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Features of the course of the disease, quality of life and cytokine profile in patients with psoriasis vulgaris in the stationary stage and comorbid depression 静止期寻常型银屑病患者的病程特点、生活质量和细胞因子谱
Pub Date : 2024-07-20 DOI: 10.33667/2078-5631-2024-9-46-50
N. A. Gorlova, Y. Sherengovskaya, D. A. Ravlyuk, D. V. Prokhorov, M. B. Ispiryan
Aim. To study the characteristics of the course of the disease, quality of life and cytokine profile in patients with psoriasis vulgaris in the stationary stage and depression.Material and methods. A prospective, cross-sectional comparative study involved 154 patients with vulgar psoriasis in the stationary stage; Of these, two groups were formed: 83 patients with comorbid depression and 71 without comorbid depression. The Hamilton scale was used to determine depressive symptoms and severity.Result. Patients with psoriasis vulgaris in the stationary stage and depression were characterized by a younger age (p=0.007), a more severe course of the disease according to the PASI index (p<0.001), visual analogue scale (p=0.014), and a higher frequency of relapses (p=0.012) and a lower level of quality of life according to the DLQI questionnaire (p<0.001), as well as higher values of IL-6 and IL-17 in the blood serum (p=0.011; p=0.001, respectively). An inverse correlation was established between the average total value on the Hamilton scale and the age of the patients (r= –0.61; p=0.002), a direct one – with the average total values on the PASI index (r=0.72; p=0.001), visually analogue scale (r=0.63; p<0.001), DLQI (r=0.69; p=0.001) and IL-17 (r=0.62; p=0.012).Conclusion. In patients with depression, psoriasis vulgaris in the stationary stage is more severe, accompanied by an increase in systemic proinflammatory changes and a more significant decrease in quality of life than in patients without depression. The results obtained must be taken into account when choosing a therapeutic strategy for psoriasis vulgaris, which will personalize treatment and increase its effectiveness.
目的研究处于静止期的寻常型银屑病患者的病程特点、生活质量和细胞因子谱。这项前瞻性横断面比较研究涉及 154 名处于静止期的寻常型银屑病患者;其中分为两组:83 名合并抑郁症的患者和 71 名无合并抑郁症的患者。采用汉密尔顿量表确定抑郁症状和严重程度。静止期寻常型银屑病合并抑郁症患者的特点是年龄较小(P=0.007),根据 PASI 指数(P<0.001)和视觉模拟量表(P=0.014)、复发频率更高(p=0.012)、根据 DLQI 问卷调查的生活质量水平更低(p<0.001),以及血清中 IL-6 和 IL-17 的数值更高(分别为 p=0.011 和 p=0.001)。汉密尔顿量表的平均总值与患者年龄呈反向相关(r=-0.61;p=0.002),与PASI指数(r=0.72;p=0.001)、视觉模拟量表(r=0.63;p<0.001)、DLQI(r=0.69;p=0.001)和IL-17(r=0.62;p=0.012)的平均总值呈正向相关。与没有抑郁症的患者相比,抑郁症患者的寻常型银屑病静止期更为严重,伴随着全身促炎性变化的增加和生活质量的显著下降。在选择寻常型银屑病的治疗策略时,必须考虑到所获得的结果,这将使治疗个性化并提高治疗效果。
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引用次数: 0
Complications after liposuction: current state of the problem (literature review) 吸脂术后并发症:问题现状(文献综述)
Pub Date : 2024-07-20 DOI: 10.33667/2078-5631-2024-9-83-86
L. A. Maitesyan
The variety of body shape correction techniques based on liposuction and currently used in plastic surgery is largely due to the desire to achieve the greatest possible cosmetic effect and, at the same time, minimize the possible negative consequences of invasive intervention. The choice of a specific method depends on a number of factors, among which are the treatment plan agreed with the patient, the individual characteristics of the patient being operated on, the presence or absence of medical contraindications to the use of certain techniques, the qualifications of the personnel, the level of material equipment of the operating unit. Liposuction is the aspiration of fat from subcutaneous tissue. It can be used for aesthetic lipoplasty or combined with body contouring surgery. The article is of a review nature and contains modern data on the medical effects of liposuction, VASER (Vibration Amplification of Sound Energy at Resonance) and PAL (Power Assisted Liposuction) techniques, and possible complications after liposuction.
目前整形外科使用的以吸脂术为基础的体形矫正技术种类繁多,这在很大程度上是由于人们希望在获得最大美容效果的同时,尽量减少侵入性干预可能带来的负面影响。具体方法的选择取决于多种因素,其中包括与病人商定的治疗计划、接受手术病人的个体特征、有无使用某些技术的医学禁忌症、工作人员的资质、手术单位的物质设备水平等。吸脂术是从皮下组织抽吸脂肪。它可用于美容性脂肪成形术或与身体塑形手术相结合。本文为综述性质,包含吸脂术、VASER(共振声能振动放大)和 PAL(动力辅助吸脂)技术的医疗效果以及吸脂术后可能出现的并发症等方面的现代数据。
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引用次数: 0
The possibilities of correction of premature greying of hair and involutive hair changes 纠正头发早白和毛发内卷变化的可能性
Pub Date : 2024-07-20 DOI: 10.33667/2078-5631-2024-9-7-11
E. Shatokhina, A. V. Topskaya, L. S. Kruglova
The review highlights the available published data on the etiopathogenesis of early graying, hair involution and restoration methods. Early graying of hair is defined as settlement before the age of 20 in Caucasians, before the age of 25 in Asians and before the age of 30 in Africans. In etiopathogenesis, an imbalance between oxidative stress and the antioxidant system is considered as the leading mechanism, a significant role is played by genetic predisposition, hormonal disorders of the thyroid gland, acute stress; the causes may also be deficiency of vitamin B12, copper, iron. Currently, the active molecule palmitoyl tetrapeptide-20 is used to prevent pigment loss and restore it. The endocannabinoid system in the hair follicle is also considered as a target for stimulation during the restoration of hair growth.
这篇综述重点介绍了有关头发早白的发病机理、头发内卷和修复方法的现有公开数据。头发早白的定义是:白种人在 20 岁之前、亚洲人在 25 岁之前、非洲人在 30 岁之前出现白发。在发病机制方面,氧化压力和抗氧化系统之间的失衡被认为是主要机制,遗传易感性、甲状腺激素紊乱、急性压力也起着重要作用;原因还可能是缺乏维生素 B12、铜和铁。目前,活性分子棕榈酰四肽-20 被用于预防和恢复色素脱失。毛囊中的内源性大麻素系统也被认为是恢复头发生长过程中的刺激目标。
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引用次数: 0
Itch prevalence analysis and its characteristics among acne patients 痤疮患者瘙痒发生率分析及其特点
Pub Date : 2024-07-20 DOI: 10.33667/2078-5631-2024-9-41-45
A. Lvov, E. E. Sidorenko, O. A. Sidorenko
Introduction. Acne is a multifactorial chronic inflammatory disease of the pilosebaceous follicle, which manifests itself as open and closed comedones, papules, pustules and nodules.Purpose of the study. Studying of itch prevalence among patients with acne, as well as assessing its impact on their quality of life and psychoemotional status.Materials and methods. Under observation were 249 patients diagnosed with acne aged from 12 to 50 years, of which 143 women (57.4%), 106 men (42.6%). Patients were diagnosed based on complaints, anamnesis and clinical picture of the disease. To assess the impact of itching on the quality of life, the Acne Psychological and Social Effect Scale (APSEA), the Dermatological Life Quality Index (DLQI), the Cardiff Social Disadaptation Index (CADI), the Rosenberg self-esteem scale, and a self-developed questionnaire were used to assess the impact of itching on the quality of life. Questionnaire, YOUR itch.Results. To solve these problems, based on the criteria for inclusion, non-inclusion and exclusion, two clinical comparison groups were formed, comparable in terms of main clinical diagnostic indicators. The first group consisted of patients with itching due to acne (64 people, 26% of subjects), the second group consisted of patients with no itching (185 people, 74% of subjects). According to the results of the study, a statistically significant relationship between the presence of itching in acne and age, gender, the presence of obesity, impaired carbohydrate tolerance, iron deficiency anemia, hyperprolactinemia was revealed, various characteristics of itching in the subjects were described, and a close correlation of the indicators of the indices used was revealed.Conclusions. Studying the prevalence of itching in acne is a relevant area and allows us to expand our understanding of the role of subjective sensations in the development of acne and further evaluate the impact of this dermatosis on the quality of life of patients.
导言。痤疮是一种由多种因素引起的皮脂腺毛囊慢性炎症性疾病,表现为开放性和闭合性粉刺、丘疹、脓疱和结节。研究痤疮患者的瘙痒发生率,并评估其对患者生活质量和心理情绪的影响。观察对象为 249 名确诊为痤疮的患者,年龄在 12 至 50 岁之间,其中女性 143 名(57.4%),男性 106 名(42.6%)。根据患者的主诉、病史和临床表现对其进行诊断。为了评估瘙痒对生活质量的影响,研究人员使用了痤疮心理和社会影响量表(APSEA)、皮肤病生活质量指数(DLQI)、卡迪夫社会适应指数(CADI)、罗森伯格自尊量表和一份自制的调查问卷来评估瘙痒对生活质量的影响。问卷、《OUR itch.Results》。为了解决这些问题,根据纳入、未纳入和排除标准,组成了两组在主要临床诊断指标方面具有可比性的临床对比组。第一组由痤疮引起瘙痒的患者组成(64 人,占受试者的 26%),第二组由无瘙痒的患者组成(185 人,占受试者的 74%)。研究结果显示,痤疮瘙痒与年龄、性别、是否肥胖、碳水化合物耐受性受损、缺铁性贫血、高泌乳素血症之间存在统计学意义上的显著关系,描述了受试者瘙痒的各种特征,并揭示了所用指数指标之间的密切联系。研究痤疮中瘙痒的发生率是一个相关领域,它使我们能够扩大对主观感觉在痤疮发展中的作用的认识,并进一步评估这种皮肤病对患者生活质量的影响。
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引用次数: 0
Using the Height-for-Age Z-score (HAZ) to predict protein-energy malnutrition in patients with congenital epidermolysis bullosa through the application of machine learning methods 通过应用机器学习方法,利用年龄身高Z值(HAZ)预测先天性表皮松解症患者的蛋白质-能量营养不良情况
Pub Date : 2024-07-20 DOI: 10.33667/2078-5631-2024-9-55-60
O. S. Orlova
Congenital epidermolysis bullosa (СЕВ) is a group of genetically and clinically heterogeneous diseases characterized by a tendency to form blisters and/or erosions on the skin and mucous membranes with minimal trauma. Nutritional deficiency stands as the most common complication observed in EB, with its development influenced by a multitude of contributing factors.Purpose of the study. To construct a predictive model for the development of protein-energy malnutrition in patients with various forms of EB, identify the main features affecting the sensitivity of the predictive model, and evaluate the model’s validity based on retrospective data on the presence of protein-energy malnutrition in this patient category.Methods. The study involved 101 patients aged 3 to 18 years with simplex (n=25), junctional (n=10), and dystrophic (n=66) СEB. The Birmingham EB Severity Score, laboratory and anthropometric parameters, as well as data on the presence of gastrointestinal complications, were used for the analysis of disease progression and predictive model construction. The Scikit-learn library of the programming language Python was utilized for building the machine learning model.Results. In the construction of the predictive model, the RandomForestClassifier model showed the best results. The developed machine learning model can correctly determine whether a patient has chronic protein-energy malnutrition (class 1, HAZ < –2) or not (class 0, HAZ > –2) with an accuracy of 92%, sensitivity of 85.7%, and specificity of 100%.Conclusions. The machine learning model presented in this study predicts the values of the Height-for-Age Z-score (HAZ) and can have practical significance in medical practice and clinical research. The model can be used for early diagnosis of protein-energy malnutrition in patients with EB, which may allow healthcare professionals to timely start nutritional support and prevent possible complications of the disease, as well as develop individual nutrition and treatment plans for patients.
先天性大疱性表皮松解症(СЕВ)是一组遗传和临床异质性疾病,其特点是在皮肤和粘膜上易形成水疱和/或糜烂,创伤极小。营养缺乏是 EB 最常见的并发症,其发病受到多种因素的影响。构建各种形式 EB 患者发生蛋白质-能量营养不良的预测模型,确定影响预测模型灵敏度的主要特征,并根据该类患者出现蛋白质-能量营养不良的回顾性数据评估模型的有效性。研究涉及 101 名 3 至 18 岁的单纯性(25 人)、交界性(10 人)和营养不良性(66 人)СEB 患者。伯明翰 EB 严重程度评分、实验室和人体测量参数以及胃肠道并发症数据被用于分析疾病进展和构建预测模型。在构建机器学习模型时,使用了编程语言 Python 的 Scikit-learn 库。在构建预测模型的过程中,随机森林分类器(RandomForestClassifier)模型的效果最佳。所开发的机器学习模型可以正确判断患者是否患有慢性蛋白质能量营养不良(1级,HAZ<-2)(0级,HAZ>-2),准确率为92%,灵敏度为85.7%,特异性为100%。本研究提出的机器学习模型可预测年龄身高 Z 值(HAZ),在医疗实践和临床研究中具有实际意义。该模型可用于 EB 患者蛋白质能量营养不良的早期诊断,使医护人员能够及时开始营养支持,预防疾病可能出现的并发症,并为患者制定个性化的营养和治疗方案。
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引用次数: 0
“Burning scalp” syndrome: relevance, place in clinical taxonomy and therapeutic approaches "灼热头皮 "综合征:相关性、在临床分类中的地位和治疗方法
Pub Date : 2024-07-20 DOI: 10.33667/2078-5631-2024-9-25-30
A. Lvov, A. D. Levina, A. A. Skandaryan
One of the sensitive skin types is the “burning scalp” syndrome. It is the most expressed subjective symptom complex of tactile sensations in the projection of the skin of the scalp. The most common manifestations of this syndrome, which significantly reduces the quality of patient’s life, are burning, itching, pain, trichodynia, redness like flushing and persistent erythema, mild exfoliation and hair loss sometimes. The “burning scalp” formation is heterogeneous and can be associated with comorbid dermatoses (seborrheic dermatitis, eczema, atopic dermatitis, psoriasis, rosacea, fungal and bacterial contamination, alopecia, etc.), organ and visceral pathology (diabetes mellitus, multiple sclerosis, tumors of the central nervous system, paraneoplastic conditions, immunodeficiencies, etc.), psychosomatic abnormalities (conversion disorders, sensory hypochondria, somatoform pruritus) and environmental influences (aquagenic pruritus, ultraviolet radiation). Now, there are no general recommendations for the “burning scalp” treatment. For long-term accompanying treatment and prevention, therapeutic cosmetics that normalize the microbiome and have antipruritic and anti-inflammatory effects are promising.
"头皮灼热 "综合征是敏感性皮肤类型之一。它是头皮皮肤投影触觉最明显的主观症状综合征。灼热、瘙痒、疼痛、毛囊炎、潮红和持续性红斑、轻度脱落和脱发是该综合征最常见的表现,有时会明显降低患者的生活质量。头皮烧灼感 "的形成是多种多样的,可能与合并皮肤病(脂溢性皮炎、湿疹、异位性皮炎、银屑病、酒渣鼻、真菌和细菌感染、脱发等)有关。)、器官和内脏病变(糖尿病、多发性硬化症、中枢神经系统肿瘤、副肿瘤性疾病、免疫缺陷等)、心身异常(转换障碍、感觉性疑病症、躯体形式瘙痒症)和环境影响(水生瘙痒症、紫外线辐射)。现在,还没有关于 "头皮烧灼感 "治疗的一般性建议。对于长期的伴随治疗和预防,使微生物组正常化并具有止痒和抗炎作用的治疗性化妆品很有前途。
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引用次数: 0
Efficacy of modern methods for assessing the severity of alopecia areata 评估斑秃严重程度的现代方法的有效性
Pub Date : 2024-07-20 DOI: 10.33667/2078-5631-2024-9-37-40
E. Matushevskaya
Purpose of the study. To evaluate the effectiveness of the standardized SALT scale to determine the severity of AA patients.Materials and methods. A one-time retrospective cohort study was conducted. There were 40 patients with AA under supervision. The gender distribution of the patients was as follows: 15 men (36.6%) and 25 (63.3%) women. The average age was 29.4 years in the 18–54 age range.Results. The AA debut varied widely in age range from 2 to 45 years. The average age at which the pathological process began was 18,2±4,4 years. 22.4% of patients with a scalp hair area of more than 25%, as well as hair loss in other areas of the body and changes in the nail.The beginning of AA is fixed to 10 years. More than two relapses occurred in 54.5% of patients with scalp hair lesions of more than 25% and only 9.2% of cases with foetal AA.The following clinical forms were diagnosed: foetal (12 patients), lenticular (ophiasis, inversive ophiasis) (7 patients), multi-focal (11 patients), total and universal (10 patients). According to the SBN Hair Loss State scale, S1 clinically corresponded to focal alopecia, S2 -S4 – ophazis, multi-focal alopecia, S5 – TA and UA. Partial or complete hair loss has been noted in these areas in 38% of patients with S2-S3 and 67% with S4-S5 clinical forms. The combination of different degrees of body hair loss and dystrophy of nail plates in examined AA patients was observed in 25% of cases.Conclusion. In determining the severity of alopecia nest principally not only the size and number of lesions on the skin scalp, but also the nature of hair loss on the skin of the eyebrows and eyelashes, as well as the possible combination of hair loss and dystrophic altered nail plates, which is considered an option for a more severe course of the disease. The SBN system effectively evaluates and describes the clinical variant of AA according to a standardized scale, which can help determine clinical management of patients with different manifestations, as well as predict the course of the disease.
研究目的评估标准化 SALT 量表在确定 AA 患者病情严重程度方面的有效性。进行一次性回顾性队列研究。共有 40 名接受监护的 AA 患者。患者的性别分布如下:男性 15 人(36.6%),女性 25 人(63.3%)。平均年龄为 29.4 岁,介于 18-54 岁之间。初次登台的 AA 患者年龄差异很大,从 2 岁到 45 岁不等。病理过程开始的平均年龄为 18.2±4.4 岁。22.4%的患者头皮毛发面积超过 25%,身体其他部位也出现脱发和指甲变化。54.5%的头皮毛发病变面积超过 25%的患者会出现两次以上的复发,只有 9.2%的患者会出现胎儿型 AA。根据 SBN 脱发状况量表,S1 临床上与局灶性脱发相对应,S2 -S4 - 卵巢性脱发、多灶性脱发,S5 - TA 和 UA。临床表现为 S2-S3 和 S4-S5 的患者中,分别有 38% 和 67% 在这些部位出现部分或全部脱发。在接受检查的 AA 患者中,有 25% 的病例合并有不同程度的体毛脱落和甲板萎缩。在确定脱发严重程度时,主要不仅要看头皮皮损的大小和数量,还要看眉毛和睫毛皮肤脱发的性质,以及脱发和甲板萎缩性改变的可能组合,这被认为是病程更严重的一种选择。SBN 系统根据标准化量表有效地评估和描述了 AA 的临床变异,有助于确定不同表现患者的临床治疗方法,并预测疾病的进程。
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引用次数: 0
Review of modern methods of treating vitiligo 回顾治疗白癜风的现代方法
Pub Date : 2024-07-20 DOI: 10.33667/2078-5631-2024-9-12-16
E. V. Bazhenova, M. S. Kruglova
Vitiligo is an autoimmune disease that causes skin depigmentation. The article is a review of the literature with a detailed description of the pathogenesis and the main combinations of therapeutic approaches. The issue of the use of oral and topical janus kinase inhibitors for the treatment of vitiligo was raised.
白癜风是一种导致皮肤脱色的自身免疫性疾病。本文是一篇文献综述,详细介绍了发病机制和主要的治疗方法组合。其中提出了使用口服和外用破伤风激酶抑制剂治疗白癜风的问题。
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引用次数: 0
Efficacy of netakimab in patients with psoriasis and disease duration up to 1 year: implementation of a strategy for early prescription of genetic engineering biological therapy 奈达单抗对银屑病患者的疗效和长达 1 年的病程:实施基因工程生物疗法早期处方战略
Pub Date : 2024-07-20 DOI: 10.33667/2078-5631-2024-9-19-25
L. S. Kruglova, N. Pereverzina, N. Rudneva
Currently, in actual clinical practice, there is an increasing consensus that early administration of a biologically active drug not only prevents the progression of the pathological process in the skin, but also prevents the development of psoriatic arthritis, and also has a beneficial effect on comorbid pathologies and complications associated with systemic inflammation. Early treatment can modify the course of the disease and prevent not only the development of severe forms and disability, but also stop the progression of psoriasis, taking into account all stages of pathogenesis. In this aspect, the prescription of IL-17A blockers is justified.Material and methods. The study included a total of 16 patients aged 18–35 years with a period of manifestation of skin psoriasis <1 year, who received netakimab at a dosage of 120 mg subcutaneously at 0, 1, 2 weeks and then 120 mg every month for 52 weeks.Results. By week 4, 68.75% (n=11) of patients achieved PASI 75, 37.5 % (n=6) PASI90 and 18.75% (n=3) PASI100. By week 8, delta PASI75 was observed in 87.5% (n=14) of patients, 68.75% (n=11) – PASI90 and 50% (n=8) – PASI100. By week 24, 100% (n=16) of patients achieved PASI75,81.25% (n=13) – PASI90 and 68.75% (n=11) – PASI100. By week 52, PASI75 delta was observed in 100% (n=16) patients, 100% (n=16) had PASI90 and 87.5% (n=14) had PASI100.Conclusions. Patients with a shorter duration of the disease (up to 1 year) during netakimab therapy achieve PASI75, PASI90, PASI100 in a shorter time (comparison with clinical trial data). In the presence of factors for the aggressive course of psoriasis (rapid progression of the process, widespread process upon manifestation, lack of effect from topical therapy, constantly progressive course, risk factors for PsA, subclinical course of PsA), early prescription of genetic engineering biological therapy (netakimab) should be considered as the most appropriate strategy.
目前,在实际临床实践中,越来越多的人一致认为,及早服用具有生物活性的药物,不仅可以防止皮肤病理过程的进展,还可以防止银屑病关节炎的发生,对合并病症和全身炎症相关并发症也有好处。考虑到银屑病发病的各个阶段,早期治疗可以改变病程,不仅可以预防严重病症和残疾的发生,还可以阻止银屑病的发展。在这方面,IL-17A 阻断剂的处方是合理的。该研究共纳入了16名年龄在18-35岁、皮肤银屑病表现期小于1年的患者,他们分别在0、1、2周时皮下注射120毫克的奈达吉单抗,然后每月注射120毫克,共52周。第4周时,68.75%(11人)的患者PASI达到75,37.5%(6人)的患者PASI达到90,18.75%(3人)的患者PASI达到100。到第 8 周,87.5%(14 人)的患者达到 PASI75,68.75%(11 人)达到 PASI90,50%(8 人)达到 PASI100。到第 24 周,100%(16 人)的患者达到 PASI75,81.25%(13 人)达到 PASI90,68.75%(11 人)达到 PASI100。到第 52 周,100%(16 人)的患者达到 PASI75 delta,100%(16 人)的患者达到 PASI90,87.5%(14 人)的患者达到 PASI100。结论:在奈达单抗治疗期间,病程较短(1年以内)的患者能在较短时间内达到PASI75、PASI90和PASI100(与临床试验数据比较)。如果存在银屑病病程迁延的因素(病程进展迅速、发病时病程广泛、局部治疗效果不佳、病程持续进展、PsA 的危险因素、PsA 的亚临床病程),应考虑尽早采用基因工程生物疗法(奈达单抗)作为最合适的策略。
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引用次数: 0
Skin microbiome and atopic dermatitis (Resolution of the Council of Experts) 皮肤微生物群与特应性皮炎(专家委员会决议)
Pub Date : 2024-07-20 DOI: 10.33667/2078-5631-2024-9-97-100
L. S. Kruglova, A. N. Lvov, E. R. Araviiskaia, A. Bakulev, M. Kokhan, E. Matushevskaya, N. Murashkin, O. Olisova, V. A. Okhlopkov, A. Samtsov, I. O. Smirnova, E. V. Sokolovsky, O. B. Tamrazova
The article presents the results of an expert council to discuss the relationship between disorders of the skin microbiome and the course of atopic dermatitis, as well as the key mechanisms of action on the skin of a complex of pro- and prebiotics in dermatocosmetics for use in patients with dermatoses from the perspective of modern clinical protocols.
文章介绍了专家委员会讨论皮肤微生物群紊乱与特应性皮炎病程之间关系的结果,以及从现代临床方案的角度探讨皮肤化妆品中的益生菌和益生元复合物对皮肤的主要作用机制。
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引用次数: 0
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