Shupenko O. Optimization the treatment of acne in males in view of pathogenesis, clinical forms of acne and comorbidity

The dissertation is devoted to: (1) theoretical generalization and a new solution of scientific problems concerning the efficiency of treatment of acne in men considering leading and supporting factors of pathogenesis and (2) optimization of complex therapy, taking into account the clinical course of cutaneous inflammation, the nature and degree of violations of intestinal microbiota indicators and some parts of the immune status of patients. The new data on intestinal microbiota in males with inflammatory form of acne were obtained. Identified that particularly in the intestines of most patients studied revealed a rather high content of yeast fungi of the genus Candida, and other quantitative and qualitative disturbances of the microflora of varying severity, which was due to conduct repeated courses of antibiotic therapy during the previous treatment of this dermatosis . The existence connections between the degree of quantitative and qualitative bowel disorders microbiota and the nature of the clinical course of acne in men and severity of skin inflammation. According to the results of immunological tests, which includes levels of several cytokines in the serum of male with inflammatory form of acne , it is found that major deviations in the cytokine profile of patients is appropriate hyperproduction of tumor necrosis factor -alfa ( TNF -alfa). It is indicates activation of cell- mediated responses and hyperproduction of transforming growth factor -betta ( TGF -betta), which contributes to the formation of scar deformities. The relation between the severity of the clinical course of inflammatory forms of acne in males and type of immune response. In particular, in patients with moderate clinical course of acne found Th2 type of immune response, and patients with severe dermatosis - Th1 type immune response dominated by delayed-type hypersensitivity. Developed improved methods of individualized combined therapy of inflammatory forms of acne in males allow for decrease of severity of the clinical course of disease and achievement of sustainable therapeutic cosmetic effect.