In our previous work, we built the model of PPARγ dependent pathways involved in the development of the psoriatic lesions. Peroxisome proliferator-activated receptor gamma (PPARγ) is a nuclear receptor and transcription factor which regulates the expression of many proinflammatory genes. We tested the hypothesis that low levels of PPARγ expression promote the development of psoriatic lesions triggering the IL17-related signaling cascade. Skin samples of normally looking and lesional skin donated by psoriasis patients and psoriatic CD3+ Tcells samples (n = 23) and samples of healthy CD3+ T cells donated by volunteers (n = 10) were analyzed by real-time PCR, ELISA and immunohistochemistry analysis. We found that the expression of PPARγ is downregulated in human psoriatic skin and laser treatment restores the expression. The expression of IL17, STAT3, FOXP3, and RORC in psoriatic skin before and after laser treatment were correlated with PPARγ expression according to the reconstructed model of PPARγ pathway in psoriasis.In conclusion, we report that PPARγ weakens the expression of genes that contribute in the development of psoriatic lesion. Our data show that transcriptional regulation of PPARγ expression by FOSL1 and by STAT3/FOSL1 feedback loop may be central in the psoriatic skin and T-cells.

Introduction. PPARγ is the most studied PPAR subtype and is expressed predominantly in adipose tissue, heart, colon, kidney, spleen, intestine, skeletal muscle, liver, macrophages, and skin. In the skin, PPARγ controls the genetic regulation of gene network expression involved in cell proliferation, differentiation, and inflammatory responses. PPARγ (Peroxisome proliferator-activated receptor gamma) has only recently come to be considered a key player in the development and pathogenesis of psoriasis and psoriatic inflammatory conditions.Aim of the study. To study PPARγ gene expression in the affected skin of psoriasis patients in comparison with visually unaffected skin. To study changes in PPARγ gene expression level in psoriasis affected skin in comparison with unaffected skin in patients before and after treatment with low-level laser radiation with a wavelength of 1.27 μm.Materials and methods. Twelve patients with psoriasis participated in the study. Biopsies from unaffected skin areas were taken at a distance of about 3 cm from the affected skin. Analysis was performed by real-time PCR.Results and Discussion. We quantitatively measured PPARγ gene expression using RT-PCR in the affected skin of patients with psoriasis in comparison with visually unaffected skin in the same patients before and after treatment with low-level laser radiation with a wavelength of 1.27 μm (the short-wave part of the infrared range). The study experimentally showed a 1.3 ± 0.27-fold decrease in PPARγ gene expression in the affected skin of psoriasis patients on average. Significant increase in over-expression of PPARγ gene up to 2,13 ± 0,47 times was observed after treatment of patients with low-level laser radiation.Conclusions. PPARγ gene expression may be an indicator of the efficacy of psoriasis treatment at the molecular level, as well as become a new therapeutic target.

Stress has always been one of the triggers of hair loss. The global pandemic of COVID-19 infection has become such a factor for many people. Considering that the pathogenesis of hair loss in this infection has not been sufficiently studied yet, many authors suggest that, as the infection itself and the associated psychoemotional condition and the therapy can cause diffuse thinning of hair and androgenic alopecia. Several studies demonstrate a link between androgens involved in the pathogenesis of COVID-19 and the possible development of androgenic alopecia. Other researchers have observed many cases of telogen hair loss associated with this infection. In our practice, we also encounter diffuse hair thinning, presumably caused by COVID-19. Often, many patients do not consider necessity of consulting with doctor for hair loss. They look for medical help only when self-medication does not give the expected result. After these attempts to independently conduct therapy in some cases patients develop negative attitude towards certain drugs. In such cases, the doctor’s task is to adequately assess the patient’s condition and offer the optimal therapy in each specific case. Often, diffuse hair thinning of a telogen nature, which has arisen against the background of various infections, can be stopped without the help of drugs. The article describes the experience of applying care products with natural and innovative components in the fight against COVID-19-induced alopecia, which can be applied in the practice of a dermatologist.

1 ФГБУн «Центр теоретических проблем физико-химической фармакологии» Российской академии наук, Москва, Россия, 119991; 2 ГБУз «Московский научно-практический центр дерматовенерологии и косметологии» Департамента здравоохранения Москвы, Москва, Россия, 119071Представлены данные по клинической картине тяжелых форм псориаза и коморбидным состояниям, наблюдающимся при этом процессе. Приведены результаты комплексной терапии, включающей процедуры плазмафереза в сочетании со стандартными методами лечения. Результаты проведенного исследования показали, что данный алгоритм терапии позволил сократить время пребывания в стационаре, а также продлить ремиссию заболевания. The reports the data on the clinical presentation of severe psoriasis and comorbid conditions observed during this process. We report the results of the complex therapy including plasmapheresis in combination with standard therapies. The results of the study showed that this therapeutic algorithm resulted in shorter time of hospitalization and longer remission of the disease.Keywords: psoriasis, plasmapheresis, pharmacotherapy, comorbid conditions. Псориаз -распространенный хронический воспалительный дерматоз мультифакторной приро-ды, ассоциированный с такими системными заболе-ваниями и состояниями, как ожирение, артериаль-ная гипертензия, сахарный диабет, дислипидемия и метаболический синдром, а также с повышенным риском сердечно-сосудистых заболеваний, инфаркт миокарда и инсульт [1]. Несмотря на пристальное внимание ученых к вопросам разработки новых ме-тодов лечения и профилактики заболевания, псори-аз и сегодня остается актуальной проблемой дерма-тологии. Распространенность данного дерматоза продолжает расти как в России, так и за рубежом. Отдельного внимания заслуживают тяжелые рас-пространенные формы заболевания, а именно экс-судативная, эритродермическая, псориатический артрит. Самой частой разновидностью заболевания является хронический бляшечный псориаз, харак-теризующийся четко очерченными папулами и бляшками, покрытыми серебристо-белыми чешуй-ками. Сыпь, как правило, симметрична, однако воз-можно и односторонее, зостериформное располо-жение бляшек. Высыпания могут держаться месяца-ми и годами, локализуясь в одной или нескольких «излюбленных» областях: на коже волосистой части головы, локтей, коленей, ладоней и подошв, пояс-нично-крестцовой области, межъягодичной склад-ки. При длительном существовании бляшек, осо-бенно расположенных на пояснице и ягодицах, мо-жет наступить их инфильтрация. Выраженная вос-палительная реакция наблюдается чаще у лиц с из-быточной массой тела, при этом развиваются экс-судативные явления, иногда с бородавчатыми и па-пилломатозными разрастаниями. Повышенная экссудация влияет на характер шелушения: сере-бристый оттенок чешуек пропадает, они становятся желтоватыми, склеиваются с образованием коро-чек, плотно прилегающих к поверхности кожи.Псориатическая эритродермия может развиться за счет постепенного прогрессирования псориати-В помощь праКтиЧесКому ВраЧу

Ichthyosis is an extensive group of hereditary skin diseases characterized by keratinization disorders of the type of hyperkeratosis, which leads to the formation of scales on the skin resembling fish scales. Of all hereditary diseases of keratinization, ichthyosis is the most common disease. In many countries, there are various support groups for patients with ichthyosis, in particular, the All-Russian Charity Foundation for Helping Children with Ichthyosis, the Children- Butterflies Foundation, the Public Organization Support for People with Ichthyosis (Russia), the Foundation for Ichthyosis and Related Skin Types (USA), etc.Objective. To assess the dynamics of the incidence of congenital ichthyosis in the city of Moscow among the population of all age groups for 2015–2020, according to the data of the Moscow Scientific and Practical Centre for Dermatovenerology and Cosmetology (Russia).Materials and methods. Using federal statistical observation form No. 12 ‘Information on the number of diseases registered in patients living in the service area of a medical organization’, approved by the order of Rosstat No. 679 dated November 22, 2019, we analyzed the incidence of congenital ichthyosis in Moscow for 2015–2020.Results. Analysis of data on the incidence of congenital ichthyosis in the context of age groups of the population of the city of Moscow for 2015–2020 showed a trend towards an increase in the incidence of congenital ichthyosis. The increase in the incidence of ichthyosis was detected in almost all age groups of the city's population and was most pronounced in 2018 and 2019 in comparison with the previous time interval.Conclusions. The revealed increase in the incidence of congenital ichthyosis in Moscow may be due to both the true number of cases and the improvement in the quality and availability of primary specialized health care. An important trend is towards wider implementation in medical practice methods, which make it possible to identify a specific genetic defect, to carry out prenatal diagnostics during pregnancy, an intravital histological (pathological-anatomical) study of a skin biopsy, if necessary, differential diagnosis and verification of the diagnosis, as well as genetic counseling of parents, including to assess the birth of children with ichthyosis during pregnancy.