Psoriasis (Ps), psoriatic arthritis (PsA), and inflammatory bowel diseases (IBDs) are characterized by a progressive course and frequently lead to disability; therefore, their early diagnosis with the assessment of a clinical phenotype and unfavorable prognostic factors and the timely initiation of therapy are important tasks. The paper provides the experts agreed opinion on the definition of the early stage of Ps, PsA, and IBDs, the goals of therapy and main unfavorable prognostic factors for the course of these diseases and gives the rationale for the early use of biological agents in patients with immune-mediated inflammatory diseases.

Описан случай запоздалой диагностики позднего кардиоваскулярного сифилиса, прогрессирование которого продолжалось несмотря на проведение двух курсов терапии цефтриаксоном. У пациента имело место сочетание всех возможных осложнений сифилитического мезаортита-аортальной и коронарной недостаточности, а также веретенообразной аневризмы восходящей аорты и проксимальных отделов дуги аорты. Обсуждаются актуальные вопросы диагностики и терапии позднего сифилиса сердечно-сосудистой системы. Ключевые слова: поздний кардиоваскулярный сифилис, сифилитический мезаортит, недостаточность аортального клапана, аневризма аорты, сифилитический стеноз устьев коронарных артерий, сочетание кардиоваскулярного и нейросифилиса, эхокардиография, лечение цефтриаксоном, клинико-серологический контроль Конфликт интересов: авторы заявляют об отсутствии потенциального конфликта интересов, требующего раскрытия в данной статье.

The paper contains review of studies on microbiota and cutaneous microbiome using modern techniques of methagenomic analysis. The existing data on microflora of normal skin and among the patients with acne, seborrhoeic dermatitis, rosacea atopic dermatitis are consequently analyzed. The interaction between microbiome and innate/adaptive immunity is presented The perspectives of knowledge on microbiome both in dermatology and cosmetology are pointed out.

Despite the abundance of existing laboratory methods the diagnosis of syphilis still faces many challenges. Though direct detection of T. pallidum plays an important role in early manifest forms of the disease, serological tests remain the mainstay of diagnosis. Traditional syphilis screening algorithm based on nontreponemal tests with subsequent confirmation using treponemal tests is a standard worldwide. Recently, the ability to automate the treponemal tests promotes the increasingly widespread implementation of reverse algorithm when these tests are used for syphilis screening. None of the current serological algorithms are able to reliably differentiate between active and previously treated syphilis, which causes uncertainty in the management of patients. There is no «gold standard» for the diagnosis of neurosyphilis, ocular, auricular and visceral syphilis. The interpretation of serological tests in children born to seropositive mothers is also complicated. Diagnosis of congenital syphilis in newborns and, consequently, the prescription of antibiotic therapy often depends on assessment of the adequacy of maternal treatment during pregnancy, which leads to subjective decisions. This article provides a comparative analysis of the «Federal guidelines for the management of patients with syphilis» and their foreign analogues, discusses significant peculiarities of these guidelines and reviews current concerns and controversies in syphilis diagnosis.

A review article is addressed the issue of the diagnosis and treatment of neurosyphilis that is developing against the background of HIV-infection. HIV-infected patients are at higher risk of neurologic, ocular and auricular manifestation of syphilis as well as treatment failures and relapses. Diagnosis of neurosyphilis in HIV-positive patients is complicated because both infections cause similar changes in the cerebrospinal fluid (CSF). The effectiveness of neurosyphilis treatment in patients with HIV co-infection is difficult to estimate, since the normalization of their CSF goes slower comparing to HIV-negatives. The increase in incidence of syphilis and HIV co-infection is anticipated in the coming years. This necessitates a comprehensive study of the problem and requires the development of new approaches to neurosyphilis diagnosis and treatment in co-infected patients.