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Introduction and purpose: Alopecia Areata (AA) is an inflammatory autoimmune disorder characterized by non-scarring hair loss. While it is not life-threatening, it can lead to significant psychological distress. With advancements in modern medicine, new treatments, personalized therapies, and various therapeutic options have emerged. The aim of this study is to review and assess the efficacy, outcomes, and side effects of the available treatment options. Material and methods : To compile this article “PUBMED” and “Google Scholar” databases were used with the great attention given to the articles not older than the year 2018 Brief description of the state of knowledge: There are various treatment options for Alopecia Areata (AA), beginning with topical treatments such as corticosteroids, prostaglandin analogs, minoxidil, and contact immunotherapy. In more severe cases, systemic therapy, biological therapy, or alternative treatments should be considered. Results and conclusions: In the treatment of mild Alopecia Areata (AA), topical therapies are the preferred option due to their minimal side effects and easy to apply nature, with corticosteroids demonstrating the best outcomes, particularly when used in combination therapies. In patients with moderate or severe AA, systemic therapies are recommended, alone or in combination with topical treatment. In patients resistant to other forms of therapy, biological treatments or less commonly used methods should be considered.

Background. Acne is a common, complex and multifactorial inflammatory disease that results from a variety of causes. Acne therapy is an urgent problem of dermatocosmetology. The clinical manifestations of dermatosis can be alleviated, and its long-term consequences can be prevented by early diagnosis and timely initiation of treatment, affecting multifaceted all parts of the pathogenesis. Aims. To evaluate the clinical efficacy and safety of the use of monotherapy of 0.1% adapalene cream (Adaclean) with combined external therapy of 0.1% adapalene cream (Adaclean) with 20% azelaic acid cream (Azix-Derm) in the treatment of mild to moderate acne. Methods. Under our supervision at the Department of Plastic Reconstructive Surgery, Cosmetology and Regenerative Medicine of the State Budgetary Educational Institution of Higher Professional Education Rost of the State Medical University of the Ministry of Health of Russia, the clinics “Ekaterininskaya” and “MIR-O-MED” there were 50 patients aged 12 to 50 years (18 (36%) men and 32 (64%) women) with mild and moderate acne. Patients with comedonal acne, in the absence of multiple inflammatory elements, which made up group 1 of observation (n = 16), were prescribed Adaclean cream, 1 time per day (evening) against the background of skin care. In the group with mild to moderate papulo-pustular acne and post-inflammatory changes (group 2, n = 34), patients were prescribed a combination of 0.1% adapalene cream and 20% azelaic acid cream (Adaclean (evening) and Azix-Derm (morning)). The follow-up period was 6 months. Results. Total clinical remission after 6 months therapy was achieved in 70% of cases, a significant improvement — in 28%, improvement — in 2%. In patients with a comedonal form of acne against the background of monotherapy with Adaclean cream, clinical recovery was obtained in 44% of patients, a significant improvement — in 50%, and an improvement — in 6%. In patients from the group of papulo-pustular acne of mild to moderate severity, after 3 months the use of complex therapy Adaclean and Azix-Derm noted almost complete relief of the inflammatory process; after 6 months therapy clinical recovery was recorded in 58%, significant improvement — in 36%; 6% showed partial improvement, which is associated with irregular use of drugs and skin care products. After 6 months combined treatment was able to achieve regression of dyschromia in 18–46% of patients, atrophic scars — in 5–22%, which significantly improved the results of therapy and made it possible to achieve a good cosmetic effect. Conclusion. The combined use of drugs for external use of adapalene (Adaclean) and AK (Azix-Derm) in the treatment of papulo-pustular acne of mild and AK (Azix-Derm) in the treatment of papulo-pustular acne of mild and moderate severity can significantly increase the effectiveness of treatment, achieve a stable clinical effect and remission of the disease, as well as improve the quality of life of patients.

Epidermolysis bullosa is a group of rare hereditary skin diseases based on mutations in the genes of structural proteins of the epidermis and the dermal-epidermal junction. Clinically, epidermolysis bullosa is characterized by the appearance of erosions and blisters on the skin and mucous membranes in response to any minor impact. Currently, the treatment of epidermolysis bullosa is only symptomatic. Pathogenetic methods of the epidermolysis bullosa therapy are under development. One of the new possible pathogenetic directions in the treatment of epidermolysis bullosa is aminoglycoside antibiotics (gentamicin, geneticin, paromomycin). A number of studies have shown the ability of gentamicin to promote readthrough terminating codon and resume the synthesis of type VII collagen in keratinocytes and fibroblasts in patients with epidermolysis bullosa with nonsense mutations in the COL7A1. The review presented the possibilities of gentamicin therapy for patients with epidermolysis bullosa, describes the mechanism of its action, summarizes data from clinical trials.

Psoriasis is a frequently occurring inflammatory skin disease. Fundamental research into the pathogenesis of psoriasis has significantly expanded our understanding of skin immunology, which has enabled the introduction of innovative and highly effective therapies. Psoriasis is a largely T-lymphocyte-mediated disease in which activation of innate immune cells and pathogenic T cells leads to inflammation and hyperproliferation of keratinocytes. Langerhans cells like dendritic cells (DCs), which play an important role in the immune system, are mainly distributed in the epidermis. Since human and mouse skin DC subpopulations share common ontogenetic characteristics, we can further investigate the role of DCs in psoriatic inflammation in mice. γδT cells are an unconventional population of T-lymphocytes that play an indispensable role in host defense, immune surveillance, and immune system homeostasis. Although γδT cells constitute only a small fraction of the total T cell pool, emerging evidence suggests that aberrantly activated γδT cells may play a role in the pathogenesis of psoriasis. Dermal γδT cells are the major IL-17-producing cells in the skin that respond to IL-23 stimulation. In addition, γδT cells have characteristics of memory cells that mediate repeated episodes of psoriatic inflammation. This review discusses the mechanisms by which Langerhans cells and γδT cells participate in the pathogenesis of psoriasis.

The last decade has seen significant progress in computer-aided image analysis and recognition, with modern computer-aided diagnostic algorithms not only catching up with, but in many aspects surpassing human abilities. At the heart of this breakthrough is the development of deep convolutional neural networks, which have given a new impetus to medical diagnosis, particularly of skin cancers. In this paper, we analyzed photo-based skin disease classification systems developed using algorithms based on deep learning convolutional neural networks. Such methods have been variously reported to enable automated diagnosis of skin neoplasms with high sensitivity and specificity. A disease that requires more detailed analysis of graphic images — skin melanoma — was chosen as the main object of study. Early diagnosis of melanoma is of great socio-economic importance, as in this case the prognosis of patients is significantly improved. The aim of this work is to analyze the results of artificial intelligence (AI) applications in dermatology, especially in the context of early detection of skin melanoma. Scientific articles were searched in PubMed, Scopus and eLIBRARY databases using the keywords “convolutional neural networks”, “skin cancer” and “artificial intelligence”. The depth of the search was 10 years. The final analysis included 38 sources where the results of our own research were presented. The advantages of artificial intelligence methods for dermatologists were analyzed. Artificial intelligence can significantly assist dermatologists in developing visual neoplasm diagnosis skills and improve diagnostic accuracy. The use of AI to process dermatoscopic data in conjunction with the analysis of anamnestic and clinical information from medical records will reduce the burden on the healthcare system through correctly diagnosed benign skin tumors. All of this promises to have a significant impact on the future development of dermatovenerology.

Background. Acne is one of the most common dermatoses, affecting more than 9% of the world’s population. Acne negatively affects the patient’s quality of life and self-esteem, often leading to the development of anxiety and depression. The combination of pharmacological drugs with different mechanisms of action in one external dosage form can provide higher therapeutic efficacy. Aims. To evaluate the effectiveness and tolerability of a combination drug with a fixed dose of clindamycin 1% and benzoyl peroxide 5% in the treatment of patients with mild to moderate papulopustular acne. Methods. A single-center, open-label, observational, prospective study lasting 6 weeks was performed, which included 40 patients with mild to moderate papulopustular acne who received a gel with a fixed dose of clindamycin 1% and benzoyl peroxide 5% once a day. A clinical assessment of the effectiveness of therapy was carried out, PH, greasiness and moisture of the facial skin were measured, and the dynamics of the dermatological quality of life index was studied. Results. The proportion of patients who showed significant improvement at the end of 6 weeks of treatment was 32/40 (80%). The total proportion of patients who showed significant and moderate improvement at the end of therapy reached 36/40 (90%). Conclusion. The results obtained showed the high therapeutic effectiveness of the gel with a fixed dose of clindamycin 1% and benzoyl peroxide 5% in the treatment of mild to moderate papulopustular acne.

Sexually transmitted infections (STIs) are socially significant diseases and require close attention due to the multifactorial causes that influence their spread. In 2012–2022, the Russian Federation maintained a downward trend in the incidence of STIs (from 267.6 to 91.3 cases per 100 thousand population), established since 1998 in all age groups. In 2022, compared to 2012, the incidence rates decreased: syphilis — by 42.7%; gonococcal infection — by 77.7%; trichomoniasis — by 75.8%; chlamydial infections — by 72.1%; anogenital herpetic infection — by 51.2%; anogenital (venereal) warts — by 36.5%. But at the same time, in 2021 and 2022, there was an increase in the incidence of syphilis and gonococcal infection: compared to 2019, the increase in the incidence of syphilis was 25.9%, and that of gonococcal infection — 5.2%. The increase in the incidence of syphilis was largely due to an increase in this indicator in the Central (from 18.1 to 37.3 cases per 100 thousand population) and Northwestern (from 14.5 to 16.2 cases per 100 thousand population) federal districts ( FO). An increase in the incidence of gonococcal infection in 2022 compared to 2019 was observed in the Central (+26.3%), Northwestern (+31.2%) and Ural (+27.6%) Federal Districts.

Background. Сurrently, much attention is paid to the quality of patients, which is a promising direction of life, allowing to put a complete and objective picture of the disease, determine the most stable method of treatment, and evaluate its results. Aims. To evaluate the effectiveness of complex therapy in patients with onychomycosis and mycosis of the feet with concomitant non-alcoholic severe liver disease (NAFLD) using a modified questionnaire-questionnaire of the combined index of quality of life (QL-Index). Methods. The combined index of quality of life (QL-Index) was determined in patients with onychomycosis and mycosis of the feet with with concomitant NAFLD before and after complex therapy. Results. Analysis of the results of assessing the presence of a combined index of quality of life in 117 patients with onychomycosis and foot mycosis with concomitant NAFLD before treatment showed that the presence of onychomycosis and mycosis of the feet in the majority of respondents has a strong impact on the lives of the respondents (69.2%). After the complex treatment, according to the results of the combined questionnaire-questionnaire of the quality of life index, it was revealed that social activity in patients with onychomycosis and foot mycosis with concomitant NAFLD increased, and the psycho-emotional state improved. The quality of life of patients has improved, which significantly increased the effectiveness of this complex treatment. Conclusion. The high efficacy and safety of complex therapy, which included the use of the systemic antimycotic itraconazole in combination with external antifungal drugs, a hepatoprotector and a prebiotic in patients with onychomycosis and mycosis of the feet with concomitant NAFLD.

Chromomycosis is a slowly occurring mycosis of subcutaneous adipose tissue and skin. Most often, cases of the disease are recorded in countries with a tropical and subtropical climate. In the Russian Federation, the disease occurs sporadically. Very rarely (2 cases out of 100) malignant transformation into squamous cell carcinoma occurs. The article presents a clinical case of chromomycosis. A description is given of a patient in whom squamous cell carcinoma was detected at the onset of the disease, which was the reason for treatment by oncologists. Six months later, the patient had a relapse in the area of the postoperative scar and a focus in the area of the right hand. Repeated biopsy with histological examination made it possible to establish the correct diagnosis. Interest in the above clinical case was caused by the detection of chromomycosis in a resident of the city of Saint Petersburg, who was not in endemic areas, was not engaged in agricultural work, and denied the primary injury. Our patient experienced a rapid malignancy of the focus, after surgical treatment, a recurrence of deep mycosis occurred. A good effect was obtained from systemic antimycotic therapy.

The functional role of sweating is not limited only to thermoregulation and excretion. There are other functions of it — the ability to enhance and maintain hydration and barrier function of the skin. Excessive sweating can lead to an exacerbation or cause many skin diseases, form psychological discomfort in a person due to wet clothes or an accompanying unpleasant odor. Primary hyperhidrosis may be an autosomal dominant genetic disease. Secondary, usually generalized hyperhidrosis is often associated with drug effects on the body or a systemic disease. The following approaches are used in the treatment of hyperhidrosis: 1) blocking the release of sweat to the skin surface (aluminum salts and formaldehyde); 2) physiotherapy (iontophoresis); 3) destruction of sweat glands and cessation of sweat production (excision of a skin flap with subcutaneous fat, curettage, microwave technology, etc.); 4) termination of the signal from the central nervous system to the sweat glands (transthoracic endoscopic sympathectomy, percutaneous radiofrequency sympathectomy, botulinum toxin injections, systemic anticholinergic drugs). External remedies for excessive sweating include the Russian drug Formagel®, containing 3.7% formaldehyde. This drug is a non-invasive, easily doable, effective, safe method of treating hyperhidrosis.

Clinical observations of three patients aged 26, 43 and 37 years with severe psoriasis and psoriatic arthritis are presented. Clinical examples show the experience of effective treatment of patients with psoriasis and psoriatic arthritis using anti-cytokine therapy with an interleukin-17 inhibitor, initiated when the disease progresses. The clinical picture of the presented observations was characterized by an aggressive course of the skin and articular process, torpidity to basic therapy, despite the young age of the patients. It has been shown that the early termination of the progression of the inflammatory process in psoriasis with the use of genetically engineered biological therapy with secukinumab leads to a decrease in symptoms, both on the part of the skin and manifestations of the disease on the part of the musculoskeletal system. The high efficacy and safety of the drug allow complete control of the disease and improve the quality of life in patients suffering from severe forms of dermatosis.

Introduction and purpose In recent years, there has been notable progress in the role of light-emitting technologies, including lasers and other energy-based devices, across various medical disciplines. Dermatology stands out as one of the prominent fields where laser treatments have gained significant popularity. In the clinical setting, a variety of laser types are utilized. A fundamental aspect of ensuring the safe use of laser devices involves comprehending their mechanisms at the tissue level. This knowledge enables practitioners to attain the desired outcomes effectively while minimizing the risk of complications. Lasers have demonstrated effectiveness in treating cutaneous vascular conditions because of their capacity to selectively target intravascular oxyhemoglobin. Rosacea, juvenile hemangioma, and port wine stains are among the vascular skin conditions for which laser therapy has shown notable success. Laser therapy is employed in treating hypertrophic scars, keloids, and acne scars because it facilitates the restructuring of the skin's architecture at the scar site, with the goal of minimizing its size and visibility. Laser therapy stands as the gold standard for removing tattoos. Materials and methods The methodology for conducting literature search involved utilizing medical subject headings terms to explore PubMed. Search terms included: “lasers”, “intense pulsed light”, “dermatology”, “rosacea”, “acne”, “scars”, “tattoo removal”. Conclusions Laser dermatological treatments are gaining popularity worldwide, driving new innovations and clinical applications. This review highlights the significant role and diverse clinical applications of lasers and intense pulsed light in dermatological practice. Improving the quality of skin in patients suffering from skin diseases can significantly increase their quality of life.

Atopic dermatitis (AD) is a chronic allergic skin disease, the most common of dermatoses during pregnancy. Exacerbation of AD can be at any stage of pregnancy, its main causes are an increase in progesterone levels, the predominance of Th2 cytokines, psychoemotional stress, violations of the gastrointestinal tract. Changes occur in the clinical picture, the lesions on the face and extensor surfaces of the extremities, papules. Treatment options for pregnant women are limited due to the unethical nature of clinical trials. It is safe to use topical glucocorticosteroids, moisturizers, narrow-band UVB 311 nm, calcineurin inhibitors are relatively safe. In systemic therapy in severe cases, the use of cyclosporine or a short course of prednisone is recommended. There is no evidence of the safety of selective immunosuppressants.

Rosacea is a chronic inflammatory dermatosis predominantly damage to the skin of the face, which has a significant negative impact on the quality patients’ lives. The main goal of treatment is to achieve the most complete remission. However, due to the fact that the pathogenesis of the disease is not fully understood, the search for new methods of treatment is especially relevant. Combined use pulsed dye laser and ivermectin drug is presented as alternative pathogenetically substantiated method of therapy. The purpose of the study is to characterize immune disorders and the role of cytokines in the pathogenesis of rosacea, as well as the possibilities of combination therapy based on literature data. An analysis of literature sources from the MedLine, Pubmed, eLibrary databases for the period from 2002 to 2022 was carried out, using the keywords “ivermectin”, “pulsed dye laser”, “rosacea”, “cytokines”, “ivermectin” , “Pulsed Dye Laser”, “rosacea”, “cytokines”.

Background. Urogenital chlamydia infections is a widespread STI, 131 million people are infected every year. Despite the absence of a reliable correlation with respect to antimicrobial resistance of chlamydia strains to tetracyclines, macrolides and fluoroquinolones in vitro and in vivo, scientists are studying the issue of reducing the sensitivity of the pathogen to traditionally used drugs and are investigating the effectiveness of antibacterial drugs active against Chlamydia trachomatis. One of the drugs with high anti-chlamydia activity is minocycline. Aims. To study the efficacy and safety of the minocycline (Minolexin®) in the treatment of urogenital chlamydia infection in comparison with the doxycycline (Unidox Solutab®). Methods. An open randomized comparative clinical trial included 100 patients: group 1 — 50 patients who received minocycline 100 mg 2 times a day for 7 days, group 2 — 50 patients who received doxycycline 100 mg 2 times a day in within 7 days. The diagnosis was confirmed by the detection of C. trachomatis by PCR. The parameter of the effectiveness of therapy was the eradication of C. trachomatis and the absence of clinical symptoms 4 weeks after therapy. Results. 1 week after therapy, clinical symptoms were registered in 20; 40.8% patients of group 1 and 28 (57.1%) patients of group 2 (p = 0.106), 4 weeks later — in 4; 8.2% patients of group 1 and 7 (18.4%) patients of group 2 (p = 0.524). In group 1, the absence of most subjective clinical symptoms was recorded in a shorter time than in the comparison group. 100% of patients had achieved eradication C. trachomatis, laboratory signs of an inflammatory reaction were recorded in 2 (5.0%) patients of group 1 and 3 (7.3%) patients of group 2 (p = 1,000). According to the frequency of adverse drug events, there were also no significant differences between the compared groups, however, in group 2 patients, adverse drug events that had a high probability of being associated with taking the drug were recorded more often than in the group of patients receiving minocycline. Conclusions. The results of the study demonstrated the comparable effectiveness of minocycline and doxycycline in the treatment of urogenital chlamydia infection and a similar safety profile of these drugs.

Background. Simultaneous (combined, simultaneous) operations are operations in which up to five different surgical procedures are performed simultaneously during one surgical intervention. According to WHO statistics, about a third of all surgical patients need simultaneous operations. A feature of medical interventions in dermatovenereology and cosmetology is the unwillingness and unwillingness of the patient to experience tangible pain discomfort during the procedures. The arsenal of modern cosmetology is constantly replenished with technologies that not only provide convincing clinical effects, but are also capable of provoking a negative psycho-emotional state in a patient who undergoes certain painful manipulations. Aims. To reflect the experience of a private medical organization, which is one of the first in the country to actively introduce simultaneous surgery in dermatology for several years. Materials and methods. Clinical observation, examination results. Results. In 2022, 32 surgical interventions were performed simultaneously with a dermatovenereologist in this clinic. Also, the clinic regularly performs simultaneous operations in the following combinations: hysteroscopy (with or without curettage) + removal of benign melanocytic/non-melanocytic skin tumors; surgical treatment of hemorrhoids + removal of papillomas/nevi; surgical treatment of anal fissure + removal of papillomas/nevi; laser vaporization of the pilonidal sinus + removal of genital warts; laparoscopic cholecystectomy + removal of nevi. Conclusion. The use of simultaneous operations in dermatovenerological practice is economically justified and justified, taking into account the modern possibilities of anesthetic care, improving their technical and medical support. Simultaneous combined operations exclude psycho-emotional experiences of the forthcoming repeated surgical intervention in patients and allow the surgeon to conduct high-quality medical interventions in a comfortable environment.

A clinical case of leprosy diagnosis in a citizen of the Republic of Chad (lepra-endemic region), а 24 year old male, student is presented. In 2019 the patient received permission to stay in the Russian Federation for educational purposes, entered one of the federal universities, and studied in Moscow, living in a hostel. During these years, he applied to various clinics, complaining of skin rashes and other symptoms characteristic of leprosy, without the effect of the prescribed treatment. In 2023, after contacting the clinic of skin diseases of the I.M. Sechenov First Moscow State Medical University (Sechenov University), was first sent to the The Federal State Research Center of Dermatovenereology and Cosmetology of the Ministry of Health of Russia with suspicion of leprosy. The results of clinical and laboratory studies including bacterioscopic examination of skin scarifications and pathohistological study of the skin confirmed the diagnosis: A30.5 Leprosy, multibacterial form, lepromatous type, active stage. This case presentation testifies to the lack of alertness regarding leprosy, especially among doctors conducting medical examinations of foreign citizens in order to obtain permission to stay in the Russian Federation, which may cause the spread of dangerous infectious diseases on the territory of the Russian Federation.

Background. Efficacy the narrow-band UVB phototherapy in patients with atopic dermatitis varies greatly. An important condition for achieving optimal therapeutic effect is the identification of factors that can impact on the efficacy of therapy and considering their influence when prescribing treatment. Aims. The present study aimed to identify the factors which affect the efficacy of narrow-band phototherapy in patients with atopic dermatitis Methods. A prospective, open-label trial was conducted to evaluate the efficacy and safety of narrow-band UVB phototherapy for patients with moderate-to-severe atopic dermatitis. All patients were treated with narrow-band UVB phototherapy four times weekly for 5 weeks. Disease severity was evaluated by SCORing of the Atopic Dermatitis Index (SCORAD) and Eczema Area and Severity Index (EASI). Distribution of patients by the severity of therapeutic effect was evaluated. To compare the efficacy of therapy depending on initial atopic dermatitis severity, initial and cumulative irradiation doses, skin phototype, and smoking status patients were divided into subgroups. Results. 40 patients with moderate-to-severe atopic dermatitis received course of narrow-band UVB phototherapy. After NB-UVB therapy SCORAD and EASI scores reduced from 45.6 ± 11.4 at baseline to 22.6 ± 12.4 (p 0,05) and from 14.4 ± 7.2 at baseline to 4.1 ± 3.9 (p 0,05) respectively demonstrating the efficacy of narrow-band UVB phototherapy in patients with atopic dermatitis. Our investigation showed that tobacco smokers had definitely lower efficacy of NB-UVB phototherapy in comparison with non-smokers. Narrow-band UVB phototherapy had definitely higher efficacy when it is started with an initial dose 0.2–0.3 J/cm2 chosen in compliance with results of MED determing in comparison with an initial dose 0.05–0.15 J/cm2 selected according to skin phototype. Conclusions. Factors that impact on the efficacy of narrow-band UVB phototherapy in patients with atopic dermatitis were identified. It was determined that using higher initial dose is associated with higher efficacy of therapy. The obtained data suggest the opportunity of decrease in efficacy of therapy in smokers with atopic dermatitis.

Background. Basal cell carcinoma is the most widespread malignant skin neoplasm. Angiogenesis is critical for the growth and metastasis of malignant tumors. Aims. To study the levels of representation of transcripts in the foci of basal cell skin cancer before and after the therapy of genes for angiogenesis proteins and their receptors: angiopoietin 2 ANGPT2, calcitonin-related polypeptide alpha CALCA, epidermal growth factor receptor EGRF, fibroblast growth factor FGF2, intracellular adhesion molecule ICAM1, vascular endothelial growth factor VEGFA and its type 2 receptor VEGFR2, matrix metalloproteinase MMP9, homologue protein of phosphatase and tensin PTEN, tachykinin receptor TAC1, and tumor necrosis factor protein genes TNF. Methods. The study included 31 patients with histologically confirmed basal cell skin cancer who received treatment at the consultative and diagnostic center of the State Research Center of Dermatovenereology and Cosmetology of Russian Ministry of Health, Moscow in the period from 2020 to 2021, using a pulsed dye laser (wavelength — 585 nm) and long-pulsed neodymium laser (wavelength — 1064 nm). The patients provided skin punch biopsies from BCC lesions and after therapy from the same localization. The gene expression was analyzed with real-time reverse transcription PCR using endogeneous control, and the gene expression ration changes during the therapy were calculated according to Livak’s double delta formulae. Results. An increased expression of the matrix metalloproteinase MMP9 and the tachykinin precursor TAC1 genes were revealed in skin biopsy samples of the superficial form of basal cell skin cancer during laser pulsed therapy. The expression of tumor necrosis factor TNF, epidermal growth factor receptor EGFR, fibroblast growth factor FGF2 genes increases to a lesser extent. The increasing expression of MMP9 and TAC1 genes also established in skin biopsy samples of the nodular form of basal cell skin cancer. It was shown that the expression of the calcitonin-related polypeptide alpha CALCA gene in the skin of patients is at basal level, which makes it possible to exclude the influence of the neuropeptide on the basal cell skin cancer pathogenesis. Despite the bidirectional changes in expression due to individuality of patients, the average values allow to conclude the expression of all the studied genes is increased after pulse laser destruction therapy. This means neoangiogenesis is continued at the skin even after the destruction of basal cell skin cancer lesions. This could be due to the presence of the basal cell carcinoma microenvironment, likely mast cells, at the affected skin area. Conclusions. Among the factors of neoangiogenesis potentially influencing the development of basal cell skin cancer, the leading role of expression of the MMP9 matrix metalloproteinase and TAC1 precursor protein of tachykinin has been shown. Simultaneous changes in the level of these proteins may be due to neuroimmune interactions in the epidermis, which is probably realized by mast cells as the microenvironment of the basal cell carcinoma. In the process of laser destruction, there is also a slightly pronounced increased expression of additional factors of neoangiogenesis.

Background. Psoriatic arthritis is a chronic inflammatory disease of the joints, spine and entheses that can occur in patients with psoriasis. The prevalence of psoriatic arthritis is 19.7%. In 70% of cases, psoriasis precedes the development of arthritis. It has been proven that a delay in the diagnosis of psoriatic arthritis even by 6 months is associated with a deterioration in long-term radiological and functional results, leading to disability. The problem of early diagnosis of joint damage can be solved by identifying predictors of the risk of developing psoriatic arthritis in patients with psoriasis. Aims. To determine possible predictors for the development of psoriatic arthritis in patients with psoriasis. Methods. The open, uncontrolled, prospective study enrolled 250 patients. The main group consisted of 190 patients diagnosed with plaque psoriasis. The control group consisted of 60 patients with psoriatic arthritis. In order to identify associations of clinical and genetic (HLA-B27 carriage) parameters with the development of psoriatic arthritis, we compared the frequency of occurrence of these parameters in patients with psoriatic arthritis and without. Results. Among 190 patients with plaque psoriasis 128 (67.4%) men, 62 (32.6%) women, aged 18 to 84 years (40.30 ± 15.56), the average duration of psoriasis was 10.09 ± 11.08 years (0–57). Among 60 patients with psoriatic arthritis 39 (65%) men, 21 (35%) women aged 18 to 86 years (44.43 ± 14.15), the average duration of psoriasis was 20.47 ± 13.22 years (2–57), the average duration of psoriatic arthritis was 7.97 ± 9.95 years (0–47). Сlinical predictors for the development of psoriatic arthritis in patients with psoriasis: nail psoriasis (OR = 2.244 [95% CI: 1.245–4.045]); severe psoriasis (PASI ≥ 20) (OR = 2.148 [95% CI: 1.161–3.975]); arterial hypertension (OR = 1.982 [95% CI: 1.031–3.812]); duration of psoriasis over 25 years (OR = 3.365 [95% CI: 1.676–6.756]), р 0,05. Conclusions. The joint consideration of informative predictors will allow us to develop an original multi-parameter mathematical model for calculating the risk of developing psoriatic arthritis in patients with psoriasis.

The article provides modern definitions and classification of urticaria. The general provisions of the treatment of chronic urticaria, the treatment of which is often very difficult, are outlined. The main provisions of the treatment of urticaria were formulated, according to which the patient should be treated until the rash is completely resolved. In chronic urticaria, it is necessary to identify and eliminate the causes of dermatosis; avoid exposure to identified triggers; increase tolerance; pharmacological treatment should be aimed at preventing the release of mast cell mediators and/or the effects of mast cell mediators. The goal of treatment should be to relieve the symptoms of urticaria as completely as possible, taking into account the safety and quality of life of the patient in each individual case. The importance of identifying and addressing underlying causes and avoiding identified triggers is emphasized. The therapy algorithm is considered in detail, including 4 lines according to the European guidelines and domestic clinical guidelines. Particular attention is paid to the treatment of various subtypes of chronic urticaria. A comparative description of the most effective antihistamines is given.

The article presents the description of three clinical cases of the successful treatment of toe onychomycosis and athlete’s foot of various etiologies using 5% amorolfine antifungal nail lacquer. The first case: a 31-year-old woman was diagnosed with white superficial onychomycosis of great toe caused by Trichophyton rubrum. The treatment with 5% amorolfine once a week for 6 months resulted in full recovery (both mycological and clinical). The second case: a 42-year-old woman developed onychomycosis after the application of decorative coating on her nails; onychomycosis was caused by Scopulariopsis brevicaulis. She was treated with itraconazole pulse therapy and 5% amorolfine lacquer. She fully recovered. The third case: a 65-year-old man with total onychomycosis of 10 toes developed the skin mycosis of the left foot and lower third of the leg. He was prescribed a therapy with sertaconazole cream and 5% amorolfine lacquer. The use of 5% amorolfine lacquer was continued to prevent from recurrent dermatomycosis. Thus, the above mentioned cases are a good example of the advantages of using 5% amorolfine lacquer in the treatment of most toe onychomycosis types caused by any pathogens (dermatophytes, yeasts or molds).

Rationale. Data from randomized clinical trials (RCTs) may differ from the results of the efficacy and safety of medicines in the conditions of daily work. Purpose. To obtain data on the long-term efficacy and safety of the use of the genetically engineered biological drug netakimab in real clinical practice. Methods. In everyday clinical practice, a multicenter non-interventional observational study BCD-085-NIS-01 (ORION) was conducted, which involved 260 adult patients with moderate to severe psoriasis. Results. It was established that the survival rate of genetically engineered biological therapy of netakimab, when analyzing data of 104 weeks of observation, remains high both in bionaive patients and in persons who have previously received treatment for this dermatosis using monoclonal antibodies. The long-term safety profile of netakimab in real clinical practice is comparable to data previously obtained in RCTs and remains favorable for follow-ups up to 2 years. Conclusion. Therapy with GIBA netakimab using a standard dose of 120 mg and regimen in patients with psoriasis is effective and safe for 104 weeks.

Background. The use of phototherapy for the treatment of dermatoses and lymphoproliferative disease is determined by the Procedure for rendering assistance in the field of "dermatovenereology" and clinical guidelines approved by the Scientific and Practical Council of the Ministry of Health of Russia. Foreign-made medical equipment for phototherapy occupies a key position in Russia, the equipment of medical organizations with it is more than 75%. However, in the current reality, foreign companies not only raise prices for the export of medical equipment, but also stop its supply and service in Russia, which may adversely affect the quality of medical care. Aims. To assess the current state of the technical support of medical organizations of the dermatovenereological profile with equipment for phototherapy of dermatoses. Materials and methods. Information about the availability of equipment for phototherapy of dermatosis and/or the need to purchase it, the intensity of use of the available equipment for various nosologies, as well as problems related to its service, obtained from 64 medical organizations of the dermatovenerological profile in 62 constituent entities of the Russian Federation. The initial data collected as a result of the survey were structured, unified and brought to a general form using the functionality of the Microsoft Excel program. Further processing of information was carried out using descriptive statistics methods. Results. 8 (12%) specialized medical organizations are currently not equipped with phototherapy equipment. In 56 medical organizations using phototherapy equipment, the share of foreign-made medical equipment is 84%. Of the 22 models of medical equipment, only 12 (54%) are included in the State Register of Medical Devices and have a valid registration certificate. 192 (75%) pieces of equipment of medical organizations are intended for local phototherapy in the medium-wave (UVB) or long-wave (UFA) ultraviolet radiation mode, and only 63 (25%) units are represented by ultraviolet cabins (57 UVA (PUVA) and UVB-311 cabins). and 6 UVA (PUVA) and UVB (SFT) booths). Out of 57 UV cabins, only 18 (32%) are simultaneously equipped with UVA and UVB-311 radiation sources. Half of the medical organizations of the dermatovenereological profile (50%) experience difficulties with servicing the installed devices, 43 (67%) medical organizations reported the need for equipment for phototherapy of dermatosis. Conclusions. Due to the instability of logistics and sanctions for the supply of medical equipment to the country, the development and registration of a medical device for phototherapy of dermatosis and T-cell lymphomas of the skin, and its further production in Russia, is relevant.

Dystrophic epidermolysis bullosa is caused by mutations in the COL7A1 gene. The disease characterized by clinical heterogeneity. To date, scientific findings allow to evaluate correlations between the severity of clinical manifestations and genetic defects underlying in the development of the disease. A systematic literature search was performed using PubMed and RSCI, and keywords including dystrophic epidermolysis bullosa, collagen VII, COL7A1. The review includes description of clinical findings of dystrophic epidermolysis bullosa. The types and localization of pathogenic mutations of the COL7A1 gene, their influence on the protein synthesis, structure and functioning are characterized. The correlation between severe course of dystrophic epidermolysis bullosa and mutations resulting in premature termination codons generation which associate with the absence of type VII collagen at the dermo-epidermal junction has been described. Nevertheless, genotype-phenotype correlations should be analyzed carefully due to mechanisms which enable to restore protein expression as well as the possibility of the formation of premature termination codons associated with a more severe course of the disease, when replacing nucleotides in case of their influence on splicing.

Granuloma annulare (GA) is a chronic inflammatory necrobiotic granulomatous skin disease, which is based on a delayed hypersensitivity reaction caused by the production of interferon- (IFN-) by tissue macrophages and th1-limocytes, tumor necrosis factor- (TNF-) and matrix metalloproteinases (MMP), which leads to the degradation of connective tissue. The most frequent form of GA if localized which is characterized clinically by grouped papules and plaques of red or pink color on the extremities. although disseminated variants of disease occur in 15% of all cases of ag. in contrast to the practically asymptomatic course of the localized form, typical signs of disseminated form are intensive sense of itching, the presence of at least ten foci of skin lesions, recurrent and resistance to treatment course. A 53-year-old female patient with a long-term recurrent course of annular granuloma after a weak clinical response to therapy with pentoxifilin, methotrexate and azathioprine turned to the dermatology department of the university hospital. In light of the lack of satisfactory treatment options anti-cytokine therapy with adalimumab was recommended at a daily dosage of 80 mg, once a week, for 2 weeks, then 1 time every two weeks for 1.5 months. Already on the 5th day after receiving the first injection, the patient reported that the feeling of itching disappeared. By the end of the second week of the induction phase of biotherapy, it became obvious that new rashes did not appear, and the old elements of the skin rash had significantly flattened, turned pale and decreased in volume. After the second week of consolidated therapy, the dermatologist confirmed the convalescence.

The annual growth in the number of people living with HIV infection inevitably leads to an increase in the number of cases of any type of comorbidity. The article analyzes modern epidemiological, clinical, therapeutic aspects of anogenital herpes simplex virus infection (AHVI) in HIV-positive patients. Human immunodeficiency virus (HIV) and herpes simplex virus 2 (HSV-2) combine epidemiological and biological synergy. Concomitant anogenital herpes increases the risk of HIV infection by 2.74.7 times, and also contributes to its transmission through unprotected sexual intercourse. In HIV-infected patients with AHVI, the genital excretion of HSV-2 is increased. Among HIV-positive individuals, the seroprevalence of HSV-2 exceeds the population figures by 1.93.8 times. The incidence of AHVI in a cohort of Russians with a positive HIV status is 57.8 times higher than in the general population. The review demonstrates that both infections can have a negative mutual influence on the clinical course of each other. Particular emphasis is placed on the timely diagnosis of cases of coinfection. Based on the current regulatory documents, the authors developed and presented an algorithm for testing for HIV in patients with a newly diagnosed anogenital herpes.

Background. Psoriatic arthritis risk prediction and early detection in patients with psoriasis may help prevent irreversible musculoskeletal changes and improve patients outcomes. Aims. To develop and validate predictive model for psoriatic arthritis risk assessment and classification for patients with moderate-to-severe psoriasis based on demographic and clinical characteristics. Materials and methods. Data of psoriasis patient registry of Russian Society of Dermatovenereologists and Cosmetologists was analyzed. Significant differences between independent variables of interest among patients with and without psoriatic arthritis were determined by means of 2-test or MannWitney test. Predictive models were developed stepwise by means of logistic regression analysis. Independent variables of low significance were excluded from the model. Regression coefficients were considered significant if p 0.05. The optimal cut-off value was derived from ROC-analysis. The model performance was evaluated by calculation of AUC, sensitivity and specificity on training and test datasets. Finally, adjusted regression coefficients, AUC, sensitivity and specificity were derived for pooled data. Results. Training sample included 3245 patients with psoriasis, 920 of them had diagnosis of psoriatic arthritis. The final predictive model included five significant predictors: psoriasis duration, medical history of psoriatic erythroderma, family history of psoriatic arthritis, arterial hypertension, and fatty liver. All regression coefficients were highly significant (p 0.001). The AUC of prediction model adjusted on pooled data was 0,7473, sensitivity 70%, specificity 66% for cut-off value 0.212. Conclusions. Developed predictive model for risk assessment of psoriatic arthritis may contribute to its earlier detection in patients with psoriasis taking into account the degree of influence of significant predictors. The proposed classification may be used to discriminate patients at higher risk of psoriatic arthritis.

The article is devoted to assessing the situation with syphilis and other sexually transmitted infections in the USSR and Russia in the period after the Second World War. On the basis of long-term statistical data, the patterns of rises and decreases in syphilis, gonorrhea, chlamydia infection are analyzed, possible factors influencing the epidemic process are discussed and a comparative assessment of the current situation in Russia and Western countries is carried out. Comparing to the previous year, there was an increase of the syphilis incidence by 39.4% in 2021, by 33.7% in 2022 and by 14.7% in the first 4 months of 2023. The incidence of gonococcal infection increased by 10.4%, 10.0% and 5.5%, respectively. The attention is drawn to the negative trend of an increase of latent and late syphilis among other forms, as well as rising number of late neurosyphilis and late cardiovascular syphilis cases. In view of the predicted increase in the incidence of syphilis and other STIs in the coming years, the authors emphasize the urgent need to develop and implement a state interdisciplinary program aimed to epidemiological monitoring, improvement of the diagnosis and treatment, prevention of the dissemination of syphilis and other STIs and controlling of factors that negatively affect the reproductive health of the nation.

The paper describes changes in resources and performance of medical organizations providing medical care in the field of dermatovenereology in 20162022. The dynamics of the main rates of the service was analyzed, and the rates achieved in 2022 were compared with those before the pandemic of a new coronavirus infection. The rates of the provision of the population of the Russian Federation with dermatovenereologists, 24-hour and daytime dermatovenereological beds are presented. The analysis of the volumes of dermatovenereologic medical care dynamics provided in outpatient, inpatient and day hospital conditions was carried out. The dynamics of incidence of sexually transmitted infections is described, contribution of syphilis cases among foreign citizens to syphilis rates is presented. The changes in prevalence and incidence rates of diseases of the skin and subcutaneous tissue, as well as atopic dermatitis, psoriasis, contact dermatitis, other dermatitis, localized scleroderma, and discoid lupus erythematosus are analyzed.

Vulvovaginal candidiasis is a widespread infection caused by Candida. The disease affects 7580% of women of reproductive age at least once during their lifetime, and 920% of them indicate the presence of three or more episodes of the disease during the year, which is classified as recurrent vulvovaginal candidiasis (RVVC). To date, the question of the causes of the formation of recurrent forms of the disease has not been definitively resolved, since RVVC is also observed in women who do not have known risk factors. Due to the fact that about 2030% of patients with RVVC are healthy women without factors predisposing to its development, interindividual differences such as genetic predisposition and ethnicity, immune disorders, as well as the species diversity of Candida fungi and their antimycotic resistance may play a key role in the pathogenesis of idiopathic RVVC. In the literature review, the main etiopathogenetic mechanisms of the disease development are presented, the role of immune and genetic factors of predisposition to the development of recurrent vulvovaginal candidiasis is evaluated, changes in the species structure of the pathogen in recent years are analyzed. Modern approaches to the treatment of the disease are described, taking into account the indicators of antimycotic resistance, and the analysis of RVVC therapy regimens according to domestic and foreign clinical recommendations is carried out. The possibilities of using sertaconazole in the treatment of the disease are considered, the results of studies of its efficacy and safety in patients with vulvovaginal candidiasis are presented.

Background: Systemic isotretinoin is an effective treatment for acne, but the significant relapse rate requires a search for optimal daily doses to prolong disease remission. Purpose: To compare the results of systemic therapy of moderate-to-severe resistant and severe papulopustular pustular acne with isotretinoin at daily doses of 0.5; 0.7 and 1.0 mg/kg body weight. Methods: In a retrospective study, data from outpatient records and facial skin corneometry results of 125 individuals (95 acne patients, 30 healthy individuals) were analyzed. Patients with acne received isotretinoin (Sotret)at a daily dose of0.5; 0.7 or 1.0 mg/kg body weight, with a cumulative dose of 120 mg/kg body weight in all patients. The duration of follow-up of patients, according to outpatient records, was 18 months. Results: Isotretinoin systemic therapy was effective in patients in all compared groups. The resolution of inflammatory elements was faster (p0.001) in those who received doses of isotretinoin 0.7 and 1.0 mg/kg body weight. After treatment, elevated values of sebumetry, skin relief, pore size, and pigmentation were normalized in all groups. There was a significant difference in the incidence of adverse events depending on the dose of isotretinoin. The number of patients with relapses registered at 18-week follow-up after therapy in Group I was 6 (18.75%); in Group II, 4 (12.5%); in Group III, 1 (3.2%), the differences between the groups being significant (p=0.003). Conclusion: Therapy of moderate-to-severe resistant and severe papulopustular acne with systemic isotretinoin (Sotret) at daily doses of 0.5; 0.7 and 1.0 mg/kg at a cumulative dose of 120 mg/kg body weight demonstrates comparable clinical efficacy. However, recurrence rates during the 18-month follow-up period correlated with the daily dose of the drug.

Indeterminate dendritic cell tumor (IDCT) is rare histiocytic tumor characterized by the proliferation of indeterminate dendritic cells. It is more often diagnosed in middle-aged people, in approximately equal proportions in men and women. The etiology of IDCT is unknown. Differential diagnosis is carried out with other diseases that mimic IDCT and is important for determining treatment tactics. The present paper presents a clinical case of IDCT in a 48-year-old man. The similarity of skin manifestations in IDCT with other cutaneous pathologies requires an immunohistochemical study of the affected areas for CD1a, CD68, S100, Langerin expression evaluation as well as the presence of Birbeck's granules visualization. Routine histological examination does not sufficient for correct IDCT diagnostics.

Rosacea is a chronic inflammatory disease of the skin mainly of the central facial region, having gender and age correlations. Currently, more and more data is accumulating on the analysis of rosacea phenotypes, scientific discussions are underway on the feasibility of switching from subtype classification to phenotypic classification to justify individualized approaches to therapy. The phenotypic classification is based on the manifestations of rosacea and distinguishes diagnostic signs from the main and secondary symptoms. Thus, phymatous changes and persistent central facial erythema are the only diagnostic signs (criteria) of rosacea, and erythema, telangiectasia and inflammatory papules/pustules are the main symptoms and only in combination can indicate the diagnosis of rosacea. Secondary signs of rosacea are hot flashes, burning, pain, swelling and a feeling of dryness. The symptoms of rosacea are based on various pathophysiological mechanisms, so therapy in most cases will consist of a combination of topical agents with systemic drugs or physiotherapy. The article presents a clinical case of rosacea based on a phenotypic approach to therapy.

Diffuse cutaneous leishmaniasis is a rare form of cutaneous leishmaniasis characterized by an inadequate immune response of the host cells to parasitic invasion (weak T-helper (Th)1 response or Th2 response with the production of interleukin IL-4 and IL-10). The characteristic features of the disease include diffuse nodular eruption, masquerading as leprosy and a frequent association with immunosuppression (HIV co-infection, for example). The Russian Federation is a non-endemic country for leishmaniasis, but this disease can be brought into the country by tourists, immigrants, refugees and military personnel. A clinical case of diffuse cutaneous leishmaniasis and HIV co-infection is presented. The patient was a citizen of Uzbekistan, a country endemic for leishmaniasis. The authors were unable to find domestic scientific publications describing cases of diffuse cutaneous leishmaniasis detected in the Russian Federation. The presented clinical case of diffuse cutaneous leishmaniasis in a patient with HIV is the first in the Russian literature.

Extramammary Paget's disease is a slow-growing cutaneous intraepithelial adenocarcinoma of the apocrine glands in the anogenital and axillary regions. The disease is extremely rare, affects predominantly postmenopausal women, and has nonspecific clinical caracteristics, so that it can take 210 years from the first clinical signs to diagnosis. The vulva and the perianal region are the most affected zones. Extramammary Pagets disease is clinically manifested as well-defined erythematous plaques with secondary changes, such as scaling, ulceration and even bleeding. Differential diagnosis is made between primary and secondary forms of Extramammary Pagets disease, candidiasis, contact dermatitis, Crohn's disease, eczema, erosive lichen planus, hydradenitis suppurativa, Langerhans cell histiocytosis, sclerosing lichen, psoriasis, squamous cell carcinoma in situ, amelanotic melanoma and mycosis fungoide. Treatment mainly includes the surgical component, as well as the use of photodynamic therapy, cytostatic agents, and, depending on the stage, systemic chemotherapy.

Patients with acne often develop neuropsychiatric disorders of varying severity, correlating, as a rule, with the severity of dermatosis. Isotretinoin is the most commonly used drug for the treatment of moderate acne. Due to the fact that in a number of studies isotretinoin was considered as a trigger for the development of various neuropsychiatric disorders, numerous studies were conducted to prove this possibility or to refute it. An analysis of the literature showed that, according to the vast majority of studies, isotretinoin does not lead to neuropsychiatric disorders. However, given the opposite opinion of some authors, it is advisable to actively identify, including in the anamnesis, any psycho-emotional disorders, and monitor them during therapy. In these cases, it is indicated to start treatment with small doses (recommendations have not been developed).

Background. Neisseria gonorrhoeae can rapidly develop resistance to antimicrobial agents due to innate mechanisms for the acquisition of antimicrobial resistance genes. Because of the rapid formation of resistance mechanisms of N. gonorrhoeae to the antimicrobial agents used in gonococcal therapy, the risk of incurable forms of the disease is high. The purpose of the study is to to summarize the results of RU-GASP over a 16-year period and assess the trends of N. gonorrhoeae resistance to antimicrobials used in the regimens of antibiotic therapy of gonococcal infection in Russia. Materials and methods. Study Objective. The study included 5356 isolates of N. gonorrhoeae received from January 2005 to December 2021 in State Scientific Center of Dermatovenerology and Cosmetology, Moscow of the Ministry of Health of Russia under the RU-GASP program from specialized medical organizations of dermatovenerological profile of 37 subjects of the Russian Federation. Primary identification of N. gonorrhoeae was performed using bacterioscopic and bacteriological methods. The cultures identified as N. gonorrhoeae were frozen in a cryogenic medium and transported to SSCDC. Received cultures were verified by biochemical criteria on a VITEK 2 Compact analyzer. For cultures identified as N. gonorrhoeae with less than 99% probability, a time-of-flight ionization mass spectrometer MALDI Microflex (Bruker Daltonics GmbH, Germany) was used for mass spectrometric analysis. Antimicrobial susceptibility testing. Sensitivity testing of N. gonorrhoeae to six antimicrobials penicillin, spectinomycin, ceftriaxone, tetracycline, azithromycin and ciprofloxacin was performed by serial dilution in agar with determination of minimum suppressive concentrations (MSC, mg/L). N. gonorrhoeae sensitivity to antibacterial agents was evaluated according to EUCAST criteria (The European Committee on Antimicrobial Susceptibility Testing, 2022, http://www.eucast.org). Results. The study showed the absence of significant changes in the ratio of sensitive and resistant to the action of antimicrobial drugs strains of N. gonorrhoeae that is a consequence of the effectiveness of the RU-GASP program, which allowed to exclude in time from therapeutic use the drugs for which a high proportion of the identified resistant strains was observed. Conclusion. Analysis of RU-GASP results over a 16-year period confirms the use of third-generation cephalosporins (Ceftriaxone, Cefixime) as the drugs of choice for therapy of gonococcal infection, and the aminocyclic antibiotic spectinomycin as an alternative drug. The continued evolution of the molecular mechanisms of antibiotic resistance of N. gonorrhoeae dictates the need to continue the RU-GASP program.

Background. The initial stages of androgenetic alopecia in men are characterized by a variety of clinical manifestation in the parietal or occipital scalp regions. However, the differences in the pathogenesis of hair loss patterns are not well understood, selective treatment has not been developed. Aims. Trichological characteristics of patients with initial stages of androgenetic alopecia with identification of genetic and non-genetic factors that determine the hair loss in the different scalp regions, and their response to conservative therapy. Materials and methods: Trichograms were photodocumented using an AramoSG microcamera (Republic of Korea). The genetic factor was analyzed by mini-sequencing of single nucleotide polymorphisms rs929626, rs5919324, rs1998076, rs12565727, rs756853. The non-genetic factors study included hormonal status (total and free testosterone, dihydrotestosterone, 17OH-progesterone, dehydroepiandrostenone, SHBG) and blood content of trace elements (Mg, Ca, Zn, Cu, Se, Fe) and vitamins (B12, D, E, folic acid). Conservative treatment was topical application of a minoxidil 5% (twice-a-day, 4 months) and a micronutrient deficiencies personalized correction. Results. The study included 47 man with initial stages of androgenetic alopecia. Their trichological examination showed two patterns, consisting a predominant decrease in the hair density and diameter in the parietal and occipital scalp regions, which were subgroups formation criteria. An intergroup comparison revealed similar genetic risk, while hormonal parameters (increased dihydrotestosterone levels, a decrease in free testosterone) characterized the subgroup with parietal hair loss pattern. Also, a multiple deficiency of Zn, Cu, Se and vitamins B12, D, folic acid was detected in all patients. Subsequent conservative treatment had a positive effect in patients with parietal hair loss pattern, while in patients with occipital pattern no significant response was observed. Conclusions. The study develops ideas about differences between androgen-dependent parietal and androgen-independent occipital hair loss patterns in the initial stages of androgenetic alopecia, which requires different approaches to their conservative therapy.

Background. Atopic dermatitis is an inflammatory skin disease characterized by recurrent lesions and intense pruritus. Nowadays there is a stepwise approach to the treatment of atopic dermatitis, which is defined by disease intensity and complications such as secondary skin infections. However, the current management of atopic dermatitis may not always lead to the expected outcome due to not only immune dysregulation of both adaptive and innate immunity but also imbalance of the skin microbiome. Aims. The aim of the study was to evaluate changes in the composition of the skin microbiome in both lesional and non-lesional skin in patients with atopic dermatitis during standard treatment. Materials and methods. Twenty patients with atopic dermatitis and twenty six healthy controls over 18 years old were included into the study. All microbiome samples were obtained from lesional and non-lesional skin sites of atopic dermatitis patients before and after therapy. Whereas samples from healthy controls were taken once from a flexor surface of the elbow. Species identification of clinical isolates were identified using MALDI Biotyper Sirius (Bruker Daltonics). Results. At baseline, the prevalence of S. aureus colonization among patients with atopic dermatitis was 34.20% in lesional skin and 32.50% in non-lesional skin. After treatment, there was a significant decrease in the prevalence of S. aureus carriage in both lesional and non-lesional skin areas (р 0.05). However, no significant difference was observed in the proportion of all other staphylococci (р 0.1). Interestingly, S. aureus was not found in healthy controls. Conclusions. The results of the study demonstrated the effectiveness of standard therapy for managing patients with atopic dermatitis as it had a positive impact on the skin microbial community and showed a decrease in S. aureus proportion after the treatment.

The aromatic hydrocarbon receptor (AhR) is a cytoplasmic receptor and transcription factor that regulates a wide range of biological and toxicological effects by binding to specific ligands. Among the effects there is detoxification of xenobiotics, maintenance of tissue homeostasis, regulation of the immune response. The structure and functions of AhR are described in the review. The mechanisms of skin homeostasis with the participation of the aromatic hydrocarbon receptor such as the effect on oxidative reactions and participation in maintaining the barrier function of the epidermis are demonstrated in details. The role of AhR in the pathogenesis of atopic dermatitis is discussed. The participation of AhR in the implementation of immune mechanisms of this disease as well as in the regulation of the production of key proteins of the skin barrier is shown. The data on the therapeutic value of its pharmacological modulation including the results of clinical studies of the topical ligand AhR Tapinarof are presented. The role of the aromatic hydrocarbon receptor in the realization of the effect of phototherapy of atopic dermatitis is demonstrated.

Introduction: Atopic dermatitis is an inflammatory disease which can significantly affect quality of life of patients. Especially severe forms of this disease are challenging to treat and for a long time forms of treatment have been limited. Because of that- it is crucial to find new ways of treatment which can be registered and impove moderate and severe dermatitis. Aim of study: Fundament purpose of this literature review is focusing on effectiveness, safety, side effects or different potential medical applications of Dupilumab. The main question, which is formulated in the title- is Dupilumab a chance for patients with moderate to severe atopic dermatitis? State of knowledge: Nowadays Dupilumab is well known drug and a lot of trials and analysis focus on efficacy, safety in treatment of moderate and severe dermatitis. The development of Dupilumab and different potential, clinical applications is also a chance for other groups of patients- for example patients with asthma, chronic rhinosinusitis with nasal polyps, eosinophilic esophagitis, prurigo nodularis. Conclusion: Dupilumab is definitely a relevant and essential element of treatment therapy for patients with moderate to severe atopic dermatitis. There were many analysis and researches which confirmed effectiveness, safety level and described Dupilumab impact on many different parameteres and scales focused on symptoms and life quality of patients during treatment with Dupilumab.

Introduction: Pemphigus is a rare group of autoimmune diseases that promote development of various skin eruptions, the most commonly it presents with blisters. The several types of pemphigus are: pemphigus vulgaris, pemphigus foliaceus, intraepidermal neutrophillic IgA dermatosis and especially rare type- paraneoplastic pemphigus, which is main topic of this publication. Paraneoplastic pemphigus is a disease which affects patients with developing carcinogenesis process. Usually it is a malignant process, but there are also some cases which describe paraneoplastic pemphigus associated with benign tumors. Because of its occurence our current level of knowledge about different aspects of paraneoplastic pemphigus is not final and as comprehensive as researchers and patients wish. Aim of study: The main purpose of this publication is presentation a review of literature about paraneoplastic pemphigus- its epidemiology, physiopathology, pathomorfology, clinical features, and description of different types of benign or malignant processes which concomitence with paraneoplastic pemphigus. State of knowledge: Paraneoplastic pemphigus is a rare autoimmune disease, which aspects are not widely described, but there are some reports about epidemiology, pathophysiology, histopathology, treatment and associated confirmed malignancies. The challenge for future is to formulate clear, formal, treatment protocols for paraneoplastic pemphigus. Conclusion: Paraneoplastic pemphigus is a very fascinating disease for researchers because there are still very limited reports and statistics about this very rare disorder. Nonetheless year by year our level of knowledge about pathogenesis, clinical features, associated malignant and benign processes is growing and it can affect more personalized, effective treatment methods and protocoles.

Introduction: Basal cell carcinoma is the most common form of skin cancer. The lifetime risk is estimated as 33% to 39% in white men and 23% to 28% in white women. Because of that it is a very crucial disease for public health. In this article will be described main pathways of treatment which are especially recommended and are the most wide used for different types of basal cell carcinoma. Main division of interventions type used in treatment of basal cell carcinoma are surgical (physical) and non-surgical (medical). Surgical (physical) includes surgical standard excision, Mohs micrographic surgery, curettage and cautery, cryosurgery and laser therapy (ablative lasers, pulsed dye lasers). Non-surgical (medical) includes radiotherapy, topical imiquimod, topical 5- fluorouracil, photodynamic therapy, intralesional interferon. Aim of study: Literature review of the most recommended treatment of basal cell carcinoma. State of knowledge: In this publication will be desribed a current state of knowledge about basic and the most crucial basal cell carcinoma treatment. Conclusion: Because of incidence rate of basal cell carcinoma which is very high- there are many reports about treatment of this disease. Treatment of this disease, especially among low risk patients, is very effective.

Artificial intelligence has been rapidly penetrating every element of our lives for quite some time. However, its presence in health care has remained elusive. This is particularly apparent in the field of dermatology, where, given the characteristics of this discipline of medicine, it would seems that its presence should be abundant. Malignant skin lesions are still high in the statistics in terms of cancer mortality while being one of the easiest to treat when diagnosed early. There are many reasons why artificial intelligence is not used in daily practice as an aid for cancers detection. However the most important one is the ongoing insufficient quality of the algorithms, which, despite great results in laboratory settings, do not produce good enough outcomes in clinical settings. Other important reasons are that people still distrust and fear artificial intelligence and simply the legal lack of adaptation of countries to its lawful and safe use. Despite the work of scientists and legislators the road to seeing artificial intelligence as a helping tool for dermatologists on a daily basis is still very long and requires the attention of scientists and the whole medical community.

Background: Platelet-rich plasma (PRP) was originally described as a small volume of plasma that contains higher concentrations of platelets, compared to peripheral blood. Although currently the use of PRP in most indications is off-label, it is not prohibited. Initially, PRP was used for wound healing and tissue regeneration in fields such as orthopaedics, dermatology, maxillofacial surgery and dentistry. Aim of the study: The aim of this article was to present and summarise the modern production methods, the mechanism of action at the molecular and biochemical level and the most important uses and indications of PRP in present-day medicine. Material and methods: A cross-sectional search of relevant literature was performed in databases using accepted wording. Publications from 2003-2023 were included. The entire process has been supplemented with additional procedures to increase the reliability of this publication. Results: Orthopaedics has gained many minimally invasive therapeutic solutions thanks to PRP. Its effects on ligament and tendon tissues have been studied, where promising data have been proven. Also in aesthetic medicine and dermatology, many treatment strategies have been developed using PRP, mainly for the treatment of acne, androgenic alopecia and delaying tissue ageing as much as possible. Conclusion: Platelet-rich plasma has found application in the treatment of many conditions in orthopaedics, dermatology, aesthetic medicine and dentistry. It is characterised by good therapeutic efficacy, with relatively low risk. However, high-quality studies are still lacking to provide more reliable data.

Patient A., aged 23, was admitted with a diagnosis of atopic dermatitis with complaints of widespread rashes accompanied by intense itching. Skin manifestations: erythroderma, xeroderma, excoriations, persistent white dermographism. The conclusion of the ophthalmologist: rhegmatogenous retinal detachment, complicated cataract, ophthalmohypertension of the right eye; hemophthalmos, complicated overmature cataract, terminal neovascular glaucoma of the left eye. A diagnosis of Andogsky's syndrome was made. He received treatment: prednisolone 60 mg per day parenterally for 14 days, methotrexate at a dose of 10 mg weekly, Reamberin, folic acid 5 mg weekly, asparcam, aevit, enterosorbents, ointments and creams with corticosteroids and moisturizers. As a result of treatment, hyperemia, infiltration, peeling and itching of the skin decreased. It is recommended to continue taking methotrexate, folic acid, prednisolone (5 mg daily) and asparkam on an outpatient basis; externally moisturizing and softening creams and ointments. The patient has been referred for a medical and social examination and is preparing to be transferred to the treatment with genetically engineered biological drugs.

In recent decades, there has been an increase in syphilis associated with HIV infection cases, especially among men who have sex with men. The global prevalence of syphilitic infection among people living with HIV exceeds population rates. Concomitant HIV infection can affect not just the clinical course of syphilis, but also the production of antibodies to Treponema pallidum. In the presence of severe immunodeficiency in patients with HIV infection associated with secondary syphilis, the results of non-treponemal and/or treponemal tests may be false-negative or may become positive at a later date. Such cases are known, they occur infrequently and cause some diagnostic difficulties. The article presents a clinical observation of delayed positivity of serological reactions in secondary syphilis in a 23-year-old HIV-positive man from the authors' practice. The tactic of managing HIV-infected patients with clinical symptoms of the secondary period syphilis and negative results of serological tests is discussed.

Hereditary ichthyosis is a group of generalized hereditary keratinization disorders characterized by general dryness of the skin, peeling, hyperkeratosis and often erythroderma. These manifestations are caused by mutations in genes mainly involved in the formation of the skin barrier. Hereditary ichthyosis is divided into syndromic and non-syndromic. Nonsyndromic ichthyoses include: vulgar ichthyosis, recessive X-linked ichthyosis, autosomal recessive congenital ichthyosis, keratinopathic ichthyosis and other forms. At present, the best result for achieving clinical remission has been established with oral retinoids: retinol palmitate, isotretinoin (1st generation of retinoids) and acitretin (2nd generation of retinoids). The ability of retinol palmitate to regulate keratinization processes, strengthen the epidermal barrier and have an antioxidant effect is used in the treatment of generalized hereditary keratinization disorders. Medium and high therapeutic doses (200010 000 IU/kg/day) are used in the treatment. The prescribed dose of retinol palmitate differs in various nosological forms of ichthyosis, and depends on the severity of the pathological process, the age and weight of the patient, which must be taken into account when prescribing therapy to obtain the best result. It should be noted that clinical manifestations mainly regress at doses that do not lead to the appearance of signs of toxicity of the drug. The methods of retinol palmitate treatment of ichthyosis and ichthyosiform erythroderma are described.

Background. There is insufficient data on the antifungal activity of activated zinc pyrithione, which is widely used in practice. Taking into account the reports about a significant role of Malassezia in the pathogenesis of a number of dermatoses, the study of this issue is of scientific, practical interest. Aims. To evaluate the antifungal activity of external forms of activated zinc pyrithione in the treatment of psoriasis, seborrheic dermatitis, pityriasis versicolor. Materials and methods. An open prospective study was conducted between March and July 2022. Patients with psoriasis, seborrheic dermatitis, pityriasis were treated with external forms of activated zinc pyrithione for 21 days. Skin scales and circular prints from lesion foci, as well as from skin areas without clinical manifestations before and after therapy were studied. A quantitative assessment of skin colonization by micromycetes of Malassezia was performed using microscopic, cultural methods of examination. Clinical efficacy and drug safety of the therapy was assessed using the Dermatological Symptom Scale Index, by recording adverse events at weeks 0, 1, 2, 3. Results. 64 patients aged 18 to 65 years with diagnoses of psoriasis, seborrheic dermatitis, and pityriasis versicolor were included. 60 patients completed the study, 4 were excluded due to failure to adhere to the schedule. In patients with seborrheic dermatitis and pityriasis versicolor in the lesion foci after therapy, a significant decrease colonization level according to the results of microscopic, cultural studies was observed. In psoriasis patients, a significant decrease in the colonization level was obtained only based on the results of microscopic examination. In all groups, significant differences in comparison to the initial level were registered already at the 1st week of treatment. No adverse events were registered. Conclusion. Activated zinc pyrithione in the form of cream and aerosol showed moderate antifungal activity against micromycetes of the genus Malassezia.