Vestnik dermatologii i venerologii

Background. Gonorrhea is a possible cause of pelvic inflammatory complications, reproductive health disorders and adverse pregnancy outcomes. The problem of gonococcal antimicrobial resistance remains actual.

Aims. Analysis of incidence, circumstances of case detection, and methods of laboratory examination for gonococcal infection used in the Russian Federation.

Methods. Analysis of state federal statistical surveillance data for 2011–2024.

Results. In 2011–2019, the incidence of gonorrhea decreased fivefold, the incidence of total STI — by 2.5 times. In 2020, the incidence of gonorrhea decreased by 13%, STI — 25%. After gonorrhea incidence increase in 2021 and 2022, it was reduced by 4% in 2023, by 15% in 2024. During COVID-19 pandemic, there was a decrease of proportion of patients detected in hospitals (from 1.6% in 2019 to 0.8% in 2020–2024); at medical examinations (from 3.0% in 2019 to 1.7% in 2023); and actively by dermatovenereologists (from 16.2% in 2019 to 12.4% in 2023). In 2019–2024, the proportion of cases confirmed by molecular-biological laboratory examination increased from 27 to 57%. In 2024, molecular-biological, microbiological or both methods were not used to diagnose gonococcal infection in state medical organizations respectively of 13, 42 and 5 constituent entities of the Russian Federation.

Conclusion. The distinctive features of gonorrhea incidence dynamics during COVID-19 pandemic are lack of acceleration in decline rate in 2020, and incidence increase in 2021 and 2022, due to an increase in the number of cases among Russian citizens. Against the background of a resumption of gonorrhea incidence decrease in 2023 and 2024, there is no recovery of active case detection measures. The access to highly sensitive laboratory methods in medical organizations of state healthcare system of a number of constituent entities of the Russian Federation is not ensured.

Acne is a chronic widespread skin disease that significantly reduces the quality of life of patients, in which timely, effective and safe treatment is necessary. Due to the steady increase in the number of patients with this dermatosis, the lesion of open skin areas with this disease, the progression of the disease, the development of its severe forms, most patients develop psycho-emotional disorders up to severe depression and social and professional maladaptation occurs. This requires a clear understanding of the pathogenesis of dermatosis and the appointment of pathogenetically based therapy to patients. The review presents a modern view of the pathogenesis and methods of treatment of the disease, justifies the use of basic skin care products using dermatocosmetics to increase the effectiveness of disease therapy and achieve a lasting clinical effect. The article proves the important role of restoring the skin microbiome in acne patients, tells about the positive effect of bacterial lysates and metabiotics on the skin. Based on the data of clinical studies, the expediency of adding bacterial lysates to dermatocosmetics has been proven to restore the skin barrier, reduce inflammation and better tolerability of external and systemic drugs for the treatment of acne. The possibilities of skin care for patients with acne with the help of a line of products called Cinovit are presented.

Background. IL-17 blockers have expanded the possibilities of psoriasis therapy. Their high efficacy and safety profile have been demonstrated in phase I–III studies and in real-world clinical practice. No direct comparative studies of the efficacy of drugs of this class registered in the Russian Federation have been conducted.

Aims. To compare the efficacy of psoriasis therapy using netakimab and secukinumab in real clinical practice.

Methods. A non-randomized comparative study of the efficacy of netakimab and secukinumab in patients with moderate to severe psoriasis was conducted. The study included 46 patients receiving therapy with IL-17 blockers (secukinumab, netakimab). The observation duration was 25 weeks. The proportions of patients who achieved PASI 100/90/75/50 values by 3, 12, 16 and 25 weeks from the start of therapy and the relative changes in PASI and BSA values were compared.

Results. 26 patients received secukinumab and 20 patients received netakimab therapy. The groups were comparable in clinical and demographic parameters. Due to therapy inefficiency, the study was terminated early in 1 patient in the secukinumab group and 2 patients in the netakimab group. Adverse events were not registered in either group. By week 25 of therapy, the proportion of patients with PASI 100/90/75/50 in the secukinumab group was 30,8/65,4/84,6/92,3% and 35/55/85/100% in the netakimab group, respectively. There was no statistically significant difference in the proportion of patients with PASI 100/90/75/50 within 25 weeks from the start of therapy (p = 0.515; p = 0.782; p = 0.972; p = 0.016). By the end of each additional week from the start of therapy, the mean PASI value with secukinumab therapy decreased by 25.8% (95% CI: 21.3–30.2; p < 0.001), with netakimab therapy by 22.0% (95% CI: 17.7–26.4; p < 0.001).

Conclusion. The proportion of patients achieving PASI 100/90/75/50 after 25 weeks of secukinumab and netakimab therapy was similar, with no statistically significant differences. The differences in the rate of PASI reduction between secukinumab and netakimab therapy were also no statistically significant.

Background. Taking into account the possible unity of etiopathogenetic mechanisms causing dysplastic processes of the cervix and vulva, one of the factors leading to synchronous damage to the cervix and external genitalia may be microbial-viral associations from the group of STIs.

Aims. Clinical and instrumental characteristics and evaluation of the microbial composition of clinical material obtained from the cervix and vulva in patients with vulvar lichen sclerosus (VLS) and their treatment.

Materials and methods. The study included 22 patients aged from 23 to 68 years with a diagnosis of VLS, who underwent microbiological, PCR studies, cutometry, corneometry, sebumetry, dermatoscopy, colposcopy.

Results. Simultaneous damage to the vulva and cervix occurred in 16 (72.7%) patients: in the form of cervical erosions and ectopia in 7 (31.8%); grade I–II dysplasia — 4 (18.2%); leukoplakia — 3 (13.6%); cervical polyps — 2 (9.1%). In 6 (27.3%) cases, the presence of human papillomavirus (HPV) 16/18 was noted, among these patients, HPV 16/18 was also detected in a vulvar biopsy in 4 (18.2%) women. Also, other types of HPV were detected in biopsies of the vulva in 9 (40.9%) patients: HPV 35 was detected in 4 patients (18.2%); HPV 6/11 — in 3 (13.6%); HPV 53 — in 2 (9.1%).

Conclusion. In patients with VLS, there is an increased frequency of dysplastic and dystrophic lesions of the cervix, such as erosions and ectopia of the cervix (31.8%), grade I–II dysplasia (18.2%), leukoplakia (13.6%), as well as an increased frequency of infections such as Ureaplasma Urealyticum (50.0%), HPV 16/18 (27.3%), HSV I type (36.4%), HSV II type (31.8%), as well as Gardnerella vaginalis (41.0%) and Candida spp. (45.5%), which can be a trigger for the development of dystrophic and dysplastic processes not only of the vulva, but also of the cervix.

Nail plates are visually significant areas of the body and not only protect the distal phalanges from mechanical damage, but also determine the aesthetic appeal of the hands and feet. Patients with pathological changes in the nails experience not only physical discomfort, but also severe emotional suffering. This determines the search for the most effective methods of treating onychodystrophies. Practitioners are provided with modern information on the etiology, pathogenesis, clinical features of various types of onychodystrophies, therapeutic approaches and methods of local treatment. It is shown that hydration of the nail plate leads to increased permeability of drugs. The use of water-soluble chitosan and other active substances in the treatment of onychodystrophies is justified. As a result of a multicenter observational prospective study to assess the efficacy, safety and tolerability of Klavio lotions for the treatment of non-infectious onychodystrophies of the hands and feet of various etiologies, the effectiveness of these products is demonstrated.

Alopecia areata is a chronic organ-specific autoimmune inflammatory disease with a genetic predisposition. Alopecia areata is characterized by damage to hair follicles, persistent or temporary non-scarring hair loss. A treatment of severe form of alopecia areata is a difficult task. Systemic glucocorticoids are indicated in the severe form of alopecia areata, which undoubtedly have side effects with a negative influence on health. The main idea of the article demonstrates clinical examples of the therapy for such patients, which based on the clinical experience. Modern medicine offers a new approach to the treatment of severe forms of alopecia areata, which bases on blocking Janus kinase (JAK). JAK converts and activates the transcription pathway in the pathogenesis of the disease. Currently, FDA (US Food and Drug Administration) has approved two Janus kinase inhibitors: baricitinib and ritlecitinib. Tofacitinib is a representative pan-JAK inhibitor that blocks JAK1/3 but inhibits JAK2 weakly. Tofacitinib hasn’t been approved for alopecia areata by FDA yet. The article demonstrates high effectiveness tofacitinibe of the therapy severe forms of alopecia areata: total and universal and also the safety of treatment.