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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="review-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Pediatrician (St. Petersburg)</journal-id><journal-title-group><journal-title xml:lang="en">Pediatrician (St. Petersburg)</journal-title><trans-title-group xml:lang="ru"><trans-title>Педиатр</trans-title></trans-title-group></journal-title-group><issn publication-format="print">2079-7850</issn><issn publication-format="electronic">2587-6252</issn><publisher><publisher-name xml:lang="en">Eco-Vector</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">106326</article-id><article-id pub-id-type="doi">10.17816/PED12677-88</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Reviews</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Обзоры</subject></subj-group><subj-group subj-group-type="article-type"><subject>Review Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Is psoriasis therapy an art based on experience?</article-title><trans-title-group xml:lang="ru"><trans-title>Терапия псориаза — искусство, основанное на опыте?</trans-title></trans-title-group><trans-title-group xml:lang="zh"><trans-title/></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5936-6232</contrib-id><contrib-id contrib-id-type="spin">5832-9510</contrib-id><name-alternatives><name xml:lang="en"><surname>Zaslavsky</surname><given-names>Denis V.</given-names></name><name xml:lang="ru"><surname>Заславский</surname><given-names>Денис Владимирович</given-names></name><name xml:lang="zh"><surname></surname><given-names></given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, PhD, Dr. Sci. (Med.), Professor, Department of Dermatovenereology</p></bio><bio xml:lang="ru"><p>д-р мед. наук, профессор кафедры дерматовенерологии</p></bio><email>Venereology@gmail.com</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="spin">2423-6196</contrib-id><name-alternatives><name xml:lang="en"><surname>Chuprov</surname><given-names>Igor N.</given-names></name><name xml:lang="ru"><surname>Чупров</surname><given-names>Игорь Николаевич</given-names></name><name xml:lang="zh"><surname></surname><given-names></given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, PhD, Dr. Sci. (Med.), Professor, Department of the Pathological Anatomy</p></bio><bio xml:lang="ru"><p>д-р мед. наук, профессор кафедры патологической анатомии</p></bio><email>Igorchuprov@gmail.com</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8120-2816</contrib-id><contrib-id contrib-id-type="spin">5446-0950</contrib-id><name-alternatives><name xml:lang="en"><surname>Nasyrov</surname><given-names>Ruslan A.</given-names></name><name xml:lang="ru"><surname>Насыров</surname><given-names>Руслан Абдуллаевич</given-names></name><name xml:lang="zh"><surname></surname><given-names></given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, PhD, Dr. Sci. (Med.), Professor, Head, Department of Pathological Anatomy with a Course of Forensic Medicine</p></bio><bio xml:lang="ru"><p>д-р мед. наук, профессор, заведующий кафедрой патологической анатомии с курсом судебной медицины</p></bio><email>rrmd@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="spin">2460-4480</contrib-id><name-alternatives><name xml:lang="en"><surname>Krasnogorskaya</surname><given-names>Olga L.</given-names></name><name xml:lang="ru"><surname>Красногорская</surname><given-names>Ольга Леонидовна</given-names></name><name xml:lang="zh"><surname></surname><given-names></given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, PhD, Associate Professor, Department of Pathological Anatomy with a Course of Forensic Medicine</p></bio><bio xml:lang="ru"><p>канд. мед. наук, доцент кафедры патологической анатомии с курсом судебной медицины</p></bio><email>krasnogorskaya@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Bolshakova</surname><given-names>Elena S.</given-names></name><name xml:lang="ru"><surname>Большакова</surname><given-names>Елена Семеновна</given-names></name><name xml:lang="zh"><surname></surname><given-names></given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Head, Department of Dermatovenereology</p></bio><bio xml:lang="ru"><p>заведующая отделением дерматовенерологии</p></bio><email>Bolena2007@rambler.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Manylova</surname><given-names>Elena S.</given-names></name><name xml:lang="ru"><surname>Манылова</surname><given-names>Елена Сергеевна</given-names></name><name xml:lang="zh"><surname></surname><given-names></given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Dermatovenereologist</p></bio><bio xml:lang="ru"><p>врач-дерматовенеролог</p></bio><email>Tulechka78@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Mineeva</surname><given-names>Olga K.</given-names></name><name xml:lang="ru"><surname>Минеева</surname><given-names>Ольга Константиновна</given-names></name><name xml:lang="zh"><surname></surname><given-names></given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Clinical Dermatovenereologist</p></bio><bio xml:lang="ru"><p>врач-дерматовенеролог</p></bio><email>mine@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Drozdova</surname><given-names>Lyudmila N.</given-names></name><name xml:lang="ru"><surname>Дроздова</surname><given-names>Людмила Николаевна</given-names></name><name xml:lang="zh"><surname></surname><given-names></given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Dermatovenereologist</p></bio><bio xml:lang="ru"><p>врач-дерматовенеролог</p></bio><email>Luddrozd@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Shternliht</surname><given-names>Ksana V.</given-names></name><name xml:lang="ru"><surname>Штернлихт</surname><given-names>Ксана Викторовна</given-names></name><name xml:lang="zh"><surname></surname><given-names></given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Pediatrician, Head of the Department, Head of the children reception Department</p></bio><bio xml:lang="ru"><p>врач-педиатр, заведующая детским приемным отделением</p></bio><email>Sara.shtern70@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0909-7588</contrib-id><contrib-id contrib-id-type="spin">3812-8400</contrib-id><name-alternatives><name xml:lang="en"><surname>Sidikov</surname><given-names>Akmal A.</given-names></name><name xml:lang="ru"><surname>Сыдиков</surname><given-names>Акмал Абдикахарович</given-names></name><name xml:lang="zh"><surname></surname><given-names></given-names></name></name-alternatives><address><country country="UZ">Uzbekistan</country></address><bio xml:lang="en"><p>MD, PhD, Dr. Sci. (Med.), Professor, Rector</p></bio><bio xml:lang="ru"><p>д-p мед. наук, профессор, ректор</p></bio><email>Medik-85@bk.ru</email><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="spin">4466-9583</contrib-id><name-alternatives><name xml:lang="en"><surname>Kovalenko</surname><given-names>Kseniya A.</given-names></name><name xml:lang="ru"><surname>Коваленко</surname><given-names>Ксения Александровна</given-names></name><name xml:lang="zh"><surname></surname><given-names></given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Student, Department of the Dermatovenereology</p></bio><bio xml:lang="ru"><p>студентка кафедры дерматовенерологии</p></bio><email>Zgbv00@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9800-7133</contrib-id><contrib-id contrib-id-type="spin">1791-0736</contrib-id><name-alternatives><name xml:lang="en"><surname>Brazhnikova</surname><given-names>Alena P.</given-names></name><name xml:lang="ru"><surname>Бражникова</surname><given-names>Алена Петровна</given-names></name><name xml:lang="zh"><surname></surname><given-names></given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Dermatovenereologist, Assistant</p></bio><bio xml:lang="ru"><p>Ассистент кафедры, врач-дерматовенеролог</p></bio><email>Alenapetrovna919@gmail.com</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6942-2880</contrib-id><contrib-id contrib-id-type="spin">3783-8565</contrib-id><name-alternatives><name xml:lang="en"><surname>Kozlova</surname><given-names>Dariya V.</given-names></name><name xml:lang="ru"><surname>Козлова</surname><given-names>Дарья Васильевна</given-names></name><name xml:lang="zh"><surname></surname><given-names></given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Student, employee, Department of Dermatovenereology</p></bio><bio xml:lang="ru"><p>cтудентка, сотрудник отделения дерматовенерологии</p></bio><email>Dashaucheneya@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">St. Petersburg State Pediatric Medical University</institution></aff><aff><institution xml:lang="ru">Санкт-Петербургский государственный педиатрический медицинский университет</institution></aff><aff><institution xml:lang="zh"></institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">St. Petersburg State North-Western Medical University named after I.I. Mechnikov</institution></aff><aff><institution xml:lang="ru">Северо-Западный государственный медицинский университет им. И.И. Мечникова</institution></aff><aff><institution xml:lang="zh"></institution></aff></aff-alternatives><aff-alternatives id="aff3"><aff><institution xml:lang="en">Fergana Medical Institute of Public Health</institution></aff><aff><institution xml:lang="ru">Ферганский медицинский институт общественного здоровья</institution></aff><aff><institution xml:lang="zh"></institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2022-04-18" publication-format="electronic"><day>18</day><month>04</month><year>2022</year></pub-date><volume>12</volume><issue>6</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><issue-title xml:lang="zh"/><fpage>77</fpage><lpage>88</lpage><history><date date-type="received" iso-8601-date="2022-04-16"><day>16</day><month>04</month><year>2022</year></date><date date-type="accepted" iso-8601-date="2022-04-16"><day>16</day><month>04</month><year>2022</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2022, Zaslavsky D.V., Chuprov I.N., Nasyrov R.A., Krasnogorskaya O.L., Bolshakova E.S., Manylova E.S., Mineeva O.K., Drozdova L.N., Shternliht K.V., Sidikov A.A., Kovalenko K.A., Brazhnikova A.P., Kozlova D.V.</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2022, Заславский Д.В., Чупров И.Н., Насыров Р.А., Красногорская О.Л., Большакова Е.С., Манылова Е.С., Минеева О.К., Дроздова Л.Н., Штернлихт К.В., Сыдиков А.А., Коваленко К.А., Бражникова А.П., Козлова Д.В.</copyright-statement><copyright-statement xml:lang="zh">Copyright ©; 2022, Zaslavsky D., Chuprov I., Nasyrov R., Krasnogorskaya O., Bolshakova E., Manylova E., Mineeva O., Drozdova L., Shternliht K., Sidikov A., Kovalenko K., Brazhnikova A., Kozlova D.</copyright-statement><copyright-year>2022</copyright-year><copyright-holder xml:lang="en">Zaslavsky D.V., Chuprov I.N., Nasyrov R.A., Krasnogorskaya O.L., Bolshakova E.S., Manylova E.S., Mineeva O.K., Drozdova L.N., Shternliht K.V., Sidikov A.A., Kovalenko K.A., Brazhnikova A.P., Kozlova D.V.</copyright-holder><copyright-holder xml:lang="ru">Заславский Д.В., Чупров И.Н., Насыров Р.А., Красногорская О.Л., Большакова Е.С., Манылова Е.С., Минеева О.К., Дроздова Л.Н., Штернлихт К.В., Сыдиков А.А., Коваленко К.А., Бражникова А.П., Козлова Д.В.</copyright-holder><copyright-holder xml:lang="zh">Zaslavsky D., Chuprov I., Nasyrov R., Krasnogorskaya O., Bolshakova E., Manylova E., Mineeva O., Drozdova L., Shternliht K., Sidikov A., Kovalenko K., Brazhnikova A., Kozlova D.</copyright-holder><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">http://creativecommons.org/licenses/by/4.0</ali:license_ref></license></permissions><self-uri xlink:href="https://journals.eco-vector.com/pediatr/article/view/106326">https://journals.eco-vector.com/pediatr/article/view/106326</self-uri><abstract xml:lang="en"><p>Psoriasis is a chronic immune-associated skin disease of a multifactorial nature with phenotypic diversity in the general population, as well as a large number of comorbid diseases in patients. The generalized pustular psoriasis, historically was considered one of the variants of the course of psoriasis. Today some authors classify it as a genetically different condition combined with a plaque psoriasis. The selected tactics of psoriasis therapy can become a trigger for the manifestation of a pustular form. Despite the availability of modern data on the immunopathogenesis of the disease, there are no standardized methods of treatment that can take into account the individual characteristics of patients, which is doubly important in pediatric practice, since the arsenal of drugs approved for use is limited. We demonstrate the clinical case of a patient with progressive plaque psoriasis, earlier getting systemic and topical corticosteroids for a long time. This therapy did not allowed to take the course of the disease under control, even more it caused appearance of complications. Our clinical example from practice allows us to focus on the problem of complications of classical therapy for psoriasis and the intricacies of prescribing both topical and systemic drugs. Systemic therapy requires the development of algorithms based on objective diagnostic criteria and the results of studies on the effectiveness and safety of modern drugs in pediatric practice.</p></abstract><trans-abstract xml:lang="ru"><p>Псориаз — хроническое иммуно-ассоциированное воспалительное заболевание кожи с поражением опорно-двигательного аппарата мультифакториальной природы с наличием фенотипического разнообразия в общей популяции, а также большого числа коморбидных заболеваний у пациентов. Генерализованная форма пустулезного псориаза, исторически считавшаяся одним из вариантов течения псориаза, сегодня частью авторов классифицируется как сочетающееся с вульгарной формой отдельное состояние, генетически отличное. Триггером к проявлению пустулезной формы может послужить выбранная тактика терапии вульгарного псориаза. Несмотря на наличие современных данных об иммунопатогенезе заболевания, нет стандартизированных методов лечения, способных учитывать индивидуальные особенности больных, что вдвойне актуально в детской практике, так как арсенал средств, одобренных для применения, ограничен. Представлено описание клинического случая пациента с прогрессирующим бляшечным псориазом, ранее длительно получавшего системную и наружную терапию глюкокортикостероидами, которая не позволила взять течение заболевания под контроль, а наоборот стала причиной возникновения осложнений. Приведенный нами пример из клинической практики позволяет заострить внимание на проблеме осложнений классической терапии псориаза и тонкостях назначения как топических, так и системных препаратов. Системная терапия нуждается в разработке алгоритмов, основанных на объективных критериях диагностики и результатах исследований эффективности и безопасности современных лекарственных средств в детской практике.</p></trans-abstract><trans-abstract xml:lang="zh"><p/></trans-abstract><kwd-group xml:lang="en"><kwd>psoriasis</kwd><kwd>pediatrics</kwd><kwd>ustekinumab</kwd><kwd>biologic therapy</kwd><kwd>methotrexate</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>псориаз</kwd><kwd>педиатрия</kwd><kwd>устекинумаб</kwd><kwd>генно-инженерная биологическая терапия</kwd><kwd>метотрексат</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><citation-alternatives><mixed-citation xml:lang="en">Baranov AA, Volodin NN, Samsygina GA, et al. Ratsional’naya farmakoterapiya detskikh zabolevanii. Moscow: Litterra; 2007. 1163 p. (In Russ.)</mixed-citation><mixed-citation xml:lang="ru">Баранов А.А., Володин Н.Н., Самсыгина Г.А., и др. 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