Medical mistakes in tactics of management of patients with atopic dermatitis associated with opportunistic yeast microflora infection

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Infectious triggers play significant role in the pathogenesis of atopic dermatitis. Candida spp. yeasts and Malassezia spp. lipophilic yeasts hold a special place among these trigger factors. The former contribute to the severity of skin process in patients with atopic diseases due to the delayed hyperergic reaction, the latter can induce the production of specific IgE-antibodies. For this reason, the complex therapy including multifunctional drugs (antimycotic, antibacterial, and anti-inflammatory) provides faster therapeutic effect and longer interrecurrent period. Objective. The objective of this study was to analyze the mistakes of dermatologists in selection of treatment of patients with atopic dermatitis due to the underestimated role of Candida spp. yeasts and Malassezia spp. lipophilic yeasts in the pathogenesis of the disease. Material and methods. The investigation was carried out at the department of skin and venereal diseases with cosmetology course at the Extension Course Institute for Medical Practitioners. The detailed analysis of the characteristic features of atopic dermatitis associated with yeast microflora infection and the reasons for ineffectiveness of conventional therapies was provided and exemplified by three clinical cases of patients aged 18, 9 and 6 years. Results. The use of clinical, immunological, and bacteriological methods enabled us to detect concomitant mycological infection, which supports chronicity of atopic dermatitis and affects the effectiveness of treatment. Conclusion. The ineffectiveness of conventional therapies is often due to hypercolonization of skin and/or mucous membranes with yeast microflora. The use of topical antimycotics agent sertaconazole (Zalain) and universal antiseptic agent povidone-iodine (Betadine) results in significant clinical effect and longer interrecurrent period.

Keywords:

atopic dermatitis

yeast flora

treatment strategy

sertaconazole (Zalain)

povidone-iodine (Betadine)

atopic dermatitis

yeast flora

treatment strategy

sertaconazole (Zalain)

povidone-iodine (Betadine)

Authors:

Sokolova T.V.

State Institute of Advanced Medical Training, Russian Ministry of Defense

SPIN RSCI: 6402-9066
Scopus AuthorID: 57213089279
ORCID: 0000-0003-3573-0874

Safonova L.A.

Physicians’ Continuing Education Institute of the Moscow State University of Food Industry, Moscow, Russia, 125080

Klivitskaya N.A.

FGBOU VPO «Rossijskij universitet druzhby narodov», Moskva, Rossija, 117197

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