Hulme John
Gachon Bio-Nano Institute, Gachon University, Seongnam-si 461-701, Republic of Korea.
Antibiotics (Basel). 2023 Jan 20;12(2):222. doi: 10.3390/antibiotics12020222.
Atopic Dermatitis (AD) skin is susceptible to (SA) infection, potentially exposing it to a plethora of toxins and virulent determinants, including Panton-Valentine leukocidin (PVL) (α-hemolysin (Hla) and phenol-soluble modulins (PSMs)), and superantigens. Depending on the degree of infection (superficial or invasive), clinical treatments may encompass permanganate (aq) and bleach solutions coupled with intravenous/oral antibiotics such as amoxicillin, vancomycin, doxycycline, clindamycin, daptomycin, telavancin, linezolid, or tigecycline. However, when the skin is significantly traumatized (sheathing of epidermal sections), an SA infection can rapidly ensue, impairing the immune system, and inducing local and systemic AD presentations in susceptible areas. Furthermore, when AD presents systemically, desensitization can be long (years) and intertwined with periods of relapse. In such circumstances, the identification of triggers (stress or infection) and severity of the flare need careful monitoring (preferably in real-time) so that tailored treatments targeting the underlying pathological mechanisms (SA toxins, elevated immunoglobulins, impaired healing) can be modified, permitting rapid resolution of symptoms.
特应性皮炎（AD）皮肤易受金黄色葡萄球菌（SA）感染，可能使其接触大量毒素和致病因子，包括杀白细胞素（PVL）（α-溶血素（Hla）和酚溶性调节素（PSMs））以及超抗原。根据感染程度（浅表或侵袭性），临床治疗可能包括使用高锰酸钾（水溶液）和漂白剂溶液，以及静脉注射/口服抗生素，如阿莫西林、万古霉素、强力霉素、克林霉素、达托霉素、替考拉宁、利奈唑胺或替加环素。然而，当皮肤受到严重创伤（表皮切片剥脱）时，SA感染可能迅速发生，损害免疫系统，并在易感区域诱发局部和全身性AD表现。此外，当AD全身性发作时，脱敏过程可能很长（数年），且与复发期交织在一起。在这种情况下，需要仔细监测触发因素（压力或感染）和皮疹发作的严重程度（最好是实时监测），以便调整针对潜在病理机制（SA毒素、免疫球蛋白升高、愈合受损）的定制治疗方法，从而迅速缓解症状。
