Introduction. Psoriasis is associated with chronic systemic inflammation and an increased cardiometabolic risk. The role of IL-17A inhibition in modifying these processes in long-term real-world clinical practice requires further investigation.
Aim. To evaluate the long-term efficacy of netakimab and the dynamics of systemic inflammation markers and cardiometabolic profile parameters in patients with plaque psoriasis.
Materials and methods. A retrospective cohort study included 73 patients treated with netakimab for at least 3 years. The analysis included patients who continued therapy and maintained a clinical response (PASI > 75). Changes in PASI, C-reactive protein (CRP), HbA1c, and lipid profile were assessed before treatment initiation and after 3 years of therapy.
Results. Against the background of therapy, a pronounced decrease in disease activity was observed (mean PASI reduction 93.0%; range 75–100%), a reduction in systemic inflammation (CRP from 7.51 ± 3.64 to 5.71 ± 3.41 mg/L), improvement in carbohydrate metabolism (HbA1c from 6.24 ± 0.96% to 6.16 ± 0.94%), and favorable dynamics of lipid parameters (total cholesterol from 5.17 ± 0.45 to 4.78 ± 0.52 mmol/L; LDL cholesterol from 3.02 ± 0.36 to 2.70 ± 0.41 mmol/L; HDL cholesterol from 1.25 ± 0.17 before treatment to 1.36 ± 0.23 mmol/L during therapy). No negative clinically significant dynamics of laboratory parameters were identified; in some patients, the changes were minimal, which corresponds to the pronounced comorbidity burden of the studied group.
Conclusion. Long-term netakimab therapy in patients with a sustained clinical response was associated with control of psoriasis activity and improvement in several cardiometabolic parameters. When interpreting the results, the selective nature of the cohort, retrospective design, and possible influence of concomitant therapy adjustments should be considered.

Introduction. Tofacitinib and baricitinib are key systemic therapies for alopecia areata. However, direct comparative data on their efficacy and predictors of treatment response in real-world practice are limited.
Aim. To compare the efficacy of tofacitinib and baricitinib in alopecia areata and identify predictors of treatment response.
Materials and methods. A 52-week prospective comparative non-randomized cohort study included 45 patients with alopecia areata (SALT >25%). Patients were divided into two groups: tofacitinib (n = 18,10 mg daily) and baricitinib (n = 27,4 mg daily). Efficacy was assessed using SALT score dynamics, SALT30 (≥30% reduction), and SALT ≤20% (clinically significant outcome). Multiple regression models and Cox regression were used to identify predictors.
Results. Groups differed in age and sex (p < 0.05). At week 52, the median hair regrowth was 81.4% for tofacitinib and 100.0% for baricitinib (p = 0.280). Achievement of SALT30 and SALT ≤20% was comparable (p > 0.05). Multivariate analysis identified baseline disease severity (SALT) as the only independent predictor of poorer response (β = -2.6% per 10% SALT, p = 0.047; OR for SALT ≤20% = 0.78, p = 0.038). Drug choice was not associated with efficacy. However, the proportion of early responders (SALT30 by week 12) was significantly higher with baricitinib (51.9% vs. 22.2%, p = 0.041). No serious adverse events occurred.
Conclusions. Tofacitinib and baricitinib demonstrate comparable efficacy and a favorable safety profile in alopecia areata. Baricitinib is associated with a higher rate of early responders. The key predictor of response is the baseline extent of hair loss, which must be considered when planning therapy and evaluating outcomes.

Introduction. According to current concepts, lichenoid pityriasis (LP) is classified as a parapsoriasis with a benign course. The disease is diagnosed in childhood and adolescence, most often in males. Studying the structure and prevalence of LP, as well as risk factors influencing the onset and progression of the acute and chronic forms of the disease in children, is highly relevant.
Objective. To analyze the clinical and epidemiological characteristics and risk factors influencing the onset of LP in children.
Materials and methods. A single-center prospective observational study was conducted. The study included data from 130 children undergoing outpatient treatment and observation at the Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology from January 2022 to March 2025. Statistical analysis methods were used: the χ² test and calculation of odds ratios (OR) with a 95 % confidence interval (CI).
Results. A consistent upward trend in the incidence of LP has been observed in the Moscow pediatric population in recent years. No statistically significant differences in the incidence of acute LP depending on gender and age were found. Males in the 7–14-year age group were more susceptible to developing LP (63.8%). A high diagnostic error rate (33.1%) was observed. Statistically significant risk factors were identified: climate change for acute LP (OR = 66.25), and seasonality for chronic LP (OR = 81.14). Herpes infections were diagnosed 1.6 times more often in patients with acute LP than in those with chronic LP (χ² 7.980; p = 0.092). Herpesvirus infection is a significant risk factor for the development of acute LP.
Conclusion. Pityriasis lichenoides et varioliformis acuta (PLEVA) and chronic pityriasis lichenoides are rare and understudied diseases. The conducted analysis of statistical data forms demonstrated a trend of increasing incidence, indicating the need to identify risk factors for the onset and progression of PL, providing timely medical care, and preventing complications. The duration of the disease depends on the speed of establishing a final diagnosis a definitive diagnosis, necessitating the development of a diagnostic algorithm.

This article analyzes current approaches to topical therapy for pyoderma, an infectious skin disease primarily caused by staphylococci and streptococci. This review covers the etiology, epidemiology, risk factors, and some clinical aspects of superficial pyoderma. Pyoderma is an infectious and inflammatory skin disease caused by bacteria. This dermatosis is the most common disease. It should be noted that pyoderma can occur independently or develop secondary to other skin conditions, thereby worsening the underlying condition and contributing to relapses. Recent studies highlight the importance of bacterial biofilms, both mono- and polyspecies, in the development of chronic recurrent pyoderma. Staphylococcus aureus biofilms colonize eccrineducts in the skin and affect keratinocytes, altering their cytokine production, leading to impaired differentiation and apoptosis. These processes disrupt the skin’s barrier function and contribute to the exacerbation of both the underlying disease and the development of bacterial complications. The most common clinical manifestations of pyoderma are impetigo and folliculitis, while deep forms are less common. Treatment includes topical antiseptic and antibacterial agents, and, if necessary, systemic antibiotic therapy. The steady increase in microbial resistance to known antimicrobial drugs determines the need for research to assess the effectiveness and safety of alternative therapies using local antiseptics. The article presents Russian and international studies demonstrating the effectiveness of the antiseptic Miramistin® against Streptococcus pyogenes, Staphylococcus aureus, and Escherichia coli and others bacterial, as well as in preventing the formation of mono- and multispecies biofilms. The findings support the use of Miramistin® as a topical antiseptic in dermatological practice, particularly for superficial pyoderma.

Introduction. Onychomycosis is a chronic fungal infection of the nails, for the treatment of which prolonged courses of systemic antifungal agents are traditionally used, often accompanied by adverse reactions. A promising method that makes it possible to reduce the drug burden is photodynamic therapy (PDT).
Aim. To assess the efficacy and safety of combination treatment of onychomycosis using PDT.
Materials and methods. A prospective comparative study included 48 patients with clinically and mycologically confirmed onychomycosis. The control group (n = 24) received standard systemic antifungal therapy. The main group (n = 24) underwent 8 PDT sessions with a chlorin-containing photosensitizer in combination with a shortened course of systemic antimycotics. Efficacy was evaluated at 3, 6 and 9 months based on microscopy findings and the area of visually healthy nail plate. Additionally, a modified OnyCOE-T quality-of-life questionnaire was used.
Results. Both groups demonstrated improvement; however, the proportion of early mycological cure at month 3 in the main group was 1.36 times higher (p ≤ 0.05). By month 9, mycological and clinical cure was achieved in 96% of patients in the main group and in 87.5% of patients in the control group. Adverse reactions were recorded only with standard systemic therapy. According to OnyCOE-T, combination treatment was associated with a marked improvement in quality of life.
Conclusion. PDT as part of combination therapy for onychomycosis increases the rate of mycological and clinical cure, allows a reduction in the duration and risk of adverse effects of systemic antifungal therapy, and improves patients’ quality of life.

Eczema herpeticum (Kaposi’s varicelliform eruption) is a disease characterized by an intoxication syndrome associated with a viral infection in children with atopic dermatitis. The most common etiological agent of eczema herpeticum is herpes simplex virus type 1 (HSV-1), less frequently herpes simplex virus type 2 (HSV-2), and, in rare cases, Coxsackievirus A16 or the vaccinia virus. The disease is typical for children aged 6 months to 2 years. This article presents a clinical case of eczema herpeticum in a 14-year-old adolescent with a burdened premorbid background, infected with several human herpesviruses simultaneously (Epstein-Barr virus (EBV), HSV-1, HHV-7) and an active infection caused by herpes simplex virus type 2. The etiological verification of the diagnosis using molecular genetic methods and enzyme immunoassay is described. The patient received systemic therapy, which included antiviral agent (acyclovir 500 mg IV 3 times daily for 5 days), infusion (0.9% sodium chloride 250 ml 2 times daily for 3 days), systemic anti-inflammatory agent (prednisolone 60 mg 2 times daily for 3 days), desensitizing agent (chloropyramine 25 mg 2 times daily for 5 days); local treatment with anti-inflammatory and antifungal/antibacterial agents (hydrocortisone + natamycin + neomycin 15 g 3 times daily for 7 days); drying and anti-inflammatory agent (zinc oxide 25 mg 2 times daily for 5 days), antibacterial eye drops (sulfacetamide 0.1 ml 4 times daily for 5 days). The treatment resulted in a significant improvement of the patient’s condition. The presented case of a typical clinical course of Kaposi’s varicelliform eruption has a scientific and practical significance in terms of the atypical age of disease manifestation and the etiology of the infectious process associated with patient’s burdened pre-comorbidities anamnesis. The presented case of a typical clinical course of eczema herpeticum is of scientific and practical interest due to the atypical age of disease manifestation and the etiology of the infectious process associated with the patient’s burdened premorbid background. The presented data are intended to increase awareness among practicing physicians regarding the clinical and laboratory diagnosis of herpes skin infections in older pediatric age groups.

Over the past decade, there has been an increase in the number of patients suffering from chronic dermatoses complicated by secondary infections. A number of factors contribute to an increase in the risks of dermatoses, both from the external environment (temperature and humidity, cleanliness of air and drinking water, food, stress), and the state of the human body (age, gender, hormonal background, the presence of concomitant diseases). An important factor determining the risk of skin pathology is the state of the microbiota, which depends, among other things, on the use of antiseptics, antibiotics, including topical ones. Insufficient activity of antimicrobial treatment may be accompanied by the development of dysbiosis, the appearance of antibiotic-resistant strains. One of the main directions of treatment of combined skin pathology is the use of polycomponent drugs in the form of creams and ointments. A combination of three components is widely used: betamethasone dipropionate, gentamicin sulfate, and clotrimazole. The pharmaceutical market of the Russian Federation is attended by both the original Triderm drug and generic drugs, in particular, Akriderm GK. There are some differences between these drugs regarding the composition of the excipients, since the developers of the ointment and cream Acryderm GC aimed to increase the penetration of antibiotic and antimycotic into the skin, increasing the effectiveness of treatment, which may reduce the risks of antibiotic resistance. At the same time, there is a study that shows the therapeutic equivalence of Akriderm GK to Triderm cream in the treatment of eczema. Akriderm GK is an interchangeable drug for Triderm cream, and can be used in the clinic as an effective, safe and cost-effective replacement for an imported drug. In this review we summarized the scientific evidence from 39 domestic and foreign research reports on both the treatment of dermatoses and the pharmacological features of agents used for the treatment of inflammatory skin diseases.

Acne affects over 9% of the global population. The overall peak incidence occurs among ages 15 to 20. Acne also occurs in adults and has its own unique characteristics. In adolescents, the disease is triggered by hormonal factors involved in puberty, while in adults, it is caused by abnormal hormonal fluctuations. Antibiotics have been traditionally prescribed as treatments for acne, but due to the increasing antibiotic resistance in recent years, acne treatment regimens have changed. In particular, the use of antimicrobial drugs has declined, while the prescription of both topical and systemic retinoids has increased. This article reviewed epidemiological data on the prevalence of acne in Moscow over the past three years. The analysis of 289 outpatient medical records of acne patients who visited Yugo-Zapadny Branch in 2024 showed that female patients prevailed (59.9% vs 40.1%). The following disease severity distribution was reported: 241 patients with mild acne (83.4%), 43 with moderate acne (14.9%), and 5 with severe acne (1.7%). Severe acne was more common among male patients, while milder forms were more common among female patients. The incidence of acne across all age groups from 2022 to 2024 increased as follows: +15% among children (under 14 years), +31% among adolescents (15–17 years), and + 12% among adults (18 years and older). Patients over 18 years of age most often seek consultative assistance from highly specialized doctors. Acne treatment typically suggests prescription of topical retinoids, topical antibiotics, and their combinations with benzoyl peroxide for mild cases, and systemic retinoids for severe cases. The authors’ own experience allows us to recommend a 1% clindamycin solution, as well as a fixed combination of 1% clindamycin and 5% benzoyl peroxide in gel form for the treatment of mild acne, and for more severe forms as part of combination therapy

Psoriasis is a chronic skin disease that has systemic effects on the body and is associated with genetic and immunological disorders. Its pathogenesis involves dysregulation of the immune system, particularly T-lymphocytes of the Th1 and Th17 types, leading to inflammation, increased keratinocyte proliferation, and skin changes. Psoriasis often affects the scalp (head), which negatively impacts quality of life. A connection has been found between scalp psoriasis and the development of hair loss (alopecia) and other morphological hair changes. Additionally, an imbalance in the microbiome, including colonization by yeastlike fungi, has been observed, which may exacerbate the disease course. Topical agents play a key role in improving treatment efficacy and patient quality of life. These include drugs with anti-inflammatory, keratolytic, and immunosuppressive effects, such as corticosteroids and salicylic acid. Modern practice favors medications that are safe and easy to use, like the lotion Akriderm with betamethasone and salicylic acid. Advances in technology enable better drug penetration and reduce the risk of side effects. Clinical experience confirms the positive role of a comprehensive approach using these treatments for controlling psoriasis of the scalp. This article presents clinical case reports of treatment of three patients with plaque scalp psoriasis in advanced stages, who presented to the consultative and diagnostic department of the outpatient clinic at the Altai State Medical University with complaints of scalp rash, itching, and inflammation. All patients were prescribed combination therapy with betamethasone dipropionate cream. In all cases, symptom relief was achieved within 2–3 weeks of treatment.

Candida fungus is an integral part of the normal human microbiome, but disruption of skin integrity and malperformance of immune function can transform it into a pathogenic form. Some Candida strains are capable of modulating the immune response through suppressing the production of proinflammatory cytokines and inducing T-helper differentiation toward a Th2 response, which contributes to the chronification of inflammation. In this article, we take a detailed look at exogenous and endogenous risk factors. Particular focus has been placed on comorbidities: the present-date knowledge on the role of Candida spp. in exacerbating the course of atopic dermatitis and psoriasis is provided. The authors presented clinical case reports of candidiasis treatment in patients with aggravated histories. Case report 1: a 19-year-old man with complaints of pain, redness, and swelling in the periungual fold area combined with changes in the color and texture of the nail plate. Diagnosis: Periungual fold candidiasis. Onychomycosis. Treatment with 2% sertaconazole cream was prescribed. After 4 weeks, clinical regression of the inflammation process and partial restoration of the nail plate structure was observed. Case report 2: a 37-year-old man with complaints of severe itching, burning, and redness in the groin folds. Diagnosis: Candidal intertrigo of the groin folds associated with antibiotic therapy due to obesity. The prescribed stepwise therapy included: 0.05% clotrimazole + 0.1% gentamicin + 1% betamethasone for 7 days, then 2% sertaconazole cream for 2 weeks. After a three-week therapy, the rash regressed and post-inflammatory hyperpigmentation developed in a patient. Case report 3: a 58-year-old woman with complains of intense itching, burning, pain, and oozing in the abdominal fold within 3 weeks. The patient's medical history told a story of chronic illness. Diagnosis: Candidal intertrigo. The prescribed stepwise therapy included: 0.05% clotrimazole + 0.1% gentamicin + 1% betamethasone for 7 days, then 2% sertaconazole cream for 2 weeks. After a three-week course of treatment, the inflammation regressed. In all cases, skin scrapings showed negative follow-up microscopic examination results.

Introduction. This study performed a comparative analysis of the gut microbiome and affected skin areas in patients with microbial eczema (ME). In addition, the effectiveness of a personalized approach to selecting systemic and topical antibiotics, taking into account antibiotic resistance data obtained from whole-genome sequencing (WGS), was assessed.
Aim. To evaluate the effectiveness of complex treatment for patients with microbial eczema, including a personalized selection of systemic and topical antibacterial agents, taking into account whole-genome sequencing data from the skin and gut microbiome.
Materials and methods. The study included 60 patients with microbial eczema in the acute stage, divided into two equal groups (main group and comparison group) of 30 people each. All patients received treatment in accordance with Federal Clinical Guidelines. For patients in the main group, systemic and topical antibacterial medications were selected individually based on antibiotic resistance data obtained by WGS. The Eczema Area and Severity Index was used to assess the dynamics of skin manifestations, and the frequency of exacerbations after the main course of therapy was also recorded.
Results. After 6 months of observation, patients in the main group showed a decrease in microbial colonization in the gut (the proportion of P. aeruginosa decreased by 9.6 times, E. coli – by 14.3 times, C. difficile – by 43.5 times, K. pneumoniae – by 11.2 times) and on the skin (the proportion of S. aureus decreased by 3.9 times, P. aeruginosa – by 11.5 times, E. coli – by 13.6 times, C. difficile – by 39.8 times, K. pneumoniae – by 5.1 times). The EASI index in the main group was 0.44 (0.23–0.69) points, while in the comparison group it was 1.00 (0.77–3.31) (p < 0.001 from the start of therapy), while in the main group of patients, relapse occurred in 2 patients (6.67%), and in the comparison group – in 5 (16.67%).
Conclusions. Whole-genome sequencing allows for a highly accurate determination of the taxonomic composition of microbiomes. Patients receiving personalized antimicrobial therapy experienced faster restoration of their skin and gut microbiomes compared to the comparison group.

Introduction. Psoriasis remains a major challenge in modern dermatology due to its high prevalence and chronic relapsing nature. A key therapeutic priority is the search for effective and safe topical agents capable of both managing flare-ups and providing long-term disease control.
Aim. To evaluate the clinical efficacy and safety of Depsoriol® lotion and cream (containing calcipotriol and dipotassium glycyrrhizinate) in patients with plaque psoriasis.
Materials and мethods. An open-label, multicenter observational study was conducted involving 108 patients (61 males, 47 females) aged 6 to 74 years across 18 Russian cities. Efficacy was assessed based on PASI score dynamics and patient satisfaction (5-point scale) over 6–8 weeks of therapy. Organoleptic properties and ease of use were also evaluated.
Results. A statistically significant reduction in the PASI score by 77.4% was observed (from 10.6 ± 9.3 to 2.4 ± 2.6 points; p < 0.001). The most pronounced improvement occurred in infiltration (83.5% reduction) and scaling (85.3% reduction), with the median for these parameters reaching 0 [0; 2] by the final visit. Erythema regression reached 73.3% (from 2.66 to 0.71 points). The therapeutic effect is driven by the synergism of calcipotriol (regulation of keratinocyte differentiation) and dipotassium glycyrrhizinate (potent anti-inflammatory and anti-cytokine activity).
Conclusion. Overall, 98.1% of participants rated the treatment results as positive. High treatment adherence was attributed to rapid itch relief and favorable organoleptic properties (fast absorption, non-greasy texture). The absence of steroid-related side effects and the positive safety profile support the use of Depsoriol® for long-term management, including proactive therapy for relapse prevention.

Introduction. The relevance of this study is determined by the rarity of pityriasis lichenoides and the limited number of scientific publications describing the dermatoscopic presentation of the disease. On the one hand, identification of characteristic dermatoscopic patterns would enable clinicians to establish a presumptive diagnosis; on the other hand, it would optimize clinical diagnosis across all age groups, including cases where histopathological examination is not feasible.
Aim. To analyze dermatoscopic patterns in patients with different clinical subtypes of pityriasis lichenoides.
Materials and methods. The study included 60 patients (median age 13 [7; 19] years) diagnosed with pityriasis lichenoides et varioliformis acuta (PLEVA) and pityriasis lichenoides chronica (PLC), who were under observation at the Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology of Moscow Health Department from 2022 to 2024. All patients had Fitzpatrick skin phototype I or II. Dermatoscopic examination of the lesions was performed using 20-fold magnification. In patients with widespread skin involvement, at least two lesions were evaluated to account for all possible dermatoscopic patterns. Pattern descriptions followed the standardized terminology based on the consensus document of the International Dermoscopy Society.
Results. In PLEVA, dotted vessels were visualized in 100.0% of all examined cases. Linear and/or glomerular vessels were detected in 60.0% of patients. The frequency of focal dotted vessels and glomerular vessels was statistically significant (p < 0.01) in PLEVA, whereas in PLC, the frequency of linear vessels was statistically significant (p < 0.01). The presence of light brown and yellowish structureless areas reliably (p < 0.001) indicates PLC, while targetoid lesions are more characteristic of PLEVA.
Conclusion. Dermoscopy is a simple, non-invasive, and informative diagnostic method that, upon detection of characteristic dermatoscopic features, can be useful for diagnosis and determining management strategies in patients with pityriasis lichenoides prior to obtaining histopathological confirmation.

The management of acne patients treated with isotretinoin has evolved quite markedly over the last years: from simply reporting elevated transaminase levels and lipids to a deeper insight into the mechanisms of these changes, development of effective correction methods, and to more clarity on patient selection criteria. Comorbid conditions that can affect safety and tolerability of systemic retinoids require special consideration. This article presents a clinical case of a 15-year-old female patient with severe, extensive, and treatment-resistant acne (IGA 4). The patient had been suffering from rashes over her face, chest, and back for three years. Her comorbidities included class I obesity (BMI 31.2), insulin resistance, hyperprolactinemia, and functional menstrual cycle disorders. The patient had a history of apathy and depressive episodes (she was emotionally stable at the time of therapy). The previous therapy with antiseptics and topical antibiotics has proved to be ineffective. Given the resistance and severity of the disease, isotretinoin was prescribed at a starting dose of 30 mg/day (0.36 mg/kg/day). After one month, improvements were noted: a decrease in sebum secretion and the number of inflammatory lesions. At 2.5 month of therapy, acute abdominal pain syndrome developed due to dietary inconsistency. Laboratory tests showed elevated transaminase levels (ALT, AST), and the abdominal ultrasound examination revealed signs of cholelithiasis. The acute condition was resolved. The isotretinoin dosage was temporally tapered to 10 mg/day, and a diet was recommended. After laboratory parameters and clinical status returned to normal, the dosage was gradually increased to 20 mg/day, and then to the initial therapeutic dose (30 mg/day). At the time of this writing, the patient was completing a course of isotretinoin therapy; the skin process regressed with development of stable clinical remission. The presented case demonstrates the potential to safely continue isotretinoin therapy with transient transaminase elevations, including in patients with comorbidities. Isotretinoin tapering, dietary therapy, and follow-up laboratory monitoring allow to maintain commitment to the treatment and achieve the target cumulative dose without discontinuation of the drug therapy.

Introduction. In Russia, chlamydia infection consistently ranks second in the ranking of sexually transmitted diseases, with an incidence of 17.8 cases per 100,000 population. The presence of associations between C. trachomatis and resistant strains of opportunistic pathogens can lead to the development of polymicrobial bacterial biofilms, contributing to the chronic course of the infection and its resistance to treatment. Given the social significance of chlamydia infection and the frequent presence of polymicrobial bacterial co-infections, research is being conducted to evaluate the effectiveness of additional antimicrobial therapy.
Aim. To evaluate the effectiveness of Wobenzym in the complex treatment of urogenital chlamydia infection, including the frequency of pathogen eradication and changes in the immune status.
Materials and methods. The meta-analysis included randomized and non-randomized controlled studies on the effectiveness of Wobenzym in the complex treatment of urogenital chlamydia infection and antibiotic therapy. The systematic review was conducted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions, Version 6.4, 2023. The risk of bias was assessed using the ROBINS-I tool.
Results and discussion. A literature search using keywords yielded 616 publications, 7 publications were selected for inclusion in the analysis for the period from 1996 to 2023. It has been established that the inclusion of Wobenzym in complex therapy increases the likelihood of pathogen eradication (OR 8.33; 95% CI 2.98–23.30), the likelihood of achieving clinical recovery (OR 4.72; 95% CI 1.85–12.06), and has a positive effect on immune status indicators, including phagocytosis, content of circulating immune complexes, interferon status, pro-inflammatory cytokines, and the readiness for apoptosis and lymphocyte activation. However, the low percentage of pathogen eradication after antibiotic therapy (22.2–32.5%), presented in a number of studies, is controversial.
Conclusion. The conducted meta-analysis demonstrated the effectiveness of complex therapy with the inclusion of Wobenzym in urogenital chlamydia infection. However, the questionable results of a number of studies require further study of this issue and additional comparative studies of the effectiveness of complex therapy.

Introduction. Skin aging is a multifactorial process, with oxidative stress playing a particularly crucial role. The formation of reactive oxygen species (ROS) initiates a cascade of reactions leading to collagen degradation and elastin disorganization, thereby contributing to visible signs of aging. A rational skincare approach, incorporating gentle cleansing and hydration combined with active ingredient action, can slow down the aging processes.
Aim. To evaluate the efficacy of a skincare line combining a biotic complex and plant extracts in caring for mature skin.
Materials and methods. 30 women aged 30 to 55 years (mean age of 42.5 years), exhibiting age-related skin changes. During the 21 days they applied gentle cleansing foam, soothing, moisturizing toner, boost-serum and eye skin care cream and during the following 7 days only foam and toner. Every week there were an assessment of epidermal barrier parameters using the Multi Skin Test Center 750/IMATE 6602 diagnostic system (Germany) and in 28th day of the study satisfaction with the topical products was evaluated via the TTSI-10 questionnaire.
Results. At baseline, the average skin hydration level was 41.3 UE, sebum production was 26.1 UE, and elasticity was 39.2 UE. At the 21^st day hydration level increased by 35.6%, and elasticity improved by 21.4%. Sebum level showed minimal change. Moreover, the epidermal barrier parameters showed minimal changes between days 21 and 28. Visually, participants reported filling of fine wrinkles and decrease in pigmentation intensity. During the study, no adverse reactions were reported.
Conclusions. The anti-aging potential of the studied cosmetic products is based on the synergistic action of plant extracts, a biotic complex, and active moisturizing components. The significant improvements observed in epidermal barrier parameters validate the importance of a comprehensive approach to caring for aging skin.

Introduction. Erythematotelangiectatic rosacea, the most prevalent subtype, is characterized by its resistance to standard therapeutic approaches. A combination of laser treatment for vascular lesions and injectable biorevitalization for the functional dermal remodeling appears pathogenetically justified. However, its clinical efficacy and safety require further investigation.
Aim. To assess the clinical efficacy and safety of Nd:YAG-laser combined with hyaluronic acid/trehalose injections within a single procedure or with 2-week interval in patients with erythematotelangiectatic rosacea.
Materials and methods. In this study, 20 patients diagnosed with erythematotelangiectatic rosacea were allocated to four groups: Group 1 (laser treatment combined with hyaluronic acid/trehalose injections within a single procedure); Group 2 (laser treatment combined with hyaluronic acid/trehalose injections with 2-week interval); Group 3 (laser treatment); Group 4 (hyaluronic acid/trehalose injections). Treatment outcomes were monitored using Antera 3D® three-dimensional skin analysis and validated clinical assessment and patient satisfaction scales.
Results. Combination therapy (Groups 1 and 2) demonstrated the most significant reduction of erythema, telangiectasia and vascular lesions. These approaches were associated with the greatest improvements in overall skin condition and patient satisfaction. No significant difference between Groups 1 and 2 was found. Nd:YAG-laser monotherapy proved most effective for the reduction of vascular lesions, it had no significant impact on skin quality parameters. Hyaluronic acid/trehalose injections improved skin hydration and texture, however demonstrated limited efficacy against telangiectasias.
Conclusion. The high efficacy and safety of Nd:YAG-laser combined with hyaluronic acid/trehalose injections both within a single procedure and with 2-week intervals support the inclusion of these treatment protocols in clinical algorithms for erythematotelangiectatic rosacea.

Introduction. In Russia, the proportion of the population with excessive weight reaches 60–62%, with class 1–3 obesity diagnosed in 20–22%.
Aim. To develop and substantiate a comprehensive protocol of dermatological support for obese patients on the background of incretin therapy, aimed at preventing and correcting undesirable skin and soft tissue changes associated with rapid weight loss.
Materials and methods. The analysis of modern literature data on the pathophysiological mechanisms of the effect of obesity on skin, muscle and bone tissue, as well as on the systemic effects of incretin drugs (GLP-1 receptor agonists and the double agonist GIP/GLP-1 tirzepatide) is carried out. Morphofunctional features of the skin and subcutaneous fat in various age and gender groups, changes in obesity and in the process of rapid weight loss, regardless of the method of body weight reduction, are considered. Based on the analysis of the evidence base and clinical experience, a step-by-step algorithm for patient management has been developed.
Results. It has been established that obesity has a multifactorial negative effect on the skin: adipokine imbalance, chronic systemic inflammation (increased TNF-α, IL-6), suppression of type I collagen synthesis, impaired microcirculation, vitamin D deficiency. Rapid weight loss exacerbates these changes, leading to gravitational ptosis, facial lipoatrophy, deepening of nasolabial and mental folds, reduction of turgor, sagging skin (the phenomenon of “Ozempic face”). An annual protocol of dermatological support is proposed.
Conclusion. The proposed protocol, based on the principles of phasing, proactivity, and an integrated and personalized approach, minimizes the undesirable aesthetic effects of rapid weight loss. Effective patient management requires interdisciplinary collaboration between an endocrinologist, a nutritionist, and a cosmetologist.