SOME FEATURES OF THE CLINICAL COURSE OF LICHEN PLANUS IN THE ORAL MUCOSA. A CLINICAL CASE OF GRINSHPAN-POTEKAEV SYNDROME.

The clinical picture and course of lichen planus (LP) on the mucous membrane of the oral cavity have significant differences from its manifestations on the skin. In particular, greater resistance to treatment, which is due to the structural features of the mucous membrane, as well as the specificity of biological and physicochemical processes in the oral cavity. There are 6 clinical forms of LP of the red border of the lips and oral mucosa - typical, hyperkeratotic, exudative-hyperemic, erosive - ulcerative, bullous and atypical. The variety of clinical manifestations and low effectiveness of treatment present certain difficulties and interest not only for dentists, but also for dermatologists in terms of diagnostics and treatment of LP with localization on the oral mucosa. A clinical case of a rare triad of symptoms of erosive lichen planus (LP) of the oral cavity, hypertension and diabetes mellitus - Grinshpan-Potekaev syndrome is presented. In the described clinical case, a 65-year-old female patient took antihypertensive drugs for a long time for arterial hypertension. Type 2 diabetes mellitus was latent and was diagnosed after contacting our clinic. Complex therapy with Delagil, tetracycline, application of corticosteroid preparations and protopic cream (on the oral mucosa) along with effective antihypertensive and antidiabetic treatment led to a rapid regression of the manifestations of LP with complete epithelialization of erosions.

[PATHOGENETIC FEATURES AND METHODS FOR TREATMENT OF VARIOUS FORMS OF ROSACEA].

The aim of the work was to study the features of the pathogenesis of various clinical forms of rosacea (the presence of mite Demodex folliculorum, the determination of VEGF, IL-2 IL-6, IL-8) and, based on the obtained results, to ensure adequate methods of therapy. Mite identification was performed by microscopy. The concentration of cytokines in patients with various clinical forms of rosacea (papulopustular form 15 patients, steroid form - 15, erythematous telangiectic form - 10, Ophthalmo Rosacea - 3, rhinophyma - 3) was determined by enzyme immunoassay using appropriate monoclonal antibodies and expressed in samples. Based on the results we obtained in the local treatment of patients with papulopustular rosacea (with a high population density of demodicosis ticks and an increased concentration of IL-8 in the blood), 1% ivermectin cream was applied externally to the skin of the face 1 time per day every day for the entire course of treatment (3-4 months). In patients with erythematous-teloangiectatic form (with a high cytokine VEGF, IL-8), a combined phased use of 1% pimecrolimus cream 14 days and 0.5% bromonidine tartrate gel was administered once a day - 14 days (with a single course of 1 month). In patients with a steroid form of rosacea with a high concentration of cytokines (IL-2, IL-6, IL-8), 1% pimecrolimus was administered 2 times a day - 1 month, 1% ivermectin 1 time a day - 14 days. During therapy, patients with advanced treatment were divided into 2 groups. Patients of group 1, who received externally 1% ivermectin 1 time per day as the main therapy, in the evening for 16 weeks. Group 2 applied 1% ivermectin and 1% pimercolimus cream for 16 weeks. In group 2 patients showed a significant improvement in a shorter time (4 weeks compared to 8 weeks in 1 group of patients). Taking into account the torpid flow and the difficulty of rosacea therapy, the pathogenetic approach when choosing new external preparations, opens promising directions for further deeper study of the pathophysiological mechanisms underlying the individual clinical forms of dermatosis. At the same time, the efficacy and safety of using ivermectin, pimecrolimus, and brimonidine tartrate in the treatment of various forms of this dermatosis suggests their widespread use in practical dermatology.

[FEATURES OF ROSACEA PATHOGENESIS IN PERIMENOPAUSAL WOMEN].

In patients with rosacea, the monitoring of blood melatonin in the menopausal period, as one of the criteria for assessing the severity of the disease, seems appropriate and pathogenetically justified. The aim of this study was determination of blood melatonin, VEGF, IL-8 concentration in perimenopausal period of women suffering by rosacea. 43 to 65 years old 15 women with various clinical manifestations of rosacea, and severe climacteric syndrome were under observation. The control group consisted of 15 female patients with rosacea but without climacteric syndrome. Melatonin, VEGF,IL-8 level in serum were determined by ELISA (IBL - international - reagent), the results were expressed in pg/ml).As the results of the study showed, the concentration of vasoactive peptides in patients with rosacea differes significantly from those in the control group. Increase the concentration of cytokinesin in the blood of patients with rosacea indicate that they are playing significant role in the pathogenesis of rosaceaAccording to the results of the study, the concentration of melatonin was reduced in all patients with rosacea (the main group). The degree of reduction was in direct correlation with the severity of climacteric syndrome (11,6÷1,5 pg/ml at a rate of ≥ 20,0 pg/ml). In the control group, the melatonin concentration was approaching to the norm (19.1 pg/ml). Statistical analysis of received data revealed the correlation in between of the severity of dermatosis and changes in lipid metabolism and concentration of melatonin (R = 0,91; p <0,05) in the main group of patients (with rosacea and climacteric period). Thus, on the basis of the obtained results it can be concluded that the inclusion of melatonin-containing preparations in prescription for rosacea patients having climacteric syndrome pathogenetically is justified.

[THE ROLE OF SOME VAZOACTIVE PEPTIDES IN THE PATHOGENESIS OF EARLY FORMES OF ROSACEA AND THE HEMOSTASIS SYSTEM].

Recently, the role of vasoactive peptides has been increasingly discussed in the pathogenesis of rosacea. The most attention is paid to the growth factor of the vascular endothelium (VEGF). VEGF affects angiogenesis and survival of immature blood vessels. Cytokine contributes to an increase in the level of IL-8, which plays a role in the development of inflammation. VEGF is synthesized by activated keratinocytes as a result of various factors. In particular, after exposure to ultraviolet irradiation, the production of cytokines-IL-1 and TNF-α-is provoced, which stimulate keratinocytes to synthesize of VEGF. The latest data on the state of the coagulation system in rosacea patients indicate a shift in the functional activity of the hemostasis system toward hypercoagulability. The aim of the study was to study the relationship between changes in the concentration of certain vasoactive peptides and the parameters of the hemostasis system in patients with rosacea. The state of the hemostasis system was assessed by prothrombin and thrombin time. The content of fibrinogen, fibrinolytic activity of blood, and also prothrombin index were determined as well. The concentration of free VEGF, IL-8 in the serum was determined by the method of enzyme immunoassay In the study, patients with rosacea, according to their age, were divided into 2 groups: -I group - patients aged 35 to 45 years, II group - patients aged 45 to 65 years. As the results of the study showed, the concentration of vasoactive peptides in patients with various clinical forms of rosacea differs significantly from those in the control group. In patients with various clinical forms of rosacea, the tendency of changes in all parameters (thrombin time, prothrombin time, fibrinogen, prothrombinic index) of the state of the coagulating system of blood with the manifestation of hypercoagulability is traced. And if the change in the content of cytokines was observed equally often in all observed patients, the manifestations of hypercoagulability were most pronounced in the second group of patients (aged 45 to 65 years) Thus, the results of the study allow us to conclude that an increase in the concentration of cytokines (which are a potent provoker of changes in permeability, atony and brittleness of the vessel walls), as well as hypercoagulable phenomena, indicative of ongoing microcracking processes, are the leading links in the pathogenesis of early forms of rosacea.

[ELEMENTAL STATUS OF PATIENTS WITH VARIOUS FORMS OF VITILIGO].

Vitiligo is a multifactorial disease in which, in each specific case of its manifestation, different mechanisms of its pathogenesis and different levels of melanin formation in the skin can be involved. Skin is one of the most metabolically active organs. Carrying out a number of vital functions (barrier, protective, respiratory, excretory, metabolic, immune, etc.), it needs microelementss. Of the 92 naturally occurring chemical elements, 81 are found in the human body. Lack of the vital elements, leads to the emergence of diseases, which are based on deficiency, excess or imbalance of micro- and macroelements in the body. To assess the elemental status of patients with various forms of vitiligo, fluorescent x-ray spectroscopy was used. The method has good informativeness, since the hair most fully reflects the level of content of both toxic and vital elements. According to the results obtained, in patients with segmental vitiligo, a slight decrease in the content of manganese and copper was detected in the hair. In the group of patients with non-segmental form of vitiligo, along with a significant decrease in the concentration of basic elements (on average from 20 to 50%) copper, manganese, selenium, zinc, there was an increase in the indices of such toxic elements as lead and cadmium. The data of multi-element hair analysis, as are confirmed by well-known information about the role of certain chemical elements in the pathogenesis of vitiligo, also allow us to make new assumptions about the possible relationship between the violation of the microelement balance of the organism with the emergence and peculiarity of the flow of various forms of vitiligo. The correct approach to understanding the mechanisms of the emergence of vitiligo, will allow to offer new effective schemes for the treatment of vitiligo.

[EFFICACY OF COMBINED USE OF ANTIOXIDATIVE AND PHOTOTHERAPY IN THE TREATMENT OF VITILIGO].

Despite of numerous investigations, carried out practically in all countries of the world for the study of vitiligo and the search for its new effective therapies, pathogenic mechanisms of vitiligo are still poorly understood, and the proposed treatments are not perfect. One of the most accepted theories of the pathogenesis of vitiligo is an oxidative stress theory, according to which a series of biochemical anomalies cause oxidative stress, leading to accumulation of melanocytotoxic substances and inhibition of natural processes of detoxification with subsequent destruction of melanocytes in vitiligo focus. On the other hand, the use of antioxidants in combination with ultraviolet therapy of dermatological diseases, has been theoretically proved by biophysical studies, according to which- the antioxidants inhibit the oxidation of products, formed in the skin after ultraviolet irradiation and greatly reduce erythema sensitivity (1.5-2 times). Due to this effect, the power of radiation exposure can be approximately increased many times. Based on the foregoing, the use of antioxidants during phototherapy of vitiligo pathogenetically is justified. The aim of the study was to evaluate the therapeutic efficacy of Se ACE in treatment of patients with various forms of vitiligo. 35 patients (23 women and 12 men) aged 18 to 40 years with duration of the pathological process from 2 months to 15 years were under observation. 17 of these were diagnosed with a form of non segmental vitiligo (NSV), 18- segmental vitiligo. In 11 patients onset of the disease was not connected with any other problem, 24 noted the appearance of white spots after stress. Vitiligo patients were divided into 2 groups: the study group and the group of comparison. The study group included 17 patients (9 women and 8 men) aged 18 to 40 years with duration of the disease from 2 months to 5 years. The comparison group consisted of 18 patients (10 women and 8 men). Distribution of patients in both groups was homologous by the sex, age, duration and clinical forms of dermatosis. All patients underwent phototherapy. In the study group Selenium was used as an antioxidant, which was administered at a dose of 1 capsule 2 times a day for a month. Phototherapy was performed by means of MEDlight OCTAderm (3 times per week, the course of treatment - 15 procedures). After a course of phototherapy in combination with Selenium (study group), 1 patient had complete regimentation, in 43.5%of patients with NSV whisk of regimentation was formed, in 60.9% of patients with partial NSV we observeda partial regimentation in the form of pigmented inclusions withinthe foci of depigmentation. In the group of comparison we did not reveal any case of full regimentation, the whisk of hyperpigmentation was observed only in 34.7%, formation of pigmented inclusions within the foci of depigmentationwere revealed in 29.1% of cases. Thus, the phototherapy of vitiligoin combination with Selenium gives a well pronounced therapeutic effect, the clinical picture of which can be described as the following: high frequency, fast enough occurrence (2-3 months), cosmetic favorability-regimentation has uniform character without noticeable hyperkeratosis and peeling, as well as without any redness and hyperpigmentation.

[MELATONIN CONCENTRATION IN THE BLOOD OF VITILIGO PATIENTS WITH STRESS IN ANAMNESIS].

In recent years, despite some progress in the study of vitiligo many aspects of pathogenesis and treatment of this dermatosis remain unsolved or are highly controversial. It is believed that progression of disease is associated with a genetic predisposition, autoimmune processes and oxidative stress, but the concrete role of stress on the processes having place in the organism of vitiligo patients so far is not investigated. As we know, epiphysis is the main regulator of adaptation of the individual to the environment. An important product of secretion of the pineal gland is the hormone melatonin - a universal regulator of vital functions and biorhythms of the body. Psychoses, neuroses, depression, immunopathology are aspects of disturbances in circadian, seasonal and annual rhythms of the synthesis of this hormone. Clinical and experimental studies indicate that the hormone melatonin, which is one of the links in a stress defense mechanism of the body, has antioxidant and immunomodulatory properties. The purpose of this study was to determine plasma level of melatonin in the blood of vitiligo patients (with stress in anamnesis), depending on the clinical form and duration of the disease. 41 patients with vitiligo (16 with segmental and 25 with non-segmental form) with stress in anamnesis and duration of disease from several months to 20 years were under observation. The level of melatonin in the blood plasma was determined by ELISA (IBL - international - reagent), the results were expressed in units of pg/ml. According to the results of our study, 8 patients with segmental vitiligo had the normal level of plasma melatonin concentration (in the range of 20.2-31.1 pg/ml), in 2 cases - the level was near the norm (19.2 pg/ml). In the group of patients with non-segmental vitiligo, the level of melatonin was below the norm (12.5 pg/ml) and in 2 cases, the content of melatonin was very low - 4.05 pg / ml. Correlation analysis of melatonin levels with duration of disease have shown direct correlation just in the group of patients with non-segmental vitiligo. For a complete analysis of our results concerning of melatonin levels in the blood of patients with stress in anamnesis and for getting of some principal conclusions that will allow outline the ways to effectively treat patients with this pathology, further research is needed.

[Capillary fragility and some hemostatic parameters in patients with rosacea].

The aim of the study was to investigate the association between capillary fragility and some hemostatic parameters, lipid profile in patients with rosacea. 50 patients (30 women and 20 men) aged 35 to 65 years were under observation. Control group consisted of 50 healthy persons, adequate to comparison group by sex and age. To determine the resistance of the capillary, Rumpel-Leede cuff (tourniquet test) was used which consists in determining the formation of petechial hemorrhages on the skin in the area of ​​short-term increase in venous pressure. The hemostatic system was evaluated in terms of prothrombin and thrombin time. Content of fibrinogen and fibrinolytic activity of blood were determined also. The serum lipid profile was studied by means of the following parameters: total cholesterol, triglycerides, HDL (high density lipoprotein), LDL (low density lipoproteins). The survey revealed that in 25 patients the arm cuff test was positive, whereas in the control group, only 2 cases it was weakly positive. Manifestations of hypercoagulation were found in half of patients with a positive cuff test, almost in half of the patients an increased level of fibrinogen and the reduced fibrinolytic activity in blood serum has been revealed. Significant correlation with lipid metabolism have not been identified. Phenomenon of hypercoagulation in rosacea patients on the one hand suggests the existence of processes of microcoagulation, on the other hand the connection with the results of a cuff test can be used to predict the severity of the dermatosis and the possible risk for developing of cardiovascular disease.

[Peculiarities of cytokine status in patients with vitiligo and stress in anamnesis].

The aim of our study was to investigate the content of some proinflammatory cytokines (IL-2, IL-6) in the serum of patients with vitiligo and stress in anamnesis. Cytokine levels in serum were measured in 50 patients with vitiligo (20 men and 30 women aged from 18 to 65 years old.) All the patients were divided according to anamnesis (27 patients with stress in anamnesis and 23 patients, where the onset of the disease was not preceded by stress). Patients of both groups were similar in terms of shape (according to T. Fitzpatrick classification) and in terms of the dermatosis stages. Concomitant autoimmune or inflammatory diseases of the skin in our vitiligo patients were not observed. The cytokines in the blood serum of vitiligo patients were determined by ELISA using the corresponding monoclonal antibodies. Student's t-test was used for evaluation of statistical significance of received results (p < 0.05 was considered as a statistically significant). Content of IL-2 in the serum of patients with vitiligo, in which stress was not preceded dermatosis, was significantly higher than that in healthy individuals (25,5 ± 7,6 vs 10,5 ± 3,6 pg/ml, p < 0,05). But the same parameter in patients with stress in anamnesis was significantly lower than those in healthy individuals (3,5 ± 1,5 vs 10,5 ± 3,6 pg/l, p < 0.05). Changes in the content of IL-6 in the serum of vitiligo patients was a similar to changes in IL-2 content, and the most significant this indicator was in patients with generalized and progressive stage of the disease. Data on increased concentrations of IL-6 agree with the majority of studies conducted earlier. For a complete analysis of our results on the reduction of the cytokines (IL-2, IL-6) content in patients with a stress in anamnesis, that will allow to identify the most effective ways to treat patients with this pathology (including their cytokine status), further research is necessary.

[Angioprotectors in the treatment of rosacea].

Rosacea - a common chronic inflammatory dermatosis (3-10% of all dermatoses) primarily affecting the skin of face. Numerous methods for the treatment of rosacea are defined by the diversity of etiologic and pathogenic factors of dermatosis, its stage and clinical form. But a significant role in its development, most researchers relate to vascular disturbances. It is suggested that vascular changes in this disease are the product of two interrelated pathological processes: the disturbances in integrity and tone of the vascular wall and disorganization of perivascular connective tissue. The results of these processes are formation of a stable dilatation of skin blood vessels clinically manifested by erythema and telangiectasia. Based on foregoing, The aim of this study was evaluation of therapeutic efficacy of Rutin Forte in complex treatment and prevention of rosacea. 30 patients with an erythematous stage of rosacea were under observation (20 women and 10 men) aged 25 to 50 years. The first group (15 patients) was treated by the standard procedure (Antibiotics, systemic metronidazole, antihistamines, traditional external therapy). Patients of the second group (15 people) additionally received a Rutin Forte containing long-acting vitamin C, zinc and selenium. The drug was administered at a dose of 2 capsule per day. Duration of treatment - 2 to 3 months. Observation period after treatment were 12 months. During this period we revealed a significant reduction of erythema, recurrence of disease in the second group of patients was not observed, but in the group of comparison recurrences were detected on 3rd month of follow up and the degree of erythema reduction was significantly less. Thus, the study revealed that Rutin Forte is an effective means for the treatment and prevention of the torpid relapsing forms of rosacea on erythematous stage of dermatosis.

[Improvement of rosacea treatment based on the morphological and functional features of the skin].

Rosacea - a widespread disease sometimes aleak with severe complications, mainly affecting the skin. Irrational and inadequate treatment leads to chronicity of diseases and psychosocial disadaptation of patients. Lately, a clear upward trend in the number of patients in whom in the process of complex treatment manifestations (with the varying degrees of severity) of impaired barrier function of the skin are observed and they need the protection and restoration of the damaged stratum corneum. In patients with rosacea in order to study the function of the facial skin's horny layer we used the skin analyzer BIA (bioimpedance analysis, which in duration of 6 seconds determines the moisture content, oiliness and the softness of the skin) and significant deviations from the norm (decrease in moisture content, fatness and increased roughness) was revealed. These changes were most clearly pronounced in patients with steroid rosacea. To restore the skin barrier the drug "Episofit A" (Laboratory of Evolutionary Dermatology, France) has been used (1-2 times a day for 6 weeks). Evaluation of treatment efficacy was conducted every 2 weeks by means of a scale from 0 to 5 for parameters of dryness, erythema, peeling and expression of subjective feelings. In accordance with received results, using of Episofit A emulsion, especially on the baсkground of long-term treatment with topical steroids, had a pronounced therapeutic effect. Thus, treatment of patients with consideration of morphological and functional features of facial skin, helps to improve the results traditional therapy, and the drug is highly effective means of the new direction in skin care - corneotherapy aimed to reconstruct and protect damaged stratum corneum.

[New possibilities in the treatment of early stages of rosacea].

Rosacea is a chronic skin disease of unknown etiology, affecting the central areas of the face skin (cheeks, chin, nose, forehead) and is characterized by periods of remission and exacerbation. Currently, about 10% of the world's population suffered from rosacea. Significant role in the pathogenesis of Rosacea, most researchers reffered to vascular disorders. Pathology of the skin capillaries can be attributed with several factors, which are united by a single result - a persistent vasodilation of the skin vessels and the subsequent blood stasis. Clinically the Rosacea manifested by erythema and telangiectasia. According to Morrison (2012) in the study of the autonomic nervous system (using the vegetative index of Kerdo) the prevalence of parasympathetic tone of the autonomic nervous system has been found in Rosacea patients. The urgency of Rosacea correction in its initial stage of development is primarily due to the state of the skin blood vessels' walls, which has not only the outward manifestation, but also influencing the trophic, morphology and function of the skin in general, the progression of the disease and its transition to a more severe stage, up to rhinophym. Thus, it is advisable to carry out remedial measures in the early stages of Rosacea in order to correct the clinical manifestations of pre-rosacea and prevent development of more severe forms of the disease. Based on foregoing, objective of the study was to investigate the therapeutic efficacy of beta-blockers and drug Rozaliak in treatment of patients with Rosacea. We observed 25 patients (15 women and 10 men) aged 25 to 49 years with erythematous stage of Rrosacea. Depending on the treatment, all patients were divided into 2 groups. 13 patients (8 women and 5 men) were included in the control group who received a full comprehensive treatment complex, including short courses of antibiotics, systemic metronidazole, antihistamines, desensitizing agents, traditional external therapy (Rosamet, 0.75% metronidazole cream). 12 patients (7 women and 5 men) were included in the study group, which additionally, after the main course (up to the revealing of clinical effects), obtained Inderal (10 mg a day for 10-20 minutes before meals) and externally - Rozaliak cream (2 times a day). Patents of this group were under the close supervision of a cardiologist. The period of observation after treatment was 12 months. During this period the relapses in the group of study were not observed, while in the control group - relapses were detected already in the third month of observation. At the same time, a substantial reduction of erythema in patients with rosacea were not revealed. Thus, this study suggests that beta-blockers and Rozaliak are effective choice for the treatment of torpid relapsing forms of Rosacea on erythematous stage of disease, as well as for stable and long-term clinical remission.

[Perifolliculitis capitis abscedens et suffodiens (case report)].

Perifolliculitis capitis abscedens et suffodiens (PCAS) is rare chronic, suppurative and inflammatory scalp disease. Its aetiology and pathogenesis is not completely understood. The treatment is usually difficult and often disappointing. We report a case of 25-year-old male who presented with tender, fluctuant nodules and abscesses, with draining pus and patchy alopecia on his scalp for 3 years. A skin biopsy from scalp lesions revealed features that are characteristic of perifolliculitis. Initially, the patient was treated with periodic incision and drainage of the scalp abscesses. The answer was very poor. When admitted to our department, isotretinoin was started at daily dose of 30 mg, because initially his cholesterol and triglyceride levels were mildly increased. When dose was reduced to 10 mg the levels of cholesterol and triglyceride remained normal. A response to treatment was excellent and rapid. The treatment of PCAS represents usually difficulties and frustration for both the patient and the physician. A long course of isotretinoin can be considered as one of the most effective treatment for PCAS.

[Assessment of psoriatic nail lesions therapy by means of nail psoriasis severity index].

The problem of psoriatic nail lesions is known for a long time. According to various authors, psoriatic onychodystrophy has been diagnosed in 15-78% of patients with psoriasis. At the same time, we know that the treatment of psoriatic nail lesions is not always successful. The aim of the study was to evaluate the therapeutic efficacy of the drug onypso in the complex treatment of patients with psoriasis by means of NAPSI index. We observed 39 patients with psoriasis (20 men and 19 women at the age of 19 to 65 years with disease duration of 1 year to 25 years). The distribution of clinical manifestations of psoriatic onychodystrophy was as follow: thimble symptom -150 plates, subungual hyperkeratosis lesion type - 90 plates, onycholysis lesion type was observed in 50 plates. As a systemic treatment we used the cytostatic agent methotrexate - parenteral administration of 25 mg (once a week). In duration of total treatment course the patient received 90 -120 mg. Local treatment was provided by means of varnish onypso (once a day for 6 months). The survey revealed that at 7 weeks of treatment there was a 25 % reduction of initial value of NAPSI index, at the end of 14 weeks of therapy the above mentioned index was reduced for 50 % and at the 24 weeks for 75% respectively. It should be noted, that resolution of the cutaneous pathology was much faster than improvement of the structure of affected nail plates. Thus, drug onypso proposed for the specific treatment of nail lesions used in the complex therapy of patients with psoriasis is simple in use, accessible, compliant and highly effective. As a conclusion, we can say that NAPSI method, used to determine the extent of lesions and the effectiveness of the therapy, can objectively evaluate the dynamics of clinical pathology of the nails and adequacy of used treatment.

[New possibilities for elimination of human papillomavirus from the organism].

The variety of mechanisms of human papillomavirus (HPV) infection suggests that the success of treatment depends on the choice of a universal method, which combines the actions of etiotropic, pathogenetic and symptomatic approaches, without causing unwanted side effect. All these requirements are met by a drug based on the products of plant origin - Indinol. The observed patients with resistant forms of genital warts were divided into 3 groups: first group received the treatment according to the standard, conventional scheme; patients of the second group in addition to the standard scheme 2 times a day (for 90 days) received 2 capsules of Indinol (200 mg) and the patients of third group simultaneously with Indinol undergo infrared irradiation. The results of the observation have shown that the addition of Indinol to the standard treatment had a significant positive effect on the healing process of patients with resistant forms of genital warts. The effects of the Indinol in combination with infrared therapy revealed a statistically significant reduction (3 times) the frequency of relapses in cases of clinically sever forms of disease. Thus, during combined treatment of patients with recurrent, clinically severe forms of genital HPV, it is advisable to use the Indinol, which evidently has the well pronounced virus-eliminative and anti-recurrent actions.

[The evaluation of nitrogen metabolism and the reactivity of the organism in patients with dry skin].

It is known that in norm horny layer of the epidermis is able to retain water due to the presence of hygroscopic substances inside corneocytes in the form of so-called natural moisturizing factors (NMF), consisting of free amino acids and their derivatives, which are formed during the decay of filaggrin as well as lactic acid, urea, sugars, and intercellular lipid membranes, creating a barrier that prevents transepidermal water loss. At the same time, the results of recent studies have shown that urea--a kind of natural antioxidant that protects tissues from the accumulation of aggressive forms of oxygen. It is able to stabilize the lysosomal membranes, thus preventing autolysis of cells. The ability of urea at low concentrations to modify the reactivity of functional groups of proteins leads to conformational changes of immunoglobulin, which has an inhibitory effect on the immune system, including the diminishing impact on the development of reaginic type reactions. Urea has anti-inflammatory, hyposensitizing, and antioxidant effect. Based on the above the aim of this study was to determine the content of urea and some indicators of cellular and humoral immunity in case of chronic dermatoses, accompanied by dryness of the skin. Indicators of nitrogen metabolism of blood serum (urea. ammonia), some parameters of cellular and humoral immunity were studied in 27 patients, who according to nosological units were distributed as follows: atopic dermatitis (12), psoriasis (7), xerosis (8). In the study of the concentration of urea in the blood, and some indicators of cellular immunity, as well as the content of immunoglobulin E in the blood of our patients a decrease in the number of T--lymphocytes, mainly due to T--suppressor and raising the level of immunoglobulin E have been revealed. Specific patterns of changes in these parameters, depending on nosological unit, severity of disease and degree of dryness of the skin have also been observed.

[Psychophysical and physical methods in treatment of dermatoses, accompanied by skin dryness and itching].

Traditionally, the exacerbation of skin diseases accompanied by itching and dryness is cutting off by using of antihistamines, indifferent ointment (sometimes together with topical corticosteroids) and antipruritic local means. For the continuous application in inter-relapsing period, patients, as a rule, are offered variety of lipid-recovery beauty creams, ointments and emulsions. At the same time, such measures do not have a significant impact on the severity of itching and the cost of these drugs is quite high. Based on the above, we propose an alternative method of treatment, including use of the variety of psychophysical method of therapy (dotted self-massage) and paravertebral UV - irradiation in combination with topical emollients for treatment of chronic dermatoses, involving dryness and itching of the skin. As the results of research in the study group of patients, compared with control group receiving traditional treatment, the main symptoms (dryness, a feeling of tightening the skin, itching) subsided considerably faster (on average 5 days), 85% patients of the study group pointed to the improvement of the general emotional state, reducing severity of depression, related to skin condition, which certainly indicates an improvement in their quality of life. After 3 weeks use of the drug "Secalia" a distinct reduction in severity of flaking skin has been revealed. By the end of the observation period (1.5 months) in patients of a main group no resumption of itching or worsening of the skin was revealed. A real advantage of this method is absolute security to the absence of contraindications (except for general contraindications for physiotherapy procedures) and unwanted side effects, excellent tolerability, simplicity and ease of use. Unlike other methods of physiotherapy the complex of psycho-physical exercises can be used in the home. Availability, simplicity, and possibility of using at home, absolute safety, effectiveness against dryness and itching relief of the proposed method, allow to recommend it as a basic tool for continuous use in patients with dermatoses, which are accompanied by dryness and itching, both in combination with other basic drugs, and as a monotherapy.

[The anti-tubercular drugs in the treatment of psoriasis].

Psoriasis - systemic disease, including complex of interdependent pathogenetic links, which attach great importance to immunological disorders. According to recent years, the basis of the pathogenesis of psoriasis is the migration of T-lymphocytes from the blood into the skin, where they activate and start a cascade release of proinflammatory cytokines. The aim of the study was the assessment of therapeutic effectiveness of the phased application of Rifampicin and electropulse therapy in the treatment of patients with psoriasis. Under observation were 25 patients with vulgar psoriasis (13 women and 12 men aged from 18 to 65 years, with duration of illness from 1 month to 25 years). Rifampicin was prescribed to a daily dose of 600 mg for 60 days. Topical therapy was limited by the use of emollients. During the sessions of electropulse therapy the apparatus of elctronarcosis has been used. The state of the patients assessed 2 times a month. The effectiveness of treatment in patients receiving Rifampicin was the same regardless of the presence or absence of concomitant bacterial infection, which suggests that the positive therapeutic results of rifampicin is related not to its antibacterial, but to immunomodulatory effects. As a conclusion we can say that, the application of electropulse therapy and Rifampicin phase-treatment in patients with psoriasis reduces the period of the normalization of clinical indices for 7 days, as well as 2,5 times reduces the frequency of relapses in the year.

[Ergobat and Daivonex in complex therapy of psoriasis].

According to data received in recent years, abnormality of phosphorous-calcium metabolism is revealed in patients with psoriasis. The combination of hypocalcemia and hypophosphatemia is considered as an indication of the relative deficiency of vitamin D. The aim of this study was the assessment of therapeutic efficacy of domestic drugs Ergobat and Daivonex in the treatment of patients with psoriasis. Under observation were 25 patients with psoriasis. Patients with lesion area less than 25% of body surface have been selected for study. Progressive stage of Dermatosis has been revealed in all patients. They were divided into 2 groups. Both groups were comparable by sex, age, onset of the disease, its duration and clinical forms and the value of PASI. The application of Daivonex ointment was included in the therapy of both groups of patients. After 28 days of therapy the reliable improvement in the skin processes was achieved in the group of patients, in which along with local application of Daivonex ointment the treatment with Ergobat was used. Active regressing of psoriatic rash and jump into the stationary phase began at 2,1+/-0,1 days earlier than in the group of patients taking just Ergobat. The contents of total calcium and inorganic phosphorus in the blood serum by the end of treatment reached the normal level in the patients taking Ergobat, such a trend in the control group we have not observed. Thus, our clinical observations allow recommending the prescription of a consistent scheme of Daivonex and Ergobat treatment in order to stabilize the psoriatic process.

[Avene-50 and Ebastine in treatment and prevention of photodermatosis].

The clinical efficacy of antihistaminic preparation "Kestine" (Ebastine) in combined treatment of 50 patients suffering from photo-allergic dermatosis (15 - solar urticaria, 20 - solar erythema and 15 - solar eczema) are evaluated. Kestine in dosage of 10 mg a day was prescribed in duration of 10 days. Itch disappearance was observed in 87% of patients, reduction of itching - in 10% and in 3% of patients an itch was remain. Photo protector Avene-50 as sunburn preparation, assigned for different type of skins, has been used. This preparation fit for different demands (including prevention of both beginnings and exacerbation of photo allergic reactions) of patients. Water- and sweat-resistance of Avene-50 formula has been taken in account. Treatment caused increasing of some indices of non specific reactions (Kavetski skin test) that confirms recovery of conjunctive tissue elements' activity. Efficacy and safety of this combined method of photodermatosis treatment allow us to use it widely in dermatologic clinic.