ABSTRACT
As numerous scientific data show, despite the fact that patients with severe psoriasis have a high risk of coronavirus infection, COVID-19 in this group proceeds quite easily. However, many specialists have encountered an unusual exacerbation of the pso-riatic process already after the infection, the reasons for which may be several. On the one hand, the skin is one of the target organs for SARS-CoV-2, on the other hand, exacerbations may be caused by the immune system response to the infection. The influence of specific therapy on the course of the psoriatic process is also not excluded. But interleukin status of patients with psoriasis is of the greatest interest. It is known that interleukin-6 (IL-6) plays an active role in pathogenesis of COVID-19 and cytokine storm arising at infection. It is also regarded as an indicator of inflammatory activity in psoriasis. In addition, IL-6 is involved in lipid and hepatobiliary disorders in this group of patients. It is also associated with IL-17, the role of which has been well studied in psoriasis and autoimmune hepatitis. Patients with psoriasis often have changes in biochemical blood parameters, similar to those seen with COVID-19. Combinations of all these factors can lead to exacerbation of psoriasis with predominance of erythroderma and toxic component. In our opinion, in such cases it is necessary to include in the therapy a systemic hepato-protective drug containing glycyrrhizic acid. It has a pronounced anti-inflammatory effect, inhibits IL-6 production and allows to achieve significant improvement of psoriatic process in a short time. © 2022, Remedium Group Ltd. All rights reserved.
ABSTRACT
A new SARS-CoV-2-associated coronavirus infection pandemic began in late 2019. The present article is devoted to the analysis of the mechanisms of COVID-19 impact on the course of psoriasis and its consequences. According to the scientific literature, patients with psoriasis are somewhat more likely to be infected with coronavirus infection than the healthy population, but tolerate it in a milder form. At the same time, cases of psoriatic process exacerbation during the active phase of the disease and after COVID-19 have been described. The negative effect of infection on skin disease can be explained by the common genome of the two nosologies, the «cytokine storm» and the prescription of COVID-19 drugs. In addition, both COVID-19 and psoriasis can cause liver dysfunction related to the specific pathogenesis of the diseases as well as the prescribed therapy. The article describes our own experience of monitoring patients with exacerbation of psoriasis against the background of coronavirus infection with pathological changes in liver tests. Inclusion of a fixed combination of glycyrrhizic acid and essential phospholipids in the complex treatment allowed to stop the exacerbation of the psoriatic process more effectively, to reduce the activity of liver enzymes without worsening the clinical conditions associated with COVID-19. Thus, in particular, a clinically significant improvement of the skin condition was recorded. In patient B., alanine aminotransferase activity decreased to 44.4 U/L and aspartate aminotransferase activity to 18.2 U/L. In turn, in patient M. the activity of liver enzymes decreased to 37.8 U/L and 34.7 U/L, respectively. The prescription of this drug can be considered pathogenetically justified, given the effect of glycyrrhizic acid on the production of key cytokines involved in the inflammatory process in psoriasis, coronavirus infection and liver pathology. In addition, the hypothesis of the ability of glycyrrhizic acid to prevent the entry of SARS-CoV-2 into the cell by reducing the expression of angiotensin-converting enzyme 2 is of interest. © Katkova K.V., Plieva K.T., Denisova E.V., Zhukova O.V., Volnukhin A.V., Korsunskaya I.M. 2021.
ABSTRACT
Hair loss has always been and remains an urgent challenge in the world today. Although this condition is not life-threatening, it still has a strong impact on the patients’ quality of life. Hairlines are affected by multiple factors including age, family history, smoking, nutrition, etc. Alopecia can take many forms, and the specialist’s objective is to determine the correct cause of the disorder of hair growth cycle by taking a medical history from a patient. The key role in the pathogenesis of androgenetic alopecia is assigned to changes in hormonal status. Telogen effluvium can be triggered by stress, medication, pregnancy, or other medical conditions. For instance, the high number of patients who have had COVID-19 are now faced with hair loss a few months after recovery. Despite the variety of underlining causes of hair loss, the principle of therapy is the same – the elimination of the trigger and the selection of drugs to normalize the natural hair growth cycle. In this case, the use of drugs containing proteoglycans that are specific proteins involved in the regulation of the hair growth cycle looks promising. Numerous studies demonstrate the efficacy of such proteoglycans as versican, decorin, and syndecan. They activate hair growth and help prolong the anagen phase. This effect of proteoglycans affords to speak about their good therapeutic and even prophylactic properties applied to the problem of hair loss. © 2021, Remedium Group Ltd. All rights reserved.
ABSTRACT
Stress has always been one of the triggers of hair loss. The global pandemic of COVID-19 infection has become such a factor for many people. Considering that the pathogenesis of hair loss in this infection has not been sufficiently studied yet, many authors suggest that, as the infection itself and the associated psychoemotional condition and the therapy can cause diffuse thinning of hair and androgenic alopecia. Several studies demonstrate a link between androgens involved in the pathogenesis of COVID-19 and the possible development of androgenic alopecia. Other researchers have observed many cases of telogen hair loss associated with this infection. In our practice, we also encounter diffuse hair thinning, presumably caused by COVID-19. Often, many patients do not consider necessity of consulting with doctor for hair loss. They look for medical help only when self-medication does not give the expected result. After these attempts to independently conduct therapy in some cases patients develop negative attitude towards certain drugs. In such cases, the doctor’s task is to adequately assess the patient’s condition and offer the optimal therapy in each specific case. Often, diffuse hair thinning of a telogen nature, which has arisen against the background of various infections, can be stopped without the help of drugs. The article describes the experience of applying care products with natural and innovative components in the fight against COVID-19-induced alopecia, which can be applied in the practice of a dermatologist. © 2021, Remedium Group Ltd. All rights reserved.