This article discusses the immediacy of the problem of rising incidence of common mycoses that dermatovenerologists deal with at outpatient visits, the reasons for their occurrence, conversion from one course of the disease to another and the use of etiological effective treatments. The author described the mechanisms of development of different mycoses according to their etiology, comorbid disorders accompanying mycoses and the features of the clinical picture based on etiological factors and sites of infection. The article places special emphasis on the reasons for infection with fungal invasions in humans, conditions and numerous contact routes. Modern features of the course of fungal skin diseases include formation of biofilms in the sites of infection, multicentricity, extension of the pathological process, frequent formation of granulomas, follicles, occurrence of numerous mycoides, as well as the low virulence of dermatophytes. The publication also presents various clinical cases of somatically healthy patients suffering from various mycoses caused by variant factors, which have pathological processes located in different sites. According to the doctor’s prescription, patients used conventional treatment regimens that included external/ topical treatment and general therapy, strictly in accordance with clinical guidelines – the use of highly active broad-spectrum antifungal drugs with fungicidal, fungistatic, antibacterial, anti-inflammatory and antipruritic action. These properties ensure a low probability resistance of microorganisms or relapses during treatment with topical dosage forms of antifungal drugs for cutaneous application. Upon completion of the course of treatment, patients reported a significant improvement in their skin condition resulting in minimization of disease symptoms, disappearance of skin rashes, skin itching, and elimination of exfoliation.

Introduction. Dyshidrotic eczema (DE) is a type of true eczema, prone to chronic recurrent course, which has a negative impact on the quality of life of patients. In the domestic literature, insufficient attention is paid to the study of the role and nature of the course of the disease on the daily life of patients with DE.

Aim. To study the quality of life in patients of DE. Provide a description of a clinical cases of DE and experience with external therapy.

Materials and methods. 105 patients with DE aged 18 to 52 years were included in the study, the mean age was 31.3 ± 8.1 years. The quality of life was assessed using the Dermatology Life Quality Index (DLQI). The Dyshidrotic Eczema Area and Severity Index (DASI) was used to clinically assess the severity of DE.

Results. All patients suffering from DE noted a negative impact of the skin process on the quality of life. At the same time, the average DLQI score in all patients was 6.99 ± 4.6, which indicates a moderate undesirable effect of DE on the quality of life, without statistically significant differences by gender. The average DASI score was 12.6 ± 8.8, which indicates a predominance of mild DE in the sample. In women, a process of moderate severity was more often diagnosed and the DASI index was 13.2 ± 8.5. The study demonstrated that the female gender is more susceptible to the influence of DE symptoms on the quality of life, regardless of the severity and extent of the skin process, and minimal changes in the skin can have a negative impact on the quality of life. The article presents clinical examples of successful treatment of DE localized on the skin of the hands with an external preparation containing a combination of 0.05% betamethasone dipropionate, 0.1% gentamicin sulfate and 1% clotrimazole.

Conclusion. DE is a common condition and affects quality of life. Proper diagnosis is essential for effective and efficient treatment. External therapy with the inclusion of a cream (ointment) containing a combination of 0.05% betamethasone dipropionate, 0.1% gentamicin sulfate and 1% clotrimazole gives better results and increases satisfaction with the treatment of patients with DE.

Questions of the etiology and pathogenesis of vitiligo remain open to this day. Of the majority of hypotheses for the development of vitiligo, the leading role today belongs to the autoimmune theory. The most relevant for solving issues of both therapy and diagnosis of the disease are studies devoted to the immunological mechanisms accompanying the development of vitiligo. The article describes both immunological markers of autoimmune diseases of satellites and changes in immunity during the disease itself. The question of the activity of the process sometimes causes great difficulties, both for the doctor, and the patient himself sometimes cannot say for sure whether there is a growth of foci, especially with a widespread process. In the article we touched upon the issues of consideration and immunological markers, which, according to pilot studies, can serve as laboratory indicators of activity. The roles of interleukin 17, imbalance between subpopulations of T-helper lymphocytes type 1 (Th 1) or Th 17 and Tregs and Th 2, cytokine imbalance, JAK1 and JAK2 kinases, CXCL 9, CXCL 10, granzyme B are described.

Introduction. Psoriasis affects various aspects of the quality of life of patients, causing psycho-emotional stress, anxiety and depression, therefore treatment of patients in terms of long-term control is the main goal of therapy.

Aim. To study the effectiveness of drugs containing calcipotriol and betamethasone in the treatment of plaque psoriasis of smooth skin, scalp, palmoplantar mild to moderate severity.

Material and methods. We observed 59 patients and 32 patients with moderate plaque psoriasis (PASI > 10 and < 20 points). In the groups, patients were randomized into subgroups with mild and moderate severity of psoriasis.

Results. In patients with mild and moderate plaque psoriasis, after 4 weeks there was a decrease in the PASI index by 89.1% and 64.1%, respectively, the DLQI index decreased by 53.8% and 61.9%, the sPGA index by 71.8% and 64.9% for mild and moderate degrees, respectively. In patients with mild and moderate palmoplantar psoriasis, after 4 weeks there was a decrease in the PPASI index by 64.2% and 62.1%, respectively, the DLQI index decreased by 56.4% and 56.7%, and the sPGA index by 63.4 % and 66.7% for mild and moderate degrees, respectively. In patients with mild to moderate psoriasis of the scalp, after 4 weeks there was a decrease in the PSSI index by 75.1% and 72.6%, the DLQI index decreased by 64.6% and 69.6%, and the sPGA index by 62.3% and 67.6% for mild and moderate degrees, respectively.

Conclusion. A 52-week follow-up demonstrated the effectiveness and safety of therapy with combination drugs (Daivobet® and Xamiol®) in patients with plaque psoriasis, including scalp psoriasis and palmoplantar psoriasis. It also showed a pronounced positive effect on the quality of life of patients, including in terms of long-term control of the disease.

The growing number of children with rare diseases such as cutaneous mastocytoma and juvenile xanthogranuloma turning to dermatologists, as well as their clinical similarity, dictate the need for specialists to pay careful attention to these diseases. cutaneous mastocytoma is a clinical form of cutaneous mastocytosis. According to the WHO classification (2022), isolated (one focus) and multiple cutaneous mastocytoma (no more than three foci) are distinguished. juvenile xanthogranuloma belongs to the group of non-Langerhans cell histiocytosis, a broad group of related diseases characterized by the proliferation of histiocytes other than Langerhans cells. We describe a case of an unusual clinical course of solitary juvenile xanthogranuloma in a 3-year-old boy referred to Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology with suspected cutaneous mastocytoma. The size, unusual shape, localization of the lesion and elevated levels of serum tryptase exceeding the age norm (<5 μg/l) determined the atypicality of this case. Dermoscopic examination revealed a central deep yellow coloration of the lesion in the center (the setting sun symptom), a vascular pattern and a clouds symptom. Pathological examination confirmed the diagnosis of juvenile xanthogranuloma. The article also reflects the results of a dynamic observation of a child with an isolated large-sized cutaneous mastocytoma. During the examination, an increase in tryptase levels (>20 μg/l), and AST values, as well as ultrasound signs of hepatomegaly were revealed. Features of the dermoscopic and pathomorphological picture demonstrated patterns characteristic of infiltration and increased activity of mast cells. Cutaneous mastocytoma and juvenile xanthogranuloma are rare and benign skin diseases that usually begin in childhood. Diagnosis of rare diseases often requires complex differential diagnosis. Features of the modern course of cutaneous mastocytoma and juvenile xanthogranuloma are an atypical clinical picture and a high risk of developing extracutaneous symptoms. The presented clinical cases demonstrate the need for interdisciplinary monitoring of patients with these diseases and change the stereotypes of treating them as independent and regressive processes without a trace.

Introduction. Alopecia areata (AA) and atopic dermatitis (AtD) are associated with significant psychosocial burden, emphasizing the importance of quality of life (QoL) assessment due to potential psychological distress and treatment hindrance.

Aim. To conduct a comparative analysis of QoL, anxiety and depression in patients with AA, AtD and their combination, according to diseases severity.

Materials and methods. The study included 91 patients of both sexes (18–52 years old). All patients were divided into 3 groups: group 1 – 25% patients with AA, group 2 – 28% with AtD, group 3 – 47% patients with both diseases; the groups were subdivided by dermatoses severity. The DLQI, Skindex-29 and HADS questionnaires were used. Mann-Whitney U-test was conducted to compare the mean values of quantitative data (М ± n) (p < 0.05).

Results. Group 1 had moderately decreased QoL according to DLQI (6.5 ± 0.67); total Skindex-29 score was 23.55 ± 2.46 (low impact) with the highest value in the emotion domain. In group 2 DLQI score was 12.5 ± 1.51, total Skindex-29 score was

48.41 ± 3.76; in group 3 DLQI was 11.5 ± 0.58, Skindex-29 – 50.46 ± 2.14. These values corresponded to very negative impact on QoL, increasing with diseases severity. There was a reliable difference in DLQI and Skindex-29 values between groups 1 and 2 and groups 1 and 3. Mean HADS scores in all groups were generally comparable and correlated with AtD and AA severity.

Conclusion. Compared to AA, AtD has a greater impact on QoL, involving all areas of social health; AA predominantly affects emotional sphere. The presence of both diseases worsens QoL as well as AtD alone, especially in aspects “emotions” and “functions”.

Hidradenitis suppurativa (HS) is a chronic recurrent inflammatory skin disease characterized by the appearance of painful, recurrent inflammatory nodules and abscesses that are prone to spontaneous opening, leading to the formation of fistulous tracts and scarring. Most often, lesions affect the apocrine glands in areas such as the armpits, groin and anogenital area. The pathogenesis of the disease is due to follicular occlusion, which occurs as a result of a number of biological inflammatory processes, including follicular epithelial hyperplasia and hyperkeratinization. According to data from various countries, the incidence ranges from 0.1% to 4%; women aged 18 to 29 years are more likely to suffer from HS, but the disease can also occur during perimenopause. Skin lesions are often accompanied by pain that can compromise daily activities, the presence of disfiguring skin lesions and foul-smelling purulent discharge negatively impact the personal and professional lives of patients. Acute and chronic pain significantly reduces quality of life and is a risk factor for the development of depression. An interdisciplinary approach plays an important role in the treatment of these patients. For treatment, systemic and local antibacterial drugs are used in various combinations and developed regimens, local anesthetics and antiseptics, non-steroidal anti-inflammatory drugs as symptomatic treatment, systemic and topical (intralesional administration) glucocorticosteroids, retinoids, physiotherapy, laser therapy, and biological drugs. Inhibitors of TNF-alpha, IL-17 act as modern pathogenetic therapy, showing good results in practice. The study of pathogenesis and the use of targeted therapy are priority areas in the study of this disease. Patients with HS need highly effective, safe drugs to maintain stable remission. This article provides an overview of current knowledge of HS, including diagnosis, pathogenesis, and treatment.

At the present stage, there is an increase in the prevalence of psychodermatological disorders, while this pathology has a pronounced negative impact on the quality of life of patients. The observed bidirectional relationship between psychological well-being and skin health is being actively studied. Skin lesions can be caused by primary psychiatric diseases or provoke their appearance. The clinical symptoms of autodestructive dermatoses can imitate parasitic infections and pyoderma, skin tuberculosis, granulomatous and allergic diseases, vasculitis, and lymphomas. In this regard, patients initially seek medical help from doctors of various profiles, which, in the absence of proper awareness of specialists, often lengthens the diagnostic search, leads to progression of the disease and a deterioration in the quality of life of patients. Increasing awareness of psychodermatological comorbidity among primary care physicians is important to reduce the time required to make a correct diagnosis and timely referral of patients to a psychiatrist. The article provides an analysis of our own clinical observations of patients with psychodermatological pathology, for whom more than a year passed from the initial visit to the doctor to verification of the diagnosis. Late diagnosis was accompanied by an increase in symptoms with the formation of pronounced destructive skin lesions. The diagnostic search was also hampered by the significant similarity of the clinical picture with other diseases that have skin symptoms. When analyzing the presented clinical cases, attention is focused on the need for a thorough differential diagnostic search, an analysis of the characteristics of the anamnesis and characteristic symptoms of the skin process in psychodermatological pathology is provided. The importance of an integrated approach to patient management with the participation of specialists from both psychiatric and dermatological profiles was noted.

Introduction. Rosacea is a chronic skin disease with about 10% prevalence in the global population. The pathogenesis of the disease is multifactorial and is not yet fully understood. The dermatosis affects the facial skin and is characterized by persistent erythema, the formation of telangiectasias, papules, pustules, and can also be complicated by ophthalmic lesions.

The disease is rooted in impaired neurovascular regulation and changes in the innate immune systems. It is known that the expression of vascular endothelial growth factors (VEGF) in the skin are increased in rosacea and the level of myeloperoxidase, a lymphocyte lysosomal enzyme, is increased in the inflammatory processes occurring in the arteries.

Aim. To study the level of these gene expression in blood lymphocytes in the acute stage of the disease.

Materials and methods. A total of 10 patients with erythematous rosacea, 10 patients with papulopustular rosacea and 10 healthy volunteers were included in the study. The peripheral blood samples were collected from the subjects for further isolation of lymphocytes. The level of gene expression was determined by real-time polymerase chain reaction.

Results. Investigators observed a 3.7-fold increase in the activity of myeloperoxidase expression in immune blood cells compared to the values of healthy volunteers. Also, the level of relative VEGFA expression increased by 6.5 times, the level of VEGFС increased by 11 times in mononuclear lymphocytes of patients compared to the values of healthy subjects. A comparative analysis in the groups of patients with erythematous and papulopustular rosacea showed a multidirectional expression pattern of vascular growth factors VEGFA and VEGFС. An increase in VEGFA expression is observed in the papulopustular rosacea, while VEGFС is higher in the erythematous form of the pathology.

Conclusion. The obtained results demonstrate that a significant increase in the gene expression levels associated with vascular activity and angiogenesis in rosacea occurs not only in the skin, but also in the peripheral blood mononuclear lymphocytes of the patients. The detected differences in the expression of vascular growth factors in different forms of the disease indicate the need for differentiated treatments.

Psoriasis is considered as system immunoassociated disease of the multifactorial nature with dominating value in development of genetic factors. Suffer псориазом from 2 to 7% of inhabitants of a planet. Psoriasis it is started, when environment factors activate plasmocytoid dentrid cages that leads to development numerous proinflammatory citokines, including the factor некроза to a tumour FNO-α, interferon (IFN) γ, interleukin (IL) 17, IL-22, IL-23 and IL-1β. Many of these citokines stimulate hyperproliferation keratinocyes which supports a chronic inflammation. The heaviest form psoriasis – psoriatic erythroderma, results adverse экзогенных from the factors, irritating treatment. Develops erythroderma at 1.5–3% of patients псориазом which amazes all surface of an integument. All skin cover gets brightly red colour, with a brown shade, is strained. Taking into account recent achievements in understanding of the inflammatory nature psoriatic research efforts have been concentrated to finding-out of a role specific proinflammatory cytokines which participate in pathogenesis diseases, for the purpose of working out of new purposeful methods of treatment. For treatment psoriatic erythroderma in medicine there is a wide spectrum of external and system means. Undoubtedly, psoriatic erythroderma has all indications to appointment of biological therapy, especially when does not give in traditional methods. Authors of article have presented a therapy material psoriatic erythroderma, a domestic preparation of genno-engineering biological therapy of (netakimab). The good clinical effect that opens prospect of application of this preparation is gained. The concrete clinical example of successful treatment is resulted.

Introduction. Therapeutic treatment modalities for acne involve both topical and oral medications. Fixed-dose combinations that affect all components of the pathogenesis of acne vulgaris are given preference among topical medications.

Aim. To evaluate the efficacy and tolerability of Metrogyl® a topical drug, containing adapalene and metronidazole, which is used as topical therapy in patients with mild to moderate acne.

Materials and methods. A prospective, open-label, randomized, single-centre comparative study was conducted in 2022. A total of 60 patients were subjected to the Mir-O-Med clinic-based observation (Krasnodar): 19 men and 41 women aged 18 to 45 years with mild to moderate acne. Group 1 received a fixed-dose combination of adapalene 1.0 mg and metronidazole

10.0 mg (Metrogyl® A); Group 2 – a fixed-dose combination of adapalene 0.1% and clindomycin phosphate 1%; Group 3 – a fixed-dose combination of adapalene 0.1% and benzoyl peroxide 2.5% gel; Group 4 – adapalene 0.1%. Group 5, a separately created group, included patients from Group 1, who continued therapy for another 3 months.

Results. After therapy, 6 (40%) patients from Group 1 archived clinical remission, and 9 (60%) patients found significant improvement. No deterioration in patients’ condition or absence of clinical effects was observed during therapy. The combination of adapalene and metronidazole (Metrogyl® A) to treat mild to moderate acne is comparable in terms of efficacy to the combination of adapalene and benzoyl peroxide, 10% more efficient than topical adapalene therapy and 30% more efficient than topical antibiotics combination.

Conclusion. The obtained results showed high therapeutic efficacy, good tolerability and safety of Metrogyl® A, which allows to use it as monotherapy and as part of combination with other agents in patients with mild to moderate acne.

Psoriasis is recognized as a systemic inflammatory disease, significantly affecting all major aspects of patients’ health, requiring a timely comprehensive approach to treatment. This approach should improve the overall well-being of patients and consider the psychosocial aspects of their lives. Special attention in modern research is given to psoriatic arthritis (PsA), which affects up to 30% of patients with psoriasis. There is growing interest in the possibility of stopping the progression of the psoriatic process and preventing the manifestation of PsA. Recent studies have shown that timely treatment with genetically engineered biological agents (biologics) can halt disease progression and prevent the development of disabling complications. The article discusses key clinical and immunological markers that can predict the development of PsA, opening pathways for earlier and targeted therapy. Special attention is given to the role of guselkumab, a monoclonal antibody targeting interleukin-23, in preventing the development of PsA in high-risk patients. Clinical observations of three patients with psoriasis treated with guselkumab showed not only complete skin clearance (PASI 0) but also positive changes in all major parameters of psoriasis severity, sustained remission of the skin process, and positive dynamics of manifestations of psoriatic onychodystrophy, which is currently considered the main predictor of PsA. These results indicate suppression of systemic inflammation and control of disease progression risk. The significant overall improvement in patient condition, along with the key indicator of therapy effectiveness – improved quality of life emphasizes the importance and efficacy of timely initiation of targeted therapy in patients with psoriasis with certain aggravating factors. 

Acne is one of the most urgent problems of dermatology, since this dermatosis is widespread, often occurs during puberty, is accompanied by cosmetic defects, causes increased anxiety, dysmorphic phobia and depressive states. As a result, the quality of life and the possibility of social adaptation decrease in patients. Therefore, it is necessary to optimize the treatment of this disease with the inclusion of modern highly effective drugs. When prescribing treatment, it is necessary to take into account all links in the pathogenesis of acne, and also remember that inflammation plays an important role in the development of dermatosis (especially severe course). With mild acne, it is recommended to prescribe only external therapy, with medium – external therapy and, if necessary, systemic, with severe systemic therapy is used as the main one. The appointment of antibiotics for this dermatosis is dictated by the presence of bacterial flora. Clindamycin is one of the antibiotics that effectively reduce colonization of C. аcnes. To ensure the high efficiency and safety of topical therapy, as well as the prevention of the development of resistance of microorganisms, there is a need to use a combination of at least two drugs. Thus, the combination of clindamycin with benzoyl peroxide makes it possible to increase the effectiveness of therapy due to bactericidal, bacteriostatic, anti-inflammatory and keratolytic actions. The convenient mode of use and the rapid therapeutic effect make it possible to include this combination in the group of priority drugs for the treatment of acne. Comedonolytic, anti-inflammatory and bactericidal effects are also observed in azelaic acid, and therefore drugs containing this component show a high pathogenetic effect in acne.

Melasma is a common, difficult-to-treat pigmented skin disease characterized by a recurrent course. The article provides an overview of the etiology, pathogenesis and principles of melasma therapy. The multifactorial nature of the disease was noted, including genetic predisposition, exposure to ultraviolet and visible light, and hormonal factors. It is known that visible light, especially high-energy visible light with a wavelength of 400–500 nm (High Energy Visible Light, HEV rays, blue light), and long-wavelength UVA rays (370–400 nm) exacerbate the course of melasma. The importance of an integrated approach to treatment, including the elimination of trigger factors, pathogenetic therapy and mandatory photoprotection using modern broad-spectrum sunscreens, is emphasized. Special attention is paid to the need to inform patients about the chronic nature of melasma and the importance of prolonged therapy. The article considers a multi-level treatment regimen based on the use of topical drugs and peels as first-line therapy, with careful and balanced use of hardware methods at subsequent stages. The key principles of hyperpigmentation therapy are described, namely, inhibition of melanogenesis, reduction of melanosome transport and acceleration of melanin elimination processes. Given example of modern depigmenting topical treatment containing Thiamidol (Beiersdorf AG patent), which contribute to the improvement of mMASI (Modified Melasma Area and Severity Index) after 2 weeks of usage, and justified treatment with Thiamidol for monoand combination therapy of melasma. The proposed three-stage treatment regimen, adapted to the severity of the disease, makes it possible to optimize therapeutic tactics taking into account the individual characteristics of the patient.

Introduction. The widespread prevalence of atopic dermatitis and decreased quality of life make the problem urgent and require the search for new treatment methods. In atopic dermatitis, excessive expression of interleukins 31 and 33 in keratinocytes is noted. In patients with atopic dermatitis, there is an increase in serum cortisol and filaggrin levels. In recent years, active development of drugs has been carried out, aimed mainly at the immune component of the pathogenesis of atopic dermatitis. However, clinical trials of these drugs are not conducted on pregnant women. For the treatment of atopic dermatitis during pregnancy, we have proposed a regimen of external therapy, including a topical moisturizer and a topical antipruritic agent.

Aim. To evaluate the levels of interleukins 31, 33, cortisol and filaggrin in blood serum before and after treatment of atopic dermatitis with a combination of emollient and topical antipruritic agent.

Materials and methods. The examination included 76 pregnant women during an exacerbation of atopic dermatitis. The levels of interleukins 31, 33, cortisol and filaggrin were determined in the blood serum at the first visit and after 4 weeks of using the proposed combination of emollient and topical antipruritic agent using enzyme-linked immunosorbent assay (ELISA).

Results. Against the background of the proposed therapy, a statistically significant decrease in the concentration of interleukins 31 was noted from 28.98 to 2.08 pg/ml, filaggrin from 9.72 to 5.26 ng/ml, cortisol from 629.80 to 472.25 pg/ml (p = 0,001). There were no statistically significant fluctuations in interleukins 33 levels (p = 0,124).

Conclusion. The combination of external therapy with the use of an emollient and a topical antipruritic agent reduces the production of interleukins 31, cortisol and filaggrin in the blood serum, but the content of interleukins 33 does not change significantly.

Psoriasis and seborrheic dermatitis are common papulosquamous dermatoses. When localized only on the scalp, they often have very similar clinical manifestations and require a comprehensive differential diagnostic approach. The article presents the main comparative clinical and diagnostic characteristics of psoriasis and seborrheic dermatitis of the scalp, including trichoscopy features and pathomorphological markers. Topical therapy with glucocorticosteroids, keratolytics and agents with antifungal activity is of key importance in the treatment of papulosquamous diseases. Modern topical drugs with a fixed combination of active ingredients provide an effect on several pathogenetic mechanisms at once, are stable, compatible, and convenient for use by patients. One of the main drugs for the treatment of psoriasis and seborrheic dermatitis is a solution of betamethasone dipropionate and salicylic acid (trade name – Akriderm SK), which in terms of anti-inflammatory activity is comparable to the highest strength topical corticosteroids, while providing a faster response to therapy and effectively relieving symptoms of itching and peeling. This is confirmed by the authors’ own clinical experience and demonstrated in the clinical cases described in the article.

Biotin deficiency is caused by inflammatory bowel diseases that impair the absorption of the vitamin, special dietary disorders with the consumption of raw eggs (excess avidin – a vitamin B7 blocker protein), magnesium deficiency, smoking, alcohol, treatment with broad-spectrum antibiotics, sulfonamides, and anticonvulsants. Hypovitaminosis B7 has also been noted in individuals with congenital genetic defects of the biotinidase gene or other genes involved in biotin metabolism. Deficiency of water-soluble vitamin B7 (vitamin H) – manifested by dry skin, seborrheic dermatitis, dermatitis around the eyes, nose, mouth, ears and groin, impaired nail growth, slow healing of skin cuts, atopic dermatitis, striations, splitting, brittle nails and alopecia (diffuse and androgenic form). Alopecia occurs when hair follicles die and leads to hair loss. The human proteome contains 51 proteins involved in biotin metabolism. In particular, D-biotin-dependent carboxylases play an important role in the metabolism of fatty acids, amino acids, carbohydrates, cell division and growth, incl. keratinocytes and hair follicle cells. The molecular mechanisms of the effects of D-biotin on the skin and its appendages may involve various growth factors: regulation of the signaling pathways of growth factors (IGF-1, FGF, KGF, HGF, VEGF, SIRT-1, Wnt and beta-catenin) has been shown. Hair follicle stem cells cause the cyclical growth of hair follicles. Growth factors are involved in the activation of stem cell growth by D-biotin; activation of the Wnt/β-catenin signaling cascade leads to the activation of cyclin D1 proteins (initiates DNA synthesis and leads to increased viability of hair follicles. The results of fundamental and clinical studies confirm the prospects of using biotin in dermatology for the treatment of diseases of the skin, hair and nails, incl. alopecia of various origins (androgenic, focal, diffuse). The results of the studies indicated that biotin was well tolerated, and there was no risk of hypervitaminosis even when taking megadoses (hundreds of milligrams).

Introduction. Medical trichology is a promising and modern direction of cosmetology, engaged in the study of the scalp and hair, both in the state of health and various diseases. However, with all the variety of various scientific publications, there are very few works devoted to the study of morphological changes in normal physiological aging of a person.

Aim. To reveal the dynamics of morphological changes in the hair bulb and hair shaft in women in the parietal region to elderly age.

Materials and methods. The work is based on the results of microscopic examination of 80 women, the study sample consisted of conditionally healthy individuals. The examined women were divided into three groups depending on their age. The first group included 27 women of the first period of mature age (26.9 ± 0.70 years). The second group consisted of 30 women of the second period of mature age (47.1 ± 1.20 years). The third group was formed by 23 women of old age (62.1 ± 1.09 years). Hair sampling was performed in the parietal region of the head by combing out the hair that had already fallen out (without pulling it out of the skin!). The width of the hair bulb and hair shaft were measured. The percentage of bulbs containing an internal root sheath to the total number of bulbs was calculated.

Results and discussion. With age, a decrease in the number of hair follicles with internal root sheath (p < 0.01) along with a tendency to decrease the width of the hair follicle and hair shaft (p > 0.05) was noted in women in the parietal region.

Conclusions. The results of this study add to the information available in the scientific literature about age-related changes occurring in the hair bulb and hair shaft in women by old age. The data obtained will be useful for trichologists in medical practice to create clinical recommendations for the early prevention of age-related alopecia areata.

Allergic contact dermatitis in the beauty industry is a common and growing problem in dermatology, due to both the annual increase in the popularity of existing beauty services and the emergence of new fashion trends. Cosmetic products in hairdressing, manicure, permanent makeup, eyelash extensions, tattooing and piercing contain a number of potent haptens, sensitization to which results in a classic delayed-type hypersensitivity reaction. The development of contact allergic reactions is important not only for consumers of these services, but also for hairdressers and beauty salon technicians themselves. Thus, hairdressers take first place in the incidence statistics of occupational contact dermatitis associated with allergens and haptens in hair dyes, products for bleaching, curling or straightening hair. In 65% of cases, allergic contact dermatitis to acrylates develops among manicurists within the first years of work. The basis of treatment for allergic contact dermatitis is external therapy using topical glucocorticosteroids. The article contains Russian and foreign literature data about the most common allergens in products used in hairdressing, permanent tattooing, eyelash extensions, manicure and piercing, on the prevalence and characteristics of allergic contact dermatitis in these areas of the beauty industry and our own clinical observations of the effectiveness of treatment of allergic contact dermatitis using Comfoderm K cream (methylprednisolone aceponate with ceramides in the base).

Introduction. Atrophic scars may be associated with significant psychological stress and a substantial negative impact on quality of life. Despite the great relevance of the atrophic scars therapy, existing treatment methods do not always provide their complete elimination.

Aim. To study the efficacy of combined therapy of atrophic scars with radiofrequency microneedling (RF-MN), subcision and hyaluronic acid filler injection.

Materials and methods. Ten female patients aged 28–44 years with a clinical diagnosis of atrophic scars were randomly assigned to two groups. Group 1 received RF-MN alone, while Group 2 received a combination treatment comprising RF-MN, subcision, and hyaluronic acid injections. Clinical effectiveness was assessed using the Goodman-Baron scar rating scale and the Global Aesthetic Improvement Scale (GAIS). Ultrasound was used to determine the changes in dermal thickness. The volume of depressions and skin texture were measured using the Antera 3D®. The safety of the treatment was evaluated by recording adverse events.

Results. The combined method demonstrated superior efficacy compared to RF-MN alone in the majority of efficacy parameters. In Group 2, a statistically significant reduction in Goodman-Baron scale was observed in 100% of patients (p = 0.026). 3D measurements of the face demonstrated a more pronounced improvement in skin texture in Group 2 relative to Group 1. Statistically significant changes (p = 0.027) in the Face-Q scale were exclusively observed in the group that received the combined treatment. Ultrasonic imaging demonstrated a restoration of dermal thickness following treatment. No serious adverse events were observed. Expected local adverse events (pain, erythema, swelling, and bruising) were mild and resolved spontaneously within 1–7 days.

Conclusion. The combined treatment with RF-MN followed by subcision and hyaluronic acid filler injections demonstrated its efficacy in patients with atrophic scars.

This article presents the REVITOX protocol, developed by the author, which includes the combination of REVI products (native hyaluronic acid + trehalose) and botulinum toxin type A (BTA) for the treatment of rosacea and correction of age-related changes. A plethora of studies has demonstrated that trehalose, an exceptional stabilizer of proteins, contributes to maintaining cellular integrity, exhibits antioxidant and angioprotective effects, and has been shown to induce autophagy. In combination with the proven effects of hyaluronic acid and BTA, these properties facilitate the optimal environment for cellular structure functioning, influencing the basic mechanisms of rosacea pathogenesis and mitigating the severity of age-related changes through the balanced elimination of dynamic and static rhytides, stimulation of neocollagenesis and improvement of the mechanical properties of the dermis. By targeting the multifactorial processes of facial aging, improving skin hydration and elasticity, the REVITOX Beauty protocol has ensured the balanced rejuvenation of the perioral and periorbital skin, resulting in a significant improvement in skin quality, as confirmed by the results of 3D diagnostics. After 3 treatment sessions of the REVITOX Derma program, the patients showed a general improvement of facial skin, a visible reduction in erythema and telangiectasia severity, regression of papulopustular elements, enhanced skin hydration and elasticity, and no recurrences at the follow-up. Further studies on the combined use of BTA and REVI will investigate the potential for using these protocols in the treatment of other dermatological conditions, including in combination with energy-based devices and beauty injections.

Introduction. Mycoses of the skin and their derivatives are one of the most common groups of fungal infections. Lesion to the nails and skin of the feet and hands occupies a leading place in the structure of this pathology. These diseases are characterized by a long course and often ineffective therapy. Onychomycosis and fungal infections of the skin of the feet and hands are characterized by certain epidemiological features and have a diverse etiology.

Aim. To study of the epidemiological characteristic of mycoses of the nails, skin of the feet and hands according to the data of the Regional Clinical Dermatovenerological Dispensary of Perm over a ten-year period to optimize the detection and further treatment of this pathology

Materials and methods. For the study, statistical data from the Regional Clinical Dermatovenerological Dispensary in Perm were used. Data were analyzed for the period 2012–2021 to assess the dynamics of the prevalence of mycoses of the skin and nails of the feet and hands, their etiological structure. Cases recorded during direct patient contact were taken into account. For laboratory confirmation of mycoses, a culture method was used.

Results and discussion. The number of cases of mycoses of the skin and nails of the feet and hands for the period from 2012 to 2021 was analyzed. It was established that the share of this pathology in the structure of superficial mycoses averaged 49.9%. There was no significant dynamics in the number of recorded cases of fungal infection of this location during the analyzed period. This pathology was more often observed in females than in males throughout the study period. The most significant etiological factors were representatives of Trichophyton spp., Candida spp., as well as molds. There has been a change in the etiological structure of mycoses of the nails, skin of the feet and hands over the observed period: there is a tendency towards a decrease in the proportion of dermatophytes and an increase in the proportion of yeast fungi.

Conclusion. The relevance of the studied group of mycoses was confirmed using the example of the Perm region. The main cause of fungal infections of the nails and skin of the feet and hands were representatives of dermatophytes and Candida spp. It is recommended to focus on identifying this pathology in males during preventive examinations due to the low frequency of their visits to medical specialists.