Vol 94, No 2 (2018)

EDITORIAL
A HUNDRED YEARS’ EXPERIENCE IN NATIONAL DERMATOVENEREOLOGY STAGES OF ORGANIZATION OF DERMATOVENEREOLOGICAL CARE FOR THE POPULATION (PART III)
Kubanova A.A., Martynov A.A., Vlasova A.V.

Abstract

The stages of the formation of a model for the organization of dermatovenereological care to the population of the Russian Federation for during the period from 1917 to 2017 were analyzed.
Vestnik dermatologii i venerologii. 2018;94(2):12-26
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MODERN IDEAS ABOUT “ATOPIC MARCH” PATHOGENESIS AND POSSIBLE ROLE OF HEAT-SHOCK PROTEINS
Ivanova N.M., Cybikov N.N., Sormolotova I.N.

Abstract

Allergic diseases pose a serious health problem worldwide. The review of literature presents some data on the role of heat shock proteins in the pathogenesis of atopic dermatitis and allergic rhinitis, as the most common diseases in the population of this nosological group. Data on the possible role of heat shock proteins in the pathogenesis of atopic march development are also presented.
Vestnik dermatologii i venerologii. 2018;94(2):27-32
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CHARACTER OF DISTRIBUTION OF HLA II ANTIGENS IN PATIENTS WITH AVERAGE AND SEVERE FORMS OF ACNE
Ryabova V.V., Koshkin S.V., Zaitseva G.A., Evseeva A.L.

Abstract

This article presents information about the distribution of antigens of the second class in patients with papulo-pustular and nodulous forms of acne. Class II antigens distribution was estimated as the total Group and groups of patients allocated depending on the severity of the clinical picture. Association revealed the presence of severe acne with antigens of histocompatibility of HLA-complex that confirms the importance of immunogenetic factors in the pathogenesis of this condition.
Vestnik dermatologii i venerologii. 2018;94(2):33-40
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MODERN APPROACH TO DIAGNOSTICS, PREVENTION AND CORRECTION OF ACNE SCARRING ON THE BASIS OF STUDY OF SKIN MORPHOLOGY BY NONINVASIVE METHODS
Ostretsova M.N., Snarskaya E.S., Tkachenko S.B., Allenova A.S.

Abstract

The efficacy of the long-acting drug of hyaluronidase (bovhyaluronidase azoximer, BHA) in acne and postacne patients has been studied. The main criteria for the efficacy of acne and post-acne therapy in the assessment by confocal laser scanning microscopy and laser Doppler flowmetry are proposed.

Materials and methods. Randomized, double-blind, placebo-controlled study, comparative in parallel groups. 90 patients aged 18 to 35 years (23.76 ± 4.59 years) with medium and severe acne and postacne were divided into 2 groups of 45 each by randomization (the first group received BHA 3000ME, the second — a placebo). There were two methods of administration of drug or placebo: intramuscular injection or ultraphoonophoresis. Evaluation of the skin was performed by confocal laser scanning microscopy (CLSM) in vivo (VivaScope®, NY, USA), microcirculation — by the laser Doppler flowmetry (LDF) with the laser capillary blood flow analyzer (LAKK-01, Russia). The effectiveness was evaluated by the Qualitative scaring grading system and Goodman’s quantitative global acne scarring system.

Results and conclusions: With the use of BHA 80 % of patients had an improvement, 8.89 % — a significant improvement, postoperative index was reduced from 14.27 ± 5.61 to 10.18 ± 4.63 points (p < 0.05). In the placebo group the reduction of indices is insignificant. The effectiveness of the use of BHA by the ultraphonophoresis was lower than by intramuscular injection. A significant change in the microcirculation index (flux) was established from 20.09 ± 1.74 PU (Perfusion Units) up to 15.2 ± 2,1 PU (p = 0,01). The normalization of the microcirculation was noted. According to the results of CLSM, among BHA patients were observed a significant decrease of severe fibrosis and inflammatory infiltration, the number of dilated vessels. In the placebo group signs persisted. Clinical and morphological monitoring showed the expediency, high efficiency and safety of BHA in the therapy of patients with medium and severe acne vulgaris and postacne. 

Vestnik dermatologii i venerologii. 2018;94(2):41-47
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GUIDELINES FOR PRACTITIONERS
CUTANEOUS MANIFESTATIONS OF ANGIOIMMUNOBLASTIC T-CELL LYMPHOMA
Chernova N.G., Sinitsyna M.N., Sidorova Y.V., Soboleva N.P., Sudarikov A.B., Kovrigina A.M., Dvirnyk V.N., Zvonkov E.E.

Abstract

Background: Angioimmunoblast T-cell lymphoma (AITL) is a rare T-cell lymphoproliferative disease that is accompanied by generalized lymphadenopathy, hepatosplenomegaly, intoxication symptoms and extranodal lesions. The extranodal manifestations of the disease frequently involve various skin changes. One of the first such manifestations is maculopapular rashes observed in about half of AITL patients and usually preceding the appearance of lymphadenopathy. Other forms of skin lesions accompany the disease considerably less frequently.

Aim: To characterize the range of skin changes in patients suffering from AITL, to establish a correspondence between the nature of skin changes and their histological picture.

Materials and methods: 54 AITL patients were being treated at the National Research Centre for Hematology from 2000 to 2017, with the male/female ratio being 30/24. The median age was 61 (29–81) years.

Results: Changes in the skin were observed in 24 (44.4 %) of 54 AITL patients, out of whom 18 (75 %) and 6 (25 %) were male and female patients, respectively. Maculopapular rash was observed in 22 (91.7 %) out of 24 patients. The morphological and molecular investigations of skin biopsy specimens exhibiting maculopapular rash demonstrated nonspecific reactive changes. Patients with maculopapular rash demonstrated an increase in the level of total (polyclonal) IgE. Specific skin lesions detected in 8 (14.8 %) cases were represented by a ‘livedo reticularis’, focal skin hyperpigmentation, erythroderma, left eyelid tumour and tumour in 3, 2, 1, 1 and 1 cases, respectively.

Conclusion: Maculopapular rash frequently observed in AITL patients is a reactive process not associated with a specific skin lesion. Specific skin lesions in AITL are much less common and can be represented by various forms. In some AITL cases, skin changes of the reactive and tumour nature can be simultaneously observed. 

Vestnik dermatologii i venerologii. 2018;94(2):48-56
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A CLINICAL CASE OF NORVEGIAN SCABIES IN A PATIENT WITH ACUTE LYMPHOBLASTIC LEUKAEMIA
Koshkin S.V., Evseeva A.L., Chermnykh T.V., Minaeva N.V., Zaitseva G.A.

Abstract

A case of Norwegian scabies is described in a patient of 19 years with a lesion of the scalp, face, trunk, upper and lower extremities that occurred against the background of acute lymphoblastic leukemia. A good effect was obtained from conducting etiotropic, pathogenetic and symptomatic therapy in combination with specific treatment of the underlying disease.
Vestnik dermatologii i venerologii. 2018;94(2):57-62
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HYSTYOCYTOSIS X: VERIFICATION OF DIAGNOSIS
Starostenko V.V., Anisimova L.A., Sidorenko O.A., Opruzhenkova E.P.

Abstract

A clinical case of histiocytosis X, rarely found in the practice of a dermatovenereologist, is described, the pathognomonic clinical symptoms of this dermatosis, including skin lesions, that occur in 50 to 80 % of cases of all forms are displayed. The modern classification of histiocytosis, pathogenetic mechanisms of development and clinic of histiocytosis Х are given. Particular attention is paid to diagnostic methods, the necessity of interaction of narrow specialists (dermatovenerologists, hematologists, oncologists, pulmonologists) is underlined.
Vestnik dermatologii i venerologii. 2018;94(2):63-68
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Лечение ринофимы с помощью лазера на парах меди с использованием сканирующей насадки
., ., .

Abstract

Введение: Ринофима считается развитой и самой тяжелой стадией розацеа[1], связанной с пролиферацией эпителия кожи носа наряду с телеангиэктазией и гиперпродукцией сальных желез.  

Лечение ринофимы остается сложной задачей. Одной из проблем, связанных с ринофимой, является утолщенная и бугристая кожа, пронизанная телеангиэктазиями.  Поэтому для лечения ринофимы актуальным является использование лазерного излучения, позволяющего осуществить селективный нагрев кровеносных сосудов. Нами впервые описано лечение ринофимы лазером на парах меди (ЛПМ) с помощью компьютеризированного сканера.

Описание: 63-летний мужчина с II типом кожи по Фитцпатрику  с типичными клиническими проявлениями ринофимы: фиматозный или гипертрофический тип, который проявлялся значительным утолщением ткани и неравномерной бугристостью поверхности кожи. Для лечения пациента применялся ЛПМ (модель Яхрома-мед, Физический институт им. Лебедева РАН). Лечение проводилось излучением с длиной волны 578 нм, длительностью экспозиции 0,2 с, энергетическая экспозиция (флюенс) 15-30 Дж/см2. Параметры обработки, используемые для ЛПМ в режиме сканера, составляли: средняя мощность 0,6-1,2 Вт, размер фокусировки светового пятна на коже1,0 мм. Использовался гексагональный шаблон сканирующей насадки с максимальным размером12 мм и расстоянием1 мм между центрами лазерных пятен. Лечение привело к восстановлению естественной формы носа без красноты. Рецидива заболевания отмечено не было.

Вывод: Излучение ЛПМ обеспечило селективную фотодеструкцию сосудов увеличенного диаметра и за счет ремоделирования сосудистого русла показало отличные результаты лечения ринофимы без побочных эффектов.

Vestnik dermatologii i venerologii. 2018;94(2):
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НАБЛЮДЕНИЕ ИЗ ПРАКТИКИ
DISSEMINATED CUTANEOUS TUBERCULOSIS
Zaslavskij D.V., Egorova Y.S., Chuprov I.N., Olovyanishnikov I.O., Gurkovskaya Y.Y., Sydikov A.A., Chuzhov A.L., Ovchinnikova Y.E., Dovgalyuk I.F., Starshinova A.A.

Abstract

Cutaneous tuberculosis is a clinically and morphologically heterogeneous group of skin diseases directly or indirectly caused by mycobacteria of the tuberculosis complex, occupying the 5th place among all localizations of extra-pulmonary tuberculosis. Manifestations of cutaneous tuberculosis are extremely diverse and depend on the immune status and ways of penetration of mycobacteria into the skin. Skin involvement can occur as a result of exogenous inoculation, contiguous spread from an adjacent focus, or hematogenous spread from other foci. Family cases of disseminated cutaneous tuberculosis are described. A combination of several clinical forms of cutaneous tuberculosis — scrofuloderma, tuberculosis cutis lichenoides (moniliformis scrophulosorum) and lupus — are observed in a 5 year old child with a family history of tuberculosis. The issues of pathogenesis and advanced methods of diagnosis of cutaneous tuberculosis are also discussed.
Vestnik dermatologii i venerologii. 2018;94(2):69-77
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ETIOPATHOGENETIC THERAPY OF INFLAMMATORY DERMATOSES
Samtsov A.V., Khairutdinov V.R., Belousova I.E.

Abstract

In chronic dermatoses significantly increases the colonization of skin by bacteria and fungi, which can have a negative impact on the course of inflammatory process. Cream Candiderm is a modern combined topical drug that has anti-inflammatory, antibacterial and antifungal activity.

The aim of the study was to assess the efficacy, safety and tolerability of the cream Candiderm in the treatment of patients with eczema and atopic dermatitis.

Material and methods. 37 patients with AD and 28 patients with eczema. Applied cream Candiderm 2 times a day, which was applied to the affected area of the skin. Before and on the 14 day of therapy was conducted bacteriological examination of the microflora of the skin rashes.

Results: at 14 days in patients with eczema remission was achieved in 17 (61 %) patients, significant improvement 6 (21 %), improvement in 4 (14 %), lack of effect in 1 (4 %); in patients with AD remission was observed in 23 (62 %) patients, significant improvement in 7 (19 %), and improvement in 5 (14 %), lack of effect in 2 (5 %).

Conclusions: high clinical efficacy of the cream of Candiderm allows recommending it for topical therapy of patients with eczema and atopic dermatitis.

Vestnik dermatologii i venerologii. 2018;94(2):78-83
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