Vol 96, No 1 (2020)

Congenital epidermolysis bullosa: modern methods of diagnosis and therapy. Prospects for regenerative medicine
Kubanov A.A., Karamova A.E., Monchakovskaya E.S.

Abstract

Congenital epidermolysis bullosa is a clinically and genetically heterogenous group of hereditary skin diseases characterized by the formation of bullae and/or erosions in response to insignificant mechanical effect. The variety and severity of clinical manifestations of the disease determine the early disablement of patients and the decrease in the quality of life, which requires the development of pathogenetic and etiological methods of treatment. Methods of gene therapy are the most promising direction to study, since they can affect the cause of congenital epidermolysis bullosa.

Vestnik dermatologii i venerologii. 2020;96(1):10-17
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Сutaneous vasculitis: classification, diagnosis and differential diagnosis (part 1)
Khairutdinov V.R., Belousova I.E., Samtsov A.V.

Abstract

Cutaneous vasculitis is a heterogeneous group of diseases caused by inflammation of the blood vessel wall of the skin. The variety of cutaneous vasculitis, their clinical similarity, lack of clear diagnostic criteria and common terminology cause an extremely complex process of diagnosis of this group of diseases. A dermatologist is often the first specialist to diagnose vasculitis. Currently there is no single "monodisciplinary" classification of v ascular damage, there is no generally accepted terminology and classification of cutaneous vasculitis. In domestic dermatovenerology, vasculitis is classified according to the morphological elements of the skin rash, and not by etiology and pathogenesis. This makes it difficult for different specialists to understand the diagnosis and maintain continuity in the management of patients.

The article presents the nomenclature of vasculitis of the 2012 revised international Chapel Hill consensus conference nomenclature of vasculitides, supplemented by organ-specific cutaneous vasculitis, describes the pathomorphological and clinical manifestations of this group of dermatoses, summarizes information about modern treatment tactics.

Vestnik dermatologii i venerologii. 2020;96(1):18-27
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Current trends in the incidence of late forms of syphilis in Novosibirsk
Khryanin A.A., Sukharev P.A.

Abstract

The main trends in the incidence of syphilis, including its late forms, are analysed in Novosibirsk in 2013—2017. It was found that during this period there was a trend to a decrease in the incidence of syphilis in Novosibirsk, but there was an increase in cases of detection of late forms of syphilis, in particular late latent syphilis and neurosyphilis, mainly in men at the age of 40 years and older. A unique clinical case demonstrating the complexity of differential diagnosis of neurosyphilis is also presented.

Vestnik dermatologii i venerologii. 2020;96(1):28-33
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GUIDELINES FOR PRACTITIONERS
Combination treatment of disseminated granuloma annulare
Karamova A.E., Znamenskaya L.F., Svishchenko S.I., Zhilova M.B., Nefedova M.A., Pugner A.S.

Abstract

Purpose. To present the results of the treatment of disseminated form of granuloma annulare with remote long-wave ultraviolet therapy and low level laser therapy.

Material and methods. Two female patients at the age of 50 and 53 years with complaints of generalised eruptions on the skin of the trunk, upper and lower limbs and a histologically confirmed diagnosis were treated using a combination of remote long-wave ultraviolet therapy and low level laser therapy of infrared spectrum. 16 sessions of remote long-wave ultraviolet therapy and 10 sessions of low level laser therapy were conducted directly on the lesions. Considering the multidirectionality of the mechanisms of action of phototherapy and laser therapy, the procedures were carried out on different days or with many hours long intervals.

Results. Combined use of the remote long-wave ultraviolet therapy and laser therapy led to a significant improvement by the 21st day of the treatment. No side effects were noticed during the treatment, tolerance of the sessions was good.

Conclusion. Combined use of the remote long-wave ultraviolet therapy and low level laser therapy of infrared spectrum is effective in treatment of disseminated form of granuloma annulare.

Vestnik dermatologii i venerologii. 2020;96(1):34-44
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НАБЛЮДЕНИЕ ИЗ ПРАКТИКИ
IgG/IgA-pemphigus — extremely rare blistering autoimmune diseases
Karamova A.E., Znamenskaya L.F., Chikin V.V., Mihina V.A., Nefedova M.A.

Abstract

Purpose. To present a clinical case of IgG/IgA pemphigus in a 32-year-old woman.

Material and methods. Clinical and laboratory examinations were performed to diagnose the disease: cytological examination of an impression smear from the bottom of the erosion, histological examination of a skin biopsy sample from the lesion, immunofluorescent examination of a biopsy sample of visually accessible unaffected skin.

Results. Clinical manifestations of the disease were similar to Duhring's dermatitis herpetiformis, morphological ones — to pemphigus vulgaris, but immunofluorescent examination of the skin biopsy sample in equal measure revealed deposits of both IgG and IgA in the epidermis, which allowed to determine a diagnosis of IgG/IgA pemphigus. Dapsone therapy at a dose of 100 mg per day led to a significant improvement in the patient's condition.

Conclusion. Diagnosis of bullous dermatoses requires immunofluorescent examination of a biopsy sample of visually accessible unaffected skin. Dapsone was an effective medication for the patient with IgG/IgA pemphigus.

Vestnik dermatologii i venerologii. 2020;96(1):45-51
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Features of the course of syphilis in HIV infected patients
Koshkin S.V., Evseeva A.L., Ryabova V.V., Kovrova O.S.

Abstract

In the present article, relevant data on the characteristics of the course of infections transmitted through sexual contact (hereinafter — STIs) are considered at the present stage. Particular attention is paid to mixed infections, in particular the combination of syphilis and HIV. Since the presence of both infections in a patient simultaneously significantly complicates the clinical picture, and also contributes to their spread in the population, which is an acute social problem. The article presents modern data on the epidemiology, level and dynamics of the incidence of syphilis and HIV infection in the Russian Federation, including among high-risk groups. Research data on the incidence of STIs (urogenital infections caused by Mycoplasma genitalium, Ureaplasma spp., Mycoplasma hominis, Chlamydia trachomatis, syphilis) and viral hepatitis B and C in 60 HIV-positive prisoners in the Kirov region are presented. The features of the development and course of syphilitic infection, the difficulties of diagnosis and therapy that occur with HIV are described. A case of own clinical observation of the malignant course of syphilis associated with HIV infection is presented. Both infections have been identified in the hospital where the patient is admitted with a diagnosis of spreading pyoderma, exhibited on the basis of complaints and clinical picture (ektimatoznye rash).

Vestnik dermatologii i venerologii. 2020;96(1):52-57
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Profiles of patients with psoriasis for appointment gene-engineering biological therapy — clinical justification
Zhukov A.S., Khotko A.A., Khairutdinov V.R., Samtsov A.V.

Abstract

Psoriasis is a chronic immune-mediated disease with predominant damage to the skin and musculoskeletal system.

This paper describes the clinical manifestations of psoriasis requiring a special therapeutic approach. The profiles of patients who showed the early assignment of genetic engineering biological therapy: patients with moderate and severe psoriasis, with rashes of “problem localization” (skin of the face, scalp, genital area and palmar-plantar region), with severe psoriatic lesion of the nail plates, as well as psoriatic arthritis.

Clinical cases of rapid and pronounced resolution of rashes with the use of the new drug netakimab (Efleira) in a dosage of 120 mg according to the standard regimen psoriasis patients with indications for systemic or phototherapy.

Vestnik dermatologii i venerologii. 2020;96(1):58-66
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Minocycline in acne system therapy
Samtsov A.V.

Abstract

Systemic antibiotics in combination with topical retinoids and benzoyl peroxide are first-line drugs for the treatment of moderate to severe acne. The systemic antibiotic Minocycline has a wide spectrum of action against gram + and gram-organisms, including strains resistant to penicillins and cephalosporins. A pronounced bacteriostatic effect is achieved by a high level of lipophilicity, rapid penetration through the lipid layer of bacteria and intensive accumulation in the sebaceous glands. Minolexin® is a highly effective and safe medication for the treatment of moderate to severe acne and can be recommended for practical use in outpatient practice.

Vestnik dermatologii i venerologii. 2020;96(1):67-71
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