Vol 19, No 5 (2016)

Epidemiological and molecular biological data suggest that the beta human papillomavirus (HPV) can cause the development of a number of epithelial skin tumors, but this interconnection is currently not fully understood. Besides detection of beta HPV, it is necessary to measure and quantify the viral load, it is a new approach in the diagnosis of HPV infection. 52 patients were examined to identify the association of epithelial neoplasias beta human papilloma virus in immunocompromised and immunocompetent patients in the department of chronic hemodialysis and kidney transplantation of Moscow Regional Research and Clinical Institute. HPV detection was performed by polymerase chain reaction (PCR) with hybridization-fluorescence detection in real time (Real-Time). Amplification and detection were performed on the tool Rotor-Gene 3000 (“Corbett Research”, Australia). For quantification of beta HPV recombinant plasmid positive controls, as well as control plasmidfragment offi-globin human gene (FSIS CRIE Rospotrebnadzor) were used. In fibroepithelial polyp and in apparently healthy skin of immunosuppressive patients - renal transplant recipients (RPT) with a high frequency was detected beta HPV DNA - 64 and 54%, respectively, compared to healthy skin (47% of cases). In fibroepithelial polyp in 57% of immunosuppressive RPT mixed infection was revealed. Viral load in the fibroepithelial polyp was higher than that as in apparently normal skin and in donors skin. The high detection ofHPVDNA in RTP, as in the fibroepithelial polyp and in apparently healthy skin was found. Immunocompetent patients had high HPV DNA detection only in fibroepithelial polyp compared with apparently healthy skin.

In the laste years several articles focalized on human microbioma - the microorganisms from skin, mucosae, bowel - and on its role in chronic inflammatory diseases of the skin as acne, rosacea, atopic dermatitis, seborrheic dermatitis. In this article the authors present an update on particular acne skin’s microbioma, on innate immunity in acne and new physiopathology mecanisms described in inflammatory process in acne, and at the end we present in vitro, ex vivo and in vivo studies on the microbioma modulation and microbiofilm of pathogenic ribotypes of P. acnes leading to a significant improvement of acne in a series of 74 acne patients.

The significant role in the pathogenesis of seborrheic keratosis (SK) plays the violation of the cell cycle regulation. According to the research unit the cell proliferation in acanthotic and irritated histological types of SK is regulated by p27 (Kip1), cyclin-dependent kinase inhibitor. Considering the variety of histological types of SK, definition of p27 expression will reveal the characteristic features of the cell cycle disorders and proliferation for each type of tumor. Material and Methods. Of the 102 tumors from patients with SK, according to the results of histological examination, were selected 10 specimens of each histological types of SK: acanthotic, hyperkeratotic, adenoid, irritated, and clonal. We assessed all specimens for p27 (Kip1) expression using immunohistochemistry (monoclonal antibody p27 at a dilution of 1:20 (Novocastra Laboratories Ltd.). Three skin biopsy samples of healthy individuals were included. Results. Severe diffuse nuclear expression of p27 was present in all cases of adenoid, irritated, and 4 cases of clonal histological types of SK. In other tumor types positive reaction with monoclonal antibody to p27 was reduced as compared with healthy skin were recorded single positively stained nuclei of basal cells. Conclusions. Thus, we have found a violation of p27 protein expression in all types of seborrheic keratosis as with the excess (adenoid, irritated, clonal SK type) and in p27 protein deficiency (acanthotic, hyperkeratotic) normal course of cell cycle phases is broken. This leads to the disappearance of control over the cell proliferative activity and apoptosis, facilitating a slow, uncontrolled growth of SK cells.

Urticaria is etiologically heterogeneous disease, where the main clinical sign is a wheal. For the duration of the disease course secrete acute and chronic urticaria. If urticaria elements in the skin of the patient are observedfrom several hours to 6 weeks, it is classified as acute urticaria, cutaneous if the process continues for more than 6 weeks, it is a chronic urticaria. The aim of our work was the optimization of diagnosis of chronic urticaria on the basis of the study of clinical and allergological and immunological characteristics of the testing results. The study involved 60 patients between the ages of 18 to 73 years with confirmed clinical diagnosis of chronic urticaria. The study was conducted in the clinic of skin and venereal diseases ofI.M. Sechenov First Medical State Medical University. Conducted clinical and anamnestic examination: medical history, assessment of complaints, determining the severity of urticaria (UAS7), quality of life (CU-Q2oL, DLQI), control of the symptoms of urticaria (UCT); laboratory tests: clinical blood test, C-reactive protein, thyroid hormones and antibodies to thyroid structures, tests to exclude physical urticaria, autologous serum skin test, D-dimer, rheumatoid factor, eosinophil-cationic protein, the total of IgE, antinuclear antibodies , C3 / C4 complement components, protein fractions, coagulation, urinalysis, general analysis offeces, feces on eggs of worms and protozoa. The study was conducted within 1 month and included diagnostic consultation period and 5 consultations every 7 days. Identified specific clinical and laboratory features that can be assigned to the diagnostic criteria for autoimmune form of chronic urticaria, which will continue to pick up these patients rational treatment. The high prevalence of urticaria, a variety offorms of the disease, the presence ofpathology predominantly in patients of working age, often ineffective diagnostic actions cause the urgency of the problem and the need for further study of this disease.

The problem of androgenetic alopecia in women is considered by experts of various specialties, however there are few reviews about metabolic processes in these patients. Objective: to increase the efficiency of treatment of androgenetic alopecia in view of metabolic abnormalities. Material and methods. 80 female patients with androgenetic alopecia were examined to identify the features of the clinical course and hormonal metabolic deviations. Results. It was found that women with the androgenetic alopecia have abnormalities in carbohydrate and lipid metabolism in the majority of cases. Combined therapy with metformin helped to increase the clinical efficacy in the treatment of women with androgenetic alopecia.

Urticaria is a common disorder. Urticaria ranks 3rd place in Russia after bronchial asthma and pollinosis. The incidence of the disease is 15.3-31%, with 41.3% of the chronic urticarial and 58.7% of the angioedema. The detection of cause of the disease and appropriate treatment is still a matter of some difficulties. The cause of the chronic spontaneous urticaria is not identified in 80-85%. The literature review of data on the main aspects of etiology, nosogenesis, diagnostic, international and local recommendations for the treatment of chronic spontaneous urticarial is presented.