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Vol 25, No 5 (2022)

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Giant lipoma of atypical localization

Snarskaya E.S., Shnakhova L.M., Semiklet J.M.


Lipoma (from the Greek λίπος ― fat), fatty tumor, wen is a benign tumor of mesenchymal origin, consisting of mature adipocytes, the pathogenesis and etiology of which remain not completely clear.

Diagnosis is based on the clinical presentation of painless, round, movable masses with a characteristic soft, doughy sensation in the subcutaneous tissues, but they can also be found in deeper tissues such as the intermuscular septa, abdominal organs, oral cavity, internal auditory canal, cerebellopontin angle, and chest, as a result of which specialized specialists are involved in the examination of the patient to obtain the results of ultrasound, magnetic resonance imaging. In addition, a histological examination is performed to exclude liposarcoma.

Treatment of a lipoma depends on the location, number, size, and subjective symptoms. Lipomas are excised by endoscopy (anemic, without the risk of noticeable scarring), open method, which makes it possible to prevent recurrence, or outpatient (under local anesthesia).

Due to the high incidence of pathology in the presence of a hereditary predisposition, a thorough examination of the patient’s relatives and the collection of a family history are necessary.

We present a clinical case of giant lipoma in a patient with a rare location of the tumor on the skin of the temporo-zygomatic region of the face.

Russian Journal of Skin and Venereal Diseases. 2022;25(5):341-348
pages 341-348 views


Androgenic alopecia in men: the significance of genetic, hormonal and metabolic factors (prospective cohort comparative study)

Kondrakhina I.N.


BACKGROUND: diagnosis and treatment of androgenetic alopecia in male patients is a topical issue in modern dermatology, this is due to the high prevalence of this disease in the population, the complexity of the therapy. In most cases, the pathogenesis of this disease is associated with genetic factors, not paying attention to the totality of non-genetic factors that affect the occurrence and development of this disease in male patients.

AIM: to study the pathogenetic mechanisms of the occurrence and development of androgenic alopecia in men on the basis of a comprehensive account of genetic, hormonal and metabolic factors.

MATERIAL AND METHODS: Genetic predisposition to androgenic alopecia in male patients was evaluated by the method of minisequencing, evaluation of non–genetic factors ― using validated evaluation methods. Further finalizing of the research results was carried out using a neural network and step-by-step linear discriminate analysis.

RESULTS: The study included 50 male patients with a verified diagnosis of “Androgenic alopecia”, stages of the disease from I to IV on the Norwood-Hamilton scale, and 25 volunteers corresponding by age and nationality. The study of nucleotide polymorphisms made it possible to assess the potentially low and high level of genetic risk of this disease. The initial zinc level turned out to be significant for assessing the prognosis of the effectiveness of disease therapy. Mono- or polydeficiency of zinc, copper, magnesium, selenium, vitamins D, B12, E, folic acid play a significant role in the occurrence and development of the disease.

CONCLUSIONS: The results of the study show the different role of genetic and non-genetic factors in the occurrence and development of androgenic alopecia in male patients.

Russian Journal of Skin and Venereal Diseases. 2022;25(5):349-361
pages 349-361 views

Possibilities of microneedling in the combined therapy of vitiligo. Literature review

Olisova O.Y., Nikulina A.S., Krotkova E.A., Lazareva P.I., Lomonosov K.M.


The Vitiligo therapy is still a topical issue today. According to the Russian and European clinical guidelines, modern therapy for vitiligo includes UVB-311 nm phototherapy, topical glucocorticoids and topical calcineurin inhibitors. Standard treatment regimens require a long time of application and their effectiveness on the average does not exceed 40%, which leads to disappointment in the treatment not only for patients but also for dermatologists. In this regard an active search for therapies for vitiligo continues. Thus, one of the modern options for the treatment of this disease is microneedling.

Microneedling is a relatively new, easy to perform, safe and minimally invasive therapeutic technique that enhances the regenerative process by creating numerous microtraumas occurring when shallow needles are punctured into the skin. This procedure causes a cascade of reactions similar to the wound healing process, stimulating the production of collagen, elastin and growth factors and increases the migration of melanocytes and keratinocytes leading to repigmentation of vitiligo lesions. Local damage to the skin with needles enhances penetration of active ingredients into deeper layers, so microneedling is often combined with the use of UV light, as well as with various biopharmaceuticals to increase efficiency. Although the procedure is relatively new it has demonstrated efficacy, good tolerability, limited undesirable effects and a short recovery time, making micro-needling a promising treatment for vitiligo.

This article is a review in nature. The purpose of this review is to update the available information on the treatment of vitiligo as well as to explore a promising new method of therapy. A systematic literature review was conducted using PubMed, Cochrane Library, CyberLeninka, Clinicaltrial.govand the open-access Internet databases to examine the efficacy, principles of action, and tolerability of the new treatment. Key words used in the literature search in the aforementioned databases were “vitiligo,” “vitiligo treatment,” “microneedling,” and “quality” of life .The results of various clinical studies are presented.

This review is addressed to practicing dermatovenerologists interested in vitiligo therapy.

Russian Journal of Skin and Venereal Diseases. 2022;25(5):363-371
pages 363-371 views

Successful treatment of pyoderma gangrenosum in a patient winh ulcerative colitis and COVID-19 infection: case report

Teplyuk N.P., Grabovskaya O.V., Kusraeva D.T., Grekova E.V., Koriakin D.A., Kostenko A.Y.


Pyoderma gangrenosum is a rare inflammatory neutrophilic dermatosis, which causes ulceration of the skin. The condition is commonly associated with underlying systemic disorders such as inflammatory bowel disease, arthritis, and hematological disorders. Herein, we describe the case of a familiar association between pyoderma gangrenosum and ulcerative colitis complicated by the newly COVID-19 infection.

It is of particular clinical interest to address pyoderma gangrenosum lesions with concurrent treatment of associated disorders that may have influence on the course of the ulcer. Moreover, the therapy should cover as many diseases as possible while not being excessive to minimize possible side effects.

Thus, the selection of treatment that spans mutual pathophysiological features of all comorbidities represents the best option to make when handling pyoderma gangrenosum patients.

We present a case of the development of gangrenous pyoderma against the background of ulcerative colitis complicated by the new coronavirus infection COVID-19, which will raise awareness of gangrenous pyoderma as a relatively rare cause of ulcerative necrotic skin lesions, which can easily be confused with an infectious process.

Of particular clinical importance in the conditions of the COVID-19 pandemic is the correct treatment of gangrenous pyoderma. Only an integrated approach can give a positive result from the therapy.

Russian Journal of Skin and Venereal Diseases. 2022;25(5):373-380
pages 373-380 views

Features of topical therapy of skin and hair mycosis caused by Microsporum genus fungi: Results of clinical observations

Yakovlev A.B.


The article summarizes the long-term experience of observing the dynamics of pathological process of tinea corporis caused by Microsporum spp. in children and adults treated at the initial stage with combined topical steroids and without them. The duration of treatment increases by 1.5–2 times when combined topical steroids are used, while with other mycoses caused by fungi of the genera Trichophyton, Epidermophyton, this does not occur. This can be explained, apparently, by the peculiarities of sporulation of fungi of the genus Microsporum spp.: most dermatomycetes at the time of penetration into the epidermis and dermis rely on the germination of mycelium, and only in fungi of the genus Microsporum spp. at the time of invasion, sporulation activity does not decrease. As a result, the fungus is able to simultaneously infect the epidermis and hair.

Most modern therapeutic programs for the external treatment of microsporia include iodine preparation and an antimycotic in the form of a cream or ointment. These drugs do not suppress the macrophage reaction in the lesion, and with the onset of treatment, sporulation decreases sharply. When using a topical combination drug containing an antimycotic and combined topical steroids, the fungus continues to actively sporulate, as a result of which the process in the epidermis stops, and the spores that have penetrated into the hair remain viable.

Russian Journal of Skin and Venereal Diseases. 2022;25(5):381-388
pages 381-388 views

Alopecia areata in children: an overview of clinical features and recent treatment options

Fomina D.E., Pinegin V.B.


Alopecia areata is a chronic relapsing autoimmune disease characterized by a local or diffuse non-scarring hair loss. Statistically, 0.2% of people worldwide are affected by alopecia areata and 1.7% were diagnosed with it at some point in life. The incidence of alopecia areata in children has been rapidly increasing in recent years.

The main role in pathogenesis of alopecia areata belongs to the loss of immune privilege due to the influence of genetics and various external factors. Follicles become vulnerable to the attack by patient’s own T-lymphocytes, which results in hair shedding. Some autoimmune and allergic diseases are known to be comorbidities of alopecia areata.

The diagnosis is made on the basis of trichoscopy results, besides there are some manifestation features in children which are different than in adults.

Currently, there are several promising drugs but the number of studies (regarding pediatric patients) is extremely limited. According to a number of authors, corticosteroids and Janus kinase inhibitors have shown their effectiveness and safety in the treatment of childhood alopecia areata, although they are not approved by the United States Food and Drug Administration (FDA) at the moment.

Russian Journal of Skin and Venereal Diseases. 2022;25(5):389-398
pages 389-398 views

The incidence of sexually transmitted infections in the Moscow region: epidemiological trends based on the results of 2021

Makhneva N.V., Almazova A.A.


Due to the restrictive epidemiological measures introduced in connection with the widespread spread of the new coronavirus infection SARS-CoV-2 in the period from late 2019 to mid 2021, the epidemiology of socially significant infections in the subjects of the Russian Federation has undergone significant changes. Among the obvious factors that can influence morbidity rates, it is possible to indicate the limitation of the volume of planned medical care to the population and the reduction of migration processes.

Analysis of the incidence of socially significant infections that pose a danger to others during the period of epidemic trouble in the country due to COVID-19 and after the abolition of all restrictive measures allows us to identify the most significant factors in the epidemiology of sexually transmitted infections.

The dynamics of the main indicators of the incidence of sexually transmitted infections, its structure, detection activity demonstrate: how the self-isolation regime and the reduction in the availability of planned medical care to the population for even a short time can change the trends of the epidemic process, worsening the epidemiological well-being in the territory of the subject as a whole, and affect population health indicators; at the same time, what factors make the greatest contribution to the spread of sexually transmitted infections when quarantine restrictions are lifted.

Russian Journal of Skin and Venereal Diseases. 2022;25(5):399-408
pages 399-408 views

Clinical significance of plasma markers of angiogenesis in patients with psoriasis

Pritulo O.A., Petrov A.A., Maraqa M.Y.


BACKGROUND: Currently, many researchers attach great importance in psoriasis pathogenesis to hyperproduction of vascular endothelial growth factor (VEGF) and endothelin-1, which leads to increased angiogenesis in dermis and mediates processes of immune inflammation. At the same time, possibility of using these angiogenesis biomarkers as additional indicators of immune inflammation activity and disease activity has been poorly studied.

AIMS: the purpose of the study was to assess the relationship between serum concentrations of VEGF and endothelin-1, structural changes in the capillary bed according to videodermatoscopy, and severity and prevalence of skin lesions in patients with psoriasis, duration of disease, presence of nail lesions, synovitis, enthesitis and spondylitis, as well as concomitant diseases of the cardiovascular system.

MATERIALS AND METHODS: The work is based on examination data analysis of 132 patients with moderate and severe psoriasis vulgaris for the period 2020–2022. Patients were determined the levels of VEGF and endothelin-1 in blood plasma and underwent digital dermatoscopy to study the characteristics of angiogenesis vascular loci (vascular glomeruli) in the papillary dermis. All psoriasis patients with symptoms of musculoskeletal system lesions were examined by a rheumatologist, which was supplemented by ultrasonography of the joints.

RESULTS: According to the results of enzyme immunoassay, it was found that the examined patients had an increased concentration of VEGF and endothelin-1 in blood plasma compared to the control group (respectively 19.5 [4.7; 48.1] pg/ml and 274.5 [146; 439] pg/ml versus 5.2 [0.5; 9.8] pg/ml and 96.5 [32; 188] pg/ml, p=0.004 and p=0.002). It was found that an increase in plasma concentrations of VEGF and endothelin-1 correlates with an increase in density of vascular glomeruli (respectively r=0.65 and r=0.74) and the average diameter of the glomerulus (respectively r=0.58 and r=0.56). A more pronounced increase in plasma concentrations of VEGF and endothelin-1 in patients with psoriasis was noted in patients with psoriatic arthritis and in the presence of synovitis. VEGF levels were higher in patients with severe psoriasis and in patients with nail lesions. Correlation analysis showed the strongest relationship between VEGF concentration and DAS28, DLQI, PASI and NAPSI values, as well as endothelin-1 concentration and PASI, BSA and DLQI values.

CONCLUSIONS: The work showed that the plasma concentration of VEGF and endothelin-1 characterizes the degree of angiogenesis expression in the psoriasis pathogenesis, reflects morphology changes in capillaries of the affected skin, and can also be used as a marker of severe psoriasis and an increased risk of developing damage to the nails and synovial membranes of the joints.

Russian Journal of Skin and Venereal Diseases. 2022;25(5):409-418
pages 409-418 views


Chronicles of A.I. Pospelov Moscow Society of Dermatovenereologists and Cosmetologists (MSDC was founded on October 4, 1891). Bulletin of the MSDC № 1149

Yakovlev A.B., Maximov I.S.


On October 18, 2022, the 1149th meeting of the A.I. Pospelov Moscow Society of Dermatovenerologists and Cosmetologists (MSDC) took place. The meeting was held in a face-to-face format. There were 128 participants in total. Accepted as a member of the MSDC 53 people.

Two clinical cases are presented for discussion: trichoadenoma ― a rare benign follicular tumor consisting of strands of epithelial cells and keratinizing cysts embedded in the sclerotic stroma, and Darier’s follicular dyskeratosis ― hereditary dermatosis characterized by the formation of follicular hyperkeratotic vegetative papules on seborrheic areas of the skin caused by a violation of the keratinization process by the type of dyskeratosis.

Scientific reports were devoted to the analysis of differential diagnosis and therapeutic tactics in Brooke–Spiegler syndrome (multiple cylindromes and trichoepitheliomas), the mechanisms of action and effectiveness of zinc pyrithione as a means of controlling colonization of the hairy skin by fungi-commensals of the genus Malassezia, as well as the most urgent problems of modern medicine ― the features of the course of chronic-severe dermatoses after SARS-CoV-2 infection (COVID-19) and an increase in the incidence of mucormycosis, which is a marker of immune breakdown that occurs immediately after COVID-19 infections.

Russian Journal of Skin and Venereal Diseases. 2022;25(5):419-426
pages 419-426 views


Photogallery of diseases of the oral mucosa. Part I

Teplyuk N.P., Lepekhova A.A., Grekova E.V., Damdinova B.S.


Nowadays, more than 300 diseases of the oral mucosa have been established in the scientific literature. Since pemphigus vulgaris and lichen planus can mimic many other skin conditions it could be difficult to make the diagnosis according only to clinical features. Moreover, pemphigus vulgaris is known to be an autoimmune life-threatening disorder which necessarily need to be treated with high doses of systemic glucocorticoids, whereas lichen planus in some cases can be transformed into squamous cell carcinoma.

The drug associated erythema and the herpes associated erythema multiforme both affect not only the oral mucosa but also the skin, which makes differential diagnosis easier. Nevertheless, in our practice we can encounter only the oral cavity involvement. Previously, Stevens–Johnson syndrome was considered as severe form of erythema multiforme affecting both the skin and the oral mucosa.

Additionally, cheilitis can be observed in patients with atopic dermatitis even in the remission stage.

Furthermore, Melkersson–Rosenthal syndrome is a rare neurological disorder characterized by recurring facial paralysis, swelling of the face and lips, and the development of folds and furrows in the tongue.

Russian Journal of Skin and Venereal Diseases. 2022;25(5):427-433
pages 427-433 views

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