Vestnik dermatologii i venerologii

Rosacea is a chronic inflammatory recurrent dermatosis that significantly reduces the quality of life and is associated with social maladjustment due to its prevalence and chronic recurrent course.

Rosacea is considered as a multifactorial disease, pathogenesis of which involves immunological, vascular, and neurogenic mechanisms, as well as psychoemotional condition, lifestyle factors, various external factors, and genetic predisposition. At the same time, recent studies of this disease have identified one key factor integrating all pathogenesis implications into a single pathophysiological process.

This review provides current understanding of the key immunological mechanisms of rosacea pathogenesis (deregulation of the TLR2–KLK5–LL-37 pathway, impaired neuroimmune regulation in the skin, and specific features of the local adaptive immune response polarization).

Atopic dermatitis is a heterogeneous disease with diverse immunological endotypes. Modern methods of high-resolution molecular analysis (RNA sequencing, spatial transcriptomics, multiomix approaches) have allowed to identify various endotypes of the disease: Th2/ILC2-associated (ILC2 — type 2 innate lymphoid cells, Th — T helpers); Th22-associated; Th17/Th1 mixed; late onset endotype (with low IgE levels); ILC2- dominant endotype; minimally inflammatory endotype.

This review provides a detailed analysis of the pathogenesis mechanisms of each endotype, including unique cytokine profiles (IL-4/IL-13/IL-31, IL-22, IL-17/interferon gamma; IL — interleukin), the main cell- mediated mechanisms (resident Th2 cells, ILC2, cytotoxic CD8⁺ Th22 cells) and their direct effect on the epidermal barrier and neuroimmune interactions. The main focus of the review is justification of the targeted biological therapy (inhibitors of IL-4/IL-13, IL-13, IL-31, JAK-STAT) choice based on the dominant pathway. The strategies for stratifying patients using serum biomarkers (TARC/CCL17, IL-22, IL-17) and the transcriptomic skin profile are considered.

Endotype-based therapy personalization may represent a novel approach for management of patients with severe atopic dermatitis and resistance to conventional treatments, which allows to overcome the torpidity to the standard therapy.

Background: Palmoplantar pustular psoriasis (PPPP) is considered a clinically and pathogenetically distinct form of psoriasis; however, its molecular patterns remain insufficiently understood. The role of circulating small non-coding RNA molecules (microRNAs) in the development of phenotypic differences between plaque psoriasis and PPPP has not been fully elucidated.

Aim: To evaluate plasma microRNA expression patterns in patients with plaque psoriasis and PPPP and to identify differences between the clinical disease subtypes.

Methods: A comparative study including 38 patients with plaque psoriasis and 31 patients with PPPP was conducted. Plasma expression levels of hsa-miR-126-5p, hsa-miR-210-3p, hsa-miR-10b-5p, and hsa-miR-130a-3p were measured using quantitative real-time polymerase chain reaction with relative expression estimated using the 2^−ΔΔCt method. Statistical processing was performed using parametric and non-parametric tests adjusted for multiple comparisons.

Results: Patients with PPPP have demonstrated a statistically significant increased expression of hsa-miR-126-5p (p = 0.04) and hsa-miR-210-3p (p = 0.01) compared with plaque psoriasis. The differences in hsa-miR-10b-5p and hsa-miR-130a-3p expression were not statistically significant. Stratification by the PASI score has shown that the expression profile in PPPP was comparable to that observed in more severe forms of plaque psoriasis.

Conclusion: The identified changes in microRNA expression indicate molecular differences between the clinical phenotypes of psoriasis. Thus, hsa-miR-126-5p and hsa-miR-210-3p may be considered as potential markers of molecular activity in PPPP and require further investigation.

Background: The dermoscopic characteristics of rare skin diseases have not been studied enough. However, the number of publications related to this topic is increasing every year, which highlights a growing interest among physicians in studying the dermoscopic patterns of patients with rare skin diseases.

Aim: To expand the available data on dermoscopic characteristics of rare skin diseases.

Methods: Researchers of the Dermatology Department at the FSBI “State Research Center of Dermatovenereology and Cosmetology of the Ministry of Health of the Russian Federation” conducted a dermoscopic examination of 4 patients with rare dermatological diseases using a HEINE DELTA 20 manual dermatoscope (HEINE Optotechnik, Germany, Registration Certificate РЗН 2014/2033).

Results: The dermoscopic patterns in 4 patients with rare skin diseases (scleromyxedema, vegetating mycosis fungoides, ashy dermatosis, and Darier disease) were described.

Conclusion: The limited data on dermoscopic patterns of rare skin diseases is related to the small number of patients. The gradual accumulation of knowledge will provide a foundation for future studies focused on searching for pathognomonic dermoscopic signs, which could improve the early diagnosis of rare skin diseases.

During an interdisciplinary advisory board held in Moscow last year, experts have performed a comprehensive review concerning the problem of diaper dermatitis, the most common condition that somehow worsens the quality of life of individuals using diapers, both in adult patients and infants, including premature newborns. Discussion implicated epidemiologal and etiological issues, as well as approaches to treatment and prevention.

Experts have agreed that the basis for both the prevention and treatment of diaper dermatitis is a set of measures called ABCDE, with a special focus on protecting the skin in the area under the diaper using barrier agents (B) containing 5% dexpanthenol as an active ingredient to maintain the epidermal barrier function, moisturize the skin and exert an anti-inflammatory effect. To create a strong semi-exclusive barrier on the skin under the diaper, a dexpanthenol 5% ointment with a 25% lanolin content can be successfully used, as it meets the requirements for an optimal diaper product and is a well-studied effective and safe medication with high preventive and therapeutic potential.

The article discusses the application of hydrodermabrasion with needle-free infusion technology in the alopecia therapy as an example of the modern trend towards non-invasive treatment methods. The relevance of this approach is driven by the pursuit of enhanced safety, cost-effectiveness, and patient compliance while maintaining high therapeutic effectiveness.

The working principle of JetPeel technique is based on hydroporation — the delivery of medicinal substances into the skin using a high-speed stream of air and solution, which ensures their deep transdermal penetration without tissue damage. This study evaluated the course efficacy of a needle-free infusion procedures of the peptide serum in patients with androgenic and telogenic alopecia. Clinical observations have demonstrated positive changes such as increased number and thickness of terminal hairs, reduced anisothrichosis, and improvement of concomitant seborrheic dermatitis manifestations.

These data, consistent with the results of other studies, allow for the conclusion that JetPeel technology is a promising, effective, and comfortable minimally invasive method for the complex therapy of scalp diseases.