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Secondary Bacterial Infections in Patients with Atopic Dermatitis or Other Common Dermatoses

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Abstract

Secondary bacterial infections of common dermatoses such as atopic dermatitis, ectoparasitosis, and varicella zoster virus infections are frequent, with Staphylococcus aureus and Streptococcus pyogenes being the bacteria most involved. There are also Gram-negative infections secondary to common dermatoses such as foot dyshidrotic eczema and tinea pedis. Factors favoring secondary bacterial infections in atopic dermatitis, ectoparasitosis, and varicella zoster virus infections mainly include an epidermal barrier alteration as well as itch. Mite-bacteria interaction is also involved in scabies and some environmental factors can promote Gram-negative bacterial infections of the feet. Furthermore, the bacterial ecology of these superinfections may depend on the geographical origin of the patients, especially in ectoparasitosis. Bacterial superinfections can also have different clinical aspects depending on the underlying dermatoses. Subsequently, the choice of class, course, and duration of antibiotic treatment depends on the severity of the infection and the suspected bacteria, primarily targeting S. aureus. Prevention of these secondary bacterial infections depends first and foremost on the management of the underlying skin disorder. At the same time, educating the patient on maintaining good skin hygiene and reporting changes in the primary lesions is crucial. In the case of recurrent secondary infections, decolonization of S. aureus is deemed necessary, particularly in atopic dermatitis.

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Acknowledgements

We thank the patients for agreeing to the publication of their photographs.

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Authors and Affiliations

  1. Service de Dermatologie Générale et Oncologique, UVSQ, EA4340-BECCOH, AP-HP, Hôpital Ambroise-Paré, Université Paris-Saclay, 9 Avenue Charles de Gaulle, 92100, Boulogne-Billancourt, France

    Romain Salle & Charbel Skayem

  2. Unité D’Infectiologie et Dermatologie, Centre Hospitalier Intercommunal de Fréjus-Saint-Raphaël, Fréjus, France

    Pascal Del Giudice

  3. AP-HP, Service de Dermatologie, Hôpital Henri Mondor, Créteil, France

    Camille Hua

  4. Consultation Dermatoses Faciales, Service d’ORL, AP-HP, Hôpital Universitaire Pitié-Salpêtrière, Paris, France

    Olivier Chosidow

  5. UPEC Créteil, Créteil, France

    Olivier Chosidow

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  1. Romain Salle
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Romain Salle, Pascal Del Giudice, Charbel Skayem, Camille Hua, and Olivier Chosidow have no conflicts of interest that are directly relevant to the content of this article.

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Members of the Infectious Skin Diseases and STI Working Group (GrIDIST) of the French Society of Dermatology: Romain Salle, Pascal Del Giudice, Camille Hua, and Olivier Chosidow.

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Salle, R., Del Giudice, P., Skayem, C. et al. Secondary Bacterial Infections in Patients with Atopic Dermatitis or Other Common Dermatoses. Am J Clin Dermatol (2024). https://doi.org/10.1007/s40257-024-00856-1

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