MOLLUSCUM CONTAGIOSUM WITH CHILDREN: PECULIARITIES OF COURSE AND MODERN APPROACHES TO THERAPY

The article deals with the main aspects of the epidemiology and clinical course of molluscum contagiosum with children. Comparative analysis of the effectiveness  of different treatment  methods has been done. Based on the data of multicenter clinical studies, the authors concluded that the high efficiency and good tolerance  of 5% potassium hydroxide solution in the treatment  of molluscum contagiosum with children children

Innate immune factor gene expression profiles in patients with atopic dermatitis

Atopic dermatitis is a multifactorial genetically determined inflammatory skin disease characterized by itching, chronically relapsing dermatitis, age-related features of localization and morphology of lesions. The pathogenesis of atopic dermatitis is complex and includes epigenetic alterations, involved in the genomic adaptation, immune response reactions and dysfunction of the epithelial barrier that together trigger the development of atopic dermatitis. The aim of this study is to detect the expression level for IL4, IL13, IL33, TLR2, TLR9 genes in the biological materials of atopic patients.The targeted genes for further expression evaluation were selected according to our previous findings on genome-wide methylation study. We detected the cascades with the differentially methylated genes that are most likely to take place in atopic dermatitis. Thus, we investigated expression levels for the IL4, IL13, IL33, TLR2, TLR9 genes in the skin, peripheral blood mononuclear cells and whole blood cells using RT-PCR on 55 pediatric patients and 26 healthy volunteers, and on 50 adult patients. Statistical analysis was performed with the use of Kruskal-Wallis H test and Mann-Whitney U test. Targeted expression analysis revealed that in the skin samples the expression of TLR9 and IL4 was 12 times significantly lower (p < 0.0001, p < 0.0005) in the lesional skin; and there was a 6-fold decrease in case of TLR2 (p < 0.01). The results for blood mononuclear cells differed and expression levels for most of the assessed targets were significantly higher before treatment. We have also found out that those differences were strongly pronounced especially in an elder age group (12-18 y.o.). Studying the IL33 gene expression in the whole blood samples of adults revealed that its level was significantly higher in case of patients with moderate form of AD. Besides, we concluded that locally in the affected skin inflammatory immune response may dominate; in the mononuclear cells Th2 immune response apparently takes place. New insights on immunological markers and links among them may shed a light on atopic dermatitis pathogenic mechanisms. The detected molecules could play role as potential therapeutic targets and form a management approach for patients with atopic dermatitis

ЗУДЯЩИЕ ДЕРМАТОЗЫ С ХРОНИЧЕСКИМ ТЕЧЕНИЕМ В ДЕТСКОМ ВОЗРАСТЕ: СОВРЕМЕННЫЕ МЕТОДЫ ЛЕЧЕНИЯ И ЭФФЕКТИВНОГО КУПИРОВАНИЯ СУБЪЕКТИВНЫХ ЖАЛОБ

The article presents contemporary data on the peculiarities of etiology and pathogenesis of chronic itching dermatosis in children. We provide classification of various itching forms and pathophysiological mechanism of the development thereof underlying chronic skin disorders. We describe results of clinical studies of effectiveness and safety of methylprednisolone aceponate for treating itching dermatosis in children.В статье представлены современные данные об особенностях этиологии и патогенеза зудящих дерматозов с хроническим течением у детей. Приведена классификация различных форм зуда и патофизиологический механизм его развития, лежащего в основе хронических заболеваний кожи. Освещены результаты клинических исследований эффективности и безопасности метилпреднизолона ацепоната в лечении зудящих дерматозов в детском возрасте

КОНТАГИОЗНЫЙ МОЛЛЮСК У ДЕТЕЙ: ОСОБЕННОСТИ ТЕЧЕНИЯ И СОВРЕМЕННЫЕ ПОДХОДЫ К ТЕРАПИИ

The article deals with the main aspects of the epidemiology and clinical course of molluscum contagiosum with children. Comparative analysis of the effectiveness  of different treatment  methods has been done. Based on the data of multicenter clinical studies, the authors concluded that the high efficiency and good tolerance  of 5% potassium hydroxide solution in the treatment  of molluscum contagiosum with children children.В статье освещены основные особенности эпидемиологии и клинического течения контагиозного моллюска у детей. Проведен  сравнительный  анализ  эффективности  различных  методов терапии заболевания.  На основании данных многоцентровых клинических исследований  авторами сделан  вывод о высокой результативности и хорошей переносимости 5% раствора гидроксида калия при лечении контагиозного моллюска в детском возрасте

Observational study of pimecrolimus 1% cream for prevention of transcutaneous sensitization in children with atopic dermatitis during their first year of life

IntroductionEpidermal barrier dysfunction in children with atopic dermatitis can cause transcutaneous sensitization to allergens and allergic diseases. We evaluated the effectiveness of an early-intervention algorithm for atopic dermatitis treatment, utilizing pimecrolimus for long-term maintenance therapy, in reducing transcutaneous sensitization in infants.MethodThis was a single-center cohort observational study that enrolled children aged 1-4 months with family history of allergic diseases, moderate-to-severe atopic dermatitis, and sensitization to ≥ 1 of the investigated allergens. Patients who sought medical attention at atopic dermatitis onset (within 10 days) were group 1 “baseline therapy with topical glucocorticoids with subsequent transition to pimecrolimus as maintenance therapy”; patients who sought medical attention later were group 2 “baseline and maintenance therapy with topical glucocorticoids, without subsequent use of pimecrolimus”. Sensitization class and level of allergen-specific immunoglobulin E were determined at baseline, and 6 and 12 months of age. Atopic dermatitis severity was evaluated using the Eczema Area and Severity Index score at baseline and 6, 9 and 12 months of age.ResultsFifty-six and 52 patients were enrolled in groups 1 and 2, respectively. Compared with group 2, group 1 demonstrated a lower level of sensitization to cow's milk protein, egg white and house dust mite allergen at 6 and 12 months of age, and a more pronounced decrease in atopic dermatitis severity at 6, 9 and 12 months of age. No adverse events occurred.DiscussionThe pimecrolimus-containing algorithm was effective in treating atopic dermatitis and prophylaxis of early forms of allergic diseases in infants.Trial registrationhttps://clinicaltrials.gov/NCT04900948, retrospectively registered, 25 May 2021

PRINCIPLES THERAPY OF ATOPIC DERMATITIS IN CHILDHOOD IN THE ASPECT OF MODERN CONCEPTS OF THE PATHOGENESIS OF THE DISEASE

The article contains data on the key links in the pathogenesis of atopic dermatitis in children. The authors of the article have covered modern approaches to topical therapy of atopic dermatitis in children. Modern algorithms of proactive therapy and control over the course of the disease are presented

CHRONIC ITCHING DERMATOSIS IN CHILDREN: MODERN METHODS OF TREATMENT AND EFFICIENT TERMINATION OF SUBJECTIVE COMPLAINTS

The article presents contemporary data on the peculiarities of etiology and pathogenesis of chronic itching dermatosis in children. We provide classification of various itching forms and pathophysiological mechanism of the development thereof underlying chronic skin disorders. We describe results of clinical studies of effectiveness and safety of methylprednisolone aceponate for treating itching dermatosis in children

SYSTEM THERAPY OF PSORIASIS IN CHILDREN (PART I)

We include a review of modern methods of systemic therapy of psoriasis in children, indications for which are moderate and severe forms of psoriasis with PASI > 10, skin pathological process that is uncontrollable with topical drugs, skin lesions with functional localization (lesions of genitals, palms and soles, facial skin), erythrodermic psoriasis, pustular psoriasis, psoriatic arthritis. We provide information on the techniques of narrow-band phototherapy (UVB 311 nm) that are used in the treatment of psoriasis in children. We provide data on efficacy, safety, necessary monitoring of clinical and laboratory indicators, peculiarities of vaccination during treatment of children with acitretin, methotrexate, cyclosporine

Systemic Psoriasis Treatment at an Early Age (Part II): Issues of Biological Therapy

The authors present an overview of the present day knowledge of methods of biological therapy used for treatment of severe psoriasis at an early age. Data is presented on efficiency, safety, required monitoring of clinical and laboratory performance, specifics of vaccination during the treatment of children with genetically engineered biological drugs. Data is presented on the authors’ own clinical observations of 10 adolescents who were administered the preparation of ustekinumab. The objective of the observational study was assessment of efficiency and safety of application of ustekinumab for treatment of severe psoriasis with children over 12 years of age. Materials and Methods. The observation covered 10 children, their average age being 15±2.8 years old, the PASI index 39.3±9.5, who were administered ustekinumab at a dose of 45 mg under a standard administration regimen. Results. The therapeutic effect was assessed based on the PASI index, which was found to decrease by 75% with 6 adolescents, and by 90% with 4 adolescents as soon as by week 14 of the therapy. As is shown by the follow-up observation, the skin pathological process was completely resolved with 80% of adolescents after 3 injections of ustekinumab, and with 100% after 4 injections. Conclusion. The preparation of ustekinumab is efficient and safe for treatment of psoriasis at an early age. As based on the PASI index as the main criterion of assessment of treatment efficiency, ustekinumab (Stelara) is the medicine of choice for treatment of severe forms of the disease from the age of 12 years old