Voloshynovych M. The complex treatment of psoriasis with the peculiarities of liver function and psycho-social adaptation of patients

The thesis is devoted to improving the efficiency of psoriasis treatment by using the narrowband UVB therapy and hepatoprotectors on the basis of studying the clinical and pathogenetic features of dermatosis taking into consideration the functional state of liver and psycho-social adaptation. The clinical features of psoriasis with the presence of liver damage in the form of reactive hepatitis, which lie in increasing the proportion of moderate forms of dermatosis, deterioration the quality of life and psycho-social adaptation of patients are established. It was proved that psoriasis is characterized by systemic immune-inflammatory activation with the increase of interleukin-23 content in blood , matrix metalloproteinase-9 and soluble molecules of intercellular adhesion-1 in connection with the violation of impaired platelet hemostasis, with the increase of adhesion, platelet aggregation and Willebrand index factor in blood, the changes in lipid peroxidation-antioxidant protection and development of metabolic intoxication, which was more clear in the presence of liver diseases. The influence of systemic immune-inflammatory activation parameters on the psoriasis activity by Psoriatic Area and Severity Index (PASI) and on the functional state of liver by hamahlutamiltranspeptidase activity was established. The recommendations as for the complex therapy of patients with psoriasis and liver disease using narrowband UVB therapy, arginine glutamate hepatoprotectors on the background of 30-day basic therapy were developed. This allows to enhance the effectiveness of dermatosis treatment and to improve the functional state of liver. The proposed narrowband UVB treatment supportive therapy and taking silymarin hepatoprotector during two months within rehabilitation period prolongs psoriasis remission period.