Infectious factors in atopic dermatitis, pharmaceutical possibilities (systematic literature review)

Patients, who suffered from atopic dermatitis (AD), are diagnosed with bacterial and viral diseases significantly more often and in a more severe form. Objective. To analyze the results of researches on infectious factors and possibilities of pharmaceutical impact in patients with AD. Material and methods. Search for articles was carried out in PubMed, Scopus, Google Scholar, E-library scientific databases by following keywords: infectious diseases, atopic dermatitis, immune responses. Results. Systemic immune responses are the basis of pathogenic relationship between AD and infectious diseases. Atopic march includes bronchial asthma, allergic rhinoconjunctivitis and/or food intolerance. In adulthood, AD may be manifested by eczematous lesions of the hands’ skin and allergic contact dermatitis. Epithelial barrier damage, increased concentrations of Th2/Th22 and cytokines, reduced levels of antimicrobial peptides, decreased bacterial diversity, prevalence of pathogens, as well as the use of immunosuppressive agents in therapy are the components of pathogenesis of allergic sensibilization and infectious pathology. Staphylococcus aureus is detected in 70—90% of cases in AD foci by bacteriological techniques, whereby some patients have predominantly methicillin-resistant S. aureus. A frequent presence of human papilloma virus, reduction of microbial diversity and colonies of Malassezia fungi are noted. Patients with AD have higher prevalence of infectious diseases of the visceral organs (streptococcal pharyngitis, upper and lower respiratory tract infections, recurrent otitis, varicella disease and urinary tract infections, esophagitis and gastritis). Conclusion. AD is associated with the morbidity of both skin infectious diseases and most diseases of the visceral organs of infectious etiology, that should be considered in scientific and therapeutic diagnostic algorithms.