Vol 24, No 4 (2021)

Cylindroma is a rare benign tumor derived from the skin appendages, its typical localization is head and neck. The histogenesis of the disease is unknown, cylindromas are thought to develop from the epithelial ducts of the eccrine or apocrine glands, or represent a neoplastic proliferation of epithelial stem cells.

The clinical presentation of the disease includes single or multiple smooth nodules and nodes of a pale pink color. Branching vessels are often visualized on their surface.

There are two types of this tumor: sporadic genetically not determined сylindroma and inherited in an autosomal dominant manner multiple сylindroma.

Multiple cylindroma may cause a lesion on the scalp that looks like a turban, due to the fusion and an increasing size of the nodules. Therefore, cylindroma are sometimes called a turban tumor.

The treatment of multiple cylindroma is a serious interdisciplinary problem due to the large area of the lesion, abundant blood supply to the scalp and the tendency of the disease to recur. The treatment methods described in the literature include traditional surgical excision, electrocoagulation, laser, Mohs micrographic surgery.

In this article we present a rare clinical case of a young male diagnosed with multiple cylindroma.

BACKGROUND: In recent decades, interest in the role of metabolic syndrome and its impact on dermatological pathology has been steadily increasing. One of the pathogenetic components of the metabolic syndrome is inflammation, and many pro-inflammatory factors play a crucial role in the development of this disease. However, the interrelation between the metabolic syndrome and facial skin lesions in seborrheic dermatitis remains not fully understood.

AIMS: To identify a possible association of seborrheic dermatitis with the involvement of the skin of the face with metabolic syndrome and diabetes mellitus.

MATERIAL AND METHODS: The study included 45 patients with seborrheic dermatitis, divided into 3 groups (patients with seborrheic dermatitis, patients with seborrheic dermatitis and metabolic syndrome, and patients with seborrheic dermatitis, metabolic syndrome and diabetes mellitus). The severity of the disease was determined by the lesion area and the seborrheic dermatitis severity index (SEDASI). The metabolic syndrome was diagnosed based on the NCEP ATP III criteria.

RESULTS: When assessing the severity of seborrheic dermatitis of the face and scalp, it was found that in group 1, a mild degree was observed in all (100%) patients. In group 2, 7 (46.7%) patients had moderate lesion and 8 (53.3%) patients had severe lesion. In group 3, a moderate degree of the disease was observed in 10 (82%) patients and severe in 5 (18%) patients. A positive correlation was found between the indices of metabolic syndrome and the severity of seborrheic dermatitis with facial skin lesions. A significant correlation was shown between the level of triglycerides and the number of anatomical zones involved in the process (r=0.74; p <0.01). In patients of groups 2 and 3, a direct interrelation was established between low levels of HDL, high levels of LDL and the severity of SD of the face (r=0.379; p=0.76), (r=0.321, p=0.037).

CONCLUSION: The severity of the course and spread of seborrheic dermatitis on the face can serve as a diagnostic marker of metabolic syndrome and diabetes mellitus. An increase in the level of LDL and triglycerides, a decrease in the level of HDL, and insulin resistance are associated with a severe course of seborrheic dermatitis in a person, playing a significant role in the pathogenesis of the disease.

Vitamin D is vital for bone health and its deficiency deemed as a disease of the past has re-emerged as an important health concern. Thanks to modern research, the role of vitamin D has been studied in detail and goes far beyond the concepts of regulating the mineral composition of bones. A small amount of active vitamin in the form of cholecalciferol is obtained by the body with food of animal origin, in the form of ergocalciferol and previtamin D ― with food of plant origin. Another way to get vitamin D is exposure to solar radiation. Both insufficient and excessive levels of vitamin D have adverse effects on the body. A constant blood level above 200 ng/ml is considered toxic and is manifested by anorexia, weight loss, polyuria and cardiac arrhythmia. Vitamin D toxicity increases the risk of kidney stones, calcification of blood vessels and tissues, as well as complications associated with these changes.

The growing interest in the role played by vitamin D in skin disease has given rise to the publication of many studies of the relationship between this vitamin and cutaneous dermatoses. Undoubtedly, a complete understanding of the synthesis of vitamin D, the main sources of its production by the body, indicators of the normal content of vitamin D levels in the blood, as well as factors that can influence their changes, are important. Of particular interest are the latest discoveries about the role of vitamin D in skin diseases such as lupus erythematosus, ichthyosis, atopic dermatitis, hidradenitis suppurativa, acne, alopecia areata, androgenetic alopecia, melanoma, and nonmelanoma skin cancer.

Also of interest is the importance of vitamin D as adjuvant therapy in patients on long-term treatment with corticosteroids. In this review, we provide an overview of the most important and most recent information regarding the relationship between vitamin D and skin disease and discuss the importance of assessing individual vitamin D status and correcting deficiencies.

Pregnancy is a particular period in woman’s life. It accompanies with plenty of adaptation changes include many on skin. Pathological morphofunctional changes form a group of pregnancy-specific dermatoses.

The clinical case of bullous pemphigoid of pregnancy is presented in the article. The disease occurs during pregnancy or postpartum period. The incidence is estimated to be approximately 1 in 60,000 pregnancies. Clinically, PG is characterized by intense pruritus and polymorphic skin eruptions. Skin lesions develop including erythematous patches and plaques, followed by urticarial rash and blisters. Diagnosis of the disease is based on the features of the clinical picture, complex data of pathomorphological and immunological research methods, including direct or indirect immunofluorescence, enzyme-linked immunosorbent assay (ELISA), immunohistochemical determination of a fragment of the complement component C4d and determination of serum antibodies to BP180.

The most effective treatment is systemic glucocorticosteroids in combination with topical steroids and/or antihistamines. Timely diagnosing and prescribing appropriate medication are highly important in preventing intrauterine fetal suffering.

Contacts with insects of the order coleoptera of the families Meloidae and Oedemeridae, in particular the bites of the abscess beetle, lead to acantholysis and the formation of intraepidermal blisters, as well as nonspecific skin damage. The family Meloidae (true abscess beetles) are distributed almost everywhere, with the exception of the territories of New Zealand, Antarctica and the Polynesian islands.

Insect species of the Meloidea family have a unique life cycle. Meloidae females lay eggs not only on coleoptera larvae, but also on any other insects, such as crickets, mantises, wasps, bees, on which their metamorphosis continues in the future. Populations of abscess beetles number a large number of individuals, which increases the risk of their meeting with humans. These species have a highly toxic colorless and odorless poison of non-protein nature ― cantharidin.

There is a rare clinical case of an abscess beetle bite. The debut of the disease occurred at the time of the patient’s trip to the island of Goa (India), where he noted insect bites with the appearance of the first blistering rashes and further progression of the skin process. The primary diagnosis was complicated by nonspecific changes detected during the pathomorphological examination of the skin, in the form of subacute dermatitis without classical manifestations of acantholysis with intradermal blisters due to delayed biopsy appointment. Against the background of ongoing treatment (prednisone; corrective therapy with potassium, magnesium, calcium, gastroprotectors; antibiotics; nonsteroidal anti-inflammatory and antimycotic drugs; combined topical glucocorticoids; a course of systemic autohemoozonotherapy) from the skin process, positive dynamics was noted in the form of relief of inflammatory phenomena, partial epithelization of wound defects.

Secondary infection of rashes, accompanied, as in this case, by abscessing, is often found with bites of various insect families: cases up to the development of necrotic fasciitis with a fatal outcome are described.

The described case is of clinical, scientific and epidemiological interest due to the isolated publications on this nosology and the complexity of diagnosis. Knowledge of the clinical picture of the disease will allow practitioners to develop tactics for managing patients with timely selection of effective therapy.

Modern scientific studies demonstrate a direct relationship between a decrease in the quantitative ratio of type I/III collagen in tissues and the severity of age-related changes, the formation of a deformative type of aging and the early development of ptosis of the lower third of the face able to compensate for the reduced ratio of type I/III collagen. In addition, the specificity of the threads used to perform lifting technologies provides an increase in collagen, predominantly of type III, and a relatively small number of them and only a certain lifting route are used. Currently, the clinical efficacy of 100% polylactic acid threads has been proven, which are able to stimulate the synthesis of type I collagen. Thus, the combination of lifting and reinforcing techniques in one procedure is expedient and relevant.

In order to achieve aesthetic and lifting results of thread techniques, as well as to increase the intensity of microcirculation, oxygenation and stimulation of collagenogenesis (including type I), we have developed a method of minimally invasive combined technique of thread implantation, including the use of lifting threads made of polydioxanone and polylactic acid copolymer and polycaprolactone and 100% polylactic acid reinforcing threads.

The minimally invasive technology provides prolongation of the lifting effect; creates the effect of volumization of facial tissues and the supporting dynamic framework in conditions of tissue displacement, and also improves the quality of skin structures by stimulating trophic and oxygenation of tissues, strengthening the collagen framework, increasing the ratio of type I/III collagen, enhancing the production of its own hyaluronic acid and extracellular matrix components.

On October 14, 2021, a conference was held in Moscow dedicated to the 130th anniversary of the founding of the Moscow Society of Dermatovenereologists and Cosmetologists named after A.I. Pospelova (MSDC).

Erythema is a disease characterized by the appearance of erythematous lesions on the skin caused by various factors. There is no generally accepted classification of erythema. Depending on the cause, there are erythema arising from exposure to exogenous factors (mechanical, biological, radiation and temperature), infections (viruses and bacteria), inflammation. Erythema can be part of a symptom complex or represent a separate nosology.

We publish a photo gallery dedicated to this issue.