ISSN (print): 2073-4034, ISSN (online): 2414-9128 Founder: LLC “Bionika Media” Editor-in-Chief: Sychev D.A., Corresponding Member of RAS, Doctor of Sc., Full Professor Frequency / Assess: 14 issues per year / Subscription Included in: Higher Attestation Commission List, RISC
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Modern methods for early prevention of surgical scars: a literature review
Scar development is the most common complication and one of the main criteria for success or failure in skin tumor removal. The location, size, and appearance of scars depend on oncological, anatomical, and surgical limitations, as well as internal factors influencing the complex healing process. Timely preventive measures for postoperative wounds and immature scars optimize the healing process in the early stages, improving the cosmetic appearance of the scar and reducing the risk of developing pathological defects. This literature review presents the main methods for the early prevention of scar development, including surgical, medicinal, and physical therapy methods, and evaluates their effectiveness as mono- or combination therapy, based on current research data.
Methods for assessing biological age: relevance, clock types, and clinical significance
Over the past century, humanity has witnessed an unprecedented increase in life expectancy, which has naturally led to global population aging. Paradoxically, despite the impressive achievements of modern medicine, the prevalence of age-related noncommunicable diseases continues to steadily increase. The fundamental goal of longevity medicine interventions is not simply to increase the number of years lived, but to significantly extend the healthy lifespan (Healthspan), slow the rate of biological aging, and improve quality of life, regardless of an individual’s chronological age. In this context, aging biomarkers represent critical tools for achieving these goals. Biological age is considered by the modern scientific community as the most promising integrated indicator combining biomarker signatures and possessing clinical and prognostic significance in longevity medicine. Epigenetic clocks, based on a thorough analysis of DNA methylation patterns, are currently recognized as the gold standard for quantitative assessment of biological age. Among the most thoroughly studied and validated models are the Horvath clock, the Hannum clock, the PhenoAge formula, the GrimAge formula, and the DunedinPACE formula, each with specific advantages in different clinical contexts. At the same time, the dynamics of many biomarkers throughout the life cycle are distinctly nonlinear and exhibit complex patterns of interaction with a nonlinear increase in mortality and the risk of developing age-associated pathologies. Therefore, the implementation of artificial intelligence technologies for multimodal data analysis opens up fundamentally new prospects for the creation of highly accurate and personalized models for assessing biological age.
Isotretinoin safety paradoxes: balancing adverse events with clinical needs
Systemic isotretinoin remains a highly effective standard treatment for severe acne, targeting key pathogenetic pathways. However, its use is associated with a wide range of adverse events, creating a safety paradox. This scientific review analyzes currently available data on the potential side effects of systemic isotretinoin therapy.
Treatment of atopic dermatitis in pediatric practice: challenges and solutions
This article addresses topical anti-inflammatory therapy for atopic dermatitis, the most common inflammatory skin disease with an early onset of clinical manifestations, which is relevant to pediatric clinical practice. The chronic, relapsing course of atopic dermatitis requires ongoing treatment and symptom control, which poses challenges not only to the efficacy but also to the safety of prescribed medications. In this regard, it is shown that pimecrolimus cream 1% is a useful topical treatment option for pediatricians. It can be prescribed both during exacerbations and for long-term anti-relapse treatment, including in infancy and early childhood. The efficacy and safety of this drug, as well as its advantages over topical glucocorticosteroids, have been confirmed by clinical studies and many years of domestic and international practice, as reflected in this article. This article examines topical anti-inflammatory therapy for atopic dermatitis (AD), the most common chronic inflammatory skin disease that manifests primarily in early childhood, which is relevant to pediatric clinical practice. The chronic, relapsing course of AD requires long-term symptom control, which presents the clinician with two key challenges: achieving sustained remission and minimizing the risks associated with prolonged use of topical medications. Particular attention is paid to balancing the efficacy and safety of therapy, including modern approaches to the use of corticosteroids and calcineurin inhibitors. Therefore, pimecrolimus cream 1% occupies an important place in the arsenal of topical therapy for atopic dermatitis (AD) in children. The drug can be used both for the relief of exacerbations and for long-term anti-relapse treatment, including in infancy and early childhood. Its efficacy and favorable safety profile compared to topical glucocorticosteroids (TGCS) are confirmed by clinical trial data and many years of experience in Russian and international practice.
An epigenetic approach to correcting involutional skin changes
The study of aging mechanisms has remained an important area of scientific research for many years. Currently, particular attention is being paid to epigenetic mechanisms of aging. Current knowledge of the epigenetic aspects of age-related skin changes opens up extensive opportunities for the development of therapeutic tools that target the cellular and molecular patterns of skin aging. Epicellin, a flavonoid from Ampelopsis grossedentata, exhibits antioxidant, anti-inflammatory, antibacterial, and antitumor activity. It reactivates youth genes and significantly eliminates signs of skin aging caused by epigenetic changes by inhibiting DNA methyltransferase 1, an enzyme that plays a key role in age-associated pathological DNA methylation.
Current principles of antibiotic therapy in the management of patients with chlamydial infection
Given the increasing global incidence of urogenital chlamydial infection caused by Chlamydia trachomatis and the challenges of its diagnosis, choosing an effective therapy is particularly important. Currently, doxycycline is the first-line drug, supported by its pharmacokinetic advantages: its ability to create and maintain long-term concentrations in the tissues of the urogenital tract and rectum necessary for successful eradication of the pathogen. High efficacy, favorable tolerability profile, and ability to treat extragenital foci of infection make Doxycycline EXPRESS the drug of choice for the treatment and post-exposure prophylaxis of chlamydial infection.
Experience with the use of a preparation containing polyhexanide and betaine in the treatment of secondary infected dermatoses
This article examines the problem of secondary infection in atopic dermatitis (AD), caused by impaired skin barrier function and dysbiosis, with a predominance of Staphylococcus aureus. The role of bacterial, fungal, and viral infections in aggravating the disease is emphasized. Three clinical cases demonstrate the effectiveness of a gel containing polyhexanide and betaine. Application of the gel ensured gentle cleansing of crusts and biofilm, exerted an antimicrobial effect, and created optimal conditions for regeneration, significantly increasing the effectiveness of subsequent anti-inflammatory therapy and achieving rapid relief of infection symptoms.
Assessment of satisfaction using the visual analogue scale and the FACE-Q scale in patients after endoscopic brow lifting
In recent years, aesthetic medicine has seen a marked increase in interest in minimally invasive methods for correcting age-related changes in facial soft tissues. This is driven by the need to improve patients’ quality of life and prolong their social activity while simultaneously reducing rehabilitation time and the risk of complications. The objective of our study was to compare patient satisfaction and pain severity at various time points after endoscopic brow lifting using standard rehabilitation, microcurrent therapy, neodymium laser therapy, and a combination of these methods, based on patient satisfaction assessments and the visual analogue scale. The study demonstrated that the use of physiotherapy methods in the early rehabilitation period contributes to increased satisfaction with the endoscopic eyebrow lifting procedure, with the combined use of a neodymium laser and microcurrent therapy being superior to either of these physical methods alone.
Endolift: an innovative minimally invasive approach in aesthetic dermatology
Aesthetic medicine is seeing a growing demand for minimally invasive procedures that provide effective results with minimal recovery time and a low risk of complications. One such modern technique is endolift – a minimally invasive laser method based on a 1470 nm diode laser. Literature data demonstrate the high efficacy and safety of the endolift technique for a wide range of aesthetic and therapeutic indications, including skin rejuvenation, lipolysis, periorbital correction, rhinoplasty, as well as the treatment of acne, scars, keloids, and hidradenitis suppurativa.
Laser therapy potential for aesthetic correction of involutional facial changes in patients undergoing medical weight loss
Background: The widespread use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for weight loss has led to the development of the aesthetic phenomenon of Ozempic face, characterized by rapid loss of midface volume, tissue ptosis, and impaired skin quality. This is associated with a reduction in subcutaneous fat and decreased synthesis of extracellular matrix components. Objective: Evaluation of the efficacy and safety of subdermal laser therapy (EndoliftX®, 1470 nm) for the correction of facial involutional changes in patients receiving GLP-1 RA therapy. Materials and methods: The study included 10 patients (8 women, 2 men) aged 35–60 years with a BMI of 25–32 kg/m2 receiving semaglutide or tirzepatide. All patients underwent a single EndoliftX® laser rejuvenation procedure. Results were assessed clinically and using 3D scanning (Liveviz) over a period of 3 to 12 months. Results: With drug therapy, average body weight loss was 10–15% (8–17 kg). The EndoliftX® laser technique improved facial contours and increased skin firmness and elasticity in all patients. No complications were reported. Conclusion: Subdermal laser therapy (EndoliftX®, 1470 nm) is an effective and safe minimally invasive method of aesthetic correction in patients with rapid weight loss while taking GLP-1 receptor agonists and can be recommended as a component of comprehensive treatment programs for these patients.
Clinical blood test indicators as biomarkers of inflammation and psoriasis severity during methotrexate and genetically engineered biological agent therapy
Background: Search for sensitive, accessible, and objective biomarkers to assess systemic inflammatory activity in patients with psoriasis. Objective: Comparative analysis of the Hematological parameters of clinical blood tests in patients with moderate to severe psoriasis depending on therapy (methotrexate or genetically engineered biological agents (GEBA)). Materials and methods: A retrospective analysis of hematological parameters in 80 patients with moderate to severe psoriasis was conducted. Patients were divided into two groups depending on therapy. The first group included patients receiving methotrexate, and the second group included patients receiving genetically engineered biological agents (GEBA). Results: In patients with moderate to severe psoriasis receiving different therapies (methotrexate or GEBA), the analysis revealed statistically significant differences in a number of hematological parameters: red blood cell (RBC), platelet (platelet), neutrophil, and basophil levels. Calculation of the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio revealed elevated values for these indices in patients receiving methotrexate. Conclusion: Monitoring hematological parameters and calculated indices of clinical blood tests (neutrophils/lymphocytes, platelets/lymphocytes) may provide accessible data for assessing the systemic inflammatory response in patients with psoriasis treated with methotrexate or GEBA.
Clinical significance and validation of dermatological indexes for assessing acne severity
Objective: Determination of the clinical significance and validity of the most common dermatological indices for assessing acne severity. Materials and methods: The results of a clinical examination of 230 acne patients (129 men and 101 women) were analyzed, resulting in the recording of data according to the GAGS, IGA/PGA, DIA, and ECCA. Results: Interpretation and statistical processing of the obtained data revealed no agreement among the indicators of any of the scales, and the reliability of these indices revealed extremely low validity thresholds. Conclusion: These data indicate the need to develop a fundamentally new and easy-to-use acne severity assessment system.
Impact of complex treatment regimens using physiotherapy and botulinum toxin type A on the quality of life of patients with erythematotelangiectatic rosacea: results of an open, prospective, randomized study
Background: Rosacea is a common chronic inflammatory skin disease, predominantly affecting the central part of the face. Patients experience a significant decrease in quality of life and self-esteem during exacerbations, which underlines the importance of effective treatment and preventive measures for this dermatosis. Objective: Evaluation of the impact of complex treatment regimens including physiotherapy and botulinum toxin type A on the quality of life of patients with erythematotelangiectatic rosacea (ETR). Materials and methods: The study was designed as a single-center, open-label, prospective, randomized trial and was conducted from 2022 to 2025. A total of 117 patients with ETR participated in the study. Group 1 (comparison, n=26) received pulsed dye laser (PDL) therapy, while Group 2 (n=33) received combination therapy using PDL and local dynamic micromassage (LDM). Patients in Group 3 (n=30) received PDL treatment followed by botulinum therapy. Group 4 (n=28) received PDL, LDM, and botulinum therapy. The impact of restorative treatment regimens on the quality of life of patients with ETR was assessed using the dermatological quality of life index (DQLI). Follow-up examinations were conducted at five points: before treatment, 2 weeks, 2, 4, and 6 months after completion of therapy. Results: The most pronounced positive effect on the quality of life of patients with ETR was demonstrated by the use of a complex regimen including PDL, LDM, and botulinum toxin type A (p<0.001). The positive effects of combination therapy with PDL and LDM and therapy with PDL and botulinum toxin type A on the quality of life of patients with ETR were comparable in the immediate follow-up period (p=0.708), with the latter showing an advantage 2 months after completion of treatment (p<0.001). The use of PDL monotherapy had the least positive effect on the quality of life of patients with ETR. Conclusion: The obtained results demonstrated the most pronounced and persistent positive impact on the quality of life of patients with ETR after combination treatment with PDL, LDM, and botulinum toxin type A.
Protocol for correcting age-related changes in the periorbital region
Background: Premature aging of the periorbital region, characterized by bone resorption, changes in fat pads, thinning skin, and the formation of «malar bags,» presents a complex aesthetic problem. Surgical methods, due to their high invasiveness and lengthy rehabilitation, often have limited popularity among patients. Objective: Development and evaluation of the effectiveness of a three-stage non-invasive protocol for periorbital rejuvenation aimed at reducing the rehabilitation period and achieving a pronounced aesthetic result. Materials and methods: The study included 32 female patients aged 28–35 years. The single-stage protocol included: 1) high-intensity focused ultrasound (HIFU) treatment of the infraorbital fat pad for compaction; 2) deep microbolus injection of a hyaluronic acid-based filler (24 mg/ml) along the ligaments for volumization; 3) microneedle radiofrequency (RF) lifting for skin remodeling. Efficacy was assessed by photographic documentation and patient questionnaires after 30 days using a numerical rating scale (NRS, 0-5 points). Results: One month after the procedure, a visible reduction in the appearance of «malar bags» and an improvement in skin condition were noted. The average patient satisfaction rating on the NRS was 4.2 points («the result exceeds expectations»). None of the participants rated the result as unsatisfactory (1–2 points). Side effects were minimal, and the recovery period was short. Conclusion: The proposed combined protocol, targeting various layers and structures (subcutaneous fat, deep volumes, skin), is a highly effective, safe, and well-tolerated alternative to surgery for the correction of age-related changes in the periorbital region, including malar bags.
Efficacy of La Roche-Posay products in the treatment of skin toxicity induced by antitumor therapy: a prospective study
Objective: Evaluation of the dynamics of the severity of skin xerosis, fissuring, and eczematization symptoms in cancer patients treated with La Roche-Posay emollients over a 4-week period. Materials and methods: This prospective study included 27 patients (mean age 55.59 ± 8.69 years; 59.3% men) with various oncological diseases who developed skin toxicity during antitumor therapy. Symptom severity (xerosis, fissures, eczematization) was assessed using a visual analog scale (VAS) before therapy and after 2 and 4 weeks. Patients used La Roche-Posay Lipikar baume AP+M and La Roche-Posay Cicaplast B5+ products for 4 weeks. A repeated-measures one-way single factor analysis of variance (ANOVA) with post-hoc pairwise comparisons using the Student’s t-test and Holm’s correction was used to assess the statistical significance of changes in the parameters. Results: A statistically significant reduction in VAS scores was observed for all assessed symptoms (p<0.001). The mean VAS score for xerosis decreased from 8.07±1.04 to 1.37±0.49, the VAS score for fissures decreased from 8.04±0.98 to 1.44±0.51, and the VAS score for eczematization decreased from 8.41±1.12 to 1.37±0.49. Pairwise comparisons between all timepoints also showed statistically significant differences (p<0.001). Conclusion: The use of La Roche-Posay moisturizing and restorative products has demonstrated high efficacy in the treatment of skin toxicity, leading to a significant and clinically significant reduction in the manifestations of xerosis, fissures, and eczematization in cancer patients undergoing antitumor treatment.
Evaluation of the efficacy of treatment for the erythrodermic form of Devergie’s disease: a retrospective 10-year single-center study
Background: Devergie’s disease (DD) is a rare inflammatory papulosquamous skin disorder of unknown etiology, often characterized by the development of erythroderma. Due to the lack of data on the etiology and pathogenesis of DD, treatment remains challenging. Systemic retinoids are the first-line therapy for DD, but they are not always effective. However, existing data on the similarity between the pathogenetic mechanisms of DD and psoriasis suggest that genetically engineered biological agents (GEBAs) may be considered as an adjunctive treatment for DD. Objective: Analysis of the data from patients with the erythrodermic form of DD and evaluation of the effectiveness of systemic therapy and phototherapy in treating this disease. Materials and methods: The study was conducted at the V.A. Rakhmanov Clinic of Skin and Venereal Diseases, Sechenov University Clinical Hospital No. 2, between May 2014 and May 2024. Fifteen patients over 18 years of age with the erythrodermic form of DD were included in the study. Patients were selected based on archival records according to the following criteria: age 18–80 years, presence of the erythrodermic form of DD (erythroderma index (EI) ≥36). The Dermatological Quality of Life Index (DQLI) was assessed before treatment, as well as 2, 3, and 4 months after treatment. Of the 15 patients with DD, 46.7% (n=7) received acitretin, 20% (n=3) – isotretinoin, 33.3% (n=5) – methotrexate, 20% (n=3) – prednisolone, 6.7% (n=1) – dexamethasone, 13.3% (n=2) – netakimab, 6.7% (n=1) – ustekinumab, and 6.7% (n=1) – phototherapy (PUVA, UVB-311nm). Before treatment, the mean EI was 89±3.5 points, and the DIQI was 21±2.1 points. Results: On acitretin therapy, patients demonstrated significant regression of the rash, followed by a decrease in the EI and DLQI to a mean of 26±3.2 and 3.7±1.9 points, respectively, demonstrating a positive effect of this drug on the dynamics of DD. For example, one patient (6.67%) underwent phototherapy (PUVA and UVB-311 nm) without achieving a clinical effect. However, our study identified cases of stabilization of the skin process and improvement in disease dynamics with a combination of phototherapy and other treatment methods. Thus, we presented cases of acitretin and phototherapy in combination (Re-PUVA) with a mean EI of 39.6±3.2 points and a DLQI of 5±1, which increases the effectiveness of phototherapy for the disease. Isotretinoin therapy demonstrated a decrease in the EI and DLQI, demonstrating positive disease dynamics, but without complete regression of the rash. The efficacy of methotrexate and phototherapy as monotherapy for Devergie’s disease remains controversial. In cases of relapses after previous therapy, insufficient response, or resistance to treatment, biological agents were the drug of choice, with efficacy comparable to acitretin. Remission in patients after successful treatment of Devergie’s disease with netakimab and ustekinumab was observed for 18 months. It is worth noting that patient follow-up to assess the long-term results of biological therapy for Devergie’s disease is ongoing. Conclusion: The obtained data support the use of systemic retinoids as first-line therapy for Devergie’s disease, particularly acitretin, which demonstrated superior efficacy compared to isotretinoin in our patients. Biological therapy may be considered an effective adjunctive treatment for severe and resistant forms of Devergie’s disease, as well as promoting long-term remission and improving quality of life in patients with this disease.
Remodeling, fibrogenesis, and proliferative activity processes and possible pathways for their activation in the skin after monopolar RF lifting and injections of a polylactic acid-based preparation
Objective: Comparative assessment of skin biopsies (20 patients) after injections of PDLLA-based preparations and monopolar RF lifting and evaluation of morphofunctional changes in the epidermis and dermis, characterizing the processes of cell proliferation, fibrogenesis, and tissue remodeling. Results: Combined use of monopolar RF lifting and polylactic acid (PDLLA) without a delay, compared to hardware therapy administered 7 days after injection therapy, demonstrated increased local tissue reactions and structural changes in the epidermis and dermis, increased fibrogenesis due to collagenogenesis and elastogenesis, and increased proliferative processes without disrupting the integrity of the basement membrane, accompanied by increased expression of the chaperone protein HSP70 in surrounding tissues. These changes were less pronounced in almost all studied parameters when combined with injection therapy and hardware therapy with a 7-day delay. Conclusion: The combined use of monopolar RF lifting and PDLLA injection therapy, compared to hardware therapy alone without injection, also demonstrated activation of the studied parameters, with the exception of no difference in the course of proliferative processes and elastogenesis, reaching the levels determined for the group with the combined use of PDLLA and RF lifting without delaying the latter. This may indicate a high degree of activation of proliferative processes and elastogenesis in both study groups.
Itching and stress: a comparative analysis of psychosomatic relationships in chronic dermatoses, skin neoplasms, and cutaneous toxic reactions
Background: Itching significantly impacts patients’ quality of life, causing stress, anxiety, or depression. Psychological stress and subsequent modulation of the immune and nervous systems significantly influence itching. Stress can worsen itching and vice versa, leading to a vicious cycle that can significantly impair a patient’s quality of life. Objective: Evaluation of the relationship between itching and stress in patients with itchy and non- itchy dermatoses, skin toxic reactions, and melanocytic skin neoplasms. Materials and methods: In a multicenter, cross-sectional, observational, continuous, non-randomized, controlled study, patients with common itchy and non-itchy dermatoses, melanocytic skin lesions, and skin toxic reactions (n=597) were examined compared with a control group (n=216). A clinical dermatological examination, assessment of the intensity of itching using a numeric rating scale (0 to 10 points), a survey about the presence of stressful events over the past year, and a psychometric examination using the PSS-10 scale for the assessment of the level of perceived stress were conducted. Results: The groups differed statistically significantly (<0.001) in the frequency of stressful events over the past year. Patients with skin toxic reactions reported stressful events most frequently (65.6%), followed by patients with psoriasis and acne (48.5% and 48.1%, respectively). The groups differed significantly in the level of perceived stress, with the highest rates observed in patients with skin toxic reactions, lower rates in those with acne and atopic dermatitis, and the psoriasis group ranking third. When assessing the association between itching and stress in different patient groups (Table 3), the strongest correlation was found in patients with melanocytic nevi, but it was not statistically significant. A moderately significant correlation was found for psoriasis and atopic dermatitis. Conclusion: Thus, this study demonstrates a significant association between itching and stress, which significantly contributes to the disease burden in patients with cutaneous toxic reactions. Comprehensive therapy for patients with itching should be aimed not only at correcting this subjective symptom but also at improving stress management.
Wound status in children with dystrophic epidermolysis bullosa
Background: Dystrophic epidermolysis bullosa (DEB) is a rare genetic disorder characterized by the formation of blisters and erosions with minimal trauma. It leads to chronic wounds and scars that limit activity and reduce quality of life. Despite the availability of international guidelines for the care of congenital epidermolysis bullosa (CEB), systematic data on chronic wound healing and temporary load-bearing in Russia are limited. Objective: To describe the clinical characteristics of wound healing and the timeframe of care in patients with the dystrophic form of VBE. Materials and Methods: This observational study included 46 children aged 7–18 years with confirmed VBE. Disease severity (based on the BEBS index), epithelialization time for typical and chronic (>3 months) wounds, duration of remission, relapse rate, and dressing change time were assessed. Data were obtained during hospitalization at the National Medical Research Center for Children’s Health of the Russian Ministry of Health and from the rare disease registry of the BELA. Butterfly Children Charitable Foundation. Normal distribution was tested using the Shapiro-Wilk test. Data were expressed as mean ± standard deviation (95% CI) or mean (Q1–Q3). Group comparisons were performed using the Student’s t-test, ANOVA, Mann-Whitney U-test, and Kruskal-Wallis test. Correlations were assessed using Spearman’s rank order, prognosis using linear regression, and discriminatory ability using receiver operating characteristic (ROC) analysis using the Youden index. Results: Average age was 12.1±3.2 years, BEBS was 24.4±11.5. Chronic wounds were observed in 34.8% of patients, and recurrent lesions were observed in 97.8%. The average wound care time was 2.0±1.3 hours/day and increased with severity (ρ=0.891; p<0.001). ROC analysis (AUC=0.805; p<0.001) confirmed the predictive value of BEBS for the risk of chronic wound development. Conclusion: DEB is accompanied by chronic and recurrent wounds requiring constant wound care. As the disease severity increases, both the duration of wound healing and the amount of daily workload increase, emphasizing the need for multidisciplinary support for patients and their families.
Experience with the combined use of phototherapy and local ozone therapy in patients with rosacea
Background: This article examines the dynamics of facial skin functional parameters using the Multiskin diagnostic system. Objective: Comparison of the effectiveness of phototherapy (PT) as a single-method physiotherapy treatment and the combined use of laser radiation and local ozone therapy in patients with rosacea. Materials and methods: A primary prospective, non-randomized study was conducted. Forty-four women were included in the study. PT group consisted of 34 patients, while 10 patients received combined PT and topical ozone therapy (O3 group). Results: The results of the study confirm the efficacy of both PT using the Candela Nordlys system and its combination with topical ozone therapy (O3) in patients with rosacea. Although both methods provided clinical improvement (regression of erythema, reduction in the number of papules and telangiectasias, and improvement in skin texture), each demonstrated advantages in specific areas of correction of functional skin parameters. Conclusion: PT is more effective for patients with rosacea who have a predominantly vascular component and pronounced erythema, while PT combined with O3 is more appropriate for patients with dry skin, decreased elasticity, and a tendency toward post-inflammatory pigmentation. This differentiated approach allows not only to achieve clinical improvement but also to individualize therapy depending on the underlying pathogenetic mechanisms and the patient’s cosmetic expectations.
Dynamics of onychodystrophy manifestations in patients with torpid psoriasis treated with an interleukin-17 blocker
Background: Psoriasis in children, especially with nail plate involvement and juvenile psoriatic arthritis, is a complex clinical problem for which there is a lack of data on the safety and efficacy of newer systemic therapies. Therefore, it is necessary to present clinical observations using modern medications. Description of the clinical cases: Two clinical observations of children aged 12 and 11 years with progressive vulgar psoriasis complicated by nail involvement are presented. One patient was diagnosed with juvenile psoriatic arthritis. In both cases, traditional treatment approaches (topical agents, phototherapy, methotrexate) were insufficiently effective or were associated with adverse effects. Use of secukinumab according to approved treatment regimens resulted in significant clinical remission of skin and nail lesions by weeks 16–24, with a reduction in PASI scores to 0 and NAPSI to 0, as well as an improvement in quality of life and the absence of serious adverse effects. Pre-therapy assessments included serological and radiographic tests, as well as consultations with specialized specialists to confirm the absence of contraindications. Conclusion: These clinical cases demonstrate the high efficacy and safety of secukinumab in children with severe psoriasis and nail lesions. This confirms the feasibility of using this biologic agent in pediatric patients who have failed traditional treatments and who need to improve their quality of life.
Successful achievement of remission in acne conglobata: a clinical case
Background: Acne is a common skin condition affecting individuals of both sexes, primarily between the ages of 12 and 25. Acne conglobata is considered the most severe form of acne due to its pronounced inflammatory response, frequent development of persistent cosmetic defects, adverse psychosocial consequences, and resistance to treatment. Description of the clinical case: Clinical case of acne conglobata (nodularis) in a male patient, born in 2005, with no signs of somatic pathology, is described. Outpatient treatment with isotretinoin was administered for 18 months (cumulative dose of 172 mg/kg body weight). Initially, reduced daily doses of isotretinoin were used in combination with prednisolone and antibacterial agents. This resulted in stable remission. The patient was declared fit for military service without restrictions. Conclusion: Severe acne can lead to the formation of persistent scarring not only directly but also due to the development of purulent complications requiring surgical intervention. Achieving stable remission may require a more cautious initiation of isotretinoin therapy, as well as an increased treatment duration and effective cumulative dose compared to standard treatments.
Dermatoscopic signs of tongue fibroma: a case report
Background: This article analyzes current knowledge about fibromas arising in the mucous membranes. The paper examines the clinical features, describes the factors most often triggering their development, and provides detailed information regarding differential diagnosis. Description of the clinical case: The authors present their own clinical observation of a fibroma in the tip of the tongue in a 71-year-old female patient, which developed after trauma. The article describes the clinical presentation in detail and provides histological data. Of particular interest is the description of the dermatoscopic appearance of the lesion, as it is characterized by a variety of features. To date, only two descriptions of dermatoscopy of traumatic fibromas have been found in the world literature. Conclusion: Based on the currently available data, it can be concluded that the main dermatoscopic features of traumatic fibromas include evenly distributed punctate vessels, a pale pink homogeneous background, and hairpin-shaped vessels at the periphery of the lesion. The location and presence of homogeneous whitish areas is likely a variable feature and depends on the location of the greatest pressure applied by the dermatoscope.