detinfДЕТСКИЕ ИНФЕКЦИИCHILDREN INFECTIONS2072-81072618-8139Association of Pediatricians and Infection Disease doctors10.22627/2072-8107-2019-18-3-5-10detinf-437Research ArticleПЕРЕДОВАЯ СТАТЬЯLEAD ARTICLEРоль сочетанной микоплазменной и герпесвирусной инфекции при поражениях кожи у детейThe role of mixed Mycoplasma and Herpesvirus infections in case of skin lesions in childrenhttps://orcid.org/0000-0002-9298-8284КувардинаН. О.KuvardinaH. O.

Кувардина Нина Олеговна (Nina Kuvardina), аспирант кафедры инфекционных болезней у детей

Ninelle31@mail.ruhttps://orcid.org/0000-0001-6347-6434ХарламоваФ. С.KharlamovaF. S.

Харламова Флора Семеновна (Flora Kharlamovа), д.м.н., профессор кафедры инфекционных болезней у детей

MD, Professor, Department of Infectious Diseases in Children 

kharlamova47@bk.ruhttps://orcid.org/0000-0001-9480-1674ПолескоИ. В.PoleskoI. V.

Полеско Ирина Васильевна (Irina Polesko), д.м.н.

irinapolesko@yandex.ruhttps://orcid.org/0000-0002-6033-6695ШамшеваО. В.ShamshevaO. V.

Шамшева Ольга Васильевна (Olga Shamsheva), д.м.н., профессор, зав. кафедрой инфекционных болезней у детей

ch-infection@mail.ruhttps://orcid.org/0000-0003-1465-4219ОстапущенкоО. С.OstapuschenkoO. S.

Остапущенко Ольга Степановна (Olga Ostapuschenko), к.м.н., главный врач

ФГБОУ ВО Российский национальный исследовательский медицинский университет им. Н. И. Пирогова МЗ РФRussian National Research Medical University named after N.I. Pirogov, Ministry of Health of the Russian FederationМногопрофильная клиника «ВЭССЭЛ КЛИНИК»Multidisciplinary clinic «VESSEL CLINIC»201908102019183510Copyright © Кувардина Н.О., Харламова Ф.С., Полеско И.В., Шамшева О.В., Остапущенко О.С., 20192019Кувардина Н.О., Харламова Ф.С., Полеско И.В., Шамшева О.В., Остапущенко О.С.Kuvardina H.O., Kharlamova F.S., Polesko I.V., Shamsheva O.V., Ostapuschenko O.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://detinf.elpub.ru/jour/article/view/437

Многочисленные литературные данные указывают на роль микоплазменной инфекции в развитии внереспираторных поражений различных органов и систем, в том числе и кожи. Герпесвирусная и микоплазменная инфекции могут являться триггером в развитии иммуно-опосредованных воспалительных реакций кожи и слизистых оболочек — многоформной экссудативной эритемы, синдрома Стивенса-Джонсона, везикулярного пустулезного дерматоза — синдрома Снеддона-Уилкинсона и др. С целью изучения частоты и характера кожных поражений при микоплазмозе, сочетанном с герпесвирусной инфекцией, наблюдалось 45 больных в возрасте от 3 до 15 лет жизни.

Проведенное комплексное клинико-лабораторное исследование выявило у 27 больных кожные поражения, ассоциированные с текущей микоплазменной и герпесвирусной инфекциями. Так, многоформная экссудативная эритема в варианте малой формы диагностирована у 13 больных, кожный васкулит — у 4, геморрагическая пурпура — у 3, уртикарная сыпь — у 3, узловатая эритема — у 2, мукозит — у 2 детей. У 18 детей установлена сочетанная микоплазменная и герпесвирусная инфекции. У 9 детей выявлена моно инфекция (у 5 — герпесвирусная и у 4 — микоплазменная).

У всех наблюдаемых больных обнаруживались антитела к антигенам гладкой мускулатуры в титрах от 1:80 до 1:160 (при норме 1:40) и у подавляющего большинства (у 24 больных) — антитела к антигенам эндотелия сосудов в титрах от 1:80 до 1:320 (при норме 1:40). Уплотнение комплекса интима-медиа выявлено у 6 больных с моноинфекцией и у 16 больных с сочетанной инфекцией, по данным ультразвукового дуплексного сканирования сосудов брахиоцефального отдела.

Таким образом, при различных иммуно-воспалительных, аллергических заболеваниях кожи необходимо обследование на инфекции, в частности, микоплазменную и герпесвирусные, для оптимизации терапии.

Numerous literature data show the role of mycoplasma infection in the development of non-respiratory lesions of various organs and systems, including the skin. Herpesvirus and mycoplasma infections can trigger the development of immune-mediated inflammatory reactions of the skin and mucous membranes — erythema multiforme exudative, Stevens-Johnson syndrome, vesicular pustular dermatosis — Sneddon-Wilkinson syndrome, etc.

In order to study the frequency and nature of skin lesions with mycoplasmosis combined with herpesvirus infection, 45 patients aged 3 to 15 years of life were observed. A comprehensive clinical and laboratory study revealed skin lesions in 27 patients associated with current mycoplasma and herpesvirus infections. Thus, multiforme exudative erythema in the small form variant was diagnosed in 13 patients, skin vasculitis in 4, hemorrhagic purpura in 3, urticaria rash in 3, erythema nodosum in 2, mucositis in 2 children. In 18 children, a combined mycoplasma and herpesvirus infection was established. In 9 children, a mono infection was detected (in 5 — herpes virus and in 4 — mycoplasma).

All observed patients showed antibodies to smooth muscle antigens in titers from 1:80 to 1:160 (normal 1:40) and in the vast majority (in 24 patients) — antibodies to vascular endothelial antigens in titers from 1:80 to 1:320 (with the norm of 1:40). Compaction of the intima-media complex was detected in 6 patients with monoinfection and in 16 patients with co-infection, according to ultrasound duplex scanning of the vessels of the brachiocephalic department.

Thus, for various immuno-inflammatory, allergic skin diseases, screening for infections, in particular, mycoplasma and herpesvirus, is necessary to optimize treatment.

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The authors declare that there are no conflicts of interest present.