Тhe well-known manifestations in psoriasis include psoriatic arthritis and psoriasis of the nails, however, at present, other conditions comorbid to psoriasis have begun to be actively studied: such as liver diseases, diabetes mellitus, diseases of the cardiovascular system, obesity, mental disorders, inflmmatory bowel diseases. and joints. In addition to similar immunological mechanisms, genes have been found that are common to psoriasis and the comorbid diseases associated with it. The article provides data on dysfunctions of the hepatobiliary system in patients with psoriasis. The article reveals the results of studies conducted by foreign and domestic authors, which have shown signifiant relationships in the severity of liver damage in psoriasis.

Acne vulgaris is a common disease affecting up to 85 % of adolescents. Localization of dermatosis in cosmetically signifiant areas, the duration of the therapy and the formation of post-acne symptoms have a high psycho-emotional load and negatively affect the quality of life. Due to the fact that acne affects the most vulnerable and socially sensitive age group, it is imperative not to overlook psychological abnormalities such as anxiety, depression and suicidal thoughts. This review presents the types of diagnostic scales for assessing the quality of life of patients with acne, pathogenesis and risk factors for scar formation – the main factor affecting the self-esteem of patients with acne vulgaris, and also proposed new methods of combination therapy with the use of corticosteroids and isotretinoin in the treatment of severe forms.

The work represents the prospective cohort analysis of patients with psoriasis treated with certolizumab pegol (CZP) at the Tula Regional Clinical Dermatovenerologic Dispensary in years 2017–2019, who achieved remission and discontinued CZP and real-time observation of the patients. The patients remained in sustained remission after discontinuation of certolizumab pegol (mean drug-free remission was 42 weeks). Patients who had not responded to systemic therapy prior to CZP treatment demonstrated good response to methotrexate and cyclosporin A, which suggests the modulation of immune response by certolizumab pegol. The obtained results demonstrate that intermittent treatment with certolizumab pegol effiiently controls psoriasis, reduces drug burden.

Psoriasis is one of the most common chronic recurrent dermatoses, which is not limited to skin lesions, leading to a violation of the functions of various body organ systems. The article presents the results of the analysis of the medical histories of patients of Clinical dermatovenerologic dispensary (Krasnodar Region of Russia) with moderate-severe and severe forms of psoriasis and concomitant cardiological pathology. The article presents data from 70 case histories of patients with moderate to severe psoriasis, the analysis of which shows the clinical and practical significance of comorbidity of psoriasis. From the analysis, we conclude that there is a direct relationship between the severity of the course of the cutaneous pathological process and the aggravation of the cardiological diagnosis. The higher the severity of psoriasis, the higher the risk of developing acute coronary syndrome, myocardial infarction and other cardiac pathology.

Modern therapeutic views on the pathogenesis of acne indicate the role of permanent inflammation and expand the arsenal of medicines and combined techniques necessary for the successful treatment of this chronic skin disease. The complex process of immune inflammation in acne with the participation of pro-inflammatory cytokines is due to the interaction of trigger factors and factors of innate immunity. It was found that C. acne is able to interact with markers of increased immunity, such as Toll-like and protease-activated receptors. Based on a detailed analysis of the literature in search systems like PubMed, eLibrary.ru, CyberLeninka, it was found that one of the key roles in inflammation in acne belongs to matrix metalloproteinases. Thus, C. acnes are involved in many processes in the pathogenesis of acne, including inflammation, hyperkeratosis and hyperproduction of sebum, which necessitates its eradication and is an important component of complex therapy. Minocycline (Minolexin) is a highly effective drug for the treatment of moderate to severe forms of acne, including a low-dose regimen, and is included in the European Treatment Guidelines. Minocycline is considered the most powerful inhibitor of MMP, has a pronounced anti-inflammatory effect and a high level of lipophilicity, quickly penetrates the lipid layer of the bacterium and intensively accumulates in the sebaceous glands.

Seborrheic dermatitis (SD) is a chronic recurrent inflammatory skin disease caused by changes of quantitative and qualitative sebum characteristics. SD comes out by appearing of erythematous plaques with sense of itch and peeling skin in areas with high concentration of sebaceous glands: on the scalp, face, upper part of the body and in the folds of skin. Due to the fact that the development of the SD is promoted by the colonization of the skin with a lipophilic yeast fungus Malassezia spp., in the treatment of uncomplicated simple forms of the disease can be applied external antifungal medicines, topical glucocorticosteroids and anti-inflammatory drugs of non-steroidal origin. Systemic therapy is also used in severe course of seborrheic dermatitis and in the treatment of forms, resistant to external therapy. In the treatment of persistent and long-term forms of SD, systemic antifungal agents and systemic retinoids are used, which allow for a long time to achieve regression of skin rashes and significantly improve the quality of life of the patient.

Stretch marks (striae distensae) are linear areas of cutaneous atrophy that appear in regions of greatest stretch of the skin. Their formation is a complex multifactorial process, its etiopathogenesis has not been fully understood yet. Aesthetic correction of stretch marks is an urgent problem of modern dermatocosmetology due to their widespread prevalence and pronounced negative impact on the patient’s quality of life. The aim of this paper was to provide a review of the literature on current reported treatment options for stretch marks. The principles of the effect of various methods of treatment, their classification and data from clinical trials are considered.

The increased level of interleukins IL-4 and IL-13 in the area of skin lesions, which are secreted by type 2 T-helpers, eosinophils and other immunocompetent cells, plays a main role in the pathogenesis of AD according to modern concepts. The genetically engineered drug dupilumab selectively binds to the subunit of IL-4Rα receptor complexes for IL-4 and IL-13 and inhibits the signaling function of these cytokines. The drug is approved for the treatment of patients with moderate to severe AD who have indications for systemic therapy, regardless of the use of topical corticosteroids from 6 years age. The efficacy and safety of dupilumab in the treatment of patients with atopic dermatitis has been confirmed by the results of numerous clinical studies. Material and methods.The study included 11 patients with moderate and severe AD at the age from 18 to 48 years. All patients received systemic treatment with dupilumab, topically used methylprednisolone aceponate (two times a day for the first 4 weeks, then a calcineurin inhibitor two times a day until the end of the observation period), emollients (two times a day). The initial dose of dupilumab was 600 mg (two injections of 300 mg at different injection sites), then 300 mg every 2 weeks. Results. After 6 months of complex therapy 73 % of patients achieved IGA 0/1. The SCORAD index decreased by an average of 71.7 % after 6 months. The mean value of the NRS scale decreased by 63.2 %. There were no adverse events reported that would lead to drug withdrawal. Conjunctivitis was noted in 2 (18.2 %) patients. Conclusion. There was a marked decrease in the intensity of the main clinical symptoms (SCORAD), including pruritus (NRS), a significant decrease in the manifestations of anxiety and depression (PROMIS).

Aging is a physiologically programmed process. And the main paradigm of medicine of the future is the preservation of health and functionality in the fight against age-associated diseases as a cause of premature aging. But with what involutive changes can the gut microbiota be associated? After all, it is not bacterial cells that age, but the bacterial composition changes in connection with concomitant diseases. Therefore, it is important to track what changes the gut microbiota undergoes with age using the example of common gerontological syndromes such as changes in innate immunity, sarcopenia and cognitive impairment. There are cultural and biological research methods that demonstrate differences in the gut microbiota of the elderly and young people. However, it is impossible to determine the chronological age threshold, after which the composition of the microbiota begins to change, rather, these changes occur gradually. Thus, the question remains open for scientists, which physiological processes are associated with changes in the microbiota and loss of health. This will make it possible to establish whether the microbiota can be a target for diagnosing the health status during aging and what measures to regulate the composition and function of the microbiota are possible to maintain active longevity. This article will provide an overview of the latest data on microbiota and involutive changes.

Purpose. To describe a clinical case of penile cancer in a patient with sclerotrophic lichen. Material and methods. Data of anamnesis, medical clinical, histological and instrumental examination. Results. A case of rapidly progressing penile squamous cell carcinoma in a patient with a long history of sclerotrophic lichen and no previous therapy was described. Conclusions.The low level of awareness of primary care physicians about the manifestations of CSAL, as a consequence, the lack of treatment and progression of the disease, expressed in urethral stenosis and malignant transformation draws attention.

In recent years, the possibilities of a dermatologist in the treatment of patients with chronic dermatoses have significantly expanded due to the emergence of new highly effective methods, such as autologous blood plasma enriched with platelet-rich-growth factors (platelet-rich-plasma, PRP). The positive results of using this technology due to its constituent growth factors, cytokines and other biologically active substances, which have a pronounced normalizing effect on the processes of tissue repair and regeneration, expands the possibilities of its use in such skin diseases as erosive and ulcerative lichen planus, scleroatrophic lichen, acne and post-acne. The aim of this review was to analyze the literature on the mechanisms of PRP action in patients with dermatological diseases.

In clinical practice, as a rule, patients with involutive changesas well havea photodamage, it should be considered when choosing a method of correction. Microneedling, including the use of PRP and hyaluronic acid, arevery promising methods.

Material and methods. There were 50 patients under observation, who were divided into three groups: 1st group – 18 patients received microneedling and PRP, 2nd group – 17 people used microneedling of hyaluronic acid, 3rd group – 15 patients received microneedling. Four procedures were performed with an interval of 4 weeks.

Results. According to dermatological status index, PRP microneedlingshowed the effectiveness, the index decreased by 86 % in the group. In group 2, the average index for the group decreased by 56 %, in group 3–41 %.

Conclusions.Microneedling is an effective safe method for correcting involutive changes in the skin of the face, combined with signs of photoaging. To increase the effectiveness of microneedling, it is recommended to use autologous plasma with cells directly after the procedure applicationinto the form or the film.

Lichen planus (LP) is a T-cell-mediated inflammatory dermatosis with an unclear etiology that affects the skin, nails and mucous membranes. The article outlines modern ideas about lichen planus, affecting the vulva. The issues of etiopathogenesis, clinical picture, differential diagnosis of various forms of this dermatosis are considered. The histopathological picture of vulvar LPL is described in detail. Possible complications, including anatomical abnormalities of the vulvar architectonics and the risk of malignant transformation, are considered. Various methods of treatment for this disease, local treatment regimens are presented, an overview of systemic drugs is given, as well as alternative approaches to patient management.

Hyaluronic acid (HA) is a viscoelastic gel. The substance has a high ability to deform. It also has properties such as plasticity, lift, ease of distribution, and tissue mobilization during facial muscle activity. The aim of the study was to evaluate the safety and effectiveness of HA at the microscopic level. The study was conducted in two stages. In the first stage, the tissue filler was injected bolus-subdermally to rats and rabbits. The second stage involved female volunteers. The drug was also administered to the problem areas on the face. In addition to the histochemical observation, the effectiveness of the procedure on the woman’s face was also evaluated. High safety was demonstrated, as well as an increase in the expression level of collagen and elastin fibers.

Azelaic acid is well suited for the treatment of acne in women, where PIH occurs most often (it is not an obstacle for use during pregnancy), the drug may be combined with systemic and topical therapy, may combined with skin care and decorative cosmetics, has no restrictions when used in active sun, possesses light peeling effect.

Material and methods.The study evaluated the effectiveness of the combined method, including systemic isotretinoin and Skinaren®cream 20 %, in patients with moderate acne – group 1A (n = 24) in comparison with isotretinoin monotherapy – group 1B (n = 25). The efficacy of Skinoren®20 % cream was also studied in patients with post-inflammatory hyperpigmentation – the group 2 (n = 37).

Research results.The combination of 20 % azelaic acid cream (Skinoren®) with oral isotretinoin (from 4th months of admission) in patients with adult acne allows to influence the formation of post-inflammatory hyperpigmentation, which ultimately leads to a more significant aesthetic result (88 % with the achievement of IGA0) and contributes to an improvement in the quality of life (reduction of APSEA by 87 %) The safety of the 20 % azelaic acid cream (Skinoren®) is assessed as very high, which is confirmed by the absence of adverse events in most patients. The use of 20 % azelaic acid cream (Skinoren®) as a monotherapy for post-inflammatory hyperpigmentation causes a pronounced positive effect in stopping PIH in all patients, while achieving clear skin is noted in 78.4 %.

The widespread spread of balanoposthitis necessitates the development of highly effective treatment methods. The experience of using combined topic steroid in a patient with balanoposthitis complicated by reactive arthritis and keratoderma is described. The high efficiency of treatment of balanoposthitis and keratoderma with a combined topical steroid with anti-inflammatory, antimicrobial, fungicidal and wound healing effects has been shown.

In a study of 115 patients, the effect of the interference of IPL exposure using filters of 640 nm and 560 nm and the use of an erbium fractional laser with a wavelength of 1565 nm on microcirculation in patients with involutive skin changes was studied. The basis of all reparative processes is the microcirculatory link, as a unit of the trophic system of the skin. Studying the effect of phototechnologies and laser fractional exposure on microcirculation, based on the results of these studies, it is possible to develop algorithms for patient management, including additional treatment methods, as well as an algorithm for standardizing procedures, including the multiplicity and number of procedures. These studies can be the starting point for the introduction of standards that will reduce the number of complications, as well as increase the clinical effectiveness of the treatment, which will make the method more widely available. The assessment of the state of microcirculation was carried out using the method of laser Doppler flowmetry (LDF), using the mathematical analysis of the wavelet transform. Under the influence of the interference of IPL exposure using filters of 640 nm and 560 nm and the use of an erbium fractional laser with a wavelength of 1565 nm, a positive dynamics of the parameters of all parts of the microcirculation was revealed according to the LDF data. In women with spastic type of MC, the initially increased neurogenic and myogenic tone of the arterioles decreased, and endothelial function improved. In women with hyperemic type of MC, there was an improvement in neurogenic tone, correction of endothelial dysfunction, and elimination of congestion in the venular link of MC. However, the above changes were more noticeable in patients with hyperemic type of MC.

A case of clinical observation of a patient with a granulomatous reaction developing in the region of both nasolacrimal grooves after the injection of a filler based on polycaprolactone (PCL) is presented. PCL is used in cosmetology as a filler and collagen synthesis stimulator. It is a biocompatible and biodegradable polymer with a proven safety profile. However, as with the introduction of other types of fillers, in some cases it can cause a granulomatous reaction of varying severity. The clinical observation of this case is of interest to practicing dermatologists, cosmetologists and plastic surgeons.

Objective: to studythe effectiveness of autologous plasma-cell microneedling in patients with different phenotypes of post-acne atrophic scars. Group 1A (n = 32) included patients with post – acne atrophic scars: ice pick – 12 patients; boxcar – 11; rolling – 9 patients. Group 1B consisted of 34 patients with scars ice pick – 12; boxcar – 12; rolling – 10 patients. In group 1A, patients underwent a microneedling procedure. In group 1B, microneedling was performed with autologous plasma with cells. To evaluate the effectiveness of the therapy methods, we used the IGA (Investigators Global Assessment) scale modified for post-acne scars, adapted for post-acne scars by the Assessment of the Psychological and Social Effects of Acne (APSEA). Special methods included ultrasound examination using an ultrasound scanner IU 22. The end result for different post-acne scar phenotypes showed the advantages of the developed complex for boxcar and rolling AR and slightly lower for ice pick. The recommended course of therapy is three procedures performed once in 4 weeks.