Among patients with psoriasis, approximately 50% are women and almost 75 % of them are under the age of 40 years. Thus, most women with psoriasis have childbearing potential. When pregnancy occurs in 22 % of patients, the activity of psoriasis persists, characteristic of the course before pregnancy, in 23 % of women, the course of the disease worsens. The article provides up-to-date data on the management of pregnant patients with psoriasis. To improve pregnancy outcomes in patients with psoriasis, it is important to prevent exacerbation of the disease. The choice of drug therapy in this case is based on an assessment of the ratio of the risk of undesirable effects of the drugs on the developing fetus and the risk of the development of exacerbation of psoriasis, which can cause an adverse pregnancy outcome. Despite the fact that the available clinical experience of using genetically engineered drugs is still limited, with a certain degree of confidence we can say that there is no increase in the risk of adverse pregnancy outcomes associated with therapy with certolizumab pegol.

Psoriasis is a chronical inflammatory disease with genetic predisposition triggered by environmental factors. Regulatory T-cells, that are considered to be an important part of immunotolerance, play a clue role in psoriasis pathogenesis. To measure the amount and functional activity of regulatory T-cells in patients with psoriasis a large number of studies are being currently conducted. The data obtained in the course of the research are rather contradictory. The data resulting from the studies are rather discrepant. This article presents already known data on the role of T_reg-cells and anti-inflammatory cytokines in the pathogenesis of psoriasis.

The article presents modern views on the pathogenesis of acne, as well as the analysis of the literature data on physiotherapy methods of treatment. Acne is the most common inflammatory chronic recurrent skin disease caused by changes in pilosebatsionnyh structures. Acne of varying severity affects 80-85 % of people in the age of 12-25 years and 11 % over the age of 25 years. This pathology has a wide range of clinical manifestations: patients have open and closed comedones, as well as inflammatory skin lesions, including papules, pustules and nodes. in modern literature, it is common to distinguish 4 main factors of acne development: pathological vulgar hyperkeratosis, increased secretion of the sebaceous glands, Propionibacterium acne activity, local inflammation. Correction of these four pathogenic factors is the aim of physiotherapeutic methods of acne treatment. Currently, the most popular are the following methods: Photodynamic therapy: this method is aimed to destruct P. Acne and sebaceous glands. The mechanism of action is based on the selective destruction of cells as a result of light - activated chemical reaction in the presence of a substance - photosensitizer. IPL (Intense Pulsed Light) therapy is a technique based on the use of a special intense pulsing light. The skin surface is exposed to incoherent pulses of visible light with a wavelength of 500-1 200 nm. it is believed that these impulses penetrate deeply into the follicle and photoactivating the porflrins of the microorganism and causing its death. Microcurrent therapy is a method of impact on the human body with the help of modulated pulse currents of low power (up to 1 mA) with minimum voltage and different frequency used for therapeutic or cosmetic effect. it is believed that the impact of low voltage currents has a positive effect on cell metabolism, increases the synthesis of adenosine triphosphate. The procedure, activates fibroblasts, improves microcirculation, normalizes the sebaceous glands and pore reduction. Also in the treatment of acne and post-acne are widely used two types of lasers: ablative type - provides a directed damage to the affected skin, including the epidermis, while laser radiation is approximately equally absorbed by all layers of the skin; non-ablative type - as a result of the radiation by this type of laser, there is a selective removal of pathological structures without damage of the epidermis. Radiation is selectively absorbed by these structures, but not by the epidermis. Reasonable combined administration of systemic and topical drugs in the combination with physiotherapeutic methods, allows to achieve a good clinical effect and improve the quality of life of patients with various forms of acne.

The article provides an overview of the use of photodynamic therapy for photodamage of the skin. The causes, pathogenesis and clinical manifestations of skin photodamage are considered. The definition, principle of action of photodynamic therapy, including the sources of light used, the classification of photosensitizers and their main characteristics are given. Analyzed studies that show the effectiveness and comparative evaluation in the selection of various light sources and photosensitizing agents for photodynamic therapy in patients with clinical manifestations of photodamage.

The article is of a review nature and contains up-to-date information on the use of genetically engineered drugs in patients with psoriasis, psoriatic arthritis in the projection of the concept of early prescription of biological therapy. The data on the feasibility of early use of genetically engineered drugs to improve the prognosis of the disease and improve the quality of life.

Over the past decades, the first breakthrough milestone in the treatment of severe forms of atopic dermatitis (AD) has been targeted therapy aimed at inhibiting IL-4 and IL-13. This was made possible thanks to advances in the understanding of the pathogenesis of AD, the driver of which is the Th2-type immune response, which also underlies such manifestations of atopy as bronchial asthma, allergic rhinitis, and polynosis. In the case of the Th2-type immune response, cytokines IL-4 and IL-13 are secreted, which are the main promoters of the inflammatory response in AD. Inhibition of IL-4 and IL-13 leads to the prevention of inflammation and is an effective approach to therapy. The use of therapy aimed at inhibition of cytokines allows you to effectively cope with the manifestations of severe and moderately severe blood pressure.

Objectives: to study communications of separate components of the metabolic syndrome (MS) and immune and oxidative characteristics of patients with psoriasis in combination with MS. Methods. The research included 312 patients with psoriasis having diagnostic signs of a metabolic syndrome. Biochemical and immunological researches were conducted by means of immunofermental and immunokhemilyuminestsentny analyses. Results. At patients with psoriasis at a combination to MS abdominal obesity, a giperleptinemiya, insulin resistance, high oxidizing potential and hyperactivity of interleukins (ILS) -1β,-6,-8, a factor of a necrosis of tumors an alpha (FNO-α), interferon scale (INF-γ) are noted. the waist circle’ is characteristic direct weak correlation with the pro-inflammatory tsitokina oxidized by lipoproteins of blood (LDL-ok) and with the general oxidizing ability of blood (OOS), weak negative correlation of an indicator - with the general antioxidant ability of blood (OAS) and superoxide dismutase (SOD). The HOMA-IR index has direct correlation link of moderate force with levels of a leptin of blood, LDL-ok, OOS, pro-inflammatory tsitokin, negative correlation of moderate force - with OAS, SOD. At patients with psoriasis with MS direct strong correlation link of level of a leptin of blood with activity of the studied pro-inflammatory cytokine, LDL-ok, OOS moderated is established with the level of insulin in the blood., the HOMA-IR index, strong negative correlation with OAS, SOD. Conclusion. Presence at patients with psoriasis of signs of a metabolic syndrome is followed by increase in activity of immune and inflammatory mechanisms, development of oxidative stress.

The article discusses issues of a differentiated approach to the treatment of genitourinary syndrome in menopause and scleroatrophic lichen of the vulva. There is a lack of awareness of doctors in approaches to the treatment of scleroatrophic lichen. The high efficacy of topical corticosteroids in the treatment of scleroatrophic lichen has been shown, the inexpediency of using it in the treatment of topical preparations of estriol has been emphasized.

A statistical analysis of the syphilis incidence in Moscow and regions from 2006 to 2017 was carried out. Despite a decrease in the general syphilis incidence an increase in incidence of such severe forms as late neurosyphilis and cardiovascular syphilis was observed. We analyzed 1,600 archive case histories of inpatients and outpatients of the Sechenov University clinics in Moscow and identified the specific lesions in heart tissues, blood vessels and the nervous system. in literal data a relatively small number of cardiosyphilis cases was described. it can be explained by the fact that earlier only gummas, that are rarely to be located in the heart and difficult to be identified clinically, were considered to be the only specific pathological and anatomical changes for syphilis of the heart.

Pyoderma is the most common disease in the practice of a dermatologist. in its development pyodermatic process takes place in consecutive stages that eventually culminate in hyperergic inflammation. The clinical manifestation of this stage is the vesicle. The purpose. To study the effectiveness of antibiotics tetracycline group of minocycline (Minolexin) with pyoderma involving severe vesicular component. Materials and methods. The efficacy of minocycline in 25 patients with different nosological forms of pyoderma was studied. Conclusions. The vesicle is a stage of hyperergic inflammation. Minocycline has not only antibacterial, but also a mild immunoregulatory effect, it contributes to the rapid cessation of the development of the vesicular component.

Clinical practice and numerous studies show that the use of medical cosmetics on the one hand helps to stop, and in some cases prevent the development of side effects of drugs, on the other hand, having a certain therapeutic activity against the main pathogenetic links of acne, improves the effectiveness of therapeutic measures. Materials and methods. Under observation there were 56 patients with mild to moderate severity (group 1), who used the derma cosmetic cream Aven Clinans Expert. Group 2 - 52 patients - in the clinical picture in which, in addition to inflammatory and retention elements, post-acne scars were noted, the Aven TriAkneal Expert emulsion regulating smoothing was used. Evaluation of the effectiveness was carried out taking into account the clinical examination methods: IGA index, DIQL index, corneometry, secumetry. Results. The number of patients with achieved IGA 0/1 effect in group 1 (n = 56) at 6 months was 80.4 % and 19.6 %, respectively, in group 2 (n = 52) at 6 months was 34, 6 % and 65.4 %, respectively. By the end of the observation period in group 1, the DIQL index decreased by 95.2 %, in group 2 - by 79.9 %. The rate of sebometry after 3 months of therapy in all groups decreased by more than 25 %. At the same time, 100 % of patients positively evaluated the tolerability of treatment and did not report any side effects. Findings. Aven Clinans Expert has antikomedogennym, sebostaticheskoe and anti-inflammatory effects, which causes high effectiveness against all clinical symptoms of acne and can be recommended as a monotherapy with a moderate degree of severity of acne (retention elements and single inflammatory). The use of emulsion Aven TriAkneal expert in patients with moderate severity of acne and atrophic scars after acne causes a high therapeutic effect due to the impact on the main pathogenetic links of the pathogenesis of not only acne, but scar cicatricial deformities. The use of Aven Clinans Expert / emulsion cream Aven TriAkneal, an expert in monotherapy, greatly improves the quality of life of patients with moderate severity of acne / acne.

The article presents the results of the use of general aerocryotherapy and narrow-band UVB phototherapy 311 nm in 70 patients with atopic dermatitis (AtD). There was a marked improvement in the dermatological status in patients of both groups after treatment (SCORAD index in the 1^st group decreased by 90 %). In the 2^nd group the reduction of the SCORAD index was 80 %, which corresponded to a significant improvement. The intensity of itching in patients who received a combined treatment decreased by 75 %. In patients receiving monotherapy with UV-311 nm phototherapy, the itching index decreased by 67 %. In the 1^st group the DLQI decreased from 24.7 ± 1.6 to 6.3 ± 0.8 after treatment, and in the 2^nd group from 25.3 ± 1.1 to 9.7 ± 0.5 points. Thus, in the group receiving combined treatment, the decrease of most indicators was significantly more pronounced, which allows us to consider it as a highly effective non-drug treatment of patients with At D.

The article presents an overview of modern methods of treatment of eyelid xanthelasm: systemic treatment, local treatment-peeling with trichloroacetic acid, cryotherapy, intraocular administration of pingiangmycin, laser removal, radiowave removal on the Surgitron device with a frequency of 4 MHz, as well as a guide to choosing the appropriate method.

Presented current data on the etiology of rosacea, the main aspects of pathogenesis, clinical forms of the disease. Reflects trigger factors leading to rosacea, as well as complicating its course. Modern methods of treatment are described, including the use of new safe preparations of ivermectin and brimonidine, providing a good, lasting effect of clinical manifestations of rosacea. The role of laser technology, actively occupying a leading place in the choice of physiotherapeutic treatment method, is noted. The need for an individual approach in the choice of therapy for each patient with rosacea is emphasized.

The creation of a fundamentally new class of medicines aimed at inhibiting IL-17A, one of the main pro-inflammatory cytokines in the development of psoriasis and psoriatic arthritis, opens up broad prospects for patients to receive effective and safe pathogenetic psoriasis therapy due to the precise anti-inflammatory target. The selective blockade of IL-17A makes it possible to block the same name of receptor binding, regardless of the route of its synthesis, unlike other groups of biologics, such as i-TNFα and i-IL12/23. After a fundamentally new selective product, secukinumab (blocker IL-17A) appeared on the Russian market, it became possible to provide patients with psoriasis with fast and effective therapy, and for patients to receive a fundamentally new quality of life within a few weeks after the start of therapy. In addition, secukinumab provide good tolerability and favorable safety for comorbidities. The article presents clinical cases patients with psoriasis and psoriatic arthritis treating by secukinumab.

Multiple primary form of melanoma is one of the variants of the clinical course of this tumor. Typically two primary lesions are diagnosed and secondary tumor differs much in terms of clinical and pathological characteristics. Besides subsequent melanomas, patients are at higher risk of developing non-melanoma skin cancer, tumors of the breast, prostate gland, kidneys and the gastrointestinal tract. The article describes the case of multiple primary skin cancer, manifested by two primary melanomas and basal cell carcinoma, and literature review on this issue.

Light technologies are widely represented in aesthetic medicine and solve a wide range of problems. To date, broadband light radiation or IPL-effect is actively studied and studies of various spectra of waves on the skin continue, which indicates the relevance of the problem. The article presents the latest trends in the use of hardware light technologies and technical solutions for the correction of aesthetic problems depending on the radiation spectrum, which allows to assign the necessary treatment differentially and solve problems depending on individual characteristics.

The article describes the mechanisms of action in laser tattoo removal. The results of the laser removal safety study were presented: the morphological picture of human skin preparations with artificial pigment in the dermis (tattoo) before and after exposure to a picosecond laser to remove the pigment was studied. It is concluded that tattoo removal using a picosecond laser is a safe procedure that allows to recommend it to patients.

We investigated the effect of combined use of superficial and deep fractional ablation on the different morphotypes of aging of the skin. A study of the condition of the skin in 32 patients, including evaluation of the results with the use of a series of pictures of 3D visualization on the device ANTERA 3D (Ireland), a photographic documentation on the unit FotoFinder (Germany) and scale-questionnaire to assess patient satisfaction with the procedure. Patients were divided into three groups according to morphotypes of involutive changes: wrinkled, deformational and mixed. After the procedure, the following dynamics was determined: according to the results of the study, the following trend was determined: with a mixed morphotype, the satisfaction of patients is higher with the correction of wrinkles and skin quality, and with a deformation morphotype, satisfaction is higher with the texture, skin color and work with pigment disorders.

Relevance. Laser technologies are widely used in various fields of medicine and are one of the most dynamically developing areas of aesthetic guineaology. In recent years, the number of patients who place high demands on aesthetics of the anogenital area has been steadily increasing. The article briefly highlights modern views on the main causes of non-tumor melanin hyperpigmentation of the genital skin, as well as examines various types of laser and light therapy and effective combinations of some treatment methods. Materials and methods. The study included 30 female patients aged from 25 to 45 years with non-tumor hyperpigmentation of the skin of the anogenital region, I-III phototype of the skin. All patients were divided into two equal groups of 15 people depending on the therapy. The patients underwent hyperpigmentation therapy with a neodymium laser (1,064 nm) with a low fluence value and an alexandrite laser (755 nm) with a low fluence value. A total of five procedures were performed at weekly intervals. The results of the study. Therapy with a neodymium laser (1,064 nm) and an alexandrite laser (755 nm) with low fluence was equally effective in the treatment of non-tumor melanin hyperpigmentation of the skin of the anogenital region and showed a high safety profile.

Any cosmetic procedure, which is accompanied by damage to the skin barrier, carries the risk of attaching not only bacterial, but also fungal or viral infections. According to a number of authors, most often these complications occur after intradermal injections, mesotherapy, ablative laser procedures, tattooing, and account for about 5 % of the total number of manipulations. Objective: to evaluate the effectiveness and safety of using Tetraderm® cream in patients with infectious and inflammatory complications after various cosmetic procedures. Material and methods. The study included 28 patients (24 women and 4 men) aged from 18 to 65 years with infectious and inflammatory complications (excluding herpes infection) after various procedures performed according to indications: involutive skin changes, acne, rosacea, hyperpigmentation, scarring of the skin All patients received Tetraderm cream 2 times a day - 7 days. Performance evaluation was carried out taking into account the index DISHC, VAS, DIQoL. Results. The DISHC index decreased by 83.5 %, from 12.7 ± 1.3 points to 2.1 ± 0.3 points (p <0.01), the DIQoL decreased by 64.8 %, from 12.2 ± 1.3 points to 4.3 ± 1.7 points (p <0.01). VAS (erythema) decreased by 82.9 %, VAS (edema) decreased by 93.3 %, VAS (pustules) - by 100 %, VAS (papules) - by 94.1 %. Findings. The use of Tetraderm® cream in the development of infectious complications of cosmetic procedures causes high efficacy both in relation to clinical symptoms and in relation to the quality of life of patients. According to the patients themselves, Tetraderm^® cream is highly effective, tolerable and comfortable to use.

During Chronic Kidney Disease (CKD) development and progression emphasis is placed on structural-functional state of red blood cells. The aim of this paper is to examine red blood values and red blood cells morphological type in peripheral blood among children with CKD. 75 children with CKD aged 5-16 years were examined. The control group consisted of 25 healthy children of the same age range. Analysis of the morphometric parameters of red peripheral blood cells - mean volume (MCV) and erythrocyte diameter, mean content (MCH) and mean hemoglobin concentration in the erythrocyte (MCHC), were performed using a Gobas Micros (Roche) hematology counter. Smears were marked according to Romanovsky-Giemsa. Morphometric studies of red blood cells were carried out using the Morphology 5.2 program and red blood cell confocal microscopy on a LSM-710 Confocal Microscope, manufactured by Carl Zeiss. The tendency to poikilocytosis in CKD was confirmed. We identified that among children with CKD the distribution of red blood cells in diameter is disturbed, the content of microcytes increases, poikilocytosis is observed with an increase in the content of irreversibly transformed elements. The revealed features may serve as an additional criterion for the diagnosis of chronic kidney insufficiency at the early stage.