Vitiligo significantly affects the quality of life of patients, their social and psychological adaptation in society. It has been noted that patients with vitiligo are more likely to develop anxiety and depressive disorders, suicidal thoughts. Standard therapy regimens today often take a long time, are not enough effective and do not always meet the expectations of the patient and the dermatologist, reduces compliance to treatment. In this regard, comprehensive therapy for vitiligo remains a pressing issue to this day. Medical camouflage is a promising adjunctive or alternative therapy for vitiligo, as it allows to control the clinical manifestations of the disease. The purpose of this review is to consider the main types of medical camouflage in the Russian and foreign markets, their availability and principles of action. The PubMed database and the Internet were used to identify the most effective, affordable, and easy-to-use products available in the Russian and foreign markets. The research identified the most significant products that are most convenient to apply to the skin and are easily available for purchase by vitiligo patients in Russia. Parameters such as shape, texture, composition and effect duration were evaluated. Each group of preparations was described in detail, as well as the technique for their correct application. Thus, this review will be useful to all practicing dermatologists in controlling the clinical course of vitiligo as well as its skin manifestations.

BACKGROUND: Vitiligo is a multifactorial acquired disease characterized by the appearance of depigmented, clearly delineated patches, on various areas on the skin. Narrowband Ultraviolet B Therapy is a first-line therapy for nonsegmental vitiligo. At the same time, it often takes at least 6 months to achieve optimal results, which is not always convenient for patients, brings additional financial costs of treatment. Therefore, in most cases to reduce the number of phototherapy sessions requires the use of additional drugs aimed at stopping the progression of the process and with a minimal spectrum of side effects. AIM: to compare the effectiveness of azathioprine in combination with NB-UVB and NB-UVB monotherapy in progressive non-segmental vitiligo. MATERIALS AND METHODS: The study included 60 patients with advanced non-segmental vitiligodivided into two groups of 30 people in each. Group A patients received therapy with azathioprine in combination with NB-UVB, and Group B patients ― NB-UVB monotherapy. VASI (Vitiligo Area Scoring Index) and DLQI (Dermatology Life Quality Index) were used for all patients to evaluate therapy efficacy. RESULTS: All 60 patients diagnosed with nonsegmental progressive vitiligo completed the study and were included in the final analysis. Among patients who received the combined therapy protocol of azathioprine combined with narrowband phototherapy, a statistically more significant reduction in the severity and prevalence of the skin process was noted compared to the group of patients who received NB-UVB alone. More significant arresting of disease progression was noticed: in group A, among 30 patients, only 4 patients developed new lesions of vitiligo within 6 months of therapy, and in group B ― in 11 out of 30 patients. Group A patients showed a more significant reduction of VASI and DLQI compared to the control group. CONCLUSION: Thus, the combination of NB-UVB and azathioprine in the treatment of non-segmental vitiligo showed great efficacy in arresting and reducing of the disease activity, prevalence and severity of vitiligo. Azathioprine is well tolerated by patients and has a low spectrum of side effects, which allows its successful use to stabilize vitiligo and stimulate repigmentation of foci.

Pregnancy is a particular period in womans life. It accompanies with plenty of adaptation changes include many on skin. Pathological morphofunctional changes form a group of pregnancy-specific dermatoses. The clinical case of bullous pemphigoid of pregnancy is presented in the article. The disease occurs during pregnancy or postpartum period. The incidence is estimated to be approximately 1 in 60,000 pregnancies. Clinically, PG is characterized by intense pruritus and polymorphic skin eruptions. Skin lesions develop including erythematous patches and plaques, followed by urticarial rash and blisters. Diagnosis of the disease is based on the features of the clinical picture, complex data of pathomorphological and immunological research methods, including direct or indirect immunofluorescence, enzyme-linked immunosorbent assay (ELISA), immunohistochemical determination of a fragment of the complement component C4d and determination of serum antibodies to BP180. The most effective treatment is systemic glucocorticosteroids in combination with topical steroids and/or antihistamines. Timely diagnosing and prescribing appropriate medication are highly important in preventing intrauterine fetal suffering.

Several types of antiviral vaccines have been developed to control the spread of the disease since COVID-19 pandemic onset. Currently, many countries are taking measures aimed at increasing vaccination rates for herd immunity formation. However, with increased number of vaccinated individuals, there are more reports of possible adverse events after vaccination, including chronic dermatoses aggravation. The article describes a clinical case of polymorphic dermal vasculitis (hemorrhagic and urticaria types combination) flare up after COVID-19 vaccination in a 73-year-old woman, who was admitted to Department of Dermatology and Venereology (Sechenov University) with complaints of skin rashes in the trunk, upper and lower extremities and intense itching. The presence of comorbid diseases (ischemic heart disease; atrial fibrillation; chronic gastritis; diverticular colon disease; chronic kidney disease) and wide range of drugs intake on a regular basis made it difficult to diagnose. Due to appropriate therapy, clinical remission was achieved 2.5 months after treatment onset as a complete rashes regression on the trunk and upper extremities. The patient was given recommendations to maintain achieved therapeutic effect. The Discussion section provides up to date statistical data on the frequency of skin reactions adverse events after various COVID-19 vaccines administration and discusses possible hypotheses for such side reactions manifestation. Recommendations are given to practicing dermatologist about possible chronic dermatoses exacerbation after vaccine administration. When deciding on vaccination, potential risks should be assessed individually and each patient should be informed accordingly. Despite developed management protocols for patients with a new coronavirus infection, treatment options are still limited. The clinical experience accumulated during the pandemic period shows that COVID-19 vaccination significantly reduces disease severity, minimizes lethal outcome and restrains pandemic outbreak. Therefore, there are no certain dermatological diseases as absolute contraindications to COVID-19 vaccination.