Vol 18, No 3 (2015)

The etiology of benign cutaneous lymphadenosis is described. This condition is a skin response to exogenous factors and is presented by accumulation of lymphocytes and other inflammatory cells in the focus of exposure; it is classified as B-cell cutaneous pseudolymphoma. The dermatosis develops in the majority of cases in response to skin trauma (tattoo, insect bites, microinjuries, acupuncture, silicone implants, ear rings, piercing) and infection agents. Lymphocytomas often develop in the presence of scabies, after vaccination, under conditions of Borrelia burgdorferi, varicella zoster, HIV, Leishmania donovani infection. A case with lymphocytoma unfolding in the presence of chronic sinusitis is presented.

A case with Kaposi’s sarcoma is described. Marked clinical polymorphism of skin changes, frequent atypical location, and uncommon manifestations of this disease impede its diagnosis and require special attention and alertness of clinicists.

Differential diagnosis of two most incident autoimmune bullous dermatoses is described: true acantholytic pemphigus and Lever’s bullous pemphigoid. Clinical picture, laboratory methods for differential diagnosis are described - classical and new ones, including noninvasive methods: life-time confocal laser scanning microscopy, optical coherent tomography, ultrasonic dermascanning, etc., and some of their modifications. Differential diagnostic criteria of true acantholytic pemphigus and Lever’s bullous pemphigoid by clinical signs are presented and the main laboratory diagnostic methods for each condition are enumerated. The advantages and limitations of the methods, potentialities of new and modified classical methodsfor differential diagnosis of the two diseases are discussed.

A clinical case of cutaneous sarcoidosis in a child is presented. The prevalence of this disease is not amply studied. According to the data available, sarcoidosis in adults is more friquent in the northern countries than in the South; young and middle-aged women predominate among the patients. Sarcoidosis is rare in infants and is characterized by involvement of the skin, joints, and eyes, and by noncasefied granulomas (in biopsy of the skin, conjunctiva, and synovial membranes), while in older age the lungs, lymph nodes, and eyes are mainly involved (similarly as in adults). The clinical case presented in this paper demonstrates the difficulties in the diagnosis of sarcoidosis in children because of its low incidence and rarity for pediatric dermatologist.

The efficiency of the method, based on limited use of drug therapy in combination with transcranial stimulation physiotherapy on an AMO-ATOS-E device, was demonstrated in the theatment of 53 patients with different forms ofpsoriasis. The treatment efficiency was evaluated by the time course of PASI values and by the results of instrumental and laboratory studies. Control group received traditional therapy and placebo sessions of transcranial physiotherapy. The treatment efficiency in the main group was 66.6-78.9%, which was 22.2-42.1% higher than in the control group. Microcirculation and immune status improved, the number of flares over a year decreased 2.5-3 times.

Therapy for onychomycosis is a difficult problem, as the patients suffering from this disease are often elderly, with severe concomitant diseases, and systemic antimycotic therapy is contraindicated for them. All these factors necessitate search for new therapeutic methods, one of them is laser therapy. A clinical case is presented. A female patient was previously ineffectively treated with various systemic and topical means. Laser therapy was carried out as follows: a session every 2 weeks during 6 months using Q-Switched modules 1064/532 nm and ND:YAG: 1064 nm on a multitechnological platform of Harmony XL Alma Lasers (Israel). The patient received 9 sessions. Examination 1 year after the beginning of laser therapy showed clinical cure, which was confirmed by negative results of microscopic and culture testing for pathogenic fungi. Hence, laser therapy of onychomycosis proved to be an effective and safe therapy.

The incidence of sexually transmitted infections, including syphilis, remains high. Recent reports discuss syphilis pathomorphosis, difficulties in the differential diagnosis, and changes in the incidence of clinical manifestations. A total of 1304 cases with syphilis are analyzed in order to detect the specific features of clinical course of the disease. Syphilis is highly prevalent in subjects of reproductive age. Latent forms predominate in the morbidity structure, the leading form is early latent syphilis. Characteristics ofprimary syphilis are demonstrated: erosive hard chancre, complicated forms such as balanopostitis, a lesser incidence of regional lymphadenitis, extragenital location of the infection. The course of secondary syphilis is characterized by a lesser incidence of hard chancre rudiments and of local scleradenitis, predominance of the papular form, lesser incidence of the palmar and plantar syphilids, wide condylomata, involvement of the buccal and lingual mucosa.