Introduction . Atopic dermatitis (AD) is a common genetically determined chronic inflammatory skin disease with a relapsing course. Over the past three decades, the prevalence of AD in industrialized countries has increased markedly. The rising incidence and variable clinical course of AD may be associated, in part, with epigenetic changes induced by environmental factors. Aim. To evaluate epigenetic changes in patients with moderate-to-severe AD, including histone acetylation, filaggrin ( FLG ) gene expression, and the DNA methylation profile. Mat erials and methods. An observational case–control study was conducted from January 2022 to October 2023 and included 60 patients with AD and 23 healthy controls. Histone acetylation and DNA methylation levels were assessed in peripheral blood samples from patients with AD and healthy controls. F LG gene expression was evaluated in the leukocyte fraction of peripheral blood using quantitative reverse transcription polymerase chain reaction (RT-qPCR). Results. DNA methylation levels were significantly higher in patients with AD than in healthy controls (98.86% vs. 66.16%, respectively; p < 0.0001). Histone acetylation levels were lower in patients with AD than in healthy controls, as indicated by a 21.0% reduction in histone acetyltransferase activity (p < 0.001). In addition, FLG gene expression in the leukocyte fraction of peripheral blood was significantly lower in patients with AD than in healthy controls (Cohen’s d = -3.03; p = 1.19 × 10 -11 ). Conclusion. The assessment of molecular genetic characteristics and epigenetic alterations in patients with AD may contribute to a better understanding of the immunopathogenesis of the disease and support the development of novel approaches to targeted therapy.
Pyoderma gangrenosum (PG) is a rare inflammatory skin condition belonging to the group of neutrophilic dermatoses. It is characterized by rapidly progressing ulcers involving deep necrosis, severe pain, and a pronounced inflammatory response. PG is clinically classified into four morphological variants, including ulcerative, bullous, vegetative, and pustular. The ulcerative form is characterized by deep necrotic ulcers with a violaceous edge and may present as either multiple or solitary lesions. The bullous form begins with painful redness and the rapid occurrence of blisters that evolve into necrosis of the skin. The pustular form is the rarest variant characterized by multiple sterile pustules over an erythematous background, typically on the lower extremities, which rapidly progress to superficial ulcers. The vegetative form progresses more slowly and is characterized by non-purulent erosions or superficial ulcers. The etiology of PG is multifactorial: some cases are idiopathic, yet the disease is frequently associated with active systemic disorders, skin trauma, and pharmacologic triggers. Comorbidities include inflammatory bowel diseases, rheumatological syndromes, hematologic malignancies, and other dermatoses, which can influence the clinical presentation, disease severity, and prognosis. The pathogenesis of PG is characterized by marked neutrophilic inflammation and partial dysregulation of IL-1 and TNF-α cytokine-mediated immune signalling, as well as disruption of regulatory pathways of inflammation. Treatment of PG is the most challenging and not sufficiently studied area in existing research literature. Evidence regarding efficacy of different systemic therapy regimens are limited and mostly comprise small case series, case reports, and expert experience. Standard treatment involves a combination of systemic immunosuppression (corticosteroids and/or cytotoxic agents) and local ulcer wound care. Ulcer care is essential to achieve a successful disease outcome. It should provide careful wound cleansing, moist wound environment, non-adherent dressings that incorporate antiseptic agents, and conditions conducive to adequate epithelialization. The article presents a clinical case of the treatment of pyoderma gangrenosum (PG) in a 52-year-old female patient. In 2023, the patient incidentally found a lesion in her right scapular region, accompanied by pronounced tenderness. The subsequent rapid growth, suppuration, and aggravated inflammation of the lesion led to a wrong diagnosis of atheroma. The patient underwent surgical treatment twice; however, the intensity of the pathological process did not subside. She was prescribed antibiotics, corticosteroids, and wound debridement using ProntoSan solution after her diagnosis of pyoderma gangrenosum was documented. The treatment regimen helped switch off inflammation and significantly reduce the symptoms of the disease. Only isolated ulcerative lesions were observed on the skin after 10 days of treatment. The patient continued her treatment at home.
Allergic skin diseases in young children are characterized by pronounced exudation due to anatomical immaturity of the skin, increased vascular permeability, spongiosis, and a disrupted epidermal barrier. This article describes in detail the mechanisms of immune inflammation, in which proinflammatory mediators (histamine, IL-4, IL-13, etc.) play a key role, as well as chronic itching and scratching, which creating a vicious cycle of “itching – scratching – inflammation”. The pathogenesis of exacerbations with oozing and exudation is discussed. Allergic skin diseases hold a leading place in the structure of childhood skin pathology, and the features of their course at this age – a tendency to exudation, involvement of sensitive areas, and a high risk of secondary infection – impose special requirements on topical agents, whose safety is no less important than efficacy. The properties of synthetic tannin and polidocanol, the basis of Neotanin – a barrier agent approved for use in children from the first month of life, free of hormones, antibiotics, and dyes, and acting within the stratum corneum without systemic absorption – are considered. Synthetic tannin forms a protective film on the skin surface, exerts astringent, drying, and antipruritic effects, and prevents secondary infection, while polidocanol additionally reduces itching. The authors present three clinical cases of successful treatment of allergic dermatoses in children with Neotanin – both in various combinations with topical glucocorticosteroids and as monotherapy, including lesions localized on sensitive skin areas. In all observations, regression of inflammation and relief of itching were achieved, and no adverse events were recorded.
Introduction. Modern aesthetic medicine is increasingly focused on regenerative technologies. Poly-L-lactic acid (PLLA) and exosomes derived from adipose-derived mesenchymal stem cells (ADSC-Exos) possess complementary mechanisms of action, making their combined use a promising approach for the correction of age-related skin changes. Aim. To compare the clinical efficacy and safety of different treatment protocols for the treatment of age-related skin changes using PLLA and an ADSC-Exos-based formulation. Mat erials and methods. A prospective pilot, two-center clinical study was conducted in 10 patients aged 35 to 71 years. Patients were assigned to one of three treatment groups according to the treatment protocol: PLLA monotherapy (n = 2); combination therapy with PLLA and ADSC-Exos-based formulation (n = 4); and a staged multilevel treatment protocol using device-based procedures, PLLA, an ADSC-Exos-based formulation, and uncrosslinked hyaluronic acid (n = 4). Efficacy was assessed using the Antera 3D imaging system, the Global Aesthetic Improvement Scale (GAIS), and a visual analog scale (VAS). Safety was evaluated by recording adverse events. Results. All treatment protocols demonstrated a favorable safety profile, with no adverse events reported. The greatest clinical effect was achieved with the staged multilevel treatment protocol, resulting in a 31.7 ± 4.6% reduction in wrinkle depth, and a GAIS score of 4.5 ± 0.5. Between-group analysis demonstrated statistically significant differences in the reduction in wrinkle depth (p = 0.027). Compared with PLLA monotherapy, combination protocols incorporating ADSC-Exos-based formulation were associated with shorter recovery periods and earlier clinical improvement. Conclusion. Combination treatment with PLLA and an ADSC-Exos-based formulation represents an effective and safe strategy for the treatment of age-related skin changes. Among the evaluated protocols, the staged multilevel approach produced the most pronounced clinical outcomes, improving objective skin quality parameters while shortening the recovery period.
Traditionally, people dedicate significant attention to hair care. There is a huge variety of products, methods, and treatments, however not all of them can help improve hair quality and health. According to some reports, around 20% of the global population are affected by hair disorders, with hair loss of various genesis constituting a major portion. These estimates underscore the importance of paying careful attention to choosing hair care products and when considering the underlying causes of changes in hair condition. The use of hair care products can trigger allergic reactions on the scalp. Hair dyes are reported as one of the most common causes of such reactions. Hypersensitivity reactions can also affect the forehead, neck, and the skin behind the ears adjacent to the area of allergen application, indicating a potentially wide area of exposure to the hair dyes. In addition, cases of hair loss after the use of more permanent dye products have been described. The chemical composition of hair dye products directly influences the extent of hair damage: permanent dyes can be more damaging to the hair structure than semi-permanent dyes. Daily hair care practices also affect hair quality. Using certain shampoos can worsen hair condition, while regular use of heat styling tools and harsh styling practices may lead to its mechanical damage, dryness, and breakage. Chemical treatments are generally associated with damage to the hair structure and texture, although they are not necessarily related to direct hair loss. Individuals experiencing hair thinning often require a specialized approach to the treatment. Certain products and techniques are contraindicated, so decisions should be patient centred, tailoring care to each individual’s hair care needs and caution when choosing hair dyes and treatments. In hair health matters, careful choice of hair care products is important to minimize exposure to harsh treatments and take care of the scalp condition.
