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Atopic dermatitis (AD) is a chronic inflammatory skin disease with high risk of skin and systemic infections. Preventive AD therapy is based on skin barrier improvement and anti-inflammatory treatment, whereas, severe skin and systemic infections require systemic therapy. This review describes pathophysiology and possible treatment and prevention methods for AD infectious complications.

The skin is the largest organ of the human body, it creates protective barrier between the internal and external environment. Skin barrier damage may result in homeostasis imbalance, inflammation, or bacterial infection. The microbiome plays a crucial role in maintaining normal skin functioning: control of pathogenic diversity of microorganisms, stimulate immune cells, and modulate chronic dermatoses development. There are various mechanisms for restoring skin barrier function. They are associated with the microorganisms’ activity. Thus, skin restoration is an important task included in the general concept of atopic dermatitis management. One of such methods is the skin surface colonization with commensals, so significant role is assigned to the new dermatological drugs. The normalization of the microbiome in affected skin areas with cosmetic care products can significantly affect the result of skin barrier restoration.

Background. Rapp-Hodgkin syndrome is a rare genetic disease from the ectodermal dysplasia group. It manifests with damage of ectodermal structures — layer of embrional tissue that provides the development of many organs and tissues in the body, such as: skin, sweat glands, hair, teeth, and nails. Disease symptoms may range from mild to severe and include dental abnormalities, fragile, thin or no hair, abnormal nails, hypohidrosis (due to the reduced number of sweat glands), cleft lips and palate. Hidradenitis suppurativa is a chronic inflammatory disease that predominantly affects apocrine glands areas. This nosology is characterized by painful nodes, abscesses, and fistulas, prone to relapses and leading to scarring.Clinical case description. The authors present a clinical case demonstrating the combination of Rapp-Hodgkin syndrome and severe hidradenitis suppurativa in 17-year-old male patient.Conclusion. The heterogeneous clinical findings of hidradenitis suppurativa and history of rare genetic disease result in patients' admissions to various medical specialists. Thus, it leads to delayed verification of the diagnosis and incorrect treatment methods. As a result, patients have persistent cosmetic skin defects, possible complications of irrational treatment, and decreased quality of life by the time of diagnosis.

Acne is chronic inflammatory skin disease. Its examination and management tactics depend on the patient's age and disease clinical form. This article presents treatment algorithms for acne vulgaris in adolescent and pre-adolescent children and describes clinical cases.

Background. Linear IgA dermatosis is a rare autoimmune bullous disease characterized by vesiculo-bullous subepidermal lesions (affecting the skin and mucous membranes) and by linear homogeneous IgA deposition in the epidermis basal membrane.Clinical case description. Clinical case of linear IgA dermatosis in children is presented. Clinical data assessment, histological examination of the skin biopsy (to determine the depth of bullous), immunofluorescent examination (to reveal IgA deposition in the epidermis basal membrane) are crucial for reliable disease diagnosis according to the studies. Altogether it helps to establish the final diagnosis and determine the patient's management. Dapsone is the first-line treatment for this disease, it has proven to be an effective and safe medication.Conclusion. This case of linear IgA dermatosis is of concern due to disease severity and its rarity in clinical practice. Differential diagnosis is rather complicated and clinically requires high-tech research methods. Only immunofluorescent examination allows to diagnose linear IgA dermatosis accurately. Lesions' regression was achieved due to systemic therapy with dapsone (1.8 mg/kg/day).

Background. Excessive colonization of the skin by various bacteria and fungi can be noted in patients with atopic dermatitis (AD), and the prevalence of secondary infection complications 30–48%. Several studies have shown that Staphylococcus aureus colonization is 60–100% in patients with AD compared to 5–30% in healthy persons from the control group. Moreover, the incidence of methicillinresistant Staphylococcus aureus (MRSA) isolates is up to 10–30% in skin cultures at AD, according to experts. Therapy of AD complicated by secondary infection is one of the crucial challenges of modern dermatology. Mupirocin can be considered as one of the most effective topical antibiotic among others used for etiotropic therapy of infectious complications in AD patients, and it has been confirmed by numerous clinical studies.Conclusion. Staphylococcus aureus is the most common trigger of AD aggravation. MRSA in AD complicated by secondary infection is difficult to manage as it becomes resistant to many types of antibiotics; however, it shows persistent sensitivity to mupirocin. Mupirocin-based (2%) external agent is the most effective, safe, and preferred therapy variant for AD complicated by secondary infection in pediatrics.

Background. Pemphigus herpetiformis is a rare atypical bullous dermatosis of autoimmune nature. It is characterized by rashes in the form of plaques with papules and vesicles at peripheral areas, or in the form of grouped papules, vesicles or tense bubbles with clinical similarity to During's herpetiformis dermatitis. Pemphigus herpetiformis diagnosis in pediatric practice is difficult due to the similarity of clinical manifestations to bullous dermatoses of other etiology, the rarity of the disease in children, and small number of scientific publications.Clinical case description. Clinical case of pemphigus herpetiformis in a child is described. All necessary diagnostic algorithms for diagnosis and therapeutic tactics for patient management are presented. Dapsone and prednisolone were used as first-line drugs during the patient's treatment. They have shown its efficacy in management of such patients.Conclusion. Differential diagnosis of pemphigus herpetiformis and other bullous dermatoses in children is presented. The results of successful drug treatment are shown.

Background. Hypotrichosis is a heritable form of alopecia that causes almost complete scalp hair loss in childhood. The diagnosis is typically established according to medical history and clinical picture. Genetic testing is an additional diagnostic method that allows to establish “hypotrichosis” in cases of ambiguous or subtle clinical signs of the disease, as well as to perform differential diagnosis of this condition with others commonly associated with atopic dermatitis (focal and diffuse alopecia). Clinical diagnosis of hypotrichosis in patients with severe dermatosis is challenging.Clinical case description. The girl, aged 2 years 4 months, was hospitalized with complaints on extended rash on the body with severe itching, and changes in hair thickness, quality of hair shaft, and hair loss. Severe atopic dermatitis and hypotrichosis were diagnosed. The diagnosis of atopic dermatitis was established clinically (SCORAD — 65), the diagnosis of hypotrichosis (type 6, monilethrix-like hypotrichosis) was confirmed via molecular genetic testing (nucleotide variant c.699C>T in exone 13 of the DSG4 gene (OMIM # 607892)). Patient's mother, brother, and two sisters were diagnosed with the nucleotide variant chr18:31409487C>T in heterozygous state in the DSG4 gene. Mother and brother had no clinical manifestations, while both sisters had mild scalp hair damage, as well as eyebrows and eyelashes, since birth. There were no clinical manifestations of atopic dermatitis in parents and other children in the family.Conclusion. Hypotrichosis clinical signs can be subtled, smoothed, or imitate the symptoms of other comorbid conditions, especially in patients with comorbidities or severe dermatosis. Also worth noting is that changes in certain genes can aggravate the course of atopic dermatitis. In this clinical case, mutation in the DSG4 gene leads to epidermal barrier failure by disrupting the synthesis of desmosomes transmembrane components. Thus, geneticist consultation and genetic testing (search for changes in certain genes) are crucial in such cases.

Atopic dermatitis is a common chronic skin disease, its pathogenesis is associated with congenital or acquired deficiency of filaggrin protein. In recent years, extensive evidence on the causes of filaggrin deficiency has been obtained. The structure and functions of this protein are described, that opens new approaches for atopic dermatitis management.

Biofilm is the dominant form of skin microbiota organization that provides adhesion and preservation of microorganisms in the skin micro-environment. It is necessary to ensure epidermal barrier function and local immunomodulation. Staphylococcus aureus becomes the major colonizer of skin lesions in case of atopic dermatitis exacerbation, and it also can form the biofilms. S. aureus growth and biofilm formation due to other microbial commensals on the skin of patients with atopic dermatitis leads to chronic output of pro-inflammatory cytokines and later to abnormalities in healthy skin microbiome. The role of microbial biofilm in human’s health makes the skin microbiota an attractive target for therapeutic intervention in various skin diseases.

Atopic dermatitis (AD) is a multifactorial inflammatory skin disease. Its pathogenetic basis is epidermal barrier dysfunction, immune system dysregulation, as well as skin microbiome diversity decrease that occurs due to genetic predisposition. Considering these factors, the skin of patients with AD requires constant care and use of medications with active regenerative properties. The inclusion of anti-inflammatory components in the composition of modern emollients (zinc sulfate and sucralfate) is crucial for restoring the microbiome and immune mechanisms controlling the skin. This article presents data on pathogenetic applicability and clinical efficacy of emollients with anti-inflammatory compounds in patients with AD.

Background. Pemphigus vulgaris is an autoimmune bullous dermatosis. Its management generally involves lifelong administration of maintenance dose of systemic glucocorticosteroids, that leading to serious adverse effects especially in children.Clinical case description. Patient is the 16 years old boy with severe course of pemphigus vulgaris. The diagnosis was confirmed by the results of cell smear study from fresh erosions (> 50 acantholytic cells were revealed), histological examination of the skin biopsy from the lesion with the vesicle element (suprabasal vesicle was localized in the center, it included fibrin, neutrophil granulocytes, and acantholytic cells), skin biopsy from the area near the lesion (visually healthy skin), via direct immunofluorescence methods (IgG deposition was detected on keratinocytes’ surface throughout the epidermis), and enzyme-linked immunosorbent assay (desmoglein 1 IgG autoantibodies — 121 U/mL (reference value < 20 U/mL) and desmoglein 3 — > 200 U/mL (reference value < 20 U/mL)). Genetically engineered biologic drug, rituximab, and systemic glucocorticosteroid, methylprednisolone, were prescribed as first-line therapy with gradual dose reduction to permanent discontinuation in 8 months. Complete remission maintained after the completion of therapy course and discontinuation of systemic glucocorticosteroid.Conclusion. Combined therapy with systemic glucocorticosteroids and rituximab can be considered as first-line therapy in pediatric patients with pemphigus vulgaris due to relatively low risk of recurrence after rather rapid and complete drugs’ discontinuation.

IntroductionEpidermal barrier dysfunction in children with atopic dermatitis can cause transcutaneous sensitization to allergens and allergic diseases. We evaluated the effectiveness of an early-intervention algorithm for atopic dermatitis treatment, utilizing pimecrolimus for long-term maintenance therapy, in reducing transcutaneous sensitization in infants.MethodThis was a single-center cohort observational study that enrolled children aged 1-4 months with family history of allergic diseases, moderate-to-severe atopic dermatitis, and sensitization to ≥ 1 of the investigated allergens. Patients who sought medical attention at atopic dermatitis onset (within 10 days) were group 1 “baseline therapy with topical glucocorticoids with subsequent transition to pimecrolimus as maintenance therapy”; patients who sought medical attention later were group 2 “baseline and maintenance therapy with topical glucocorticoids, without subsequent use of pimecrolimus”. Sensitization class and level of allergen-specific immunoglobulin E were determined at baseline, and 6 and 12 months of age. Atopic dermatitis severity was evaluated using the Eczema Area and Severity Index score at baseline and 6, 9 and 12 months of age.ResultsFifty-six and 52 patients were enrolled in groups 1 and 2, respectively. Compared with group 2, group 1 demonstrated a lower level of sensitization to cow's milk protein, egg white and house dust mite allergen at 6 and 12 months of age, and a more pronounced decrease in atopic dermatitis severity at 6, 9 and 12 months of age. No adverse events occurred.DiscussionThe pimecrolimus-containing algorithm was effective in treating atopic dermatitis and prophylaxis of early forms of allergic diseases in infants.Trial registrationhttps://clinicaltrials.gov/NCT04900948, retrospectively registered, 25 May 2021.

Atopic dermatitis (AD) is a disease characterized by chronic skin inflammation and epidermal barrier dysfunction leading to decrease in patients' quality of life. AD is widespread in general population including children. This article covers the disease pathophysiological mechanisms including those that depend on the endotype, as well as core principles of systemic therapy for children with moderate and severe AD. Features of targeted therapy of such patients with dupilumab (IL-4 and IL-13 inhibitor) are presented. The studies' results on dupilumab efficacy and safety in the short- and long-term are shown.

Atopic dermatitis (AtD) is multifactorial inflammatory skin disease with high prevalence in pediatric population. It is crucial to implement long-term maintenance therapy to prevent AtD exacerbations according to current clinical guidelines and expert reports. The article summarizes the results of the major studies on using pimecrolimus 1% cream. Its efficacy and safety in long-term proactive therapy of children with AtD are presented.

The spread of new coronavirus infection (COVID-19) changes specialists' approaches to patients with chronic diseases, including those with chronic dermatoses. The high risk of COVID-19 complications in patients with psoriasis is connected to the features of disease pathogenesis (such as high activity of proinflammatory cytokines) and used immunosuppressive therapy. Psoriasis affects up to 1% of children in Europe, while 10-20% of them have moderate or severe form of disease. These children may require immunosuppressive treatment, including genetically engineered biological therapy. There is only limited data on adults and children with psoriasis during the COVID-19 pandemic.

Healthy newborn skin care is challenging task. The basic principles of care should be taught to both medical staff and parents. This care is more crucial in children with atopic dermatitis who have abnormal skin acidity due to multifactorial exposure. Significant pH reduction leads to aggravation of the skin process that requires active therapeutic measures. The article presents guidelines for the first infant's skin cleaning, for conducting first and daily bathing, for using cleansing agents and daily care solutions to prevent skin acidity disorders and the development of atopic dermatitis.

Photodermatoses is a heterogeneous group of diseases resulting from abnormal skin hypersensitivity to sunlight and presented as local or generalized rashes. Specific sensitivity of children's skin to ultraviolet is often the first sign or clinical symptom of photodermatosis. Abnormal photosensitivity can be represented by diverse group of primary idiopathic conditions or photo-mediated aggravation of existing dermatosis. Number of genetic genodermatoses, metabolic disorders and connective tissue diseases is also widely known. These conditions can manifest with photosensitivity associated to other extracutaneous clinical and laboratory features. Timely diagnosis of photosensitivity in childhood allows to minimize long-term complications associated with insufficient photoprotection.

Atopic dermatitis (AtD) is multifactorial inflammatory skin disease, one of the aspects of its pathogenesis is epidermal barrier dysfunction. Early development of AtD is associated with filaggrin dysfunction. Filaggrin is a protein involved in aggregation of keratin filaments in the upper layers of epidermis and the retention of lipids and proteins between corneocytes. Frequently, filaggrin dysfunction can be accompanied with secondary infection and high risk of other allergic diseases development. This can happen due to disturbance in terminal differentiation of epidermal cells and, as consequence, malfunction of epidermal barrier. Thus, the long regular use of emollients is the basis of AtD therapy. New class of emollients (“emollents plus”) allowed us to achieve more significant treatment results in patients with AtD. These emollients reduce inflammatory process activity in the skin by replacing structural components of abnormal epidermal barrier.

Skin is the natural habitat for complex bacterial, fungal, and viral communities (ecosystems). The microbiome of such communities is always in close relationship with the host genome, and the development of these ecosystems happens under the effects of morpho-physiological and immunological characteristics of the skin (sebaceous glands concentration, humidity, and temperature) and environmental factors. Metagenomic studies have shown significant diversity in skin ecosystems. Moreover, the role of commensal microorganisms in skin immune response modulating to various agents and, thus, its correlation with skin diseases pathogenesis is no longer in doubt. New probiotic and antimicrobial agents for external treatment have been developed according to these knowledges.

Background. Malformations in epidermal barrier in children with atopic dermatitis (AD) can cause transcutaneous sensitization with further development of allergic diseases that can worsen the AD course and significantly reduces patients’ quality of life.Objective. The aim of the study was to determine the effect of topical treatment and maintenance therapy with pimecrolimus 1% cream (PIM) and topical glucocorticosteroids (tGCS) in infants with AD on reducing the risk of developing transcutaneous sensitization (due to the levels of specific IgE to the cow milk protein over time) and on reducing the disease severity (by the EASI scale).Methods. The study included children aged from 1 to 4 months with early manifestations of moderate and severe AD. The severity of AD was estimated via the EASI scale at start of observation, then at 6, 9 and 12 months of life. The class and level of specific IgE to cow milk proteins (CMP) were determined by the ImmunoCAP method at the point of enrolment and at the ages of 6 and 12 months. Statistical analysis of studied indicators dynamics and their comparison in research groups was carried out using multifactorial dispersion analysis.Results. The study included 36 patients. All patients have received standard tGCS therapy in combination with emollients (wet wrap) for 10 days. The maintenance therapy was prescribed in postacute period. It included topical calcineurin inhibitor PIM 2 times/day for 3 months, then double application (morning/evening) 3 times/week up to the age of 1 year old (group 1). Other group had maintenance therapy — tGCS2 times/week for 3 months, and then at AD aggravation (group 2). Group 1 has shown lower level of sensitization to CMP at the age of 6 and 12 months and more significant decrease in AD severity according to EASI scale compared to group 2.Conclusion. The treatment with PIM is effective in therapy of AD and prevention of transcutaneous sensitization in infants.

Atopic dermatitis (AD) is the disease with chronic inflammation, epidermal barrier dysfunction and microbial dysbiosis. AD is widespread, including pediatric population. The article discusses the disease’s pathogenesis: skin barrier deficiency, immunological causes of chronic inflammation, characteristics of normal skin microbiome and its disorders on both affected and unaffected skin of children with AD. Main principles of systemic treatment for moderate and severe forms of disease are considered. Features of targeted therapy with dupilumab (IL 4/IL 13 inhibitor) in children with moderate and severe forms of AD are discussed. The overview of the research results on the dupilumab efficacy and safety is presented.

Vitiligo is a common skin disease characterized by idiopathic progressive skin hypomelanosis. Vitiligo is associated with several comorbid autoimmune diseases such as localized scleroderma. This article demonstrates the general development mechanism of these pathologies, as well as the key aspect of cross-effect between autoimmune diseases on the molecular level. Recently, dermatologists have noted the increasing number of patients suffering from combined pathologies. Such patients (in pediatrics) have torpid course of disease and no pathognomonic symptoms. That exaggerates the diagnostics and adequate therapy prescription. This leads to increased awareness among physicians of different specialties on possible combinations, clinical presentation and pathogenesis aspects of such conditions.

Background. The study of psoriasis biological therapy aspects in children has certain topicality due to the small number and disunity of individual observations and the lack of special registers for pediatric patients.Objective. Our aim was to study ustekinumab efficacy and safety in children with plaque (PP), erythrodermic (EP) and palmoplanar (PPP) forms of psoriasis.Methods. The analysis of ustekinumab efficacy and safety has been carrying out for 1 year. The evaluation of therapy efficacy was based on definition of improvement of PASI scores (PASI 75, PASI 90 and PASI 100) on the 16th, 28th, 40th and 52nd weeks of follow-up and children's dermatology life quality index (CDLQI). Ustekinumab therapy safety analysis was based on registration and evaluation of adverse effects. Results. The study included 67 children with PP, EP and PPP aged 12 to 18 years. PP group results: the PASI 75 response at the 52nd week of therapy was observed in 35 children (100%), PASI 90 — in 33 (94%), PASI 100 — in 30 (86%). EP group results: 10 patients (56%) have reached PASI 75 on the 16th week, while none of patients have improved to PASI 90 and PASI 100 scores. The PASI 75 response at the 52nd week of therapy was observed in 18 children (100%), PASI 90 — in 17 (94%), PASI 100 — in 7 (39%). Only 1 patient (7%) with PPP has showed the score decrease to PASI 75 on the 16th week. Adverse effects were reported in 2 patients.Conclusion. Ustekinumab is the effective and safe treatment for moderate and severe forms of PP and EP in children, and it can also be considered as one of the alternative methods for PPP treatment in pediatrics.

Psoriasis is multifactorial systemic disease characterized by excessive hyperkeratosis due to impaired keratinocytes proliferation and differentiation. This disease often manifests in childhood and it is usually associated with the development of comorbid conditions some of which are combined by the term «psoriatic march» (obesity, metabolic syndrome, etc.). The course of psoriasis and related comorbidities in children has several specific features that determine topicality of studying all the aspects of clinical diagnosis and prevention in childhood. The article summarizes recent ideas on the prevalence, pathogenesis features and early diagnosis of comorbid diseases in children with psoriasis.

Pruritus is one of the main clinical manifestations of atopic dermatitis, and it significantly reduces the quality of life of patients in childhood. Scientific images on its pathophysiological basis have now undergone significant changes. The histamine exceptional role in pruritus development was confounded, as well as data on immune system involvement in its maintenance was given. This article presents current data on differential approaches to pruritus management depending on its etiopathogenetic characteristics. The role of dermocosmetics in restoration of the skin barrier as the first stage prevention of pruritus in atopic dermatitis was considered. The results of clinical studies showing efficacy of topical agents (innovative component with anti-pruritic action — STIMU-TEX) application are presented.

Background. Nowadays, dermatoses with mixed clinical picture and resistant to classical management become more common. The presence of various genetic disorders typical for most chronic dermatoses may indicate possible combination of several nosologies.Clinical Case Description. The article presents the clinical case of multimorbid condition in 10 years old patient who has nucleotide variants in CARD14 and EXPH5 genes. Mutations in CARD14 gene are typical for patients with type 2 psoriasis and pityriasis rubra pilaris (autosomal dominant type), while mutations in EXPH5 gene are typical for patients with non-specific epidermolysis bullosa (autosomal recessive type). Mutation in the TGM1 gene that is described in patients with congenital ichthyosis (autosomal recessive type), pathogenic mutations in KRT74 gene typical for ectodermal dysplasia, hypotrichosis and uncombable hair syndrome, and mutations in the KRT86 gene typical for monilethrix were also revealed. Medical history taking and histological examination as well as clinical data evaluating are crucial for correct diagnosis. They allow to understand the absence of the such manifestations in relatives and reveal various pathological processes in the epidermis. Molecular genetic testing with new generation sequencing (NGS) helps to finally establish the diagnosis and determine the further tactics for patient management.Conclusion. Multidisciplinary approach and use of high-technology methods of examination and treatment (such as molecular genetic testing and biological therapy) are required for final diagnosis in severe forms of chronic dermatosis resistant to treatment and for decision on correct tactics for the further management of such patients.

Federation Skin lesions with development of erosive-ulcerative defects and impaired skin barrier function are common for large number of diseases. Successful epithelization of skin defects depends on the wound process, body’s compensatory functions, environmental factors and correctly selected treatment. Comprehensive treatment should include systemic and local therapy as well as current dressings. The article shows current dressings possibilities the treatment of various skin diseases, outlines all pros and cons of the major current dressings.

Atopic dermatitis (AD) is chronic recurrent inflammatory skin disease with a high prevalence and significant negative effect on patients' quality of life. AD pathogenesis is based on the complex interactions between genetic factors, immune mechanisms, state of the skin barrier and environmental effects. The climate itself is the complex of many components, such as: temperature, humidity, precipitation, wind and season. All of them play fundamental role in the natural ecosystem and human health establishment. The climate is changing rapidly, and these changes are progressing faster than ever in the last thousand years. This review shows how climate and environmental changes can affect the course of AD. The data on utilization efficiency of emollient plus for moderating of climatic conditions adverse effects on epidermal structures at patients with AD is presented.

Psoriasis is chronic inflammatory skin disease that can develop at any age. Approximately 20–30% of all patients report about first rashes before the age of 18. Psoriatic arthritis is one of psoriasis comorbid conditions. Its signs can range from mild to extremely severe destructive forms. Arthralgia, joint stiffness and swelling are the most common symptoms. Early psoriatic arthritis treatment onset allows to control joint damage which usually occurs during the first 2 years of the disease. The moderate and severe course of psoriasis and psoriatic arthritis may require systemic therapy, however, there is not much data on the efficacy and toxicity of systemic agents in the pediatric practice. This article provides the review of studies on etanercept efficacy and safety in children with psoriatic arthritis.

Atopic dermatitis (AD) is one of the most common inflammatory diseases of childhood, and it is the first one in gradual development of allergic diseases, also known as «atopic march». Sensitization establishment during the AD uncontrolled course is associated with the high risk of developing of serious allergic pathologies, increase in the severity of the disease course, and patients’ quality of life reduction. Thereby, it is crucial to achieve quick jugulation of the inflammatory process in case of severe AD with early onset of disease. This article shows modern therapeutic approaches to disease control in children.

Background. Wells syndrome (eosinophilic cellulitis) is recurrent granulomatous dermatitis with peripheral blood eosinophilia. This is extremely rare pathology, therefore, there are no reliable epidemiological data on its prevalence. Only about 200 cases were recorded worldwide and 30 of them among children according to the meta-analysis (2012). The disease is mostly sporadic, there are rare family cases, according to the results of little number of scientific publications.Clinical Case Description. The clinical case of Wells syndrome in female 4 years old patient is presented. Clinical findings included symmetrical skin lesions, nodes and large irregular edematous plaques of red-purple color with clear fluid vesicles on its surface. The disease had wavy course: rashes have recovered spontaneously over 7–10 days, new elements appeared alongside with feeling unwell, fever up to 37,8°C and abdominal pain. Similar clinical findings of rashes were observed in paternal relatives of the child.Conclusion. Differential diagnostics of Wells syndrome should be carried out with skin granulomatous diseases and hypereosinophilic syndrome that may be characterized by similar clinical findings. Verification of Wells syndrome diagnosis is complicated due to its rareness, low awareness of dermatologists and pediatricians about this pathology, as well as ignoring the need to carry out histological tests during the disease exacerbation.

Atopic dermatitis (AD) is one of the common multifactorial inflammatory diseases manifesting predominantly in childhood. There is significant number of cases of self-regression of the disease with aging. On the other hand, there is also another scenario ending with AD persistent course and/or development of comorbid allergic pathologies that can significantly worsen patient’s quality of life and finally lead to social maladjustment. The pathogenesis of such way includes epidermal barrier disturbance, transcutaneous sensibilisation and aberrant allergic (Th2) immune systemic response development. Main role in preventing of this pathological pathway is lying on the new class of moisturizers containing active components "emollients plus". They are considered as foundation for the therapy and prevention of the development of AD and other allergic diseases. This literature review provides relevant data on AD pathogenesis and development of comorbid allergic pathologies. This paper also covers data on the effect of emollients in restoration of the epidermal barrier and their use as preventive measures.

Pyodermas are the most frequent reason for visiting dermatologists among children. The immunity to development of pyodermas is based on skin barrier the part of which is cutaneous microbiome. The microbiome composition is unique and depends on age, localization on various body regions, environment. The change of its qualitative and quantitative composition leads to the development of purulent dermal diseases characterized by clinical diversity and severe course and development of complications (without adequate treatment). In this regard the choice of the correct therapy remains relevant. The results of studies covering the effectiveness of various topic antibacterial agents are analysed. Practical aspects of pyodermia therapy in children using local therapy are illustrated.

Atopic dermatitis is a chronic inflammatory disease characterized by relapsing course, severe itching, erythema and dry skin due to skin barrier defects and staphylococcus infection. According to current guidelines for the treatment of atopic dermatitis (prepared by dermatological societies) the background therapy is prolonged application of emollients directly on the skin and its use during bathing. Clinical studies have shown that repeated administration of emollients moisturizes the skin, restores its barrier and normal functioning, and reduces the amount of glucocorticosteroids needed for atopic eczema therapy in infants, children and adults. The results of trials and long-term clinical practice have proven that emollients are safe and effective in patients with atopic dermatitis. This article presents the information based on the recent data concerning emollients: their characteristics, mode of action, role in atopic dermatitis treatment, and results of clinical trials conducted in such patients.

The atopic dermatitis (AD) is common skin disease and has significant impact on patients and their families quality of life. In recent years the term “sensitive skin" has been used more frequently. It is separate syndrome with subjective perception (such as burning, itching, tingling, etc.) along with thickening and dryness of the skin in response to environmental factors (biotic, abiotic and anthropogenic) which normally do not cause such symptoms. This syndrome is often associated with AD. The AD and sensitive skin syndrome pathogenesis and their management are presented in the article. Efficiency and safety parameters of pimecrolimus 1% cream in children (including its appliance on sensitive skin areas) are analysed.

Background. Epidermolysis bullosa acquisita (EBA) is chronic disease accompanied with subepidermal blistering on skin and mucous membranes as a result of autoimmune aggression to type VII collagen. EBA diagnostics in children is complicated due to similarity of clinical presentation with other bullous dermatosis in children.Clinical Case Description. The description of three clinical cases of EBA in children is provided. It is shown that for establishing the diagnosis it is necessary to estimate clinical evidence and to define the depth of blisters according to the results of histological examination of skin biopsy sample. Determination of IgG deposition positions relatively to the skin basal membrane due to performed indirect immunofluorescence test helps us to establish final diagnosis and specify patient management. Medical drug Dapsone was used in children with EBA, it has shown to be effective and safe to use as the first-line drug in management of such patients.Conclusion. The algorithm for EBA differential diagnosis with other bullous dermatosis in children is provided. Successful results of medical treatment are described.

Background. In recent years, the opinion has been established that skin manifestations of psoriasis are associated with the damage of other organs and systems, and that psoriatic lesions have a systemic nature, and therefore the term ‘psoriatic disease’ is increasingly used in scientific literature. Among psoriasis comorbidities, metabolic disorders and cardiovascular diseases are of particular clinical importance. Our aim was to study the effect of systemic cytostatic therapy with methotrexate on the remodelling processes of large vessels in children with psoriasis who have normal and increased body mass index. Methods. The primary data was collected by extracting data from medical records and case follow-up records. The subsequent accumulation, storage, grouping and primary sorting of research data were carried out using a personal computer and Excel application package. Clinical evaluation of the severity of psoriasis and skin lesions was assessed by calculating the PASI index. Non-invasive oscillometric arteriography was performed on a portable ArterioGraph (TensioMed Ltd, Hungary). Results. A direct significant correlation has been established between the revealed impairments of the function of large arteries and the indicators of fat metabolism, the severity of psoriasis and body mass index. During the systemic pathogenetic cytostatic therapy with methotrexate, a significant positive dynamics of the function parameters of large arteries was revealed in children with psoriasis who have both normal and increased body mass index. Conclusion. The undertaken studies showed that methotrexate is an effective and safe agent for treating psoriasis in children aged from 3 to 18 years, has a positive effect on the function of large vessels.Nikolay N. Murashkin — receiving research funding from pharmaceutical companies Jansen, Eli Lilly. Receiving fees for scientific advice from Galderma, Pierre Fabre, Bayer, Astellas, Libriderm.Alexander I. Materikin — receiving research funding from pharmaceutical company Eli Lilly. Receiving fees for scientific advice from Bioderma, Libriderm.

The article presents the modern knowledge of the structural and functional peculiarities of the skin in children. Information on the etiopathogenesis of a debut atopic dermatitis has been also given. The results of our own observations with an analysis of the clinical efficacy and safety of cosmetics based on highly purified lanolin and cotton extract in infants have been presented.

Reduced skin barrier properties in patients with atopic dermatitis (AtD) are largely caused by microbiome changes and extensive Staphylococcus aureus colonisation of the skin. In this regard, the integument of patients with AtD requires constant care and the use of various emollients. The inclusion of lysates of non-pathogenic microorganisms and prebiotics in the composition of emollients ensures the normalisation of the microbiome composition and the immunological barrier of the skin. The article presents the results of our own observations on the application of two cosmetic scin-care products for damaged skin with vitamin F in children with AtD complicated by a secondary infection, while the composition of one of the products is additionally enriched with ceramides and prebiotics. The safety and high efficacy of both products have been shown, however, the presence of ceramides and prebiotics in the emollient composition makes it possible to achieve a marked decrease in the degree of S. aureus colonisation of the skin.

Atopic dermatitis is a common chronic inflammatory skin disease characterized by a recurring course and progressive decrease in the quality of life. Recent studies in this area demonstrate the multifaceted pathogenesis of atopic dermatitis. Interaction of such factors as epidermal dysfunction, immune system disorders, and the consequences of genetic mutations contributes not only to the development of the disease but also to its progression and chronic course. The article presents various components of the etiopathogenesis of atopic dermatitis, describes the role of lipids, thereby the new therapeutic targets are revealed to specialists.

Diaper dermatitis is a disease belonging to the group of contact dermatitis. Clinical manifestations include skin inflammation in the area of contact with the diaper due to barrier epidermal dysfunction. The paper analyses the pathogenesis of the disease and presents data on a local clinical study on the safety and efficacy of the medication with a regenerative potential.

The article analyzes the current data on the pathogenesis of atopic dermatitis. It discusses the role of the damaged dermal barrier structure in the development of food allergies and presents the results confirming the theory of transdermal sensibilisation to allergens in addition to hereditary and exogenous factors. Current local treatment of atopic dermatitis using topical glucocorticosteroids (tGCs) aimed at reducing the severity of symptoms is often associated with the risk of complications. The data on the effective use of topical calcineurin inhibitors (TCI) to eliminate the side effects of tGCs are presented. The results of the possible use of pimecrolimus in the form of 1% cream for gradual withdrawal of tGCs in the long-term use are shown. The data of reviews and meta-analyses for the last decade are given showing that there is no evidence that the use of TIC is associated with an increased risk of lymphoma. The authors conclude that pimecrolimus in the form of 1% cream is the best medication for topical therapy in children with mild and moderate form of the disease. It is also considered the best preparation for the proactive treatment of atopic dermatitis in the long period of time in order to prevent recurrences.