The article is of an overview nature and contains up-to-date information about one of the main factors in the violation of the skin barrier, filaggrin dysfunction, which is a component of the natural moisturizing factor. The data on the leading role of the filaggrin defect in the pathogenesis of a number of dermatoses make it an attractive target for the creation of topical dermatocosmetics in order to compensate for its deficiency. The first and only registered emollient with a modulator of filaggrin activity from unsaponifiable fractions of vegetable oils is filagrinol, which stimulates the maturation of profilaggrin by activating ATPases involved in dephosphorylation of profilaggrin and inducing the incorporation of histidine into the granular layer [30]. It is expected that thanks to plant lipids this formula enhances the skin’s ability to renew, significantly slowing down the aging process and restores the skin’s water-holding capacity, thereby normalizing the degree of hydration.

A clinical case of leg skin chromomycosis is described, a review of the literature is given, the main modern medical methods, as well as methods of historical significance are briefly described. The individual links of the pathogenesis of chromomycosis (CM) are described, a list of nosologies to which chromomycosis should be differentiated is presented.

Materials and methods. A clinical case of chromomycosis in a 63-year-old patient is presented. The process developed as a result of systematic frequent injury of the shins with sharp parts of plants.

Results. The diagnosis of chromomycosis was established on the basis of anamnesis, clinic data, detection of the pathogen in the biopsy material.

Conclusions. Thus, CM is a serious deep skin mycosis, which still causes an epidemiologically significant morbidity in workers of agricultural and related fields! It is difficult to treat it, especially in more severe clinical forms. Treatment usually consists of long periods of treatment with antifungal drugs, often associated with physical procedures and immunotherapy. This publication is intended to extract HMM from the list of ′forgotten diseases′ at least for a short time!

This article presents data on the pathogenesis of acne, the mechanisms of choosing therapy, the tactics of prescribing isotretinoin and further management of patients. Answers are given to important questions concerning the appointment of an adequate daily dose and the obligation to set of cumulative dose concerning the mandatory, the safety of drugs containing isotretinoin. In addition, the possibility of prescribing drugs based on vitamin A (retinol palmitate) in large doses in patients with acne and related adverse reactions is being discussed. The article is illustrated with three clinical examples of patients diagnosed with acne with a description of management tactics.

A sample of 120 patients with lichen planus presents the results of a prospective clinical study of phenotypic variants of dermatosis, in which itching acts as a leading nosogenic factor in the development of adjustment disorders of the depressive, neurotic, hypochondriac circle. The study of comorbid psychosomatic disorders associated with phenotypic manifestations of lichen planus is an urgent problem both in connection with severe forms of the disease, including excruciating itching, localization of rashes in open areas of the body, in the genital area, oral mucosa and the risk of malignant transformation of lesions, so and mediated violations of compliance at the stage of therapy and in the process of rehabilitation. The introduction of an integrated interdisciplinary approach into clinical practice contributes to the optimization of therapy for skin diseasе and an improvement in the quality of life of patients with comorbid psychosomatic pathology.

In recent years, comorbidity in psoriasis has been actively studied, one of the most significant of which is obesity. Obesity is a risk factor for dermatosis in susceptible individuals, which can affect the effectiveness of therapy for the disease, including genetically engineered biological drugs.

The aim of the study. To study the effectiveness of therapy with an interleukin‑17 inhibitor (iskekizumab) and the dynamics of lipid parameters in patients with psoriasis and overweight and obesity.

Material and methods. A retrospective study of 25 patients diagnosed with psoriasis vulgaris was carried out. Inclusion criteria were PASI more than 12 points, BSA more than 10% and sPGA more than 3 points, age over 18 years. Anthropomeric parameters and lipid profile data were studied. All patients received iksekizumab treatment according to the standard regimen. Evaluation of the effectiveness of therapy was carried out according to the dynamics of PASI indicators, as well as the frequency of patients achieving the response PASI 75, PASI 90 and PASI 100.

Results. Obesity and overweight were diagnosed in 13 patients who made up the main observation group. The comparison group included 12 nonobese patients. Patients in the observation groups did not differ in sex and severity of psoriasis. In patients of the main group, hypertriglyceridemia was significantly more often diagnosed (55.6%; 95% CI: 33.7–75.4; in its absence in the comparison group; p = 0.0200), as well as other comorbidity – hypertension and metabolic syndrome (p = 0.0016 and p = 0.0052, respectively). On the background of therapy, skin rashes were resolved in patients of both observation groups. By the seventh week of therapy, there was a significant decrease in PASI, sPGA and BSA, by the 36th week, the rash was completely resolved in all patients (p < 0.001). There were no significant differences between the groups in the dynamics of clinical indicators of the severity of the disease. Body mass index did not change statistically significantly over the observation period in patients of both groups (p = 0.6690). Changes in lipid profile for all parameters were statistically insignificant. There were no significant differences in the frequency of achieving PASI of 75, 90 and 100% between the groups.

The relationship of xerosis with various skin diseases is very multifaceted, at the same time, xerosis can be the cause of the onset or aggravation of itching. Modern recommendations for the external treatment of chronic dermatoses, accompanied by xerosis and itching, imply two directions: direct therapeutic measures during an exacerbation and the use of dermatocosmetics adapted to certain symptoms.

Material and methods. We observed 26 patients (mean age 38.7 ± 1.9 years with atopic dermatitis, eczema, psoriasis or pruritus, where xerosis was present in the clinical picture and pruritus was noted. All patients used topical drugs in accordance with the nosology, in as an adjuvant therapy – Neotanin Comfort Plus cream.

Research results. In atopic dermatitis, the corneometry index increased by an average of 21%, with eczema – by 20%, with psoriasis – by 22%, with skin itching – by 12%. Transepidermal water loss decreased in atopic dermatitis by 19.8%, with eczema – by 22.8%, with psoriasis – by 21.8%, with pruritus – by 18.4% The value of the total BRS index decreased by more than two times.

Conclusion. The use of Neotanin Comfort Plus cream in combination with topical drug therapy (GCS, multicomponent drugs) is highly effective and safe in patients with atopic dermatitis, eczema, psoriasis or pruritus, which makes it possible to recommend it for use in wide clinical practice.

Актуальность. Розацеа – хронический воспалительный дерматоз преимущественно центрофациальной локализации. Для клинической картины характерны разнообразные симптомы сосудистого и воспалительного характера, часто отмечается их сочетание. Терапия пациентов проводится с учетом преимущественной клинической симптоматики. Основным препаратом лечения папуло-пустулезного подтипа является ивермектин. Учитывая наличие сосудистого компонента при папуло-пустулезном подтипе, актуальным является изучение эффективности и безопасности комбинированного применения фототехнологий и ивермектина.

Материал и методы. В зависимости от терапии пациенты с сочетанием эритемато-телеангиэктатического и папуло-пустулезного подтипов розацеа были распределены на три группы: 1-я группа (33 больных) получала процедуры ИЛК и топическую терапию ивермектином, 2-я группа (32 больных) –процедуры c неодимовым лазером и ивермектином наружно, 3-я группа (21 пациент) –процедуры широкополосным некогерентным светом и ивермектин. Оценка эффективности проводилась с использованием визиосканирования, с учетом дерматологического индекса GSS (Global Severity Sсore), дерматологического индекса шкалы симптомов (ДИШС).

Результаты исследования. По данным суммарного индекса ДИШС, наибольшая эффективность в купировании и воспаления, и сосудистого компонента наблюдалась во 2-й (89,6%) и 3-й (93,8%) группах, несколько ниже – в 1-й группе (73,2%). Совокупная оценка эффективности комбинированных методов показала, что положительный результат был получен у всех пациентов, при этом в соответствии с показателем GSS клиническая ремиссия (снижение ДИШС на 100%) отмечалась у 51,5, 78,1 и 76,2% в 1-й, 2-й и 3-й группах соответственно. Значительное улучшение (снижение ДИШС на 90%) – у 42,4, 18,8 и 23,8% в 1-й, 2-й и 3-й группах соответственно.

Выводы. Комбинированное применение ивермектина и различных видов фототехнологий является высокоэффективным и безопасным.

In this work we discuss a case of Bullosus pemfigoid (B.P.) developed after pneumonia caused by new coronavirus disease COVID‑19 in a patient with psoriasis. Provided description is supported with the data of histological and serologic analysis, the lgG of epithelial basement membrane was detected to antigen ВР230-CF and to antigen ВР180-NC16A.

This study reports about efficacy and safety of photodynamic therapy in Genitourinary Syndrome of Menopause (GSM).

Material and methods. The study group included 12 patients with a diagnosis of urogenital syndrome of menopause. The trismeglumine salt of chlorin E6 in the form of a 1% gel was used as a photosensitizer. LED phototherapy apparatus Garmonia (photodynamic therapy apparatus (emitter 660 nm) was used as a radiation source. The PDT procedure was performed once every 7 days. The following scales were used to assess the effectiveness: Vaginal Health Index, Visual Analogue Scale, Dermatology Life Quality Index score, and general satisfaction with the course of procedures was also assessed.

Results. The patients noted a significant regression of itching, burning, pain and dyspareunia after the course of photodynamic therapy. There was a decrease in dryness, on average, up to 3 points upon completing the course of procedures. Itching completely regressed in 6 out of patients. Dyspareunia significantly decreased in 4 patients and completely disappeared in 2 patients. The greatest effect according to the results of assessing the index of vaginal health was noted in relation to Ph-metry, as well as in relation to elasticity (4.17 points) and moisture (4.33 points). The median satisfaction score with treatment outcomes was 2.7 at last follow-up. There were no serious side effects during the entire period of treatment and after it.

Conclusions. The following study reports that the photosensitizer with trismeglumine salt of chlorin E6 and PDT with a wavelength of 660 nm with an exposure for 30 minutes, an energy of 100 J/cm2, a power of 100 mV/cm2 , once every 7 days, is an effective and harmless method of treating GSM.

The article is of the overview nature and contains up-to-date information about the current methods of treatment of various forms of seborrheic dermatitis (SD). The data on modern methods of management of patients with severe forms of SD, allowing for a long time to achieve regression of skin rashes and significantly improve the quality of life of the patient, are presented.

Information on the epidemiology, clinical manifestations, prevention and treatment of the new coronavirus infection COVID‑19 is constantly updated. Clinical manifestations of COVID‑19 on the skin have been described, including angiitis, acrodermatitis (acroangiitis), papulo-vesicular rashes, papulosquamous rashes, lichen rosacea, measles-like rash, toxicoderma, exacerbation of chronic dermatoses of the skin, hair and artifical lesions. One of the most significant triggers of hair loss is stress. The global COVID‑19 pandemic has become such a factor for many. To date, there is no complete understanding of the pathogenesis of hair loss associated with COVID‑19. Many authors suggest that both the infection itself and the associated psychoemotional state, and the therapy of the disease, can act as the causes of telogen hair loss and androgenic alopecia in COVID‑19. A number of studies demonstrate a link between androgens involved in the pathogenesis of COVID‑19 and the possible development of androgenic alopecia. Other authors have observed cases of telogen hair loss associated with COVID‑19 disease. In our practice, we also encounter diffuse hair thinning, presumably caused by COVID‑19. Often, patients do not consider it necessary to consult a doctor for hair loss, and for the first time make an appointment only after self-medication is ineffective. Self-treatment attempts that do not give any results can form a negative attitude towards a number of drugs. In this case, the doctor’s task is to adequately assess the patient’s condition and select the optimal therapy regimen for each specific clinical situation.

The article describes a clinical case of a five-fold administration of a direct lipolytic–phosphatidylcholine / deoxycholic acid for cosmetic purposes, which resulted in widespread septal panniculitis, systemic inflammatory reaction, secondary myositis, thrombotic microangiopathic syndrome, fatty necrosis of the pancreatic head, necrotic nephrosis and multiple organ failure, which led to death of the patient.

Materials and methods. Analysis of medical records, histological examination of autopsy material.

Conclusions. Injection lipolysis using phosphatidylcholine / deoxycholate causes uncontrolled necrosis of adipose and vascular tissue, fibrosis, which makes the indefinitely long-term consequences of the administration of drugs for the non-surgical treatment of subcutaneous fat deposits. Phosphatidylcholine / sodium deoxycholate is not recommended for use in the presence of general obesity, somatic pathology, or in elderly patients.

The article highlights the problem of artificial dermatitis (pathomimia) as a manifestation of a mental disorder. A direct correlation is shown between the severity of mental illness and the severity of injuries inflicted on the skin. It is shown that it is necessary to manage such patients with the participation of a psychiatrist and a dermatologist. Positive results of treatment of infected skin lesions using Levomekol® ointment are presented.

Materials and methods. We observed 19 patients, 7 women and 12 men. All patients, even with shallow, but extensive excoriations, Levomekol® ointment was prescribed under a bandage with a superficial additional fixation with a Band-Aid bandage in order to prevent self-removal of the bandage.

Results. All 19 patients had epithelialization of existing erosions and healing (the beginning of scarring) of ulcers. The healing time of self-injuries was as follows, depending on the depth of the lesion: surface erosion and excoriation‑2 days, deep excoriation – 5 days, surface ulcers: on the upper extremities and neck – 9 days, on the lower extremities‑11 days.

Conclusions. 1) Psychosomatic disorders, most often encoded by dermatologists under the heading ‘artificial dermatitis (ArD)’, are one of the pressing problems of modern medicine at the intersection of psychiatry and dermatology. 2) The severity and depth of destructive manifestations of ArD on the skin directly correlates with the severity of mental disorders. 3) With deep and multiple skin injuries, already at the level of impulsive disorders, there is a high probability of secondary infection. With ulcerative defects, such infection occurs inevitably. 4) Levomekol® ointment is a drug not only with a proven antimicrobial and regenerating effect, but also with a proven possibility of use in wounds with a pronounced exudative component, with excoriations of any depth. 5) When applying Levomekol® ointment on a large surface or on deep ulcers, the possibility of systemic effects should be taken into account, according to the instructions (such effects were not recorded in the presented study).