Atopic dermatitis is a common chronic dermatosis characterized by a wide variability of endotypes and phenotypes. Approaches to the treatment of atopic dermatitis are currently undergoing significant changes, especially in patients with moderate and severe forms of atopic dermatitis. JAK inhibitors according to the results of numerous studies have shown their efficacy in the treatment of various immune-mediated dermatological diseases such as atopic dermatitis, vitiligo, focal alopecia and psoriasis, etc. The article presents the experience of treating adult patients suffering from a severe form of atopic dermatitis with the selective JAK-1 inhibitor upadacitinib. The observations presented are of particular interest due to the fact that the patients were treated with upadacitinib monotherapy. It should be noted that the drug is highly effective against itching. No adverse events (including the development of infectious diseases, hematological disorders) were registered during dynamic observation (according to the results of laboratory studies).
Федеральное государственное бюджетное учреждение «Медицинский научно-образовательный центр Московского государственного университета имени М.В . Ломоносова», 119192, г. Москва, Российская Федерация 2 Федеральное государственное бюджетное учреждение дополнительного профессионального образования «Центральная государственная медицинская академия» Управления делами Президента Российской Федерации, 121359, г. Москва, Российская Федерация 3 Федеральное государственное бюджетное учреждение дополни тельного профессионального образования «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской Федерации, 125993, г. Москва, Ро ссийская Федерация РезюмеРассмотрены основные виды дерматологических иммуноопосредованных нежелательных явлений, возникающих на фоне проведения современной иммунотерапии злокачественных новообразований ингибиторами контрольных точек PD-1/PD-L1. Представлены клинические случаи, изложены подходы к наружной и системной терапии больных с данным типом иммуноопосредованных побочных эффектов. Представлен алгоритм ведения пациентов с дерматологическими нежелательными явлениями иммунотерапии с учетом клинической картины и степени тяжести.
Background. Microsporia is a zooanthroponotic mycosis of skin and hair caused by fungi genus Microsporum. Microsporia is most common among children, including infants. The microsporia incidence has slow steady increase over recent years. Clinical cases description. Follow-up results of two children of different ages (younger/older than 1 year) with microsporia are presented. Successful management approach is shown. Major limitations of drug therapy in infants as well as common therapeutic errors were analyzed. Conclusion. Diagnosis and management of microsporia in infants and young children is a challenging task. Major errors in microsporia management in patients of these age groups are associated with peculiarities of clinical picture as well as limited variations of drugs that are appropriate for the requirements on efficacy and safety of therapy among young children.
Due to the improvement of oncologic services, optimization of surgical treatment methods, and the emergence of new approaches to systemic anti-tumor therapy, a gradual decrease in the mortality rate from malignant tumors has been observed. The changing clinical spectrum of side effects that develop during the treatment of malignant tumors determines the need to optimize approaches to remedial therapy. One of the most common side effects of drug and radiation anti-tumor therapy are dermatological adverse events. The use of physical factors is a promising area in supportive oncology, including with regard to dermatological side effects. This article presents a review of scientific publications devoted to the prevention and remedial treatment of dermatological side effects of anti-tumor therapy with the use of physical factors. The high safety profile of a number of techniques and their pronounced positive therapeutic effect, allowing for the continuation of life-saving drug and/or radiation therapy, are demonstrated. Optimization of approaches to accompanying physiotherapeutic treatment of dermatological adverse events and more active introduction into practical medicine of those methods of treatment that have already proven their effectiveness and safety are an essential scientific and practical task of modern medicine.
Therapy with epidermal growth factor receptor (EGFR) inhibitors is inevitably accompanied by the phenomena of dermatological toxicity. Being, on the one hand, a favorable prognostic factor for the effectiveness of anticancer therapy, these adverse events are one of the most frequent indications for treatment withdrawal. This article presents the clinical characteristics of a wide spectrum of dermatological adverse events, as well as the pathogenetic rationale for their correction. Algorithms for prescribing of external and systemic therapy based on the assessment of severity of skin lesions and skin appendages involvement are presented.
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