Функция крупных сосудов при псориазе у детей с нормальной и избыточной массой тела на фоне терапии метотрексатом

Background. In recent years, the opinion has been established that skin manifestations of psoriasis are associated with the damage of other organs and systems, and that psoriatic lesions have a systemic nature, and therefore the term ‘psoriatic disease’ is increasingly used in scientific literature. Among psoriasis comorbidities, metabolic disorders and cardiovascular diseases are of particular clinical importance. Our aim was to study the effect of systemic cytostatic therapy with methotrexate on the remodelling processes of large vessels in children with psoriasis who have normal and increased body mass index. Methods. The primary data was collected by extracting data from medical records and case follow-up records. The subsequent accumulation, storage, grouping and primary sorting of research data were carried out using a personal computer and Excel application package. Clinical evaluation of the severity of psoriasis and skin lesions was assessed by calculating the PASI index. Non-invasive oscillometric arteriography was performed on a portable ArterioGraph (TensioMed Ltd, Hungary). Results. A direct significant correlation has been established between the revealed impairments of the function of large arteries and the indicators of fat metabolism, the severity of psoriasis and body mass index. During the systemic pathogenetic cytostatic therapy with methotrexate, a significant positive dynamics of the function parameters of large arteries was revealed in children with psoriasis who have both normal and increased body mass index. Conclusion. The undertaken studies showed that methotrexate is an effective and safe agent for treating psoriasis in children aged from 3 to 18 years, has a positive effect on the function of large vessels.Nikolay N. Murashkin — receiving research funding from pharmaceutical companies Jansen, Eli Lilly. Receiving fees for scientific advice from Galderma, Pierre Fabre, Bayer, Astellas, Libriderm.Alexander I. Materikin — receiving research funding from pharmaceutical company Eli Lilly. Receiving fees for scientific advice from Bioderma, Libriderm.Обоснование. В последние годы утвердилось мнение об ассоциации кожных проявлений псориаза с поражением других органов и систем, а также о системности поражений при псориазе, в связи с чем в научной литературе все чаще применяется термин «псориатическая болезнь». Среди коморбидных псориазу состояний особое клиническое значение имеют метаболические нарушения и кардиоваскулярные заболевания. Цель исследования — изучить влияние системной цитостатической терапии метотрексатом на процессы ремоделирования крупных сосудов при псориазе у детей с нормальным и повышенным индексом массы тела. Методы. Сбор первичных данных осуществлялся путем выкопировки данных из историй болезней и карт динамического наблюдения. Последующие накопление, хранение, группировка и первичная сортировка данных исследования осуществлялись с использованием персонального компьютера и пакета прикладных программ Excel. Клиническая оценка тяжести течения псориаза и степени выраженности поражения кожного покрова оценивалась путем подсчета индекса PASI. Неинвазивная осциллометрическая артериография проводилась на портативном аппарате ArterioGraph (TensioMed Ltd, Венгрия). Результаты. Установлена прямая значимая корреляционная взаимосвязь выявленных нарушений состояния функции крупных артерий с показателями жирового обмена, тяжестью течения псориаза и индексом массы тела. На фоне проведения системной патогенетической цитостатической терапии метотрексатом выявлена значимая положительная динамика параметров функций крупных артерий у детей с псориазом как с нормальным, так и повышенным индексом массы тела. Заключение. В результате проведенных исследований установлено, что метотрексат является эффективным и безопасным средством для терапии псориаза у детей в возрасте от 3 до 18 лет, оказывает положительное влияние на функции крупных сосудов.Н.Н. Мурашкин — получение исследовательских грантов от фармацевтических компаний Jansen, Eli Lilly. Получение гонораров за научное консультирование от компаний Galderma, Pierre Fabre, Bayer, Astellas, Libriderm.А.И. Материкин — получение исследовательских грантов от фармацевтических компаний Eli Lilly. Получение гонораров за научное консультирование от компаний Bioderma, Libriderm

Вопросы профилактики и лечения пеленочного дерматита у детей в свете современных представлений о патогенезе заболевания

Diaper dermatitis is a disease belonging to the group of contact dermatitis. Clinical manifestations include skin inflammation in the area of contact with the diaper due to barrier epidermal dysfunction. The paper analyses the pathogenesis of the disease and presents data on a local clinical study on the safety and efficacy of the medication with a regenerative potential.Пеленочный дерматит принадлежит к группе контактных дерматитов и проявляется воспалением кожи в области контакта с подгузником вследствие барьерной эпидермальной дисфункции. В статье изучен патогенез заболевания, а также представлены данные о локальном клиническом исследовании безопасности и эффективности применения препарата с регенеративным потенциалом.Конфликт интересовН.Н. Мурашкин — получение исследовательских грантов от фармацевтических компаний Jansen, Eli Lilly. Получение гонораров за научное консультирование от компаний Galderma, Pierre Fabre, Bayer, ООО «Зелдис-Фарма». Л.С. Круглова — получение гонораров за научное консультирование от компаний Galderma, Bayer, Astellas, Libriderm, ООО «Зелдис-Фарма». А.И. Материкин, Э.Т. Амбарчян Р.В. Епишев — отсутствие конфликта интересов, о котором необходимо сообщить

Инновации в терапии атопического дерматита, осложненного вторичной инфекцией

Reduced skin barrier properties in patients with atopic dermatitis (AtD) are largely caused by microbiome changes and extensive Staphylococcus aureus colonisation of the skin. In this regard, the integument of patients with AtD requires constant care and the use of various emollients. The inclusion of lysates of non-pathogenic microorganisms and prebiotics in the composition of emollients ensures the normalisation of the microbiome composition and the immunological barrier of the skin. The article presents the results of our own observations on the application of two cosmetic scin-care products for damaged skin with vitamin F in children with AtD complicated by a secondary infection, while the composition of one of the products is additionally enriched with ceramides and prebiotics. The safety and high efficacy of both products have been shown, however, the presence of ceramides and prebiotics in the emollient composition makes it possible to achieve a marked decrease in the degree of S. aureus colonisation of the skin.Снижение барьерных свойств кожного покрова у пациентов с атопическим дерматитом (АтД) во многом обусловлено изменениями микробиома и обширной колонизацией кожи Staphylococcus aureus. В связи с этим наружный покров больных АтД требует постоянного ухода и использования различных эмолентов. Включение в состав эмолентов лизатов непатогенных микроорганизмов и пребиотиков обеспечивает нормализацию состава микробиома и иммунологического барьера кожи. В статье представлены результаты собственных наблюдений применения у детей с АтД, осложненным вторичной инфекцией, двух косметических средств по уходу за поврежденной кожей с витамином F, при этом состав одного из них дополнительно обогащен церамидами и пребиотиком. Показана безопасность и высокая эффективность обоих препаратов, однако наличие в составе эмолента церамидов и пребиотиков позволяет добиваться выраженного снижения степени колонизации кожного покрова S. aureus.КОНФЛИКТ ИНТЕРЕСОВН. Н. Мурашкин — получение исследовательских грантов от фармацевтических компаний Jansen, Eli Lilly. Получение гонораров за научное консультирование от компаний Galderma, Pierre Fabre, Bayer, Astellas, Libriderm.А. И. Материкин — получение исследовательских грантов от фармацевтических компаний Eli Lilly. Получение гонораров за научное консультирование от компаний Bioderma, Libriderm.Э. Т. Амбарчян — получение исследовательских грантов от фармацевтических компаний Eli Lilly. Получение гонораров за научное консультирование от компаний Jansen, Libriderm.Р. В. Епишев — получение исследовательских грантов от фармацевтических компаний Eli Lilly. Получение гонораров за научное консультирование от компаний Jansen, Libriderm.Д. В. Фёдоров подтвердил отсутствие конфликта интересов, о котором необходимо сообщит

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

The Function of Large Vessels in Normal-Weight and Overweight Children With Psoriasis During Methotrexate Therapy

Background. In recent years, the opinion has been established that skin manifestations of psoriasis are associated with the damage of other organs and systems, and that psoriatic lesions have a systemic nature, and therefore the term ‘psoriatic disease’ is increasingly used in scientific literature. Among psoriasis comorbidities, metabolic disorders and cardiovascular diseases are of particular clinical importance. Our aim was to study the effect of systemic cytostatic therapy with methotrexate on the remodelling processes of large vessels in children with psoriasis who have normal and increased body mass index. Methods. The primary data was collected by extracting data from medical records and case follow-up records. The subsequent accumulation, storage, grouping and primary sorting of research data were carried out using a personal computer and Excel application package. Clinical evaluation of the severity of psoriasis and skin lesions was assessed by calculating the PASI index. Non-invasive oscillometric arteriography was performed on a portable ArterioGraph (TensioMed Ltd, Hungary). Results. A direct significant correlation has been established between the revealed impairments of the function of large arteries and the indicators of fat metabolism, the severity of psoriasis and body mass index. During the systemic pathogenetic cytostatic therapy with methotrexate, a significant positive dynamics of the function parameters of large arteries was revealed in children with psoriasis who have both normal and increased body mass index. Conclusion. The undertaken studies showed that methotrexate is an effective and safe agent for treating psoriasis in children aged from 3 to 18 years, has a positive effect on the function of large vessels.Nikolay N. Murashkin — receiving research funding from pharmaceutical companies Jansen, Eli Lilly. Receiving fees for scientific advice from Galderma, Pierre Fabre, Bayer, Astellas, Libriderm.Alexander I. Materikin — receiving research funding from pharmaceutical company Eli Lilly. Receiving fees for scientific advice from Bioderma, Libriderm

THE ROLE OF EPIDERMAL BARRIER IMPAIRMENTS IN ATOPIC DERMATITIS: MODERN CONCEPTS OF DISEASE PATHOGENESIS

Atopic dermatitis is a common chronic inflammatory skin disease characterized by a recurring course and progressive decrease in the quality of life. Recent studies in this area demonstrate the multifaceted pathogenesis of atopic dermatitis. Interaction of such factors as epidermal dysfunction, immune system disorders, and the consequences of genetic mutations contributes not only to the development of the disease but also to its progression and chronic course. The article presents various components of the etiopathogenesis of atopic dermatitis, describes the role of lipids, thereby the new therapeutic targets are revealed to specialists

Contemporary View of the Structural and Functional Peculiarities of the Skin, Items of Care and Prevention of Dermatological Pathology in Infants

The article presents the modern knowledge of the structural and functional peculiarities of the skin in children. Information on the etiopathogenesis of a debut atopic dermatitis has been also given. The results of our own observations with an analysis of the clinical efficacy and safety of cosmetics based on highly purified lanolin and cotton extract in infants have been presented

Problems of Prevention and Treatment of Diaper Dermatitis in Children within the Current Concepts of the Disease Pathogenesis

Diaper dermatitis is a disease belonging to the group of contact dermatitis. Clinical manifestations include skin inflammation in the area of contact with the diaper due to barrier epidermal dysfunction. The paper analyses the pathogenesis of the disease and presents data on a local clinical study on the safety and efficacy of the medication with a regenerative potential

Innovations in the Therapy of Atopic Dermatitis Complicated by a Secondary Infection

Reduced skin barrier properties in patients with atopic dermatitis (AtD) are largely caused by microbiome changes and extensive Staphylococcus aureus colonisation of the skin. In this regard, the integument of patients with AtD requires constant care and the use of various emollients. The inclusion of lysates of non-pathogenic microorganisms and prebiotics in the composition of emollients ensures the normalisation of the microbiome composition and the immunological barrier of the skin. The article presents the results of our own observations on the application of two cosmetic scin-care products for damaged skin with vitamin F in children with AtD complicated by a secondary infection, while the composition of one of the products is additionally enriched with ceramides and prebiotics. The safety and high efficacy of both products have been shown, however, the presence of ceramides and prebiotics in the emollient composition makes it possible to achieve a marked decrease in the degree of S. aureus colonisation of the skin

Features and Basic Approaches to Pyoderma Topical Treatment in Children

Pyodermas are the most frequent reason for visiting dermatologists among children. The immunity to development of pyodermas is based on skin barrier the part of which is cutaneous microbiome. The microbiome composition is unique and depends on age, localization on various body regions, environment. The change of its qualitative and quantitative composition leads to the development of purulent dermal diseases characterized by clinical diversity and severe course and development of complications (without adequate treatment). In this regard the choice of the correct therapy remains relevant. The results of studies covering the effectiveness of various topic antibacterial agents are analysed. Practical aspects of pyodermia therapy in children using local therapy are illustrated