatively impact the entire body, contributing to the dysfunction of many systems. The aim of this study was to review the literature on the impact of selected air pollutants on the development or exacerbation of atopic dermatitis, and to elucidate the mechanisms responsible for this. Materials and methods The literature available in PubMed and Google Scholar databases was reviewed using the keywords: “air pollution”, “atopic dermatitis”, “skin lesions”. Description of the state of knowledge Available studies have provided information on the significant impact of air pollution on the development and exacerbation of atopic dermatitis. Air pollutants can induce skin changes through various mechanisms, such as damage to the epidermal barrier, disruption of skin microflora, oxidative stress, initiation of inflammatory responses, or activation of the aryl hydrocarbon receptor pathway. Conclusions Reducing air pollution is crucial for improving overall public health and decreasing the incidence of many diseases, including atopic dermatitis. Further research is needed to deepen the understanding of the relationship between air pollution and atopic dermatitis, as well as the mechanisms responsible for it, and to develop effective strategies for protecting the skin from pollutants.

Dynamics of the level of interleukin 31 and 33, cortisol and filaggrin in the blood serum of pregnant women with atopic dermatitis during treatment with a combination of an emollient and a topical antipruritic agent

Introduction. The widespread prevalence of atopic dermatitis and decreased quality of life make the problem urgent and require the search for new treatment methods. In atopic dermatitis, excessive expression of interleukins 31 and 33 in keratinocytes is noted. In patients with atopic dermatitis, there is an increase in serum cortisol and filaggrin levels. In recent years, active development of drugs has been carried out, aimed mainly at the immune component of the pathogenesis of atopic dermatitis. However, clinical trials of these drugs are not conducted on pregnant women. For the treatment of atopic dermatitis during pregnancy, we have proposed a regimen of external therapy, including a topical moisturizer and a topical antipruritic agent.Aim. To evaluate the levels of interleukins 31, 33, cortisol and filaggrin in blood serum before and after treatment of atopic dermatitis with a combination of emollient and topical antipruritic agent.Materials and methods. The examination included 76 pregnant women during an exacerbation of atopic dermatitis. The levels of interleukins 31, 33, cortisol and filaggrin were determined in the blood serum at the first visit and after 4 weeks of using the proposed combination of emollient and topical antipruritic agent using enzyme-linked immunosorbent assay (ELISA).Results. Against the background of the proposed therapy, a statistically significant decrease in the concentration of interleukins 31 was noted from 28.98 to 2.08 pg/ml, filaggrin from 9.72 to 5.26 ng/ml, cortisol from 629.80 to 472.25 pg/ml (p = 0,001). There were no statistically significant fluctuations in interleukins 33 levels (p = 0,124).Conclusion. The combination of external therapy with the use of an emollient and a topical antipruritic agent reduces the production of interleukins 31, cortisol and filaggrin in the blood serum, but the content of interleukins 33 does not change significantly.

Allergy in HIV-Infected patients (on the example of clinical observation)

The article is devoted to the study of the causes of the formation of allergic diseases in patients with HIV infection on the example of a clinical case. Patient C., 35 years old, was under medical supervision at the Victory Clinic from 2013 to 2015 with manifestations of skin allergies. Over the next four years, the patient received therapy for exacerbation of atopic dermatitis, followed a diet with the exception of dairy products and beef. The patient’s condition could be assessed as satisfactory; relapses of atopic dermatitis were noted 2 times after a violation of the diet. In 2017, after an unprotected contact, the patient noticed: weakness, weight loss, dry skin and enlarged peripheral lymph nodes. In June 2017, the patient turned to the district pediatrician, who prescribed a referral for a general blood and urine test, a blood test for AIDS and hepatitis. As a result of the examination, the patient was diagnosed with HIV infection. The patient was examined and treated at the Yakutsk AIDS center. Since August 2017, the patient has been worried about nasal congestion, sneezing, watery eyes, and headaches. In early September 2017, the patient turned to an allergist-immunologist. An examination was conducted: a blood test was taken for allergoscreen panel No. 1 and an immunogram, rhinocytogram. The following results were obtained: according to allergoscreen No. 1, allergy to birch 3.0, milk 3.2, wheat flour 2.8. Rhinocytogram data from 09/28/2017: neutrophils 67 per-field and eosinophils 10 per-field. People infected with the human immunodeficiency virus (HIV) have high levels of allergic conditions, including allergic rhinitis (hay fever), drug allergies and asthma. The HIV virus infects and destroys CD4+T cells, a type of white blood cell. This leads to a change in immune function, which contributes to the development of allergies, infections, cancer and other immune problems. In a patient with HIV infection, after the pathology is detected, the formation and transformation of allergic diseases is observed. The formation of allergopathology in HIV patients is associated with a reduced level of CD4+ cells, which is one of the factors contributing to the development of allergy transformation. The treatment of allergic diseases such as: bronchial asthma, atopic dermatitis, allergic rhinitis and allergic urticaria in patients with HIV is the same as in patients not infected with HIV. Oral administration of glucocorticosteroids should be avoided due to the immunosuppressive effects of this group of drugs.

The role of nemolizumab in the treatment of atopic dermatitis for the adult population.

Atopic dermatitis (AD) often requires long-term treatment that may be associated with adverse effects. This review aims to characterize nemolizumab as a treatment for AD in adults. A literature search was performed to assess nemolizumab's role in moderate-to-severe AD in adults. Currently, clinical trials are being conducted to evaluate the clinical efficacy, safety profile and optimal dosing of nemolizumab for adults with moderate-to-severe AD. The most common adverse effects include nasopharyngitis, AD exacerbation and increased blood creatinine phosphokinase. Recent data from clinical trials suggest nemolizumab may be an acceptable treatment in adults with moderate-to-severe AD.

Association of frequent intake of trans fatty acids and saturated fatty acids in diets with increased susceptibility of atopic dermatitis exacerbation in young Chinese adults: A cross-sectional study in Singapore/Malaysia.

Numerous evidence has attributed diets with a high fatty acids (FAs) intake to be associated with atopic dermatitis (AD) development. Therefore, this study investigated the association between intake frequencies of five dietary FAs and AD exacerbations among young Chinese adults from Singapore and Malaysia. A validated International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was investigator-administered to 13,561 subjects to collect information on socioeconomic, anthropometric, dietary and lifestyles habits, and personal/family medical histories. Six novel dietary indices were derived to analyse the associations between total FAs, trans fatty acids (TFAs), saturated fatty acids (SFAs), monounsaturated fatty acids, linoleic acids, and alpha-linolenic acids in diets and AD exacerbation. Synergy factor (SF) analysis was used to identify interactions between the dietary FAs to influence disease susceptibility. In our multivariable model adjusted for age, gender, BMI, parental eczema, and lifestyle factors, a diet high in total estimated FAs was strongly associated with AD (Adjusted Odds Ratio (AOR): 1.227; 95% Confidence Interval (CI): 1.054-1.429; adjusted p-value <0.01). Particularly, high estimated total TFAs and SFAs were significantly associated with AD exacerbations including chronic and current moderate-to-severe AD. The association between TFAs and AD remained strong even controlled for the total FAs in diets and false discovery rate corrected (AOR: 1.516; 95% CI: 1.094-2.097; adjusted p-value <0.05). Similarly, having a high SFAs in diets was associated with AD (AOR: 1.581; 95% CI: 1.106-2.256; adjusted p-value <0.05) independently on the total FAs in diets. FAs in diets do not interact to influence AD. Overall, these results highlighted an association between high dietary TFAs and SFAs and AD exacerbations in an Asian population.

Genomic analysis and identification of a novel superantigen, SargEY, in Staphylococcus argenteus isolated from atopic dermatitis lesions.

Staphylococcus aureus is frequently isolated from active lesions of atopic dermatitis (AD) patients. We reported that 17%-22% of S. aureus isolated from AD patients produced a novel superantigen staphylococcal enterotoxin Y (SEY). Unlike many S. aureus superantigens that activate T cells via T-cell receptor (TCR) Vß, SEY activates T cells via TCR Vα and stimulates cytokine secretion. Staphylococcus argenteus was isolated from AD patients during the surveillance for S. aureus. Phylogenetic comparison of the genome indicated that the isolate was very similar to S. aureus causing skin infections. The isolate encoded a SEY-like protein, designated SargEY, which, like SEY, activated T cells via the TCR Vα. ST2250 is the only lineage positive for SargEY gene. ST2250 S. argenteus harboring a superantigen SargEY gene may be a novel staphylococcal clone that infects human skin and is involved in the exacerbation of AD.

Association of Mold Exposure with Atopic Dermatitis

Atopic dermatitis (AD) is a common inflammatory skin disease associated with immune dysregulation. Research suggests environmental exposures may contribute to AD development and exacerbation. AD is classified in the realm of allergies and asthma. Sensitivities to mycotoxins and other allergens may cause AD, as well as other inflammatory diseases. This paper reviews evidence on the relationship between mold exposure and AD. Multiple clinical studies find higher rates of AD and worsening symptoms in water-damaged buildings with mold contamination. Experimental studies demonstrate immune and skin barrier responses to mold allergens that may exacerbate symptoms of AD. However, significant research gaps remain regarding underlying mechanisms. Additional longitudinal studies are needed to establish causality between mold and AD while accounting for genetic and other environmental factors. Determining the impact of mold on AD has important implications for prevention, diagnosis, and treatment.

Impact of Atopic Dermatitis on Adult Women's Lives: A Survey of 1,009 French Women.

Atopic dermatitis (AD) is one of the most common inflammatory diseases, and has a higher prevalence among females in adulthood. The aim of this observational, cross-sectional, survey-based study was to evaluate the impact of AD on the daily lives of adult women patients. A scientific committee composed exclusively of women constructed a specific questionnaire in partnership with the French Eczema Association. Severity of AD was evaluated with the Patient-Oriented Eczema Measure (POEM). A sample of 1,009 adult women (mean age ± standard deviation: 41.8 ± 14.2 years) with AD was identified from a representative sample of the French population (82% response rate 1,230 women surveyed). According to the POEM, 50.64% (n = 511) of subjects were identified as having mild AD, 39.35% (n = 397) moderate AD, and 10.01% (n = 101) severe AD. Overall, 67.7% (n = 682) reported that their eczema involved a visible area (face, neck or hands), and 19.6% (n = 198) a sensual area (breasts/chest, genital area or buttocks). Of the 720 women with menstrual cycles, exacerbations of AD were reported to occur mostly before (50.6%) and during (48.3%) menstruation. A small proportion of women, 7.3% (n = 74), reported being afraid of becoming pregnant because of their eczema. If AD involvement was in a visible area it had a greater impact on romantic relationships, sexual relationships and occupation. If AD involvement was in a sensual area it had a greater influence on romantic relationships and sexuality. Particular attention should be given to patients with localization of AD on the face, neck or hands, as they have a higher risk of social exclusion. Moreover, these results should encourage health professionals to ask patients with AD about the possible involvement of sensual areas.

Staphylococcus aureus–specific skin resident memory T cells protect against bacteria colonization but exacerbate atopic dermatitis–like flares in mice

BackgroundThe contribution of Staphylococcus aureus (S. aureus) to the exacerbation of atopic dermatitis (AD) is widely documented, but its role as a primary trigger of AD skin symptoms remains poorly explored. ObjectiveTo reappraise the main bacterial factors and underlying immune mechanisms by which S. aureus triggers AD-like inflammation. MethodsWe capitalized on a pre-clinical model, in which different clinical isolates were applied in the absence of any prior experimental skin injury. ResultsWe report that the development of S. aureus-induced dermatitis depended on the nature of the S. aureus strain, its viability, the concentration of the applied bacterial suspension, the production of secreted and non-secreted factors, as well as the activation of accessory gene regulatory quorum sensing system. In addition, the rising dermatitis, which exhibited the well-documented AD cytokine signature, was significantly inhibited in inflammasome adaptor protein ASC- and monocyte/macrophage-deficient animals, but not in T- and B-cell-deficient mice, suggesting a major role for the innate response in the induction of skin inflammation. However, bacterial exposure generated a robust adaptive immune response against S. aureus, and an accumulation of S. aureus-specific γδ and CD4+ tissue resident memory T (Trm) cells at the site of previous dermatitis. The latter both contributed to worsen the flares of AD-like dermatitis upon new bacteria exposures, but also, protected the mice from persistent bacterial colonization. ConclusionThese data highlight the induction of unique AD-like inflammation, with the generation of pro-inflammatory but protective Trm cells in a context of natural exposure to pathogenic S. aureus strains.

Studying the role of cortisol in the pathogenesis of atopic dermatitis during pregnancy

Introduction. Atopic dermatitis (AD) is one of the most common dermatitis, characterized by complex pathogenetic mechanisms. Psychological stress is recognized as one of the triggers of AD. Stress causes a high release of cortisol and epinephrine or norepinephrine, stimulating the immune system, primarily T helper cells type 1 (Th1 cells), to produce pro-inflammatory cytokines, leading to a cellular immune response and inflammation. In recent years, there has been an increase in incidence among pregnant women, however, the specific mechanisms of the development of AD during pregnancy still remain poorly understood. Aim. To study the role of cortisol in AD during pregnancy.Materials and methods. The study included 76 pregnant women during an exacerbation of AD, 20 non-pregnant women during an exacerbation of AD, 20 non-pregnant women without AD, 20 pregnant women without AD. The severity of AD was determined using the SCORAD index. Cortisol levels were determined in blood serum using enzyme-linked immunosorbent assay (ELISA). Anxiety level was determined using the Beck Anxiety Inventory. The level of itching was determined using a 5D itching scale.Results. Cortisol levels in pregnant women with AD (629.8 pg/ml) were significantly higher than in non-pregnant women with AD (386.15 pg/ml) (p &lt; 0.05). Cortisol levels were correlated with the severity level (Spearman coefficient = 0.203, p = 0.018), anxiety level (Spearman coefficient = 0.411, p = 0.001), and level of itching (Spearman coefficient = 0.352, p = 0.001).Conclusions. Cortisol is important in the pathogenesis of AD during pregnancy. During pregnancy with exacerbation of AD, higher values were observed than outside pregnancy.

Chronic Gut Inflammation and Dysbiosis in IBS: Unraveling Their Contribution to Atopic Dermatitis Progression.

Emerging evidence suggests a link between atopic dermatitis (AD) and gastrointestinal disorders, particularly in relation to gut microbial dysbiosis. This study explored the potential exacerbation of AD by gut inflammation and microbial imbalances using an irritable bowel syndrome (IBS) mouse model. Chronic gut inflammation was induced in the model by intrarectal injection of 2,4,6-trinitrobenzene sulfonic acid (TNBS), followed by a 4-week development period. We noted significant upregulation of proinflammatory cytokines in the colon and evident gut microbial dysbiosis in the IBS mice. Additionally, these mice exhibited impaired gut barrier function, increased permeability, and elevated systemic inflammation markers such as IL-6 and LPS. A subsequent MC903 challenge on the right cheek lasting for 7 days revealed more severe AD symptoms in IBS mice compared to controls. Further, fecal microbial transplantation (FMT) from IBS mice resulted in aggravated AD symptoms, a result similarly observed with FMT from an IBS patient. Notably, an increased abundance of Alistipes in the feces of IBS mice correlated with heightened systemic and localized inflammation in both the gut and skin. These findings collectively indicate that chronic gut inflammation and microbial dysbiosis in IBS are critical factors exacerbating AD, highlighting the integral relationship between gut and skin health.

Dual-Site Biomimetic Cu/Zn-MOF for Atopic Dermatitis Catalytic Therapy via Suppressing FcγR-Mediated Phagocytosis.

Atopic dermatitis (AD) is a prevalent chronic inflammatory skin disease that carries a significant global economic burden. Elevated levels of reactive oxygen species (ROS) have been recognized as contributing to AD exacerbation, making them a potential therapeutic target for AD treatment. Here, we introduce a dual-site biomimetic copper/zinc metal-organic framework (Cu/Zn-MOF) featuring four types of enzyme-like activities for AD treatment via suppressing the Fcγ receptor (FcγR)-mediated phagocytosis signal by mimicking the bimetallic sites of natural copper-zinc superoxide dismutase (CuZn-SOD). Interestingly, the neighboring Cu and Zn sites in both Cu/Zn-MOF and CuZn-SOD are at similar distances of ∼5.98 and ∼6.3 Å from each other, respectively, and additionally, both Cu and Zn sites are coordinated to nitrogen atoms in both structures, and the coordinating ligands to Cu and Zn are both imidazole rings. Cu/Zn-MOF exhibits remarkable SOD-like activity as well as its glutathione peroxidase (GPx)-, thiol peroxidase (TPx)-, and ascorbate peroxidase (APx)-like activities to continuously consume ROS and mitigate oxidative stress in keratinocytes. Animal experiments show that Cu/Zn-MOF outperforms halcinonide solution (a potent steroid medication) in terms of preventing mechanical injuries, reducing cutaneous water loss, and inhibiting inflammatory responses while presenting favorable biosafety. Mechanistically, Cu/Zn-MOF functions through an FcγR-mediated phagocytosis signal pathway, decreasing the continuous accumulation of ROS in AD and ultimately suppressing disease progression. These findings will provide an effective paradigm for AD therapy and contribute to the development of two-site bionics (TSB).

Impact of climate change on atopic dermatitis: A review by the International Eczema Council.

Atopic dermatitis (AD), the most burdensome skin condition worldwide, is influenced by climatic factors and air pollution; however, the impact of increasing climatic hazards on AD remains poorly characterized. Leveraging an existing framework for 10 climatic hazards related to greenhouse gas emissions, we identified 18 studies with evidence for an impact on AD through a systematic search. Most climatic hazards had evidence for aggravation of AD the impact ranged from direct effects like particulate matter-induced AD exacerbations from wildfires to the potential for indirect effects like drought-induced food insecurity and migration. We then created maps comparing the past, present, and future projected burden of climatic hazards to global AD prevalence data. Data are lacking, especially from those regions most likely to experience more climatic hazards. We highlight gaps important for future research: understanding the synergistic impacts of climatic hazards on AD, long-term disease activity, the differential impact on vulnerable populations, and how basic mechanisms explain population-level trends.

Atopic Dermatitis Associated Retinal Detachment and Retinal Vasculitis: A Case Report

Atopic dermatitis is usually associated with various ocular complications. We report a 21-year-old Chinese male who presented to our ophthalmology clinic with bilateral retinal detachment and cataracts. The patient had a clear medical history of atopic dermatitis, which had been diagnosed eight years earlier and had been treated with loratadine and pimecrolimus. Cataract surgery was performed for both eyes, combined with scleral buckling for the right eye and pars plana vitrectomy for the left eye. During postoperative follow-up, fundus fluorescein angiography showed retinal vasculitis in both eyes and macular edema in the left eye, which coincided with an exacerbation of atopic dermatitis. Macular edema improved after four months of regular dupilumab treatment in the dermatology department. The ocular condition remained stable three years postoperatively.

Successful use of dupilumab for egg-induced eosinophilic gastroenteritis with duodenal ulcer: a pediatric case report and review of literature

BackgroundNon-esophageal eosinophilic gastrointestinal disorder (non-EoE-EGID) is a rare disease in which eosinophils infiltrate parts of the gastrointestinal tract other than the esophagus; however, the number of patients with non-EoE-EGID has been increasing in recent years. Owing to its chronic course with repeated relapses, it can lead to developmental delays due to malnutrition, especially in pediatric patients. No established treatment exists for non-EoE-EGID, necessitating long-term systemic corticosteroid administration. Although the efficacy of dupilumab, an anti-IL-4/13 receptor monoclonal antibody, for eosinophilic esophagitis, has been reported, only few reports have demonstrated its efficacy in non-EoE EGIDs.Case presentationA 13-year-old boy developed non-EoE-EGID with duodenal ulcers, with chicken eggs as the trigger. He was successfully treated with an egg-free diet, proton pump inhibitors, and leukotriene receptor antagonists. However, at age 15, he developed worsening upper abdominal pain and difficulty eating. Blood analysis revealed eosinophilia; elevated erythrocyte sedimentation rate; and elevated levels of C-reactive protein, total immunoglobulin E, and thymic and activation-regulated chemokines. Upper gastrointestinal endoscopy revealed a duodenal ulcer with marked mucosal eosinophilic infiltration. Gastrointestinal symptoms persisted even after starting systemic steroids, making it difficult to reduce the steroid dose. Subcutaneous injection of dupilumab was initiated because of comorbid atopic dermatitis exacerbation. After 3 months, the gastrointestinal symptoms disappeared, and after 5 months, the duodenal ulcer disappeared and the eosinophil count decreased in the mucosa. Six months later, systemic steroids were discontinued, and the duodenal ulcer remained recurrence-free. The egg challenge test result was negative; therefore, the egg-free diet was discontinued. Blood eosinophil count and serum IL-5, IL-13, and eotaxin-3 levels decreased after dupilumab treatment. The serum levels of IL-5 and eotaxin-3 remained within normal ranges, although the blood eosinophil counts increased again after discontinuation of oral prednisolone.ConclusionsSuppression of IL-4R/IL-13R-mediated signaling by dupilumab may improve abdominal symptoms and endoscopic and histologic findings in patients with non-EoE-EGID, leading to the discontinuation of systemic steroid administration and tolerance of causative foods.

Clinical effect of aquatop rescue cream in patients with mild or moderate exacerbation of atopic dermatitis

Introducción: La dermatitis atópica, produce prurito y lesiones eccematosas, afectando la calidad de vida. Actualmente está disponible el dermocosmético Aquatop crema rescate, indicado para cuadros leves a moderados. El objetivo fue describir el curso clínico de una cohorte de pacientes con exacerbación de la dermatitis atópica, que recibieron tratamiento con Aquatop crema rescate durante quince días. Métodos: Estudio descriptivo retrospectivo, con base en registros clínicos de pacientes con exacerbación leve a moderada de su dermatitis atópica. Se describió su evolución empleando la variable SCORAD que mide el nivel de severidad de la dermatitis atópica. Se registró el promedio de prurito y su nivel máximo en las últimas 24 horas. Se hicieron tres evaluaciones: basal, al día siete y al día quince. Resultados: Se incluyeron 60 pacientes, con una mediana de edad de 12.5 años (RIQ:7-19,5), 50% eran hombres (30/60). La mediana de SCORAD al ingreso fue de 29,4 puntos, se redujo a 14 puntos al día siete y llegó a 12,2 puntos al día quince. Al inicio del seguimiento, el 65% de los casos fueron clasificados como exacerbación moderada, y este porcentaje se redujo al día siete hasta un 13,3%, que para el día quince disminuyó a 10%. En total se presentaron nueve eventos adversos leves. Conclusiones: Aquatop crema rescate, es una alternativa terapéutica que tiene un efecto clínico favorable en los pacientes con exacerbaciones de la dermatitis atópica leves y moderadas, por su rápido efecto sobre la reducción de los síntomas y su adecuado perfil de seguridad.

Atopic dermatitis and pregnancy

Atopic dermatitis (AtD) is a chronic allergic skin disease, the most common of dermatoses during pregnancy. Exacerbation of AtD can be at any stage of pregnancy, its main causes are an increase in progesterone levels, the predominance of Th2 cytokines, psychoemotional stress, violations of the gastrointestinal tract. Changes occur in the clinical picture, the lesions on the face and extensor surfaces of the extremities, papules. Treatment options for pregnant women are limited due to the unethical nature of clinical trials. It is safe to use topical glucocorticosteroids, moisturizers, narrow-band UVB 311 nm, calcineurin inhibitors are relatively safe. In systemic therapy in severe cases, the use of cyclosporine or a short course of prednisone is recommended. It is possible to continue the course of azathioprine at a reduced dose. There is no evidence of the safety of selective immunosuppressants.

Efficacy of treating allergic dermatoses with the original drug of topical mometasone furoate in standard clinical practice

Skin allergic dermatoses represent a significant issue and account for one of the commonest causes for patients seeking consultations with dermatologists. The prevalence of atopic dermatitis (AD) in the general population reaches 10 % among adults and 20 % among children. Despite the significant deepening of our understanding of the complex pathogenesis of allergic dermatoses and the establi­shing role of many genetic and epigenetic factors in provoking exacerbations of AD or predisposition to the development of allergic contact dermatitis (ACD), topical corticosteroids remain the cornerstone treatment for flare­ups of these disorders.We investigated the effectiveness of the mometasone furoate 0.1 % topical cream (Elocom®) for the treatment of patients with allergic dermatoses. The study included 20 patients whose participation was determined based on clinical anamnesis and examination, diagnosed with AD (n = 13) and ACD (n = 7). The duration of treatment was from 7 to 30 days. During the study, all the 20 patients (100 %) noted a significant improvement in the skin condition, 18 (90 %) — improvement during the first days of treatment. Throughout the study, none of the patients experienced side effects linked to the use of the medication. The average value of the Dermatology Life Quality Index among patients before the start of treatment was (13.0 ± 6.83) points, after treatment — (4.8 ± 3.56) points. A decrease in the Index by an average of 8.2 points indicates a significant improvement in the patients’ quality of life. The obtained results demonstrate the high effectiveness of topical mometasone furoate in the treatment of patients with allergic dermatoses. Since these results were obtained in the process of observational research, they have significant practical value.Thus Elokom®, a topical mometasone furoate preparation, is advisable for the treatment of allergic dermatoses in routine clinical practice.

Practical issues of using emollients for the prevention of exacerbations of atopic dermatitis during the flowering season: expert resolution

In February 2023, a meeting of the Council of Experts was held, attended by leading specialists in the fields of allergology, pediatrics and dermatology. The Working Group discussed the problem of sensitization to pollen allergens in patients with atopic dermatitis and exacerbation of the disease during the pollination season of plants, as well as the formation of epicutaneous sensitization through a damaged epidermal barrier. The experts comprehensively considered the criteria that a modern emollient used for the care of atopic dermatitis patients’ skin should meet, discussed the role of moisturizers in preventing seasonal exacerbations of atopic dermatitis based on previously conducted research, and developed unified recommendations on the principles of managing this type of patients. Suggestions were made for further informational and organizational measures aimed at expanding the knowledge of patients and medical specialists about the problem of epicutaneous sensitization to aeroallergens in atopic dermatitis patients, their role in the development of seasonal exacerbations of atopic dermatitis, and the possibility of their prevention using modern emollients.