The article describes high incidence and morbidity rate of psoriasis, substantial reduction in the life quality and psychosocial disadaptation of patients, and presents certain particular features of psoriasis pathogenesis taking into consideration the role of immune mechanisms and relation between the disease and other chronic processes in the organism, as a result of which psoriasis is considered to be a multimorbid condition. The multimorbidity of psoriasis is an important factor for selecting a therapy, especially for patients with severe forms of the disease.

К л и н и ч е с к и е р е к о м е н д а ц и и Ключевые слова: междисциплинарные рекомендации, псориаз, псориатический артрит, воспалительные заболевания кишечника, болезнь Крона, язвенный колит Для цитирования: Абдулганиева ДИ, Бакулев АЛ, Белоусова ЕА, Знаменская ЛФ, Коротаева ТВ, Круглова ЛС, Кохан ММ, Лила АМ, Хайрутдинов ВР, Халиф ИЛ, Хобейш ММ. Проект междисциплинарных рекомендаций по диагностике, методам оценки степени активности воспалительного процесса, терапевтической эффективности и применению генно-инженерных биологических препаратов у пациентов с сочетанными иммуновоспалительными заболеваниями (псориаз, псориатический артрит, болезнь Крона).

Bullous dermatoses are the diseases characterized by vesication and erosion of skin and/or mucos coats, production of autoantibodies against the structural components of epidermis and/or derma. The most frequent diseases of these disorders are pemphigus, bullous pemphigoid, dermatitis herpetiformis, beningn familial chronic pemphigus (Gougerot Hailey-Hailey disease).Diagnostics of bullous dermatoses is based on assessement of clinical signs, results of cytological and histological studies and immunological tests. However none of the current diagnostic methods allows to reveal bullous dermatosis severally and with absolute certainty. Consequently it is necessary to perform wide range of clinical and laboratory tests for early diagnosis and treatment order.

Aim: to present a clinical case of a rare dermatosis — Langerhans cell histiocytosis (LCH) in an adult patient.Materials and methods. A clinical and laboratory examination of a 64-year-old woman who had complained of rashes on the skin of the scalp, neck, trunk and lower extremities accompanied by itching was carried out. A histological study of skin biopsy samples from the lesion area, as well as an immunohistochemical study of Langerhans cell markers — langerin and S-100 protein — were performed.Results. Clinical manifestations of the disease, the presence of histiocytic infiltrate in the epidermis and dermis during the histological study and immunohistochemical detection of langerin infiltrate cells and S-100 protein were all consistent with the diagnosis of LCH. The therapy with methotrexate subcutaneously significantly improved the patient’s condition.Conclusion. Verification of the LCH diagnosis requires a histological study of skin biopsy samples and an immunohistochemical study of Langerhans cell markers. The efficacy of methotrexate in the treatment of this disease has been confirmed.

Monitoring of disseminated superficial actinic porokeratosis (DSAP) in patient suffering from plaque psoriasis treated by PUVA therapy was presented. DSAP is a rare skin disease developing in the result of keratosis disorder caused by solar radiation and appearing as clearly localized ringed or line plates. As patients with DSAP are sensitive to solar radiation, phototherapy is contraindicated for them. In this regard, subcutaneous injections of Methotrexate 10 mg once a week were prescribed to a patient suffering from psoriasis. Psoriatic rashes were regressed after the second injection, instead of them DSAP rashes remained.