BACKGROUND: Androgenic alopecia is a common problem in a dermatological practice. The pathogenesis of the disease is caused by the effect of dihydrotestosterone on hair follicles which leads to progressive shortening of the anagen phase and decrease in hair diameter. Despite numerous treatments approved for this condition, the clinical response is not always sufficient. Therefore practitioners need to develop new treatment regimens for androgenic alopecia that will improve treatment effectiveness. AIM: To evaluate the effect of photodynamic therapy on the course of androgenic alopecia in monotherapy and in combination with platelet rich plasma. METHODS: An open prospective pilot randomized study was conducted at the Rakhmanov Clinic of Skin and Venereal Diseases. Ten patients (five men and five women) diagnosed with androgenetic alopecia were divided into two groups. Patients in the first group received red-spectrum photodynamic therapy with hypericin. The wavelength was 670 nm, the power was 17 mW/cm2, and the procedure time was 15 minutes. The course consisted of 10 procedures performed once a week. Patients in the second group received photodynamic therapy with similar parameters and platelet rich plasma injections. The plasma course consisted of five procedures performed every two weeks. Primary outcomes: safety assessment, phototrichogram parameters (changes in hair density, percentage of anagen hairs and hair growth rate). RESULTS: Treatment outcomes were obtained for 10 patients. No serious side effects were reported. One patient reported transient folliculitis during the first 3 days after plasma therapy. No side effects were observed due to photodynamic therapy procedures. In both groups, statistically significant positive dynamics were observed in hair density parameters in the parietal zone (group 1: p=0.039; group 2: p=0.005), and the percentage of anagen hair. A comparative analysis of “delta” index showed a statistically significant increase in hair growth rate in group 2 in zone 1 compared to monotherapy (p=0.045). No statistically significant differences were found between the groups for other parameters likely due to the small sample size. CONCLUSION: Combination therapy is considered safe and demonstrates a tendency toward greater efficacy than monotherapy. The results confirm the potential of photodynamic therapy in treating patients with androgenic alopecia and justify further full-scale clinical trials.
Hidradenitis suppurativa (HS) is a chronic, relapsing inflammatory skin disease characterized by the formation of painful inflammatory nodules, abscesses, infiltrates, and sinus tracts, predominantly affecting intertriginous areas, including the axillary, inguinal, and anogenital regions. The disease is associated with a marked impairment in patients’ quality of life, chronic pain syndrome, the development of scarring, and frequently leads to significant social and psychological maladaptation. Despite substantial progress in understanding HS pathogenesis, the mechanisms underlying persistent inflammation and the recurrent course of the disease remain a subject of ongoing scientific debate. In recent years, increasing attention has been paid to the role of the skin microbiome as a key factor contributing to the initiation and maintenance of chronic inflammation. Modern molecular and genetic studies of the skin microbiota have demonstrated that HS is associated with pronounced dysbiosis, characterized by alterations in bacterial diversity and an increased abundance of anaerobic microorganisms. Affected skin areas exhibit the formation of highly organized microbial communities, including representatives of the generaPrevotella,Porphyromonas,Peptoniphilus, andAnaerococcus, whereas the relative abundance of typical skin commensals, such asCutibacteriumand certainStaphylococcusspp., may be reduced. The formation of bacterial biofilms within sinus tracts plays a critical role in disease pathogenesis, conferring increased resistance of microorganisms to host immune responses and antimicrobial therapy. In addition, systemic microbiome alterations may contribute to HS, including changes in the gut microbiota and the «gut–skin» axis, which предполагает a functional interplay between the intestinal microbiota, the immune system, and skin homeostasis. Microbial metabolites and bacterial products are capable of modulating both innate and adaptive immune responses and influencing the expression of pro-inflammatory cytokines, which play a central role in sustaining the inflammatory cascade in HS.
Objective. To characterize changes in the biophysical parameters of the skin barrier in pressure-prone areas in patients with limited mobility during the early post-stroke rehabilitation period while receiving preventive care. Methods. A series of three clinical cases is presented. Daily monitoring of corneometry and sebumetry was performed over 30 days in typical pressure-prone areas, namely the sacral region, heels, and scapular areas, using the Aramo SG device. All patients received a standardized preventive care regimen that included regular repositioning, control of skin microclimate and moisture, hygiene care, timely linen changes, and once-daily topical application of a dexpanthenol-containing cream to intact skin in at-risk areas. Results. At baseline, all patients were assessed as having a high risk of skin barrier impairment. Despite a similar overall risk level, the patients differed in age and sex, stroke type, degree of functional dependence, nutritional status, and the spectrum of concomitant risk factors. During preventive care, all patients demonstrated positive changes in corneometry values, indicating improved skin hydration. The most pronounced changes were observed in the sacral region and heels in completely immobile patients. In the patient with hemiparesis, parameter changes in symmetrical body areas showed an asymmetric pattern. In all cases, sebumetry values remained low and did not change within clinically significant variability. Conclusions. Daily monitoring with corneometry and sebumetry may complement clinical examination and photographic documentation in high-risk post-stroke patients with limited mobility. These observations confirm the heterogeneity of skin barrier impairment risk profiles and demonstrate the clinical feasibility of personalized dynamic skin monitoring in the inpatient setting.
Crusted scabies is a highly contagious form of scabies, most often diagnosed in patients with immunodeficiency, peripheral sensory impairment, and cognitive impairment, especially in residential social service settings. The problem is particularly relevant due to the high risk of nosocomial outbreaks and the spread of infection among contacts and staff of institutions where a patient with crusted scabies is identified. The clinical presentation of the disease is nonspecific, complicating timely diagnosis and complicating its course. A clinical analysis of crusted scabies in a patient with Down syndrome revealed typical manifestations of crusted scabies: mild itching, hyperkeratotic crusts, scalp lesions, and nail changes. The diagnosis of crusted scabies was confirmed by identifying the mite during microscopic examination of a skin scraping and by histological examination of a skin biopsy from the lesion. Treatment consisted of topical antiparasitic and keratolytic agents, as well as a range of preventive measures, which resulted in the patient's recovery. It is important to note that patients at risk for developing crusted scabies include those with immunodeficiency, impaired peripheral sensitivity, drug addiction, long-term use of hormonal and cytostatic drugs, the elderly, and those with significant comorbidities (especially cardiovascular and endocrine diseases). Timely diagnosis and implementation of a full range of medical and non-medical measures to treat scabies and prevent its spread are the foundation of care for this group of patients.
Parasitic dermatoses retain significance due to their high prevalence in contemporary society. The most frequently encountered diseases are scabies and pediculosis. These dermatoses are commonly observed in groups of individuals living together (nursing homes, psychiatric hospitals, hospices, dormitories, children's homes, barracks). Poor socio-hygienic conditions and non-compliance with personal hygiene rules also contribute to disease development.Scabies is a dermatоsis-zoonosis caused by the scabies mite Sarcoptes scabiei hominis. It is characterized by intensely pruritic eruptions and the presence of scabies burrows, which is a pathognomonic sign. It develops at any age, although it is most frequently encountered in children and elderly individuals. Severe forms of the disease include scabies lymphoplasia, scabies erythrodermia, and Norwegian scabies.Pediculosis is caused by blood-sucking insects — lice. Three species of lice parasitize human skin: head louse (Pediculus humanus capitis), body louse (Pediculus humanus corporis), and pubic louse (Pthirus pubis). Complications of pediculosis include pyodermias and allergic dermatitis; it should also be noted that lice are vectors of typhus fever.Myasis is a parasitic disease caused by larvae of dipterous flies (Dermatobia hominis). Lesions are frequently detected on the face and scalp, presented as nodules from which serous-purulent contents may be discharged.Onchocerciasis ("river blindness") is a chronic parasitic disease caused by the filarial nematode Onchocerca volvulus. It is characterized not only by skin involvement but also frequently by severe ocular damage.Cutaneous leishmaniasis is a vector‑borne human disease attributable to the unicellular, flagellated protozoan Leishmania tropica. The infection is transmitted by sandflies of the genus Phlebotomus, with Phlebotomus papatasi being the principal vector. Trombidiasis is a disease caused by the penetration into the skin of larval mites of the genus Trombidiidae (family Trombiculidae). The infection manifests as local inflammation, papule formation, and erythema at the site of larval insertion. The photo gallery presents various cases of parasitic dermatoses and their causative agents.
On October 21, 2025, the 1164th meeting of the A.I. Pospelov Moscow Society of Dermatovenerologists and Cosmetologists (MSDC) was held. An in-person meeting was held at the V.A. Rakhmanov Clinic of Skin and Venereal Diseases, Sechenov University. A total of 110 participants attended. Between May and October 2025, 84 applications were submitted for membership in the MSDC by physicians and residents from various dermatology and esthetic medicine clinics in Moscow. In the clinical section of the meeting, two reports were presented. The first report addressed the differential diagnosis of follicular lichen planus of the scalp. The authors suggest a differential diagnosis with discoid lupus erythematosus, folliculitis decalvans, dissecting cellulitis, and other types of cicatricial alopecia for which the umbrella term “pseudopelade of Brocq” is frequently used. The second report discussed IgA pemphigus, using a clinical case to demonstrate an exacerbation caused by self-discontinuation of treatment. The scientific section of the meeting featured reports on novel synthetic retinoids, modern concepts of microsporosis, and new phototherapy options in dermatology. Lidose® isotretinoin resulted in clinical remission in 100% of patients treated at the V.A. Rakhmanov Clinic of Skin and Venereal Diseases; the rash was fully eliminated, and skin greasiness was reduced. The report “Modern Concepts of the Clinical Course, Diagnosis, and Treatment of Microsporosis” addressed contact infections of the skin, hair, and nails caused by various Microsporum fungi. The report on new phototherapy options in dermatology explored the multifaceted effects of ultraviolet radiation in the skin.
BACKGROUND: The skin is involved not only in barrier and immune defense but also in the formation of bodily self-awareness and the integration of somatic information into the structure of the self. In severe forms of chronic dermatoses, this function is impaired by persistent sensory stress (itching, pain), health threats, and the need for long-term systemic therapy, which contributes to increased mental comorbidity. AIM: This study aimed to develop a structure of comorbid mental disorders with a comprehensive assessment of psychosomatic relationships in patients with severe forms of chronic dermatoses. METHODS: A single-center, observational, cross-sectional study was conducted on a consecutive sample of patients who consecutively visited the clinic between 2017 and 2025. A total of 445 patients (158 men, 287 women; mean age 42.3 ± 13.7 years) were included. Inclusion criteria were a severe form of chronic dermatosis (psoriasis, atopic dermatitis, lichen planus, true acantholytic pemphigus, true eczema, acne vulgaris, vitiligo, rosacea, and seborrheic dermatitis) and the presence of a comorbid mental disorder according to the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10). RESULTS: Comorbid mental pathology manifested mainly as adjustment disorder (F43.2) in 103 patients (23.1%), depressive episode (F32.0) in 66 (14.8%), and hypochondriacal disorder (F45.2) in 63 (14.2%). A transnosological hypochondriacal nosogenic complex was identified in 400 patients (89.9%). Three clinical types were identified: (1) depressive-hypochondriacal (n = 250, 62.5%) — hypothymia with hypochondriacal phobias, with a significant correlation between the Clinical Symptom Index and anxiety levels (r = 0.49, p 0.001), depression (r = 0.52, p 0.001), and DLQI (ρ = 0.46, p 0.001); (2) masked hypochondria (n = 123, 30.8% ) — a rational-overcoming response style with no correlation between the Clinical Symptom Index and psychometric indicators; (3) aberrant hypochondria (n = 27, 6.7%) — paradoxical denial of illness despite objectively severe somatic status. CONCLUSION: The proposed typology facilitates diagnosis and creates the basis for a differentiated psychotherapeutic and psychopharmacological approach in psychodermatology.
Cutaneous amyloidosis is a condition caused by impaired protein metabolism due to the formation and extracellular deposition of amyloid, a specific protein-polysaccharide complex, in the skin. Cutaneous lichen amyloidosis is a form of primary localized cutaneous amyloidosis. This is a rare condition with comparable incidence rates in males and females. Cutaneous amyloidosis affects the psychological state and quality of life due to its chronic course, severe subjective discomfort, and limited efficacy of existing therapeutic options. Cutaneous amyloidosis is frequently associated with chronic pruritus, the most bothersome subjective symptom that causes irritable mood and sleep disorders, as well as secondary hyperpigmentation, which enhances esthetic discomfort and psychological stress, especially in young women. The low treatment efficacy is associated with the nature of this condition and the mechanisms of amyloid deposition in the skin. Localized amyloidosis is easier to treat than generalized amyloidosis. Quinolines, dimercaprol, aromatic retinoids, topical glucocorticoids, topical calcineurin inhibitors, and other commonly prescribed drugs are not always effective. Laser dermabrasion (ablative and non-ablative) with mechanical removal or destruction of amyloid deposits in the skin is a promising therapeutic option in cutaneous amyloidosis. In this clinical case of primary cutaneous lichen amyloidosis, a CO2 laser was used as additional therapy with favorable outcomes, including a reduction in skin rash and discoloration. Given the growing interest in laser therapy for various dermatoses, it is relevant to explore and apply selective laser photothermolysis in the treatment of cutaneous amyloidosis to transform the therapy of metabolic skin diseases.
BACKGROUND: Atopic dermatitis (AD) is a chronic inflammatory skin disease involving T-helper type 2 cells and complex immune regulation; the JAK-STAT pathway and cytokines, including interleukin-2 (IL-2), play an important role in the pathogenesis. Objective: To study the distribution of alleles and genotypes of IL-2 (-330 T/G, rs2069762) and JAK2 (Val612Phe) polymorphisms in patients with AD and evaluate their association with disease severity. Despite the established role of cytokines and the JAK-STAT signaling pathway in the pathogenesis of atopic dermatitis, the contribution of IL-2 (-330 T/G, rs2069762) and JAK2 (Val612Phe) genetic polymorphisms to disease severity remains poorly understood, especially in certain populations. There is a lack of data on the relationship between these genetic variants and the clinical course of AD, which limits the possibilities of a personalized approach to risk assessment and disease prognosis. AIM: To study the distribution of alleles and genotypes of IL-2 (−330 T/G, rs2069762) and JAK2 (Val612Phe) polymorphisms in patients with atopic dermatitis and assess their relationship with disease severity. METHODS: The studies were conducted from February 2023 to December 2025. A total of 157 patients with AD were examined. The control group consisted of 72 conditionally healthy individuals. The study is conducted at the Tashkent State Medical University - Asmo Clinic; clinical assessment of AD severity is performed at inclusion using the standardized SCORAD scales. Genotyping of IL-2 (-330 T/G, rs2069762) and JAK2 (Val612Phe) polymorphisms is performed using the PCR-RFLP method after isolation of genomic DNA from peripheral blood. The primary endpoint is the identification of an association of these genetic polymorphisms with the presence and severity of AD; additional endpoints are the distribution of alleles and genotypes in the study groups. Statistical analysis involves comparing allele and genotype frequencies, calculating odds ratios and 95% confidence intervals, and testing the distributions for Hardy–Weinberg equilibrium; the level of statistical significance is set at p 0.05. RESULTS: JAK2 Val612Phe frequencies in the overall sample did not differ from controls (G 97%); no statistically significant associations with the risk or severity of AD were found (p 0.05). IL-2 polymorphism (−330 T/G) demonstrated an increased frequency of GG homozygotes in patients compared to controls (16.6% vs. 6.9%, respectively). Moreover, GG carriage was associated with an increased risk of AD (OR ≈ 2.6; p≈0.048). In patients with severe disease, a more pronounced association of GG and disease severity was observed (OR ≈ 4.0; p≈0.025). No study-related adverse events were recorded CONCLUSION: In the present population, the IL-2 -330 T/G polymorphism (homozygote GG) may be associated with an increased risk and severity of atopic dermatitis, while JAK2 Val612Phe does not show a significant effect. These results require confirmation in larger and more representative cohorts and, if possible, functional studies of the effect of the -330G variant on IL-2 expression. In the study sample, carriage of the GG genotype of the IL-2 polymorphism (-330 T/G) was associated with an increased risk and more severe course of atopic dermatitis, while no significant associations were found for the JAK2 Val612Phe polymorphism. These results should be interpreted taking into account the limitations of the study, including the limited sample size and the lack of a functional assessment of the effect of the -330G variant on IL-2 expression
Lymphoproliferative diseases are characterized by abnormal production and accumulation of lymphocytes in the bone marrow, blood, and lymphoid organs/tissues and most often develop in individuals with a weakened immune system. Despite significant progress in the study of lymphoproliferative diseases, the diagnosis and especially the differential diagnosis of skin changes in leukemia present considerable difficulties. These difficulties are associated not only with the diversity of clinical symptoms but also with the external similarity of lesions to those seen in inflammatory dermatoses, as well as the absence of distinct cellular atypia in some cases, particularly at the disease onset. In the vast majority of patients, skin lesions occur simultaneously with the appearance of objective symptoms of the underlying disease or during its advanced clinical stage. Unlike primary cutaneous malignant lymphomas, in leukemia, regardless of the time of onset, skin symptoms are considered secondary to the underlying disease, i.e., caused by systemic involvement of the hematopoietic or lymphoid tissue. Skin lesions in leukemia are typically divided into specific and nonspecific types due to their substantial differences in pathogenetic, clinical, and morphological features. At the same time, this division, while convenient in clinical practice, is somewhat conditional because it is based on histological structure rather than morphological characteristics. This article presents various types of skin lesions in lymphoproliferative diseases to improve diagnosis, including differential diagnosis, and to ensure timely administration of appropriate treatment.
BACKGROUND: Despite the high efficacy of targeted therapy in psoriasis, there is an increase in loss of response (escape phenomenon), including due to the formation of antibodies against biologicals. At the same time, the role of other factors is insufficiently studied. These include comorbidities that are common in psoriasis, such as gastrointestinal diseases, bacterial endotoxemia, and intestinal or skin microbiocenosis disorders. AIM: The work aimed to assess the effect of netakimab, an IL-17A inhibitor, on the long-term efficacy of psoriasis therapy by targeting bacterial endotoxemia and abnormal intestinal and skin microbiocenosis. METHODS: The study included 30 patients with severe plaque psoriasis who received netakimab, an IL-17A inhibitor, between 2021 and 2024. The Psoriasis Area and Severity Index (PASI) was measured at baseline and weeks 12, 28, and 52 to assess treatment efficacy (PASI 75/90/100). At weeks 28 and 52, bacterial endotoxin levels in peripheral blood were measured, and intestinal and skin microbiota parameters were assessed using chromatography–mass spectrometry. In patients with a relapse (escape phenomenon) and abnormal markers of bacterial endotoxin and intestinal and skin microbiota, treatment was prescribed to improve microbiocenosis, and its impact on the efficacy of targeted therapy was assessed. RESULTS: At baseline, the mean PASI, Dermatology Life Quality Index, and endotoxin level were 38.4 ± 2.7, 29.3 ± 3.5, and 2.7 ± 0.35 nmol/mL, respectively. By week 52, the majority of patients (24; 80%) reached PASI 90/100. At week 28, 6 (20%) patients had a loss of response with persistent endotoxemia (2.5 ± 0.4 nmol/mL) and signs of dysbiosis. Following treatment to improve microbiocenosis, the endotoxin level decreased to 0.5 ± 0.1 nmol/mL, resulting in clinical remission with PASI 90 by week 52. By week 104, 70% of patients remained in remission (PASI 90/100), and 30% had PASI 75. CONCLUSION: Persistent endotoxemia and dysbiosis were associated with the escape phenomenon on netakimab therapy; the treatment restored the response to PASI 90 and provided sustained remission. To maintain netakimab’s long-term efficacy, it is advisable to re-evaluate endotoxemia and microbiota by chromatography–mass spectrometry at weeks 28 and 52, and initiate treatment as needed.
Chronic spontaneous urticaria and prurigo are debilitating skin conditions characterized by persistent pruritus and inflammation, often leading to significant reductions in quality of life. Conventional treatments, including antihistamines, corticosteroids, and immunosuppressive therapies, may prove ineffective, leading to the need for alternative treatment approaches. Innovative methods such as general aerocryotherapy, in which cold air is applied to the skin site, have attracted much attention. It is believed to work through vasoconstriction, inhibition of mediator release from mast cells, and modulation of sensory nerve impulses, ultimately reducing inflammation and itching. Early research has revealed positive signs that aerocryotherapy could help reduce the itch intensity and inflammation in individuals with a range of skin disorders. In the present systematic literature review, the use of general aerocryotherapy as an additional treatment approach for chronic spontaneous urticaria and prurigo will be explored in terms of contribution to reduction in symptoms and the quality of life of a patient. Finally, we summarize clinical evidence from clinical trials, review the rationale of aerocryotherapy in terms of pathophysiology, and list the therapeutic strategies for its application in the practice of dermatology. Further studies are needed to refine aerocryotherapy treatment regimens and investigate its long-term effects, particularly in post-traumatic chronic wounds and other skin diseases.
BACKGROUND: Erythroplasia of Queyrat (ICD-10 code: D07.4) is an intraepithelial neoplasia affecting the glans penis and inner preputial leaf. It is classified as a squamous cell carcinoma in situ. However, available publications lack data on its prevalence across age groups. AIM: The work aimed to examine the clinical and epidemiological aspects of erythroplasia of Queyrat and assess the efficacy of various diagnostic approaches. METHODS: A retrospective, cross-sectional case history study in patients who sought medical advice for penile lesions of various origins (n = 327) and a prospective observational study in patients with erythroplasia of Queyrat (n = 49) were conducted. Toluidine blue staining, dermatoscopy, and cytological and histological examinations were used in the diagnosis of erythroplasia of Queyrat. Additionally, an ultrasound of the penis and inguinal lymph nodes, tests for sexually transmitted infections, and a transrectal prostate ultrasound were performed. RESULTS: The observational study in patients with erythroplasia of Queyrat revealed a trend towards younger onset. The majority of patients (30.61%) were aged 50–59 years, with the disease detected before the age of 29 in 12.24% of cases and at the age of 30–39 in 20.4% of cases. A total of 89.8% of patients saw physicians of various specialties (urologists, dermatovenerologists, oncologists, etc.), whereas 10.2% self-medicated. The time between the onset of penile rashes and seeking medical advice is particularly concerning, ranging from 1 week (4.0%) to more than 5 years (2.0%). Thus, patients with a disease duration of ≥ 1 year (12.1%) are at the highest risk of penile squamous cell carcinoma. The majority of patients with erythroplasia of Queyrat consult with a dermatovenerologist, with the final diagnosis made on the initial or follow-up visit in 93.87% of cases, indicating that dermatovenerologists are familiar with clinical signs and diagnostic approaches in this condition. CONCLUSION: This work addresses the gaps in the modern assessment of clinical and epidemiological aspects and diagnostic efficacy in patients with erythroplasia of Queyrat, facilitating the selection of effective therapeutic options.
Background. Narrowband UVB therapy at 311 nm is a first-line treatment for non-segmental vitiligo; however, repigmentation is slow, and some patients demonstrate an insufficient early response. Data on the use of low-temperature argon plasma in combination with phototherapy for non-segmental vitiligo are virtually nonexistent, while the complementary mechanisms of both modalities justify their combination. Aim of the study. To evaluate the efficacy and safety of the combined use of low-temperature argon plasma and UVB-311 nm compared with UVB-311 nm monotherapy in patients with non-segmental vitiligo, based on changes in the VASI and quality of life (VitiQoL) over 8 weeks and 1 month after completion of treatment. Methods. Adult patients with non-segmental vitiligo with depigmented lesions assessed by the VASI were included in this prospective, non-randomized, controlled comparative study. Patients with segmental and mixed forms of vitiligo, pregnant women, individuals with photodermatoses, a history of systemic immunosuppressants, and skin cancer were excluded. Patients in the study group received treatment of lesions with the Plasmoran device followed by a UVB-311 nm session, while the comparison group received UVB-311 nm monotherapy. Treatment was administered three times a week for 8 weeks. Assessments were performed at baseline, after 4 , 8 weeks, and 1 month after completion of therapy. Results. Sixty patients were included; all completed the follow-up. In the main group, the median VASI score decreased from 3.8 to 2.3 points by week 8 (a 39.5% decrease), and in the comparison group, from 4.1 to 3.1 points (24.4%); the difference between groups was 0.5 points [95% CI 0.04–0.96], p = 0.03. After 1 month, the difference remained (2.1 versus 2.9 points, p = 0.04). According to VitiQoL, the median score at week 8 was 30.5 versus 35.0 points (p = 0.04), and after 1 month, 28.0 versus 33.5 points (p = 0.03). The advantage of the combination regimen was significant for non-acral locations and disease durations of less than 5 years. Adverse events were reported in 7 of 28 patients in the study group and 5 of 32 in the comparison group; all were transient and resolved spontaneously. Conclusion. The combination of low-temperature argon plasma with 311 nm UVB therapy provides a statistically significantly greater reduction in VASI and improvement in quality of life compared to monotherapy. This is a pilot study, conducted in a non-randomized design with a short follow-up, which limits the validity of the conclusions and requires a randomized controlled trial.
Background. Androgenetic alopecia (AGA) is the most common form of non-cicatricial alopecia, characterized by progressive follicular miniaturization and a significant impairment in patients' quality of life. Conventional therapies, such as minoxidil and 5α-reductase inhibitors, offer limited efficacy and are associated with adverse effects, highlighting the need for novel, pathogenetically grounded approaches. Recently, exosome-based therapeutics – particularly those derived from non-human sources – have emerged as a promising avenue in regenerative trichology. Aim. To evaluate the clinical efficacy and pathogenetic rationale of salmon-derived exosomes in patients with androgenetic alopecia based on phototrichogram data and expression of cellular proliferation (Ki-67) and angiogenesis (CD31+) markers in scalp skin biopsies. Materials and Methods. A prospective, single-group interventional study was conducted involving 20 patients (14 males with AGA stages III–IV on the Norwood–Hamilton scale and 6 females with stages I–II on the Ludwig scale). All participants underwent 4 sessions of intradermal injections of salmon-derived exosomes, followed by microneedling, at 14-day intervals. Efficacy was assessed at week 12 using phototrichogram analysis (ARAMO SG, TrichoScan v4.5) and histological/immunohistochemical evaluation of scalp biopsies (markers: Ki-67, CD31). Results. By week 12, all key parameters showed significant improvement: hair density increased by +44.4 hairs/cm² (p0.001), the proportion of vellus hairs decreased from 40.4% to 3.4% (p=0.005), mean hair shaft diameter increased by 22.4 µm (p0.001), and the proportion of anagen hairs rose by +36.4% (p0.001). Histological analysis confirmed an increase in follicular density (+1.4 follicles/mm², p0.001) and normalization of the terminal/vellus ratio (from 2.3 to 9.6, p0.001). Immunohistochemistry demonstrated enhanced cellular proliferation (Ki-67 in the outer root sheath: +55.5%, p0.001) and angiogenesis (CD31+: +11.5 vessels per field of view, p0.001). No serious adverse events were recorded. Conclusion. Monotherapy with salmon-derived exosomes combined with microneedling represents a highly effective and safe treatment for AGA, exerting pathogenetically justified effects by restoring the functional reserve of hair follicles, reversing miniaturization, and normalizing the follicular microenvironment. These results position salmon-derived exosomes as a promising cell-free regenerative strategy for clinical practice. Keywords. Androgenetic alopecia, exosomes, salmon-derived exosomes, phototrichogram, Ki-67, CD31.
BACKGROUND: Pityriasis rubra pilaris (Devergie disease) is a rare chronic inflammatory skin disease classified as papulosquamous dermatosis. Despite the pathognomonic clinical and pathomorphological signs, diagnosing erythrodermic pityriasis rubra pilaris can be difficult because clinical signs such as diffuse erythema and scaling affecting more than 80% of the body surface area can also be observed in other dermatoses, including psoriasis and cutaneous T-cell lymphoma (mycosis fungoides). AIM: The work aimed to assess the clinical, anamnestic, histological, and immunohistochemical signs of erythrodermic pityriasis rubra pilaris and perform a differential diagnosis with psoriasis and mycosis fungoides. METHODS: A retrospective analysis of medical history, clinical manifestations, and laboratory parameters was performed in 147 patients with erythroderma admitted to the V.A. Rakhmanov Clinic of Skin and Venereal Diseases, University Clinical Hospital No. 2, Sechenov University, in 2014–2024. Of these, 17 (11.6%) patients had erythrodermic pityriasis rubra pilaris. For differential diagnosis, the study included 26 (17.7%) patients with mycosis fungoides and 104 (70.7%) patients with psoriatic erythroderma. Skin biopsies were performed, followed by histological, immunohistochemical, and molecular biological tests (as needed). RESULTS: At admission, the diagnosis of pityriasis rubra pilaris was made based on clinical signs and medical history in 64.7% of patients (n = 11), with histological confirmation in 52.9% of cases (n = 9). In patients with nonspecific histological signs, repeated skin biopsies from several sites were performed to verify the diagnosis. Immunohistochemical and molecular biological tests were used to rule out mycosis fungoides. The clinical and histological signs of erythroderma can be nonspecific, necessitating a comprehensive diagnostic approach. Therefore, the medical history, clinical manifestations, and laboratory and imaging findings must be considered and compared. Moreover, it is essential to rule out mycosis fungoides, a particularly aggressive disease. CONCLUSION: The findings highlight the need for differential diagnosis algorithms for disorders associated with erythroderma.
The etiopathogenesis of hyperandrogenism in women has recently received considerable attention, given its relevance and significance in modern dermatology. Elevated androgen levels are associated with a variety of skin changes, such as androgenetic alopecia, acne, and hirsutism, which affect quality of life. These symptoms not only cause physical discomfort but also frequently result in reproductive dysfunction and psychoemotional disorders, impairing overall well-being and social adjustment. There are currently no specific guidelines for treating women with symptoms of hyperandrogenism, making standardized therapy difficult. This review summarizes recent publications on the pathogenesis, clinical signs, diagnosis, and treatment of hyperandrogenism in women, with an emphasis on skin manifestations (acne, androgenetic alopecia, hirsutism), their pathogenesis, diagnosis, and therapeutic strategies. These multifaceted conditions with diverse skin manifestations and complex clinical presentation require a deep understanding of etiopathogenesis and clinical features, necessitating a personalized, interdisciplinary approach to the diagnosis and treatment of hyperandrogenism in women. The work includes reviews, guidelines, original studies, and case reports published in the recent decade in leading databases (PubMed, MEDLINE, UpToDate) and websites (eLIBRARY.RU, disserCat.ru, Cochrane Library, Scopus).
BACKGROUND: Atopic dermatitis is a chronic, relapsing, immune-mediated inflammatory pruritic skin disease that substantially impairs patients' quality of life. In some patients with moderate to severe disease that is resistant to standard therapy, pronounced pruritus and high disease activity persist, prompting the search for pathogenetically justified combination treatment approaches. AIM: The study aimed to evaluate the clinical efficacy and safety of combination therapy with azathioprine and narrowband UVB 311-nm in patients with moderate to severe refractory atopic dermatitis. METHODS: This non-controlled clinical study involved 20 patients (14 men and 6 women aged 18–60 years) diagnosed with atopic dermatitis according to the Hanifin and Rajka criteria. Patients received oral azathioprine 50 mg twice daily for 3 to 4 weeks in combination with narrowband UVB 311-nm therapy (4 procedures per week, 12–16 sessions; initial single dose, 0.1–0.2 J/cm2, with increments of 0.1 J/cm2). Clinical efficacy was assessed using the Scoring Atopic Dermatitis (SCORAD) index, the Dermatology Life Quality Index (DLQI), and the Pruritus Index for patients with various dermatoses (Prurindex). Laboratory monitoring included complete blood count, biochemical parameters (alanine aminotransferase, aspartate aminotransferase, bilirubin, and creatinine), and thiopurine methyltransferase activity. RESULTS: By the end of the treatment course, a marked reduction in pruritus was observed. The mean morning Prurindex score decreased from 8.2 ± 0.7 to 1.8 ± 0.4; daytime values decreased from 8.4 ± 0.6 to 2.0 ± 0.3; and evening values decreased from 9.2 ± 0.8 to 2.3 ± 0.5. After 1 month of follow-up, the mean SCORAD score decreased from 48.5 ± 3.2 to 18.2 ± 2.8 (transition from moderate to mild disease severity); the mean DLQI score decreased from 19.5 to 6.0 (transition from a strong to a moderate effect). Laboratory parameters remained within reference ranges. CONCLUSION: Combination therapy with azathioprine and narrowband UVB 311-nm in patients with atopic dermatitis resulted in a relatively rapid and pronounced clinical response, including a marked reduction in pruritus, and may be considered a valuable alternative treatment strategy for refractory atopic dermatitis with a manageable safety profile.
Psoriasis is a chronic multifactorial immune-mediated inflammatory skin disease with a strong genetic predisposition, affecting approximately 1%–2% of the population worldwide. The disease is characterized by keratinocyte hyperproliferation, neovascularization, and chronic inflammation with systemic manifestations. A significant proportion of patients, particularly those with moderate-to-severe disease, require systemic therapy. Traditional systemic drugs, including methotrexate, cyclosporine, and acitretin, have proven effective; however, their use may be limited by the development of toxic effects, notably hepatotoxicity, nephrotoxicity, and oxidative stress, which reduces patient compliance. In recent years, particular attention has been given to dimethyl fumarate, an oral immunomodulator belonging to the fumaric acid esters, which possesses anti-inflammatory, antioxidant, and immunoregulatory properties. Dimethyl fumarate is a simple α, β-unsaturated organic small molecule with a highly electrophilic character. Dimethyl fumarate activates the transcription factor Nrf2, promotes the differentiation of regulatory T cells (Tregs), and suppresses pathologically significant Th1 and Th17 responses, thereby targeting key pathogenesis pathways of psoriasis. Randomized clinical trials and real-world clinical practice data demonstrate the high effectiveness of dimethyl fumarate in the treatment of moderate psoriasis, including its effect on difficult-to-treat localizations (scalp, nails, palmoplantar areas), as well as a favorable safety profile with long-term use. The most common adverse events (gastrointestinal disorders, flushing, and lymphopenia) are transient and can be readily managed. Unlike biological disease-modifying antirheumatic drugs, dimethyl fumarate does not require parenteral administration and is associated with a lower risk of severe infectious complications. In 2025, a dimethyl fumarate–based drug was approved for the first time in the Russian Federation (30 mg and 120 mg). This review summarizes current data on the pathogenetic mechanisms of action of dimethyl fumarate in psoriasis, its clinical effectiveness, and safety profile in the treatment of this disease.
The diagnosis and treatment of livedoid vasculopathy continue to be one of the major challenges in modern dermatovenereology. The etiological and pathogenetic mechanisms underlying this condition are insufficiently studied; however, they are critical for distinguishing between livedoid vasculopathy and similar skin diseases and developing effective therapeutic strategies. Clarifying the pathogenesis and developing precise diagnostic criteria will improve differential diagnosis, accelerate its verification, and thereby promote quality of life through combination therapy. The paper presents a clinical case in a 56-year-old female patient with long-term livedoid vasculopathy secondary to insulin-independent diabetes mellitus and genetically determined thrombophilia caused by numerous mutations in hemostasis genes. The diagnostic workup included a differential diagnosis with ulcerative necrotic polymorphic dermal angiitis and chronic varicose ulcers. A comprehensive examination confirmed the final diagnosis of livedoid vasculopathy. This case highlights the critical role of extended diagnostic workup in patients with chronic skin ulcers, which is essential for a timely, accurate diagnosis and pathogenetically appropriate therapy, with a special focus on concomitant thrombophilia.
