Atopic dermatitis is a hereditary inflammatory skin disease characterized by pruritus, a long recurrent course and certain evolutionary dynamics. Atopic dermatitis of moderate and severe severity is considered a systemic disease that exacerbates the course of associated pathologies, including cardiovascular, neuropsychiatric, and malignant diseases. The current paper presents the essentials about moderate and severe severity atopic dermatitis, statistical epidemiologic and pathogenetic data is thoroughly processed, the issues of the quality of life of such patients are especially accentuated. It is known that a few years ago the therapy of moderate and severe atopic dermatitis was based on systemic corticosteroids and classical immunosuppressants, but they had limited efficacy and were not suitable for long-term treatment due to their safety profile. This article highlights the development of new effective and easy-to-use therapies for atopic dermatitis, which led to the emergence of selective Janus kinase inhibitors. The review presents the way selective inhibitors of Janus kinases works and their effect on the barrier function of the skin. The paper provides the research data on the very first drug from the group of selective inhibitors - upadacitinib, which proved its efficacy on a par with a high degree of safety. The authors presented their own clinical observation of the use of upadacitinib in adolescents with severe atopic dermatitis. The use of upadacitinib in the described clinical cases led to a decrease in the severity of subjective and objective symptoms of inflammatory skin diseases.

Skin xerosis is a common symptom that indicates of impaired skin barrier function. Such diseases as atopic dermatitis (AD) and ichthyosis are associated with genetic mutations of epidermal differentiation genes, while in other diseases (contact dermatitis, eczema) epidermal barrier disorders occur as a result of inflammatory process in the skin, mechanical or chemical damage, significantly affecting the course of the pathological process. The article highlights modern data on the importance of the main structural protein of the stratum corneum filaggrin (FLG) and the role of its deficiency not only in dermatologic diseases, but also in the development of hyperresponsiveness. The main methods of correction of skin barrier disorders are emollients, which belong to the methods of basic therapy in AD and are recommended for the complex therapy of other pathological conditions accompanied by xerosis. At the present time, an innovative method has been developed, that allows not only to replace FLG deficiency, but also to activate and stimulate protein synthesis in the skin. In this regard, a unique dermatocosmetics product “Admera”, which belongs to the category of “emollients plus” due to the combination of all the necessary properties of the emollient and the presence of FLG synthesis modulator filagrinol, is of interest. Filagrinol is a proprietary complex of active ingredients that activate enzymes involved in dephosphorylation of the FLG predecessor profilaggrin and increase the concentration in the stratum granulosum сells of a histidine-rich glycoprotein, involved in the formation of the stratum corneum cytoskeleton. The article presents a review of clinical studies on the efficacy of Admera cream and presents our own clinical experience of its use in patients with AD and hand eczema.

Introduction. Atopic dermatitis (AD) is one of the most common dermatitis, characterized by complex pathogenetic mechanisms. Psychological stress is recognized as one of the triggers of AD. Stress causes a high release of cortisol and epinephrine or norepinephrine, stimulating the immune system, primarily T helper cells type 1 (Th1 cells), to produce pro-inflammatory cytokines, leading to a cellular immune response and inflammation. In recent years, there has been an increase in incidence among pregnant women, however, the specific mechanisms of the development of AD during pregnancy still remain poorly understood. Aim. To study the role of cortisol in AD during pregnancy.

Materials and methods. The study included 76 pregnant women during an exacerbation of AD, 20 non-pregnant women during an exacerbation of AD, 20 non-pregnant women without AD, 20 pregnant women without AD. The severity of AD was determined using the SCORAD index. Cortisol levels were determined in blood serum using enzyme-linked immunosorbent assay (ELISA). Anxiety level was determined using the Beck Anxiety Inventory. The level of itching was determined using a 5D itching scale.

Results. Cortisol levels in pregnant women with AD (629.8 pg/ml) were significantly higher than in non-pregnant women with AD (386.15 pg/ml) (p < 0.05). Cortisol levels were correlated with the severity level (Spearman coefficient = 0.203, p = 0.018), anxiety level (Spearman coefficient = 0.411, p = 0.001), and level of itching (Spearman coefficient = 0.352, p = 0.001).

Conclusions. Cortisol is important in the pathogenesis of AD during pregnancy. During pregnancy with exacerbation of AD, higher values were observed than outside pregnancy.

Psoriasis therapy is an acute issue in modern medicine. To date, much progress has been made in the field of genetically engineered biological therapy (GEBT) for psoriatic disease. The new treatment paradigm was made possible by the continuous advancement of understanding of the pathophysiology of the disease. GEBT represents an evolved treatment regimen in which targeted immunomodulation has led to significant improvements in the safety and efficacy of biological agents. Understanding the key role of interleukin-23 (IL) in the pathogenesis of psoriasis has led to the development of new drugs. Risankizumab is a humanised monoclonal antibody – immunoglobulin class G1 – specifically targeted at cytokine IL-23 inhibition by binding to its subunit p19. The efficacy and safety of the agent have been demonstrated both by the results of clinical trials and studies of real clinical practice. The article presents key data on the applicability of the drug risankizumab, and describes the clinical experience of managing a patient with psoriasis and aggravated comorbid conditions. It is currently known that a significant problem in the management of patients receiving GEBT is the presence of comorbid diseases. Difficulty in optimal treatment control, decreased response to therapy and increased risks of adverse events have all been noted. This study confirms the efficacy and safety of risankizumab therapy in patients with psoriasis and comorbidities. Thus, risankizumab is a promising drug for the treatment of moderate and severe forms of psoriasis, its use can significantly improve the quality of life of patients suffering from this disease.

Atopic dermatitis (AtD) is currently considered as a systemic disease due to the fact, that disorders of innate and adaptive immune response, especially pronounced in severe course, are manifested not only in skin inflammation, but also can be realized in the development of other chronic diseases, including autoimmune profile. One of the autoimmune comorbid diseases in AtD is alopecia areata (AA), which is confirmed by epidemiologic data, clinical features and identification of common immune links of pathogenesis in the case of association of these diseases. Janus-kinase inhibitors, which represent a new class of targeted synthetic basic anti-inflammatory drugs, are currently the main pathogenetic treatments for severe forms of AtD and AA. Acting on several immune axes, these drugs selectively and reversibly modulate the signaling activity of key inflammatory cytokines, which makes them the most promising strategy for systemic therapy of these dermatoses, including in cases of their combination. The article covers the review of pathophysiology and application of first and second generation JAK-inhibitors in AtD and AA, including the analysis of their efficacy in the simultaneous presence of these pathological conditions. We present own observations of two patients with severe comorbid conditions AtD and AA, treated with the JAK-inhibitors abrocitinib and upadacitinib. These examples confirm the efficacy of Janus-kinase inhibitors in AtD and AA in real clinical practice and describe the experience of switching from one JAK-inhibitor of the first generation to another, selective JAK-inhibitor, as well as the effect of of these drugs on the course of both pathologies. Taking into account the necessity of long-term use of JAK-inhibitors, further study of their long-term efficacy and safety remains relevant.

Often enough, women of reproductive age make medical appointments for problems such as acne and rosacea. Treatment of these diseases in this group of patients has unique features. For example, isotretinoin can only be administered for some indications and in combination with most effective contraceptive methods due to its teratogenicity. Also worth noting is that acne prevalence rates among pregnant women are quite high – up to 43% according to various studies. In fact, symptoms of the disease develop during the second and third trimesters. The choice of therapy for these patients is limited and mainly includes topical drugs. The acne management strategies in women planning pregnancy are similar to that in pregnant women. Foreign studies show the relationship between rosacea and hormonal and reproductive factors. Thus, the disease often develops in premenopause; the risk of developing rosacea is also increased in nulliparous women and women delivering their first and last child at an older age. In our practice, we often prescribe a 1% clindamycin solution as a topical antibiotic. The drug is easy to apply and is not visible on the skin after its use. Absence of drug-induced photosensitivity is a significant advantage of the solution over drugs from other groups, which allows using the drug during periods of high solar activity (in particular, in spring and summer). This is also important for patients with rosacea, as exposure to ultraviolet light is one of the factors known to aggravate the disease. A number of management strategies and treatment algorithm for patients of reproductive age suffering from acne and rosacea that are provided in this work will help physicians to select the optimal and safe treatment with due account for reproductive life plans.

This article discusses the relevance of the causes and further development of contact dermatitis. In accordance with the clinical recommendations of the Ministry of Health of the Russian Federation, simple irritable contact dermatitis is an acute or chronic inflammatory skin disease caused by the irritating effect of environmental factors on the skin. Allergic contact dermatitis is an acute or chronic inflammatory skin disease that occurs in response to skin contact with substances that can cause sensitization and specific allergic inflammation. Allergic contact dermatitis can develop because of a reaction to absolutely any substance. This is a common pathology among skin diseases, manifested by polymorphic symptoms and its regression as the etiological factor and appropriate therapy disappear. The mechanisms of development of various forms of dermatitis are described, the immunological disorders that occur in this pathology are indicated, the clinical features are indicated. The publication examines various clinical cases of somatically healthy patients suffering from simple contact and allergic dermatitis caused by variant factors, with localization of the pathological process in the facial area. According to the doctor’s prescription, patients used traditional therapy regimens consisting of external/topical treatment and general therapy, strictly in accordance with clinical recommendations. Topical glucocorticosteroids are the first line of therapy for contact dermatitis and it is extremely important to choose modern drugs with a high safety profile when localizing foci on the face. At the end of the course of treatment, patients noted a significant improvement in the condition of the dermis in the form of minimizing the manifestations of erythema of the skin, the disappearance of polymorphic skin rash elements, and the disappearance of exfoliation.

Psoriasis is a chronic immune-mediated disease that leads not only to damage to the skin and its appendages, but is also associated with concomitant systemic diseases, including damage to the musculoskeletal system, cardiovascular pathologies, kidney disease, metabolic syndrome and changes in the nervous system. Not long ago, a term was introduced to unite psoriasis and concomitant comorbid diseases – psoriatic disease. Recently, special attention has been paid to assessing the psychoemotional state and quality of life of patients with psoriasis who bear the burden of a chronic disease. It is no secret that any skin disease significantly worsens the quality and standard of life of the patient and can lead to social and professional stigma and discrimination, and a number of restrictions. Psoriatic disease is recognized as a multisystem inflammatory disease and a holistic approach to treatment is recommended, focusing on comorbidities, including mental health, psychosocial well-being and quality of life. The Dermatological Life Quality Index (DLQI) is one of the most convenient indices that allows you to assess the severity of the burden of chronic skin diseases, including psoriasis, on a person’s daily activities; a correlation was found between the severity of psoriasis, the presence of concomitant diseases, especially psoriatic arthritis and the DLQI level. DLQI is higher in patients with moderate to severe psoriasis, in patients with mild psoriasis (low PASI index), but with damage to socially significant areas of the skin (face, hands and feet, scalp, genitals, nail plates), in patients with active manifestations of psoriatic disease in the form of concomitant diseases, which complicates the choice of drug for treatment. The availability, effectiveness, and treatment regimens of modern drugs play an important role in the psycho-emotional state of patients. Today the biological drugs have been actively used in the treatment of psoriasis, which have a number of advantages compared to drugs of basic anti-inflammatory therapy and phototherapy, and, accordingly, are more effective and are of value for patients who experience emotional discomfort from a chronic skin disease in everyday life. The purpose of this article was to study the prevalence and nature of mental and psychiatric pathologies in patients with psoriasis, the possible improvement of DLQI in patients with psoriasis using a biological drug from the group of interleukin-23 inhibitors guselkumab.

The review article is devoted to the aspects of rosacea therapy in a megalopolis, where a dermatological service is widely developed and it is possible to provide modern diagnostic, therapeutic and preventive measures. Rosacea negatively affects the emotional state of patients, and low awareness of chronic dermatoses often leads to self-medication and skin deterioration. The pathogenetic mechanisms of the disease have not been fully studied. Both genetic predisposition and environmental factors contribute to the occurrence of rosacea. A number of studies confirm that the triggers can be ultraviolet radiation, stress, intense physical activity, temperature changes, dietary characteristics, imbalance of the intestinal microbiota, alcohol consumption. Every day, residents of megalopolises face a combination of these factors, which combined with genetically determined features of the epidermal barrier and immune function, makes them more susceptible to rosacea and other skin diseases. The multifactorial nature of rosacea causes a variety of treatment methods that must be individualized in accordance with the clinical picture of the disease. With mild to moderate rosacea, monotherapy with external drugs is effective – azelaic acid, brimonidine tartrate, ivermectin, metronidazole. For the treatment of severe forms of rosacea, it is advisable to prescribe systemic therapy from groups of retinoids and antibiotics. The results of numerous studies are presented that physiotherapy methods which are available in large cities increase the effectiveness of treatment by reducing erythema and telangiectasia, enhancing repair and microcirculation in the epidermis. The accumulated experience of Russian dermatologists and foreign colleagues allows to determine the most effective combinations of treatment methods to achieve stable remission in patients.

The skin, as an organ in combination with a large number of commensal bacteria that colonized its surface and hair follicles, should be considered as a full-fledged and complex ecosystem. The imbalance of the skin microbiome can lead to skin diseases. The proportion of pyoderma among all skin pathology ranges from 17 to 36% among the population of the Russian Federation. Most skin infections occur de novo, but pyoderma often occurs when exposed to predisposing factors (for example, a violation of the skin barrier, the presence of maceration, old age, diabetes mellitus, obesity, peripheral arteriovenous insufficiency, corticosteroid treatment or chemotherapy, dysglobulinemia, blood diseases, cachexia, congenital or acquired immunodeficiency). Staphylococcus aureus and Streptococcus spp. they are the cause of most pyoderma. In patients undergoing long-term hospital treatment, S. aureus, P. aeruginosa, Enterococcus spp. and Escherichia coli are often the causative agents of skin infections. In localized, uncomplicated superficial pyoderma, local therapy is most often used. Dioxidin® is a derivative of di-N-oxy quinoxaline, a synetic broad-spectrum bactericidal drug that has been actively used by otolaryngologists and surgeons since 1976 to combat various bacterial infections. The drug is produced in the form of an aqueous solution for intravenous and intracavitary administration, as well as in the form of new dosage forms for topical and external use. Dioxidin is characterized by high bactericidal activity against a wide range of microorganisms, including anaerobic ones, and also acts against Candida albicans. This drug is able to completely suppress microorganisms with acquired resistance to antimicrobial drugs of other classes, including multiresistant strains. Dioxidine® in a new dosage form (0.25 mg/ml solution for topical and external use) has shown high efficacy when applied cutaneous to superficial pyoderma.

Post-inflammatory hyperpigmentation (PIH) is one of the most significant problems in patients with acne. The prevalence of PIH among patients with acne varies from 45 to 87%. Post-acne, including PIH, has an extremely negative impact on the quality of life and psychological well-being of patients, as it is often resistant to therapy and can persist for even several years. Successful acne treatment does not guarantee complete elimination of PIH and other post-acne symptoms. In the development of PIH, a key role is played by the mechanism associated with the production and distribution of melanin, which is activated by inflammation and the release of cytokines that promote an increase in the level of immunoreactive tyrosinase, which stimulates melanocytes, activation of melanogenesis and further transfer of melanosomes to surrounding keratinocytes. It is important for clinicians to recognize the psychosocial impact of PIH and manage inflammation, as well as proactively address residual PIH with appropriate treatment. Thus, prevention and correction of PIH should be one of the goals of acne treatment. Topical therapy for PIH in acne is considered the most acceptable and can be prescribed both as monotherapy and as part of combined methods. Tyrosinase is a target for topical anti-pigmentation agents, including hydroquinone, kojic acid, and resorcinyl thiazole derivatives. The latter includes isobutylamidothiazolyl resorcinol – thiamidol. The article provides a brief overview of data on the epidemiology of PIH, its pathogenesis, impact on the quality of life of patients and the perception of their image by people around them. Clinical experience with the use of anti-hyperpigmentation serum with thiamidol, licochalcone A and sodium hyaluronate is presented, which confirms the effectiveness, safety and feasibility of prescribing products with thiamidol for the treatment of PIH caused by acne.

Hand eczema is one of the most common dermatoses at the doctor’s office during visits. There is some evidence that the prevalence rates reach almost 15% of the population. This disease greatly affects patients’ quality of life, work activities and other areas of life. The eczema pathogenesis is quite complex and is built up of genetic factors, environmental effects and various irritating agents. Disturbances of skin barrier also plays a significant role in the development of the disease. For example, patients with atopic dermatitis often suffer from hand eczema. Excessive hand hygiene (frequent washing and use of alcohol-based products) also increases the risk of developing this unpleasant dermatosis. Clinical features distinguish acute from chronic eczema. Acute eczema manifests as erythema, oedema, and vesicular rashes. The chronic course is characterized by skin thickening, peeling, erosion and cracks. Exacerbations occur 2 or more times per year. Hand eczema can be divided into irritant, which develops in response to contact with physical, mechanical, and chemical irritants, and allergic, which is provoked by contact with an allergen that induces type IV immune response. It is also common to distinguish protein contact dermatitis, which refers to a subtype of allergic eczema. Traditionally, moisturizers and topical corticosteroids are used for the treatment of hand eczema. Among topical corticosteroids, methylprednisolone aceponate (Advantan®) is especially worth noting. In addition to the pronounced therapeutic effect, the option to use it once a day is an undoubted advantage over many other drugs. This fact has a positive effect on therapy adherence. This topical corticosteroid is well tolerated and highly effective for the treatment of eczematous dermatitis, which is confirmed by many-year experience in using it.

Peri-wound dermatoses are a fairly common occurrence in clinical practice. In general, they are all allergic in nature and occur on the skin around the surface area of both primary and postoperative wounds. Peri-wound skin lesions can develop as paratraumatic eczema, simple contact or allergic dermatitis. All these dermatoses can be complicated by a secondary bacterial or mycotic infection, both exogenous and endogenous, which significantly complicates the course of the dermatitis itself and wound healing. The patient is exposed to a fairly large number of potential allergens in the course of surgical care provided at all stages: both in the pre- and postoperative period, and during the surgical intervention. Among them may be drugs and antiseptics, surgical sutures, implants, and even latex gloves of healthcare practitioners in some cases. When it comes to potential allergens, foci of chronic infection in the patient’s body, as well as secondary wound infections should be noted as a separate matter. The presence of peri-wound dermatoses is the most common cause of delayed surgical debridement, and can also become an obstacle to surgical treatment and healing of the wound surface. In addition, pre-existing paratraumatic eczema can progress to a chronic course and contribute to the further spread of the inflammatory process. Thus, peri-wound dermatoses are a pressing interdisciplinary issue. Patients with peri-wound dermatoses require a personalized selection of combination therapy and additional consultative assistance from highly specialized doctors. Fixed-dose topical glucocorticoids combined with antibiotics and antimycotics may be the drugs of choice for patients with peri-wound eczematous process, with due account for complex pathogenetic effects and ease of use. The article describes clinical cases of dermatoses developed in surgical patients.

Psoriasis is a chronic immune-mediated skin disease of a multifactorial nature, characterized by accelerated proliferation of keratinocytes and impaired differentiation, an imbalance between pro-inflammatory and anti-inflammatory cytokines, with frequent involvement of the musculoskeletal system in the pathological process. The etiology of psoriasis is unknown, but several risk factors have been identified, including family history, smoking and obesity. The high prevalence of obesity, diseases of the cardiovascular system and digestive organs in patients with psoriasis allows us to consider it as an indicator of the patient’s metabolic disorders. In the structure of comorbidity of patients with psoriasis, special attention is drawn to non-alcoholic fatty liver disease (NAFLD), which occupies a leading position in the structure of the incidence of chronic diffuse liver diseases among the adult population in many countries of the world, including Russia. Patients with psoriasis are more often diagnosed with NAFLD, regardless of the presence of metabolic syndrome and other traditional risk factors. The presence of NAFLD is associated with more severe psoriasis and worse outcomes. On the other hand, a negative effect of psoriasis on the course of liver pathology has been noted. In this regard, it seems particularly relevant to study the etiological factors and pathogenetic links underlying this comorbidity, as potential targets for targeted therapy, which can improve the effectiveness of treatment for this cohort of patients. The purpose of this review publication is to summarize and systematize the available data on the prevalence of comorbidity of psoriasis and NAFLD in the population, the mechanisms of its formation and approaches to patient management.

Inflammation of the lip skin that can be characterized by peeling, erythema and swelling is known as cheilitis. This condition may be present in a number of skin and systemic diseases. The inflammation process is usually limited to the vermillion border of the lips, but in some cases, it may spread to the skin surrounding the lips and even to the oral mucosa. Cheilitis can be divided into several types due to its causes. Irritant contact cheilitis is the result of frequent hot or dry air exposure. Allergic cheilitis is a delayed reaction following contact with allergens. Atopic cheilitis occurs in individuals suffering from atopic dermatitis. Infection with Candida albicans or Staphylococcus aureus is a common cause of angular cheilitis, which also often occurs as a result of insufficient oral hygiene or improperly selected dentures. Drug-induced cheilitis occurs as a result of intake of certain medications, mainly systemic retinoids. Therapy for cheilitis depends on the factor that triggered the inflammation and is aimed at eliminating unpleasant symptoms. Due to variety of triggers for cheilitis, treatment of this disease may need to consider the involvement of different specialists: dermatologists, dentists, and in some cases, oncologists. Common elements of the treatment of cheilitis, regardless of its etiological factor, is the prescription of special-purpose care products that will have moisturizing and softening effects on the lip skin. This article describes several clinical cases demonstrating the effectiveness of lip care products, which composition provides anti-inflammatory, moisturizing and regenerating effects.

Psoriasis is a common immune-mediated disease, often accompanied by inflammatory and metabolic disorders. About 20–30% of patients have moderate to severe psoriasis and require systemic methods of treatment, which include conventional, targeted and genetically engineered biological drugs (GEBDs). When selecting a biological agent, a number of factors must be considered related to the disease, patient and therapy. Assessment of severity and activity, area of skin affected, frequency of relapses, pruritus and other symptoms, the presence of comorbidities, especially psoriatic arthritis (PsA), are important. The presence of comorbidities that may contribute to or interfere with the use of GEBD is the main factor determining personalised therapy. Personalised treatment implies maximum efficacy and minimum risk of side effects. In addition, it is possible to modify the course of the disease, inducing long-term remission and preventing the development of PsA, which is possible in case of timely prescription of GEBD. To date, several classes of GEBDs are available in the arsenal of dermatovenerologists, among which interleukin (IL) inhibitors have the highest efficacy and safety. The drug ixekizumab is a member of the IL-17 inhibitor group, a monoclonal antibody of the IgG4 class that binds to IL-17A with high affinity and specificity. The drug has shown high efficacy and reliable safety profile in the treatment of psoriasis and PsA within the framework of numerous clinical trials and studies of real clinical practice, including in patients with an aggravated comorbid background and with involvement of hard-to-treat localisations. The presented article presents key data of safety and efficacy studies of ixekizumab therapy, describes a clinical case of successful treatment of a patient with psoriasis and psoriatic onychodystrophy. Timely initiation of therapy helped to stop the progression of the disease and significantly improved the quality of life of the patient. Thus, the presented data confirm the advantages of ixekizumab in psoriasis treatment.

Currently, in dermatology and cosmetology, the range of cosmetic procedures and minor invasive interventions, which use local anesthetics, is expanding. They are used alone or as part of an integrated anesthetic approach. Procedures such as mesotherapy, biorevitalization, contour plastic surgery, removal of skin tumors, and laser procedures require anesthesia in the form of local topical anesthesia. Local anesthetics have long been known and well-studied; they have many advantages, significantly increasing patient comfort during invasive procedures, but they also have some disadvantages, including the risk of toxicity. The purpose of using a local anesthetic is to increase the effectiveness of the procedure, convenience and comfort for the patient, minimize negative emotions associated with pain, and the ability to achieve local anesthesia without anatomical distortion of the tissue (i.e., without the use of infiltration anesthesia). Often, the severity of the pain experienced depends on the individual response of the patient. The characteristics of pain are subjective and can vary depending on the “pain threshold”, type of temperament, and previous negative experience. For some patients, sometimes minimal pain becomes a serious obstacle to performing a particular procedure. Some invasive, painful procedures that are performed on pediatric patients require a particularly careful approach to the choice of anesthesia drug and method of administration. In this article, we analyzed the mechanisms of pain pathogenesis, methods of local anesthesia, focused on the role of local anesthetics in cosmetology and dermatology, examined the features of using a cream for local and external use containing a combination of lidocaine 2.5% and prilocaine 2.5%, its therapeutic effectiveness, clinical recommendations for use in various procedures in dermatology and cosmetology. When choosing a drug for local anesthesia, safety is important for the doctor, when used correctly, a low level of side effects, timely pain relief, effectiveness, ease of use and accessibility.

Introduction. The nail psoriasis severity does not always correspond to the skin process intensity, but often correlates with a more severe, prolonged and aggressive course of the disease.

Materials and methods. 48 adult patients (n = 48) with nail psoriasis were under observation. The severity of the psoriatic lesion of the nails was determined using the NAPSI index (Nail Psoriasis Severity Index). The assessment was carried out before the start of treatment, in the first week, and then every 4 weeks up to and including 52 weeks. The Dermatological Quality of Life Index (DLQI) were determined by questionnaires before the start of treatment, at the 12th and 52nd weeks. All patients on an outpatient basis received netakimab monotherapy at a dose of 120 mg in the form of two subcutaneous injections of 1 ml (60 mg) of the drug, each administered once a week at weeks 0, 1 and 2, then 1 time every 4 weeks. The total duration of treatment for each patient was 52 weeks. The safety of netakimab was evaluated based on the development of adverse events and local reactions to the administration of the drug.

Results. The results of the study for 52 weeks showed high efficacy of netakimab. Average NAPSI score improved – 33.1% by the week 12 of treatment and – 72.3% by the week 52 compared to baseline, the quality of their life improved. During the 52 weeks of the study, there were no cases of early withdrawal due to adverse events and cases of serious adverse events.

Conclusion. Based on the study results we recommend netakimab for medical use among patients with moderate and severe nail psoriasis.