Lichen planus (LP) is a chronic T-cell-mediated inflammatory disorder affecting the skin and mucous membranes, characterized by a complex pathogenesis. In the pediatric population, LP is a rare dermatosis; consequently, the scientific literature is predominantly comprised of reports describing single cases or small case series. The aim of the present review was to analyze and synthesize data on LP in children (aged 0–17 years) reported in both domestic and international literature. An electronic search was conducted across the Medline, PubMed, Google Scholar, and Russian Science Citation Index (RSCI) databases up to May 2026. The analysis included full-text original research articles, clinical case reports, and narrative reviews published in English and Russian. The search strategy employed the following keywords: “childhood/pediatric lichen planus, LP”, and “treatment of LP in children”. A total of 134 articles were identified using the specified keywords, of which 40 articles, published between 1993 and 2026, were selected for quantitative and qualitative analysis; of these, 37 were in English and 3 in Russian. It was determined that LP in children exhibits a distinct clinical profile and disease course compared to LP in adults, which complicates timely diagnosis and influences case registration rates. This review summarizes current knowledge regarding the clinical features, course, and diagnostic approaches to the various clinical forms of the disease in children. Despite the high prevalence of this dermatosis in the general population and the wide array of available therapeutic options, no evidence-based international or national clinical guidelines exist specifically for the management of LP in children. The updating and systematization of contemporary data on the pathogenesis, risk factors, and clinical characteristics of LP in pediatric dermatovenereological practice are essential to reduce the incidence of diagnostic errors and to broaden the therapeutic possibilities for this condition.

Bullous pemphigoid (BP) is the most common autoimmune subepidermal blistering dermatosis of the elderly, mediated by Th2-driven inflammation and autoantibodies to BP180/BP230. Its association with both malignant and chronic non-malignant diseases of the digestive system is increasingly discussed, but clinical correlations remain insufficiently characterized. In the first case, a 77-year-old man developed widespread BP shortly before the diagnosis of adenocarcinoma of the gastric antrum. Preoperative chemotherapy followed by subtotal gastrectomy resulted in complete and sustained remission of the skin disease until the patient died from postoperative sepsis. In the second case, a 56-year-old man with immunopathologic ally confirmed BP was found to have severe chronic calculous cholecystitis with a “non-functioning” gallbladder and hepatic steatosis. Initial disease control was achieved with systemic glucocorticoids, but definitive long-term remission occurred only after laparoscopic cholecystectomy and complete withdrawal of prednisolone. These observations support the concept of BP as a potential cutaneous marker of pathology of the digestive system. Patients with newly diagnosed widespread BP should undergo oncological screening with evaluation of the gastrointestinal tract and targeted assessment of the hepatobiliary system, and their management should be organized within a multidisciplinary framework.

Introduction. Atopic dermatitis (AD) is a common genetically determined chronic inflammatory skin disease with a relapsing course. Over the past three decades, the prevalence of AD in industrialized countries has increased markedly. The rising incidence and variable clinical course of AD may be associated, in part, with epigenetic changes induced by environmental factors. Aim. To evaluate epigenetic changes in patients with moderate-to-severe AD, including histone acetylation, filaggrin (FLG) gene expression, and the DNA methylation profile.

Materials and methods. An observational case–control study was conducted from January 2022 to October 2023 and included 60 patients with AD and 23 healthy controls. Histone acetylation and DNA methylation levels were assessed in peripheral blood samples from patients with AD and healthy controls. FLG gene expression was evaluated in the leukocyte fraction of peripheral blood using quantitative reverse transcription polymerase chain reaction (RT-qPCR).

Results. DNA methylation levels were significantly higher in patients with AD than in healthy controls (98.86% vs. 66.16%, respectively; p < 0.0001). Histone acetylation levels were lower in patients with AD than in healthy controls, as indicated by a 21.0% reduction in histone acetyltransferase activity (p < 0.001). In addition, FLG gene expression in the leukocyte fraction of peripheral blood was significantly lower in patients with AD than in healthy controls (Cohen’s d = -3.03; p = 1.19 × 10^-11).

Conclusion. The assessment of molecular genetic characteristics and epigenetic alterations in patients with AD may contribute to a better understanding of the immunopathogenesis of the disease and support the development of novel approaches to targeted therapy.

Introduction. Continuous glucose monitoring (CGM) systems have become an integral component of type 1 diabetes mellitus therapy. However, their widespread adoption has revealed an underestimated problem: skin reactions, which serve as a significant barrier to consistent device usage.

Aim. To assess the prevalence and structure of skin reactions associated with CGM use, perform differential diagnosis of dermatitis types, and identify factors influencing patient adherence to this technology.

Materials and methods. The study included 75 pediatric patients with type 1 diabetes mellitus using CGM systems. Demographic data, duration of device usage, and characteristics of skin manifestations were analyzed.

Results. The mean age of participants was 13.1 ± 3.5 years, with a mean CGM usage duration of 7.5 ± 2.7 months. Skin reactions were observed in 18 patients (24.0%). Simple contact dermatitis predominated, affecting 12 patients (66.7% of those with reactions; 16.0% of the total cohort). Allergic contact dermatitis was diagnosed in 6 patients (33.3%; 8.0%). All 12 patients (100%) with simple contact dermatitis continued CGM use despite symptoms. In contrast, adherence in the allergic dermatitis group was significantly lower: 5 out of 6 patients (83.3%) discontinued CGM due to intense pruritus and worsening skin conditions upon reapplication. Only one patient (16.7%) maintained adherence by employing pharmacological treatment and rotating sensor insertion sites. Conclusions. Skin reactions occur in 24.0% of CGM users, confirming the clinical significance of this issue. Simple contact dermatitis is twice as common as allergic contact dermatitis, follows a benign course, and does not compromise treatment adherence. Conversely, allergic contact dermatitis is a key factor leading to technology abandonment. These findings underscore the necessity for timely diagnosis and the development of personalized management strategies to ensure continued access to CGM therapy.

Vulgar psoriasis is a systemic chronic immunoinflammatory disease associated with high comorbidity and a significant decrease in the quality of life of patients. Psoriasis is considered a T-cell-mediated disease, and the corresponding cytokine profile of psoriatic lesions indicates an important role of interferon (IFN)-α, interleukin (IL)-22, the IL-23/IL-17 axis, and tumor necrosis factor (TNF) in the development of psoriasis. In addition to local skin inflammation, patients with psoriasis have elevated levels of pro-inflammatory cytokines in their blood serum (TNF-α, IL-17, and IL-23, among others), which may contribute to an increased risk of cardiovascular disease and traditional risk factors for cardiovascular disease, including hypertension, diabetes, hyperlipidemia, obesity, and NAFLD. In recent years, the emergence of new genetically engineered biological drugs targeting IL-23 has revolutionized the treatment of psoriasis, demonstrating sustained long-term efficacy and safety. Understanding the systemic nature of the disease has transformed the approach to therapy. Biological therapy with the IL-23 inhibitor guselkumab has shown high clinical efficacy, rapid achievement of skin remission, and a favorable safety profile in patients with moderate to severe psoriasis vulgaris with various comorbidities.The article presents the clinical and anamnestic characteristics of patients receiving genetically engineered biological therapy with an interleukin-23 (IL-23) inhibitor, as well as clinical observations of the successful use 

Introduction. Localized scleroderma (LS) is associated with an increased risk of malignant neoplasms. The combination of these diseases creates the phenomenon of double psychological vulnerability. The features of the subjective experience of such comorbidity are poorly studied.

Aim. To compare psychological well-being and subjective vitality in patients with isolated LS and LS associated with malignant neoplasms, as well as to assess the relationship between psychological indicators and clinical and laboratory characteristics of the disease.

Materials and methods. The study involved 87 patients with verified LS: the main group (n = 60) with a history of malignant neoplasms, and the control group (n = 27) without malignant neoplasms. A comprehensive assessment was conducted, including medical history collection, assessment of clinical and dermatoscopic signs of LS to objectify the severity of the skin process, determination of cancer markers (AFP, CEA, CA 19-9, CA 72-4, and CA 15-3) for screening the activity of the oncological process and identifying subclinical changes, psychological diagnostics (K. Riffʼs Psychological Well-Being Scale, T.V. Maltsevaʼs Subjective Vitality Questionnaire). Statistical analysis included nonparametric criteria, regression and factor analysis.

Results. Patients of the main group revealed a critical decrease in goal-setting (β = -0.57) and competence in managing the environment (β = -0.51). A paradox of vitality was found: the mobilization of energy (r = 0.354) was combined with a decrease in the meaning of life (r = -0.347), which indicates the phenomenon of “exhausting adaptation.” Factor analysis confirmed the bipolar structure of adaptation: “acceptance-autonomy” (main group) and “meaning-management” (control group). Statistically significant correlations were found between elevated levels of cancer markers (CEA, CA72.4), individual dermatoscopic signs (erythema, hyperkeratosis), and indicators of psychological distress.

Conclusion. Psychological adaptation in combined pathology is characterized by transformation of the semantic sphere and dissociation of resources. The revealed correlations between somatic and psychological indicators, independent of patient awareness, indicate complex psychosomatic and somatopsychic relationships that require further study.

Micronization of topical therapeutic agents is the reduction of the particle size of topical medications. We conducted a systematic search of publications in PubMed, Scopus, Google Scholar, eLIBRARY.RU, cyberleninka.ru, using the keywords micronization, topical glucocorticosteroids, betamethasone dipropionate, dermal penetration, and Russian-made betamethasone dipropionate combination products. In the initial search, 128 publications were identified, 76 of which were excluded due to insufficient relevance to the topic. Fifty-two articles were selected for full-text evaluation because they contained data on micronization technology, as well as the results of experimental, longitudinal, cohort, comparative clinical studies, and reviews. Following the full-text analysis, six publications were excluded due to insufficient relevance to the topic, and four due to duplicate data. This article presents the history and essence of micronization as a process, demonstrating the impact of particle size changes on the properties of topical medications. Decreasing particle size increases the specific surface area, accelerates dissolution, can increase the local concentration of the active ingredient, and enhances the diffusion gradient. In dermatology, this translates into potential increased deposition in targeted areas, a more rapid onset of effect, and the ability to reduce the active ingredient dose while maintaining clinical results and minimizing adverse effects. This is why micronization technologies are important for topical glucocorticosteroids, azelaic acid, and other topical medications. The paper summarizes literature data on the impact of micronization of topical glucocorticosteroids in both monoand combination dosage forms on their physicochemical properties, active ingredient penetration into the skin, systemic absorption, and safety in dermatological practice, including in light of increased compliance among dermatological patients.

Introduction. Currently, the comprehensive and personalized treatment of psoriasis requires the use of medications for basic therapy, but also drugs that support stable remission of the disease – emollients. The latter, having proven effectiveness, restore the protective and barrier functions of the skin.

Aim. To identify differences in the results of treatment of vulgar psoriasis using local emollients in groups of patients receiving different therapies.

Materials and methods. The study included 155 patients with moderate to severe psoriasis (age over 18 years, duration of the disease from 6 months to 3 years), randomized into 3 treatment groups with the mandatory use of emollients. Patients of the first group used daily applications of mometasone furoate in the form of 0.1% ointment. Patients of the second group received methotrexate intramuscularly at 15 mg once a week according to the scheme. The third group of patients were treated with an IL-17A inhibitor (netakimab) subcutaneously 120 mg. The clinical outcome was assessed after 3 months by reducing the PASI index by 50% or more (PASI 50) and the BSA index. Statistical processing was performed in the StatTech v. 4.11.2 program.

Results. All 155 patients, regardless of the type of therapy, showed significant clinical improvement – peeling disappeared and the degree of inflammatory reaction decreased. There were also no adverse events with the use of emollients.

Conclusions. The use of emollients in complex therapy provides a personalized approach, as well as reduces the severity of clinical manifestations and maintains a longer period of remission.

The modern course of mycoses is determined by a complex of factors, including irrational therapy, concomitant somatic pathology, and the development of drug resistance. Intertriginous mycoses are characterized by acute inflammatory symptoms and are often complicated by bacterial infection, which can lead to chronicity and require a comprehensive approach to patient management. This article presents a series of clinical observations of patients with intertriginous mycoses, characterized by late diagnosis verification due to ineffective self-treatment. The infection was caused by various pathogens, and its progression was facilitated by concomitant metabolic disorders, hyperhidrosis, microtrauma, and the inappropriate use of topical steroids. Diagnosis was based on clinical examination, microscopic examination, and culture results. Two-stage topical therapy was used in all cases. During the first stage, a combination medication containing betamethasone, gentamicin, and clotrimazole (Akriderm GK cream) was prescribed, which quickly relieved inflammatory symptoms and eliminated itching. The duration of its use was determined by the rate of regression of acute inflammatory symptoms. This avoided the undesirable effects of the topical steroid and created conditions for a safe transition to the second stage, during which a dual-action antifungal agent, sertaconazole (Acrimicol cream), was used to completely eradicate the pathogen. Sequential administration of topical agents enabled rapid relief of inflammation and infection without the risk of iatrogenic complications, resulting in regression of clinical symptoms and mycological cure, as demonstrated by laboratory tests.

Allergic skin diseases in young children are characterized by pronounced exudation due to anatomical immaturity of the skin, increased vascular permeability, spongiosis, and a disrupted epidermal barrier. This article describes in detail the mechanisms of immune inflammation, in which proinflammatory mediators (histamine, IL-4, IL-13, etc.) play a key role, as well as chronic itching and scratching, which creating a vicious cycle of “itching – scratching – inflammation”. The pathogenesis of exacerbations with oozing and exudation is discussed. Allergic skin diseases hold a leading place in the structure of childhood skin pathology, and the features of their course at this age – a tendency to exudation, involvement of sensitive areas, and a high risk of secondary infection – impose special requirements on topical agents, whose safety is no less important than efficacy. The properties of synthetic tannin and polidocanol, the basis of Neotanin – a barrier agent approved for use in children from the first month of life, free of hormones, antibiotics, and dyes, and acting within the stratum corneum without systemic absorption – are considered. Synthetic tannin forms a protective film on the skin surface, exerts astringent, drying, and antipruritic effects, and prevents secondary infection, while polidocanol additionally reduces itching. The authors present three clinical cases of successful treatment of allergic dermatoses in children with Neotanin – both in various combinations with topical glucocorticosteroids and as monotherapy, including lesions localized on sensitive skin areas. In all observations, regression of inflammation and relief of itching were achieved, and no adverse events were recorded.

Pyoderma gangrenosum (PG) is a rare inflammatory skin condition belonging to the group of neutrophilic dermatoses. It is characterized by rapidly progressing ulcers involving deep necrosis, severe pain, and a pronounced inflammatory response. PG is clinically classified into four morphological variants, including ulcerative, bullous, vegetative, and pustular. The ulcerative form is characterized by deep necrotic ulcers with a violaceous edge and may present as either multiple or solitary lesions. The bullous form begins with painful redness and the rapid occurrence of blisters that evolve into necrosis of the skin. The pustular form is the rarest variant characterized by multiple sterile pustules over an erythematous background, typically on the lower extremities, which rapidly progress to superficial ulcers. The vegetative form progresses more slowly and is characterized by non-purulent erosions or superficial ulcers. The etiology of PG is multifactorial: some cases are idiopathic, yet the disease is frequently associated with active systemic disorders, skin trauma, and pharmacologic triggers. Comorbidities include inflammatory bowel diseases, rheumatological syndromes, hematologic malignancies, and other dermatoses, which can influence the clinical presentation, disease severity, and prognosis. The pathogenesis of PG is characterized by marked neutrophilic inflammation and partial dysregulation of IL-1 and TNF-α cytokine-mediated immune signalling, as well as disruption of regulatory pathways of inflammation. Treatment of PG is the most challenging and not sufficiently studied area in existing research literature. Evidence regarding efficacy of different systemic therapy regimens are limited and mostly comprise small case series, case reports, and expert experience. Standard treatment involves a combination of systemic immunosuppression (corticosteroids and/or cytotoxic agents) and local ulcer wound care. Ulcer care is essential to achieve a successful disease outcome. It should provide careful wound cleansing, moist wound environment, non-adherent dressings that incorporate antiseptic agents, and conditions conducive to adequate epithelialization. The article presents a clinical case of the treatment of pyoderma gangrenosum (PG) in a 52-year-old female patient. In 2023, the patient incidentally found a lesion in her right scapular region, accompanied by pronounced tenderness. The subsequent rapid growth, suppuration, and aggravated inflammation of the lesion led to a wrong diagnosis of atheroma. The patient underwent surgical treatment twice; however, the intensity of the pathological process did not subside. She was prescribed antibiotics, corticosteroids, and wound debridement using ProntoSan solution after her diagnosis of pyoderma gangrenosum was documented. The treatment regimen helped switch off inflammation and significantly reduce the symptoms of the disease. Only isolated ulcerative lesions were observed on the skin after 10 days of treatment. The patient continued her treatment at home.

Chronic dermatoses (CDs) represent a heterogeneous group of skin disorders that impose a substantial economic burden and significantly affect the quality of life of patients and their families. Topical corticosteroids have been widely used in the treatment of CDs due to their various effects, such as anti-inflammatory and immunomodulatory, antiproliferative, antipruritic, and vasoconstrictive action. There is a sufficiently large range of topical corticosteroids on the pharmaceutical market. On the plus side, a wide range of topical corticosteroids ensures that individuals with CDs receive personalized treatment tailored to their specific needs; on the minus side, it complicates the practitioner's choice of an optimal medication. The aim of this article is to discuss approaches to choosing topical corticosteroids for the treatment of CDs, using the example of Akrikhin’s products. The potency and safety of topical corticosteroids depend on their chemical structure, including the presence of halogens and molecular esterification. Betamethasone (fluorinated) and methylprednisolone aceponate (non-halogenated) refer to the potent topical corticosteroids. To enhance the molecule's lipophilicity, betamethasone is reasonable to use in the dipropionate salt form of betamethasone. Methylprednisolone aceponate has a more favourable safety profile, as it is a prodrug and its prodrug design enables its activation within a site of inflammation. Combination products containing these substances are also commercially available. In case of secondary skin infection, the most rational choice is the use of betamethasone/clotrimazole/gentamicin product (Akriderm GK). In the presence of hyperkeratosis, it may be appropriate to choose a topical corticosteroid combined with a keratolytic agent, such as betamethasone/ salicylic acid product (Akriderm SK). Salicylic acid increases the skin penetration rate of steroids and has an independent effect on the course of skin diseases. Betamethasone dipropionate, methylprednisolone aceponate, and their combinations are available in different dosage forms, which makes it possible to choose a medication according to the needs of an individual patient.

Introduction. Pityriasis rubra pilaris (Devergie’s disease) is a rare chronic papulosquamous dermatosis characterized by impaired keratinization and variability in clinical manifestations.

Aim. To evaluate the efficacy and safety of netakimab, a genetically engineered biologic IL-17 inhibitor, in patients with the erythrodermic form of pityriasis rubra pilaris.

Materials and methods. An analysis of 9 patient registry data from 2023 to 2026 was performed. Patients received netakimab according to the following regimen: 120 mg at weeks 0, 1, and 2, followed by transition to administration every 4 weeks. The mean duration of therapy was 38 ± 15 weeks (Me = 48 weeks).

Results. During netakimab therapy, statistically significant positive dynamics were observed across all evaluated parameters. The PASI score decreased from 35.51 ± 1.75 points (Me = 35.60; Q₁ –Q₃ : 34.00–36.20) to 0.52 ± 0.33 points (Me = 0.60; Q₁ –Q₃ : 0.50–0.70) (p = 0.004). The Erythroderma Index decreased from 87.89 ± 4.59 points (Me = 89.00; Q₁ –Q₃ : 87.00–90.00)1 (Me  =  2.00; Q₁ –Q₃ : 2.00–4.00) (p  =  0.004). The  Dermatology Life Quality Index decreased from 24.00 ± 1.00 points (Me = 24.00; Q₁ –Q₃ : 24.00–25.00) to 0.78 ± 0.44 points (Me = 1.00; Q₁ –Q₃ : 1.00–1.00) (p = 0.004).

Conclusions. The obtained results confirm the promising potential of IL-17A inhibitors in the treatment of the erythrodermic form of pityriasis rubra pilaris; however, their interpretation is limited by the small sample size and the absence of a control group.

Understanding the physiology of the incretin system is critically important for the safe and effective use of medications that modulate this system – GLP-1 receptor agonists (liraglutide, semaglutide) and a dual GLP-1 and GIP receptor agonist (tirzepatide) in weight-correction programs with a cosmetic purpose. Tirzepatide demonstrates higher efficacy in reducing body weight compared to GLP-1 monoagonists.The available data on the positive effect of the dual agonist (Sejaro®) on metabolic processes demonstrate its enormous therapeutic potential as a drug of choice for obesity and hyperglycemia. Due to their effect on the regulation of digestive system function, the most common side effects of incretin system modulators are gastrointestinal disorders (nausea, vomiting, diarrhea, constipation), which are caused by a slowdown in gastroduodenal motility and adaptation of the gastrointestinal tract to reduced food intake. These effects can lead to loss of skin turgor, the formation of striae, and atrophy of the subcutaneous fatty tissue in the facial area (Ozempic face) as a result of nutrient deficiency, reduced synthesis of collagen and elastin, and redistribution of soft tissue volume. In this regard, the prevention of cosmetic complications during weight loss using incretin system modulators, particularly tirzepatide, should include gradual titration of the drug dose, small-portion nutrition, and monitoring of skin condition dynamics. All therapeutic and preventive measures should be carried out within the framework of interdisciplinary collaboration between an endocrinologist, a dietitian, a cosmetologist, a plastic surgeon, and other specialists. A differentiated approach using incretin-based medications, particularly dual GLP-1 and GIP receptor agonists (tirzepatide, Sejaro®), given their highest efficacy, will make it possible to achieve targeted weight loss results, minimize aesthetic complications, increase patients’ satisfaction with treatment outcomes, and ensure long-term adherence to therapy. In this review we summarized the scientific evidence from 52 domestic and foreign medical periodicals.

Introduction. Modern aesthetic medicine is increasingly focused on regenerative technologies. Poly-L-lactic acid (PLLA) and exosomes derived from adipose-derived mesenchymal stem cells (ADSC-Exos) possess complementary mechanisms of action, making their combined use a promising approach for the correction of age-related skin changes.

Aim. To compare the clinical efficacy and safety of different treatment protocols for the treatment of age-related skin changes using PLLA and an ADSC-Exos-based formulation.

Materials and methods. A prospective pilot, two-center clinical study was conducted in 10 patients aged 35 to 71 years. Patients were assigned to one of three treatment groups according to the treatment protocol: PLLA monotherapy (n = 2); combination therapy with PLLA and ADSC-Exos-based formulation (n = 4); and a staged multilevel treatment protocol using device-based procedures, PLLA, an ADSC-Exos-based formulation, and uncrosslinked hyaluronic acid (n = 4). Efficacy was assessed using the Antera 3D imaging system, the Global Aesthetic Improvement Scale (GAIS), and a visual analog scale (VAS). Safety was evaluated by recording adverse events.

Results. All treatment protocols demonstrated a favorable safety profile, with no adverse events reported. The greatest clinical effect was achieved with the staged multilevel treatment protocol, resulting in a 31.7 ± 4.6% reduction in wrinkle depth, and a GAIS score of 4.5 ± 0.5. Between-group analysis demonstrated statistically significant differences in the reduction in wrinkle depth (p = 0.027). Compared with PLLA monotherapy, combination protocols incorporating ADSC-Exos-based formulation were associated with shorter recovery periods and earlier clinical improvement.

Conclusion. Combination treatment with PLLA and an ADSC-Exos-based formulation represents an effective and safe strategy for the treatment of age-related skin changes. Among the evaluated protocols, the staged multilevel approach produced the most pronounced clinical outcomes, improving objective skin quality parameters while shortening the recovery period.

Facial ageing is a multilevel process involving the epidermis, dermis, subcutaneous tissue, the superficial musculoaponeurotic system, retaining ligaments and bone. Epigenetic mechanisms – DNA methylation drift, altered histone modifications and chromatin accessibility, and remodelling of non-coding RNA profiles – link environmental exposures to gene activity and are modified by age, ultraviolet radiation, inflammation and mechanical loading, including signalling through the YAP/ TAZ–cGAS–STING axis. The strongest clinical and molecular evidence supports daily photoprotection. For retinoids, hyaluronic acid, platelet-rich plasma, polynucleotides, collagen biostimulators, energy-based methods and thread procedures, clinical efficacy has been documented for selected indications, but the role of epigenetic mechanisms in mediating these effects is not established. Direct in vivo evidence of altered cutaneous DNA methylation exists only for dihydromyricetin and the 1940-nm non-ablative fractional laser; small samples and short follow-up preclude conclusions on durability. Partial reprogramming and systemic DNMT/HDAC inhibitors have no clinical rationale in aesthetic medicine. An epigenetically informed approach involves reducing ongoing damage, restoring barrier function and supporting controlled tissue remodelling, with assessment of clinically meaningful and durable outcomes. This review addresses the role of epigenetic regulation in age-related changes of facial tissues and how it may inform aesthetic practice. PubMed/MEDLINE, Cochrane Library, Crossref, ClinicalTrials.gov, official journal pages and regulatory agency websites were searched; negative findings and safety signals were sought separately. The search was last updated in 2026.

Aesthetic medicine sees a steady annual increase in injectable procedures. The procedures have a risk of developing adverse post-procedural events. The most common post procedural events are pain, localized swelling, hematomas, and ecchymosis. These reactions are associated with the duration of the rehabilitation period and decreased patient satisfaction with the procedure's results. At the same time, a smooth and easy skin recovery is directly linked to subsequent adherence to a prescribed rehabilitation regimen. To achieve effective recovery, heparin sodium (Lyoton) 1,000 IU/g in gel form was applied. Its action lies in heparinʼs ability to positively influence microcirculation, reduce local coagulation and inflammation, and stimulate tissue regeneration. The article presents a series of clinical cases where patients experienced adverse events following biorevitalization procedures. All patients were recommended to use Lyoton 1000 gel to relieve pain and accelerate skin recovery. The product was applied 2–3 times a day, and the female patientsʼ state was assessed daily for 3 consecutive days after the procedure. The performed therapy helped achieve significant improvements and/ or complete skin recovery. These results suggest that the local use of heparin sodium is promising in relieving pain and shortening post-procedural skin rehabilitation.

Introduction. Age-related skin changes are associated not only with decreased hydration levels but also with alterations in the extracellular matrix, structural changes in the dermis, and reduced functional activity of tissues. The modern concept of biorevitalization considers hyaluronic acid as a tool for correcting multilevel skin alterations aimed at restoring skin quality rather than merely providing temporary hydration.

Aim. To evaluate the efficacy and safety of an injectable gel based on native high-molecular-weight hyaluronic acid for the treatment of skin dehydration and textural abnormalities.

Materials and methods. It was a prospective, single-center, interventional clinical and instrumental study involving 20 female patients aged 30–55 years. The treatment course included two procedures with ARION Hydro 1.5% 2.0 mL administered at an interval of 21–28 days ± 2 days using the HYDRO VEIL technique of multiple intradermal microbolus injections.

Results. Ultrasound examination demonstrated a significant increase in total dermal thickness and reticular dermal layer thickness. Corneometry showed a significant increase in skin hydration in the forehead, cheekbone, and upper lip areas, while no significant changes were observed in the control area of the neck. According to the PGAIS and SGAIS scales, improvement of varying degrees was observed in 100% of patients by the final visit, and 95% of patients rated the outcome as satisfactory or very satisfactory according to the Face-Q questionnaire.

Conclusions. ARION Hydro 1.5% 2.0 mL demonstrated efficacy and good tolerability in the treatment of age-related changes in skin quality. The obtained data allow the product to be considered as a tissue bioremodulation agent aimed at improving skin hydration and dermal structural condition.

Introduction. Existing gaps occurring in the knowledge of seborrheic dermatitis etiopathogenesis determine the need for a comprehensive approach aiming to identify the cause-and-effect relationships between genetic, morphofunctional, and microbiological factors of SD, as well as to develop evidence-based models to tailor medical decisions for individual patients. Aim. Identify key factors in the development and course of seborrheic dermatitis using Bayesian network analysis and to evaluate the efficacy of topical betamethasone dipropionate 0.05% + salicylic acid 2% solution.

Materials and methods. The study consisted of two phases. In the first phase, a clinico-pathogenetic model was reconstructed using non-parametric Bayesian network analysis based on data from 90 patients with SD. In the second phase, an open-label prospective study evaluated the efficacy and safety of Akriderm SK solution in 62 patients with scalp SD over 2 weeks of active treatment and 4 weeks of follow-up.

Results. The SD model revealed a triad of clusters: “metabolism – epidermis – microbiota”; correlations were established between glucose and cholesterol with keratinization and dysbiosis, associations of the TNF-α AA genotype with Candida albicans colonization (r = 0.88), and hyperbilirubinemia with pruritus (r = 0.91). In the treatment of patients with scalp SD with the solution for external use Akriderm SK, clinical remission (SEDASI ≤ 2) was achieved in 90.3% of patients by the end of the 2nd week of therapy, while the relapse rate after 4 weeks of observation was 1.6%.

Conclusions. The proposed Bayesian model elucidates the multifactorial pathogenesis, visualizing the interdependencies and hierarchy of factors and clinical manifestations and supporting a personalized approach. Betamethasone dipropionate 0.05% + salicylic acid 2% solution is an effective and safe treatment for scalp SD.

Traditionally, people dedicate significant attention to hair care. There is a huge variety of products, methods, and treatments, however not all of them can help improve hair quality and health. According to some reports, around 20% of the global population are affected by hair disorders, with hair loss of various genesis constituting a major portion. These estimates underscore the importance of paying careful attention to choosing hair care products and when considering the underlying causes of changes in hair condition. The use of hair care products can trigger allergic reactions on the scalp. Hair dyes are reported as one of the most common causes of such reactions. Hypersensitivity reactions can also affect the forehead, neck, and the skin behind the ears adjacent to the area of allergen application, indicating a potentially wide area of exposure to the hair dyes. In addition, cases of hair loss after the use of more permanent dye products have been described. The chemical composition of hair dye products directly influences the extent of hair damage: permanent dyes can be more damaging to the hair structure than semi-permanent dyes. Daily hair care practices also affect hair quality. Using certain shampoos can worsen hair condition, while regular use of heat styling tools and harsh styling practices may lead to its mechanical damage, dryness, and breakage. Chemical treatments are generally associated with damage to the hair structure and texture, although they are not necessarily related to direct hair loss. Individuals experiencing hair thinning often require a specialized approach to the treatment. Certain products and techniques are contraindicated, so decisions should be patient centred, tailoring care to each individual’s hair care needs and caution when choosing hair dyes and treatments. In hair health matters, careful choice of hair care products is important to minimize exposure to harsh treatments and take care of the scalp condition.

This review systematizes current evidence on cutaneous lupus erythematosus (CLE) that denotes a heterogeneous spectrum of dermatological manifestations associated with autoimmune inflammation. The analysis of the literature included 43 sources from both Russian-language and foreign scientific periodicals. Epidemiologically, CLE was estimated to occurs two to three times more frequently than systemic lupus erythematosus, with the annual incidence of 4.3 per 100,000 cases. Reported female-to-male ratio ranges from 3:1 to 4:1, depending on the disease subtype. People of African ancestry are 5.4 times more likely to develop the disease than people of European ancestry. At the same time, a steady rise in incidence has been observed, which requires to take measures to improve diagnostic algorithms. The review explored the classification approaches, ranging from the traditional three-tier division into acute, subacute, and chronic to the validated scoring system for discoid lupus (sensitivity: 84%; specificity: 76%), taking into account the morphological features of the dermatosis. It also paid particular attention to etiopathogenesis and provided an in-depth characterisation of genetic factors: polymorphisms in FCGR2A (acute cutaneous lupus erythematosus), TYK2, IRF5, and TNF-α (subacute form), and ITGAM (discoid form); monogenic mutations in TREX1 and SAMHD1; and associations with HLA-B8, HLA-DR, and HLA-DQ. The authors described key disease triggers, including ultraviolet radiation, over 100 medications (hydrochlorothiazide, proton pump inhibitors, terbinafine, and immunobiological agents), smoking, as well as COVID-19 infection and vaccination. According to current understanding of CLE, keratinocytes have a central role in disease pathogenesis — specifically through their Fas/FasL-mediated apoptosis; production of type I and III interferons and CXCL9/10/11 chemokines; activation of the JAK/STAT signalling pathway; and interactions with plasmacytoid dendritic cells, neutrophil extracellular traps (NETs), and cytotoxic CD8+ T-lymphocytes accelerating keratinocyte death via granzyme B and the caspase cascade, thereby perpetuating a vicious cycle of inflammation. Therefore, further investigation into CLP pathogenesis and updating classification approaches represents an important and urgent task, the solution of which will improve the quality of the disease's diagnosis and treatment.

Lyell’s syndrome (toxic epidermal necrolysis) is a rare, life-threatening disease with a mortality rate of up to 30–50%, caused by the frequent development of septic complications, dehydration, and electrolyte imbalances. Drugs play a key role in the development of this pathology. Currently, over 100 known trigger drugs are known, including those widely used in medical practice such as nonsteroidal anti-inflammatory drugs, antiepileptic and antigout drugs, sulfonamides, and antibiotics. Moreover, the simultaneous use of several drugs increases the risk of developing Lyell’s syndrome. Less frequently, the disease has been described as occurring in the context of Mycoplasma pneumoniae and herpes simplex virus infection. This paper discusses current theories of toxic epidermal necrolysis pathogenesis, emphasizing the modern clinical features of this pathology: rapid generalization of the process, nonspecific initial symptoms, and a high risk of multiple organ failure. Criteria for assessing the severity and prognosis of the disease are presented. Particular attention is paid to the complexities of treatment due to the lack of a unified patient management protocol. The need for interdisciplinary collaboration between a dermatovenerologist, ophthalmologist, otolaryngologist, combustion specialist, surgeon, and, when treating children, a pediatrician is emphasized. This article presents a case study of a patient with Lyell’s syndrome who had a history of lamotrigine use. Due to the nonspecific nature of her initial symptoms, the disease was misdiagnosed as infectious, leading to the additional prescription of oseltamivir. Errors in patient management after the correct diagnosis was verified are described, and the effectiveness of treatment in the combustion department is highlighted thanks to the collaborative determination of therapeutic strategies in a multidisciplinary consultation.