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Vol 24, No 1 (2021)

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Primary cicatricial alopecia: a literature review

Zvezdina I.V.


The term cicatricial alopecia results from irreversible damage to epithelial stem cells located in the bulge region of the hair follicle with subsequent scarring. Based on the mechanism involved in follicular destruction, cicatricial alopecia is divided into primary and secondary forms. Primary cicatricial alopecia are divided into four groups according to their prominent inflammatory infiltrate: with lymphocytic, neutrophilic, mixed or nonspecific cell inflammation pattern.

The review presents the main clinical, histological and dermatoscopic signs of various types of primary cicatricial alopecia.

Russian Journal of Skin and Venereal Diseases. 2021;24(1):5-16
pages 5-16 views

Possibilities of skin ultrasound examination in the management of patients with localized scleroderma

Krakhaleva Y.A., Kolerova A.V., Sorokina E.D., Mikailova D.A., Krinitsyna Y.M., Filimonov P.N., Sergeeva I.G.


With the help of ultrasound examination (ultrasound), it is possible to visualize the skin of patients with suspected localized scleroderma, as well as to objectively determine the stage of the disease and assess the effectiveness of therapy.

Three patients with linear, plaque forms of scleroderma, as well as lichen sclerosus, underwent skin ultrasound using a Skinscanner DUB TPM device with a 75 MHz transducer, 4 mm penetration, 21 μm resolution in the area of lesions and in adjacent areas of healthy skin, using their ratio coefficient (RC) for comparative evaluation. The thickness of the epidermis and dermis, their echogenicity were determined.

With a linear form of scleroderma, an increase in the thickness of the epidermis in the area of the focus (RC 0.85±0.0125) and a decrease in its echogenicity (RC 1.58±0.46) were observed. The echogenicity of the dermis was significantly reduced in the lesion (RC 3.02±1.17). The dermis thickness was slightly less in the center of the lesion (RC 1.09), at the periphery of the lesion it was moderately increased (RC 0.86). In the plaque form of scleroderma, a decrease in the echogenicity of the epidermis was observed in the foci (RC 1.32±0.49); an increase in the thickness of the dermis (RC 0.79±0.16) and a decrease in its e echogenicity (RC 1.26±0.57). In 7 of 11 foci, a subepidermal hypoechoic band was visualized. With lichen sclerosis in the foci, an increase in the thickness of the epidermis (RC 0.42±0.12) and its acoustic density (RC 0.63±0.0793), a decrease in the thickness and echo density of the dermis (RC 1.32±0.00943 and RC 1.55±0.6, respectively).

With different forms of LS, a different ultrasound picture was observed, depending on the stage and activity of the process. The changes identified during treatment reflect the effectiveness of the therapy and the rate of restoration of the skin structure during therapy.

Russian Journal of Skin and Venereal Diseases. 2021;24(1):17-24
pages 17-24 views

Lyell´s syndrome provoked by external drug use

Krivosheev A.B., Ermachenko T.V., Khavin P.P., Krivosheeva I.A., Morozov D.V.


Lyell´s syndrome is rare. Up to 10 cases are registered per million population per year. The mortality rate for Lyell’s syndrome is 5–12%.

Two patients were observed aged, respectively, 38 years and 72 years with Lyell’s syndrome. The disease manifested itself against the background of local application of drugs. In one case ― Doloben’s gel as an analgesic at the site of a bruise of the right hand. In another case, a 20% solution of chlorohxidin biogluconate as a mouth rinse for stomatitis. The first symptoms of the disease occurred locally at the site of application of these medicines. In the first case, the skin of the right hand, in the second ― the mucous membrane of the mouth. The outcome of the disease depended on early diagnosis, urgent hospitalization in a specialized department, from the area of skin lesions, the appointment of adequate therapy.

Lyell’s syndrome can occur at any age, and the risk of developing the disease increases in those over the age of 40. In the elderly, SL in terms of the first symptoms and rate of disease progression, the nature of skin and mucous membrane lesions does not have any fundamental differences with those in younger patients. The distinctive features and risk factors of Lyell’s syndrome in the elderly include, firstly, its occurrence against the background of the already formed comorbid age-related pathology of internal organs, secondly, the concomitant age-related pathology during the development of an acute toxic-allergic reaction is decompensated, a multiorgan failure is formed, which is the cause of more severe Lyell’s syndrome and higher mortality. In young people, a comorbid viral infection can be considered a risk factor, especially the combination of HIV-infection and chronic hepatitis C.

Russian Journal of Skin and Venereal Diseases. 2021;24(1):25-34
pages 25-34 views

Optimization of the molecular genetics for the diagnosis of early mycosis fungoides

Olisova O.Y., Grekova E.V., Alekseeva E.A., Zaletaev D.V.


BACKGROUND: Mycosis fungoides (MF) is the most common disease among the cutaneous T-cell lymphomas (85–90%). The accuracy of the diagnosis of MF, which is confirmed only by clinical, histological and immunohistochemical signs, is 50–75%.

AIMS: To investigate genetic marker STAT4 for early diagnosis of mycosis fungoides.

MATERIALS AND METHODS: A study involving 42 patients with MF and chronic benign dermatoses (CBD) was performed. The analysis of gene expression STAT4 was carried out by TaqMan Real time-PCR. The objects of the study were lesional skin samples of patients. A group with MF consisted of 29 patients, a group with CBD consisted of 13 patients, a control group included 10 healthy volunteers.

RESULTS: The study revealed that the level of STAT4 gene expression showed a significant (9 times) increase in the expression of gene STAT4 in patients with MF (168.2) compared with patients with CBD (18.5; p <0.001) and 561 times — with healthy volunteers (0.3; p <0.001).

CONCLUSION: For early diagnosis of MF the level of expression STAT4 is of great importance. Inclusion of STAT4 in the list of diagnostic algorithm increases the accuracy of differential diagnosis of MF and CBD from 59.1 to 92.2%.

Russian Journal of Skin and Venereal Diseases. 2021;24(1):35-44
pages 35-44 views

Modern ideas about the sclerosing lichen of the vulva

Surkichin S.I., Kruglova L.S., Apolikhina I.A., Mayorov R.Y., Avin M.


Lichen sclerosus (LS) is a chronic inflammatory disease that is 6-10 times more common in women than in men. The drug affects between 1 in 1000 and 1 in 300 people in the general population, but the exact prevalence is unknown due to the fact that the disease is often asymptomatic. The article presents modern ideas about lichen sclerosus. Issues of various etiological theories of origin and pathogenesis are considered. The description of the clinical picture of lichen sclerosus is given. Diagnostic approaches are described, including the histological picture. Possible complications, including anatomical abnormalities of the vulvar architectonics and the risk of malignant transformation, are discussed in detail. Various methods of treatment and care for this disease, local treatment schemes are presented, an overview of systemic drugs and surgical operations, as well as further observation and management of patients is given.

Russian Journal of Skin and Venereal Diseases. 2021;24(1):45-52
pages 45-52 views

Prevalence and etiology of onychomycosis in patients with psoriasis: a single-center study

Kochergin N.G., Maximov I.S.


BACKGROUND: Changes in nails with psoriasis are observed in 80–90% of patients. Pathological processes in the nail apparatus in patients with psoriasis are associated with both the underlying disease and the infectious nature.

AIMS: To evaluate the clinical features of the affected nail plates in patients with psoriasis, the prevalence and etiology of onychomycosis in patients with psoriasis with altered nail plates.

MATERIALS AND METHODS: 102 patients with psoriasis vulgaris, mild and moderate, stationary stage with altered nail plates were examined. A clinical and laboratory (microscopic and cultural) study of the affected nail plates was carried out.

RESULTS: After mycological studies and physical examination of the affected nails of 102 patients, the following groups of nail diseases in patients with psoriasis were identified: psoriatic onychodystrophy (76; 74.5%) patients, onychomycosis (30; 29.4%) patients, traumatic onycholysis (4; 3,9%) patient, onychocryptosis (3; 2.9%) patients. 11 (14.5%) patients with psoriatic onychodystrophy had a complication in the form of a fungal infection. Distal-lateral subungual form of onychomycosis was detected in 17 patients (56.7%), total dystrophic form ― in 10 patients (33.3%), white superficial form ― in 2 patients (6.6%), proximal subungual form ― in 1 patient (3.3%).

CONCLUSIONS: According to the results of clinical and mycological examination of the affected nails of patients with psoriasis, it was revealed that 74.5% of patients have manifestations of psoriatic onychodystrophy, 29.4% ― onychomycosis. Among patients with psoriatic onychodystrophy, 14.5% had a complication in the form of a secondary fungal infection. The main causative agents of onychomycosis are Candida spp. (63.3%). The incidence of dermatophytes (Trichophyton spp.) Was 36.7% of the total number of cases. The main clinical forms of onychomycosis in patients with psoriasis are distal-lateral (56.6%), total dystrophic (33.3%).

Russian Journal of Skin and Venereal Diseases. 2021;24(1):53-59
pages 53-59 views

Self-induced dermatosis: a diagnostic problem at the intersection of two specialties

Olisova O.Y., Teplyuk N.P., Kayumova L.N., Smirnova L.M., Anpilogova E.M., Nikulina A.S.


Self-induced dermatoses is a group of artificial skin injuries and its appendages caused by self-injuring by the patient in order to get rid of negative emotions and painful sensations or to simulate a well-known dermatitis because of the pathological desire to be hospitalized to meet emotional or financial needs.

A significant similarity of clinical manifestations of self-induced dermatoses and oorganic dermatoses (vasculitis, cystic medicine, gangrenous pyoderma, drug reactions, etc.), the inefficiency of dermatological treatment with the sudden appearance of new lesions, as well as the deliberate concealment by the patient the real causes of skin lesions and giving false anamnesis lead to difficulties in diagnosis of self-induced dermatoses. The article presents current data on the main diagnostic criteria and effective methods of treatment of this disease based on several foreign and russian publications; own clinical cases’ descriptions are also provided.

Self-induced dermatoses must be considered as a possible differential diagnosis in cases when no well-known dermatoses can explain the clinical picture and anamnesis does not match it; new destructive lesions appear spontaneously, despite the ongoing treatment.

Russian Journal of Skin and Venereal Diseases. 2021;24(1):61-70
pages 61-70 views

Clinical case of acne inversa

Teplyuk N.P., Pirogova A.S.


Acne inversa is a rare skin disease characterized by recurrent nodules and abscesses that rupture with suppurative discharge and lead to sinus tracts and scarring. The disease is chronic and debilitating. In typical cases, it is diagnosed at late stages, when more aggressive therapeutic treatment is obligatory. There is not generally any accepted therapeutic algorithms, therefore, it is a difficult-to-manage disease, which determines the necessity for further study.

We present a clinical case of acne inversa with non-classical phenotypic features and the results of its treatment with systemic retinoids, and metformin. We also provide a review of the literature on the etiology, pathogenesis, and diagnosis of acne inversa.

Currently, there is no reliable algorithms of diagnostics and effective treatment for patients with acne inversa, which underlines the importance of further study of this disease.

Russian Journal of Skin and Venereal Diseases. 2021;24(1):71-77
pages 71-77 views

Microneedling in the threatment of post-acne symptom complex

Bykanov A.S., Snarskaya E.S.


The review presents data from foreign and domestic clinical studies on the efficacy and safety of microneedling application in the treatment of post-acne symptom complex. An analysis of the database of systematic reviews of Russian, European, American researchers, comparative studies on the effectiveness of the microneedling therapy in patients with different skin types for the treatment of postacne symptom complex is presented. Possibilities of microneedling monotherapy and variants of combined treatment, in particular the combinations of microneedling with PRP-therapy, acid peels, non-ablative lasers, injection gels (PMMA-collagen, hyaluronic acid, sodium succinate) are shown.

Russian Journal of Skin and Venereal Diseases. 2021;24(1):79-92
pages 79-92 views


Delayed inflammatory reaction of hyaluronic acid fillers against the background of flu-like illness

Ikonnikova E.V., Manturova N.E., Kruglova L.S.


Traditionally, it is considered that inflammatory reactions with delayed onset that occur due to the use of fillers based on hyaluronic acid (HA) are included in the category of rare complications. But in recent years, due to the increasing popularity of injection procedures, such reactions have become more common, which attracts the attention of both the scientific community and clinicians.

This article presents a clinical case of a late inflammatory response, describes the diagnosis and tactics of therapy, and provides an overview of the etiology, pathogenesis, diagnosis, and therapy of such reactions. 7 months ago, HA filler was injected into the area of both tear troughs. 3 months after the procedure, the patient underwent acute respiratory viral infection, against which for the first time she noted the sudden appearance of inflammation. 3 months after the first episode of an inflammatory reaction in the tear troughs, against the background of acute pharyngitis, its relapse occurred, accompanied by similar symptoms.

Similar inflammatory reactions can occur with any HA filler, but their frequency may vary depending on various factors. Timely detection and proper treatment can successfully eliminate the inflammatory reaction within a few days.

Russian Journal of Skin and Venereal Diseases. 2021;24(1):93-100
pages 93-100 views


Skin lymphomas (photogallery)

Olisova O.Y., Grekova E.V., Chernova N.G.


Skin lymphomas are a heterogeneous group of lymphoproliferative diseases characterized by clonal proliferation and primary accumulation of tumor lymphocytes in the skin with the possibility of secondary extracutaneous spread (lymph nodes, blood, spleen, lungs, liver). 65% of all skin lymphomas originate from mature T-cells, 25% from mature B-cells, 10% originate from natural killer cells (NK).

Russian Journal of Skin and Venereal Diseases. 2021;24(1):101-106
pages 101-106 views

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