Introduction. Androgenetic alopecia (AGA) is the most common type of alopecia, characterized by diffuse progressive thinning of the hair in the fronto-parietal area in patients with a genetic predisposition. Topical minoxidil remains the primary pharmacological treatment for AGA both in men and women. The efficacy in hair regrowth is reported to be between 40 and 50%.Aim. To evaluate prognostic factors of minoxidil response in AGA patients.Matherials and methods. The prospective open study was carried out. Thirty participants with AGA were enrolled and completed the study (twenty one women I–II Ludwig stage and nine men I–III Hamilton – Norwood stage). Primary outcomes consisted of measuring of hair density, telogen hair rate, the percentage of vellus hairs and hair diameter at baseline and repeated at 4 months. The SULT1A1 enzyme activity and the concentration of ATP in plucked hairs were measured at baseline. Patients were treated with 5% topical minoxidil applying daily for 4 months. In order to investigate prognostic factors in groups of responders and non-responders to minoxidil treatment these measured morphometric and biochemical characteristics were assessed.Results. After 4 months of treatment 77% of patients demonstrated hair regrowth and improvement of hair density, hair diameter and decrease of vellus hairs level. The SULT1A1 enzyme activity (p = 0.0008), the concentration of ATP (p = 0.004) in plucked hairs and baseline total hair density (p = 0.01) was significantly lower in group of non-responders compared to group of responders. The study demonstrated strong positive correlation between SULT1A1 enzyme activity and increase of total hair density (r = 0.7, р = 0.00002); moderate positive correlation was founded between concentration of ATP and increase of total hair density (r = 0.6, р = 0.0004).Conclusion. The negative prognostic factors for minoxidil treatment of AGA include SULT1A1 enzyme activity, concentration of ATP in plucked hairs and low total hair density at baseline.

Introduction. Solitary mastocytoma is a rare clinical variant of cutaneous mastocytosis that makes its debut in infancy and early childhood. Сhanges in clinical manifestations at different ages and the rate of regression of the disease are insufficiently covered in the literature.Aim. To study the clinical manifestations and timing of regression of solitary mastocytoma in children, through retrospective analysis.Materials and methods. We retrospectively reviewed data from 32 children aged 3 months to 9 years who were on outpatient treatment and observation at the State Budgetary Healthcare Institution “Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology of Moscow Health Department” in the period from 2016 to 2020 inclusive. Diagnosis information obtained from medical records.Results and discussion. The average age of disease onset was 2.5 ± 0.7 months. Solitary mastocytoma was observed more often in boys than in girls (1.4:1). In 81.2% of children, solitary mastocytoma clinically regressed before the age of 6 years. Delayed regression of rashes in the age range from 6 to 9 years was observed in 18.8% of children. Late correct diagnosis, lack of timely recommendations for care and treatment, traumatization of elements are factors that slow down the regression of the disease. Dermatoscopic examination can be used for dynamic observation of mastocytoma, since the patterns in the foci of regression differ from mature mastocytomas in the absence of yellow-orange areas. A pronounced brown pigment network on a yellow background can be a sign of the activity of the process and a reason for the appointment of symptomatic therapy.Conclusion. The clinical features of the modern course of solitary mastocytoma are the tendency to multiple rashes, the variety of localization and the long-lasting positivity of the Darier sign. Obviously, clinical monitoring using dermatoscopy and laboratory research methods allows to follow-up the activity of the process and promptly adjust drug treatment. To prevent delayed regression of solitary mastocytoma, traumatization of rashes of any localization should be excluded.

Relevance. Atopic dermatitis (AD) is an inflammatory disease characterized by a chronic course with periods of remissions and exacerbations. IgE-independent atopic dermatitis is a medical and social problem of our time, since the disease manifests itself most often in childhood and is one of the most frequent forms of dermatoses among the pediatric population. The prevalence of atopic dermatitis among children is up to 20 %, among adults - 2-8 %. Recently, there has been a significant increase in atopic diseases worldwide. The aim: to study specific features of IgE-independent atopic dermatitis in children living in a metropolis. Materials and Methods. A prospective cohort study was conducted, which included 451 children aged 5 to 14 years with a diagnosis of AD who applied for outpatient care at the Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology for the period 2020-2021. All parents (guardians) have given voluntary informed consent to the participation of children in the study and the publication of personal data. Examination of patients included general clinical methods, assessment of the SCORAD index and laboratory allergological examination (total and 73 specific IgE in blood serum with the most common food and aeroallergens). In 103 (22.8 %) children (57 (55.3 %) boys and 46 (44.7 %) girls), the results of the allergological analysis did not confirm concomitant allergic sensitization. Atopic dermatitis in these children was defined as IgE-independent. Results and Discussion. Predictors of the development of IgE-independent AD were hereditary predisposition [odds ratio (OR) 2.42; 95 % confidence interval (CI) 1.12-5.25], artificial feeding [OR 4.04; 95 % CI 1.46-11.20], comorbidities [OR 1.42; 95 % CI 0.57-3.52], late onset [OR 1.67; 95 % CI 0.81-3.41]. According to the SCORAD index, the majority of patients (75.7 %) had a moderate degree of AD and no seasonality. Features of skin rashes corresponded to the age periods of the course of AD: erythematous-squamous forms with lichenification foci prevailed. For the first time, the features of IgE-independent atopic dermatitis in children were shown. The role of risk factors for the development of IgE-independent atopic dermatitis in children has been shown for the first time. Conclusion. IgE-independent type of AD can be diagnosed in every fifth child with AD. The study of risk factors will allow predicting the development of this type of disease.

Introduction. Colonization of the skin with S. aureus and S. epidermidis in children with atopic dermatitis leads to the initiation of inflammation and worsening of the disease. The control of overcolonization with S. aureus is an important issue in pediatric dermatological practice. At the same time, to achieve a controlled level of colonization, it is preferable to prescribe non-steroidal external agents. Activated zinc pyrithione has a wide range of complementary pharmacodynamic effects, including anti-inflammatory, pro-apoptogenic, antimicrobial, and antifungal. The article presents the results of the use of zinc pyrithione in mild IgE-independent atopic dermatitis in children. The results of the main clinical studies confirming the effect of zinc pyrithione on the microbiome in AD and the severity of the disease were analyzed.Aim. To evaluate the therapeutic and microbiological efficacy of activated zinc pyrithione as monotherapy in patients with IgEindependent atopic dermatitis.Materials and methods. 30 patients aged 2 to 8 years with mild atopic dermatitis in the acute stage were divided into 2 groups. Group 1 received activated zinc pyrithione, group 2 received a combined topical steroid.Results. Both groups showed a significant reduction in S. aureus skin colonization. In both groups, in comparison with the initial state, a significant decrease in the severity of clinical manifestations of AD was obtained. The therapeutic efficacy of zinc pyrithione was 93.3%, clinical remission was observed in 73.3% of cases.Conclusion. The totality of currently available data on the clinical efficacy and safety of activated zinc pyrithione allows us to recommend it as one of the effective agents for external therapy of mild IgE-independent atopic dermatitis. The use of activated zinc pyrithione showed a rapid, pronounced positive result of treatment, a decrease in the risk of secondary infection in observed children with IgE-independent atopic dermatitis.