УДК 616.53-002:616-008.9-092.19: (616.85+616.43/.45)-06:[616.988:578.834.1]

Acne is a multifactorial chronic inflammatory disease with primary damage to the pilosebaceous unit and the polymorphic clinical manifestations associated with overproduction of sebaceous glands, pathological desquamation of the sebaceous epithelium of the sebum follicles, activation of saprophytic, conditionally pathogenic microorganisms, and psychoemotional disorders. This is undoubtedly one of the most common dermatoses in clinical practice, accounting for 20—25 % of dermatology consultations. Today, especially in wartime, acne vulgaris remains a socially important problem in approximately half of patients with psychoemotional disorders, mainly of a depressive and anxiety associated nature with a sharp decrease in the quality of life of patients.Objective — to study a pathogenic role of certain neuroendocrine, metabolic and immunological disorders as well their consequences in the development of acne in women who had COVID-19.Materials and methods. 134 women with acne, aged 18 to 45 years old, were examined. The levels of cortisol and prolactin, C-reactive protein(C-RP), total cholesterol (TC), high-density lipoproteins (HDL), low-density lipoproteins (LDL), triglycerides (TG), concentration of cytokines, atherogenic index (AI), index HOMA (insulin resistance index) and anxiety were determined. Results and discussion. Most of the examined patients with acne have shown varying degrees of changes in some neuroendocrine and metabolic indices. The total cholesterol level in patients with acne was higher by 27.78 % (p < 0.001), and in patients with acne associated with COVID-19 by 45.37 % (p < 0.001), compared with the control group. The HDL level was lower by 27.91 and 39.53 % (p < 0.001), respectively, compared with the control group, LDL was higher by 34.35 and 58.78 % (p < 0.001), respectively, and the TG level was twice as high (p < 0.001), as the control group level in both groups of women with acne. At the same time, an increase in the atherogenic index by 28.09 % (p < 0.01) and 37.02 % (p < 0.001) respectively, was also observed compared with the control group level, but without significant changes between the levels of both groups of women with acne. An increased level of pro-inflammatory cytokines, have been observed in patients of both groups, with insufficient synthesis of anti-inflammatory interleukins in all examined women with acne, at that, more significant abnormalities in the examined immune indices have been observed in patients who have had COVID-19.Conclusions. High level of anxiety, the changes in cytokine profile, neuroendocrine and metabolic indices (C-RP, TC, HDL, LDL, TG, AI), have been observed in women with acne. At that, more significant abnormalities in the examined indices have been found in patients who have had COVID-19 that substantiates the necessity to develop new comprehensive methods of treatment, taking into account the impact of neuroendocrine and metabolic disorders and immunological changes associated with COVID-19.

Introduction & Objectives: . The most common in dermatological practice are psoriasis and acne, the
pathogenesis of which today is considered from the standpoint of immunopathological diseases. The article
analyses features of anamnesis, clinical, instrumental and laboratory tests related to chronic dermatitis (acne,
psoriasis, arthropathic psoriasis (АР)), considers the relationship of probable mechanisms of disease aggravation
and progression.
Objective. The objective of our work was to improve the diagnostics of common chronic dermatoses (acne,
psoriasis, АР) taking into account some indicators of the immune system and features of the disease course to
specify their role in pathogenesis of these disease. 

УДК: 616.53-002:616.345]-008.87-036

Вucoкuŭ piвeнь зaхвopювaнocmi aкнe, cхuльнicmь дo хpoнiчнoгo пepeбiгу з фopмувaнням peзucmeнmнocmi дo лiкувaння, чacmuŭ poзвumoк глuбoкuх фopм вuзнaчaюmь вaжлuвe мeдuчнe ma coцiaльнe знaчeння пpoблeмu.

Meтa - вuвчumu ma oцiнumu cmупiнь змiн мiкpoбioцeнoзу шкipu i пopoжнuнu moвcmoï кuшкu у хвopuх з вугpoвoю хвopoбoю зaлeжнo вiд ïх клiнiчнoгo пepeбiгу.

Maтepiaл i мeтоди. Пiднaшuм cпocmepeжeнням пepeбувaлo 85 хвopuх з вугpoвoю хвopoбoю вiкoм вiд 18 дo 45 poкiв, з нuх 49 (57,65±5,36%) ociб жiнoчoï ma 36 (42,35±5,36%) - чoлoвiчoï cmami i 35 пpaкmuчнo здopoвuх ociб (дoнopiв) пoдiбнoгo вiку, якi ввiŭшлu дo кoнmpoльнoï гpупu. Склaд мiкpoбiomu шкipu i пopoжнuнu moвcmoï кuшкu дocлiджувaлu бaкmepioлoгiчнuм мemoдoм.

Рeзультaти й обговоpeння. Вcmaнoвлeнo,щo у хвopuх з aкнe вipoгiднo мeншuŭ вмicm у moвcmiŭ кuшцi бiфi- дo ma лaкmoбaкmepiŭ, бaкmepoïдiв ma зaгaльнoï кiлькocmi кuшкoвoï палuчкu на mлi бiльшoï кiлькocmi кuш- кoвoï палuчкu з ферменmнuмu влаcmuвocmямu, умoвнo паmoгеннuх енmерoбакmерiŭ, енmерoкoкiв mа грuбкiв рoду кандuда. Прu заcmocуваннi непарамеmрuчнoгo дucперciŭнoгo аналiзу Фрiдмана вcmанoвленo наяв- нicmь вiрoгiднoï рiзнuцi мiж чаcmomoю вuявлення cmану нoрмoценoзу i cmупенем дucбioзу пoрoжнuнu moвcmoï кuшкu i рoзвumкoм клiнiчнuх фoрм акне. Прu цьoму у хвoрuх з кoмедoннuмu фoрмамu акне вiрoгiднo чаcmiше вuявлялu cmан нoрмoценoзу, а папульoзнi i вузлуваmi фoрмu вiрoгiднo чаcmiше вuнuкалu у хвoрuх iз прoявамu рiзнoгo cmупеня дucбioзу. У мiкрoбioценoзi шкiрu у хвoрuх на акне булo вuявленo збiльшення oбciменiння аcoцiацiямu Streptococcus a Haemoliticus + Staphylococcus Haemoliticus + Micrococcus, Streptococcusb Haemoliticus+StaphylococcusAureus+E.Coli+Candida albicans i значне збiльшення рocmу Streptococcus a Haemoliticus, Staphylococcus Haemoliticus, Staphylococcus aureus, прuчoму вci вuщеназванi мiкрooрганiзмu не вuciвалucь в ociб кoнmрoльнoï групu.

Bисновок. В oбcmеженuх хвoрuх з акне вcmанoвленo змiнu пoказнuкiв мiкрoбioценoзу шкiрu mа пoрoжнuнu moвcmoï кuшкu якicнoгo mа кiлькicнoгo харакmеру, якi залежаmь вiд клiнiчнoгo перебiгу дермаmoзу, щo i вказус на неoбхiднicmь дoдаmкoвoгo oбcmеження mакuх пацiснmiв з меmoю прuзначення паmoгенеmuчнo oбгрунmoванoï mерапiï.