Vol 29, No 3 (2026)

BACKGROUND: Vitiligo is a chronic dermatosis characterized by depigmented patches, with a considerable impact on the patient’s psychoemotional state. Given the growing prevalence of vitiligo, the need for well-tolerated and effective combination therapies remains relevant.

AIM: The work aimed to assess the efficacy and tolerability of calcipotriol combined with microneedling in patients with stable non-segmental vitiligo.

METHODS: A single-center, pilot, prospective experimental study included 15 patients (9 women and 6 men; mean age: 18–60 years) with stable non-segmental vitiligo. All patients had microneedling once weekly, followed by daily application of calcipotriol throughout the treatment period. The study lasted 16 weeks (12 weeks of therapy and 4 weeks of follow-up). The following outcome assessments were used: Vitiligo Area Scoring Index (VASI), visual analog repigmentation scale (G0–G4), Dermatology Life Quality Index (DLQI), and numeric rating scale (NRS, 0–10 points) for pain.

RESULTS: After 12 weeks of therapy, VASI improved by 44.4% (Wilcoxon signed-rank test, p <  0.05), and 86.7% of patients achieved repigmentation of >25%. Mild adverse events (primarily transient erythema, pruritus, and pain) were reported in 73.3% of patients. There were no serious adverse reactions, and none of the patients discontinued treatment. Pain during procedures was mild (median NRS score 2.0). There was a significant improvement in quality of life, with a 4-point reduction in DLQI (40%; р <  0.05).

CONCLUSION: Calcipotriol combined with microneedling is effective and well-tolerated in patients with stable non-segmental vitiligo, with a considerable improvement in quality of life.

The article presents the main stages in the study of Devergie disease (pityriasis rubra pilaris)―from the first mentions in the works of 19^th-century dermatologists to modern concepts of its etiology and pathogenesis. The earliest descriptions of the disease are found in the works by T. Bateman (1815), C. Tarral (1835), and A. Devergie (1856), who laid the foundation for the clinical understanding of this rare papulosquamous dermatosis. Further contributions to the study of the disease were made by F. Hebra, E. Besnier, M. Kaposi, and Russian researchers including V.F. Burgsdorf, who systematized the clinical features and substantiated the independence of this condition. A significant step in the study of Devergie disease was associated with the development of concepts about its possible association with vitamin A metabolism disorders and hereditary factors, as reflected in the publications of the 20^th century. At the same time, the first classification was proposed by W. Griffiths. A new stage began with the introduction of molecular-genetic technologies, particularly the discovery of CARD14 mutations and the involvement of the NF-κB and MAPK signaling pathways, as well as the IL-1β/CCL20 and IL-23/IL-17A axes, which made it possible to consider the disease as an autoinflammatory dermatosis and explained the effectiveness of modern genetically engineered biological therapies. In addition, new clinical subtypes of the disease have been identified, including facial discoid dermatitis, HIV-associated, paraneoplastic, postinfectious, and CAPE subtypes.

Despite significant progress in understanding the pathogenesis and the availability of modern therapeutic options, Devergie disease remains difficult to diagnose and requires further research to clarify its nosological nature and develop personalized treatment approaches.

Background: Despite accumulating evidence on the role of cytokines in the immunopathogenesis of herpesvirus infections, the contribution of polymorphisms in immunoregulatory cytokine genes to the development of severe forms of recurrent genital herpes remains insufficiently studied. Most published studies are characterized by limited sample sizes, heterogeneous designs, and the lack of analysis of severe disease as a distinct clinical phenotype. Therefore, further investigation of immunogenetic factors associated with severe recurrent genital herpes is warranted.

AIM: To investigate the distribution of alleles and genotypes of the IL-1 -511T/C, IL-2 -330T/G, and IL-10 G-1082A polymorphisms in patients with severe recurrent genital herpes.

Methods: This observational case–control study included 124 participants of both sexes aged 18–64 years who were examined between 2018 and 2024. The study group comprised patients with severe recurrent genital herpes (n=62), while the control group consisted of individuals without clinical manifestations of recurrent genital herpes (n=62). Genotyping of the IL-1 -511T/C, IL-2 -330T/G, and IL-10 G-1082A polymorphisms was performed using polymerase chain reaction with allele-specific primers. Associations were evaluated by calculating odds ratios (ORs), χ² statistics, and 95% confidence intervals (CIs).

Results: Patients with severe recurrent genital herpes demonstrated a significantly lower frequency of the C allele and CC genotype of the IL-1 -511T/C polymorphism, suggesting a possible protective role of these genetic variants. No significant differences in allele or genotype distributions were observed between the groups for the IL-2 -330T/G polymorphism. In contrast, the IL-10 G-1082A polymorphism was characterized by a higher frequency of the G allele and GG genotype among patients with severe disease, which was associated with an increased risk of an unfavorable clinical course (p < 0.05).

Conclusion: Severe recurrent genital herpes is associated with specific allele and genotype distributions of the IL-1 -511T/C and IL-10 G-1082A polymorphisms. These findings support the importance of immunogenetic factors in predicting disease severity. The limitations of the study include a relatively small sample size and the lack of assessment of functional cytokine activity.

BACKGROUND: Androgenetic alopecia is a chronic progressive disorder characterized by follicular miniaturization, perifollicular fibrosis, and microcirculatory impairment. Conventional therapies (minoxidil, finasteride) have limited efficacy and are associated with adverse effects. In recent years, regenerative approaches—platelet-rich plasma (PRP), exosomes, microneedling with growth factors, and others—have been widely used; however, direct comparative data on their cosmetic effectiveness and pathogenetic rationale (including terminal/vellus hair ratio, anagen proportion, and tolerability) remain extremely limited.

AIM: To conduct a comparative evaluation of the visible cosmetic effect and pathogenetic rationale of salmon tissue-derived exosomes and PRP in patients with mild-to-moderate androgenetic alopecia.

METHODS: A two-arm, randomized, controlled clinical trial involved 40 participants (14 men with Norwood–Hamilton stages III–IV and 6 women with Ludwig stages I–II per group). Patients in group 1 (n=20) received four exosome sessions every 14 days; those in group 2 (n=20) received five PRP sessions at the same interval. Assessments were performed before treatment and 12 weeks after the last procedure using phototrichography (ARAMO SG, TrichoScan v.4.5) and included hair density, percentage of vellus hairs, terminal/vellus (T/v) ratio, anagen proportion, mean hair diameter, and anisotrichosis. Adverse events were recorded at each visit.

RESULTS: Hair density increased by 44.4±7.8 hairs/cm² in the exosome group and by 26.3±6.5 hairs/cm² in the PRP group (difference of 18.1 hairs/cm²; p < 0.001). Vellus hair proportion decreased by 37.0% vs 21.2% (p=0.003); the T/v ratio increased from 2.4 to 9.7 vs 4.8 (p=0.001); anagen proportion increased by 36.4% vs 23.4% (p=0.002); mean hair diameter increased by 22.4 μm vs 12.4 μm (p < 0.001), respectively. Transient local reactions were less common in the exosome group (40% vs 70%; p=0.028). No serious adverse events were reported with either treatment.

CONCLUSION: Salmon tissue-derived exosomes demonstrated significant advantages over PRP therapy across the majority of the evaluated parameters (including the terminal/vellus hair ratio, anagen proportion, and tolerability), even with fewer sessions. These results suggest that exosomes may have a more profound impact on mechanisms involved in terminal hair miniaturization and the hair growth cycle.

Vitiligo is a chronic autoimmune skin disease characterized by progressive destruction of melanocytes, the mechanisms of which have long remained poorly understood. Despite significant advances in understanding certain aspects of the disease, until recently, a comprehensive picture of the molecular basis of vitiligo and effective therapeutic approaches was lacking. The need to systematize the latest data on the genetic, immunological, and therapeutic aspects of the disease prompted this review of current research.

This search and analytical review of studies published between 2020 and 2025 has revealed revolutionary changes in our understanding of vitiligo pathogenesis. Genome-wide association studies have identified 54 gene loci associated with the disease, with familial and SNP heritability estimates of 0.75–0.83 and 0.78, respectively, indicating that the genetic architecture of the disease has been almost completely defined. The key role of cytotoxic CD8+ T lymphocytes in the selective destruction of melanocytes via the perforin-granzyme pathway and the interferon-γ-induced chemokine loop CXCL10-CXCR3 has been established. Novel biomarkers have been identified, including the transcription factor NFATC1, FOXP3 promoter polymorphisms, and NKG2D+ memory CD8+ T cells. Clinical trials demonstrate the breakthrough potential of JAK inhibitors, with topical ruxolitinib showing efficacy through suppression of local immune autoreactivity and tofacitinib providing systemic effects through blockade of interferon-γ signaling.

The presented analysis systematizes, for the first time, current data on the complete genetic architecture of vitiligo, new molecular biomarkers, and revolutionary therapeutic approaches, including the concept of enhancing the PD-1/PD-L1 axis and CAR-Treg therapy, which opens up prospects for personalized diagnosis and pathogenetically based treatment of the disease.

BACKGROUND: This study presents the results of an investigation into the relationship between the composition of culturable microbiota in skin lesions and disease severity of hidradenitis suppurativa according to the Hurley staging system.

AIM: To assess the relationship between the microbial composition of skin lesions in patients with hidradenitis suppurativa and disease severity according to the Hurley scale.

METHODS: A single-center, retrospective cohort study included 37 patients with hidradenitis suppurativa (median age 38 years), with Hurley stage I in 9 (24.3%), stage II in 12 (32.4%), and stage III in 16 (43.2%). Microorganisms were isolated from lesion exudates and identified using culture-based methods and MALDI-ToF mass spectrometry.

RESULTS: A total of 31 microbial species were identified; the most frequently detected were Staphylococcus epidermidis (91.9%), Staphylococcus haemolyticus (67.6%), Corynebacterium amycolatum (59.5%), and Staphylococcus aureus (48.6%). Staphylococcus hominis predominated in mild disease (88.9% in stage I vs. 16.7% in stage II and 0% in stage III; p < 0.001), whereas Corynebacterium species (C. amycolatum, C. aurimucosum, C. striatum, C. accolens, C. tuberculostearicum, and C. simulans) were significantly more common in severe disease (p < 0.001). The prevalence of Enterococcus faecalis increased significantly with disease progression (0% in stage I, 33.3% in stage II, and 56.3% in stage III; p=0.007), along with a trend toward increased prevalence of S. aureus (68.8% in stage III vs. 33.3% in stage I; p=0.075). A strong positive correlation was found between Hurley stage and the number of microbial species detected (ρ=0.69; p < 0.001), indicating increasing microbial diversity as hidradenitis suppurativa progresses.

CONCLUSION: Mild disease was associated with the presence of the commensal S. hominis, whereas severe disease was characterized by Corynebacterium predominance and increased microbial diversity. These findings support further investigation of the role of microbiota in the pathogenesis of hidradenitis suppurativa and the development of personalized therapeutic approaches.

BACKGROUND: Data on the clinical efficacy of combined photodynamic therapy (PDT) and photobiomodulation (PBM) in rosacea are limited to a small number of studies, mostly based on subjective assessment methods. Only a few studies include objective instrumental parameters reflecting skin microcirculation and standardized clinical scales.

AIM: To evaluate the clinically and instrumentally confirmed efficacy of combined PDT and PBM together with specialized home skincare, including topical ivermectin cream, in patients with erythematotelangiectatic and papulopustular subtypes of rosacea.

METHODS: This pilot study, with within-group comparison of pre- and post-treatment parameters, included 9 patients aged 27–44 years with rosacea, facial erythema, telangiectasia, and papulopustular lesions, who were divided into 3 groups of 3 patients each depending on the clinical subtype of rosacea and the treatment regimen (PDT+PBM, 6 sessions at 7-day intervals) combined with a home skincare line. Assessment methods included photographic documentation, ultrasound examination with Doppler modes to assess vascularization, and the GAIS (Global Aesthetic Improvement Scale), DLQI (Dermatology Life Quality Index), IGA (Investigator Global Assessment), and RDAS (Rosacea Diagnostic Assessment Scale).

RESULTS: Improvement in clinical parameters was observed in all treatment groups, confirmed by objective and subjective assessment methods. Specifically, lower scores after treatment compared with baseline indicated a transition from moderate erythema to very mild erythema on the IGA (p < 0.001), a reduction in overall rosacea symptom severity on the RDAS (p < 0.001), and a shift from moderate to minimal impact of the disease on quality of life on the DLQI (p < 0.001). According to 3D Antera 3D imaging, a reduction in the vascular component and changes in vascular pattern homogeneity were observed in all three groups, as well as statistically significant improvement in the microvascular network parameters. Group 3 showed the greatest improvement, with a 52.4% reduction in the vascularization index (p=0.005), a 35.2% decrease in vessel diameter (p=0.003), and a 28.7% reduction in vessel depth (p=0.023). In addition, patients reported a subjective reduction in facial discomfort.

CONCLUSION: These data indicate the potential efficacy of PDT and PBM in combination with home skincare. The combined approach using ivermectin cream in the treatment of various rosacea subtypes shows the most pronounced therapeutic outcomes.

On December 10, 2025, the 1165th meeting of the A.I. Pospelov Moscow Society of Dermatovenereologists and Cosmetologists was held.

The meeting was held in person at the Hyatt Regency Moscow Petrovsky Park hotel and was attended by 140 participants.

No applications for membership in the Society were submitted on December 10, 2025.

The scientific section of the meeting featured two presentations : one on current individualized treatment protocols for acne and another on current perspectives on the clinical presentation, diagnosis, and treatment of rosacea.

Acne is a multifactorial inflammatory disease affecting the pilosebaceous unit. Inflammation in acne has been shown to be primary and to precede follicular hyperkeratosis. Metagenomic sequencing has shown that acne is associated with changes in the strain composition of Cutibacterium acnes. In topical acne therapy, an individual approach to each patient holds promise. The speaker presented three clinical cases of acne in patients aged 18 to 29 years, confirming the efficacy of topical trifarotene in acne. It was reported that during the initial stage of treatment with trifarotene, patients may experience temporary side effects such as redness, dryness, peeling , and skin irritation (retinoic dermatitis) ; therefore, the use of moisturizers is recommended, and the frequency of application may be reduced or treatment temporarily suspended if necessary.

Rosacea occurs in both sexes between the ages of 30 and 50 (more often in women) in individuals with a genetic predisposition to transient facial flushing due to vasodilation, and less commonly in the neck and décolleté area. Although the disease can occur in any skin phototype, it more frequently affects individuals with skin phototypes I–II (Northern Europeans). Rosacea is a risk factor for diabetes, hypertension, dyslipidemia, and cardiovascular disease. Rosacea should be differentiated from acne, tuberculous lupus, and discoid lupus erythematosus. When several clinical features are present concurrently, therapy should include more than one agent, as well as daily facial skincare and physiotherapeutic procedures. The presentation included clinical cases demonstrating the efficacy of ivermectin and brimonidine, which are key drugs included in all rosacea treatment protocols.

In recent decades, international tourism has shown steady growth, accompanied by an increasing number of patients presenting with skin diseases acquired during travel to countries with tropical and subtropical climates. The particular interest of travelers in exotic regions has led to physicians more frequently encountering so-called travelers' dermatoses, whose diagnosis often poses considerable difficulty in temperate-climate countries. Among the most common skin conditions in tourists is contact dermatitis resulting from exposure to unusual environmental factors. In resort regions of Turkey, Egypt, India, North African countries, and other popular tourist destinations, allergic reactions may develop after application of temporary henna tattoos. Cases of coral dermatitis, jellyfish dermatitis, and phytophotodermatitis have also been reported. Significant risks are posed by infectious skin diseases, including tropical ulcer — a persistent and torpidly progressing ulcerative condition predominantly localized in the ankle area. Although relatively rare in travelers, this condition often causes diagnostic and therapeutic difficulties for physicians without sufficient experience in tropical medicine. Parasitic diseases occupy an important place among travelers' dermatoses and are caused by exposure to insects, mites, small parasites, and their larvae. One of the typical pseudo-scabies conditions found in tropical regions is trombiculiasis, caused by infestation of human skin with larvae (chiggers) of red mites of the family Trombiculidae. The disease presents with papular, vesicular, and urticarial rashes accompanied by intense itching, often persisting for a long time after the bites. In addition, travelers may also present with other parasitic diseases, including cutaneous larva migrans and dirofilariasis. From some endemic tropical areas, patients may return with signs of cutaneous leishmaniasis, which poses substantial diagnostic challenges in temperate-climate regions.

The article presents various types of travelers' dermatoses encountered after visiting tropical and subtropical regions to improve diagnostic accuracy, including differential diagnosis, and to enable timely and appropriate treatment.