Vol 24, No 1 (2021)

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.

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.

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.

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.

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.

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.

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).