Vol 96, No 2 (2020)

Below you will find the analysis of the first published data and international clinical recommendations for the systemic treatment of patients with moderate and severe psoriasis in the context of the COVID-19 pandemic in different countries (France, Italy, USA, Spain, and Germany).

This article is a continuation of the literature review on skin vasculitis. In the first part, information was presented on the current nomenclature and prevalence of vasculitis, pathomorphological changes in the skin, as well as diagnostic algorithms for examining patients with this pathology are reflected.

The second part of the article contains a detailed description of the elements of the skin rash with systemic and organ-specific vasculitis, presents the clinical manifestations observed with damage to other organs and systems, the development of possible complications.

The data on modern treatment tactics are summarized, modern approaches using pathogenetic and symptomatic therapy of patients with various vasculitis are reflected.

Background. The reconstructed human epidermis (RE) is an in vitro tissue-engineering construct similar to the native epidermis.

Objective. To develop a full-layer RE. Describe its structure: determine the presence of all layers of the epidermal component, including basal, spinous and granular layers and stratum corneum of the epidermis; detect the basement membrane, the border between the epidermal and mesenchymal component.

Materials and methods. Isolation of keratinocytes and fibroblasts from human donor skin. Cultivation of keratinocytes and fibroblasts in vitro under 2D conditions, cell subculturing and 3D modeling of RE, obtaining cryosections, histological staining, immunohistochemical (IHC) study with antibodies to cytokeratins 14 and 10, Ki67 protein, loricrin, laminin 5 and plectin.

Results. A technique was developed for the formation of RE. Histological examination showed that the stratification of keratinocyte layers occurs during the formation of RE. Layers are formed including basal, spinous and granular layers and stratum corneum. The IHC study has shown the proliferative activity of keratinocytes of the basal layer and has detected the presence of marker proteins of keratinocytes at different stages of differentiation. RE basal keratinocytes, like native ones, form hemidesmosomes and synthesize basement membrane proteins.

Conclusions. A full-layer human RE was obtained in vitro. RE meets all the characteristics of the native epidermis and it is suitable for basic and practical research in the field of skin biology, dermatology, and cosmetology.

A review of the literature on the etiology, pathogenesis, and evidence base of therapeutic approaches for the management of patients with Hoffman's recalcitrant dissecting folliculitis is presented. The article describes the clinic of the disease, complications and optimal therapeutic tactics at the present stage. Attention is focused on the problem of antibiotic resistance and ways to solve it. A clinical case with a successful therapeutic outcome is presented. The article is illustrated with photos on the patients from the author's archive.

The article contain the main challenges meet doctors in real practice using biologics for treatment patients with psoriasis.Different aspects and concerns have been analised from new point of view: the aims of Bx therapy (incl. control of remission, personalized goals, etc.) primary and secondary responses, immunogenicity, treatment survival, retention rate or long lasting regain of response in psoriasis patients treated by biologics.

Psoriasis is a chronic immune-mediated inflammatory disease with predominant skin lesions. External therapy is an important area of treatment for such patients. Non-steroidal anti-inflammatory drugs based on zinc pyrithione do not have side effects inherent in the glucocorticosteroid drug and can be an alternative to them. Evaluation of the effectiveness of drugs is not always convenient in humans. The use of laboratory models allows us to study changes in the clinical, histological and immunohistochemical characteristics of the skin during topical therapy.

Goal. On laboratory models of psoriasis, conduct a comparative assessment of the anti-inflammatory effectiveness of Skin-cap in comparison with other drugs.

Materials and methods. In the experiment, 50 Balb / c inbred mice were used, randomized to 5 groups. The formation of a model of psoriasis by listening to them, after which I perform euthanasia with a skin biopsy in mice. Group II mice are treated with activated zinc pyrithione cream (Skin-cap), group III - zinc pyrithione cream (Zinocap), group IV — betamethasone dipropionate cream (Akriderm) — 2 p/d — 14 days. Group V was monitored without therapy. The Clinical PASI Index (mPASI) score is given daily. On the 29 day of studies, group II-V mice undergo euthanasia and skin biopsies, which were examined histologically (epidermal thickness, severe inflammatory infiltrate) and immunohistochemical methods (Ki-67, CD3). The differences were considered significant at p<0.05.

Results. The initial mPASI index value was 7.2 [5.2—9.3]. The mPASI index in the Skin-cap group was 1.8 [1.1—3.2], zinc pyrithione 2.9 [2.1—4.2] and betamethasone dipropionate 1.3 [1.0] —3.1], which is significantly lower than in the group without therapy — 5.8 [5.0—6.8] (p <0.05). A histological examination in mice receiving zinc pyrithione-activated showed a more pronounced decrease in the thickness of the epidermis (2.7 times) than with pyrithione zinc (2 times) and, immunohistochemical analysis showed the most significant decrease in the proliferative activity of the epidermis and the number of T-lymphocytes when using betamethasone and zinc pyrithione activated.

Conclusions: it was found that the use of the drug leads to the suppression of the inflammatory process in the skin, comparable in effectiveness with a strong topical glucocorticosteroid.

Skin-cap has no atrophogenic effect, which allows us to recommend this drug for the treatment of psoriasis patients with any localization of rashes.