Objective — to study the condition of the connective tissue in patients with common psoriasis and define the criterion­relevant evaluative indicators.
Materials and methods. The results of the study of collagen and elastin metabolism in 124 patients with advanced psoriasis are presented. The determination of collagenolytic activity of the blood plasma was based on the total amount, with the enzymatic breakdown of free and peptidically bound hydroxyproline. Hyaluronic acid was studied by the method of enzyme immunoassay.
Results and discussion. The study in the stationary phase showed a reduction of hyaluronic acid, collagenolytic activity, glycosaminoglycans, free hydroxy-proline, bound hydroxy-proline and elastase compared with the advanced stage of the disease. These indicators of the assessment of the connective tissue condition are closely correlated with the activity of the pathological process.
Conclusions. The analysis of the connective tissue shows the changes of such indicators as adhesion and intercellular interactions, angiogenesis, reactivity of the immune system, transport of nutrients, ions of metals and transducing function of hormones and neurotransmitters, the integrity of the structural and functional units of cells and intracellular organelles.

Keywords: hyaluronic acid, elastase, hydroxyproline, connective tissue.

Objective — to determine the effect of tobacco smoking on the clinical features and course of psoriasis as well as on indicators of external respiration, blood oxygen saturation, lipid metabolism and quality of life of patients with psoriasis.
Materials and methods. 45 patients with psoriasis aged 26—54 were observed (males — 31, females — 14, including 15 patients, who never smoked and 30 patients who had been smoking for more than 5 years. The smoker index, number of pack­years, quality of life, concentration of cotinines in urine, lipid metabolism, spirometry and pulse oximetry were determined.
Results and discussion. The survey found that smoking is a multifactorial problem. Patients who smoked tobacco, in contrast to those of the control group, had an increased average smoker index, cotinine concentration in urine, the number of scores for Fagerstrom Test and pack­years. These patients were also marked with specific clinical manifestations and course of psoriasis: prevalence of disseminated forms, lesions of palms and soles, onychodystrophy, shortening of remissions and torpidity to therapy. According to spirography, patients with psoriasis who smoked tobacco, mostly men, had changes in lung ventilation function and susceptibility to bronchial hyper-reactivity syndrome with further obstruction. Pulse oximetry established the inhibition of blood oxygen saturation. The study of lipid metabolism in patients with psoriasis, especially smokers, revealed a statistically significant increase in levels of total lipids and number of phospholipids. Adverse effects of smoking on quality of life, especially in women, were established.
Conclusions. An adverse effect of smoking on clinical features and course of psoriasis was established, namely: pathology of external respiration and oxygen saturation, lipid metabolism, dependence on gender, socio-demographic factors (an increase in the smoker index, Fagerstrom Test, number of pack­years), which led to deterioration in quality of life.

Keywords: psoriasis, smoking, tobacco, respiration, blood, oxygen, lipids.

Objective — to test whether active substances, such as vitamin A and vitamin E, contained in emulsion will penetrate the membrane imitating skin.
Materials and methods. Two derivatives were the analysed active compounds: retinol palmitate and tocopherol acetate. Permeation studies were conducted using Franz-type diffusion cells made of borosilicate glass. The collected samples were subjected to determination by the MALDI-TOF MS method and the analytical HPLC technique. The studies were in vitro tests, which allow for testing of active substances outside a living organism while representing the effects of these compounds on the organism.
Results and discussion. The permeability testing shows that some of the compounds contained in the w/o type of emulsion pass through membranes, which was confirmed using selected methods of HPLC qualitative analysis and MALDI-TOF MS. In addition, apart from the analysed complex, other active ingredients included in the emulsion formula also managed to get through.
Conclusions. In the test carried out at a temperature of (37 ± 0.5) °C in a diffusion cell derivatives of vitamins A and E were detected much faster than in the tests carried out at laboratory temperature of (22 ± 0.5) °C. The temperature of 37 °C corresponds to the transdermal systems used on the skin.

Keywords: Vitamin A, vitamin E, in vitro permeability, Franz diffusion cell.

List of references:  
1.    Molski M., Chemia piękna.— Warszawa: PWN, 2012.
2.    Johnson A., Chandraratna R.A.S. Novel retinoids with recep­tor selectivity and functional selectivity // Br. J. Dermatol.— 1999.
3.    Boryczka M., Pasker B., Sosada M. Retinoidy jako substancje czynne produktów leczniczych, kosmetyków i suplementów diety // Farmaceutyczny Przegląd Naukowy.— 2010.— N 8.— S. 8—16.
4.    Bojarowicz H., Płowiec A. Wpływ witaminy A na kondycję skó­ry // Prabi High Epidemiol.— 2010.— N 91 (3).— S. 352—346.
5.    Zejca A., Gorczyca M. (red.) Chemia leków.— Warszawa: PZWL, 2002.
6.    Lamer-Zarawska E., Chwała C., Gwardys A. Rośliny w kosmetyce i kosmetologii przeciwstarzeniowej.— Warszawa: PZWL, 2012.
7.    Kuczyński S. Kosmeceutyki — ​więcej niż kosmetyki // Panacea.— 1/2006.
8.    Lipiak D. Kosmeceutyki // Świat Przemysłu Kosme­tycz­ne­go.— 03/2011.
9.    Winter H. Griffith, Wielki leksykon witamin, ziół, sklad­ników mineralnych i suplementów.— Wydawnictwo Amber, 2002.
10.    Lange K., Badanie trwałości α-tokoferolu w kompleksach inkluzyjnych z cyklodekstrynami. Rozprawa na stopień doktora nauk farmaceutycznych.— Poznań, 2012.
11.    Kumirska J., Gołębiewski M., Paszkiewicz M., Bychowska A. Skrypt z ochrony środowiska. Analiza żywności.— Gdańsk: Wydaw­nictwo Uniwersytetu Gdańskiego, 2010.
12.    Jachowicz R. (red.) Receptura apteczna.— Warszawa: Wydawnictwo Lekarskie PZWL, 2009.
13.    Moreno P, Salvadó V, Determination of eight water- and fat-soluble vitamins in multi-vitamin pharmaceutical formu­lations by high-performance liquid chromatography // J. Chro­matogr. A.— 2000.— N 870 (1—2).— S. 207—215.

Nowadays, an ever-growing number of peelings are offered to dermatologists during their daily practice. But all peelings are not the same. Every dermatologist must first make a rigorous selection of the peeling that most accurately complies with his patient’s skin and the indication to be treated, secondly he should apply it according to a scientific methodology which is now well established. Pre-peeling and post-peeling are also two crucial phases, which will account for the successful results and for the absence of complications. The latter will be treated in the second part of this paper.

Keywords: Сhemical peeling, exfoliation, glycolic acid, trichloracetic acid, salicylic acid, phenol peeling.

List of references:  
1.    Brody H.J., Monheit G.D., Resnik S.S., Alt T.H. A history of chemical peeling // Dermatol. Surg.— 2000.— Vol. 26 (5).— P. 405—409.
2.    Hebra F., Kaposi M. On Diseases of the Skin.— Vol. 3. London.— Р.  New Sydenham Society, 1874.— Р. 22—23.
3.    Unna P.G. Thérapeutiques générales des maladies de la peau.— 1882.
4.    Van Scott E.J., Yu R.J. Hyperkeratinization, corneocyte cohesion and alpha hydroxy acids // J. Am. Acad. Dermatol.— 1984.— Vol. 11.— P. 867—879.
5.    Clark E, Scerri L. Superficial and medium-depth chemical peels // Clin. Dermatol.— 2008.— Vol. 26 (2).— P. 209—218.
6.    Rubin M.G. Manual of chemical peels.— Philadelphia.: JB Lipincot; 1992.— 20 p.
7.    Figueiredo Yokomizo V.M., Henneberg Benemond T.M., Chisaki C., Henneberg Benemond P. Chemical peels  review and practical applications // Surg. Cosmet. Dermatol.— 2013.— Vol. 5 (1).— P. 5868.
8.    Deprez P. Easy Phytic Solution. A New Alpha Hydroxy Acid Peel with Slow Release and without Neutralization // Int. J. Cosm. Surg. Aesth. Derm.— 2003.— Vol. 5 (1).— P. 45—51.
9.    Wójcik A., Kubiak M., Rotsztejn H. Influence of azelaic and mandelic acid peels on sebum secretion in ageing women //Postep Derm. Alergol.— 2013.— Vol. 3.— Р. 140—145.
10.    Monheit G.D. The Jessner’s and TCA peel a medium-depth chemical peel // J. Dermatol. Surg. Oncol.— 1989.— Vol. 15.— P. 945—950.
11.    Brody H.J. Variations and comparisons in medium-depth chemical peeling // J. Dermatol. Surg. Oncol.— 1989.— Vol. 15 (9).— P. 953—963.
12.    Coleman W.P., Futrell I.M. The glycolic acid-trichloroacetic acid peel // J. Dermatol. Surg. Oncol.— 1994.— Vol. 20.— P. 76—80.
13.    Sharad J. Glycolic acid peel therapy — ​a current review //Clin. Cosmet // Investig. Dermatol.— 2013.— Vol. 11 (6).— P. 281—288.
14.    Banga G., Patel K. Glycolic Acid peels for nail rejuvenation // J. Cutan. Aesthet. Surg.— 2014.— Vol. 7 (4).— P. 198—201.
15.    Wang C.M., Huang C.L., Hu C.T., Chan H.L. The effect of glycolic acid on the treatment of acne in Asian skin //Dermatol. Surg.— 1997.— Vol. 23 (1).— Р.  23—29.
16.    Atzori L., Brundu M.A., Orru A., Biggio P. Glycolic acid peeling in the treatment of acne // J. Eur. Acad. Dermatol. Venereol.— 1999.— Vol. 12 (2).— P. 119—122.
17.    Kim S.W., Moon S.E., Kim J.A., Eun H.C. Glycolic acid versus Jessner’s solution which is better for facial acne patients? A randomized prospective clinical trial of split-face model therapy // Dermatol. Surg.— 1999.— Vol. 25 (4).— P. 270—273.
18.    Grover C., Reddu B.S. The therapeutic value of glycolic acid peels in dermatology // Indian J. Dermatol. Venereol. Leprol.— 2003.— Vol. 69 (2).— Р. 148—150.
19.    Kessler E., Flanagan K., Chia C. et al. Comparison of alpha- and beta-hydroxy acid chemical peels in the treatment of mild to moderately severe facial acne vulgaris // Dermatol. Surg.— 2008.— Vol. 34 (1).— P. 45—50; discussion 51.
20.    Erbağci Z., Akçali C. Biweekly serial glycolic acid peels vs long-term daily use of topical low-strength glycolic acid in the treatment of atrophic acne scars // Int. J. Dermatol.— 2000.— Vol. 39 (10).— Р. 789—794.
21.    Lim J.T., Tham S.N. Glycolic acid peels in the treatment of melasma among Asian women // Dermatol. Surg.— 1997.— Vol. 23 (3).— P. 177—179.
22.    Javaheri S.M., Handa S., Kaur I., Kumar B. Safety and efficacy of glycolic acid facial peel in Indian women with melasma // Int. J. Dermatol.— 2001.— Vol. 40 (5).— P. 354—357.
23.    Sarkar R., Kaur C., Bhalla M., Kanwar A.J. The combination of glycolic acid peels with a topical regimen in the treatment of melasma in dark-skinned patients a comparative study // Dermatol. Surg.— 2002.— Vol. 28 (9).— Р. 828—832; discussion 832.
24.    Khunger N., Sarkar R., Jain R.K. Tretinoin peels versus glycolic acid peels in the treatment of Melasma in dark-skinned patients // Dermatol. Surg.— 2004.— Vol. 30 (5).— P. 756—760; discussion 760.
25.    Kligman D.E. Tretinoin peels versus glycolic acid peels //Dermatol. Surg.— 2004.— Vol. 30 (12 Pt 2).— Р. 1609.
26.    Kumari R., Thappa D.M. Comparative study of trichloro­acetic acid versus glycolic acid chemical peels in the treat­ment of melasma // Indian J. Dermatol. Venereol. Leprol. 2010.— Vol. 76 (4).— P. 447.
27.    Burns R.L., Prevost-Blank P.L., Lawry M.A. et al. Glycolic acid peels for post inflammatory hyperpigmentation in black patients. A comparative study // Dermatol. Surg.— 1997.— Vol. 23 (3).— P. 171—174; discussion 175.
28.    Tse Y., Ostad A., Lee H.S. et al. A clinical and histologic evaluation of two medium-depth peels. Glycolic acid versus Jessner’s trichloroacetic acid // Dermatol. Surg.— 1996.— Vol. 22 (9).— P. 781—786.
29.    Piacquadio D., Dobry M., Hunt S. et al. Short contact 70 % glycolic acid peels as a treatment for photodamaged skin. A pilot study // Dermatol. Surg.— 1996.— Vol. 22 (5).— P. 449—452.
30.    Newman N., Newman A., Moy L.S. et al. Clinical improve­ment of photoaged skin with 50 % glycolic acid. A double-blind vehicle-controlled study // Dermatol. Surg.— 1996.— Vol. 22 (5).— P. 455—460.
31.    Moy L.S., Murad H., Moy R.L. Glycolic acid peels for the treatment of wrinkles and photoaging // J. Dermatol. Surg. Oncol.— 1993.— Vol. 19 (3).— P. 243—246.
32.    Lee S.H., Huh C.H., Park K.C., Youn S.W. Effects of repetitive superficial chemical peels on facial sebum secretion in acne patients // J. Eur. Acad. Dermatol. Venereol.— 2006.— Vol. 20.— P. 964—968.
33.    Ejaz A., Raza N., Iftikhar N., Muzzafar F. Comparison of 30 % salicylic acid with Jessner‘s solution for superficial chemical peeling in epidermal melasma // J. Coll. Physicians Surg. Pak.— 2008.— Vol. 18 (4).— P. 205—208.
34.    Lawrence N., Cox S.E., Cockerell C.J. et al. A comparison of the efficacy and safety of Jessner‘s solution and 35 % trichloroacetic acid vs 5 % fluorouracil in the treatment of widespread facial actinic keratoses // Arch. Dermatol.— 1995.— Vol. 131 (2).— P. 176—181.
35.    Fischer T.C., Perosino E., Poli F. et al. Cosmetic Dermatology European Expert Group. Chemical peels in aesthetic dermatology.— Р.  an update 2009 // J. Eur. Acad. Dermatol. Venereol.— 201.— Vol. 24 (3).— P. 281—292.
36.    Humphreys T.R., Werth V., Dzubow L., Kligman A. Treat­ment of photodamaged skin with trichloroacetic acid and topical tretinoin // J. Am. Acad. Dermatol.— 1996.— Vol. 34 (4).— P. 638—644.
37.    Kubiak M., Mucha P., Dębowska R., Rotsztejn H. Evaluation of 70 % glycolic peels versus 15 % trichloroacetic peels for the treatment of photodamaged facial skin in aging women // Dermatol. Surg.— 2014.— Vol. 40 (8).— P. 883—891.
38.    Han S.H., Kim H.J., Kim S.Y. et al. Skin rejuvenating effects of chemical peeling.— Р.  a study in photoaged hairless mice // Int. J. Dermatol.— 2011.— Vol. 50 (9).— P. 1075—1082.
39.    Chun E.Y., Lee J.B., Lee K.H. Focal trichloroacetic acid peel method for benign pigmented lesions in dark-skinned pa­­tients // Dermatol. Surg.— 2004.— Vol. 30 (4 Pt 1).— Р. 512—516; discussion 516.
40.    Puri N. Comparative study of 15 % TCA peel versus 35 % glycolic acid peel for the treatment of melasma // Indian Dermatol. Online. J.— 2012.— Vol. 3 (2).— P. 109—113.
41.    Mradula P.R., Sacchidanand S. A Split-face Comparative Study of 70 % Trichloroacetic Acid and 80 % Phenol Spot Peel in the Treatment of Freckles // J. Cutan. Aesthet. Surg.— 2012.— Vol. 5 (4).— P. 261—265.
42.    Sacchidanand S., Shetty A.B., Leelavathy B. Efficacy of 15 % trichloroacetic Acid and 50 % glycolic Acid peel in the treatment of frictional melanosis a comparative study // J. Cutan. Aesthet. Surg.— 2015.— Vol. 8 (1).— P. 37—41.
43.    Zayed A., Sobhi R.M., Abdel Halim D.M. Using trichloro­acetic acid in the treatment of acanthosis nigricans a pilot study // J. Dermatolog Treat.— 2014.— Vol. 25 (3).— P. 223—225.
44.    Garg S., Baveja S. Combination therapy in the management of atrophic acne scars // J. Cutan. Aesthet. Surg.— 2014.— Vol. 7 (1).— P. 18—23.
45.    Holzer G., Pinkowicz A., Radakovic S. et al. Randomized controlled trial comparing 35 % trichloroacetic acid peel and 5-aminolevulinic acid photodynamic therapy for the treat­ment of multiple actinic keratosis // Br. J. Dermatol.— 2016.— doi.— Р. 10.1111/bjd.15272.
46.    Carvalho Costa I.M., de Carvalho Mesquita K. Treating papular nodular lesions of rosacea with a medium chemical peel // Surg. Cosmet. Dermatol.— 2010.— Vol. 2 (3).— P. 237—239.
47.    Sharquie K.E., Al-Tikreety M.M., Al-Mashhadani S.A. Lactic acid as a new therapeutic peeling agent in melasma //Dermatol. Surg.— 2005.— Vol. 31 (2).— P. 149—154; discussion 154.
48.    Sharquie K.E., Al-Dhalimi M.A., Noaimi A.A., Al-Sulta­ny H.A. Lactic Acid as a new therapeutic peeling agent in the treatment of lifa disease (frictional dermal melanosis) //  Indian J. Dermatol.— 2012.— Vol. 57 (6).— Р. 444—448.
49.    Vavouli C., Katsambas A., Gregoriou S. et al. Chemical peeling with trichloroacetic acid and lactic acid for infra­orbital dark circles // J. Cosmet. Dermatol.— 2013.— Vol. 12 (3).— P. 204—209.
50.    Singh R., Goyal S., Ahmed Q.R. et al. Effect of 82 % Lactic Acid in Treatment of Melasma // Int. Sch. Res. Notices.— 2014.— 17.— Vol. 2014.— P. 407142.
51.    Prestes P.S., Oliveira M.M., Leonardi G.R. Randomized clinical efficacy of superficial peeling with 85 % lactic acid versus 70 % glycolic acid // An. Bras. Dermatol.— 2013.— Vol. 88 (6).— P. 900—905.
52.    Sachdeva S. Lactic acid peeling in superficial acne scarring in Indian skin // J. Cosmet. Dermatol.— 2010.— Vol. 9 (3).— P. 246—248.
53.    Sarkar R., Garg V., Bansal S et al. Comparative Evaluation of Efficacy and Tolerability of Glycolic Acid, Salicylic Mandelic Acid, and Phytic Acid Combination Peels in Melasma // Dermatol. Surg.— 2016.— Vol. 42 (3).— P. 384—391.
54.    Dainichi T., Ueda S., Imayama S., Furue M. Excellent clinical results with a new preparation for chemical peeling in acne 30 % salicylic acid in polyethylene glycol vehicle // Dermatol. Surg.— 2008.— Vol. 34 (7).— P. 891—899; discussion 899.
55.    Dayal S., Amrani A., Sahu P., Jain V.K. Jessner‘s solution vs. 30 % salicylic acid peels a comparative study of the efficacy and safety in mild-to-moderate acne vulgaris // J. Cosmet. Dermatol.— 2016.— doi. Р. 10.1111/jocd.12266.
56.    Alba M.N., Gerenutti M., Yoshida V.M., Grotto D. Clinical comparison of salicylic acid peel and LED-Laser photothe­rapy for the treatment of Acne vulgaris in teenagers // J. Cosmet. Laser Ther.— 2017.— Vol. 19 (1).— P. 49—53.
57.    Cotellessa C., Manunta T., Ghersetich I. et al. The use of pyruvic acid in the treatment of acne // J. Eur. Acad. Dermatol. Venereol.— 2004.— Vol. 18 (3).— P. 275—278.
58.    Jaffary F., Faghihi G., Saraeian S., Hosseini S.M. Comparison the effectiveness of pyruvic acid 50 % and salicylic acid 30 % in the treatment of acne // J. Res. Med. Sci.— 2016.— Vol. 9.— Vol. 21.— P. 31.
59.    Berardesca E., Cameli N., Primavera G., Carrera M. Clinical and instrumental evaluation of skin improvement after treatment with a new 50 % pyruvic acid peel // Dermatol. Surg.— 2006.— Vol. 32 (4).— Р. 526—531.
60.    Ghersetich I., Brazzini B., Peris K. et al. Pyruvic acid peels for the treatment of photoaging //  Dermatol. Surg.— 2004.— Vol. 30 (1).— Р. 32—36; discussion 36.
61.    Cucé L.C., Bertino M.C., Scattone L., Birkenhauer M.C. Tretinoin peeling // Dermatol. Surg.— 2001.— Vol. 27 (1).— P. 12—14.
62.    Khunger N., Sarkar R., Jain R.K. Tretinoin peels versus glycolic acid peels in the treatment of Melasma in dark-skinned patients // Dermatol. Surg.— 2004.— Vol. 30 (5).— P. 756—760; discussion 760.
63.    Ghersetich I., Troiano M., Brazzini B. et al. Melasma treat­ment with 10 % tretinoin peeling mask // J. Cosmet. Dermatol.— 2010.— Vol. 9 (2).— P. 117—121.
64.    Magela Magalhães G., Melo Borges M.F., Raissa de Carvalho Queiroz A. et al. Double-blind randomized study of 5 % and 10 % retinoic acid peels in the treatment of melasma clinical evaluation and impact on the quality of life // Surg. Cosmet. Dermatol.— 2011.— Vol. 3 (1).— P. 17—22.
65.    Wójcik A., Kubiak M., Rotsztejn H. Influence of azelaic and mandelic acid peels on sebum secretion in ageing women // Postepy Dermatol. Alergol.— 2013.— Vol. 30 (3).— Р. 140—145.
66.    Park J.H., Choi Y.D., Kim S.W. et al. Effectiveness of modified phenol peel (Exoderm) on facial wrinkles, acne scars and other skin problems of Asian patients // J. Dermatol.— 2007.— Vol. 34.— P. 17—24.
67.    Puri N. Efficacy of Modified Jessner‘s Peel and 20 % TCA Versus 20 % TCA Peel Alone for the Treatment of Acne Scars // J. Cutan. Aesthet. Surg.— 2015.— Vol. 8 (1).— P. 42—45.
68.    Sezer E., Erbil H., Kurumlu Z. et al. A comparative study of focal medium-depth chemical peel versus cryosurgery for the treatment of solar lentigo // Eur. J. Dermatol.— 2007.— Vol. 17 (1).— Р. 26—29.
69.    Cook K.K., Cook W.R.Jr. Chemical peel of nonfacial skin using glycolic acid gel augmented with TCA and neutralized based on visual staging // Dermatol. Surg.— 2000.— Vol. 26 (11).— Р. 994—999.

References
1.    Brody HJ, Monheit GD, Resnik SS, Alt TH. A history of chemical peeling. Dermatol Surg. 2000 May; 26(5):405-9.
2.    Hebra F, Kaposi M. On Diseases of the Skin, vol 3. London: New Sydenham Society, 1874:22-3.
3.    Unna PG, Thérapeutiques générales des maladies de la peau, 1882.
4.    Van Scott EJ, Yu RJ. Hyperkeratinization, corneocyte cohesion and alpha hydroxy acids. J Am Acad Dermatol 1984; 11:867-79.
5.    Clark E, Scerri L. Superficial and medium-depth chemical peels. Clin Dermatol. 2008 Mar-Apr; 26(2):209-18.
6.    Rubin MG. Manual of chemical peels. Philadelphia: JB Lipincot; 1992. p. 20.
7.    Figueiredo Yokomizo VM, Henneberg Benemond TM, Chisaki C, Henneberg Benemond P. Chemical peels: review and practical applications. Surg Cosmet Dermatol 2013; 5(1):5868.
8.    Deprez P. Easy Phytic Solution: A New Alpha Hydroxy Acid Peel with Slow Release and without Neutralization. Int J Cosm Surg Aesth Derm. 2003; 5(1):45-51.
9.    Wójcik A, Kubiak M, Rotsztejn H. Influence of azelaic and mandelic acid peels on sebum secretion in ageing women. Postep Derm Alergol 2013; XXX, 3: 140-145.
10.    Monheit GD. The Jessner’s and TCA peel: a medium-depth chemical peel. J Dermatol Surg Oncol 1989; 15:945-50.
11.    Brody HJ. Variations and comparisons in medium-depth chemical peeling. J Dermatol Surg Oncol. 1989 Sep; 15(9):953-63.
12.    Coleman WP, Futrell IM. The glycolic acid–trichloroacetic acid peel. J Dermatol Surg Oncol 1994; 20:76-80.
13.    Sharad J. Glycolic acid peel therapy — ​a current review. Clin Cosmet Investig Dermatol. 2013 Nov 11; 6:281-8.
14.    Banga G, Patel K. Glycolic Acid peels for nail rejuvenation. J Cutan Aesthet Surg. 2014 Oct-Dec; 7(4):198-201.
15.    Wang CM, Huang CL, Hu CT, Chan HL. The effect of glycolic acid on the treatment of acne in Asian skin. Dermatol Surg. 1997; 23(1): 23-29.
16.    Atzori L, Brundu MA, Orru A, Biggio P. Glycolic acid peeling in the treatment of acne. J Eur Acad Dermatol Venereol. Mar 1999; 12(2):119-122.
17.    Kim SW, Moon SE, Kim JA, Eun HC. Glycolic acid versus Jessner’s solution: which is better for facial acne patients? A randomized prospective clinical trial of split-face model therapy. Dermatol Surg. 1999; 25(4)270-273.
18.    Grover C, Reddu BS. The therapeutic value of glycolic acid peels in dermatology. Indian J Dermatol Venereol Leprol. 2003; 69(2): 148-150.
19.    Kessler E, Flanagan K, Chia C, Rogers C, Glaser DA. Comparison of alpha- and beta-hydroxy acid chemical peels in the treatment of mild to moderately severe facial acne vulgaris. Dermatol Surg. 2008; 34(1):45-50; discussion 51.
20.    Erbağci Z, Akçali C. Biweekly serial glycolic acid peels vs long-term daily use of topical low-strength glycolic acid in the treatment of atrophic acne scars. Int J Dermatol. 2000; 39(10):789-794.
21.    Lim JT, Tham SN. Glycolic acid peels in the treatment of melasma among Asian women. Dermatol Surg. 1997; 23(3):177-179.
22.    Javaheri SM, Handa S, Kaur I, Kumar B. Safety and efficacy of glycolic acid facial peel in Indian women with melasma. Int J Dermatol. 2001; 40(5):354-357.
23.    Sarkar R, Kaur C, Bhalla M, Kanwar AJ. The combination of glycolic acid peels with a topical regimen in the treatment of melasma in dark-skinned patients: a comparative study. Dermatol Surg. 2002; 28(9):
828-832; discussion 832.
24.    Khunger N, Sarkar R, Jain RK. Tretinoin peels versus glycolic acid peels in the treatment of Melasma in dark-skinned patients. Dermatol Surg. 2004; 30(5):756-760; discussion 760.
25.    Kligman DE. Tretinoin peels versus glycolic acid peels. Dermatol Surg. 2004;30(12 Pt 2):1609.
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27.    Burns RL, Prevost-Blank PL, Lawry MA, Lawry TB, Faria DT, Fivenson DP. Glycolic acid peels for post inflammatory hyperpigmentation in black patients. A comparative study. Dermatol Surg. 1997; 23(3):171-174; discussion 175.
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29.    Piacquadio D, Dobry M, Hunt S, Andree C, Grove G, Hollenbach KA. Short contact 70 % glycolic acid peels as a treatment for photodamaged skin. A pilot study. Dermatol Surg. 1996;22(5):449-452.
30.    Newman N, Newman A, Moy LS, Babapour R, Harris AG, Moy RL. Clinical improvement of photoaged skin with 50 % glycolic acid. A double-blind vehicle-controlled study. Dermatol Surg. 1996; 22(5):455-460.
31.    Moy LS, Murad H, Moy RL. Glycolic acid peels for the treatment of wrinkles and photoaging. J Dermatol Surg Oncol. 1993; 19(3):243-246.
32.    Lee SH, Huh CH, Park KC, Youn SW. Effects of repetitive superficial chemical peels on facial sebum secretion in acne patients. J Eur Acad Dermatol Venereol. 2006; 20:964-968.
33.    Ejaz A, Raza N, Iftikhar N, Muzzafar F. Comparison of 30 % salicylic acid with Jessner‘s solution for superficial chemical peeling in epidermal melasma. J Coll Physicians Surg Pak. 2008 Apr; 18(4):205-8.
34.    Lawrence N, Cox SE, Cockerell CJ, Freeman RG, Cruz PD Jr. A comparison of the efficacy and safety of Jessner‘s solution and 35 % trichloroacetic acid vs 5 % fluorouracil in the treatment of widespread facial actinic keratoses. Arch Dermatol. 1995 Feb; 131(2):176-81.
35.    Fischer TC, Perosino E, Poli F, Viera MS, Dreno B; Cosmetic Dermatology European Expert Group. Chemical peels in aesthetic dermatology: an update 2009. J Eur Acad Dermatol Venereol. 2010 Mar; 24(3):281-92.
36.    Humphreys TR, Werth V, Dzubow L, Kligman A. Treatment of photodamaged skin with trichloroacetic acid and topical tretinoin. J Am Acad Dermatol. 1996 Apr; 34(4):638-44.
37.    Kubiak M, Mucha P, Dębowska R, Rotsztejn H. Evaluation of 70 % glycolic peels versus 15 % trichloroacetic peels for the treatment of photodamaged facial skin in aging women. Dermatol Surg. 2014 Aug; 40(8):883-91.
38.    Han SH, Kim HJ, Kim SY, Kim YC, Choi GS, Shin JH. Skin rejuvenating effects of chemical peeling: a study in photoaged hairless mice. Int J Dermatol. 2011 Sep; 50(9):1075-82.
39.    Chun EY, Lee JB, Lee KH. Focal trichloroacetic acid peel method for benign pigmented lesions in dark-skinned patients. Dermatol Surg. 2004 Apr; 30(4 Pt 1):512-6; discussion 516.
40.    Puri N. Comparative study of 15 % TCA peel versus 35 % glycolic acid peel for the treatment of melasma. Indian Dermatol Online J. 2012 May; 3(2):109-13.
41.    Mradula PR, Sacchidanand S. A Split-face Comparative Study of 70 % Trichloroacetic Acid and 80 % Phenol Spot Peel in the Treatment of Freckles. J Cutan Aesthet Surg. 2012 Oct; 5(4):261-5.
42.    Sacchidanand S, Shetty AB, Leelavathy B. Efficacy of 15 % trichloroacetic Acid and 50 % glycolic Acid peel in the treatment of frictional melanosis: a comparative study. J Cutan Aesthet Surg. 2015 Jan-Mar; 8(1):37-41.
43.    Zayed A, Sobhi RM, Abdel Halim DM. Using trichloroacetic acid in the treatment of acanthosis nigricans: a pilot study. J Dermatolog Treat. 2014 Jun; 25(3):223-5.
44.    Garg S, Baveja S. Combination therapy in the management of atrophic acne scars. J Cutan Aesthet Surg. 2014 Jan; 7(1):18-23.
45.    Holzer G, Pinkowicz A, Radakovic S, Schmidt JB, Tanew A. Randomized controlled trial comparing 35 % trichloroacetic acid peel and 5-aminolevulinic acid photodynamic therapy for the treatment of multiple actinic keratosis. Br J Dermatol. 2016 Dec 23. doi: 10.1111/bjd.15272. [Epub ahead of print]
46.    Carvalho Costa IM, de Carvalho Mesquita K. Treating papular nodular lesions of rosacea with a medium chemical peel. Surg Cosmet Dermatol. 2010; 2(3)237-9.
47.    Sharquie KE, Al-Tikreety MM, Al-Mashhadani SA. Lactic acid as a new therapeutic peeling agent in melasma. Dermatol Surg. 2005 Feb; 31(2):149-54; discussion 154.
48.    Sharquie KE, Al-Dhalimi MA, Noaimi AA, Al-Sultany HA. Lactic Acid as a new therapeutic peeling agent in the treatment of lifa disease (frictional dermal melanosis). Indian J Dermatol. 2012 Nov;57(6):444-8.
49.    Vavouli C, Katsambas A, Gregoriou S, Teodor A, Salavastru C, Alexandru A, Kontochristopoulos G. Chemical peeling with trichloroacetic acid and lactic acid for infraorbital dark circles. J Cosmet Dermatol. 2013 Sep; 12(3):204-9.
50.    Singh R, Goyal S, Ahmed QR, Gupta N, Singh S. Effect of 82 % Lactic Acid in Treatment of Melasma. Int Sch Res Notices. 2014 Jul 17; 2014:407142.
51.    Prestes PS, Oliveira MM, Leonardi GR. Randomized clinical efficacy of superficial peeling with 85 % lactic acid versus 70 % glycolic acid. An Bras Dermatol. 2013 Nov-Dec; 88(6):900-5.
52.    Sachdeva S. Lactic acid peeling in superficial acne scarring in Indian skin. J Cosmet Dermatol. 2010 Sep; 9(3):246-8.
53.    Sarkar R, Garg V, Bansal S, Sethi S, Gupta C. Comparative Evaluation of Efficacy and Tolerability of Glycolic Acid, Salicylic Mandelic Acid, and Phytic Acid Combination Peels in Melasma. Dermatol Surg. 2016 Mar; 42(3):384-91.
54.    Dainichi T, Ueda S, Imayama S, Furue M. Excellent clinical results with a new preparation for chemical peeling in acne: 30 % salicylic acid in polyethylene glycol vehicle. Dermatol Surg. 2008 Jul; 34(7):891-9; discussion 899.
55.    Dayal S, Amrani A, Sahu P, Jain VK. Jessner‘s solution vs. 30 % salicylic acid peels: a comparative study of the efficacy and safety in mild-to-moderate acne vulgaris. J Cosmet Dermatol. 2016 Aug 25. doi: 10.1111/jocd.12266. [Epub ahead of print]
56.    Alba MN, Gerenutti M, Yoshida VM, Grotto D. Clinical comparison of salicylic acid peel and LED-Laser phototherapy for the treatment of Acne vulgaris in teenagers. J Cosmet Laser Ther. 2017 Feb; 19(1):49-53.
57.    Cotellessa C, Manunta T, Ghersetich I, Brazzini B, Peris K. The use of pyruvic acid in the treatment of acne. J Eur Acad Dermatol Venereol. 2004 May; 18(3):275-8.
58.    Jaffary F, Faghihi G, Saraeian S, Hosseini SM. Comparison the effectiveness of pyruvic acid 50 % and salicylic acid 30 % in the treatment of acne. J Res Med Sci. 2016 May 9; 21:31.
59.    Berardesca E, Cameli N, Primavera G, Carrera M. Clinical and instrumental evaluation of skin improvement after treatment with a new 50 % pyruvic acid peel. Dermatol Surg. 2006 Apr;32(4):526-31.
60.    Ghersetich I, Brazzini B, Peris K, Cotellessa C, Manunta T, Lotti T. Pyruvic acid peels for the treatment of photoaging. Dermatol Surg. 2004 Jan;30(1):32-6; discussion 36.
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Objective — to study the role of psoriasis as social factor of public health in the leading countries of the world. To do that we should examine the epidemiological situation regarding psoriasis in Europe, the US and other countries taking into account the presence of medical statistics in these countries which could effectively organize the collection and processing of statistically reliable information on this disease, as well as data on bio­economical significance of this dermatosis.
Materials and methods. Biblio­semantic retrospective analysis of available literature and Internet sources was conducted; methods of structural and logical analysis, synthesis and prediction were applied.
Results and discussion. Significant global prevalence of psoriasis was established; medical and social impact of psoriasis was demonstrated, including the resulting high risk of heart attacks, strokes and death from cardiovascular diseases in persons with severe psoriasis, as well as patients’ psychic and emotional changes. The economic component of psoriasis treatment is demonstrated.
Conclusions. Taking into account the tendencies, we consider it possible to suggest health and social exponents for psoriasis as an indicator of the proper functioning of public health system, primary care and dermatovenereologic services.

Keywords: psoriasis, epidemiology, bioeconomy, Public Health, WHO, Ukraine.

Objective — to develop and assess the effectiveness of a differentiated method of treatment of onychomycosis by prescription of means for correction of various hemodynamic types of microvasculature according to laser Doppler flowmetry.
Materials and methods. 125 patients (40 men, 85 women) with onychomycosis were comprehensively examined. The patients’ age was from 18 to 74 years (mean age — 48.86 ± 13.92 years). The mean duration of the disease was (2.97 ± 5.17) years (from 3 months to 35 years). Local and/or systemic antifungals were prescribed for patients of the comparative group (n = 49); patients of the main group (n = 76) were additionally given medications for microcirculatory disorders correction, with consideration of their individual characteristics.
Results and discussion. Based on the results of the study of microcirculation by laser Doppler flowmetry, the presence of microcirculatory disorders in the skin of the affected fingers was revealed in 56.8 % of patients with onychomycosis. Among them, the spastic type was found at 44.8 %, stagnant­static type — at 9.6 %, congestive type — at 2.4 % of patients. The average time of antifungal therapy was significantly greater in the comparative group of patients with onychomycosis — (12.45 ± 3.92) weeks vs. (9.34 ± 3.24) weeks in the main group where differentiated correction of microcirculatory disturbances detected by laser Doppler flowmetry was performed (p < 0.001). The vast majority of patients in the main group — 65 (85.5 %) persons — had mycological negative reaction at week 12, which was 40.6 % higher than among patients in the comparative group, where in 12 weeks of treatment the mycological negative reaction took place only in 22 (44.9 %) cases (OR = 7.25, 95 % CI 3.095—16.99, p < 0.001). The time of mycological elimination of the pathogen in patients with spastic and stagnant­static microcirculation disturbances were significantly longer compared with patients without disturbances of microcirculation: (13.79 ± 3.24) and (15.6 ± 1.67) weeks vs (10.19 ± 3.89) weeks, respectively, in patients with normal hemodynamics results (p = 0.002 and p < 0.001). Slow recovery is directly correlated with the presence of microcirculatory disturbances (r = 0.504, p < 0.001). Stagnant­static type of microcirculatory disorders to the maximum extent increases the time of mycological negative reaction in patients with onychomycosis (p < 0.001).
Conclusions. Hemodynamic disorders of microvasculature affect the time of negative reaction of mycological study results in patients with onychomycosis. Application of differential approach to correction of comorbid microcirculatory disorders makes it possible to accelerate the elimination of pathogens of onychomycosis and reduce the time of antifungals applica­tion.

Keywords: onychomycosis, microcirculation, treatment.

Clinical examples of skin pathology as first HIV infection manifestation in HIV-infected patients have been presented.
The variety of dermatological manifestations of HIV in patients demands greater vigilance of specialists in skin and venereal diseases and family doctors as ones being in touch with those patients first of all, with the purpose of improving the timely diagnosis of HIV infection.

Keywords: HIV-positive patients, skin pathology.

Objective — to determine and evaluate the results of detecting Trichomonas in the urogenital system of patients with inflammatory processes of the urogenital organs using culture diagnosis (cultivation on special nutritious «SVT» medium) as compared with the method of polymerase chain reaction in real time (PCR RT) with the use of primers for the detection of Trichomonas vaginalis, Trichomonas tenax и Pentatrichomonas hominis.
Materials and methods. Using the methods of polymerase chain reaction in real time and seeding on special nutritious «SVT» medium we investigated the biological material taken from genitals of 97 patients who were examined for urogenital infections at Dermatovenerologic Dispensary N 1, Kyiv.
Results and discussion. Using the method of seeding on the special nutritious «SVT» medium, Trichomonas vaginalis was found in 15 (15.5 %) of 97 patients under observation. During the study by PCR RT method this activator was diagnosed only in 6 (6.2 %) persons. However, PCR RT with the use of primers for the detection of Trichomonas tenax and Pentatrichomonas hominis helped to diagnose Trichomonas tenax in 9 (9.3 %) patients and Pentatrichomonas hominis — in 12 (12.4 %) patients.
Conclusions. The simultaneous use of primers for the detection of Trichomonas vaginalis, Trichomonas tenax and Pentatrichomonas hominis allows making the dianosing of trihomonad in urogenital system with the use of PCR RF method more effective (27.9 %) than with the use of the culture method — the seeding on special nutritious «SVT» medium (15.5 %). When diagnosing trichomoniasis with the use of culture method, in most cases Trichomonas tenax and Pentatrichomonas hominis are mistakenly identified as Trichomonas vaginalis. We established a high level of diagnosing Trichomonas tenax and Pentatrichomonas hominis in urogenital system of patients, which is the evidence of the growing value of the «alternative» sexual contacts, particularly of oral and anal sex unprotected by means of contraception in causing and/or progression of inflammatory processes of the urogenital tract.

Keywords: Trichomonas vaginalis, Trichomonas tenax, Pentatrichomonas hominis, method of polymerase chain reaction, real time, seeding, special nutritious «SVT» medium.

Objective — to increase the effectiveness of treatment of vitiligo patients by reducing the period of treatment, ensuring the stability of the results and reducing the number of complications with combined methods of treating the stable form of vitiligo using cellular technologies. Our task was to compare the effectiveness of combined surgical vitiligo treatment using cultured melanocytes and keratinocytes with methods approved by European standards and national orders (NB UVB, external anti-inflammatory therapy).
Materials and methods. 65 patients with vitiligo were examined and treated, including 27 patients aged 9 to 63 years who agreed to participate in our study (the main group) and 38 patients aged 15 to 67 years (comparison group). We divided the main and the comparative groups into 2 subgroups depending on the skin photo type. Thus we obtained 4 groups of patients.
Results and discussion. In the two main groups treated by method developed by us, we reached complete repigmentation (75—100 %) in 15 (56 %) patients, partial repigmentation (50—75 %) — in 10 (37 %) patients and no repigmentation — in 2 (7 %) patients. Therapy duration in groups 1 and 2 was 10—14 weeks. In the comparative groups 3 and 4, complete repigmentation (75—100 %) was reached in 7 (41 %) patients of group 3 and in 9 (43 %) patients of group 4; partial repigmentation (50—75 %) — in 8 (47 %) patients of group 3 and 9 (43 %) patients of group 4. Absence of repigmentation (less than 50 %) was in 2 (12 %) patients of group 3 and in 3 (14 %) patients of group 4. Therapy duration in groups 3 and 4 was 4—18 months. It should be noted that in groups 1 and 2, the treatment time significantly reduced compared with control groups. The percentage of patients with complete repigmentation increased. Approximately 40 % of patients of group 2 (with III and IV skin photo type by Fitzpatrick) needed re­entering of the cells, which should be taken into consideration when designing programs of treatment for these patients. Perhaps for such patients we should use higher doses of cells.
Conclusions. For optimal results of treatment of stable forms of vitiligo, we offer a comprehensive method based on the use of autologous melanocytes and keratinocytes. Its essence lies in the preparation of donor skin (induction of pigmentation or use of naturally hyperpigmented zones), preparation of the recipient vitiligo sites (intradermal injections of plasma enriched with platelets to produce high concentrations of growth factors) and the actual intradermal injection of melanocyte­keratynocyte suspension diluted in PrP solution in depigmented skin followed by local NB UVB 311 nm phototherapy.

Keywords: chromatodermatosis, stable form of vitiligo, melanocyte­keratinocyte suspension, cellular technology, phototherapy.

Objective — clinical estimation of effectiveness and safety of cosmetic medicines of «DemoSkin» series in treatment of complex acne, acneiform dermatites (rosacea, perioral dermatitis) and their combination with demodecosis.
Materials and methods. We were observing 112 patients aged 18 to 53 with acne and acneiform dermatites, and also their combination with demodecosis confirmed by microscopic study. Dermatological index of life quality (DILQ) was determined in these patients before and after treatment. All the patients were prescribed complex therapy according to the standards of beauty treatment as well as additional external therapy implying application of cosmetic preventive medicines of «DemoSkin» series.
Results and discussion. Application of complex therapy with cosmetic preventive medicines of “DemoSkin” series improved clinical results of acne and acneiform dermatitis treatment (inflammatory reaction of eruption elements and itching intensity reduced, feeling of discomfort and irritation disappeared). Full regress of eruption was observed after 1.5 months of treatment in 69 patients (61.61 %), after 2 months — in 39 patients (34.82 %), and only 4 patients (3.57 %) had to undergo treatment with this medicine for a longer period.
Only 34 (30.36 %) patients complained of moderate influence of the skin disease on their life quality, while the rest 78 (69.64 %) complained of its significant influence. After treatment, only 16 (14.29 %) patients complained of significant influence of skin disease on their life quality, and the rest 96 (85.71 %) patients felt evident improvement of their life quality. Patients with acne and acneiform dermatitis in combination with demodecosis proved not to have bugs-demodicides on the 7­th and 21­st days after treatment course completion.
Conclusions. Complex acne and acneiform dermatitis therapy treatment with cosmetic preventive medicines of «DemoSkin» series allows improving clinical results of such treatment, eliminating some of the factors that cause the disease, namely Demodex bug, which leads to significant (р < 0.05) increase of DILQ rates. Thus the medicine should be recommended for everyday application in combination with complex acne and acneiform dermatitis treatment, especially for the patients with acne and acneiform dermatitis in combination with demodecosis.

Keywords: acne, acneiform dermatites, demodecosis, treatment, «DemoSkin».

Inclusion of drugs that restore epidermal barrier in the complex therapy of chronic dermatoses will help to accelerate the evolution of clinical manifestations of the disease and reduce the time of treatment, which in turn, will permit to improve the health and social indicators of life of patients with chronic dermatosis.

Keywords: epidermal barrier, dry skin, atopic dermatitis.

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Objective — to assess therapeutic efficacy and tolerability of «Dermabin», skin ointment for psoriasis treatment manufactured by LLC «Pharmaceutical Plant “Biofarma”», Bila Tserkva, Ukraine.
Materials and methods. In total 82 patients with various forms of psoriasis were included in the study (53 men and 29 women), aged 18 to 65 years, with disease duration of 5 to 10 years and 5 to 10 % of the affected skin area. PASI (Psoriasis Area and Severity Index) was used for an impartial assessment of severity of the disease and efficacy of the treatment. Patients with PASI > 10 were included in the study. Clinical and laboratory examination of patients included full blood count and common urine analysis, as well as biochemical blood tests. Patients were divided into the treatment group and reference group, 41 persons in each. Patients of the treatment group received «Dermabin» and those of the reference group — a reference product «Diprosalic». The products were applied on the affected skin areas twice a day during 4 weeks. Safety of «Dermabin» was assessed based on monitoring of patients’ condition, frequency and nature of adverse reactions, findings of laboratory examinations, and evaluation of the general condition of patients.
Results and discussion. According to the patient examination record at the screening stage, 44 patients were diagnosed with psoriasis vulgaris, 30 — with exudative psoriasis, and 8 — with a long standing disease. Psoriatic process in most patients was progressive: emergence of fresh psoriatic elements, peripheral growth rim, strong­positive psoriatic triad. After 28 days of treatment, patients of both groups showed a statistically significant decrease in rash intensity (erythema, exfoliation, infiltration). As the treatment proceeded, both groups of patients had a gradually decreasing skin affection area and PASI index. During the entire treatment, patients did not report any complaints, adverse reactions, complications or intolerability events in relation to both products.
Conclusions. «Dermabin», skin ointment manufactured by LLC «Pharmaceutical Plant “Biofarma”», is an efficient and safe agent to treat various forms of psoriasis, since it contributes to a considerable reduction of clinical manifestations of the disease, thus significantly improving the quality of patients’ life. In terms of efficacy, «Dermabin» (LLC «Pharmaceutical Plant “Biofarma”», Bila Tserkva, Ukraine) is therapeutically equivalent to the reference product «Diprosalic» («Schering­Plough Labo», Belgium) and can be recommended for topical use in dermatology.

Keywords: psoriasis, treatment efficacy, «Dermabin», betamethasone dipropionate, salicylic acid.

Objective — to study nucleotropic properties of «Cidipol» — technologically improved «Cidipol» — preparation for the individual prevention of sexually transmitted diseases; at the second stage — to treat patients with herpes infection with «Cidipol».
Materials and methods. Laboratory researches in vitro were carried out by a special technique. Clinical effect of the local application of «Cidipol» was evaluated on 35 patients with herpes infection(20 — with simple orofacial herpes, 10 — with genital herpes and 5 — with Herpes Zoster).
Results and discussion. Using the model of the polymerase chain reaction in vitro we revealed a highly active nucleotropic action of «Cidipol» against the DNA of herpes simplex virus type 1, which served as the basis for the clinical study of its effectiveness as a topical agent in treatment of herpes skin and urogenital infections. Clinical observations have given positive results (complete elimination of clinical manifestations during 6—11 days). Expressed local anesthetic­antipruritic effect of «Cidipol» should be considered an dditional feature.
Conclusions. Use of «Cidipol» in the complex treatment of herpes diseases of the skin and mucous membranes contributes to quicker clinical recovery of patients. The drug can be used as a means of individual prevention of urogenital herpes virus infection.

Keywords: herpes virus infection, topical treatment, «Cidipol».

A rarecase of genodermatosis — family lamellar ichthyosis was described.

Keywords: lamellar ichthyosis, clinical case, course of disease, systemic retinoids.

Objective — to study the characteristics of clinical and morphological signs of skin lesions in patients with recurrent course of capillary purpura of Schenlein—Henoch (SHV) which began in childhood and adulthood.
Materials and methods. The study included 174 patients with SHV (53 % men and 47 % women). Vasculitis made its debut in childhood (on average at the age of 12) in 92 patients, and in adulthood (on average at the age of 25) — in 82 patients. I, II and III degrees of activity of the pathological process are set at a ratio of 1 : 2 : 2.
Results and discussion. Skin lesions in chronic recurrent course of SHV are recorded in 2/3 of patients as urticarial, hemorrhagic, papule­nodular, papule­necrotic, pustular­ulcerative, necrotic­ulcerative, nodose­ulcerative and polymorphic forms, depending on the integrated severity of the disease, the degree of activity of the pathological process, damages of joints, skeletal muscles, liver, pancreas and central nervous system. It is accompanied by a high serum level of immunoglo­bulin A, fibrinogen and rheumatoid factor which determine the clinical course of cutaneous vasculitis. At that, the disease which was transformed from juvenile SHV, in adults has urticarial form and not necrotic­ulcerative form with infiltration of skin with polymorph nuclear leukocytes and development of vasotrombosis. Age dimorphism of SHV is characterized by different frequency of eosinophilic infiltration and fibrinous necrosis of vessels, extravasation of red blood cells and fibrinogen deposition.
Conclusions. SHV proceeds in 8 different forms of skin syndrome, whose incidence, clinical manifestations and pathoge­netic features of constructions depend on the age of patients at the onset of the disease.

Keywords: capillary purpura, skin, children, adults.