УДК: 616. 5-018.74-007.14:616.13/.16

Objective. Determination of morphological features of skin lesions in patients with widespread psoriasis, study of the level of expression of immunohistochemical markers of vascularization.
Materials and methods. 80 patients with psoriasis were under observation. The control group consisted of 20 practically healthy people (control group) of the same age. All patients underwent a skin biopsy with a histological evaluation of the biopsy material to determine the form and severity of the course of psoriasis in accordance with the requirements of the morphological section of the modern classification.
Results and discussion. Applying the scale of intensity of skin vascularization according to Amin M.M. et. al. (2012), it was detected that damaged dermal areas due to psoriasis, on average, had 17.25±5.34 micro vessels at magnification (×400), which corresponds to the level of moderate vascularization (11-20 capillaries). Normal skin in control group had mean index 4.32±2.01 at (×400) at the level of weak vascularization (4-10 capillaries), which statistically reliably differs from general group (р˂0.05). Analysis of the condition of vascular bed at different levels of severity of psoriasis course showed that a number of cells at moderate degree of severity (22.65±5.87) was considerably higher than at mild psoriasis (10.09±3.22), and even more numerous than in CG (4.32±2.01). Statistically reliably both groups differ between them (р<0.05), and with CG (р<0.05). According to Fisher’s exact test, distribution of absolute meanings of monitoring of intensity of cytoplasmic staining with VEGF marker in all groups between them had a reliable difference (р<0.05). We detected a moderate correlation connection between increased intensity of VEGF expression and amplification of the severity of psoriasis course (r=+0.430). According to Fisher’s exact test, distribution of monitoring of intensity of cytoplasmic staining with MMP-9 marker in all groups between them had a reliable difference (р<0.05); a moderate correlation connection between increased intensity of MMP-9 marker expression and amplification of the severity of psoriasis course was detected (r=+0.532).
Conclusions. The results of conducted clinical, morphological and immunohistochemical investigations enable to consider importance of neoangiogenesis processes in pathogenesis of this dermatosis and need in elaboration of therapeutic measures with direct influence on this aspect of pathogenesis.
Key words: psoriasis, immunity, neoangiogenesis.

УДК 616.13-002-036-053.2-07:616.155.02

Kawasaki disease (KD) is an acute systemic vasculitis that is the most common cause of acquired heart disease in children under 5 years of age with hyperthermia. Diagnosis of KD is a clinical challenge, given the wide range of clinical manifestations and similarities with many viral and bacterial diseases. Purpose - to describe a clinical case of refractory КD in a three-month-old girl with an emphasis on the importance of echocardiography and coronary angiography for the final verification of the disease, urgent initiation of treatment with minimal suspicion of КD. Clinical case. The article reports on a three-month-old patient with a difficult diagnosis of refractory form of КD. The disease debuted with hyperthermia, enterocolitis, obstructive bronchitis, and hepatoliver syndrome. The manifestations of skin exanthema were initially considered as an allergic dermatitis to the use of a cephalosporin antibiotic. Multisystemic inflammatory syndrome associated with SARS-CoV-2 infection was suspected. After the use of immunosuppressive therapy with mega-doses of dexamethasone and intravenous human immunoglobulin 2 g/kg/day for 3 days, clinical improvement was achieved. Subsequently, the haemogram showed an increase in neutrophilic hyperleukocytosis to the appearance of blast cells, hyperthrombocytosis and severe anaemia. A differentiation was made between a leukemic reaction, the debut of myeloproliferative disease, juvenile myelomonocytic leukaemia. Against the background of a rapid decrease in the number of leukocytes, the girl developed hyperthermia, migratory intermittent maculopapular rash, and foots edema. Laboratory findings included thrombocytosis and an increase in acute-phase parameters. Echocardiography revealed left ventricular dilation, a small amount of excess fluid in the pericardium, dilatation of the left coronary artery evenly to the bifurcation. Computed tomography revealed giant coronary artery aneurysms, which gave grounds to diagnose KD

УДК: 616.53-002:616.155.3-008.13]-085.8-078.73

Introduction. Acne is one of the most common dermatological diseases. It may have a chronic course, leaving permanent marks, and in last years has been tending to have more and more severe clinical course with widespread skin lesions. According to recent studies, the development of acne is due to the combined effect of endogenous and exogenous factors, among which endocrine diseases, disorders of metabolic processes, reduced systemic immunity and phagocytic ability of mononuclear phagocytes and granulocytes at various stages of phagocytosis of pyogenic cocci, which contributes to more severe clinical course, and frequent relapse of this diseases. It was also proved that the intestinal microbiota plays an important role in the formation of homeostasis and immune response. The Objective of the study is to determine the evolution of phagocytosis indices in patients with acne under different comprehensive treatments, using oral antibiotics, immunotherapy (PRPtherapy), probiotics, low-dose birth control pills and IPL- therapy.
Materials and methods. We observed 93 women with acne aged from 18 to 25 years old. In 19 (20.43%) patient mild acne was diagnosed, in 41 (44.09%) – moderate acne, in 33 (35.48%) persons – severe acne, 54 (58.06%) persons suffered from acne up to 1 year, 39 (41.93%) – from 1 to 3 years. To assess the state of phagocytosis in patients with acne vulgaris, we determined phagocytic activity (PA) and phagocytic index (PI) of polymorphonuclear leukocytes, nitro blue tetrazolium recovery test (NBT test spontaneous) and NBT-test pyrogenal stimulated by recognized methods.
Results. Analysis of the studied parameters of phagocytosis at the end of treatment showed a significant increase in patients of the core group who were administered a comprehensive treatment which included oral antibiotic, probiotic, and low-dose birth control pills, PRP-therapy and IPLtherapy, as compared with the patients of other groups under study.
Conclusions. Using combined therapy for women with acne occurring against the backdrop of a sluggish process of phagocytosis and concomittant intestinal dysbiosis leads to normalization of the leading indices of phagocytosis (PI, PA, NBT tests both spontaneous and stimulated), and enchances their phagocytic activity both during capture and formation of bactericidal activity and in the final stages of phagocytosis justifying the feasibility of a combined use of antibiotics, probiotic, low-dose birth control pills PRP-therapy and IPL-therapy in the treatment of acne.
Key words: acne, phagocytosis, probiotic, PRP-therapy, IPL-therapy, low-dose birth control pills. 

Eight million Ukrainians have taken refuge in the European Union. Many have asthma and/or allergic rhinitis and/or urticaria, and around 100,000 may have a severe dis- ease. Cultural and language barriers are a major obstacle to appropriate management. Two widely available mHealth apps, MASK-air® (Mobile Airways Sentinel NetworK) for the management of rhinitis and asthma and CRUSE® (Chronic Urticaria Self Evaluation) for patients with chronic spontaneous urticaria, were updated to include Ukrainian versions that make the documented information available to treating physi- cians in their own language. The Ukrainian patients fill in the questionnaires and daily symptom-medication scores for asthma, rhinitis (MASK-air) or urticaria (CRUSE) in Ukrainian. Then, following the GDPR, patients grant their physician access to the app by scanning a QR code displayed on the physician's computer enablin to read the app contents in his/her own language. This service is available freely. It takes less than a minute to show patient data to the physician in the physician's web browser. UCRAID—developed by ARIA (Allergic Rhinitis and its Impact on Asthma) and UCARE (Urticaria Centers of Reference and Excellence)—is under the auspices of the Ukraine Ministry of Health as well as European (European Academy of Allergy and Clinical immunology, EAACI, European Respiratory Society, ERS, European Society of Dermatologic Research, ESDR) and national societies.

UDC  618.03-06:616.441-002-073.7:612.882.3

Thyroid disease is the second most common endocrine disorder after diabetes inpregnancy.Thyroidhormonesarecrucialforthegrowthandmaturationofmanytargettissues,especiallythebrain and skeleton. During critical periods in the first trimester of pregnancy, maternal thyroxine is essential forfetal development as it supplies thyroid hormone-dependent tissues. The purpose of the study was to researchthe features of the bioelectrical activity of the brain in pregnant women with thyroid pathology and determine thefrequency of such changes. Materials and methods.The state of bioelectrical activity of the brain was evaluatedby electroencephalography in 160 pregnant women with thyroid pathology. The biopotentials of the brain in thesubjects were studied with software and hardware complex DX-NT32 (DX Complexes software, Kharkiv, Ukraine)and computer processing of electroencephalography data. Electrodes in the amount of 16 pieces were appliedaccording to the international scheme 10/20 in the bipolar interpretation. Results. Specific changes in electro-encephalograms characteristic of each type of thyroid pathology and dependent on its severity were revealed inpregnant women. Acquired disorders adversely affect the course of pregnancy and childbirth in women with thyroidpathology. Increased anxiety with depressive tendencies, reduced general activity, a feeling of depression, anxiety,and low mood were detected in women with thyroid disorders. The identified criteria make it possible to attributethese changes to the manifestations of a pathological neurotic state in conditions of maladaptation, which wasconfirmed by electroencephalography data. Conclusions. The detected disorders of spontaneous and evokedbrain activity indicate the existence of a cerebral basis of psychological stress, which has a qualitative effect onelectroencephalography. Acquired disorders negatively affect the course of pregnancy, childbirth, perinatal out-comes, and future development of the child.Keywords:pregnant women; thyroid gland; diffuse non-toxic goiter; diffuse toxic goiter; electroencephalography