RETROSPECTIVE CHART ANALYSIS OF PATIENTS DIGNOSED WITH ACANTHOLYTIC PEMPHIGUS FOR THE PERIOD 2008-2018.

OBJECTIVE: The aim: Determine the clinical and anamnestic criteria that cause the аcantholytic pemphigus (AP) morbidity in the course of the treatment. PATIENTS AND METHODS: Materials and methods: Analysis of medical histories of patients who underwent the therapy on the basis of the clinic for 10 years. In the analysis of 174 medical case histories were determined the factors provoking the onset and exacerbation of the disease. The disease severity was assessed using the IKEDA index. RESULTS: Results: During the analysis, patients were divided into two groups. The I group - patients who required combination therapy - systemic glucocorticosteroids (SGCs) and immunosuppressant (azathioprine (AZA)). For patients of group II used SGCs - according to the indications. The presence of intoxication and signs of pyoderma were more common in patients of group I. The number of exacerbations per year for an unknown reason in group I was almost 3 times higher. The ineffectiveness of high starting doses of SGCs was 20.2% of cases compared with those in group II. CONCLUSION: Conclusions: According to clinical and anamnestic data, during the retrospective analysis of case histories, the criteria determining the severity of acantholytic pemphigus during treatment were determined: the age of patients, the diagnosis period, the prevalence of lesions and severity of dermatosis according to the IKEDA index, the selection of adequate treatment tactics, taking into the complications caused as a result of the systemic glucocorticosteroids therapy.

PECULIARITIES OF TREATMENT OF PATIENTS WITH ONYCHOMYCOSIS WITH CONTRAINDICATIONS TO SYSTEMIC ANTIMYCOTICS.

OBJECTIVE: The aim: To increase the effectiveness of treatment of patients with onychomycosis with contraindications to administration of systemic antifungal therapy. PATIENTS AND METHODS: Materials and methods: The study involved 63 patients with onychomycosis of the toes aged 18 to 72 years under supervision at the clinic of the Institute of Dermatology and Venereology of the National Academy of Medical Sciences of Ukraine, who were divided into groups: Group I (30 patients) received naftifine hydrochloride solution and cream; Group II (33 patients) additionally used nail kit mycosan and cytoflavin 2 tablets 2 times a day for 1-1.5 months. The study implied microscopic and molecular genetic examination of nail plates before treatment and starting from the 4th week every 2 weeks. The study included patients with onychomycosis with positive results of both microscopic and PCR studies. Mycological recovery was noted in case of coincidence of results of these studies. RESULTS: Results: Mycological recovery in patients of Group II began in the sixth week in 6.3% and occurred in 100% of cases at the 24th week of treatment, depending on the severity and clinical form. The overall effectiveness of therapy at the 48th week reached 56.7% in Group I and 72.7% in Group II. CONCLUSION: Conclusions: The developed method of treatment, which includes the use of naftifine hydrochloride solution and cream, nail kit micozan and cytoflavin, allows to achieve clinical and mycological recovery in 72.7% of patients and is a priority in the treatment of patients with onychomycosis with comorbid conditions.