S. S. Ismatullaeva

According to epidemiological data, superficial mycoses may affect approximately 20–25% of the global population. They account for 37–40% of all dermatological diseases, which further underscores the need for discussion and development of preventive strategies both within the specialty and in an interdisciplinary context. The imperative to update approaches to timely prophylaxis and appropriately prescribed antifungal therapy is driven by the rising incidence of complications associated with long-standing dermatophytoses, as well as by recurrent mycotic infections in high-risk populations. The article analyzes 34 publications devoted to the treatment of mycoses of the feet and onychomycosis, posted on the websites of specialized foreign and Russian scientific publications. This article reviews contemporary risk factors for tinea pedis and onychomycosis, including a dynamic lifestyle, self-medication, hereditary predisposition, and comorbid conditions. Preventive measures are examined, the observance of which is critical not only for achieving optimal outcomes of antimycotic treatment but also for preventing disease recurrence. Topical agents are systematically categorized, with their potential utility as adjuncts in combination therapy for mycoses and as prophylactic tools for modifying risk factors for tinea pedis and onychomycosis. The successful management of mycosis depends not only on accurate diagnosis but also on patient adherence to prolonged treatment regimens and preventive measures, as well as on the recognition that relapses are common and are likely to necessitate further therapy. At present, robust evidence is lacking to support a long-term maintenance regimen of topical etiotropic therapy as a strategy for preventing or reducing the frequency of recurrences. Nevertheless, a number of straightforward preventive principles have been identified, which patients may adopt to improve their clinical status, achieve remission, and, over the long term, prevent the recurrence of mycosis.

Kerion Celsi is an acute inflammatory reaction that develops in response to the penetration of dermatophytes into hair follicles and is accompanied by a secondary bacterial infection and a reaction of the lymph nodes. The incidence of kerion in mycosis of this localization can vary from 15% to 57%. Despite the widespread distribution of dermatophytes in the pediatric population, studies in the field of etiology and diagnostics of kerion Celsi are limited and contradictory. The aim of this study is to analyze to analyze the clinical and laboratory features of kerion Celsi caused by Trichophyton tonsurans. The article describes a case of kerion Celsi caused by the anthropophilic fungus T. tonsurans . The patient received complex treatment in the conditions of the daily dermatovenereology hospital of the Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology of Moscow Health Department. The development of kerion Celsi was caused by incorrect long-term use of topical glucocorticosteroids, and was also delayed due to incorrect diagnostic tactics in the outpatient setting. During the laboratory examination of the pathological material obtained from the patient, the growth of the T. tonsurans culture was not obtained. The etiological diagnosis was made based on the results of direct microscopy and PCR. Direct microscopy of the hair revealed the location of the spores as endothrix . After hospitalization in the pediatric dermatovenereology department, the patient quickly responded to treatment with oral antimycotics and antibiotics. Kerion Celsi is a difficult-to-treat form of scalp mycosis that negatively affects the quality of life of the child and family. The international and domestic experience in diagnosing kerion Celsi demonstrated in the article indicates the need to refer children with rashes on the scalp to a dermatovenereologist for timely diagnosis of mycosis and prevention of serious complications.

Introduction. Mycosis of the scalp (Tinea capitis) is one of the most common infections localized on the scalp and occurs mainly in children. The frequency of purulent inflammatory type (Kerion celsii) is about 15% of all cases of of scalp mycosis. The causative agents are zoophilic dermatophyte fungi that cause skin mycoses in cattle, donkeys, dogs, goats, sheep and horses. Zoonotic infection Trichophyton verrucosum is reported ubiquitously, more frequently in Asia and the Middle East. Human infection occurs in rural areas where close contact with animals is more likely. The urgency of the problem is associated with the increasing number of cases of severe scalp mycosis caused by T. verrucosum.Aim. Analyse clinical and laboratory features of T. verrucosum infection.Results. The article describes two cases of mycosis of the scalp caused by T. verrucosum. Both patients received complex treatment in the inpatient department of the Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology. Effective treatment was delayed due to incorrect clinical and laboratory diagnosis of the disease. After hospitalization in the pediatric dermatovenereology department, both patients quickly responded to treatment with oral antifungals. No growth of T. verrucosum culture was obtained during laboratory diagnostics of pathological material. Direct microscopy revealed an ectothrix-like arrangement of spores.Conclusions. Due to active migration and the popularity of tourism, dermatovenerologists in their daily practice must be prepared for an increase in infectious diseases. A properly collected anamnesis allowed specialists to establish the correct diagnosis of scalp mycosis caused by a zoophilic dermatophyte. In the given clinical examples, when the bacteriological method did not give a result, direct microscopy allowed to confirm the clinical diagnosis, identify the etiologic agent (T. verrucosum) and optimize the tactics of systemic and topical therapy.

Post-inflammatory hyperpigmentation (PIH) is one of the most significant problems in patients with acne. The prevalence of PIH among patients with acne varies from 45 to 87%. Post-acne, including PIH, has an extremely negative impact on the quality of life and psychological well-being of patients, as it is often resistant to therapy and can persist for even several years. Successful acne treatment does not guarantee complete elimination of PIH and other post-acne symptoms. In the development of PIH, a key role is played by the mechanism associated with the production and distribution of melanin, which is activated by inflammation and the release of cytokines that promote an increase in the level of immunoreactive tyrosinase, which stimulates melanocytes, activation of melanogenesis and further transfer of melanosomes to surrounding keratinocytes. It is important for clinicians to recognize the psychosocial impact of PIH and manage inflammation, as well as proactively address residual PIH with appropriate treatment. Thus, prevention and correction of PIH should be one of the goals of acne treatment. Topical therapy for PIH in acne is considered the most acceptable and can be prescribed both as monotherapy and as part of combined methods. Tyrosinase is a target for topical anti-pigmentation agents, including hydroquinone, kojic acid, and resorcinyl thiazole derivatives. The latter includes isobutylamidothiazolyl resorcinol – thiamidol. The article provides a brief overview of data on the epidemiology of PIH, its pathogenesis, impact on the quality of life of patients and the perception of their image by people around them. Clinical experience with the use of anti-hyperpigmentation serum with thiamidol, licochalcone A and sodium hyaluronate is presented, which confirms the effectiveness, safety and feasibility of prescribing products with thiamidol for the treatment of PIH caused by acne.

In recent years, there has been an increase in the proportion of AFA in the structure of acne incidence. The etiopathogenesis of the disease is multicomponent and has not been fully elucidated. It is assumed that hormonal factors and chronic activation of innate immunity are involved in the process against the background of genetic predisposition, which are stimulated by external environmental factors: daily stress, Western-style diet, tobacco use, hormonal drugs, cosmetics. The article presents a modern classification of the clinical course of AFA and scales for assessing the severity of the course of the disease: GEA (Global Acne Severity Scale) and AFAST (Adult Female Acne Scoring Tool). AFA is predominantly characterized by a mild or moderate course. Treatment requires a personalized approach with particular attention to the individual needs and characteristics of adult women. When choosing a topical therapy, the doctor should consider the less pronounced oiliness of the skin, the slow progression of the disease with the outcome in hyperpigmentation and scarring. Modern acne treatment regimens include systemic and topical therapy along with proper basic skin care. The most effective topical agents include retinoids, which can induce a specific biological response by binding and activating retinoic acid receptors. Comedonal and mild papulopustular acne are indications for adapalene monotherapy for acne in adult women. Adaklin (0.1% adapalene) cream is a highly effective first choice for the pathogenetic treatment of AFA. Rational mono- and combination therapy with adapalene is the key to successful external therapy of mild and moderate AFA and prevention of post-acne. The review provided up-to-date, evidence-based information on the clinical presentation, etiopathogenesis, and treatment of adult female acne (AFA).

The post-treatment period plays a great role in the prevention of complications and shortens the rehabilitation time. The article provides up-to-date international statistics on the number of cosmetic procedures performed annually according to the International Society for Aesthetic and Plastic Surgery (ISAPS). A successful clinical experience of using a repair cream con taining oat plantlets extract, l-ALA-l-GLU dipeptide and hyaluronic acid as post-procedure care on the example of 2 patients is described. In the first case, a 32-year-old patient presented with postacne scars underwent a fractional radiofrequency ablation procedure followed by application of a cream with oat plantlets extract on the left side of the face, and a cream with dexpanthenol on the right side for 10 days. 5 minutes after application on the left side, the patient noted a pronounced reduction in burning, tingling, itching and soreness sensation. The entire post-treatment period also was faster and more comfortable on the side of the face, where the cream with oat plantlets extract was applied and ended successfully by the 8^th day after the procedure. On the comparison side, the full rehabilitation process took 10 days. In the second case, a 27-year-old patient with acne, after a chemical peeling procedure, as a final remedy and further post-procedure care used the cream with oat plantlets extract on one side of the face, and a cream recommended by the manufacturer of peeling systems on the other side. When re-examined after 7 days, there was also a faster regression of inflammatory elements, post-procedural erythema and edema, dryness and discomfort after peeling were less pronounced on the side of the face where the cream with oat plantlets extract was applied. Repair cream containing oat plantlets extract, l-ALA-l-GLU dipeptide, and hyaluronic acid showed excellent efficacy and tolerability, had synergistic efficacy (moisturizing, healing, preventing aesthetic defects). The authors consider to recommend it as a mean of post-procedural rehabilitation.

Introduction. The paper presents modern literature and clinical research data on the efficacy and safety of dietary therapeutic and prophylactic foods in the complex therapy of diseases associated with Helicobacter pylori. Aim. To assess the efficacy and safety of the use of dietary therapeutic and prophylactic food products in the complex therapy of diseases of the gastrointestinal tract associated with Helicobacter pylori. Materials and methods. To evaluate the efficacy of dietary therapeutic and prophylactic food products such as Vegetable Puree Soup with Herbs and Oatmeal, Oatmeal Porridge with Herbs and Flax Seed, Protein-Sea Buckthorn Cocktail (LEOVIT Nutrio LLC), the main group of patients with gastrointestinal diseases (n = 41) was formed, which was further divided into four subgroups. Each of three subgroups received one specialty food product, and the fourth subgroup received all three products. Changes in complete blood count were evaluated using Sysmex XT-2000i analyzer, those in proteinograms – using SAS1, SAS2 protein fraction analyser and those in metabolic liver disorders, lipid profile and glucose level – using Konelab PRIME 30i (Thermo Fisher Scientific) analyzer. All parameters were studied three times: before use, 14 and 60 days after use of the products. Results and discussion. After 14 days, complaints of lack of appetite decreased in the main group, discomfort in the epigastrium, feeling of heaviness and nausea decreased. After 60 days, 100% of patients reported no heartburn, belching, nausea, pain, rumbling in the abdomen, appetite and stool returned to normal. There was a marked significant (p < 0.05) decrease in the level of alpha-1 globulin against the background of an increase in albumin, a decrease in the concentration of CRP and ESR, the levels of leukocytes and neutrophils in all subgroups of the main group after 60 days. Conclusions. The investigated products are safe, no adverse reactions were noted, including the phenomena of intolerance and allergies, and are recommended for use in dis[1]eases of the gastrointestinal tract associated with Helicobacter pylori.