Acne vulgaris is a highly prevalent inflammatory skin disease involving sebaceous follicle. Although the pathogensis of acne remains uncertain, skin microbes are considered to plays an essential role in acne vulgaris. Cutibacterium acnes is the most important microbe in acne pathogenesis and its several processes: colonization, over-proliferation and inflammation have long been thought to contribute to the disease. Moreover, Staphylococcus epidermidis and Malassezia also synergistically collaborate with Cutibacterium acnes. Besides, given the growing number of patients who are treatment resistant, assessments are needed on phenotypic changes in the skin microbiome with retinoids and antibacterial therapy. Further research on the role of microbes in the pathogenesis of acne and the relationship between pathogenic microbes is expected to provide a new theoretical basis for clinical treatment of acne.

Modern aspects in the pathogenesis of atopic dermatitis (AD) are analyzed. The role of Malassezia spp. fungi is discussed; sensitization to these fungi is one of the most significant trigger factors in AD pathogenesis. The results of studies and the data are presented, which confirm high efficiency of tacrolimus (calcineurin inhibitor) in AD and its probable clinical antimycotic effect against Malassezia fungi.

Chronic urticaria (CU) is one of the 20 most prevalent cutaneous diseases. It is associated with spontaneous weals, itching, and/or angioedemas persisting 6 weeks or longer. The cause of CU remains obscure in 7090% cases, in the rest cases the disease can be due to concomitant diseases, including autoimmune ones. We offer one of the first descriptions of CU associated with a rare autoimmune disease primary biliary cirrhosis (PBC) in a female patient aged 30 years. In recent time three cases with CU associated with PBC (including cases with normal level of hepatic enzymes) have been descibed, which may indicate a relationship between these two diseases. In our observation PBC was asymptomatic for a long time, but with concomitant urticaria and high levels of hepatic enzymes and specific autoantibodies. Our data indicate the need in more profound immunological diagnosis in some cases, even with slight CU, good quality of life, response to treatment, and without other symptoms of PBC..

Gene expression in atopic dermatitis was analyzed and the epigenetic profiles (DNA methylation status) of biopsy specimens from normal subjects and patients with atopic dermatitis before therapy were studied by the Illumina microchips in order to detect the key components of the pathological process. The results suggested more rational therapeutic approaches with consideration for the results of individual epigenetic testing.

Published data on the use of eximer laser in therapy for circumscribed forms of atopic dermatitis are reviewed. The authors present the results of their comparative studies of treatment efficiency in patients with atopic dermatitis treated with the use of eximer laser exposure and topical glucocorticoids. The advantages of combined therapy with the use of eximer laser is demonstrated.

The authors of this review of literature discuss the pathogenesis of autoimmune urticaria and the history of its distinguishing as a nosological entity. These data on autoimmune urticaria will be useful for specialists and will promote optimization of its diagnosis and therapy. Some autoimmune diseases can manifest by symptoms of chronic urticaria; on the other hand, urticaria is autoimmune in 30—40% cases. In addition, it is assumed that the disease is associated with the presence of autoantibodies — anti-FceRI and (rarely) anti-IgE. It is essential to differentiate autoimmune urticaria from other disease forms by intradermal test with autoimmune serum and in vitro studies. It is characterized by a more severe prolonged course and resistance to antihistaminic therapy. In many cases the diagnosis of autoimmune urticaria allows dscontinuing further tests, aimed at detection of the disease cause.

Tacrolimus, a new calcineurin inhibitor, was used for topical therapy of skin diseases. Characteristics of the drug are presented, the mechanism of its action is described. The efficiency of tacrolimus is demonstrated by published data and the authors’ experiance. Tacrolimus was effective in the treatment of atopic dermatitis, its efficiency was comparable to that of topical corticosteroids. Tacrolimus was also effective in psoriasis, vitiligo, rosacea, and seborrheic dermatitis.

Androgenic alopecia remains one of the most common variants of hair loss. Changes in androgen metabolism and genetic liability underlie this process. Androgenic alopecia develops under conditions of high serum levels of free testosterone and the so-called weak androgens in the presence of high levels of androgen receptors and 5a-reductase. As for the genetics of the process, a relationship between androgenic hair loss and chromosome X locus 20p11 has been described. The disease is rather stubborn. Finasteride and minoxidil remain the most effective therapy. The first results of therapy with botuloxin A and platelet-rich plasma have been published. The available treatment is effective in just 10% patients. This necessitates search for new approaches to solution of the problem.

Published data on modern antitumor drugs, acting as epidermal growth factor receptor inhibitors, are pre sented. Their inevitable side effects — skin toxicity — are explained by their nature. Therapeutic approaches to management of these reactions are discussed and a clinical case is presented.