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The causes for the fault diagnosis of pemphigus vulgaris are discussed. The lowering of the age of patients noted the last years, clinical peculiarities similar with those in other bullous dermatoses and toxic epidermal necrolysis and multiforme exudative erythema are considered. A case in a 35-year old man who was sequentially in different clinics diagnosed Exacerbation of chronic nasopharyngitis. aphthous stomatitis, Lacunar tonsillitis. oral thrush, Chemical burn of the mucosa of the oral cavity, Chemical burn of the esophagus. Erosive - ulcerative form of lichen ruber planus of the mucosa of the oral cavity, Multiforme exudative erythema is presented. According to the diagnosis different medicines were prescribed, any improvement was not noted The vulgar pemphigus was diagnosed in 2 months after the appearance of the first eruption.

A new SARS-CoV-2-associated coronavirus infection pandemic began in late 2019. The present article is devoted to the analysis of the mechanisms of COVID-19 impact on the course of psoriasis and its consequences. According to the scientific literature, patients with psoriasis are somewhat more likely to be infected with coronavirus infection than the healthy population, but tolerate it in a milder form. At the same time, cases of psoriatic process exacerbation during the active phase of the disease and after COVID-19 have been described. The negative effect of infection on skin disease can be explained by the common genome of the two nosologies, the «cytokine storm» and the prescription of COVID-19 drugs. In addition, both COVID-19 and psoriasis can cause liver dysfunction related to the specific pathogenesis of the diseases as well as the prescribed therapy. The article describes our own experience of monitoring patients with exacerbation of psoriasis against the background of coronavirus infection with pathological changes in liver tests. Inclusion of a fixed combination of glycyrrhizic acid and essential phospholipids in the complex treatment allowed to stop the exacerbation of the psoriatic process more effectively, to reduce the activity of liver enzymes without worsening the clinical conditions associated with COVID-19. Thus, in particular, a clinically significant improvement of the skin condition was recorded. In patient B., alanine aminotransferase activity decreased to 44.4 U/L and aspartate aminotransferase activity to 18.2 U/L. In turn, in patient M. the activity of liver enzymes decreased to 37.8 U/L and 34.7 U/L, respectively. The prescription of this drug can be considered pathogenetically justified, given the effect of glycyrrhizic acid on the production of key cytokines involved in the inflammatory process in psoriasis, coronavirus infection and liver pathology. In addition, the hypothesis of the ability of glycyrrhizic acid to prevent the entry of SARS-CoV-2 into the cell by reducing the expression of angiotensin-converting enzyme 2 is of interest.

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