Introduction. Localized scleroderma is a rare autoimmune disorder characterized by a thickening of the skin due to the overdeposition of collagens and other proteins in the dermal extracellular matrix. Matrix metalloproteinases (MMPs) is a family of proteolytic enzymes, playing a crucial role in the catabolism of collagens, maintaining the protein composition of the dermis. Alterations in MMPs activity and expression contribute to the development of the disease.

Aim. To investigate changes in the expression of secreted matrix metalloproteinases (MMP-1, MMP-2, MMP-3, and MMP-9) in scleroderma lesional skin using quantitative polymerase chain reaction to identify potential therapeutic targets.

Materials and methods. Biopsies of lesional and unaffected skin were obtained from patients with scleroderma. PCR was used to assess changes in the expression of MMPs.

Results. The analysis of experimental data revealed significant changes in the expression of MMPs: the increased levels of MMP-2 (3.379 ± 1.177) and MMP-9 (4.471 ± 1.836), and the decreased levels of MMP-1 (0.169 ± 0.036) and MMP-3 (0.240 ± 0.086).

The correlation analysis revealed a strong negative correlation (r = –0.93) between the expression of MMP-1 and the area of scleroderma lesional skin. The computer analysis suggested that changes in the expression of MMPs may contribute to the development of skin lesions as a factor.

Conclusions. The results of this study suggest that some MMPs may serve as biomarkers for assessing the severity of localized scleroderma and as potential molecular targets for therapeutic intervention.

Introduction. The article presents the results of a study of differences in the skin microbiota of patients with PLC compared with healthy individuals.

Aim. To study the composition of the skin microbiota in patients with chronic lichenoid pityriasis compared with healthy individuals.

Materials and methods. The objects of the study were 30 patients with PLC and 30 patients with PLEVA, who were under observation in the dermatological hospital department of the State Budgetary Institution of Healthcare in Ufa (comparison group – 30 healthy individuals). All participants were examined and clinically examined by a dermatovenereologist with the clarification of anamnestic data, determination of the form of the PL.

Results. Were examined 30 patients with CLP (group 1) and 30 healthy people (group 2). Un sanitized foci of infection (caries, tonsillitis, sinusitis, etc.) were more often detected in group 1 – in 28 (93.3%) vs. 10 (33.3%) individuals in groups 1 and 2 (p < 0.05). The concentration of CIC in group 1 was significantly higher than in the control group (112.2 vs. 54.9 IU/ml, p < 0.05), as well as CD8+ lymphocytes (27.6 vs. 14.0%, p = 0.042). The most common manifestations of the microflora of patients with CLP are Staph. epidermidis (26.6%), Corynebacterium (23.3%) and Candida albicans (26.6%), in the control group – Staph. epidermidis (70.0% of cases), Staph. hominis (30.0%) and Corynebacterium (13.3%).

Conclusion. In patients with lichenoid pityriasis, there is a diversity of the main representatives of the skin microbiota, which has some differences from the microbiota of healthy individuals. There are differences in contamination by various representatives of the microbiome in the affected and intact areas. These data may indicate an association of changes in the skin microbiota in PLC with the progression of the disease and the expression of certain subpopulations of T-lymphocytes.

The main issues of etiopathogenesis and approaches to the treatment of psoriasis are presented in this article. The most modern current data on the pathogenetic component of psoriasis are reflected. The possibilities of therapeutic measures using targeted therapy have been determined. Psoriasis is a chronic immune-mediated inflammatory disease primarily affecting the skin. The prevalence of psoriasis is 0.4–4%, occurs mainly in adults aged 20 to 60 years, and there is no significant gender difference. Currently, the leading etiopathogenetic role in psoriasis is determined by hereditary immune disorders. Many immune cells involved in the inflammatory process contribute to the pathogenesis and development of psoriasis. The most important in this aspect are Th17, which contribute to the formation of increased amounts of interleukins (IL) 17, which are important in maintaining chronic inflammation associated with the induction and pronounced synergistic effect of other proinflammatory cytokines. Taking into account the available data, it should be noted that IL-17 (mainly IL-17A and IL-17F) are the key cytokines of the pathogenetic component of psoriasis, and human epidermal keratinocytes are the dominant population of skin cells expressing receptors for IL-17. The IL-17 pathway has also been suggested to modulate inflammatory responses linking comorbid systemic diseases to psoriasis. The latest priority research into the etiopathogenesis of psoriasis was the trigger for the creation of a group of fundamentally new genetically engineered biological drugs (GEBPs), and understanding the key role of IL-17 formed the basis for the development of drugs with a targeted effect on this target. The use of a fundamentally new targeted drug – the interleukin IL-17A blocker – netakimab in patients with psoriasis is important and significant in terms of treating cases that are torpid to therapy with cytostatics and phototherapy and achieving prolongation of clinical remission.

Introduction. Mastocytosis is a rare neoplasm characterized by abnormal proliferation and activation of clonal mast cells usually harbouring the KIT D816V mutation. Systemic symptoms of mastocytosis induced by mast cell mediators can occur spontaneously or are provoked by certain stimuli such as hymenoptera insect stings and blood-sucking dipteran insect bites. Today, the epidemiological aspects, features of clinical presentation and laboratory diagnosis associated with insect bites in children with cutaneous mastocytosis are poorly known.

Aim. To review the incidence, clinical and laboratory features of insect allergy in children with various clinical forms of cutaneous mastocytosis.

Materials and methods. A prospective observational single‐centre study was conducted. It contained information from 310 children who underwent outpatient treatment and observation at the State Budgetary Healthcare Institution – Moscow Center of Dermatovenereology and Cosmetology during the period from March 2022 to October 2024.

Results. Reactions to Hymenoptera bites in the group of children with cutaneous mastocytosis developed rarely, in 1.3% of cases. The risk group included children with maculopapular cutaneous mastocytosis with a basal serum tryptase (BST) level above 5.0 μg/L. The proportion of children with systemic manifestations to bites of both stinging and blood-sucking insects and a BST level of more than 8.0 μg/L was 45.5%, which is significantly higher (p < 0.01) than the proportion of children with low BST values (18.1%). Reactions to Diptera (blood-sucking) insect bites were observed in 9.4% of children with all clinical forms of cutaneous mastocytosis. A study of the level of specific IgE to wasp venom showed an insignificant degree of sensitization in all children with systemic reactions to hymenoptera bites.

Conclusions. Monitoring the dynamics of tryptase levels in children with cutaneous mastocytosis and timely therapeutic correction of cutaneous manifestations of mastocytosis (vesicles, wheals, itching, flushes) is an important aspect aspect of the prevention of systemic mediator symptoms and anaphylaxis to insect bites. Children with mastocytosis and insect allergy should be treated jointly by a dermatovenerologist and an allergist-immunologist. Particular attention should be paid to patients with monomorphic (“adult”) type of maculopapular cutaneous mastocytosis with tryptase level above 20.0 μg/l, who have risks of developing systemic mastocytosis and anaphylaxis to hymenoptera bites. The results of our study demonstrate the relevance of further study of clinical, epidemiological and laboratory features of insect allergy in a group of children with cutaneous mastocytosis.

Skin dryness is a moderately common symptom, especially in a group of elderly patients. Xerosis can be caused both by age‐associated skin features and chronic diseases, and the use of certain drugs. Retinoids are the drugs used to treat young patients, which are prescribed due to acne and rosacea. Systemic and topical retinoids induce thinning of the stratum corneum, changes in the sebum composition, which becomes the cause of increased transepidermal moisture loss. Antineoplastic drugs can also induce skin dryness. In particular, xerosis is a common side effect that occurs when epidermal growth factor receptor (EGFR) inhibitors are administered. Antihistamines, high blood pressure drugs, for instance diuretics, statins that are used to lower cholesterol levels, can induce xerosis. Therefore, care products with pronounced moisturizing effects should be included in the guidelines on the treatment with drugs inducing skin dryness. Preference should be given to combination drugs, which ingredients will not only restore the normal moisture level of the skin, but also have an antipruritic action, as itching is often observed in xerosis, and repair a damaged skin barrier that inevitably occurs in skin dryness. Care products should have a prolonged action, allowing them to be used 1–2 times a day, a pleasant texture, and be quickly absorbed without leaving a greasy feeling. This will not only eliminate the unpleasant side effect of the backbone therapy, but also improve the patients’ quality of life.

Atopic dermatitis is a hereditary chronic skin disease characterized by severe itching, recurrent course and association with other diseases of atopic nature, as well as numerous complications, which include the addition of a secondary infection. Head and neck atopic dermatitis (HNAD) is a special phenotype of atopic dermatitis that occurs in adolescents and adults. A characteristic feature of HNAD is the lesion of skin areas rich in sebaceous glands (face, neck, upper third of the chest and back), which is associated with the active participation of Malassezia fungi in the pathogenesis of the dermatosis. The multifactorial pathogenesis of HNAD, often persistent course, the impossibility of complete elimination of the provoking factor, as well as the addition of a secondary bacterial infection against the background of itching, necessitate a comprehensive approach to the treatment of this condition and the use of combination drugs containing a glucocorticosteroid, an antimycotic and an antibiotic to relieve exacerbations. The article examines the etiology, mechanisms of development of HNAD, clinical features, as well as modern methods of therapy, the practical application of which is demonstrated in a clinical example: patient, 19 years old, complaining of itchy, flaky rashes in the face and neck area, existing for 3 weeks. Based on the clinical picture, a diagnosis was made: atopic dermatitis of the face and neck. Given the multifaceted cause of the condition, namely the participation of both a pronounced immune response characteristic of AD, active colonization by Malassezia fungi, as well as open “gates” for secondary bacterial infection in the form of erosions, the prescription of a topical glucocorticosteroid was pathogenetically justified.

One of several comorbidities associated with chronic inflammatory skin diseases, namely psoriasis, is cancer. Although a chronic inflammatory state may cause protumorigenic effects, there is debate as to whether drugs used in clinical practice play a leading role in tumor development. Recently, the therapeutic arsenal for the treatment of immune-mediated chronic systemic diseases has expanded significantly due to the emergence of heterogeneous groups of biological drugs that affect the immune system. A lot of controversy raises questions about whether the development of malignant tumors (MNT) is a side effect of treatment with biological drugs. The article discusses the risks of developing cancer in patients with psoriasis and their relationship, approaches to the management of patients diagnosed with psoriasis and cancer, modern ideas about immunological disorders during the development of cancer, a review of studies on the role of genetically engineered biological therapy (GEBT) drugs from various groups in development of tumors of various localizations. Patients with psoriasis often have a history of concomitant diseases, which makes it difficult to select the necessary treatment, however, the severity of skin manifestations requires systemic treatment. We present a clinical case from practice about the use of GIBT with an interleukin-17 inhibitor (IL-17) in a patient with widespread severe psoriasis and a history of prostate cancer. Increased preclinical evidence has also demonstrated that the balance between IL-12 and IL-23 is critical in carcinogenesis and that disruption of IL-12 and/or IL-23 signalling both promotes and suppresses tumour growth. Although the mechanisms underlying these biological activities have not been studied in depth and the interpretation of preclinical studies on the involvement of IL-12 and IL-23 in tumour biology is controversial, the clinical studies indicate that IL-23 inhibitors are drugs with a favourable safety profile.

Interleukin-23 (IL-23) inhibitors have become a crucial tool in the treatment of psoriasis. This group of genetically engineered biological drugs offers promising prospects for achieving long-term remission and improving patients’ quality of life. Modern therapies, such as guselkumab, demonstrate high efficacy in achieving complete skin clearance (PASI 90/100) and maintaining treatment outcomes, even in patients with a long history of the disease or previous failure with TNF or IL-17 inhibitors. Particularly noteworthy are recent studies aimed at confirming the concept of disease modification. According to the latest findings, early intervention using IL-23 inhibitors accelerates remission and increases the frequency of super-response, especially in patients with a short history of severe psoriasis (≤2 years). The concept of disease modification (DM), defined as a sustainable change in the pathophysiology of psoriasis that minimizes the need for ongoing treatment, underscores the importance of IL-23 inhibitors. Key criteria for DM include reducing BSA to <1% and achieving PGA 0/1 within 12 months without active therapy. Additionally, IL-23 inhibitors have been shown to reduce systemic inflammation and improve control over subclinical psoriatic disease activity. These advancements open new horizons for a personalized approach to psoriasis treatment, enabling not only symptom control but also altering the course of the disease. Future research should focus on developing clinically applicable biomarkers for assessing inflammatory activity, optimizing strategies for transitioning between drug classes, and investigating long-term effects following therapy cessation. IL-23 inhibitors are solidifying their role as a cornerstone of modern therapeutic regimens, providing physicians and patients with new opportunities to combat psoriasis. 

Psoriasis is associated with a wide range of somatic diseases and conditions. It shares some common components of pathogenesis with psoriatic arthritis and inflammatory bowel diseases, coexists with cardiovascular diseases and endocrine disorders. In addition, liver diseases are quite often diagnosed in patients with psoriasis. In particular, up to 65% of patients have non-alcoholic fatty liver disease. Idiopathic changes in blood biochemical values have also been observed in psoriasis. These changes are thought to be caused by metabolic disorders, alcohol consumption, and hepatotoxic therapy prescribed as part of treatment for psoriasis. Our own retrospective chart review of patients with psoriasis and psoriatic arthritis showed alterations in biochemical parameters, such as the level of ALT, AST and total bilirubin in about 30% of patients. In addition, ultrasound findings demonstrated that some patients had signs of various hepatobiliary tract disorders. Based on our many years of experience, we found that administration of ademetionine in patients with psoriasis and hepatobiliary tract disorders resulted in significant improvement in burden of disease. This drug has a more rapid onset of action than some other hepatoprotective agents. 1–2 months of its regular use was able to normalize biochemical blood levels. Besides, a decreased level of anxiety and emotional instability, to which patients with psoriasis are prone, is observed. It should be noted that timely administration of hepatoprotective therapy in patients with psoriasis require regular monitoring of liver changes, which can develop both due to comorbidities and intake of hepatotoxic drugs.

Introduction. Dyshidrotic eczema (DE) is a common type of eczema characterized by vesicular or bullous rashes on the skin of hands and (or) feet, prone to chronic and recurrent course, refractoriness to therapy and development of complications.

Aim. To analyze the clinical and anamnestic features of dyshidrotic eczema. Describe clinical cases of DE and experience with external therapy.

Materials and methods. The study included 132 patients (55 men and 77 women) with DE aged 19 to 78 years, the average age was 33.7 ± 10.3 years. To assess the severity of the course of DE, The Dyshidrotic Eczema Area and Severity Index (DASI) was used, and a visual analog scale, The Visual Analogue Scale (VAS), was used to assess itching.

Results. Aggravated allergic anamnesis was revealed in 40.1% of patients, atopic anamnesis – in 18.2% of patients. Hyperhidrosis of hands and feet was diagnosed in 3.8% of patients. The mean DASI index score was 12.6 regardless of gender (p = 0.096). The clinical course of DE was characterized by predominance of mild (68.2%) and moderate severity (31.0%) with localization of the pathological process mainly on the skin of hands in 73.5% of cases. Cutaneous itching accompanied the rashes in 54.5% of cases. External therapy with cream containing betamethasone dipropionate 0.05%, gentamicin sulfate 0.1% and clotrimazole 1% showed high efficacy in the treatment of acute and subacute course of DE of hands and feet complicated by secondary infection. The drug demonstrated achievement of the clinical effect of “clear skin” in 82.1% of patients with DE.

Conclusions. The study of anamnestic and clinical features of DE is important for optimization of systemic and external therapy of the disease, analysis of risk factors that allow to control the course of the disease and develop individual schemes for prevention of exacerbations.

Psoriasis is a chronic non-infectious immune-mediated skin disease, which is an important problem for modern medicine. More than 60 million people in the world suffer from psoriasis. This disease worsens the quality of life of patients, can lead to the development of depression, social isolation and disability of patients. Despite the long history of psoriasis studies, scientific research continues to discover new mechanisms of pathogenesis. Psoriasis is associated with genetic disorders and trigger factors of the external and internal environment. The disease is complex and multifactorial. Various immune-dependent cells, cytokines, interleukins are involved in the pathogenesis of psoriasis. Numerous scientific papers have been published on pathological changes in the skin and intestinal microbiota in patients with psoriasis. The “gut-skin” axis is a new concept of the interaction between skin diseases and the microbiome through inflammatory mediators, metabolites and the intestinal barrier. Researchers have shown that disturbances in the balance of the intestinal microbiome are associated with autoimmune conditions such as rheumatoid arthritis, systemic lupus erythematosus, multiple sclerosis, and psoriasis. Experiments on laboratory animals are of interest, for example, the study of mouse models of psoriasis development. An important role is played by concomitant comorbid pathology, especially metabolic diseases. A number of authors have studied the relationship of psoriasis with metabolic syndrome, diabetes mellitus type 2, non-alcoholic fatty liver disease, obesity, arterial hypertension, and chronic kidney disease. Despite numerous studies, the problem of psoriasis is still relevant and will not lose relevance in the future. This scoping literature review examines the modern studied mechanisms of etiology and pathogenesis, the influence of skin and gut microflora, as well as comorbidity on the course of psoriasis.

Psoriasis often occurs with desquamative lesions of the scalp. The clinical symptoms of the disease vary from limited papulosquamous rashes to sharply infiltrated plaques distributed over the entire area of the scalp. Localization of the rash on open areas and pronounced subjective symptoms of psoriasis negatively affect the quality of life of patients and can lead to the development of social maladjustment and depression. The mechanisms of the formation of the clinical picture are due to the complex interaction of genetic, immunological and exposome factors, as well as the anatomical and physiological characteristics of the scalp. It is assumed that there is a bidirectional pathogenetic relationship between the physiological activity of hair follicles and psoriatic rashes. Another feature of the scalp is the presence of a large number of sebaceous glands with high activity, which determines a certain composition of the microbiome, which, through the activation of immune mechanisms, can also affect the exacerbation of the disease. According to the accumulated data, topical therapy is the first line for patients with any severity of psoriasis. At the same time, the high density of follicles and sebaceous glands in the scalp, as well as the need for long-term therapy, cause certain difficulties in the selection of external drugs. The article focuses on the features of the use of topical glucocorticosteroids during exacerbation and remission of the disease. It is noted that combining these drugs with salicylic acid can reduce the duration of their use. To reduce the risk of adverse reactions, such treatment during exacerbation of psoriasis is recommended to be used in a short course, after which switch to maintenance therapy in an intermittent mode. An important aspect of the effectiveness of treatment is the use of compliant external forms of drugs. The article presents our own clinical observations of patients with scalp psoriasis, in whose therapy a solution containing betamethasone and salicylic acid was used.

Introduction. The article reflects modern literature data on the role of estrogen levels, changes in the homeostasis system, the influence of vasoactive peptides and mediator substances on the course of rosacea. The results of our own study are shown regarding the influence of vascular inflammation biomarkers on the development of rosacea at different periods of menopause. Aim. Determine the role of vascular well-being factors in the development of rosacea in women of perimenopausal age.

Materials and methods. The study included 60 patients of the control group and 97 women with rosacea aged 45–54 years, who were divided into 2 subgroups: (1) premenopausal and (2) postmenopausal period. The levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), progesterone, estradiol, vascular endothelial growth factor (VEGF), and fibrin-stabilizing factor (FXIII) in the blood serum were studied.

Results. In the main and control groups, the LH level was within the reference range in the preand postmenopausal periods; in patients with rosacea, it was statistically significantly higher than in healthy women. In the preand postmenopausal periods, estradiol in the control group exceeded the level in patients with rosacea by 1.5 times (p < 0.0001). FSH was significantly higher in patients with rosacea both in the premenopausal period (p < 0.0001) and postmenopause (p = 0.0481). VEGF and FXIII in the main and control groups in healthy women did not depend on the stage of the perimenopausal period, but in rosacea, the median VEGF indicator is 2 times higher than in the control group in the premenopausal period (p < 0.0001), in the postmenopause (p < 0.0001), and the activity of FXIII is statistically significantly higher in the control group both in patients of the premenopausal period (p < 0.0001) and in the postmenopause (p < 0.0001).

Conclusions. In patients with rosacea, the level of gonadotropic hormones is statistically higher than in the group of healthy patients. VEGF and FXIII are significantly increased, which may indicate dysfunction of the vascular endothelium.

The main aspects of the etiopathogenesis of pityriasis versicolor are presented in the article. The characteristics of the fungi of the genus Malassezia and their pathogenicity factors are given in detail, the conditions leading to the activation of fungi and the development of clinical manifestations, including relapse are also defined. Significant attention is paid to the issues of external therapy of pityriasis versicolor taking into actuality data from clinical recommendations. Pityriasis versicolor is a chronic superficial fungal infection of the skin, which is caused by the activation of lipid-dependent yeast-like fungi of the genus Malassezia. Despite the accepted scientific opinion about the lack of contagiousness (fungi of the genus Malassezia are representatives of the normobiota of the skin of most people), the disease is found everywhere. M. furfur, M. globosa and M. sympodialis most often cause clinical manifestations on the skin with pityriasis versicolor of the almost 20 species of fungi of the genus Malassezia. Decrease in local and general immunological reactivity of the macroorganism is of decisive importance in the development of the pathological process in pityriasis versicolor, which is accompanied by the formation of hyphal forms of Malassezia and is a favorable factor for their uncontrolled spread on the surface of the epidermis. Due to the specific metabolism of Malassezia, the pathogenetic basis for pityriasis versicolor is an increase in the permeability of the epidermal barrier and disruption of the normal function of keratinocytes. Various antifungal agents are used in the treatment of pityriasis versicolor with varying degrees of success and subsequent relapse rates. The article discusses clinical cases using sertaconazole nitrate 2% in the form of a cream in the treatment of pityriasis versicolor.

Introduction. A scar is a newly formed connective tissue that develops at the site of deep skin defects accompanied with the destruction of the dermis due to ulcerations, burns, cracking, and inflammatory processes. Each stage of cicatricial deformation is characterized by specific morphological changes such as alteration and inflammation, fibroblast proliferation and formation of the granulation tissue, epithelialization of the defect, scar tissue maturation and remodelling.

Aim. To identify the genetic predisposition to the formation of cicatricial deformities in patients showing signs of undifferentiated connective tissue dysplasia (UCTD) and to develop an optimal algorithm for the prevention and correction of striae distensae using Linerase collagen replacement therapy.

Materials and methods. The study was conducted at the laboratory of Melsytech LLC (Nizhny Novgorod). A total of 52 patients (men and women, average age of 21.9 ± 4.4 years) were enrolled in the study. These patients sought advice from the Melsytech clinics (Moscow) in the period from 2022 to 2024. An UCTD screening questionnaire and genetic marker testing was used to diagnose signs of UCTD. A clinical examination of patients, identification of cicatricial changes in the skin and wound healing pattern were carried out separately.

Results. The study showed that the risk of predisposition to atrophic scars correlates with the degree of predisposition to UCTD. Incidence rates of a special type of skin healing with the formation of characteristic “cigarette paper” scars, and predisposition to atrophic striae not associated with pregnancy or weight change are higher in patients with UCTD.

Conclusions. The risk of predisposition to atrophic scars correlates with the degree of predisposition to UCTD. Replenishment of the building material deficiency and stimulation of collagen I and III gene expression are a pathogenetic therapy option for the correction of atrophic scars and striae.

Introduction. Poly-L-lactic acid (PLLA) has a multifactorial effect on skin aging. It stimulates extracellular matrix components synthesis. High-molecular weight hyaluronic acid (HA) offers the advantage of maintaining optimal skin hydration and inhibiting matrix metalloproteinases. The combination of these agents appears to be promising, as evidenced by the synergistic effect observed in their actions.

Aim. To evaluate the efficacy and safety of a hybrid one session treatment with PLLA and high-molecular weight HA for skin rejuvenation using both ultrasound (US) and histological diagnosis.

Materials and methods. Reconstituted PLLA was injected to a depth of 3–4 mm into the anterior abdominal wall in six healthy females. Intradermal injections of HA were conducted to a depth of 2–3 mm. The efficacy of the injection treatments was assessed after 24 hours and 6 weeks based on visual assessment, photography, US, and histologic examination.

Results. Six weeks after the treatment, the clinical signs included skin thickening and visual smoothing of the skin relief. Ultrasound results demonstrated zones of varying acoustic density, indicative of a gradual increase in connective tissue density. Areas of hyperechogenic density indicated structural reorganization and an increase in the number of connective tissue components. Histological examination of biopsy specimens confirmed active connective tissue restructuring. A comparison with the pre-treatment histology confirmed the formation of a denser network of collagen fibers at the level of dermis and subcutaneous adipose tissue.

Conclusions. The developed hybrid protocol was characterized by a favorable clinical efficacy and safety profile. These results were confirmed by histology and US, and were characterized by structural reorganization of connective tissue, with an accumulation of collagen fibers in the dermis and subcutaneous fat.

Diffuse telogen alopecia is a common condition characterized by temporary hair loss due to the premature transition of hair follicles into the telogen phase. This article examines the key etiological factors, pathogenetic mechanisms, and modern approaches to the diagnosis and treatment of this condition. Diffuse telogen alopecia can develop as a result of physiological processes such as pregnancy and the postpartum period, as well as due to pathological conditions. Special attention is given to the impact of stress factors, infectious diseases, endocrine dysfunctions, severe systemic illnesses, metabolic disorders, micronutrient deficiencies, and adverse drug reactions on the onset and progression of this condition. Identifying triggering factors is crucial for determining an effective treatment strategy. The diagnosis of diffuse telogen alopecia requires a comprehensive approach, including a detailed medical history, clinical examination, trichoscopy, and laboratory investigations aimed at identifying potential causes of hair loss. The treatment of diffuse telogen alopecia is multidisciplinary and focuses on eliminating the primary causative factor, normalizing metabolic processes, regulating the nervous and endocrine systems, improving scalp microcirculation, and stimulating hair growth. This article discusses the application of a therapeutic system consisting of specialized cosmetic products and a pharmaceutical preparation containing active natural ingredients that contribute to achieving stable therapeutic results. The composition of these agents and their pharmacodynamic mechanisms for enhancing scalp microcirculation and restoring the metabolic activity of hair follicles are analyzed in detail. The effectiveness of a comprehensive treatment approach is demonstrated through a clinical case of successful management of post-infectious diffuse telogen alopecia in a 10-year-old boy.

Introduction. Alopecia areata (AA) associated with atopic diseases (AD) is characterized by specific clinical, epidemiological, and immunological features, allowing the identification of an “atopic type” of AA. Currently, certain treatment methods may be effective for both AA and AD.

Aim. To analyze current treatment options for “atopic” AA based on literature and clinical experience.

Materials and methods. Review of publications concerning the connection between AA and atopy and treatment methods; assessment of clinical and laboratory data and treatment outcomes for patients with AA and AD.

Results. Seventy-eight publications were analyzed, and two clinical cases were described. In the first case, a patient receiving dupilumab showed positive effects on universal AA, atopic dermatitis (AtD), and bronchial asthma. The second patient with AtD and subtotal AA achieved partial remission through combined therapy, including UVB 311 nm and antihistamines. Specific treatment options for comorbid AA and AD were identified. Notably, phototherapy used for AtD may aid in hair restoration; antihistamines used for AD symptoms are potentially effective for AA, particularly during active stage. For systemic therapy needs in AA and AtD, oral JAK inhibitors – baricitinib, upadacitinib, and abrocitinib – should be considered. Dupilumab may be the treatment of choice for AA with severe AtD and respiratory allergies, including in younger pediatric patients.

Conclusions. The treatment strategy for patients with concomitant AA and AD should focus on reducing pharmacological burden and improving quality of life. Modern therapeutic approaches provide options for addressing shared pathological mechanisms while considering diseases severity and patient age.