The authors discuss the reasons of the violation of the skin barrier in patients suffering from atopic dermatitis and determine the role of pyococcus, dermatomycetes and yeast-like fungi in the development of this disease. They also describe the reasons of failures of the external therapy of atopic dermatitis with the use of combined drugs containing antibiotics. The authors substantiate the possibility of using the Travocort cream in case the disease is complicated with a secondary infection. They also describe their own study of the treatment of eczema herpeticum when the Travocort cream was included in the external therapy.

Goal of the study. To assess the efficacy and safety of Kerawort (Imiquimod, 5% cream for topical administration) vs. placebo used for treatment of anogenital warts. Methods and materials. The single-blind comparative placebo-controlled study involved 90 patients (44 female and 46 male) with anogenital warts. The patients were randomized into two groups: the main group (n = 45) receiving treatment with Kerawort (Imiquimod, 5% cream) and the control group (n = 45) receiving placebo. The diagnosis was confirmed by the identification of human papillomavirus by the polymerase chain reaction method. The patients received treatment three times a week until clinical signs disappeared but for not more than 16 weeks. Results. In 95.6% of patients from the main group and 8.9% of patients from the control group, anogenital warts disappeared completely or the quantity/area of pathological eruptions reduced at least by 70% as compared to the baseline. No relapses occurred during the treatment and follow-up period (28 days after the completion of treatment) in patients from the main group. An increase in the size and/or area of anogenital warts and/or development of new eruptions on the skin and mucous membrane of the genitals were recorded in 11.1% of patients from the control group. No serious adverse events were revealed during the study. Conclusion. Higher efficacy (р < 0.0000001) and comparable safety of Kerawort (Imiquimod, 5% cream for topical administration) used for treatment of anogenital warts vs. placebo were reliably established.

Purpose.Development and validation of the severity index of lichen planus (LP). Materials and methods.At the first stage, by means of theoretical substantiation, the main parameters and signs were identified that affect the severity of the disease and the quality of life of patients, which culminated in the derivation of the final index formula, which was called the lichen area and severity index (LPASI). At the second stage, LPASI was validated during the examination of 45 LP patients who were treated in the clinic of skin and venereal diseases of the Military Medical Academy in 20182019. Determination of LPASI was carried out by five dermatovenerologists independently of each other twice with an interval of one week. The analysis of the results was carried out using STATISTICA 10.0 programs and SPSS Statistics 17.0. The Spearman Brown and Pearson correlation coefficients were used to evaluate the intra-expert and inter-expert reliability of the index, and the Cronbach's alpha coefficient was calculated to assess the internal consistency of the scale. Results.The final formula for calculating LPASI is as follows: 0.2A+2B+5С+D, where A is the area of skin lesions in percentage, B is the severity of clinical manifestations on the skin, C is the severity of clinical manifestations on the oral mucosa and D is the severity of subjective sensations. The index can range from 0 to 82. The LPASI values for the whole group (n=45) were characterized by a normal distribution of the trait (p0.05), the minimum and maximum values varied from 7.2 to 42 points, the median was 22 points, the interquartile span from 14 to 27 points. The values of the Spearman Brown and Pearson coefficients were equal to 0.91 (95% CI 0.890.99) and 0,87 (95% CI 0.860.93), which indicates the reproducibility of the results and the reliability of the index. In this case, a high consistency between the selected features within the scale (Cronbach's alpha criterion 0.93) was established. Conclusion.Objectification of the severity of the disease using LPASI should become an integral part of the clinical examination of patients. The use of LPASI will allow to control the effectiveness of prescribed therapy, as well as to compare the results of scientific research.

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