Lopandina A. Pathogenetic substantiation of complex treatment of patients with psoriasis considering the factors of angiogenesis and the features of mental state

The object of the study is psoriasis. The aim is to increase the treatment effectiveness for patients with psoriasis by developing the pathogenetically grounded therapy method based on the study of factors of angiogenesis and mental state. Methods: clinical, immunofermental, questionnaire, instrumental, statistical. For the first time the pathogenetic significance of the imbalance in angiogenesis in psoriasis has been established due to significant increase in blood levels of proangiogenic factors – vascular endothelial growth factor and cytokines (tumor necrosis factor α and interleukin-8) and the decrease in the antiangiogenic factor of melatonin level. Disorders of the mental state of patients with psoriasis in the form of depressive syndromes of predominantly weak and moderate severity, dyssomnia disorders were revealed. The value of melatonin in the development of depressive syndrome in psoriasis has been proved. The expediency of use in the treatment of patients with phototherapy and melatonin is substantiated. The method provides the increase in the treatment effectiveness in 1.6 times, a reduction in the number of relapses by 2.2 times, remission lengthening by 1.4 times in comparison with similar indicators in patients with the use of traditional treatments. The results of the dissertation work were introduced into the medical practice of the SE "Institute of Dermatology and Venereology of the National Academy of Medical Sciences of Ukraine", MNE “Regional Clinical Skin and Venereological Dispensary No. 1” of the Kharkiv Regional Council, ME "Regional Skin and Venereological Clinical Dispensary" of the Dnipro Regional Council, MNE “City Skin and Venereological Dispensary No. 4» of the Kharkiv City Council, as well as in the educational process of the Department of Dermatovenerology of the Kharkiv Medical Academy of Postgraduate Education of the Ministry of Health of Ukraine. The field of use is dermatovenereology.