Vol 29, No 1 (2026)

BACKGROUND: The chronic stage of eczema is characterized by marked impairment of the skin barrier function, necessitating prolonged multimodal therapy. In cases of pronounced infiltration, lichenification, and resistance to standard treatment, positive effects of incorporating retinoids into therapeutic regimens for this condition have been reported.

AIM: The work aimed to evaluate the efficacy and safety of oral oily retinol palmitate solution as part of combination therapy in patients with chronic eczema.

METHODS: The study included 60 patients with mild-to-moderate chronic eczema who were divided into two groups of 30 patients each (main group and comparison group) according to the treatment received. Therapy in both groups comprised topical calcineurin inhibitors, zinc pyrithione, 10% naftalan oil liniment, and an emollient containing 10% urea. Patients in the main group additionally received oral retinol palmitate solution. Treatment efficacy was assessed based on changes in the Eczema Area and Severity Index (EASI), the Dermatology Life Quality Index (DLQI), and the number of disease exacerbations recorded before treatment and on days 30, 60, and 90 of therapy.

RESULTS: By day 30 of treatment, patients in both groups demonstrated significant improvement in skin manifestations (p ≤0.05). However, symptom regression was more pronounced in the main group, where EASI scores decreased by 77.0%, compared with a 58.1% reduction in the comparison group (p ≤0.05). The marked clinical improvement was accompanied by a reduction in disease-related quality-of-life impairment: DLQI scores decreased by 53.1% in the main group and by 39.4% in the comparison group (p ≤0.05). During subsequent follow-up, the positive trends of disease symptoms persisted, although no significant differences between the groups were observed.

CONCLUSION: The addition of oral oily retinol palmitate solution to combination therapy for patients with chronic eczema is associated with accelerated regression of clinical symptoms and improved quality of life. At the same time, topical therapy including calcineurin inhibitors, zinc pyrithione, 10% naftalan oil liniment, and an emollient containing 10% urea demonstrates sustained efficacy throughout the treatment course.

BACKGROUND: Despite the availability of multiple therapeutic options for atopic dermatitis, the search for strategies that effectively control key symptoms of the disease, including pruritus, remains relevant. Azathioprine, used as a systemic immunomodulatory agent, is considered a potential therapeutic option in patients who do not respond to standard treatment.

AIM: The study aimed to evaluate the antipruritic effect of azathioprine in patients with atopic dermatitis.

METHODS: This pilot study was conducted at the Rakhmanov Clinic of Skin and Venereal Diseases and included 10 patients, namely 8 men and 2 women, aged 18–60 years with atopic dermatitis and persistent, clinically significant pruritus resistant to standard therapy. Participants received 100 mg of oral azathioprine daily for 10 days while maintaining standard basic skin care.

RESULTS: Treatment resulted in a substantial reduction in pruritus intensity. Scores on the 6-point Prurindex scale decreased by 74%–78% in all time periods (morning, daytime, evening). Investigator’s Global Assessment scores decreased from a baseline mean of 2.8 to 1.6. Additionally, reduced serum immunoglobulin E levels and decreased severity of inflammatory skin changes were observed.

CONCLUSION: Owing to its systemic immunosuppressive mechanism, azathioprine demonstrated a clinically significant antipruritic effect and led to overall clinical improvement. These findings support the potential role of azathioprine in the treatment of chronic inflammatory pruritic dermatoses.

BACKGROUND: Vitiligo is a chronic depigmenting skin disorder that has a substantial impact on patients’ psychosocial well-being. Currently available treatment options, including long-term use of topical corticosteroids and phototherapy, have several limitations related to adverse effects and depend on skin phototype. This underscores the need for the development and implementation of new, safe, and effective treatment methods for vitiligo.

AIM: The study aimed to clinically evaluate the efficacy and safety of low-temperature argon plasma therapy in patients with non-segmental vitiligo.

METHODS: This open-label, non-comparative clinical study included patients with a confirmed diagnosis of non-segmental vitiligo (n=20), aged 18–65 years, with a body surface area involvement ranging from 1% to 10%. The participant enrollment and intervention period lasted 8 weeks (20 procedures, 3 times a week), followed by a 1-month follow-up period. Procedures were conducted using the plasma-arc surgical system Plazmoran. The primary efficacy endpoint was the Vitiligo Extent, Stage, and Spreading Index (VETF). Secondary endpoints included the depigmented area (%), the Dermatology Life Quality Index (DLQI; points), and the type and degree of repigmentation. Assessments were performed at baseline, at weeks 4 and 8, and 1 month after treatment. Safety was evaluated based on the number of recorded adverse events.

RESULTS: All patients completed the planned treatment course. Complete repigmentation (76–100%) was achieved in 4 patients, marked repigmentation (51–75%) in 7 patients, moderate repigmentation (26–50%) in 6 patients, and minimal repigmentation (1–25%) in 3 patients. A significant reduction in VETF scores was observed, decreasing from 8.4±3.6 at baseline to 6.8±3.2 at week 4, 4.2±2.8 at week 8, and 3.6±2.4 1 month after therapy (p <0.001 for all time points compared with baseline). The depigmented area decreased from 4.6±2.8% to 2.0±1.8% (p <0.001). DLQI scores significantly improved, declining from 18.6±5.4 to 14.2±4.8, 9.8±3.6, and 7.4±2.9, respectively (p <0.001), indicating a marked improvement in quality of life. Comparison of subgroups by disease duration showed that the best outcomes were achieved in patients with a duration of less than 3 years (mean repigmentation 68.5% vs. 32.3% in those with a duration exceeding 7 years). Higher efficacy was observed in lesions located on the face, neck, and trunk compared with acral areas (hands and feet). The predominant repigmentation pattern was follicular (16), followed by peripheral (8) and diffuse (2). Continued repigmentation was noted during the 1-month post-treatment follow-up period. Mild transient adverse events (temporary erythema and sensation of warmth) were reported in 12 patients.

CONCLUSION: Therapy using the plasma-arc surgical system Plazmoran demonstrated high clinical efficacy and a favorable safety profile in the treatment of non-segmental vitiligo. The method was not associated with serious adverse events characteristic of conventional therapies (skin atrophy or telangiectasia). These findings support the potential of low-temperature argon plasma as a promising modern therapeutic option for vitiligo in dermatological practice.

Psoriasis is one of the most prevalent and socially important skin diseases. For a long time, the main treatment approaches included a combination of topical therapies, physiotherapeutic methods, and systemic agents targeting keratinocyte proliferation.

Currently, advances in understanding the immunopathogenesis of psoriasis have made the use of genetically engineered therapy the most justified approach. The introduction of this new class of drugs has substantially improved the efficacy and safety of treatment in patients with moderate-to-severe psoriasis. However, a major limitation of genetically engineered therapy is the predictable development of secondary clinical nonresponse during long-term therapy. Traditionally, this phenomenon has been attributed to the formation of anti-drug antibodies against targeted agents; nevertheless, accumulated clinical evidence indicates that loss of clinical response may also occur in the absence of detectable anti-drug antibodies. Current research into the mechanisms underlying secondary clinical nonresponse to genetically engineered therapy has led to the development of new therapeutic approaches for psoriasis treatment aimed at activating alternative immunopathological pathways, including the addition of adjuvant therapy (most commonly methotrexate), switching to another targeted agent, or reinitiation of treatment with the same biologic drug.

The article discusses the possibility of using extracorporeal photochemotherapy in the syndrome of secondary clinical ineffectiveness of gene-engineered biological therapy with netakimab in the absence of anti-drug antibodies. Favorable clinical outcomes of the proposed approach are demonstrated in two patients.

We discussed possible mechanisms underlying secondary clinical nonresponse, and provided a pathogenetic rationale for the use of extracorporeal photochemotherapy. This method exerts a comprehensive immunomodulatory effect, including induction of lymphocyte apoptosis, modulation of antigen-presenting cell function, induction of regulatory T cells, and alteration of the cytokine profile. Overall, extracorporeal photochemotherapy contributes to the restoration of immune homeostasis, which may lead to the reversal of pathologic immune processes altered by genetically engineered therapy and characteristic of psoriasis, returning them toward the original inflammatory mechanisms.

On April 15, 2025, the 1162nd meeting of the A.I. Pospelov Moscow Society of Dermatovenereologists and Cosmetologists (MSDC) was held. An in-person meeting was held at the V.A. Rakhmanov Clinic of Skin and Venereal Diseases, Sechenov University. A total of 120 participants attended the meeting. Two applications for admission to MSDC membership were submitted by physicians from private aesthetic clinics in Moscow.

The title of Honorary Member of the MSDC named after A.I. Pospelov was awarded to Professor Anton S. Dvornikov, Doctor of Sciences in Medicine, Head of the Department of Dermatovenereology, Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation.

In the clinical section of the meeting, three presentations were delivered. The first report, devoted to scabies in a patient with comorbid neurologic disease, emphasized that long-term use of vital medications, including hormonal preparations, may mask the classic manifestations of scabies in this category of patients. The second report addressed the importance of a differentiated approach and key therapeutic strategies in disseminated granuloma annulare. The report on metatypical carcinoma in the setting of primary multiple basal cell carcinoma was expanded to include information on pathogenesis, clinical forms, and risk factors of this severe disease.

In the scientific section of the meeting, three reports were also presented, describing the role of netakimab in treatment programs for psoriasis involving difficult-to-treat localizations; new contemporary capabilities of dermatoscopy; and rapid diagnosis of cutaneous melanoma using the artificial intelligence–based MelanomaCheck program.

Diseases affecting the anogenital skin and mucosa represent a relevant and complex interdisciplinary clinical problem. The spectrum of conditions affecting this anatomical region is extremely broad and diverse. This creates substantial difficulties for practicing clinicians in performing differential diagnosis and establishing a definitive diagnosis. Moreover, the clinical manifestations and disease course of certain conditions may vary depending on patient sex.

This article presents a case series involving HIV-positive men from the author’s archive. The photo gallery includes anogenital diseases of various etiologies, including conditions confined exclusively to this region as well as manifestations representing just some of the more widespread dermatoses. The presented conditions include multiple scrotal epidermoid cysts, angiokeratoma of Fordyce, herpes zoster, molluscum contagiosum, scabies, microsporia, Stevens–Johnson syndrome, and gonococcal infection.

An epidermoid cyst is a cystic tumor with low malignant potential. In addition to the external genitalia, it may occur on the scalp, face, or trunk. Lesions are often multiple and may reach up to 6 cm in diameter.

Angiokeratoma is a vascular lesion characterized by persistent dilation of subepidermal capillaries and postcapillary venules in combination with epidermal hyperkeratosis and acanthosis. Several clinical forms are distinguished depending on lesion localization and number, one of which is angiokeratoma of Fordyce (genital angiokeratoma), presenting on the scrotum in men or the vulvar region in women.

Genital herpes zoster in men involves dermatomes innervated by the sacral spinal nerves S₂–S₄. Such cases account for no more than 5% of all herpes zoster presentations and may be accompanied by urinary dysfunction.

In adults, molluscum contagiosum most commonly affects the pubic region, external genitalia, lower abdomen, and perianal area. Multiple lesions are typically observed in immunocompromised individuals.

Genital involvement in scabies often remains unrecognized, as specific features of skin structure, increased humidity and temperature, and mechanical friction may alter the clinical presentation of the dermatosis.

Dermatophytosis of the male external genitalia is rare and primarily affects young individuals. Microsporum canis is the most common causative agent. Although diagnosis of typical skin and hair involvement caused by Microsporum species usually presents little difficulty, atypical clinical presentations and/or unusual localization may complicate recognition.

In Stevens–Johnson syndrome, anogenital involvement accounts for 44%–78% of cases. Resulting bullae rapidly rupture, forming painful, extensive erosions covered with fibrinous exudate.

The presented case of gonococcal urethritis serves as a reminder of gonococcal infection, the incidence of which has been steadily declining in the Russian Federation.

The photographs in the gallery are accompanied by descriptions of the pathological process. Cases of syphilis and sexually transmitted infections caused by human papillomavirus and herpes simplex virus types 1 and 2 were not included, as these conditions were addressed in previous issues of the journal.