Introduction. The severity of the psoriatic process is associated with the involvement of the scalp, genitals, fold zones and nails in the process. The selection of effective therapy for psoriasis of difficult localizations is an urgent task of modern dermatology.Aim. To evaluate the effectiveness of treatment of moderate psoriasis and nail psoriasis with an IL-17A inhibitor in combination with a combined betamethasone dipropionate + salicylic acid ointment.Material and methods. A 12-week prospective study included data from 60 patients who were under observation at the Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology in 2020-2021. Group 1 included 30 patients who received only the biological drug IL-17 inhibitor. Group 2 included 30 patients who received an IL-17 inhibitor in combination with topical therapy with an ointment of 0.05% betamethasone dipropionate and 3% salicylic acid (Rederm). The ointment was applied twice a day in two courses of 3 weeks with a break of 6 weeks between courses. When comparing indicators between groups, Student’s t-test was used for normal samples and the Mann- Whitney test for non- Gaussian samples.Results. When comparing PASI and NAPSI in patients of group 2 who received an IL-17 inhibitor in combination with external therapy with an ointment of 0.05% betamethasone dipropionate and 3% salicylic acid 2 times a day for two courses of 3 weeks with a break of 6 weeks between courses, the index values statistically significantly decreased after 12 weeks of therapy (p = 0.003) compared to group 1 (p = 0.015).Conclusions. The study showed that patients who received an IL-17 inhibitor in combination with a combined betamethasone dipropionate + salicycylic acid ointment achieved a significantly greater effect compared to patients who received only biologics. In addition, the combination with Rederm ointment has shown greater efficacy in the treatment of psoriatic onychodystrophy, which is difficult to treat even with biologics.

In recent years, there has been an increase in the proportion of AFA in the structure of acne incidence. The etiopathogenesis of the disease is multicomponent and has not been fully elucidated. It is assumed that hormonal factors and chronic activation of innate immunity are involved in the process against the background of genetic predisposition, which are stimulated by external environmental factors: daily stress, Western-style diet, tobacco use, hormonal drugs, cosmetics. The article presents a modern classification of the clinical course of AFA and scales for assessing the severity of the course of the disease: GEA (Global Acne Severity Scale) and AFAST (Adult Female Acne Scoring Tool). AFA is predominantly characterized by a mild or moderate course. Treatment requires a personalized approach with particular attention to the individual needs and characteristics of adult women. When choosing a topical therapy, the doctor should consider the less pronounced oiliness of the skin, the slow progression of the disease with the outcome in hyperpigmentation and scarring. Modern acne treatment regimens include systemic and topical therapy along with proper basic skin care. The most effective topical agents include retinoids, which can induce a specific biological response by binding and activating retinoic acid receptors. Comedonal and mild papulopustular acne are indications for adapalene monotherapy for acne in adult women. Adaklin (0.1% adapalene) cream is a highly effective first choice for the pathogenetic treatment of AFA. Rational mono- and combination therapy with adapalene is the key to successful external therapy of mild and moderate AFA and prevention of post-acne. The review provided up-to-date, evidence-based information on the clinical presentation, etiopathogenesis, and treatment of adult female acne (AFA).

Introduction. Mastocytosis as a result of mast cell infiltration of the skin and other organs develops at any age. The relevance of this work is determined by the lack of systematic data on the pathomorphological features of the clinical forms and types of cutaneous mastocytosis, defined by the Consensus European-American Mastocytosis Group and the WHO classification in 2016. The variability of dermatological clinical manifestations in children and adults, the difficulties in interpreting laboratory tests create a problem for verifying the diagnosis and further treatment. The aim. To determine the main pathohistological features of clinical forms and types of cutaneous mastocytosis. Material and methods. The article includes data from patients who were treated and monitored at the Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology in 2019–2022. Results. The literature and own data on the characteristic pathomorphological patterns that are important for the diagnosis of mastocytosis with skin lesions in children and adults are systematized. The pathological substrate of lesions in diffuse cutaneous mastocytosis and mastocytoma was a massive infiltrate of mast cells in the papillary and reticular layers of the dermis. The histological picture in the monomorphic type of maculopapular cutaneous mastocytosis (MPCM) in children was characterized by a relatively lower density of mast cell infiltration of the papillary dermis compared to other clinical forms of mastocytosis. Also, in children, the density of mast cells in the affected skin was significantly higher compared to adults. In addition, in adults with PPCM, the  papillary dermis was less infiltrated with mast cells. This confirms the  opinion that the  monomorphic type of MPCM in children is phenotypically similar to MPCM in adults. Conclusions. Further prospective follow-up of patients may allow conclusions to be drawn about the prognostic value of pathological examination in mastocytosis in adults and children.