No 3S (2017)

In the conditions of modern reality, a doctor during outpatient reception hours must solve complex problems on the precise diagnosis of skin diseases and the selection of specific therapy in a short time. Some inflammatory diseases can mimic the proliferative/tumor process and vice versa. The risk for misdiagnosis is greater in rare diseases. In difficult cases, it is often necessary to perform a diagnostic biopsy. There is also much concern about the choice of medicines. The pharmacological industry offers an abundance of therapeutic and cosmeceutical agents, which contribute to the resolution of inflammatory processes in the skin. The article presents an overview of modern achievements in the field of non-invasive diagnostics of skin diseases and discusses actual issues of selection of topical therapy.

The review article presents clinical and epidemiological data on herpesvirus infection, in particular genital herpes. Modern potentials for the treatment of recurrent genital herpes are discussed. The main mechanisms of action of acyclic nucleosides are given. A detailed description of valaciclovir (Valvir) is presented.

In order to evaluate the effectiveness of therapy with a fixed combination of calcipotriol and betamethasone in the treatment of local psoriasis, 107 patients with psoriasis vulgaris of different localizations were examined. As a therapy, patients used a fixed combination of calcipotriol and betamethasone in the form of a gel once a day in different modes until a clinical remission or significant improvement was achieved or combination therapy, optionally including phototherapy. Thereafter, for the purpose of long-term control of the disease, the combined preparation was used as needed or by an intermittent scheme. The duration of the follow-up period was 1 year. Using monotherapy in 82.6% of patients, PAS1100 was achieved in 31 (67.4%), and PASI 75 - in 7 (15.2%) patients; using combined treatment, 38 (62.3%) patients achieved PAS1100, and 13 (21, 3%) - PASI 75. Depending on the method of application, 82.4% and 77.5% of patients managed to control the process during the year. The obtained results allow to draw a conclusion about high efficacy of this type of topical therapy in relieving exacerbations. The use of a fixed combination makes it possible to control the disease for a long time, which is accompanied by minimal side effects, a positive effect on the quality of life, and ease of use. The above mentioned components make the use of a fixed combination as the first-line method in the treatment of local psoriasis.

The article presents a brief review of modern views on atopic dermatitis as an immune-dependent skin disease with prolonged chronic course, which is characterized by certain difficulties in the organization of treatment of patients. Among them there are two main problems that require constant overcoming: high incidence of secondary infection of dermatosis due to pathogenetic disturbance of the skin microbiota of patients and a deficiency of congenital and adaptive immunity in atopic patients, as well as low adherence of patients to the topical therapy prescribed by physicians. Through the examples of high clinical efficacy and good tolerability of Triderm cream and ointment, their advantages over similar combined preparations and ways of solving existing therapeutic challenges in atopic dermatitis and other chronic immunodeficient dermatoses are discussed.

The article presents an overview of the pathological reactions of the skin to solar irradiation. Within the framework of photodermatoses, a clinical case of an unusual skin reaction to irradiation is presented: the appearance of not only disseminated small rashes on the trunk and the back of the hands, but also rashes, exactly following the shape of the palms. By way of exception, the author came to the conclusion that the cause of the phototoxic reaction in this case was azithromycin.