Goal of the study: to study the efficacy and tolerance of Acnecutan for the treatment of acne in teenager patients. Materials and methods. The study involved 43 patients aged 12-18 with moderate to severe acne, who received Acnecutan* as a monotherapy. The skin process dynamics was assessed visually based on the Basic Acne Severity Index (BASI). Results. Clinical recovery was achieved in 39 patients (90.7% of all cases), and clinical improvement was observed in 4 patients (9.3%). Conclusion. The results of Acnecutan administration demonstrate a high level of its efficacy and tolerance in teenagers. To assess the stability of the results achieved and to draw final conclusions, the patients will be followed up within a year after the end of the therapy. Therefore, the drug can be recommended as a monotherapy for acne of different clinical forms in teenager patients.
Tumor necrosis factor alpha (TNF-α) is one of the key inflammatory cytokines in the pathogenesis of psoriasis and psoriatic arthritis, and its inhibition with genetically engineered biological drugs ensures control of the main symptoms of these diseases. Certolizumab pegol is a PEGylated (linked to polyethylene glycol) Fab’ fragment of a monoclonal antibody that inhibits human TNF-α. It is approved for treatment of moderate to severe plaque psoriasis and psoriatic arthritis. This review summarizes the results of randomized clinical trials of efficacy and safety of certolizumab pegol in plaque psoriasis (CIMPASI 1, CIMPASI 2, and CIMPACT) and psoriatic arthritis (Rapid-PsA). The represented data demonstrate high efficacy of certolizumab pegol is bio-naïve patients and in patients previously exposed to other TNF inhibitors or IL17 inhibitors. The absence of the Fc-fragment in certolizumab pegol ensures minimal to no placental transfer of the drug and enables its usage during the entire pregnancy.Conflict of interest: the authors state that there is no potential conflict of interest requiring disclosure in this article.
This article presents results of examination of 63 patients with atopic dermatitis (AD) aged 3 to 18 years. It was demonstrated, that in 87.3% of cases their skin was contaminated by Staphylococcus aureus. In 58.2% of cases pathogenic strains of methicillin-resistant Staphylococcus aureus (MRSA) were detected. Direct correlation between the frequency of MRSA detection and severity of the disease (r = 0,68) as well as age of children (r = 0,58) was revealed. Authors revealed high frequency of multidrug-resistant strains to a variety of antibiotics, except mupirocin, vancomycin, clindamycin, and ciprofloxacin (in the total group of MRSA the prevalence of resistant strains to these antibiotics ranged from 2% in mupirocin to 18% in ciprofloxacin, depending on the severity of AD). Algorithm of the effective combined therapy with mupirocin containing topical drugs (Supirocin ointment, Supirocin B ointment) is presented. This algorithm allowed to achieve stable clinical remission in 100% of cases.
The article presents the results of clinical studies and real practice of the effectiveness and safety of the use of a new genetically engineered biological drug Risankizumab. Skyrizi (risankizumab) is an innovative drug, it is a humanized monoclonal antibody – immunoglobulin class G1 (IgG1) – which specifcally inhibits the cytokine IL-23 by binding to its subunit p19. It is believed that cytokine IL-23, involved in inflammatory processes, is associated with a number of chronic immune-mediated diseases, including psoriasis. According to direct comparative randomized clinical trials, risankizumab is superior in effectiveness in the short term and, most importantly, in the long term most genetically engineered biologic drugs, including TNF-α inhibitors, secukinumab, ustekinumab. In the ultIMMa-1 and ultIMMa-2 studies, sPGA 0/1 and PASI 90 (p < 0.001) were achieved after 16 weeks of treatment with Skyrizi. After 16 weeks of treatment in both studies, the majority of patients achieved sPGA 0/1 (88% and 84%, respectively), and PASI 90 in both studies reached 75% of patients receiving Skyrizi. According to the LIMMitless open extended study, after completion of ultIMMa-1 and –2 (based on LOCF analysis), the proportion of patients receiving Skyrizi up to 2.5 years (136 weeks) withholding PASI 90 and PASI 100 was 87% and 63%, respectively. One of the potential advantages of IL-23 inhibitors is also the long-term maintenance of the achieved effect after treatment cessation. During patient management in the course of randomized controlled trials of phase 3, data were obtained on the high safety of the drug and the absence of signifcant risks in relation to serious infections, cardiovascular events, malignant neoplasms. The drug is effective in case of insuffcient response to adalimumab, ustekinumab, secukinumab. The article presents two clinical cases of the use of risankizumab in patients of different ages with severe psoriasis, with ineffciency or intolerance to systemic therapy, as well as in connection with the eluding effect of previously conducted treatment methods. PASI 90/100 was achieved in all patients. No adverse events were observed.
Background. Polymorphism of clinical manifestations of mental pathology in dermatology often leads to diagnostic errors and severe social exclusion of patients.Clinical case description. The presented clinical case demonstrated the similarity of the clinical picture of self-destructive dermatosis with the symptoms of pyoderma gangrenosum, which determined our differential diagnostic search. Ulcerous defects in the patient were localized in places accessible for self-destruction and did not cause severe pain characteristic of pyoderma gangrenosum. In addition, lack of association with systemic diseases, unsuccessful long-term dermatological treatment, uniformity of skin lesions, and rapid healing of skin manifestations resulting in a scar were more characteristic of self-destructive dermatosis. A pathomorphological examination of the skin revealed morphological data typical of artificial dermatitis in combination with sclerotic changes, and excluded the presence of granulomatous diseases, vasculitis, and deep purulent inflammation of the dermis (neutrophilic dermal abscesses). Thus, histological changes in the biopsy material did not correspond to the clinical skin manifestations. The constant self-destructive actions of the patient resulted in excoriations, ulcerations, with the subsequent secondary infection and conspicuous cicatricial skin changes.Conclusion. The presented clinical case demonstrated the complexity of the diagnostic search for a psychodermatological disorder due to the similarity of the clinical picture of self-destructive dermatosis with the symptoms of pyoderma gangrenosum, which led to a delayed diagnosis.
Aim. The aim was to evaluate the epidemiological situation of dermatomycosis and scabies in Krasnodar region, to identify the tendencies and the development trend of the epidemiological situation, as well as the main directions of work retrospectively and in the dynamics of 2013-2017.Materials and methods. Statistical data forms №9, №34 in the last five years, which shape the incidence of contagious dermatoses in Krasnodar region, were used in the study. The morbidity rate of the population of the region is indirectly linked to macroeconomic and social objective and subjective processes in the society.Results. The analysis of the incidence of infectious skin diseases (hereinafter – ISD) shows a negative trend for scabies and major dermatomycosis, with the exception of mycosis of the feet and hands, in the studied five-year period. Structural analysis shows the ratio of sex-age categories of patients with different nosologies: the prevalence of the feet and hands mycoses in adult female patients and microsporia in male children. The link between the number of cases of contagious skin diseases and the territorial gradation of patients was considered. Conclusion. A retrospective analysis of the epidemiological situation of dermatomycosis and scabies in Krasnodar region was conducted. Gender, age and territorial aspects of contagious dermatoses, and the development trends were identified over the analyzed period. The factors contributing to the spread of contagious dermatoses were studied: climatic features of the southern region of the Russian Federation, migration flows, and socio-economic declines. The prospects of preventive work include raising public awareness and joint activities with non-medical services with an emphasis on active detection.
Goal of the research: to determine the efficacy of a new line of Atopic cosmetic products for skin care in children suffering from atopic dermatitis. Materials and methods: The study involved three groups of 15 children aged 3-12 suffering from atopic dermatitis in each group. Subjects from Group 1 were treated with Atopic Soothing Cream, from Group 2 with Atopic Soothing Stick Cream and from Group 3 with Atopic Everyday Care Cream. Different inclusion and exclusion criteria were developed for each group, and the algorithm for the product application and efficacy criteria were determined. According to recommendations, Atopic Soothing Cream and Atopic Soothing Stick Cream were applied to clean and dry skin in the morning and in the evening for the study period of 14 days. The patients’ skin condition was assessed prior to the study and on Day 14 of the therapy; the assessment covered parameters necessary for calculating the SCORAD Index. Atopic Everyday Care Cream was applied to clean and dry skin in the morning and in the evening for 28 days. The patients’ skin condition was assessed prior to the study and on Days 14 and 28 of the therapy including the SCORAD Index and assessments of the skin hydration level of the epidermal corneous layer and transepidermal waster loss (TEWL) using the DermaLabCombo CORTEX device. According to the study results, the line of Atopic cosmetic products fully complies with the properties specified by the manufacturer, reliably improves the skin condition in children suffering from atopic dermatitis, has no irritant or sensitizing effect, and can be recommended for the complex treatment and rehabilitation of patients suffering from the pathology.
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