Iuliia K. Akulinina

This article presents a clinical-pharmacological overview of current approaches to treating onychomycosis, the most common fungal nail infection, with a global prevalence of approximately 4–5.5%. It examines the epidemiology, etiological profile (characterized by the predominance of Trichophyton rubrum and an increasing proportion of non-dermatophyte molds), risk factors, and key mechanisms of pathogen resistance, including the spread of Trichophyton indotineae, which exhibits terbinafine resistance rates of up to 70%. Regimens for local (lacquers, solutions, creams) and systemic therapy (terbinafine, itraconazole, fluconazole) are analyzed in detail, along with criteria for drug selection based on clinical form, severity of infection, and comorbidities. Particular attention is paid to treating specific patient groups, such as children, the elderly, and patients with diabetes or immunosuppression, as well as to safety monitoring principles for systemic antifungal therapy. The necessity of a combined approach, including mandatory debridement and footwear disinfection, to achieve lasting cure and prevent recurrence is emphasized.

BACKGROUND: The clinical utility of effective acne vulgaris therapies is hindered by long treatment regimens, adverse events, and poor patient adherence, prompting the search for novel treatment modalities such as photodynamic therapy (PDT). AIM: To evaluate the clinical efficacy and safety of personalized multispectral PDT using a medical light-emitting diode (LED) device for PDT and phototherapy and a combination photosensitizer (0.5% 5-aminolevulinic acid and 0.5% chlorin e6 [5-ALA + Ce6]) in female patients with mild-to-moderate acne vulgaris. METHODS: Ten female patients (aged 17–25 years; mean age, 20.9 ± 2.6 years) with mild-to-moderate acne vulgaris underwent a PDT course comprising 2 to 3 sessions. The intervention utilized a medical LED device for PDT and phototherapy (400 nm [20%], 633 nm [40%], 660 nm [40%], 850 nm [20%]) in conjunction with a 5-ALA + Ce6 combination photosensitizer. Photosensitizer incubation and light exposure lasted 20–40 and 20 min, respectively, with a 1-week interval between sessions. Efficacy was evaluated via the Global Acne Grading System (GAGS), inflammatory lesion counts, and sebumetry/corneometry values. Safety was assessed by the incidence and nature of adverse events. RESULTS: Post-treatment, all patients showed clinical improvement, shifting from moderate to mild acne severity. Significant reductions were observed in mean inflammatory lesion counts (17.30 ± 6.07 to 9.0 ± 4.08; 48% reduction, p 0.001), GAGS scores (18.50 ± 4.25 to 8.70 ± 3.74; 53% reduction, p 0.001), and sebum production (177.30 ± 14.27 to 106.10 ± 16.74 µg/cm2; 40% reduction, p 0.001). Corneometry values increased (35.50 ± 3.63 to 46.20 ± 10.28 AU; 30% increase, p 0.01). Adverse events were mild, transient, and required no intervention. CONCLUSION: Personalized multispectral PDT, utilizing a medical LED device for PDT and phototherapy in conjunction with a 5-ALA + Ce6 combination photosensitizer, demonstrated pronounced clinical efficacy and a favorable safety profile in female patients with mild-to-moderate acne vulgaris. Further studies involving larger sample sizes and a control group are required.

Restoring lost volume with dermal fillers is a well-established aesthetic technique that utilizes various tissue-injectable materials, such as hyaluronic acid (HA), calcium hydroxyapatite, collagen, poly-L-lactic acid, agarose gel (AG). While HA-based implants remain the market leaders, there is a risk of adverse reactions if enzyme-induced degradation of these gels is necessary. Agarose-based gel is considered safe because it can be easily dissolved and removed from the injection site by administering normal saline and water for injection. Objective. To investigate the effect of solvents (normal saline and water for injection) on the rate of induced degradation of agarose gel in vitro and in vivo. Material and methods. A clinical observation of 5 patients was performed to evaluate the feasibility of controlled dissolution of an agarose-based filler using normal saline and water for injection. Agarose-based gels (at concentrations of 1.5 and 2.5%) were subjected to induced degradation by two solutions: 0.9% sodium chloride and water for injection. The induced degradation process was assessed by studying the physicochemical and rheological properties of the gel in vitro and ultrasound imaging of soft tissues in vivo. Results. Both agents effectively dissolve the AG-based gel. In vitro studies revealed the lowest stability in samples exposed to water for injection as the solvent, indicating significantly faster filler degradation compared to those treated with normal saline. In vivo, water for injection also showed greater dissolution capacity than normal saline. The AG-based filler bolus was completely degraded after a single use of water for injection, which was confirmed by ultrasound imaging. Conclusion. The efficacy and safety of using normal saline and water for injection to induce agarose gel degradation were demonstrated.

Introduction Peptide-C ampoules (PC) contain peptides, 10% of vitamin C, hyaluronic acid, and Vichy volcanic mineralizing water. Aims To assess the effectiveness and tolerability of PC. Patients and Methods An observational study conducted in 9 countries in women ≥30 years old with signs of facial skin aging (grade >0 for forehead and/or crow's feet wrinkles and bothered by skin quality). Investigator assessments and subject questionnaires were performed at initial visit and Day 30 after application of PC twice daily for 28 days. Tolerance was assessed throughout the study. Results Effectiveness and safety were analyzed in 1382 and 1742 subjects, respectively. Most subjects (mean age 48.5 ± 8.6 years) had skin phototype II or III (91.7%) and dry or combination skin (63.9%). PC was used as a standalone care or prior to a planned procedure (70%), or after a procedure (30%). Between baseline and Day 30, 63% and 64% of all subjects (N = 1360) had an improvement in forehead wrinkles and crow's feet wrinkles, respectively. Skin hydration improved in 67.3% of subjects. According to investigator and subject assessments, skin quality, skin radiance, skin aging signs, wrinkles, complexion, and skin pores significantly improved by Day 30. Similar results were observed for subgroup analyses when PC was used as standalone skin care or after a procedure. Tolerance of PC was rated as good to very good by 97.7% of subjects. Conclusions Peptide-C ampoules is effective in reducing visible signs of skin aging, and well tolerated, when used alone or as an adjunct to anti-aging procedures.