Vol 26, No 6 (2023)

Dermatofibrosarcoma protuberans (Darier–Ferrand) is a rare mesenchymal tumor of fibrohistiocytic genesis with moderate malignancy and low incidence of metastasis, the pathogenesis and etiology of which remain unclear. The diagnosis is based on the clinical picture of a reddish-brown dense plaque or papule that gradually becomes a painful node with ulceration. Histological examination reveals the infiltrate with a moire pattern in the dermis in the form of fusiform cells with diffuse CD34+ staining during immunohistochemical analysis. Treatment of dermatofibrosarcoma protuberans (Darier–Ferrand) is a serious problem due to the high tendency for recurrence after removal. The methods described in the literature include extensive excision, Mohs surgery, chemotherapy, radiation therapy and targeted treatment with an anticancer protein-tyrosine kinase inhibitor.

The authors present their own clinical observation of a patient with dermatofibrosarcoma protuberans (Darier–Ferrand) in whom a diagnostic error by only visual method and an incorrect treatment led to the worsening of skin process. The interest of this clinical observation lies in the difficulty of diagnosis during the initial visit, in the complexity of differential and morphological diagnosis.

Treatment of lichen planus of the oral mucosa remains one of the most complex and urgent problems in dermatovenerology and dentistry.

In the article, the authors present an analysis of current scientific studies on various aspects of lichen planus of the oral mucosa, including its etiology and prevalence, clinical manifestations, as well as the potential risk of malignant transformation and the microbiota of the oral cavity in patients with this pathology. Potential factors influencing the development of the disease and the possible impact of changes in the microbiota on the clinical course of lichen planus of the oral mucosa are considered.

To date, the etiopathogenetic mechanisms of the development of lichen planus of the oral mucosa remain not fully understood. The determination of pathogenesis and the use of differentiated, combined methods will allow us to propose an optimal strategy for the prevention of the disease, increase the effectiveness of its prediction and treatment.

The call for further research emphasizes the need to study the red lichen planus of the oral mucosa not as an independent nosology, but as a system of complex neurohumoral and immunoallergic changes, disorders that can affect the patient's quality of life.

Psoriatic onychodystrophy is observed in about 80% of patients with psoriasis. Psoriasis can affect two nail structures ― the matrix and the nail bed.

Involvement of the nail matrix in the pathological process can lead to the formation of leukonychia, thimble symptom, red spots in the area of the hole and destruction of the nail plate. On the other hand, the lesion of the nail bed is characterized by the formation of onycholysis, subcutaneous hyperkeratosis and subcutaneous hemorrhages.

Nail lesions in psoriasis are accompanied by functional disorders and aesthetic defects, and also indicate a severe course of psoriasis.

Treatment of psoriatic onychodystrophy includes topical medications, systemic therapy in cases accompanied by extensive skin lesions.

This article is an overview of the main clinical features, diagnostic issues and evaluation methods, as well as treatment options for nail psoriasis.

BACKGROUND: Acne is an actual problem for both patients and doctors of different specialties, especially dermatovenerologists and cosmetologists. Up to 85% of young people are affected by the disease. Skin lesions on the face and lack of effect of previously administered therapy are often accompanied by severe psychosocial maladjustment even in mild forms of dermatosis. In addition, recently there has been a tendency towards increased resistance of Cutibacterium acnes to antibacterial agents, which requires the development of drugs, including those to prevent antibiotic resistance.

AIM: Clinical and morphofunctional assessment of the effectiveness and tolerability of the Zerkalin Intensive gel (benzoyl peroxide and clindamycin) in patients with mild to moderate acne.

MATERIALS AND METHODS: the study involved 30 patients with acne (28 women and 2 men) aged 18 to 34 years, 4 of them had mild severity, 26 had moderate severity. All patients applied benzoyl peroxide and clindamycin gel once a day in the evening, the observation period was 12 weeks. Dermatological examination was carried out visually with a simple count of inflammatory lesions (papules, pustules). In order to assess the morphofunctional parameters of facial skin, all patients underwent a non-invasive digital study using the Capricorn AI Intelligent Imager Bitmoji device, based on 3D visualization. To study the impact of the disease on various aspects of the patient's life and as an effectiveness criterion, the Dermatology life Quality Index (DLQI) was used.

RESULTS: in all patients using the benzoyl peroxide and clindamycin gel there was a regression of inflammatory and non-inflammatory elements and a decrease in post-acne phenomenon, while an improvement in the condition of the skin process was registered within the first 2–4 weeks. As a result of the treatment, complete cleansing of the skin was achieved in 8 patients, significant improvement in 17, and improvement in 5. At the end of the entire observation period, according to the questionnaire, the subjects observed a decrease in DLQI compared with the baseline (18.4±3.03 versus 3.03±0.15; p <0.05), which indicates an improvement of the quality of life and psychoemotional state of patients and the effectiveness of therapy.

CONCLUSION: Benzoyl peroxide and clindamycin gel for the treatment of mild to moderate acne is an effective remedy, especially with a predominance of pustular elements, which is confirmed based on the results of a visual examination and the positive dynamics of indicators of superficial and deep analysis of facial skin (sebumetry, corneometry, pigmentation, reactivity and level colonization by C. acnes). The gel was well tolerated by patients and did not cause any adverse events or allergic reactions.

Schamberg's disease (chronic purpura pigmentosa) is the most common type of pigmentary purpuric dermatosis, most commonly seen in men and primarily affecting the areas of the tibia, thighs, buttocks, trunk, or upper extremities, with a classic presentation characterized by petechiae, purpura, and enhancement skin pigmentation. This is a benign disease that is often asymptomatic and requires treatment if there are associated symptoms or if the patient wishes to improve a cosmetic defect.

Schamberg's disease is usually not difficult to diagnose, but its treatment can be challenging. The current standard of treatment for chronic purpura pigmentosa includes systemic and external drug therapy, correction of identified concomitant diseases that can maintain and worsen the course of cutaneous vasculitis. There are many other, including non-pharmacological, methods described in the literature, few of which have been shown to be effective. Considering the small number of studies on this topic, numerous exacerbations and the possibility of spontaneous resolution of the disease, patients’ concerns about residual pigmentation, the search for an optimal therapeutic approach remains an urgent task.

This article describes the experience of using broadband pulsed light in the treatment of Schamberg disease in a 34-year-old man. The equipment settings, diagram and exposure protocol for broadband pulsed light are presented. As a result of a follow-up examination carried out 1 month after treatment, a positive dynamic of the therapeutic process was determined: there were no new rashes, individual foci of the rash regressed completely, the remaining elements of the rash paled significantly. At a follow-up examination, four months after the therapy, a stable treatment result was recorded.

On October 17, 2023, the 1154th meeting of the Moscow Society of Dermatovenerologists and Cosmetologists named after A.I. Pospelov took place.

The meeting was held in a face-to-face format. There were 118 participants in total. 65 applications were submitted for membership in MSDC! Due to the large number of applicants for membership in the MSDC, a list vote was held: approved unanimously.

Two reports were presented in the clinical part of the meeting: Pityriasis rubra pilaris after suffering COVID-19 (Sechenov University); A clinical case of a rare hereditary disease ― erythrokeratoderma (State Scientific Center of Dermatovenereology and Cosmetology).

Reports were made in the scientific part of the meeting: Topical therapy for xerosis of various genesis (Sechenov University); Modern paradigms for improving the effectiveness of treatment of allergodermatoses taking into account violations of the skin microbiome (Federal Scientific and Clinical Center of Intensive Care and Rehabilitation); The use of transcranial electrical stimulation in patients with atopic dermatitis (Sechenov University).

Genodermatoses are a group of hereditary diseases primarily affecting the skin. To date, there are more than two hundred genetically determined dermatoses representing about 35% of all genetic diseases and 10% of all skin diseases. Genodermatoses can be caused by mutations in a single gene or the interaction of several genes and environmental factors. Hereditary diseases are characterized by a wide variety of phenotypic manifestations and the diagnostic complexity which represents a serious problem in modern dermatology.

We present a gallery of hereditary dermatoses.

Unna-Tost disease is a genodermatosis inherited in an autosomal dominant manner and characterized by diffuse excessive keratinization of the skin on the palms and soles, manifesting in the first to second year of life.

Buschke-Fischer-Brauer punctate palmoplantar keratoderma is a late-developing focal dermatosis in which painful hyperkeratotic papules can occur when traumatized.

Ehlers-Danlos syndrome is a condition demonstrating skin hyperextensibility and a number of typical symptoms of the skeletal and cardiovascular systems.

Progeria manifests as premature skin aging, affecting the endocrine, skeletal, cardiovascular, and other systems of the body, as well as increasing the risk of developing malignant neoplasms of internal organs and skin.

Congenital ichthyosiform erythroderma of Brocq is a severe chronic skin disease with autosomal recessive inheritance, which follows the pattern of lamellar ichthyosis but to a milder degree.

X-linked ichthyosis, a hereditary "darkening" condition, occurs only in males and is characterized by impaired keratinization and the presence of gray-black scales on the skin.

Lamellar ichthyosis is an autosomal recessive dermatosis characterized by generalized skin involvement.

Netherton syndrome is a rare condition characterized by a combination of ichthyosis with structural anomalies of the hair shaft and atopy.