Secondary infection in allergic dermatoses, variety of forms and individual choice of therapy

Background. According to the incidence rate in pediatric practice, patients with allergic dermatosis complicated by a secondary infection rank first and account for 30-40% of the total number of visits. The most common manifestations are atopic dermatitis with symptoms of secondary infection, microbial eczema, advanced scabies complicated by pyoderma, seborrheic dermatitis (eczema), paratraumatic eczema, contact-allergic dermatitis complicated by secondary infection. Objective. Evaluation of the therapeutic effects and safety of using Levomekol medicinal ointment in the routine pediatric clinical practice in children with secondarily infected dermatoses. Methods. Non-interventional prospective study of the use of Levomekol® ointment in routine clinical practice in children with dermatoses complicated by secondary infectionwas conducted on the basis of the Children’s City Clinical Hospital n.a. Z.A. Bashlyaeva. 35 patients who received combined therapy with Levomekol® ointment and topical glucocorticosteroids - GCS (methylprednisolone aceponate, betamethasone dipropionate, hydrocortisone acetate, fluocinolone acetonide) were followed-up. The primary endpoint of efficacy was the relief of wound infection clinically characterized as the absence of edema, hyperemia, and purulent discharge at the sites of infection. Secondary efficacy criteria: reduction in the area of the site of infection by visual assessment using the results of photofixation; clinical improvement according to the CGI-I scale and efficiency index according to the CGI-E scale (in points); CGI-S score (disease severity); reduction of pain in the area of the site of infection (wound) by VAS by 2 or more points or by 50% of the initial value in points. Results. Achievement of the primary end point when using the drug Levomekol® (no edema, hyperemia and purulent discharge in the area of the site of infection) in patients with secondarily infected dermatoses was registered earlier than the 14th day. Additional administration of systemic drugs during treatment was not required. When evaluating secondary efficacy criteria, it was noted that Levomekol® demonstrated 90-100% efficacy according to all studied criteria in the treatment of secondarily infected dermatoses by the 3-7th day of therapy, as well as absolute safety and good tolerability by patients. Conclusion. The studied drug Levomekol® demonstrated a pronounced anti-inflammatory effect, high efficiency in the relief of wound infection, a high safety profile and good tolerance by patients. The method of combined use of Levomekol ointment and topical corticosteroids in the treatment of allergic dermatosis complicated by a secondary infection has many advantages: the possibility of selective selection of the «molecule» of corticosteroids, regulation of «priorities» antibiotic or corticosteroids; the presence of methyluracil in the composition of Levomekol® ointment enhances regeneration in case of cracks and excoriations.

allergic dermatosis, secondary infection, Levomekol®, atopic dermatitis, microbial eczema, paratraumatic eczema, allergic contact dermatitis, scabies, seborrheic eczema, nummular eczema