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Vol 20, No 3 (2017)

Articles
PUVA AND INTERFERON Α COMBINED THERAPY IN PATIENTS WITH MYCOSIS FUNGOIDES
Olisova O.Y., Smirnov K.V., Grekova E.V.
Abstract
The results of mycosis fungoides (MF) treatment using therapy that combines interferon α (IFNα) and PUVA-therapy are presented. We observed 16 patients with MF. The diagnoses were verified with histological, immunohictochemical methods and molecular analysis. The response to treatment was defined by the index of the modified assessment of the severity of skin lesions scale (mSWAT). In addition, the safety and tolerability of IFNα and PUVA-therapy were evaluated. In terms of the stage of the disease, patients were distributed as follows: IB-IB - 1 (6%), IIA - 3 (19%), IIB - 6 (38%), IIIA - 2 (12.5%), IIIB - 1 (6%), IVA - 2 (12.5%), IVB - 1 (6%). PUVA-therapy was performed four times a week with the initial dose of the irradiation 0.5-1.0 J/cm2. The course of therapy consisted of 40 ± 8 procedures. The total dose was 157 ± 45 J/cm2.IFNα was prescribed to patients (3 IU three times a week). The total dose was 96 ± 31 IU. After the therapy 12 (75%) patients with stage IB-IIIA, mSWAT index was reduced by 90-100%, which corresponded to complete clinical remission in the form of the disappearance of cutaneous manifestations and subjective sensations. 3 (19%) patients with stage IIIB-IVA had mSWAT index decreasing from 50 to 75%, i.e. partial remission was observed as decrease of the injury area and rash brightness, reduce scaling, itching. 1 (6%) patient with stage IVB had no effect of the therapy. Studies have shown that PUVA-therapy in combination with interferon α can be successfully used at patients with MF, regardless of the disease stages, however, more positive effect was in patients with stage IB-IIB MF.
Russian Journal of Skin and Venereal Diseases. 2017;20(3):132-139
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CLINICAL CASE OF MULTIPLE STEATOCYSTOMA
Molochkov V.A., Khlebnikova A.N., Molochkova Y.V.
Abstract
A description of a rare disease multiple steatocystoma is presented. The disease is characterized by the development of cysts of hair follicle walls and sebaceous gland ducts. Clinical signs are multiple yellow-colored nodules located in the areas with high density of sebaceous glands. Description of clinical case of multiple steatocystoma at 31-year-old female patient, that was treated for a long time with an “unknown dermatosis” and literature review are presented. The correct diagnosis was verified based on anamnesis, clinical findings and pathomorphologic study.
Russian Journal of Skin and Venereal Diseases. 2017;20(3):140-142
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CLINICAL CASE OF PALMOPLANTAR KERATODERMA TYPE UNNA-THOST
Pashinyan A.G., Ilienko L.I., Akopyan A.N.
Abstract
Palmar-plantar keratoderma is a heterogeneous group of hereditary dermatosis, which can be independent diseases or combined with various congenital malformations, most of ectodermal origin. Approaches to differential diagnosis and clinical features of each form of this pathology are described. Keratoderma, Unna Toast genodermatosis belongs to the group, which is characterized by hyperkeratosis on the palms and soles without migration to other skin areas.
Russian Journal of Skin and Venereal Diseases. 2017;20(3):143-145
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PEMPHIGUS VEGETANS IMITATING SKIN CANCER
Bazaev V.T., Tseboeva M.B., Tsarueva M.S., Dzhanaev V.F.
Abstract
Case of a rare form of vegetating true acantholytic pemphigus with atypical manifestations on the face and scalp, interpreted as skin cancer, is described. The process was accompanied by the generation of high level of immunoglobulin G only to desmoglein type 3. This example demonstrates the difficulty in the diagnostics of true pemphigus not only for general doctors of different specialties but also for dermatologists.
Russian Journal of Skin and Venereal Diseases. 2017;20(3):146-150
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СHROMOSOMAL REARRANGEMENTS AND ATOPIC DERMATITIS
Svechnikova E.V.
Abstract
Objective. To determine the frequency and patterns of chromosomal abnormalities in patients with atopic dermatitis. Material and methods. 470 patients with torpid variant of atopic dermatitis were observed. The study included patients with established and recorded in the medical record diagnosis of atopic dermatitis, which has been confirmed in accordance with the diagnostic criteria of J. Hanifin and G. Rajka. Karyological study was performed to 47 patients with skin rash, interpreted as atopic dermatitis and various polysystemic lesions that could be associated with chromosomal aberrations. Results. According to results of karyotyping, 8 (17%) patients had a variety of deviations from the normal karyotype, which made 1.8%. In 3 cases the karyotype corresponding to syndrome Turner was detected. One patient had karyotype 46XY inv7 (gh ph). In 2 patients minor, differing in size inversion of chromosome 9 was detected. In 2 patients translocation forms of chromosomal rearrangements were identified. Conclusion. Given that the prevalence of chromosomal diseases in the population is 0.5%, the frequency of chromosomal rearrangements obtained in this study was 1.8%, significantly higher than general population figures. According to the results, we can recommend karyotyping for torpid form of atopic dermatitis particularly with concomitant pathology polysystemic or reproductive harm.
Russian Journal of Skin and Venereal Diseases. 2017;20(3):150-153
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CICATRICIAL PEMPHIGOID: AN INTERDISCIPLINARY PROBLEM
Tarasenko G.N., Gladko V.V., Sysoeva A.N., Sviderskaya O.S., Kuzmina Y.V., Tokmakova A.N.
Abstract
Clinical case of patient with rashes on mucous membrane of oral cavity with severe pain, edema, redness, deformation of eyelids on both eyes and decreased visual acuity is presented. After examination by several specialists (dentist, ophthalmologist and dermatologist) cicatricial pemphigoid with primary lesion of eyes was diagnosed. Authors point out doctors on danger of serious complications of this disease, which demand active involvement of doctors of other specialties.
Russian Journal of Skin and Venereal Diseases. 2017;20(3):154-156
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TRUE ACANTHOLYTIC PEMPHIGUS FROM THE STANDPOINT OF PSYCHOSOMATIC MEDICINE: A REVIEW OF THE LITERATURE
Dorozhenok I.Y., Teplyuk N.P., Katranova D.G.
Abstract
Today the problem of correlation of mental disorders and skin diseases is relevant in Russia. Psychosomatic disorders, comorbid true acantholytic pemphigus (pemphigus) and cases of affective disorders are described on this literature review. The relationship between manifestation and exacerbations of pemphigus with psychogenic disorders is shown. Studies investigating quality of life of patients with pemphigus are described. The literature was searched in the following databases: MedLine, PubMed, Concilium Medicum, SCOPUS, Web of Science, LILACS, PEPSIC, Russian State Library, the Sechenov central science medical library.
Russian Journal of Skin and Venereal Diseases. 2017;20(3):157-163
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EXPERIENCE OF THE LONG-TERM USE OF ANTICYTOKINE THERAPY IN PSORIASIS
Kovtunova V.A., Dumchenko V.V., Bakhmutova E.G., Tkachenko T.A., Yanchevskaya E.Y., Mesnyankina O.A.
Abstract
Increasing the effectiveness of treatment and restoring the quality of life in patients with moderate to severe and severe forms of psoriasis is one of the most important trends in modern dermatology. The appearance of biological products in the late XXth century opened new opportunities in the treatment and control of the course of the disease in patients suffering from moderate and severe forms of psoriasis. Conducting maintenance system treatment with biological products reduces the severity of course of dermatosis, and in some cases prevents the occurrence of disease relapses. Despite the increasing popularity of anti-cytokine drugs, there are difficulties in the treatment of choice of the therapy in some cases. Among the main reasons for the lack of response to ongoing biological therapy are the genetic characteristics of the patient and the immunogenicity of the drugs. Failures in the use of biological therapy can also result a low concentration of the drug before the next administered dose. It has been proven that the combined use of methotrexate and infliximab inhibits the development of anti-drug antibodies that are associated with the development of a low therapeutic response. The article describes the clinical observation of a patient suffering for 20 years from a severe form of psoriasis and psoriatic arthritis. The experience of long-term (about 10 years) prescription of the biological preparation infliximab with sufficient clinical response without additional use of methotrexate is shown. The results of successful combined therapy of psoriatic erythroderma and psoriatic arthritis with infliximab and acitretin in order to reduce the immunogenicity of the tumor necrosis factor α blocker and avoid the ”escape” effect are described. The data of restoration of a good therapeutic response to systemic biological therapy with infliximab after administration of acitretin are presented.
Russian Journal of Skin and Venereal Diseases. 2017;20(3):163-166
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MODERN VIEW OF THE ETIOPATHOGENESIS AND CLASSIFICATION OF ACNE SCARRING
Ostretsova M.N.
Abstract
Acne vulgaris is a common chronic skin disease involving blockage and inflammation of pilosebaceous units. It has a genetic predisposition and sharply reduces the quality of patients’ life and the level of their social adaptation through the formation of conspicuous cosmetic defects in open areas of the skin. The processes of pathological scarring (atrophic, hypertrophic and keloid scars) is described in detail as one of the most severe consequences of acne vulgaris and its treatment. The problem is described from the modern point of view of the pathogenesis of acne vulgaris. Differential diagnosis between keloid and hypertrophic scars, as well as the most relevant approaches to classification and evaluation of severity of postacne scarring according to the valid international scales, are presented.
Russian Journal of Skin and Venereal Diseases. 2017;20(3):167-173
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CORRECTION OF VARIOUS TYPES OF FACIAL HYPERPIGMENTATION USING MICROPLASMA RADIO FREQUENCY TECHNOLOGY
Pinson I.Y., Olisova O.Y., Verkhoglyad I.V.
Abstract
Correction of facial hyperpigmentation is a very common and complex problem faced by dermatologists, cosmetologists and plastic surgeons. Recently developed microplasma radiofrequency technology allows to accurately and rapidly affect the areas with hyperpigmentation and is an effective method of its treatment. The aim of this study is to evaluate the effectiveness of hyperpigmentation treatment using microplasma radiofrequency technology. The study included 35 patients with benign hyperpigmentation with localization on the face. All patients had II - IV skin phototypes according to Fitzpatrick. We used a device with an output power of 60-90 W and performed 2-6 passes (rolling with a roller nozzle) in different directions. Three to five procedures were performed with 8-week intervals. As a result of treatment, all patients had improvement, which is manifested in clarification of hyperpigmentation spots of varying severity. Complications were not observed. Improvement of skin condition with reduction of hyperpigmentation phenomena was assessed by patients and physicians who compared digital images taken before the treatment and 2 months after the last procedure. The results of the study showed that the patients had a positive effect on the treatment of hyperpigmentation using microplasma radio frequency technology. The average index of pain intensity was estimated from 0 to 10 using a visual analog scale, which was 6.7 ± 0.7. After a course of therapy in 32 of 35 patients hyperpigmentation decreased by more than 51%, and 3 patients managed to achieve a clinical cure. The average improvement in the treatment of hyperpigmentation was 4.28. Thus, microplasma radiofrequency technology is a highly effective and safe method of treating facial hyperpigmentation.
Russian Journal of Skin and Venereal Diseases. 2017;20(3):174-177
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HYPERPIGMENTATION OF THE SKIN: MODERN VIEWS ON ETIOLOGY AND PATHOGENESIS (PART 1)
Kruglova L.S., Ikonnikova E.V.
Abstract
Brief literature review of the etiology and pathogenesis of hyperpigmentation on the basis of modern scientific publications is presented. The review focuses on actively studied mechanisms of melanin synthesis in norm and pathology, the physiology of pigment cells (melanocytes), their interaction with other structures of the epidermis and dermis and on the mechanisms of regulation of melanogenesis. The main factors influencing the appearance of hyperpigmentation are described.
Russian Journal of Skin and Venereal Diseases. 2017;20(3):178-183
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CLINICAL AND EPIDEMIOLOGICAL ANALYSIS OF THE INCIDENCE OF NEUROSYPHILIS IN THE OMSK REGION
Novikov Y.A., Ochlopkov V.A., Kravchenko E.N.
Abstract
Purpose - to conduct clinical and epidemiological analysis of the incidence of neurosyphilis in the Omsk region in the period from 2008 to 2015. Material and methods. The assessment of level of a condition of a case rate of various groups of the population and implication of epidemic process carried out on the basis of the analysis of data of the statistical account on Omsk and the Omsk region and statistical cards of the patients. Complex clinical examination of patients with a lues for the purpose of identification of signs of a lesion of a nervous system is conducted. Results. The analysis of an epidemic situation in Omsk and the Omsk region for the specified period of observations showed that the case rate a neurolues of the population of the region remained stable. Conclusion. Now depression of the general case rate by a neurolues with symptoms against body height of a case rate an asimptomny neurolues is observed. In the conditions of body height of a case rate an asimptomny neurolues closer interaction of dermatovenerologists and neurologists in questions of diagnostics and treatment of a neurolues is necessary.
Russian Journal of Skin and Venereal Diseases. 2017;20(3):184-187
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INFLUENCE SIFILITIC IN PREGNANT WOMEN ON THE HEALTH OF NEWBORN CHILDREN
Matyskina N.V., Taranushenko T.E., Karacheva Y.V.
Abstract
A particular challenge for child health represent cases of early and congenital syphilis, which is characterized by a severe multiorgan pathology in children and high mortality in newborns. Purpose. To study the incidence of early congenital syphilis, depending on the time of detection of syphilis infection in women and to present the clinical features of this disease in newborns with the frequency of the detection of the most important specific manifestations of the disease. Material and methods. We observed 114 women with confirmed syphilis infection and newborns from these mothers. Results. The data presented indicate the prevalence of Lues latens praecox in the structure of syphilis infection in pregnant women with newly diagnosed disease. In children from women who were diagnosed with syphilis during this pregnancy early congenital syphilis (PBC) exhibited in 74.3% of cases, while 27 cases in 19 newborns syphilis was accompanied by clinical symptoms. Conclusion. In the pathological process in congenital syphilis, with greatest frequency involved bone, followed - mucous membranes (rhinitis).
Russian Journal of Skin and Venereal Diseases. 2017;20(3):188-192
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