Russian Journal of Skin and Venereal Diseases

The discovery of a new group of modern anticancer drugs was a breakthrough in the treatment of cancer. Immune checkpoint inhibitors that block cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), programmed cell death protein-1 (PD-1), and programmed cell death receptor ligand (PD-L1) may improve prognosis for patients with malignant neoplasms with a high level of microsatellite instability. Despite the high effectiveness of these drugs, immune checkpoint inhibitors can lead to dysregulation of immune responses and the occurrence of adverse reactions associated with an increase in the activity of immunocompetent cells in the body.

The aim of this review is to analyze the available data on the immune-related dermatological adverse events during treatment with immune checkpoint inhibitors.

Porokeratoses are a very rare group of dermatoses, acquired or hereditary, of unknown etiology, characterized by a violation of keratinization. The disease is manifested by one or more atrophic spots, each of which is surrounded by a characteristic hyperkeratotic, ridge-like border called a "horny plate". There are several forms of this pathology, among which there are sporadic cases and family variants with an autosomal dominant pattern of inheritance of various penetrance.

This article presents a clinical case of the occurrence of superficial disseminated actinic porokeratosis in a 59-year-old woman after prolonged exposure to the sun. The eruptions were represented by small spots, rounded, pinkish-yellow-brown in color with an atrophic center, surrounded by a raised narrow roller with a groove on the surface, have no tendency to merge, symmetrically arranged. Screening for diseases that cause immunosuppression (human immunodeficiency virus, hematological malignancies) and renal insufficiency did not reveal pathology. Histological examination showed a typical well-limited plume of parakeratotic cells (horn plate), hypogranulosis, dyskeratotic cells or vacuolated keratinocytes, which made it possible to make a final diagnosis.

Considering that insolation in this case is a causally significant factor and the likelihood of malignant neoplasms against the background of dermatosis remains, it is extremely important for such patients to use sunscreens with a high degree of protection as part of complex therapy, as well as regular skin examinations.

BACKGROUND: Acne is one of the most common dermatoses. The most effective drug for the treatment of severe forms of acne is systemic isotretinoin, which affects all links in the pathogenesis of acne. The article presents scientific data on the innovative drug Aknecutan, which uses the patented Lidose technology in its production. The use of isotretinoin in the composition of innovative product with Lidose technology makes it possible to reduce the amount of isotretinoin taken by the patient by 20% without compromising the therapeutic effectiveness of the drug.

AIM: to analyze comparative studies of bioavailability and relevant pharmacokinetic parameters, which made it possible to prove that the initial dosages of 8 and 16 mg with Lidose technology are bioequivalent to dosages of 10 and 20 mg of the usual form of isotretinoin.

MATERIALS AND METHODS: Over the past 7 years, 1044 patients have received acne treatment for moderate to severe acne (651; 62.4% women and 393; 37.6% men) in a daily dose of 0.4–0.8 mg per 1 kg of body weight with a total dose of the drug ― 100–120 mg/kg per course of therapy.

RESULTS: After therapy, clinical remission was achieved in all patients, which required from 7 to 12 months of treatment, depending on the daily dose of the drug. Among the side effects in all patients, cheilitis and retinoic dermatitis of the face were noted, which were completely resolved when using moisturizers and sticks. An increase in liver enzymes, triglycerides and lipoproteins was noted in 5–10% and did not exceed 20–30% of the norm and did not require discontinuation of therapy. At the end of treatment, these indicators returned to normal. Other side effects were extremely rare. Relapses of the disease are most often caused by a low total dose of the drug or the presence of endocrinological and gynecological diseases.

CONCLUSION: Thus, innovative product with Lidose technology is one of the most highly effective and safe systemic retinoids for the treatment of moderate to severe acne. Comparative studies of bioavailability and corresponding pharmacokinetic parameters have demonstrated the bioequivalence of isotretinoin in the composition of innovative product with Lidose technology, which fully corresponds to that in the original preparation.

BACKGROUND: Atopic dermatitis is the most common diseases in dermatology, among the main pathogenetic mechanisms of development of which a complex interaction of a genetically determined defect in the barrier function of the skin, an overactive state of the immune system is considered, and a neurogenic theory of disease development is not excluded, which is based on the relationship of anxiety-stress reactions and neuropsychiatric stresses with the occurrence of pathological changes on the skin. Modern atopic dermatitis therapy is characterized by the appointment of a large number of medications according to clinical recommendations, and the associated increase in allergic and toxic-allergic reactions dictates the need to search for new non-drug treatments for this disease. In order to prevent the pathological effects of stress, as well as to increase resistance to its damaging effects, activation of opioidergic mechanisms may be useful.

AIM: To evaluate the effectiveness and acceptability of the transcranial electrical stimulation technique in patients with atopic dermatitis.

MATERIALS AND METHODS: A controlled study was conducted among 60 patients with moderate atopic dermatitis, 33 women (55.0%) and 27 men (45.0%) aged 19 to 72 years. Transcranial electrical stimulation was carried out by a pulsed bipolar electrical stimulator with an acoustic effect "TRANSAIR-07", stimulation was carried out by an electric current with a frequency of 77.5 Hz and a duration of 3.5 ms. Patients underwent 10 procedures, 1 time a day, lasting 30 minutes, with a current of 1−3 mA. SCORAD, EASI, IGA, DLQI, HADS, and BDI scales were used to assess the dynamics of clinical manifestations. The assessment was carried out on the first and last day of treatment.

RESULTS: During statistical data processing, when comparing the scales in the first and last days of the procedures, depending on the patient groups: the 1st group was the main one, received transcranial electrical stimulation treatment in combination with therapy, according to clinical recommendations, the 2nd group was the control group, received treatment according to clinical recommendations, without the use of transcranial electrical stimulation, significant improvement of itching indicators, clinical manifestations and improvement of quality of life after 4 weeks of therapy in both groups. A statistically more significant dynamics of the indicators of the main clinical scales in favor of combination therapy was established: according to the SCORAD scale ― in the main group from 47.50±2.25 to 21.00±1.00, in the control group from 47.00±2.00 to 39.00±1.75; DLQI ― in the main group from 8.00±2.00 to 2.00±0.75, in the control group ― from 8.50±1.50 to 5.00±1.00.

CONCLUSION: The paper presents the positive results of our own research and presents data confirming the clinical effectiveness of transcranial electrostimulation in patients with atopic dermatitis compared with the traditional drug treatment of this disease, which allows us to recommend the treatment regimen we have proposed for widespread implementation in the practice of a dermatovenerologist.

Vulgar acne is a chronic inflammatory skin disease that has a significant impact on patients' quality of life. The search for new highly effective and treatments with favorable safety profile remains relevant due to the high incidence in the population.

The launch of a 4th generation retinoid, trifarotene, which has a selective mechanism of action on RAR-γ (γ-retinoic acid receptors agonist), represents a new era in topical therapy of acne vulgaris and is of particular interest to practical healthcare.

A systematic literature overview in PubMed, Google Scholar, and ClinicalTrials.Gov databases was conducted to evaluate the mechanism of action, efficacy, and safety profile of the selective 4th generation retinoid, trifarotene 50 µg/g (0,005%) in dosage form topical cream.

In a systematic overview, 12 contemporary studies (2015–2023) were selected confirming the high efficacy of trifarotene in protocols for the treatment of acne vulgaris with localization on both facial and truncal skin. The drug demonstrates a unique ability to modulate cell adhesion, optimize transepidermal water loss and reduce the activity of membrane metalloendopeptidases, which determines its proven efficacy.

Trifarotene, an innovative 4th generation topical retinoid approved by the FDA in 2019 for the treatment of acne in patients over 9 years of age, opens new possibilities in the treatment of acne vulgaris. Its selective activity to RAR-γ receptors, proven efficacy and favorable safety profile make it a promising agent in therapeutic practice.

In recent decades, the world has seen an increase in the number of patients suffering from syphilis and HIV infection at the same time. There is a traditional opinion that concomitant HIV infection can aggravate the clinical manifestations and course of syphilis. However, in the era of widespread use of antiretroviral therapy, most people living with HIV have a typical course of syphilis. However, with quantitative and/or qualitative HIV-associated immune dysfunction, deviations in the clinical picture of syphilitic infection from its classical patterns are possible. This is evidenced by annual publications in Russian and foreign specialized publications.

We present to your attention a photo gallery of cases of syphilis in HIV-positive patients with characteristic and atypical manifestations.