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Vol 23, No 5 (2020)

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Restricted Access Access granted
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DERMATO-ONCOLOGY
Diagnosis of melanocytic neoplasms: a literature review
Olisova O.Y., Pritulo O.A., Kirilyuk T.I.
Abstract

This article presents an analysis of foreign literature sources describing the possibilities of using various diagnostic methods and combining diagnostic methods and their analytical software and artificial intelligence for the diagnosis of benign and malignant melanocytic nevi. Evaluation of efficiency was performed. The disadvantages of diagnostic methods based on the results of foreign studies in recent years are described.

Russian Journal of Skin and Venereal Diseases. 2020;23(5):278-287
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Diagnostic performance study on the melanoma automated diagnosis software powered by artificial intelligence technologies
Sergeev V.Y., Sergeev Y.Y., Tamrazova O.B., Nikitaev V.G., Pronichev A.N., Sergeeva M.A.
Abstract

INTRODUCTION: The research evaluates a series of publications on the machine recognition efficacy of cutaneous melanoma dermatoscopic images. Some authors report high sensitivity and specificity of automated diagnostics of skin tumors. Significant differences in the published data can be attributed to the use of different algorithms and groups of skin neoplasms to calculate the accuracy rate.

MATERIALS AND METHODS: The diagnostic performance of two automated artificial intelligence systems is compared.

RESULTS: The convolutional neural network algorithm improves the overall diagnostic accuracy by 7% compared to the algorithm without deep learning, while the overall accuracy rate was 78%. An initial set of 100 dermatoscopic images used in the study is published online for the assessment of the applicability of the obtained data when introducing existing artificial intelligence systems.

CONCLUSION: The main limitations and possible ways to further improve the automated diagnosis of skin tumors based on digital dermatoscopy are outlined.

Russian Journal of Skin and Venereal Diseases. 2020;23(5):288-292
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CLINICAL PICTURE, DIAGNOSIS, AND THERAPY OF DERMATOSES
Rationale and utility of sub-therapeutic/low dose cytokines and growth factors in dermatology: an overview
Podder I., Sadoughifar R., Goldust M., Torello L.
Abstract

The review presents data on a new low-dose medicine approach in several dermatoses such as psoriasis, atopic dermatitis and vitiligo based on the signaling molecules, which are responsible for the cross-talk between the psychoneuroendocrine and immune system and regulate the cellular responses to internal and external stimuli. An imbalance of specific signal molecules leads to inflammatory, allergic and autoimmune disorders. The mechanisms of signal molecules’ action and aspects of Psycho-neuro-endocrine-immunology are presented. Recent studies on efficacy of low-dose medicine along with recommended strategies in psoriasis vulgaris (IL-4, IL-10, IL-11), atopic dermatitis (IL-12, IFNγ), and vitiligo (IL-10, IL-4, anti-IL-1, b-FGF) are observed.

Russian Journal of Skin and Venereal Diseases. 2020;23(5):293-302
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Clinical efficacy and characteristics of immunological changes in patients with psoriasis following the combined use of sulfide peloids from Lake Saki
Kuznetsova M.Y., Pritulo O.A., Dovgan I.A., Sokolova O.N.
Abstract

BACKGROUND: Psoriasis is a common disease, and many of its forms are resistant to treatment.

AIM: This study aimed to analyze the effects of complex treatment with Lake Saki sulfide peloids on the clinical and immunological parameters patients with psoriasis.

MATERIALS AND METHODS: The study included 90 patients with steady-state psoriasis of mild or moderate severity (51 men and 39 women) aged 23–65 (mean age 37.3 ± 12.7) years, who received treatment at the N.I. Pirogov Saki Military Clinical Health Resort of the Russian Ministry of Defense. The control group consisted of 30 apparently healthy volunteers.

RESULTS: Taking into account the clinical and immunological parameters of patients with mild and moderate psoriasis, we have developed a complex differentiated method of treatment using Lake Saki peloids and brine supplemented with an alpha-lipoic acid preparation.

CONCLUSION: The presented complex method of peloid balneotherapy in combination with alpha-lipoic acid preparation intensifies the 14-day course of sanatorium-resort treatment, increases the duration of remission, and enhances the quality of life of patients with mild-to-moderate psoriasis.

Russian Journal of Skin and Venereal Diseases. 2020;23(5):303-311
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Psychovegetative status and neurological symptoms in patients with idiopathic eczema
Dubensky V.V., Gutyansky O.G., Dubensky V.V., Gutyanskaya E.Y., Nekrasova E.G.
Abstract

INTRODUCTION: The study included 68 patients with idiopathic hand eczema.

RESULTS: Neurological symptoms were detected in 75% of patients; the most frequently recorded symptoms were myodefans (66.1%) and radicular sensory impairment (52.9%). Disorders of the psychoemotional state of patients were manifested by signs of depression in 38.1% of patients and personal and reactive anxiety in 63.8% and 72% of patients, respectively. The prevalence of indicators of depression and reactive anxiety and personal anxiety were found in men and women, respectively. The manifestation of the psychovegetative syndrome was found in 75% of patients. Degenerative-dystrophic changes in the spine were observed in 91.1% of patients, and two or more conditions were observed in 52.9% of the examined patients. The most pronounced changes were observed in C5–C7 segments of the spine, and in 57.3% of the patients, these changes were associated with the side of the inflammatory process on the skin.

CONCLUSION: The obtained data substantiate the correction of the psychovegetative syndrome and treatment of dorsopathy in hand eczema.

Russian Journal of Skin and Venereal Diseases. 2020;23(5):312-316
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Changes in the serum levels of anti-inflammatory interleukins in patients with atopic dermatitis after a course of phototherapy
Plakhova K.I., Khasanova A.R., Tarasenko G.N., Shadyzheva L.I.
Abstract

BACKGROUND: The role of immunological disorders in the development of atopic dermatitis (AD) is currently beyond doubt.

AIMS: Changes in the serum levels of IL-4, IL-10 and IL-13 in patients with atopic dermatitis (AD) after UV therapy combined with standard drug treatment have been studied.

MATERIALS AND METHODS: The study included 80 patients with moderate to severe AD and 80 healthy volunteers. The patients with AD received a course of 311 nm UVB phototherapy combined with standard drug therapy. Serum IL-4, IL-10 and IL-13 levels were determined through enzyme-linked immunosorbent assay (ELISA).

RESULTS: In the studied sample, patients with AD were found to have statistically significantly higher serum levels of IL-10 and IL-13 compared with healthy volunteers of the control group. Serum IL-10 level was 18.3 pg/ml in patients with AD and 13.2 pg/ml in those of the control group; the level of IL-13 was 15.8 pg/ml and 11.5 pg/ml, respectively; after the course of 311 nm UVB, serum IL-10 and IL-13 levels in patients with AD decreased (IL-10 by 27.8% and IL-13 by 12.5%). IL-4 values did not differ significantly in patients with AD and those in the control group, being 0.06 pg/ml and 0.05 pg/ml, respectively; after the course of phototherapy, serum IL-4 levels remained unchanged and were equal to 0.05 pg/ml.

CONCLUSION: The results obtained confirm the assumptions about the significant role of IL-10 and IL-13 in the mechanisms of AD regulation and pathogenesis and demonstrate the anti-inflammatory efficacy of phototherapy (311 nm UVB) in patients with severe and moderate AD.

Russian Journal of Skin and Venereal Diseases. 2020;23(5):317-323
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Current management options for rosacea: clear skin is our reality
Olisova O.Y., Anpilogova E.M.
Abstract

BACKGROUND: Treatment of rosacea makes enough difficulties. Review of current etiology, pathogenesis and social burden of rosacea are presented, as well as results of international studies on efficacy of brimonidine gel (Mirvaso Derm) and ivermectin creme (Soolantra) usage in erytemato-teleangiectatic and papulopustular rosacea.

AIMS: To evaluate efficacy and safety of topical ivermectin and brimonidine for the treatment of rosacea.

MATERIALS AND METODS: Results of our own experience of using these drugs in 87 rosacea patients are presented. Depending on the subtype and severity of the disease, patients with erythematotelangiectatic subtype rosacea were treated with Mirvaso Derm gel (59%), Soolantra cream, and tacrolimus ointment (41%); doxycycline 0.1–0.2 g twice a day and Soolantra cream (29%); and minocycline 0.05–0.1 g a day and Soolantra cream (37%).

Moreover, patients with papulopustular subtype rosacea were treated with the following combined therapy: doxycycline/minocycline + Mirvaso Derm gel + Soolantra cream (34%). Regardless of the severity of the process, all patients received Cetaphil Pro for redness prone skin (Cetaphil Redness Control line until 2018) as daily skin care products. The mean duration time of therapy for antibiotics was 1.5–2 month and topical therapy had a relatively longer duration time of therapy: from 8 to 24 months for Mirvaso Derm and 3 to 10 months for Soolantra.

RESULTS: After the therapy 43 and 55% of patients with papulopustular rosacea achieved Investigator Global Assessment (IGA) scores of 0 (clear) and 1 (almost clear), respectively; and 41% and 50% of patients with erythemato-telangiectatic rosacea achieved IGA scores 0 and 1, respectively. During the 1-year follow-up ‘clear and almost clear skin’ (IGA = 0–1) remained in 87% of patients with papulopustular subtype rosacea and 79% of patients with erythemato-telangiectatic subtype rosacea.

CONCLUSION: Thus, based on the results, Mirvaso Derm gel and Soolantra creme have demonstrated to be very effective and safe options for rosacea treatment.

Russian Journal of Skin and Venereal Diseases. 2020;23(5):324-333
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Clinical case of lupus erythematosus panniculitis
Teplyuk N.P., Grabovskaya O.V., Razhev P.A.
Abstract

BACKGROUND: This clinical case is interesting because of extreme rarity of lupus panniculitis in the population, as well as the possible risk of developing systemic lupus erythematosus.

CASE REPORT: The article presents a clinical observation of a rare skin disorder – lupus erythematosus panniculitis and the results of a successful combined treatment of the disease with systemic glucocorticoids (prednisolone), and an antimalarial agent (hydroxychloroquine). A review of the literature on the etiology, pathogenesis, and diagnosis of lupus panniculitis has been conducted.

CONCLUSION. Early detection of lupus erythematosus panniculitis (LEP) makes systemic steroid therapy and quinoline drugs more effective in achieving remission. That is why dynamic monitoring of patients with LEP is important to identify new or progressive symptoms.

Russian Journal of Skin and Venereal Diseases. 2020;23(5):334-340
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Miramistin: from dermatovenerology to prevention of coronavirus infection. Literature review
Vintserskaya G.A., Pritulo O.A., Sherengovskaya Y.V., Babanin V.A., Marakah M.Y.
Abstract

IMPORTANCE: In 2019, the world faced a serious threat – a new coronavirus infection (COVID-19) –which entailed severe social and economic losses. Considering the massive spread of COVID-19 in 2020, recently, studying the methods of prevention used to prevent the spread of the disease is considered relevant.

RESULTS: We have analyzed scientific publications devoted to the study of prevention in databases, such as Scopus, Web of Science, and CyberLeninka. Antiseptic drugs were of particular interest; thus, this article describes the nonspecific preventive measures with the use of miramistin antiseptic drug. This drug has a wide antimicrobial and antiviral spectrum of action. It has a bactericidal effect on aerobic and anaerobic bacteria, and their association on fungal microflora with significant influences on herpes viruses, human immunodeficiency, hepatitis, and sexually transmitted pathogens. Therefore, for many years, this drug is actively used as a means of prevention. Scientific evidence stating that miramistin can inactivate coronaviruses exists. The obtained data show that miramistin in 0.0001% concentration reduces the infectious activity of human coronavirus almost twice, and miramistin in 0.005% concentration and above completely neutralizes the infectious activity of human coronavirus. It has been proven that miramistin has an immunoadjuvant effect, which leads to increased protective reactions of the skin and enhances skin regeneration due to the activation of cellular and humoral immune responses.

CONCLUSION: Miramistin preparation has the following important advantage: it has a selective effect on pathogens and does not have an adverse effect on body tissues.

Russian Journal of Skin and Venereal Diseases. 2020;23(5):341-346
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COSMETOLOGY
Thread lifting and single-step facial volumization as an optimum balanced technique of aesthetic correction
Gribanov I.I., Starokozheva N.Y.
Abstract

BACKGROUND: Development and introduction of minimally invasive lifting techniques is considered a demanding and relevant objective of contemporary dermatocosmetology as these techniques result in nonsurgical lifting with minimal disruption of facial harmony due to the activation of a maximal number of key anatomic landmarks following the simultaneous insertion of lifting threads and hyaluronic acid fillers.

AIMS: To study the clinical efficacy and safety of minimally invasive lifting technique and filling up of the tissue volume deficiency with the combination of thread lifting from the temporal approach and hyaluronic acid filler augmentation.

MATERIALS AND METHODS: The study group included 193 female patients (mean age 41.3 ± 8.5 years) with gravitational ptosis of the 1st, 2nd, and 3rd degrees. Group 1 (main) comprised 42 (21.8%) patients who underwent lifting by the method of implantation of 12 threads with shaped polydioxanone spikes DG-Lift and injection of 2 ml of hyaluronic acid biphasic filler. Group 2 (comparison) comprised 64 (33.2%) female patients who underwent lifting using only 12–20 polydioxanone DG-Lift threads. Group 3 (comparison) comprised 87 (45%) female patients who received tissue volumization with 4–8 ml of biphasic hyaluronic acid filler in each case.

RESULTS: A total of 82%, 59%, and 48% of patients in groups 1, 2, and 3, respectively, noted the optimal cosmetic result and full satisfaction with the result according to the Global Aesthetic Improvement Scale. The incidence of complications in group 1 (6.4%) was lower than that in group 2 (9.1%) and group 3 (17.7%). This is due to low invasive nature and lower tissue traumatization with the use of fewer fillers and threads to obtain optimal cosmetic effect.

CONCLUSION: The proposed technique of thread lifting with biodegradable threads DG-Lift from the temporal approach combined with tissue volumization with hyaluronic acid fillers is safe and significantly effective for patients with gravitational ptosis of the 1st, 2nd, and 3rd degrees.

Russian Journal of Skin and Venereal Diseases. 2020;23(5):347-353
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PHOTO GALLERY
Photo gallery: Lichen planus
Olisova O.Y., Teplyuk N.P., Grabovskaya O.V., Kolesova Y.V.
Abstract

Lichen planus (LP) is a chronic inflammatory disease of skin and mucous from group of papular dermatosis, less often affecting nails and hair. The article presents photographs of patients with various clinical forms of LP for a more thorough differential diagnosis of this disease.

Russian Journal of Skin and Venereal Diseases. 2020;23(5):356-360
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