aidsВИЧ-инфекция и иммуносупрессииHIV Infection and Immunosuppressive Disorders2077-9828Baltic Medical Education Center10.22328/2077-9828-2020-12-4-98-107aids-588Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL STUDIESСеборейный дерматит, ассоциированный с ВИЧ-инфекцией: новые концепции и гипотезыSeborrheic dermatitis associated with HIV infection: new concepts and hypothesesХрянинА. А.KhryaninA. A.

Хрянин Алексей Алексеевич — доктор медицинских наук, профессор кафедры дерматовенерологии и косметологии

630091, г. Новосибирск, Красный проспект, д. 52

Alexey A. Khryanin

Novosibirsk

khryanin@mail.ruРусскихМ. В.RusskikhM. V.

Русских Мария Викторовна — аспирант кафедры дерматовенерологии и косметологии

630091, г. Новосибирск, Красный проспект, д. 52

Maria V. Russkikh

Novosibirsk

БочароваВ. К.BocharovaV. K.

Бочарова Валентина Константиновна — студентка VI курса педиатрического факультета

630091, г. Новосибирск, Красный проспект, д. 52

Valentina K. Bocharova

Novosibirsk

НадеевА. П.NadeevA. P.

Надеев Александр Петрович — доктор медицинских наук, заведующий кафедрой патологической анатомии

630091, г. Новосибирск, Красный проспект, д. 52

Alexandr P. Nadeev

Novosibirsk

Новосибирский государственный медицинский университетРоссияNovosibirsk State Medical UniversityRussian Federation20200902202112498107Copyright © Хрянин А.А., Русских М.В., Бочарова В.К., Надеев А.П., 20212021Хрянин А.А., Русских М.В., Бочарова В.К., Надеев А.П.Khryanin A.A., Russkikh M.V., Bocharova V.K., Nadeev A.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://hiv.bmoc-spb.ru/jour/article/view/588

В обзорной статье обобщены сведения о себорейном дерматите, ассоциированном с ВИЧ-инфекцией. Изложены современные данные литературы, посвященные вопросам этиологии и патогенеза себорейного дерматита, а также особенностям клинического течения себорейного дерматита на фоне ВИЧ-инфекции. Обсуждаются новые гипотезы и концепции сочетания этих заболеваний. Основную роль в развитии себорейного дерматита отводят грибам рода Malassazeia, которые в процессе жизнедеятельности используют липиды с поверхности кожи, чтобы производить ненасыщенные и насыщенные жирные кислоты. Последние, находясь на поверхности кожи и контактируя с внешней средой, способны индуцировать развитие воспалительной реакции. При этом общая концентрация липидов на поверхности кожи ВИЧ-позитивных и ВИЧ-негативных пациентов с себорейным дерматитом может быть одинаковой. Однако отмечаются значительные изменения в липидных фракциях ВИЧ-позитивных пациентов, включая уменьшение концентрации сквалена и увеличение содержания холестерола и эстеров холестерола, что способствует гиперколонизации кожи дрожжеподобными грибами и переходу их в патогенную мицеллярную форму. Авторами представлен клинический случай, демонстрирующий тяжелое течение себорейного дерматита, ассоциированного с ВИЧ-инфекцией.

The review article summarizes information about seborrheic dermatitis associated with HIV infection. The article presents current literature data about etiology and pathogenesis of seborrheic dermatitis, as well as the features of the clinical manifestations of seborrheic dermatitis associated with HIV infection. This article contains new hypotheses and concepts about combination of these two diseases. The most important role in pathogenesis of seborrheic dermatitis is belong to the fungus Malassazeia, which uses lipids from the skin surface to produce unsaturated and saturated fatty acids. These fatty acids, being left in the individual’s skin, may induce an inflammatory response. At the same time, the total lipid concentration on the skin surface of HIV-positive and HIV-negative patients with seborrheic dermatitis was similar. However, it was reported about significant alterations in the lipid fractions of HIV-positive patients including a reduction in squalene and an increase in cholesterol and in cholesterol esters, which lead to hypercolonization of the skin with yeast-like fungi and their transition in the pathogenic micellar form. The authors present a clinical case, which is demonstrating a severe course of seborrheic dermatitis associated with HIV infection.

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