Vol 25, No 2 (2022)

Multiple cutaneous and uterine leiomyomatosis (MCUL), also known as Reed’s syndrome, is a rare genodermatosis, with an autosomal dominant pattern of inheritance. It results from a germline heterozygous mutation of fumarate hydratase gene, that is classified as a tumor suppressor gene. Hereditary leiomyomatosis and renal cell cancer is characterized by the association of multiple cutaneous and uterine leiomyomatosis with renal cell carcinoma. The diagnosis of multiple leiomyomas is based on the identification of morphological characteristic rashes (small, oval, red-brown or flesh-colored nodules located around the hair follicles, often painful) and is confirmed by the method of pathomorphological examination. Treatment of leiomyomas depends on their number, size, area of skin lesion and severity of subjective symptoms. With single rashes, surgical excision of the largest and most painful elements is possible, with severe pain syndrome ― calcium channel blockers, alpha-blockers and gabapentin. Cryotherapy, diathermocoagulation, and laser ablation with a carbon dioxide laser are used to destroy the nodes.

The presence of cutaneous leiomyomas in patients dictates the need for careful collection of anamnesis, including family and obstetric-gynecological, conducting a full-fledged clinical, laboratory and instrumental examination and consulting by related specialists. Annual screening for early detection and therapy of renal cell carcinoma is also mandatory.

Due to the existing probability of the hereditary nature of Reed’s syndrome, a thorough examination of the patient’s relatives is necessary.

We report a case of a 58-year-old woman with Reed’s syndrome: multiple cutaneous leiomyomas, uterine leiomyoma and renal cysts.

According to the recent changes in the classification of the family Arthrodermataceae, it may already include 9 genera and 79 species. Dermatophytes associated with human and animal infections belong to the genera Trichophyton, Microsporum and Epidermophyton, whereas Arthroderma, Ctenomyces, Guarromyces, Lophophyton, Nannizzia and Paraphyton are mainly represented by geophilic species. Since morphological and physiological traits in fungi cannot provide reliable basis for classification, the modern system of dermatophytes was built on the basis of phylogenetic analysis of nucleotide sequences. The new dermatophyte classification employs the principle of “one fungus, one name”, according to which genetically similar perfect and imperfect forms belong to the same species.

At the current state of genosystematics, the taxonomic identification of dermatophytes in most cases requires the use of molecular methods, in particular, DNA sequencing of the ITS region.

In this review, we briefly outline the history of dermatophyte classification, summarize generic and species composition of the family and provide data on their ecology, accession numbers for reference sequences of ITS region, and references to major taxonomic publications.

BACKGROUND: Psoriasis is one of the most common dermatoses. The disease has a negative impact on every aspect of the patient’s life ― social, physical and psychological. Psoriasis is accompanied by a marked deterioration in the quality of life of patients, which often leads to their social maladaptation.

AIMS: This study is aimed at assessing the nature of epidemiological and clinical manifestations of psoriasis in the Republic of Uzbekistan.

MATERIALS AND METHODS: The data of the population register of psoriatic diseases created on the basis of the Republican Skin and Venereological Clinical Hospital the city of Tashkent, the Republican Specialized Scientific and Practical Center of Dermatology and Cosmetology of the Republic of Uzbekistan were studied. A retrospective analysis of case histories for the period 2015–2019 was also carried out at the clinical base of the Department of Dermatovenerology of the Tashkent Medical Academy.

RESULTS: The prevalence of psoriasis among the general population of the Republic of Uzbekistan from 2010 to 2020 during the study period significantly increased, especially in the age group of 15–29 years. Men suffer from psoriasis more often, this disease is characterized by an earlier onset of the disease (age group up to 40 years). The most common clinical form of psoriasis is vulgar psoriasis.

CONCLUSIONS: There is a clear need to improve the quality and increase the amount of data related to the epidemiology of psoriasis in the Republic of Uzbekistan. Diagnostic criteria and reports on morbidity and prevalence should be standardized.

Lupus erythematosus is a multisystemic connective tissue disease that has a wide range of manifestations affecting the skin and mucous membranes, joints, kidneys, heart, lungs, and central nervous system. In dermatology, cutaneous forms of lupus erythematosus can be classified into discoid, disseminated, centrifugal erythema, lupus panniculitis, subacute and chronic lupus, and systemic lupus erythematosus with damage to internal organs. It can develop as an independent disease or can be a result of progression of cutaneous forms.

The skin is the second most commonly affected organ in systemic lupus erythematosus folowing the joints, with skin manifestations observed in 80% of patients throughout the course of the disease. And in 20−30% of cases, the disease debuts with skin rash. Thus, these patients primarily present to dermatologists. Knowledge of the criteria for making a diagnosis, the clinical characteristics, in combination with performance of advanced laboratory diagnostic tests allow a dermatologist to suspect a systemic process in a timely manner and prescribe appropriate therapy.

The article presents two clinical observations of male patients with systemic lupus erythematosus, the diagnosis of which could not have been established for several years. The diagnosis in these cases met the 2019 European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR) classification criteria for systemic lupus erythematosus, confirmed by laboratory tests. Patients had a positive trend to response to therapy.

The article deals with the issues of face and neck skin involutional changes, which are considered to be the first and easily determined signs of the body aging. Clinical studies of the effectiveness of the therapy with medicines based on hyaluronic acid, silicon and zinc are presented. Based on the presented data, the possibility of further clinical trials of pharmacological preparations used to treat the skin of the face and neck is discussed.

Of particular interest are data on the dynamics of expression of key biomarkers of skin aging in the combined use of silicon- and zinc-containing injectable drugs. The addition of zinc can enhance the effect of silicon compounds in the composition of these drugs.

Organosilicon (silanol) increases the synthesis of type III collagen and elastin and has a protective effect against photodamage of the skin. An increase in the formation of type III collagen was revealed when using silicon complexes with chitinase, while an increase in the expression of TGF-β and an increase in fibroblast proliferation were also revealed.

The use of silicon- and zinc-containing drugs is a promising, but still insufficiently studied direction of therapy for involutional changes in the skin of the face and neck. Silicon and zinc in the composition of drugs for anti-aging therapy can have a synergistic effect, affecting a number of important molecular mechanisms of skin aging.

The 1147^th meeting was held in a face-to-face format. In total there were 95 participants. Four people were accepted as members of the MSDC.

Among the clinical observations presented at the meeting were patients with psoriatic erythroderma (two cases) and erythroderma in Deverji’s disease. Erythroderma is a severe, often life threatening condition characterized by a universal inflammatory lesion of the skin, itching, generalized lymphadenopathy and fever. A case of cryoglobulinemic vasculitis, characterized by polymorphism of the course and a tendency to necrosis, is also presented in a 65-year-old patient who developed drug-induced Itsenko–Cushing syndrome during treatment. A case of multiform exudative erythema was also considered in a 40-year-old patient with abundant rashes on the skin of the trunk and extremities caused by subacute SARS-CoV-2-associated myocarditis of high immunological activity, moderate course.

The topics of scientific reports were devoted to auto-inflammatory syndrome (SAPHO; PEPA; PUSH; PUSH) and acne. It has been reported that biological anticytokine therapy ― IL-1 antagonists ― is the most acceptable for the treatment of all syndromes with the main dermatological manifestation in the form of acne. For severe forms of acne, an algorithm for patient management was proposed.

Metabolic dermatoses are signs of some internal diseases, which makes it possible to identify them before clinical manifistation. Thus amyloidosis is often associated with Familial Mediterranean fever, and its timely diagnosis contributes to the detection of diseases such as medullary thyroid cancer, multiple myeloma, Waldenstrom macroglobulinemia and other monoclonal gammopathy, nephropathy, generalized sensorimotor polyneuropathy, dysfunction of the gastrointestinal tract, etc. Necrobiosis lipoidica is associated with diabetes mellitus, mucinosis ― with thyroid diseases, xanthomas ― with histiocytosis X, porphyria ― with liver disease, calcinosis ― with abnormality calcium metabolism.