Elizaveta Denisovna Zaslavskaya

Introduction . Skin aging is a multifactorial process, with oxidative stress playing a particularly crucial role. The formation of reactive oxygen species (ROS) initiates a cascade of reactions leading to collagen degradation and elastin disorganization, thereby contributing to visible signs of aging. A rational skincare approach, incorporating gentle cleansing and hydration combined with active ingredient action, can slow down the aging processes. Aim . To evaluate the efficacy of a skincare line combining a biotic complex and plant extracts in caring for mature skin. Materials and methods . 30 women aged 30 to 55 years (mean age of 42.5 years), exhibiting age-related skin changes. During the 21 days they applied gentle cleansing foam, soothing, moisturizing toner, boost-serum and eye skin care cream and during the following 7 days only foam and toner. Every week there were an assessment of epidermal barrier parameters using the Multi Skin Test Center 750/IMATE 6602 diagnostic system (Germany) and in 28th day of the study satisfaction with the topical products was evaluated via the TTSI-10 questionnaire. Results . At baseline, the average skin hydration level was 41.3 UE, sebum production was 26.1 UE, and elasticity was 39.2 UE. At the 21 ^st day hydration level increased by 35.6%, and elasticity improved by 21.4%. Sebum level showed minimal change. Moreover, the epidermal barrier parameters showed minimal changes between days 21 and 28. Visually, participants reported filling of fine wrinkles and decrease in pigmentation intensity. During the study, no adverse reactions were reported. Conclusions . The anti-aging potential of the studied cosmetic products is based on the synergistic action of plant extracts, a biotic complex, and active moisturizing components. The significant improvements observed in epidermal barrier parameters validate the importance of a comprehensive approach to caring for aging skin.

Dry skin (xerosis, xeroderma) in various age groups of the population causes serious concern for many specialists. According to literary data, the dry phenotype is diagnosed in every fifth inhabitant of our planet. Particularly complex is the combination of xeroderma with hypersensitivity to various exogenous and endogenous factors. Dry skin significantly disrupts the psycho-emotional state, causes certain difficulties in communication, and disrupts the quality of life in general [1–6]. Xeroderma can be the basis for the formation of immunoallergic pathological processes in the skin, and contribute to the development of inflammatory dermatological diseases. Xerosis is recorded in such chronic dermatoses as ichthyosis, atopic dermatitis, psoriasis, etc. In particular, disturbances in the skin barrier have been identified that accompany atopic dermatitis and lead to the formation of dry skin in such patients, closing the vicious circle: dry skin — atopy — sensitive dry skin with increased manifestations of xeroderma [2–6]. Conclusion. Genetic mutations, combined with acquired endogenous disorders and negative exogenous factors, can act as triggers, clinically inducing a dry skin phenotype. Xeroderma manifestations not only cause aesthetic discomfort but can also serve as an underlying condition for the development of dermatological diseases, leading to a decline in the quality of life of patients and their families. Atopic dermatitis, the most common chronic dermatological pathology, is clinically accompanied by pronounced manifestations of xerosis. Patients require therapeutic and preventive measures (care procedures, corneotherapy) to restore the skin barrier and prevent transepidermal water loss, bacterial contamination, and allergen penetration. Modern physiotherapy procedures are effective for dermatological patients of all ages. They expand and complement traditional conservative treatment for patients with atopic dermatitis and are indicated for rehabilitation. A promising physiotherapeutic method in the complex treatment of children and adolescents suffering from atopic dermatitis is photochromotherapy.

Objectives. To study the clinical manifestations of atopic dermatitis in adolescents undergoing inpatient treatment and to substantiate the need to include physiotherapy methods in complex therapy. Material and Methods. We observed 242 adolescents (105 girls and 137 boys) aged 12–17 years, hospitalized in 2024 in the Dermatovenereology Department of the Saint Petersburg State Pediatric Medical University, Ministry of Health of the Russian Federation. The diagnosis of atopic dermatitis was established based on clinical and anamnestic data, coding was performed according to ICD-10: L20.8 Other atopic dermatitis. The primary and secondary criteria for atopic dermatitis proposed by J. M. Hanifin and G. Rajka were taken into account when making the diagnosis. Comprehensive treatment of patients was carried out in accordance with the «Standard of Medical Care for Children with Atopic Dermatitis (Diagnosis and Treatment)» and «Clinical Guidelines. Atopic Dermatitis.» Results. The adolescents observed presented with widespread and diffuse forms of atopic dermatitis, including lichenoid, erythematosquamous with lichenification, and eczematized clinical patterns. Complicated pyoderma was observed in 55 % of cases, significantly complicating the underlying dermatological process. Concomitant pathologies were identified in two-thirds of patients, including gastrointestinal and hepatobiliary disorders (67 %), ENT pathologies, and respiratory diseases (28 % and 19 %, respectively). Physiotherapy methods used included photochromotherapy, laser therapy, ultratonotherapy, and phonophoresis, which demonstrated clinical efficacy based on the SCORAD index. All children who completed the full course of prescribed physiotherapy procedures in conjunction with the necessary dermatological treatment were discharged with improvement and in satisfactory condition. Conclusion. Based on the obtained results, it is recommended to include physiotherapy methods in the comprehensive treatment of children with atopic dermatitis at various stages, including in health resorts.

The range of skin diseases in which it is necessary to moisturize the skin is wide and includes atopic dermatitis, ichthyosis, psoriasis, eczema, xerosis and even acne. In turn, the morbidity with these dermatoses is increasing, and their severity has been worsening in recent years. The search for alternative and additional treatment methods that minimize the need for corticosteroids and other topically applied drug products is one of the main challenges of dermatology. The new strategy for treatment of chronic skin diseases accompanied by dryness is called «emollients plus». Emollients plus — a new class of cognitive moisturizing agents, capable of providing a comprehensive approach to the treatment of frequent dermatosis accompanied by defects of the epidermal barrier precisely by restoring the barrier function of the skin and reducing the intensity of subjective manifestations. Unlike conventional emollients, which simply moisturize the skin, emollients plus contain active ingredients that have anti-inflammatory, anti-pruritic, antibacterial, antioxidant, modelling microbiome and epidermal barrier indicators properties, and this is not an exhaustive list. The article presents historical aspects of the evolution of skin softening products from vaseline and lanolin to modern classification including hydratants, occlusive agents, emollients, enhancers and «emollients plus». The mechanisms of action of topically applied agents of different classes and correct selection of emollient depending on the clinical situation are also considered.

BACKGROUND: A special place among dermatological diseases is occupied by dermatoses affecting the oral mucosa, in particular pemphigus vulgaris. Constant damage to the mucous membrane, combined with the presence of abundant microflora in the oral cavity, leads to rapid variability in the primary or pathognomonic manifestations of specific diseases, making them look similar. Erosion and ulcers in the oral cavity are very difficult to treat and are accompanied by severe pain. The role of the oral microflora in the development and progression of pemphigus vulgaris has not been fully studied, however, it is known that the microflora of patients differs significantly from that of healthy individuals. Today, much attention is paid to studying the composition, properties and role of the microflora of the oral mucosa in the manifestation and course of pemphigus vulgaris. AIM: determination of the most effective combination of a three-component film biocoating based on sodium carboxymethylcellulose for patients with pemphigus vulgaris, by assessing and comparatively in vitro comparison of quantitative and qualitative characteristics of the oral microflora, as well as local oral protective factors (lysozyme titer, phagocytosis index neutrophils and the level of the secretory fraction of immunoglobulin class A) MATERIALS AND METHODS: A cross-sectional single-center study was performed among patients with pemphigus vulgaris (n=12). Oral fluid was collected by washing (rinsing) 4.5 ml of physiological solution from the oral mucosa. Subsequently, in the laboratory, a series of serial dilutions were prepared, some of which were inoculated by quantitative sectoral sowing on media intended for the cultivation of aerobic and anaerobic microbes. Microbiological and immunological sensitivity to films with different concentrations of mometasone furoate (20–40–80 mg) and propolis (2.5–5–7.5–10%) was determined. RESULTS: The most pronounced antibacterial activity was observed in the following 2-component forms (gel film and propolis at a concentration of 7.5%; gel film and mometasone furoate in an amount of 20 mg) and in 3-component gel films (gel film, propolis at a concentration of 5% and mometasone furoate 20 mg). According to the results of a comparative quantitative assessment of local factors protecting the oral cavity in patients with pemphigus vulgaris, their positive dynamics, characterized by the restoration of immunodeficiency, were most influenced by the three-component composition, including a gel film, propolis 5% and mometasone furoate 80 mg. CONCLUSION: The three-component composition of the film biocoating based on carboxymethylcellulose significantly reduces the quantitative and improves the qualitative indicators of microorganisms in the oral cavity, thereby having a positive effect on the treatment process for patients with pemphigus vulgaris.

Emollients are an integral part of the therapy for patients with atopic dermatitis. The most effective will be the new generation of emollients – emollients plus, which normalize the skin microbiome. Their effectiveness can be assessed by determining the parameters of the epidermal barrier (hydratation, sebum level, pH) and skin elasticity.Objectives. To evaluate the effectiveness and safety of a lipid-restoring cream containing a biotic complex LE SANTI in children with atopic dermatitis.Material and methods. From August to December, 25 children (9 girls, 36 % and 16 boys, 64 %) aged from 3 to 17 years (average age 9.2 years) with atopic dermatitis participated in an observational program to evaluate the effectiveness and safety of a lipid-restoring cream LE SANTI. For 21 days, patients applied the cream twice a day, they had 6 visits, during which was collected their medical history, adverse events, physical examination, determined indicators of the epidermal barrier (hydratation, sebum content, pH), biomechanical characteristics (skin elasticity), and also severity of disease (SCORAD) and quality of life (CDLQI). At visit 6, patients were assessed for satisfaction with the use of the cream.Results. All participants of the observation program completed their participation on time. As part of the observational program, there was an increase in skin hydration and sebum level by 3 and 3.5 times, respectively, pH level turned to the acidic values by 18%, an increase in elasticity by 30%, a decrease in SCORAD and CDLQI indices by 1.9 times or more 3 times respectively. The patients did not experience any adverse events; the satisfaction rating from the use of the cream was 4.78/5.Conclusions. Lipid-restoring cream LE SANTI can be recommended for inclusion in the treatment regimen for atopic dermatitis as a basic external agent that meets all the requirements for effectiveness and safety for children with atopic dermatitis, as well as basic care during remission.

Melasma is an acquired pigmentation disorder associated with excessive melanin deposition in the skin, which is characterized by skin discoloration of varying intensity. The presence of hyperpigmentation in melasma is accompanied by reduced quality of life, development of depressive and anxiety disorders. Melasma is the most common disfiguring skin disease, since exactly the localization of lesions on the face has a pronounced negative impact both in aesthetic and socio-economic aspects. Treatment aimed at hyperpigmentation correction is not always successful. This is due to many causes and factors (ignoring the doctor’s recommendations, reference to specialists of incorrect profile, presence of unsuccessful experience of treatment with the side effects development, use of external remedies with questionable effectiveness and safety). Currently, the cosmetic agents market, including the category of depigmenting drugs, is developing rapidly. It has been found that the most promising group of whitening agents are tyrosinase inhibitors, which is a key enzyme in melanin synthesis, and that isobutylamido thiazolyl resorcinol has the highest specific action regarding tyrosinase. The molecule is characterized by greater effectiveness and higher safety profile compared to other group’s representatives, such as arbutin and hydroquinone, which were once the gold standard of skin hyperpigmentation treatment. The article presents epidemiological, topical, clinical, psychosocial aspects of melasma, as well as modern and historical approaches to treatment.