Acne is one of the most common dermatoses, especially among young people. The worldwide prevalence reaches up to 80% of young people aged 15 to 17 who have symptoms of acne, and the condition often persists into adulthood. In the pathogenesis of acne, in addition to pathological hyperkeratosis and inflammation, an important role is played by such factors as massive microbial contamination, species composition, biological properties of pathogens, in particular, their drug resistance. For the treatment of acne of moderate and severe severity, antibacterial drugs are used – tetracycline, erythromycin, doxycycline. These drugs have a bacteriostatic effect on Cutibacterium acnes by inhibiting the synthesis of bacterial proteins. Antibiotics for acne demonstrate antimicrobial and anti-inflammatory effects and act in two directions: they reduce the colonization of C. acnes and inhibit the production of inflammatory mediators associated with С. acnes. Side effects in antibiotic treatment are rare, but the main problem in their appointment is resistance, the frequency of which is increasing every year. The review part of the article presents the literature data of domestic and foreign authors on the formation of С. acnes resistance to antibiotic therapy in acne patients in the process of therapy evolution. Cause-and-effect relationships of the formation of resistance in the application of antibacterial drugs of various classes are described. The strategy and tactics of a doctor to limit the spread of C. acnes antibiotic resistance are considered. A special place in the article is given to the important role of benzoyl peroxide, clindamycin and the synergistic effect of the fixed combination of clindamycin / benzoyl peroxide in overcoming the resistance of С. acnes and achieving the effectiveness and safety of therapy. The second part of the article presents our own clinical observations of the effectiveness of the domestic combined preparation of the Klindavit Combo gel (clindamycin / benzoyl peroxide) in the treatment of patients with papulopustular acne who are on outpatient treatment by a dermatologist.

The relevance of microbic eczema is caused by prevalence of a disease, a long chronic current, frequent, is long the proceeding recurrence, insufficiently studied pathogeny and difficulties of the choice of effective treatment. Microbic eczema – the chronic recurrent dermatosis which is characterized by evolutionary polymorphism of elements of rash, wet an itch and a peculiar allergic reaction of the sensibilized skin to decomposition products of microorganisms and their toxins arising against the background of it is long the existing piogenic center at disturbance of the major regulatory systems of an organism. At patients with microbic eczema disbioz skin it is shown by reduction of a share of S. epidermidis, Bifidobacterium spp., Lactobaccilus spp. and significant increase in opportunistic and pathogenic flora, associations of mushrooms quite often meet representatives of obligate flora. Allergenic action of S. aureus and fungal microflora, in particular, of C. Albicans at microbic eczema considerably amplify in the conditions of a mikstinfektion. In recent years microbic eczema tends to a heavy current with a frequent long recurrence, considerable distribution of process on skin and is characterized by resistance to the standard methods of treatment. Elimination of action of microbic, mycotic dissimination and normalization of a biocenosis of skin at microbic eczema are the key principle of treatment of patients interfering recuring of chronic eczema. The article focuses on microbial eczema, as the most difficult type of eczema in therapy, presents our own clinical observations of the course of microbial eczema of various localization and severity, and also shows the effectiveness of the Russian-made topical drug Akriderm GK, containing a micronized form of betamethasone dipropionate, gentamicin sulfate and clotrimazole in the complex therapy of patients with microbial eczema.

Introduction. The systemic psoriatic process affects not only the skin, but also other organ systems, including the cardiovascular system. Immunopathological inflammation that occurs in the skin and articular tissues is a central link in the pathology of the cardiovascular system in psoriasis.Objective. Identify diseases of the cardiovascular system and factors of their development in patients with psoriasis and to assess their severity depending on the severity of dermatosis.Materials and methods. The study included 406 patients with psoriasis aged 18 to 74 years, who were divided into three subgroups depending on the severity of the course. Assessment of the state of the cardiovascular system was carried out using the following methods: uestionnaire, clinical, physical, laboratory and statistical. The comparison group consisted of 200 people.Results. In 53.9% of patients, psoriasis occurred against the background of cardiovascular comorbidity. More than 90% of patients with moderate to severe psoriasis have more than three risk factors for CCC diseases. Patients are more susceptible to the development of hypertension, hypercholesterolemia, obesity, abdominal obesity, stress and smoking. The higher the cardiovascular risk, the more severe psoriasis is.Conclusions. The presence of unmodified and modifiable risk factors for the development of cardiovascular diseases is aggravating for the course of psoriasis, which means that the risk of undesirable fatal events is higher. Patients with psoriasis need additional preventive measures aimed at preventing the development of cardiovascular pathology.

Background. Currently, onychomycosis is an urgent and widespread problem in dermatology. The defeat of the nail plates is the cause of a cosmetic defect and a decrease in the quality of life of patients. Systemic antimycotics are effective, but have a number of side effects when used. Thus, a modern and effective approach to the treatment of patients with this pathology is needed. The aim of the study. To prove the efficacy, safety and tolerability of Ekzilak as local monotherapy of onychomycosis compared with cyclopyrox monotherapy. Materials and methods. А randomized open-label study with active control included 172 outpatient subjects: men and women aged 18 to 75 years, with microscopically confirmed onychomycosis of the big toe (one or both feet), a superficial or distal form of onychomycosis with a lesion of no more than 1/3 of the nail length (KIOTOS from 1 to 6). Patients were randomized into two groups: the 1st group of patients applied Ekzilak locally daily for 6 months, the 2nd group of patients applied Ciclopirox nail lacquer topical solution 8% as follows: 1 time a day for the first month, 2 times a week for the second one and 1 time a week for the months third-sixth. The preparations were applied in a thin layer to the affected nail. The primary efficacy endpoint in the study was the proportion of patients who achieved complete recovery of the target toenail at the end of therapy (clinical + mycological recovery). Secondary endpoints included the proportion of patients who achieved clinical recovery after 6 months of treatment (clinical recovery is a complete restoration of the normal morphology of the affected nail), the proportion of patients who achieved mycological recovery (microscopy with KOH solution) after 3 months of treatment, the proportion of patients who achieved complete recovery of the target toenail in 4 weeks after the end of treatment; IGA (Investigator's Global Assessment), Integrated Medicine Patient Satisfaction Scale (IMPSS); the safety Analysis was carried out throughout the study and included an assessment of adverse events, laboratory data, vital signs. Results. The results of the study showed that Ekzilak is superior in terms of efficacy to the registered drug Ciclopirox nail lacquer topical solution 8% as a local monotherapy of onychomycosis. The difference in the proportion of patients who achieved complete recovery between the study drug and the reference drug was 22.09%, 95% CI for the difference in the proportion was [8.21%; 35.97%], the differences between the groups are statistically significant (p=0.002). At the same time, the analysis of safety data, including the assessment of adverse events, laboratory studies and impact on vital signs, did not reveal statistically and clinically significant differences between the treatment groups. Conclusions. New combination drug Ekzilak is an effective and safe treatment option for patients with onychomycosis.

The most common localization of dermatoses of combined etiology are intertriginous areas. In recent years, an increase in the number of patients suffering from dermatoses of combined etiology has been recorded. The reasons for this situation can be both irrational therapy and background comorbidities in the patient, as well as a number of anatomical and physiological prerequisites for the formation and maintenance of an inflammatory infectious process with localization, namely in the area of skin folds. The article describes in detail the anatomical and physiological features of these areas, the causes of the development of dermatosis of the combined etiology of the fold area. Epidemiological and statistical data on the distribution of a combination of acute, chronic, infectious and non-infectious dermatoses, the causes and frequency of their occurrence are given. Particular attention is paid to the microbiocenosis of the skin in various dermatoses with an emphasis on intertriginous localizations. Approaches to the treatment of such conditions involve the use of combined external agents containing topical corticosteroids, antimicrobial and antifungal components. The article presents data available in the literature on the effectiveness of the use of a multicomponent preparation – Tetraderm cream (consisting of an antibiotic-aminoglycoside + tissue repair stimulant + GCS for local use + an antifungal agent – econazole nitrate) for various dermatoses localized in intertriginous areas. We present our own clinical observations of the effectiveness of the use of this polycomponent preparation Tetraderm in the treatment of patients with skin lesions of combined etiology in the area of folds in atopic dermatitis, allergic dermatitis, mycotic, staphylo-streptococcal infections occurring in combination.