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Goal. To obtain information on typical errors in medical aid rendered to acne patients in dermatovenerology dispensaries in St. Petersburg in order to develop measures to improve the quality of medical aid rendered to this group of patients. Materials and methods. The authors conducted a special expert examination of 55 patients with acne who received treatment at St. Petersburg dermatovenerology dispensaries in 2013. The quality of medical aid was assessed using the Automated Expert Examination Technique (hereinafter referred to as AEET). Major results. The percentage of cases when medical aid of due quality was rendered to acne patients was 49%. Treatment and diagnostics errors prevailed in the structure of errors in medical aid. Errors in treatment were mainly a wrong combination of drugs, simultaneous administration of external and systemic antibacterial drugs, delayed comedolytic therapy and pathogenically infeasible therapy. Errors in diagnostics included absence of indications of the form and/or severity of acne. The most important error in the collection of information was absence of gynecology examinations for women to determine whether peroral contraceptives were necessary including in case of the administration of isotretinoin. Conclusion. The similarity of errors in medical aid rendered for acne as well as high percentage of errors relating to medical aid rendered to patients demand the development of consistent measures to improve the quality of medical aid rendered to such patients and repeated expert examination using preliminary (prompt) control of the quality of medical aid.

The concept of the exposome, formulated more than fifteen years ago, is increasingly discussed in the modern scientific literature. The term “exposome” is understood as a cumulative measure of the impact of environmental factors on an individual throughout his or her life (from the prenatal period to death) and the biological response associated with it. The sum of these factors has a significant impact on the occurrence, course, and treatment efficacy of multifactorial diseases. The skin is a border organ and is constantly exposed to environmental influences, i.e., it is a target for the exposome. The influence of the latter components has been described in skin aging, atopic dermatitis, and malignant skin neoplasms. Acne is one of the most common chronic inflammatory dermatoses. Over the past decade, the worldwide increase in the incidence of acne, its early onset and a prolonged course, affecting adult men and women, has been noted. The review presents an analysis of the data on the effects of the components of the exposome – diet, medications, stress, and pollutants - on the course of acne. Particular attention is paid to the few data on the nature of interaction between the components of the exposome and the skin microbiome, which, on the one hand, is involved in the pathogenesis of dermatoses, including acne, and, on the other hand, is changed under the influence of exposome factors, acting as an intermediary between the environment and the human body. The search for environmental factors has at least two objectives: the discovery of potential pathogenetic links, the strength of their relationship with the clinical manifestations of the disease to develop new therapies aimed at new targets; and the creation and recommendation of a protective regime for factors with a proven effect on the course of the disease, for patients suffering from acne.