Dermatological Index Research Articles

Influence of combined use of gas-liquid peeling and PDT on quality of life of patients with visible signs of involutive skin changes

Objective of the study. To develop a questionnaire to determine the quality of life of a patient with visible signs of involutive skin changes. To determine the effect of the combined use of gas-liquid peeling and PDT on the quality of life of patients with visible signs of involutive skin changes.Materials and methods. The study involved 50 patients aged 35 to 45 years. The state of the emotional sphere was assessed before and after the course of treatment using the following methods: a scale for assessing discomfort; ‘The Scale of States’ methodology by А. B. Leonova, Hospital Anxiety and Depression Scale (HADS), Dermatological Life Quality Index (DLQI). The condition was assessed before and after treatment (gas-liquid peeling and photodynamic therapy).Results. The use of the questionnaire developed by us made it possible to determine the index for assessing the quality of life in persons with agerelated skin changes and to reveal the influence of the latter on the emotional sphere and behavior of the respondents. A clear positive trend was observed when comparing indicators of discomfort, anxiety, depression, quality of life. The data obtained make it possible to recommend an assessment of the dermatological index of the quality of life in patients with age-related skin changes as a criterion for the effectiveness of the therapy, and also focus on the need for further study and correction of factors that cause deterioration in life in this category of women.

Clinical efficiency of the combined application of physiotherapeutic technologies and drinking mineral waters in patients with curral skin changes under conditions of insulin resistance

BACKGROUND: One of the effective and pathogenetically substantiated methods of therapeutic action on cicatricial changes in the skin are laser technologies in combination with collagenases. However, as previous studies have shown, the presence of metabolic syndrome in patients significantly reduces the clinical efficacy of the combined use of laser therapy and phonophoresis of Fermencol. The most reasonable solution in this situation can be scientific research and experience in the practical use of drinking mineral waters, which have a high corrective efficiency in relation to metabolic processes, the course of which is significantly impaired in type II diabetes mellitus and metabolic syndrome. AIMS: Assessment of clinical indicators of cicatricial changes in the skin of patients with metabolic syndrome in the combined application of the method of phonophoresis Fermenkol, fractional photothermolysis and drinking mineral waters. MATERIAL AND METHODS: The study included 60 patients (49 men and 11 women) with cicatricial changes in the skin aged 19 to 50 years, with a confirmed diagnosis of metabolic syndrome. All patients by the method of simple fixed randomization were divided into two groups: the control group (30 people) and the main group (30 people). Both groups received treatment, which included a course of phonophoresis of 0.01% Fermencol gel in combination with the technique of fractional laser therapy. Patients of the main group, in contrast to the control group, in addition to the specified physiotherapeutic treatment received bottled sodium bicarbonate-chloride water Essentuki No. 17 (mineralization 11.8 g/l) at room temperature, 200250 ml three times a day for 1520 minutes before meals for 3 weeks. RESULTS: The addition of physiotherapeutic combined anti-scar therapy with a course of drinking mineral water Essentuki No. 17 in patients with cicatricial changes in the skin in combination with metabolic syndrome was accompanied by a significantly more pronounced clinical effect, assessed by the Vancouver scale and the Dermatological Index of Quality of Life. CONCLUSION: Additional course use of drinking mineral water Essentuki No. 17 is accompanied by a more pronounced dynamics of clinical manifestations of cicatricial deformities of the skin and an indicator of the quality of life of patients, due to the sanogenetic mechanisms of the drinking balneofactor.

IL-17A in the treatment of nail psoriasis

BACKGROUND: Psoriasis is an inflammatory skin disease that significantly worsens the quality of the patients life. With vulgar psoriasis, the most common form of the disease, nail damage is observed in more than 50% of cases.
 AIMS: To evaluate the efficacy and tolerability of secukinumab in the treatment of nail psoriasis (psoriatic onychodystrophy) in real clinical practice.
 MATERIALS AND METHODS: The study was carried out on the basis of the Clinic for Skin and Venereal Diseases. V.A. Rakhmanov Sechenov University. The participants were 12 patients diagnosed with psoriasis, aged 29 to 60 years. All patients were diagnosed with a severe degree, 2 (16.7%) patients ― psoriatic erythroderma, 10 (83.3%) ― psoriasis vulgaris, all studied patients had nail plate lesions. All patients were treated with a genetically engineered biological drug ― an IL-17A inhibitor secukinumab (Cosentix), 300 mg subcutaneously once a week (5 injections), followed by a maintenance dose of 300 mg once a month. The course of therapy was 20 weeks (9 injections). Assessment of the severity of nail psoriasis and the effectiveness of therapy was carried out using indices: NAPSI (index of the degree of damage to the nail plates), DLQI (dermatological index of quality of life), which were studied in dynamics before treatment and after 20 weeks of treatment.
 RESULTS: The NAPSI index was 25.33.4 points before treatment, and at week 20 it decreased to 2.20.7 points. These results demonstrate a regression of clinical manifestations by more than 80% from the initial state of the nails. When assessing the dermatological index of quality of life (DLQI), it was found that in the study group of patients before the start of treatment, it was 27.42.1 points, which reflected a strong negative effect of psoriasis on the quality of life of patients. After treatment, this indicator was 3.10.5 points among all patients. No patient experienced any side effects from the therapy.
 CONCLUSIONS: Secukinumab is a highly effective and safe drug for the treatment of nail psoriasis in patients with vulgar psoriasis and psoriatic erythroderma and contributes to improve the quality of the patients life.

ЭФФЕКТВНОСТЬ ТЕРАПИИ АКНЕ У ПАЦИЕНТОК С ЯИЧНИКОВОЙ ГИПЕРАНДРОГЕНИЕЙ

The aim of the study was to show the effectiveness of treatment of acne with moderate severity in women with ovarian hyperandrogenism. A total of 25 female reproductive voerast patients with moderate acne and ovarian hyperandrogenism who were not planning pregnancy were examined. All patients were examined, which included a consultation with a gynecologist with a gynecological examination, ultrasound examination of the pelvic organs, a study of the hormonal status, a biochemical blood test, as well as a dermatological examination with the determination of the dermatological index of acne (DIA). After the examination, the patients underwent complex therapy using the external treatment recommended by the dermatovenerologist (skin cleansing, gel with azelaic acid and / or gel with adapalene), as well as the appointment of a combined oral contraceptive (COC) Jes Plus. Based on this study, it can be concluded that complex therapy, including local treatment and taking Jes Plus, is the first choice in the treatment of androgen-dependent dermopathy, manifested by moderate acne, in patients with ovarian hyperandrogenism due to PCOS. Such therapy contributes not only to the formation of a pronounced clinical result, but also causes a low probability of side effects. The administration of COC containing drospirenon and the active form of folate, in the form of the calcium salt levomefolate, allows a favorable effect on the metabolic processes in the body as a whole, and in particular, provides a positive effect on the skin, the cardiovascular system, reduces the risk of systemic and local inflammation, relieving the state of hyperhomocysteinemia, providing prevention of cardiometabolic risks.

Treatment outcomes and objectification methods of the thoracoscopic sympathectomy in patients with focal hyperhidrosis and blushing syndrome

Uniportal video-assisted thoracoscopic sympathectomy (VATS) is an effective minimally invasive surgical method of choice for the treatment of primary focal hyperhidrosis and blushing syndrome due to uncontrolled operation of the sympathetic nervous system. The aim of this study was to provide an objective assessment of the improvement in the quality of life of patients with primary focal hyperhidrosis and blushing syndrome after bilateral monoport video-assisted thoracoscopic sympathectomy. Materials and methods. The results of surgical treatment were performed for 62 patients aged 17 to 42 years, 26 men and 36 women with a diagnosis of primary focal hyperhidrosis of the extremities and blushing syndrome. All patients underwent bilateral uniport video-assisted thoracoscopic sympathectomy. Patients are divided into 3 groups depending on the level of coagulation of the sympathetic trunk: the first group of the study (n = 9) includes patients after bilateral uniport sympathectomy at the level of R3 (isolated palmar hyperhidrosis), the second (n = 31) - at the level of R3-R4 (palmar and axillary hyperhidrosis), the third group (n = 22) - at the level of R2 (blushing syndrome). Results. In this study, coagulation and separation of the sympathetic trunk through a single port using a silicone port was performed. An excellent clinical result was achieved due to the minimally invasive operation - all 62 patients (100%) were satisfied with the achievement of a rapid stable effect. According to the results of the Dermatology Life Quality Index DLQI (1 month after surgery), the best quality of life measures were observed in patients who underwent separation of the sympathetic trunk at the R3 level – improvement from 20.3 ± 5.9 points to 0.8 ± 0.8 points. After the operation at the R3-R4 level scores the quality of life decreased from 22.77 ± 5.4 points to 2.3 ± 1.3 points, and at the level of R2 - from 16.5 points (QI 14 points - QIII 20 points) to 2 points (QI 1 point - QIII 3 points) p <0.001). There was a difference in quality of life measures in our three groups of patients according to the severity of the disease before surgery. The lowest quality of life was determined in patients with the 4th degree of severity (33 people) and was 26.0 points (QI 23.0 points - QIII 27.3 points) compared with patients with 2d and 3d degrees of severity, 10.0 points (QI 7.7 points - QIII 10.0 points) and 17.0 points (QI 14.0 points - QIII 19.5 points) respectively (p <0.001). After a single-port VATS in three groups there was an increase in quality of life measure, regardless of the severity of the disease before surgery. Conclusions. The most highly specific tests that allow to determine an objective assessment of the severity of the disease and a real assessment of the effectiveness of surgical treatment for hyperhidrosis was TEWL-metry, for blushing syndrome – capillaroscopy. VATS is an effective method of treating patients with hyperhidrosis and blushing syndrome, which significantly improves the quality of life according to the results of the Dermatological Index of Life Quality DLQI (p <0.001) questionnaire.

Effectiveness of microneedling in correction of involutive skin changes

In clinical practice, as a rule, patients with involutive changesas well havea photodamage, it should be considered when choosing a method of correction. Microneedling, including the use of PRP and hyaluronic acid, arevery promising methods.Material and methods. There were 50 patients under observation, who were divided into three groups: 1st group – 18 patients received microneedling and PRP, 2nd group – 17 people used microneedling of hyaluronic acid, 3rd group – 15 patients received microneedling. Four procedures were performed with an interval of 4 weeks.Results. According to dermatological status index, PRP microneedlingshowed the effectiveness, the index decreased by 86 % in the group. In group 2, the average index for the group decreased by 56 %, in group 3–41 %.Conclusions.Microneedling is an effective safe method for correcting involutive changes in the skin of the face, combined with signs of photoaging. To increase the effectiveness of microneedling, it is recommended to use autologous plasma with cells directly after the procedure applicationinto the form or the film.

Gender features of the influence of depressive and dissominal symptoms on the quality of life of patients with psoriasis

Quality of life indicators (QL) of patients are widely used in dermatological practice, but the influence of depressive and dissomnic symptoms on QL of patients with gender differences is not sufficiently studied.Objective:to identify depressive and dissominal symptoms in patients with psoriasis and evaluate its impact on the quality of life of these patients taking into account gender differences.Materialsandmethods:34 patients with psoriasis were examined. Clinical examination included: analysis of complaints, medical history, assessment of dermatological status. Diagnosis of the presence and severity of depression was performed using a PHQ-9 patient health rating scale. Dissominal symptoms in patients with psoriasis were determined using the index of severity of insomnia ISI. To assess the quality of life, a dermatological index of quality of life (DLQI) was used.Resultsanddiscussion.Sleep disorders were detected in 15 patients (44.1%), depressive symptoms were determined in all patients, a negative effect of the disease on the quality of life of patients was found in 32 people (94.1%).Correlation analysis of data from the entire population of patients revealed statistically significant correlations of DLQI with the severity of depressive symptoms (r = 0.45, p = 0.008) and sleep disorders (r = 0.35, p = 0.04). In women, DLQI significantly correlates with the severity of depression (r = 0.48, p = 0.04) and tends to be associated with sleep disturbances (r = 0.43, p = 0.07). In men, the relationship between DLQI and indicators of depression and sleep disturbances is significantly weaker and is not statistically significant ((r = 0.34, p = 0.22) and (r = 0.17, p = 0.55), respectively).Conclusion.depressive symptoms and sleep disorders are interrelated with the quality of life of patients with psoriasis, and this relationship is more pronounced in women. Consequently, it is advisable to include effects aimed at normalizing mood and sleep in the program of complex therapy of psoriasis, taking into account gender differences.

Pioglitazone in treatment of patients with comoribidity of psoriatic disease and alimentary obesity

An indisputable link between psoriasis and obesity has recently been proven. Alimentary obesity exacerbates systemic inflammation in patients with psoriasis, complicating the course of dermatosis, causing deterioration of the dermatological index of quality of life of patients and frequent exacerbation of psoriasis, which leads to ineffectiveness of standard treatments. PPAR-activated receptors are the link between lipids and inflammation because lipids stimulate the chronic form of systemic inflammation and are ligands that activate PPAR. Thus, PPAR can be used as the main target when choosing a treatment for this comorbidity. To date, the literature has accumulated a large number of prospective observations indicating a positive effect of pioglitazone (PG) on systemic inflammation. The mechanism of action of this drug is aimed at suppressing chronic systemic delayed inflammation of low intensity. The anti-inflammatory effect of PG is associated with its activating effect on nuclear transcription factors of PPAR. Objective — to determine the effectiveness of the inclusion of different doses of pioglitazone in the complex treatment of patients with advanced psoriasis vulgar with concomitant alimentary obesity of I—II degree. Materials and methods. Clinical and immunological study of systemic inflammation. Results and discussion. The results of the study showed the effectiveness of this method of treatment, which depended on the dose of PG and the duration of treatment. The use of PG in the complex treatment of patients with vulgar psoriasis of moderate severity with concomitant alimentary obesity of I—II degree for 26 weeks led to a decrease in inflammation both locally, according to the Psoriatic Area and Severity Index, and at the systemic level due to reduction in the level of systemic inflammation, namely the level of interleukin-33, interleukin-6 and highly sensitive C-reactive protein in the blood serum.Conclusions. Long-term use of PG can be recommended for the personalized and comprehensive treatment of patients with comorbidity of psoriasis and alimentary obesity of I—II degree.

Assessment of quality of life and psychoemotional state of patients with psoriasis against the background of standard medicamentous therapy and the differentiated photochromotherapy use

Background. Psoriasis is a systemic disease with the presence of comorbid pathology, which is the cause of serious psychological problems.
 The aim of the study was to assess the quality of life and psychoemotional status of patients with psoriasis against the background of standard drug therapy with the inclusion of photochromotherapy (PCT).
 Methods. The randomized controlled study included 144 patients (mean age 48.34 13.51 years) with psoriasis in the advanced stage. Patients, depending on the method of treatment, were divided into 4 groups, comparable by clinical and functional characteristics. For all groups, standard drug treatment was prescribed, including antiinflammatory, hyposensitizing, detoxification and external therapy, while additionally for 10 days, patients of the 2nd group (n = 47) received PCT with narrow-band optical radiation (NOR) 540 nm, patients of the 3rd group (n = 48) PCT with NOR 650 nm, patients of the 4th group (n = 21) imitation of PCT (placebo). Patients of the 1st group (n = 28) received only standard treatment.
 Results. The positive effect of NOR 540 nm on the psychoemotional state and NOR 650 nm on the quality of life of patients with psoriasis has been demonstrated.
 Conclusion. Thus, taking into account the significant positive effect of green radiation (NOR 540 nm) on the indicators of the psychoemotional state of patients with psoriasis in the advanced stage and the positive effect of red radiation (NOR 650 nm) on the indices of integral dermatological index of quality of life (improving the quality of life), NOR with these wavelengths can be recommended in the complex therapy of patients with exacerbation of psoriasis to increase the overall effectiveness of treatment.

Assessment of the dynamics of dermatologic index indicators of symptom scale and dermatologic quality of life index under the influence of complex phototherapy in patients with a combination of rosacea subtypes

Background. Taking into account the data of recent studies on the treatment of rosacea, the development of new methods of treating this dermatosis using complex physiotherapeutic approaches and their synergism is of scientific and practical interest. In this work, we took into account the synergism of physiotherapeutic effects exerted by intense pulsed light and submilisecond neodymium 1064 nm laser radiation, as well as an increase in the destruction of pathologically altered vessels observed with the sequential use of both procedures.
 Aims: to assess the effect of complex phototherapy on changes in the indicators of the dermatological index of the symptom scale and the dermatological index of quality of life, reflecting the effect of the therapy on the clinical manifestations of the disease and the patient's subjective assessment of the skin condition.
 Material and methods. In the period 20172020 we conducted a randomized controlled study in which 130 patients with a combination of rosacea subtypes took part. All patients were divided into 4 groups. In each separate group, the following types of therapy were used: in group I laser therapy and 1% metronidazole cream; in group II phototherapy and 1% metronidazole cream; in group III complex photo-laser therapy and 1% metronidazole cream; in the comparison group (IV), patients received only 1% metronidazole cream. The treatment included 6 sessions with an interval of 2 weeks, with a total duration of 3 months. The effectiveness of therapy was assessed according to the results of the dermatological index of quality of life (DQL) and the dermatological index of the symptom scale (DYS) before and after treatment.
 Results. The developed complex method of combination of rosacea subtypes therapy demonstrated maximum efficiency, which was reflected in the maximum (by 55.21%) decrease in DYS in group III compared with the other three groups: in group I, the decrease in DYS was 30.54%, in II 21.51%, in IV 21.56%. The DQL in group III decreased by 67.4%, which was significantly higher than the indicators of the other three groups: in group I, DQL decreased by 31.3%, in group II by 27.4%, in IV by 20.7%.
 Conclusion. After the course of complex phototherapy in the group of patients with combination of rosacea subtypes, there was a decrease in the severity of clinical manifestations of the disease, as well as an increase in the quality of life of patients according to the data of the DYS and DQL, respectively.

Comparison of the effectiveness of treatment and the effect on the composition of the microbiota in patients with acne when using isotretinoin monotherapy and its combination with phototherapy with broadband incoherent light

Background. Laser and LED light sources operating in the range of 400700 and 8001400 nm can affect the links of the pathogenesis of acne (they destroy the pathogenic bacterial flora and lead to atrophy of the sebaceous glands due to heating of the vessels feeding the glands, which ultimately reduces the production of sebum) and can be very effective in the treatment of patients with acne. Aims: To evaluate the effectiveness of the combination of incoherent broadband light (IPL) and low doses of systemic isotretinoin compared with standard isotretinoin monotherapy, as well as the effect on the composition of the microbiota in patients with acne. Materials and methods. 78 patients with a diagnosis of acne, papulo-pustular form, moderate severity were monitored on an outpatient basis. Depending on the method of therapy, patients are divided into 2 groups. The dermatological status of patients was assessed taking into account the dermatological index GSS (Global Severity Ssore), the dermatological index of acne (DIA), the IGA scale (Investigator's Global Assessment), the quality of life index (QOL). To study the composition of the skin microbiota in all patients before and after therapy, an analysis was performed using the method of chromatography-mass spectrometry of microbial markers. Results. Both methods are effective, but according to the global scale of severity (GSS), clinical remission was significantly more frequent in the combination therapy group compared to the motor therapy group (88 and 74%, respectively, p 0.05). In addition, in the group of patients who received the combined method of treatment, there was a more pronounced positive dynamics of DIQH compared to the group of patients who received monotherapy 76 and 84%, respectively (at p 0.05, compared with the indicators before treatment). After treatment, there was a pronounced positive dynamics and normalization of most indicators of the microbiota of the skin of the face, but the number of some targeted microorganisms was slightly higher than normal after therapy. Conclusions. Thus, the combined treatment with IPL and low doses of systemic isotretinoin is a safe and effective method of treating moderate acne.

Study of the psychoemotional status of patients with medium and severe acne severity on the background of isotretinoin monotherapy (Sotret)

Rationale. Acne vulgaris is a widespread chronic disease with no age, gender, or race restrictions. It does not pose a direct threat to the patient's life, but is reflected in his psycho-emotional status, which requires appropriate medical intervention.
 Purpose of the study. To study the psychoemotional status of patients aged 2224 years with moderate and severe acne and its changes during monotherapy with isotretinoin (Sotret).
 Methods. In an open, non-randomized study lasting 12 months, 310 students of the Samara State Medical University were included (52% healthy, 33% with mild acne, 13% with a moderate degree, 2% with a severe degree). All patients in the study before treatment and after 3, 6, 12 months were assessed the severity of the course using the dermatological index of acne (DIA); quality of life assessment using the Cardiff Acne Disability Index (CADI scale); assessment of the psychological and social impact of acne using the APSEA questionnaire. All patients received monotherapy using the drug Erase. The median and interquartile distance Me (Q3-Q1) were indicated as descriptive statistics. The Wilcoxon signed rank test was used to compare related groups. The comparison was carried out with 95% confidence.
 Results. An analysis of the assessment of the psychological and social status of patients with moderate and severe acne before treatment, 3, 6, 12 months after the start of treatment with isotretinoin (Erase) is presented. The study included 36 people (20 women and 16 men) aged 22 to 24 years with a disease duration from 1 to 10 years. The results of psychological testing at various intervals gave comparable data: all patients had a pronounced persistent level of social maladjustment. An important indicator of the effectiveness of acne therapy with isotretinoin is the frequency of cases of the formation of a persistent clinical effect from treatment, which is clearly expressed in the restoration of the psycho-emotional background of patients, improving the quality of life of patients.
 Conclusion. An important indicator of the effectiveness of acne therapy with Erase is the frequency of cases of the formation of a stable clinical effect of treatment, which is clearly expressed in the restoration of the psycho-emotional background of patients, improving the quality of life of patients. The treatment allowed us to change the psychoemotional background of our patients for the better, which increased their motivation to study, communication, and the desire for self-development.

Experience of using an emollient with an anti-inflammatory effect based on ammonium glycyrrhizinate in the complex therapy of patients with atopic dermatitis

Background. Despite the advances achieved in recent years in the treatment of AD, prevention and rehabilitation of patients, who suffering from this disease, belong to the most difficult tasks of practical dermatovenerology.
 Objective. The aim of this study was to assess the efficacy, safety and tolerability of Reglisam Cream in the complex therapy of patients with atopic dermatitis.
 Methods. The study involved 48 patients with atopic dermatitis, who were divided into two groups. There were two observation periods for each patient: 28 days the period of exacerbation therapy, and 6 months basic care and prevention of relapses.
 In exacerbation period all patients used external moisturizers in addition to topical glucocorticosteroids: in group I (study group) patients applied Reglisam Cream to the skin; in group II (control group) cold cream. After the period of exacerbation patients of group I were prescribed basic therapy Reglisam Cream for 6 months, patients of group II cold cream. In each group were assessed the therapeutic efficacy, safety and tolerability of treatment. During the study were conducted registration of adverse events, assessment of the dermatological status with the determination of the intensity of pruritus according to the visual analogue 10-point scale, the calculation of the severity index of the disease and the area of the lesion in eczema / atopic dermatitis (EASI) and the dermatological index of quality of life (DLQI), measurement of skin moisture, general clinical research.
 Results. In the first 28 days of acute atopic dermatitis period therapy, the EASI index decreased on average by 76% from 20.4 to 4.8 points (p 0,05), in group II by 57% from 19.7 to 8.4 points (p 0,05); the intensity of pruritus after treatment with Reglisam Cream in the dynamics decreased by 70% and amounted to 2.3 points, which was lower than in the comparison group 4.1 points (p 0,05); the level of skin hydration in group I was 36.8 units, during the treatment period increased by 80%, and was higher than in group II 26.7 units. (p 0,05); DLQI in group I decreased by 68%, amounting to 4.7 points, and was almost 2 times less than in group II 9.2 points (p 0.05).
 In group I for 6 months were registered a statistically lower frequency of exacerbations of atopic dermatitis (28%) than in group II (63%). The average duration of atopic dermatitis remission in group I was 22.4 weeks, for 4 weeks more than in group II (p 0,05). Meanwhile the average duration for the exacerbation period of atopic dermatitis in group I was more than 3.5 times less in comparison with group II; the average EASI in group I did not exceed 6.4 points and was significantly lower than that in group II (p 0,05).
 Conclusion. The use Reglisam Cream as basic skin care in patients with AD increases the duration of remission and reduces the frequency and duration of relapses of the disease, leads to an improvement the quality of life, a decrease in the intensity of pruritus and a significant increase in the moisture content of the stratum corneum of the epidermis. The obtained clinical results allow us to recommend Reglisam Cream as an effective external agent in the complex therapy of patients with AD.

Psoriasis therapy: problems and prospects

Annotation. Modern therapy of psoriasis is to contain the manifestations of the disease, the choice of treatment tactics depends on the severity of the course. However, the effectiveness of standardized complex therapy remains rather low and the results of treatment are unpredictable, which requires further study of ways to increase the effectiveness of psoriasis therapy. Aim – to evaluate the effectiveness of standard psoriasis therapy. An analysis of the effectiveness of standard therapy for psoriasis was carried out in 30 patients who were under the supervision of a dermatologist at the Vinnitsa Regional Clinical Dermato-Venereal Dispensary in 2019–2020. In addition to general clinical research methods, the patients were evaluated for the skin lesion index and the severity of the psoriatic process (PASI) and the quality of life was assessed – the dermatological index of quality of life (DLQI). Statistical processing of the study data was performed using the program Statistica® (StatSoft, Tulsa Oklahoma), using the Wilcoxon test, the difference between the mean m at p<0.05 was considered probable. The results obtained showed the existence of an empirical approach to therapy and the choice of topical and systemic drugs. The low efficiency of the used therapy tactics was also found, as indicated by the insignificant dynamics of the PASI and DLQI indicators. The PASI indicator decreased from 11.6 to 7.6 (p≥0.05), and the DLQI indicator decreased from 14 to 10 points (p≥0.05). In general, the indicators of the group corresponded to the average severity of the course of the disease when it is necessary to give preference to complex topical therapy with the addition of systemic drugs in some cases. However, the question of a rational combination of drugs that can enhance the basic therapy remains open. Thus, modern therapy of patients with psoriasis is insufficiently effective in controlling both the disease itself and in relation to the impact on the quality of life of patients. Insufficient effectiveness of existing treatment combinations requires further search for promising drugs.

Experience of using a CO₂ laser in the stage treatment of vulvar lichen sclerosus

Vulvar lichen sclerosus is a chronic dermatosis in which first-line drugs are topical glucocorticosteroids, and alternative drugs are topical calcineurin inhibitors. To date, there is insufficient data on the effectiveness of using CO₂ lasers in the treatment of VLS, although the authors of the published works note a positive therapeutic effect. The results of step-by-step application of the Lutronic CO₂ fractional laser were studied. The efficiency of the treatment was evaluated using the skin activity index and the lesion area index developed by the author. The study included 8 women diagnosed with VLS. The obtained results demonstrated a positive effect of step-by-step treatment of VLS with sequential use of topical glucocorticosteroid and autologous plasma injections, followed by CO₂ laser fractional exposure. The positive dynamics of the treatment was confirmed by the dermatological index of quality of life, as well as the indices of assessment of the area and activity of the skin process of VLS.

New possibilities of external therapy for atopic dermatitis based on the use of natural silicon oxide

The article presents new approaches to the external therapy of atopic dermatitis using a moisturizing, toning, anti-inflammatory cream «Fatiderm». Clinical studies have shown that Fatiderm cream helps to reduce the severity of the dermatological index of the symptom scale, eliminate subjective sensations, and improve the dynamics of the skin pathological process.

Aspects of comprehensive treatment for adolescents with acne vulgaris from
 the perspective of psychological counseling

This article discusses the manifestations of the adolescence crisis in patients with acne vulgaris, using a four-level personality model (biological, psychological, social, and spiritual levels). On the one hand, the adolescence crisis can trigger acne vulgaris in case of a genetic predisposition; on the other hand, acne can aggravate the process of experiencing the adolescence crisis. The authors suggest the use of psychological counseling (relaxation techniques, methods of rational psychotherapy, etc.) within the dermatological care for adolescent patients with mild and moderate acne vulgaris. The authors present the results of a study of the efficacy of comprehensive therapy (including psychological counseling) in adolescent patients with mild-to-moderate acne vulgaris, compared with traditional dermatotropic therapy. Statistically significant differences between two groups were revealed in the changes in the indicators of the mental condition presentation (r = -0.90; p 0.05), the dermatological index of acne (DIA) (r = -0.34; p 0.05), and indicators of quality of life (r = -0.72 and r = -0.68. according to the questionnaires of the Dermatology Life Quality Index and Skindex-29, resp.; p 0.05). Simultaneous improvement in the psychoemotional status was correlated with positive cutaneous changes, as evidenced by the direct rather than pronounced statistically significant relationship between the indices of the experience scale and the ADI index (r = 0.52; p 0.05). The obtained results show that the use of psychological counseling in the comprehensive treatment for adolescents with mild-to-moderate acne vulgaris is more effective compared with the traditional dermatotropic therapy.

Combined use of fractional co2 laser and collagenase diadynamophoresis in correction of contour plastic surgery complications

Background. One of the most frequent complications of aesthetic correction methods is the problem of contouring, visualization, or local tightening of the skin at the sites of administration of the agent based on calcium hydroxyapatite, which occurs in violation of the injection technique.
 Aim: to study the efficiency of the combined method including a course of diadynamophoresis of collagenase 1000 KE (collagenase units) and a fractional CO2 laser procedure in correction of a surface-injected preparation in late terms.
 Methods. Clinical and instrumental examination of 24 women (average age 38.2 3.5 years) was conducted. All patients complained of complications after the contour plastic surgery procedure using a preparation based on calcium hydroxyapatite, in the form of contouring of the preparation and superficial skin tightening on the face at the filler injection site.
 Results. When comparing the control, main and reference groups, it was revealed that the combined use of collalysin diadynamophoresis and fractional CO2 laser at low parameters improves significantly the quality of life in terms of the adapted dermatological index. Clinical improvement was registered in all groups, but it was most significant in the main one, which correlated with the data of ultrasound examination with a 33 MHz sensor. In the main group, faster biodegradation was noted, and the volume of the surface-injected filler decreased 2.5 times after 1 month and 6 times after 2 months.
 Conclusion. The combined use of collalysin diadynamophoresis and a fractional CO2 laser is an effective complex for the correction of complications after contour plastic surgery of fillers based on calcium hydroxyapatite.

Combined use of fractional co2 laser and collagenase diadynamophoresis in correction of contour plastic surgery complications

Background. One of the most frequent complications of aesthetic correction methods is the problem of contouring, visualization, or local tightening of the skin at the sites of administration of the agent based on calcium hydroxyapatite, which occurs in violation of the injection technique.
 Aim: to study the efficiency of the combined method including a course of diadynamophoresis of collagenase 1000 KE (collagenase units) and a fractional CO2 laser procedure in correction of a surface-injected preparation in late terms.
 Methods. Clinical and instrumental examination of 24 women (average age 38.2 3.5 years) was conducted. All patients complained of complications after the contour plastic surgery procedure using a preparation based on calcium hydroxyapatite, in the form of contouring of the preparation and superficial skin tightening on the face at the filler injection site.
 Results. When comparing the control, main and reference groups, it was revealed that the combined use of collalysin diadynamophoresis and fractional CO2 laser at low parameters improves significantly the quality of life in terms of the adapted dermatological index. Clinical improvement was registered in all groups, but it was most significant in the main one, which correlated with the data of ultrasound examination with a 33 MHz sensor. In the main group, faster biodegradation was noted, and the volume of the surface-injected filler decreased 2.5 times after 1 month and 6 times after 2 months.
 Conclusion. The combined use of collalysin diadynamophoresis and a fractional CO2 laser is an effective complex for the correction of complications after contour plastic surgery of fillers based on calcium hydroxyapatite.

Antipruritic therapy as main component of improving quality of life of patients with dermatoses

Itchy skin, a symptom of various diseases, present in 54.4 % of patients with skin pathologies, is a rather difficult task when choosing a therapy.Material and methods. Under observation were 45 patients (27 women and 18 men) with various dermatoses, accompanied by itching. All patients received Neotanin therapy (cream and spray) with standard topical therapy. Efficiency assessment was carried out taking into account the indices Prurindex, BRS, dermatological status indices for each nosology (SCORAD, EASI, PASI), and DIC.Results. In patients with idiopathic skin itching, Prurindex decreased by 100 % by the end of 3rd weeks, BRS – by 96.8 %. In atopic dermatitis, the SCORAD index decreased by 78.3 %, BRS index reduced by 91.9 %, Prurindex index decreased by 95.4 %. With eczema, the EASI index decreased by 96.1 %, the BRS and Prurindex index were reduced by 100 %. In psoriasis, the PASI index decreased by 86.5 %, BRS index – by 90.8 %, Prurindex index – by 94.2 %.Conclusions. The use of the topical Neotanin as monotherapy for idiopathic pruritus, as a part of comprehensive treatment for atopic dermatitis, eczema, psoriasis, significantly improves the quality of life of patients.