Over the past 30 years, the number of people with obesity has almost doubled in the world – a chronic disease accompanied by progressive metabolic disorders and an increased risk of developing diseases such as diabetes, hypertension, coronary heart disease, etc. The rapidly growing number of overweight adults and adolescents, the severity and low efficiency of existing traditional methods of treating obesity, prompt the search for the most effective and safe methods of therapy. Semaglutide is a glucan-like peptide 1 agonist that has demonstrated promising efficacy not only in glycemic control, but also in weight loss by delaying gastric emptying, enhancing and prolonging the feeling of satiety, reducing appetite and energy consumption. The article discusses the main mechanisms of action of semaglutide, and also presents data from STEP studies on the efficacy and safety of semaglutide at a dose of 2.4 mg per week in patients with obesity or overweight without diabetes mellitus.

The article presents modern data on the classification, clinical features of diffuse telogen effluvium (TE), its causes and triggers, and also discusses the features of diagnosis and treatment of different forms of TE.

Melasma is a common acquired pigmentation disorder, represented by patches of light brown or brown color localized on areas of the skin exposed to prolonged sunlight. The increased activity of melanocytes, which underlies the pathogenesis of melasma, is due to genetic predisposition, chronic insolation and hormonal imbalance. In postmenopausal women, the increased severity of melasma is associated with a combination of these factors. In addition, pigmentation disorders may be affected by taking certain medications and other environmental factors. There are many methods of treating melasma, including the use of topical remedies, chemical peels, laser therapy and others. In recent years, more and more attention has been paid to an integrated approach that combines various treatment methods to achieve the best result. One of the effective methods of treating this pathology is the use of a CO₂ laser. However, many patients relapse after laser treatment. In this regard, there has been interest in the combined use of laser therapy using topical agents that reduce the severity of pigmentation. One of these drugs is tranexamic acid, which has the property of reducing the activity of melanocytes.

The purpose of this literature review is to study the latest publications on the treatment of melasma using laser-associated administration of tranexamic acid.

Material and methods. The literature data on search words – melasma, hyperpigmentation, tranexamic acid, CO₂ laser, fractional grinding, laser-associated administration, postmenopause in computer databases PubMed, Elibrary, Cochrane Library, Medscape were studied. Web of Science, Scopus. Publications included basic scientific research, randomized controlled trials, comments and reviews. The results of clinical improvement were assessed by the MASI melasma area and severity index, as well as the modified mMASI index.

The article describes the main links in the etiopathogenesis, clinical picture, diagnosis and treatment of lichen sclerosus, and in particular vulvar lichen sclerosus (VLS). The main etiopathogenetic concepts of the occurrence of VLS are presented, existing modern methods of treatment for VLS are presented, among which priority is given to minimally invasive treatment methods.

Bullous pemphigoid (BP) is an autoimmune subepidermal bullous dermatosis that significantly affects the quality of life of patients due to pronounced subjective symptoms, affecting mainly the elderly. Autoantibodies against hemidesmosomal proteins BP180 and BP230 are involved in the pathogenesis of BP, which leads to detachment at the junction of the dermis and epidermis, as well as the formation of blisters. The severity, prevalence of the pathological process and painful itching require the appointment of high doses or constant use of systemic glucocorticoids, which is not always possible due to extensive concomitant pathology and a large list of side effects. The article presents modern methods of bullous pemphigoid therapy using monoclonal antibodies (rituximab, dupilumab, omalizumab). The mechanisms of therapeutic effect of the drugs described in the article are aimed at various pathways of immunopathogenesis of bullous pemphigoid. The new treatment methods described in the article offer alternative ways of helping patients who have contraindications to the appointment of systemic glucocorticosteroids, demonstrating the lack of effect from the use of basic therapy, with a recurrent process. New therapeutic techniques will improve results and reduce high cumulative doses of systemic corticosteroids and their associated toxic effects.

Rosacea is a chronic inflammatory dermatosis of facial localization. Treatment tactics for patients with rosacea is a complex task, since it depends on the severity and individual characteristics of the patient. Numerous studies determine the relevance of this problem. Observation of 22 patients, 11 of whom received only topical treatment with the erythematotelangiectatic subtype of rosacea treatment in the form of 15% azelaic acid, 0.5 % brimonidine tartrate gel, and 1 % metronidazole cream. In 11 other patients, topical treatment was combined with phototherapy – broadband incoherent pulsed light at intervals of 1 time in 4 weeks, 3 procedures per course. Evaluation of the effectiveness of therapy was carried out using the Antera 3D visualization and skin diagnostics device. Also, the dermatological index GSS (Global Severity Score) and the dermatological index of symptom scale (DISS) were used as clinical evaluation methods. The combination of 15 % azelaic acid, 0.5 % brimonidine tartrate gel, with broadband pulse therapy (3 procedures) showed higher efficiency than monotherapy with topical agents. The obtained results, indicating higher efficiency of the combined treatment method, can be explained by the synergistic effect of the combination of the physiotherapeutic factor and external drugs affecting the pathogenetic mechanisms of disease development.

Purpose. Analysis of the effectiveness of remote monitoring in the management of skin toxicity in oncology patients.

Materials and methods. A comparative study of 2 cohorts of oncology patients with skin toxicity receiving supportive care through remote monitoring using the PSP “Healthy Skin” and outpatient consultations. Nonparametric statistical methods were used with a significance level of p<0.05.

Results. A comparative analysis of 150 patients divided into 2 equal groups showed the effectiveness of using the remote monitoring (group 1) in the form of a reliable decrease in median BSA (%) by 67 %, 5D itching scale by 65 %, DLQI by 70 % compared to 10 %, 22 %, 20 % in group 2, respectively, over 4 weeks of the study. In group 2, deterioration of the skin condition was noted in 13.3 % of patients, 9 % of patients underwent a reduction in the dose of the anticancer therapy, 5 % had a break, while in group 1 such episodes were not noted due to the stability of the condition. Positive dynamics in the form of a decrease in the severity of skin toxicity was noted in 48 % of cases in group 1 and in 10 % of cases in group 2. An assessment of patient satisfaction with the use of the application (B 2C (business-to-consumer) analysis) revealed satisfaction in 91.4 % of respondents.

Conclusion. The availability and effectiveness of the use of the PSP «Healthy Skin» will ensure timely supportive care, significantly reduce the severity of skin toxicity and improve the quality of life in oncology patients.

Background. Telogen hair loss is one of the most common forms of alopecia, associated with a disruption in the phases of the hair growth cycle – specifically, the premature transition of the hair follicle into the telogen phase. The primary causes are the influence of triggering factors such as increased stress levels and previous illnesses. The main goal of therapy is to prolong the anagen phase and stimulate hair growth through the use of topical peptides and a multivitamin complex.

Objective. To study the effectiveness of a hair growth restoration method in the treatment of telogen alopecia using cosmetic hair growth products and dietary supplements.

Methods. The study involved 20 patients diagnosed with telogen alopecia who received treatment with the topical cosmetic products «Time to Grow» and the dietary supplement «Thick and Strong Hair» for 9 weeks. The effectiveness of the treatment was assessed at 3, 6, and 9 weeks after the start of therapy.

Results. The analysis of the study showed statistically significant changes in trichoscopy indicators in patients with telogen alopecia, demonstrating the effectiveness of using hair growth cosmetics (p<0.05). At the final assessment point, a reduction in hair loss was observed in 100 % of the subjects, along with improvements in hair quality and volume. A survey evaluating the participants’ subjective experiences demonstrated satisfaction with the treatment and adherence to the therapy.

Conclusion. The use of hair growth products and the dietary supplement «Time to Grow» has proven effectiveness in the treatment of telogen hair loss.

In severe psoriasis, systemic therapy is required, but the number of studies on the use of biologics drugs in patients with existing or history of cancer is limited, which creates difficulties in prescribing this group of drugs. The presented clinical case demonstrates the interdisciplinary interaction between a dermatologist and an oncologic surgeon. A patient diagnosed with psoriasis, psoriatic arthritis, and basal cell carcinoma underwent successful therapy with the IL-23 inhibitor risankizumab, which has demonstrated high safety and efficacy in the treatment of psoriasis, and surgical removal of the basal cell carcinoma by Mohs micrographic surgery. For patients with psoriasis and an existing or history of cancer, multidisciplinary collaboration is required to determine optimal therapeutic tactics.

Treatment of any type of psoriasis involves the use of external therapy. Recommended topical preparations include: corticosteroids, calcipotriol in combination with corticosteroids, zinc pyrithione, keratolytics, tar. A special place in the therapy of psoriasis is occupied by a drug containing activated zinc pyrithione (Skin-cap), due to its effectiveness, safety and the availability of various forms (aerosol, cream, shampoo), which allows it to be used in both short-term and long-term therapy at different stages of the disease. Complex treatment, including the use of topical forms containing activated zinc pyrithione, is a highly effective, safe, pathogenetically substantiated method of treating various forms of psoriasis, allowing to achieve rapid regression of rashes, minimize the risk of adverse effects and achieve long-term control over the disease, which significantly improves the quality of life of patients

Longitudinal erythronychia presents as a red stripe running along the nail plate, originating from the base of the nail and stretching to its tip. It can vary in appearance and is categorized into different types based on the number and pattern of red stripes: type Ia (single stripe), Ib (split single stripe), IIa (single stripe affecting multiple nails), and IIb (multiple stripes affecting multiple nails). Additional symptoms may include nail brittleness and separation from the nail bed (onycholysis). Erythronychia can stem from various underlying conditions, including tumors, and diagnosis often involves a nail biopsy, especially in older patients, to rule out cancer. Treatment depends on the cause and may involve surgical removal if the condition causes discomfort or severe nail damage. Longitudinal erythronychia is gaining attention among dermatologists and other medical professionals due to its significance in diagnosing nail plate disorders. The appearance of red stripes on the nails can indicate a range of issues, from tumors to systemic diseases and injuries. Recent years have seen an uptick in reported cases, underscoring the need for research into its causes, diagnosis, and treatment. Despite increasing interest, many aspects of longitudinal erythronychia remain unclear. This review aims to examine existing clinical studies to better understand its defining features, risk factors, and diagnostic and therapeutic strategies. The review will draw from contemporary literature to provide up-to-date insights into this phenomenon.

Purpose of the study. To analyze observations of sleep disorders in children with psoriasis and comorbid diseases.

Materials and methods. This article describes clinical cases of sleep disorders in 14- and 15-year-old patients with psoriasis and comorbid diseases (psoriatic arthritis (PsA) and exogenous-constitutional obesity of the 2nd degree) who were treated at National Medical Research Center for Children’s Health of the Ministry of Health of the Russia.

Results. Based on the results of collecting anamnesis and polysomnographic study (PSG), it was found that a 14-year-old child with a combination of severe plaque psoriasis (PASI index-21.3 points) and PsA had restless legs syndrome (RLS) of moderate severity, decreased sleep efficiency, and increased sleep fragmentation due to frequent awakenings. A 15-year-old patient with severe plaque psoriasis (PASI-66 score) and grade 2 exogenous-constitutional obesity had moderate obstructive sleep apnea syndrome (OSAS), as well as increased time to fall asleep, reduced sleep efficiency, and increased sleep fragmentation due to frequent awakenings.

Conclusions. Sleep disorders are common in children with psoriasis and comorbid pathologies. At the same time, the implementation of a specific variant of dyssomnia or parasomnia depends on both the underlying disease and the concomitant ones.

Psoriasis is a chronic skin disease with a variety of clinical forms. Rare variants of pustular psoriasis are associated with the dominance in the pathogenesis of innate and autoinflammatory immune reactions, the leading role in which is played by the cytokine IL-36. Prospects for therapy of generalized pustular psoriasis are associated with the use of inhibitors of the activity of this cytokine. Data on the efficacy of treatment of generalized pustular psoriasis with IL-17A inhibitors are limited, although the drugs are more readily available in practice. A series of clinical cases of successful use of netakimab in the therapy of generalized pustular psoriasis is demonstrated.

Localized scleroderma is an autoimmune chronic connective tissue disease characterized by the appearance of foci of local inflammation in various areas of the skin, followed by the formation of sclerosis and/or atrophy of the skin and underlying tissues in them. Among systemic connective tissue diseases, scleroderma occupies the second place in terms of frequency, mainly female patients. The authors observed a severe comorbid patient S., 75 years old, who was hospitalized at the Federal Center of Brain Research and Neurotechnologies of the FMBA of Russia in the department of medical rehabilitation for patients with impaired central nervous system function № 1 from 02.11.2022 to 03.01.2022 with a diagnosis of the underlying disease: the consequences of an ischemic stroke in the basin of the left middle cerebral artery from 02.23.2021, cardioembolic pathogenetic variant. Right-sided hemiparesis. Complex motor aphasia. After consulting a dermatovenerologist, a diagnosis was added to the concomitant diseases: localized scleroderma. Limited plaque shape. Patient S. external treatment was carried out (fluticasone ointment 0.005 % applied to the affected areas of the skin 1 time a day in a thin layer for 4 weeks), upon discharge, a course of physiotherapy at the place of residence was recommended.

Melasma is a fairly common pathology that refers to acquired melanin hyperpigmentation with clinical symptoms affecting exclusively the skin and manifested in the form of spotty elements with color variations from light to dark brown and typical localization of the pathological process on the skin of the face. In this study, we assessed the effectiveness of the developed combined therapy method using dermatocosmetics, IPL therapy and laser therapy with a neodymium laser. The overall therapeutic effectiveness in accordance with the dynamics of the MASI index was 59.6 %, the MSI index – 77 %, and the MELASQoL – 74.2 %.

Today, diffuse alopecia is considered a multifactorial dermatosis, in the development of which an important role is played by a genetic determinant with a polygenic inheritance system with a determining effect of provoking factors, through the action of which a predisposition to hair loss is realized. The purpose of this study is the scientific substantiation and development of a combined method including fractional laser therapy, transvenous blood irradiation and minoxidil for the treatment of patients with diffuse telogen effluvium. Based on the data obtained, it can be concluded that the greatest impact on the indicators of the microcirculation efficiency index is exerted by combined therapy with an erbium laser, transcutaneous laser blood irradiation and external use of minoxidil. In second place is an erbium laser and external use of minoxidil, in 3rd place is transcutaneous laser blood irradiation and external use of minoxidil, in 4th place is external use of minoxidil.

Psoriatic erythroderma is the most severe and rare form of psoriasis, with damage to at least 90 % of the body surface area. Most often, psoriatic erythroderma develops in patients with uncontrolled psoriasis and without timely treatment becomes a potentially life-threatening condition. Against the background of generalized damage to the skin, there is a high risk of developing systemic disorders, and therefore effective and safe treatment methods are needed. Traditional systemic drugs such as retinoids, cyclosporine and methotrexate are not effective and safe enough for psoriatic erythroderma, and in most cases have contraindications associated with comorbid conditions. Systemic genetically engineered biological drugs, including TNF-a inhibitors, IL-17 inhibitors, IL-12/23 inhibitors, IL-23 inhibitors show high efficacy and safety in vulgar psoriasis, which makes it possible to use them in psoriatic erythroderma. However, studies and publications regarding the appointment of systemic biological therapy in psoriatic erythroderma are isolated despite the fact that this is a severe, albeit rare form of psoriasis. Data on the use, as well as the efficacy and safety of the IL-23 inhibitor guselkumab in psoriatic erythroderma are limited. In this article we discuss the clinical manifestations of psoriatic erythroderma, the impact on the quality of life of patients and, using clinical cases as an example, the efficacy and safety of genetically engineered biological therapy with an IL-23 inhibitor (guselkumab) for psoriatic erythroderma are shown.

The article carries out a statistical analysis of sports injuries, with the greatest attention paid to injuries of the knee joint, as the most common among athletes of a high level of professional skill in various sports. An analysis of the causes leading to injuries and operations on the knee joint was carried out, most often these are stress injuries. Risk factors for injury were analyzed.

On June 15, 2024, an expert council was held in Moscow on the topic: «The Place of Topical Combined Multicomponent Drugs in the Treatment of Complicated Dermatoses.» The council became the basis for discussing the accumulated clinical and organizational problems in the field of using multicomponent drugs in algorithms for managing patients with dermatoses of combined etiology, with concomitant visceral or cutaneous comorbidity, the influence of exposome factors on the course of steroid-sensitive, potentially complicated skin diseases. The council discussed the feasibility of prescribing multicomponent drugs in patients with altered skin microbiome against the background of dermatoses, taking into account the risk factors for the addition of a secondary infection. The prerequisites for creating a modern algorithm for the use and the place of a three-component drug produced using micronization technology, containing betamethasone, gentamicin and clotrimazole, as part of the complex therapy of chronic inflammatory itchy skin diseases were discussed.