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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.

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 (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.

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.

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.

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.