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Vol 23, No 3 (2020)

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DERMATO-ONCOLOGY
Integrative virogeny of skin-type beta papillomaviruses with concurrent progressive dermatoheliosis as a potential risk of malignant carcinogenesis
Snarskaya E.S., Zhaber A.Z.
Abstract

Background: Epidemiological and molecular biological data suggest that papilloma viruses of the beta genus are capable of causing the development of a number of epithelial non-melanocytic skin neoplasms. One of the most probable hypotheses of the influence of cutaneous human papillomaviruses is of great interest, in which they are considered as a cofactor for the promotion of tumor growth of cells already damaged by tumor-initiating epigenetic factors – the result of cumulative ultraviolet-induced damage (UVI), that is, photoaging. Cutaneous papillomaviruses of the genus beta infect the stratified squamous epithelium of the skin, which determines the spectrum of clinical targets, which are the morphological structures of the skin epidermis. The oncogenic strategy of carcinogenic papillomaviruses is enhanced by a number of mechanisms for increasing the aggressiveness of tumor growth, an important feature of which is integrative virogeny, the process of incorporating the viral genome into the cellular chromosomes of epithelial cells.

Materials and methods: The article presents the results of our own studies of the incidence and degree of viral load of HPV genus beta DNA in 80 patients (42 patients with dermatogeliosis of III–IV degrees according to Glogau and epithelial neoplasias, 38 patients without dermatogeliosis) and 40 healthy donors.

Results: We have demonstrated that high rates of detection of papillomaviruses in proliferating tissue identified in immunosuppressive patients with catastrophic manifestations of dermatogeliosis and multiple epithelial neoplasias (papillomas, fibroepitheliomas, keratomas, skin carcinomas) significantly exceed the viral load of virus DNA in normal skin (1.42 ± 0.6 log) and correlate with other clinical and anamnestic signs, in particular, pronounced signs of dermatogeliosis according to Glogau (IV catastrophic stage) and a constitutionally high degree of photosensitivity (II–III according to Fitzpatrick), which indicates the formation of a "pathological tandem", which is local immunosuppression and multiple proliferative foci of the epidermis.

Russian Journal of Skin and Venereal Diseases. 2020;23(3):132-145
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CLINICAL PICTURE, DIAGNOSIS, AND THERAPY OF DERMATOSES
Efficacy of 1% clotrimazole cream versus 2% sertaconazole cream in the management of seborrheic dermatitis: A randomized controlled trial
Kothari R., Sadoughifar R., Lotti T., Goldust M.
Abstract

Background: Antifungals are regarded as one of the first line agents in the management of seborrheic dermatitis (SD). However, the data on head to head comparison among various antifungal agents is deplete and is required to broaden the number of first line agents that can be used in SD treatment.

Aim: To compare the efficacy of 1% clotrimazole cream with 2% sertaconazole cream in the management of SD.

Methods: 60 patients of SD were included and divided into 2 groups. The first group (n = 30) received topical 2% sertoconazole cream for twice a day application for four weeks. The other group (n = 30) received 1% clotrimazole cream applied similarly for 4 weeks. The patients were assessed by an independent dermatologist for response or any side effects due to the medications used at 0 (baseline), 2 and 4 weeks. Subjective sebum production, Scalp and/or facial pruritus, scaling, erythema, SD severity index (SI), and patient satisfaction were used in the final efficacy outcome.

Results: Out of the total 60 patients, 65% (39/60) and 35% (21/60) were females and males respectively with age ranging from 6–58 years (mean age: 32.88 ± 12.68 years). 45% (27/60) had generalized and 55% (33/60) had localized disease. The severity of SD changed from moderate to mild in many patients after 4 weeks in both the groups, however, the difference was statistically significant only in the sertaconazole group (p = 0.007). 90% (27/30) and 53.4% (16/30) patients had good level of satisfaction in the sertaconazole and clotrimazole group on 28TH day. The relation was statistically significant only in the seratconazole group (p = 0.006). Subjective sebum production, pruritus, scaling and erythema reduced in both the groups. The follow-up period of 1-month post completion of therapy didn’t show any relapse in either of the groups.

Conclusion: Both topical 1% clotrimazole cream and topical 2% sertaconazole cream may be regarded as effective therapies in SD with topical 2% seratconazole cream performing better as compared to topical 1% clotrimazole cream in terms of patient efficacy and acceptability by the patients.

Russian Journal of Skin and Venereal Diseases. 2020;23(3):146-149
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Clinical observation of two cases of Gottron skin carcinoid papillomatosis
Kovaleva Y.S., Kuropyatnikova O.R.
Abstract

The article presents modern and historical data of domestic and foreign literature on rare severe dermatosis – Gottron skin carcinoid papillomatosis. Two own clinical observations of Gottron skin carcinoid papillomatosis in a young woman of 48 years proceeding against the background of malignant neoplasm of the ovary, and a man of 70 years with a concomitant vascular disease of the lower extremities are described.

Russian Journal of Skin and Venereal Diseases. 2020;23(3):150-156
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Clinical and morphological characteristics of lichen planus and lichenoid drug eruption of the skin
Zaslavsky D.V., Sidikov A.A., Sadykov A.I., Chuprov I.N., Kozlova D.V., Nasyrov R.A., Timoshchuk E.A.
Abstract

Background: Lichen ruber planus (LP) and lichenoid skin reaction (LSR) are clinically and histologically similar. The performance of histological diagnosis in these diseases remains controversial.

Materials and methods: We prospectively studied 33 patients with clinical manifestations and histological signs of the classic form of LP and LSR to assess the accuracy of an isolated histological LP and LSR examinations and to identify a variety of microscopic features. Each histological study was conducted by a pathomorphologist, who was blinded to the patients’ clinical characteristics and diagnosis.

Results: Isolated histopathological examination made it possible to make a correct diagnosis in 25 (75%) of 33 patients: in particular, the diagnosis of LRC was established in 10 (30%), CPL-in 15 (45%) cases. Based on a combined assessment of histological and clinical data and response to therapy, the final diagnosis was established in 30 (91%) of the 33 patients who were divided into two groups. The first group comprised 18 patients diagnosed with LSR, and the second group comprised 12 patients diagnosed with the classic form of LP.

Conclusions: Through this investigation, some differences in these diseases based on their clinical and pathomorphological features were identified. The diseases were characterized by different typical localizations and lesion sizes. The pathomorphology of both diseases is represented by lichenoid type of interface dermatitis.

Russian Journal of Skin and Venereal Diseases. 2020;23(3):157-164
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Gender, clinical and topographic features of the localized scleroderma lesions in anogenital area
Snarskaya E.S., Semenchak Y.A.
Abstract

Background: Currently, there is an increase in the number of skin lesions of anogenital localization, which is a “silent” epidemic, both due to the steady increase in the incidence of this pathology, and the interdisciplinary aspect of this problem.

Materials and methods: In the article, the authors first analyzed and presented the data of clinical and morphological analysis of 104 patients with various clinical variants of limited scleroderma, on the basis of which the main phenotypic and gender-specific clinical and topographical features of anogenital zone lesions in this group of patients are presented.

Results: Scleroatrophic lichen is one of the clinical variants of limited scleroderma, which is characterized by damage to the mucous membranes of the external genitals in both women and men. Lesions of such localization are late and often mistakenly diagnosed by specialists of related disciplines (obstetricians, gynecologists, urologists, family doctors, allergists, cosmetologists), which leads to high risks of developing genitourenal syndrome.

Conclusions: The development of scleroatrophic lesions in the anogenital zone is accompanied by pronounced clinical symptoms, including: itching, pain of varying intensity, dysuria, dyspareunia and significant sexual dysfunction.

Russian Journal of Skin and Venereal Diseases. 2020;23(3):165-173
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Is it possible to identify compliance and adherence to therapy? Experts opinion
Sokolova T.V., Davidenko M.S., Malyarchuk A.P.
Abstract

Today, the terms “compliance and adherence” are often used in the medical literature. The problem of patient compliance/adherence to therapy is the basis of the physician–patient relationship complex. The study of this complex is used by specialists with various profiles to assess the effectiveness of therapy. This publication has studied the opinion of specialists when answering the following question: “Is it possible to identify compliance and adherence to therapy?” The factors determining the compliance/adherence of patients to treatment regardless of nosological forms of the disease are systematized. A total of four groups of factors of nonadherence to therapy associated with the disease, patient, doctor, and treatment were identified in this study.

Russian Journal of Skin and Venereal Diseases. 2020;23(3):174-181
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Transdermal redermalization in rosacea: Rehab procedures in intercurrent period
Romashkina A.S., Olisova O.Y., Snarskaya E.S.
Abstract

Background: The authors presented their own experiences of skin restoration in patients with rosacea after a course of active therapy using transdermal redermalization.

Aim: The course of cosmetic correction procedures using this method aimed to restore the energy potential of cells, water balance, and structures of the dermal elastin fibers, normalize microcirculation processes, and create an optimal physiological environment for the mitotic activity of epidermal cells.

Materials and methods: An innovative method of transdermal redermalization represents the administration of a drug containing hyaluronic acid and sodium succinate using the technique of papular intradermal injections, taking into account the peculiarities of lymphatic drainage in the facial area.

Results: To assess the therapy’s efficiency, noninvasive monitoring of changes in morphological structures of the skin was performed using confocal laser scanning microscopy.

Conclusions: The authors revealed the high efficiency of the method, which controls the remission state for a long term, subsequently avoiding drug therapy

Russian Journal of Skin and Venereal Diseases. 2020;23(3):182-187
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COSMETOLOGY
Study of the efficiency of a peptide-based cosmetic product in topical therapy for diffuse alopecia
Korolkova T.N., Kharitonova E.E., Shepilova I.A., Nesterovich D.S.
Abstract

Background: Hair loss is a significant health problem; hence, individuals experiencing hair loss immediately visit a doctor for treatment. Diffuse (symptomatic) alopecia can be the result of various external and internal factors. A doctor should determine the cause of the hair loss and prescribe treatment, including topical agents.

Aim: to study the clinical efficacy of hair spray with peptides in the treatment of patients with diffuse alopecia and its effect on the trichogramma parameters.

Materials and methods: Thirty female patients with diffuse alopecia, aged from 18 to 59 years, were monitored in the Center of Medical Cosmetology of the I.I. Mechnikov North-Western State Medical University. In a controlled comparative study, the patients were divided into two equal groups. In group 1 (main), the drug of choice was a spray based on peptides; while in group 2 (comparison), a cosmetic product based on enzymes was applied. The drugs were used topically for 3 months. Patients were examined using questionnaires (objective assessment by the doctor and subjective evaluation by the patient) and photographs and by assessing the morphometric parameters of hair growth before treatment, 3 months after the start of treatment, and 1 month after treatment termination.

Results: In group 1, in the parietal zone, the hair density increased significantly by 19% after 3 months and by 23% after 4 months. The number of anagen hair increased by 8% after 3 months and by 16% after 4 months, with a corresponding decrease in the number of telogen hair compared to the initial level. In the occipital zone, the number of anagen hair increased by 7% after 3 months and by 13% after 4 months, with the corresponding dynamics of telogen hair compared to the initial level. The cosmetic product has been shown to be tolerated well, and no allergic reactions were noted.

Conclusion: The peptide-based spray can be recommended for patients with diffuse alopecia as a topical therapy.

Russian Journal of Skin and Venereal Diseases. 2020;23(3):188-193
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Articles
Photo gallery of onychodystrophies
Maksimov I.S.
Abstract

Onychodystrophies are various pathological processes in the nail apparatus of infectious and non-infectious nature, related to changes in its morphology. The most common cause of nail changes is a fungal infection. However, onychodystrophy can be a manifestation of dermatological diseases, trauma, medication, systemic and tumor processes. Since the clinical symptoms of onychodystrophies are unspecific, sometimes it can cause difficulties in making a diagnosis. This photo gallery presents clinical pictures of diseases that a physician may encounter in everyday practice.

Russian Journal of Skin and Venereal Diseases. 2020;23(3):194-196
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Multiple painful ulcerative-necrotic lesions in the lower extremities
Teplyuk N.P., Grabovskaya O.V., Kusraeva D.T., Varshavsky V.A.
Abstract

Patient K., 44 years old, has been ill since November 2018, when for the first time, for no apparent reason, noted the appearance of a painful pustule in the anterior surface of the left leg. After spontaneous opening of the element, an ulcer was formed, characterized by rapid growth (in 14 days up to 8-9 cm in diameter). I turned to a dermatologist, after consultation, treatment was carried out (prednisolone 30 mg per day, antibacterial drugs, vascular therapy, non-steroidal anti-inflammatory drugs) with a positive effect in the form of a gradual, complete scarring of the ulcer.

Russian Journal of Skin and Venereal Diseases. 2020;23(3):197-198
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