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Objective — to increase the effectiveness of treatment of various forms of actinic keratosis (AK) with application of topical immunoregulator imiquimod in combination with carbon dioxide (СО2) laser in the form of dermal optical thermolysis (DOT). Materials and methods. 95 patients with various forms of AK were under observation. They were divided into two groups: the main group (50 persons) and the control group (45 persons). Patients of both groups used imiquimod as the main method of treatment for AK. In the main group, before applying imiquimod, additional treatment of AK zone was carried out 1 cm along the peripheral area with a СО2-laser in the form of DOT. Results and discussion. The results of treatment of patients of both groups were evaluated 10, 20 and 60 days after the last application of imiquimod. The following characteristics were analyzed: soreness during and after the procedure, speed of epidermis recovery, presence or absence of dermatoscopic signs of AK, formation of complications (scarring or dyschromic), absence or presence of disease recurrences within 2 months. It was noted that combined treatment with imiquimod and СО2-laser slowed down the epithelialization of the affected areas (up to 20 days in 37 (39.5 %) patients of the main group and only in 19 (20 %) patients of the control group), by increasing the depth and intensity of the intervention, but it slightly increased the effect of post-traumatic hyperpigmentation (after 60 days) in 5 (5.2 %) patients of the main group and in 3 (3.1 %) patients of the control group. This therapy reduced the number of AK recurrences (especially in the hyperkeratotic form) by 3.2 % compared to the imiquimod monotherapy and had a positive effect on the rate of disappearance of dermatoscopic signs of AK (20 days after the end of treatment, they were observed only in 2 (2.1 %) patients of the main group and in 7 (7.5 %) patients of the control group). Conclusions. The combined treatment of AK that includes the application of imiquimod and the use of СО2-laser is promising, etiopathogenetically justified and well tolerated.

Introduction. According to the WHO, the highest incidence of STIs / HIV-infection, including syphilis, is in prisons, which currently have more than 10 million people worldwide. The objective. To assess the current state of the spread of syphilitic infection in prisons in the context of a holistic view of sexually transmitted diseases, taking into account our own pilot studies on the prevalence of sexually transmitted infections (STIs) and HIV, as well as risk factors infection. Materials and methods. The search was performed according to the recommendations of PRISMA 2008, 2021 (The Preferred Reporting Items for Systematic reviews and Meta-Analyzes). The data of own pilot studies of 160 prisoners (80 women and 80 men) from the key risk group for STIs / HIV-infection in Ukrainian prisons are also presented, as well as some social characteristics of convicts and risk factors for syphilis are analyzed. Results. It has been confirmed that convicts as a separate social group have an increased risk of syphilis infection in penitentiary institutions of the world. At the same time, the incidence is several times higher compared to the general population. According to pilot studies, 16.3% of the surveyed convicts were diagnosed with serological markers of Treponema pallidum, including women (12.5%) and men (20%), and markers of other STIs, namely Chlamydia trachomatis (women – 37.5%, men – 15%), Ureaplasma urealyticum (5 and 62% respectively), HSV­1 (97.5 and 95%), HSV­2 (72.5 and 50%), HCV (25 and 47.5%), HBV (12.5 and 7.5%), HIV (50 and 80%), as well as the pathogens Trichomonas vaginalis (35% – women) and Neisseria gonorrhoeae (17, 5 and 2.5%, respectively) and dermatological pathology (scabies (10%), allergodermatoses (15%) – in women; psoriasis (1.3%) – in men) and tuberculosis (7.5 and 5% respectively). Risk factors for contracting STIs, including syphilis, in particular, were latent forms of infection, risky sexual behavior, drug use (women – 47.5%, men – 88%) and alcoholism (52.5 and 8.4%, respectively), repeated and long-term imprisonment (42.5 and 82.5%), no family (73.5 and 90%), tattoos (27.5 and 95%), and neglect of condom use, including number of visits while incarcerated. Conclusions. The high concentration in the institutions of the penitentiary system of key groups at risk of contracting syphilis creates a unique opportunity for scientific further research and practical application of the implementation of a number of effective therapeutic, diagnostic, organizational and preventive public health measures.

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A modern three-stage therapeutic pemphigus treatment algorithm were discussed and analyzed in the article. The main characteristics of each drug and dosage regimens were indicated. The objective. To introduce doctors-dermatovenereologists to the experience of using biological therapy in the treatment of persistent forms of pemphigus. Materials and methods. Two clinical cases of the using of the monoclonal antibodies CD20 rituximab in patients with pemphigus vulgaris and foliaceus are presented. Results. The efficiency of the using of rituximab was analyzed. It was found that monoclonal antibodies CD20 allow not only accelerate the healing of erosions in pemphigus, but also suppress the production of specific antibodies to desmoglein in the early stages of treatment, thus, reduce the corticosteroid load on the patient’s body. Conclusions. The use of modern methods of treatment of pemphigus significantly improves the prognosis of the disease. The most effective of them include the combined using of corticosteroids and monoclonal antibodies CD20.