Summary Background Pemphigus vulgaris and pemphigus foliaceus are potentially life‐threatening autoimmune disorders triggered by IgG autoantibodies against mucosal and epidermal desmogleins. There is an unmet need for fast‐acting drugs that enable patients to achieve early sustained remission with reduced corticosteroid reliance. Objectives To investigate efgartigimod, an engineered Fc fragment that inhibits the activity of the neonatal Fc receptor, thereby reducing serum IgG levels, for treating pemphigus. Methods Thirty‐four patients with mild‐to‐moderate pemphigus vulgaris or foliaceus were enrolled in an open‐label phase II adaptive trial. In sequential cohorts, efgartigimod was dosed at 10 or 25 mg kg−1 intravenously with various dosing frequencies, as monotherapy or as add‐on therapy to low‐dose oral prednisone. Safety endpoints comprised the primary outcome. The study is registered at ClinicalTrials.gov (identifier NCT03334058). Results Adverse events were mostly mild and were reported by 16 of 19 (84%) patients receiving efgartigimod 10 mg kg−1 and 13 of 15 (87%) patients receiving 25 mg kg−1, with similar adverse event profiles between dose groups. A major decrease in serum total IgG and anti‐desmoglein autoantibodies was observed and correlated with improved Pemphigus Disease Area Index scores. Efgartigimod, as monotherapy or combined with prednisone, demonstrated early disease control in 28 of 31 (90%) patients after a median of 17 days. Optimized, prolonged treatment with efgartigimod in combination with a median dose of prednisone 0·26 mg kg−1 per day (range 0·06–0·48) led to complete clinical remission in 14 of 22 (64%) patients within 2–41 weeks. Conclusions Efgartigimod was well tolerated and exhibited an early effect on disease activity and outcome parameters, providing support for further evaluation as a therapy for pemphigus.

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Purpose of the study. To determine the safety and efficacy of 20% azelaic acid cream in the treatment of patients with papulopustular acne vulgaris. Materials and methods. 65 patients with acne vulgaris were examined. The control group consisted of 30 healthy individuals. Acne severity was evaluated according to G. Michaelsson et al. scale, Cook’s scale, absolute number of papules and pustules. Assessment of quality of life was performed. Facial skin microbiocenosis was assessed. All patients with acne vulgaris applied 20% azelaic acid cream during 15 ± 2 days. Results and discussion. The use of 20% azelaic acid cream contributed to the rapid regression of inflammatory acne. After 10 days of treatment, the number of papulopustular elements decreased in 3 times. After 10 days of therapy acne score according to G. Michaelsson et al. decreased in 1,5 times and after 15 days of treatment – in 1,9 times. After 10 days of therapy the acne score on the Cook’s scale decreased in 1,4 times. At the end of the study the acne score on the Cook’s scale was 2,4 points. There was a significant decrease in the total number of bacteria, the number of coagulase-positive staphylococci, quantity of Propionibacterium acnes on facial skin in 15 days after the start of therapy. A significant difference in the average value of the DLQI was fixed before (18,9 ± 0,31) and at the end (8,1 ± 0,54) of treatment. Conclusions. The high effectiveness of 20% azelaic acid cream in treatment of papulopustular acne vulgaris was proved. 20% azelaic acid cream provides a rapid regression of inflammatory forms of acne, reduction of total quantity of bacteria and Propionbacterium acnes on skin.

ABSTRACT. Quassia amara is a plant of the family Simaroubaceae of Northern Brazilian origin. Its use in folk medicine is widespread, especially as an antiparasitic, antifungal and antibacterial agent. Our purpose was testing a Quassia amara ethanol wood extract (QWE) on various parasites, fungi and bacteria which had not been previously screened for this ingredient.QWE was found to have a strong antiparasitic effect on Demodex spp by counting the number of mites extracted from biopsies of pustules of patients with erythematotelangiectatic and papulopustular subtypes of rosacea along a topical treatment with 4% QWE, these numbers reaching their physiological value after a 42-day course. In vitro testing of this extract on cultures of Trichomonas vaginalis collected from symptomatic patients showed a rapid inhibition of the growth of the trophozoites after 48 hours of contact. QWE also showed a marked antifungal activity on Candida spp (namely C. albicans, C. parapsilosis, C. glabrata and C. krusei, the latest at a lesser extent, and Malassezia furfur isolated from samples of infected patients, inhibiting the growth of fungi in both a time-and dose-dependent manner.The antibacterial activity of QWE was demonstrated in cultures of P. acnes and coagulase-positive Staphylococci where the growth of the bacteria was reduced in a significant manner (p<0.05) and at a lesser extent in cultures of coagulase-negative Staphylococci where the growth inhibition was not statistically significant. Contrarily, QWE had no effect on the growth of Chlamydia trachomatis, but uniquely altered the morphology and quantity of chlamydial inclusions. To the best of our knowledge, this is the first time that QWE is shown to have antiparasitic activity on Trichomonas vaginalis and Demodex spp, an antifungal activity on Malassezia furfur and Candida spp and an antibacterial activity on P. acnes. 1.INTRODUCTIONQuassia amara belongs to the family of Simaroubaceae. It features a shrub or small tree growing 4 to 6 meters in height. Quassia amara is indigenous to Northern Brazil and the Guyanas and it also grows in Venezuela, Columbia, Argentina, Panama and Mexico. Its popular use as a medicinal plant is widespread in many indications, especially in gastro-intestinal disorders but also as an antimalarial. In Europe, Quassia amara is registered in the British Pharmacopoeia, but also in the Pharmacopeia of Belgium, Denmark, France, Germany, Norway, Spain, Switzerland and Sweden. Quassia amara wood contains a great number of active ingredients, mainly quassinoids (triterpenoid compounds); the most important are quassin, neoquassin, 18 hydroxyquassin and Simalikalactone D but isoquassin, parain, quassimarin, quassinol and quassol are also present. Quassinoids are the major components responsible for the biological and pharmacological activities in this family.

The study of the etiology and pathogenesis of allergic skin diseases, as well as a reasonable selection of their optimal treatment are extremely relevant problems of modern medicine. Changes in the sex and gonadotropic hormones levels, which occur in patients with chronic allergic dermatoses and affect them, are studied insufficiently.The objective of this work was to study changes in levels of sex and gonadotropic hormones in patients with allergic dermatoses in older age groups and the development of effective methods of their treatment. Materials and Methods.Were examined 203 men: 36 healthy persons aged 25-44 years, 167 male aged 45-64 years (including 63 healthy males and 104 patients with chronic allergic dermatoses). The assessment of allergic dermatoses severity was conducted according to the SCORAD system. The evaluation of patients' life quality was performed by means of a DLQI questionnaire. The Aging Males Symptoms Scale was used. The concentration of testosterone, testosteron-binding globulin, follicle stimulating hormone, luteinizing hormone, prolactin were studied in blood serum by ELISA.Results. During the study it was found that male patients with chronic allergic dermatoses had significantly lower testosterone levels and significantly higher levels of follicle stimulating hormone, luteinizing hormone, prolactin, testosteron-binding globulin in comparison with the group of healthy men of similar age. Additional use of drug on the basis of steroidal saponins in the complex therapy of male patients aged 45-64 years with chronic allergic dermatoses had a positive clinical effect, which manifested by reduction of SCORAD index, DLQI index, Aging Males Symptoms Scale index and also normalized the level of testosterone. Additional use of nootropic drug in this cohort of patients had positive clinical effect, which manifested by reduction of SCORAD index, DLQI index, Aging Males Symptoms Scale index and also normalized the levels of testosterone, follicle stimulating hormone, luteinizing hormone and prolactin. Conclusions.The obtained results indicate the existence of age-related dishormonal state in male patients aged 45-64 years with chronic allergic dermatoses. The results of investigation substantiate the feasibility of corrective measures in male patients with allergic chronic dermatoses, by the use of nootropic drug and drug on the basis of steroidal saponins.Хронічні алергічні захворювання шкіри у чоловіків: вплив вікового дисгормонального статусу Н. Ю. РезніченкоВивчення етіології та патогенезу алергічних захворювань шкіри, як і вибір оптимального лікування, являють собою надзви-чайно важливі проблеми сучасної медицини. Зміни рівнів статевих і гонадотропних гормонів, що відбуваються в пацієнтів із хронічними алергічними дерматозами та впливають на них, вивчені недостатньо.Мета роботи -вивчити зміни рівнів статевих і гонадотропних гормонів у пацієнтів з алергодерматозами старших вікових груп і розробити ефективні методи їх лікування.Матеріали та методи. Обстежили 203 чоловіки: 36 здорових осіб (2...