Vestnik dermatologii i venerologii

Background. Hidradenitis suppurativa hidradenitis is a chronic recurrent inflammatory skin disease that develops after puberty and is characterized by the appearance of recurrent painful nodes, abscesses, the formation of fistula passages and scars on skin areas rich in apocrine sweat glands. Treatment of purulent hidradenitis is aimed at suppressing inflammation, relieving pain, preventing the formation of fistulas and scars.

The objectives of this review. Summarize the information in the published international clinical guidelines for the diagnosis and treatment of purulent hidradenitis, their comprehensive assessment and comparison with each other.

Methods. In the period from December 2022 to February 2023, scientific articles were searched in the PubMed database of the National Center for Biotechnological Information. Inclusion criteria: scientific articles in English, without date restrictions; interdisciplinary publications of specialists in which dermatovenereologists participated.

Results. The analysis of the existing relevant international clinical recommendations for the diagnosis and treatment of purulent hidradenitis indicates the absence of specific treatment schemes and algorithms, criteria for evaluating the effectiveness of therapy. In the treatment of purulent hidradenitis, the use of external keratolytics, antiseptics and antibiotics is recommended. Among systemic drugs, antibiotics, retinoids, immunosuppressive agents, hormonal drugs are used. The highest therapeutic efficacy in patients with purulent hidradenitis was shown by genetically engineered drugs that inhibit TNF-α and IL-17A.

Conclusions. Patients with purulent hidradenitis require various treatment approaches, including a variety of surgical interventions, depending on the stage, severity, prescription of the disease and the general condition of the patient. The basic principle is the individual selection of the treatment method for a particular patient. In this regard, there is a need to develop domestic clinical guidelines for the management of patients with purulent hidradenitis.

Background. Squamous cell skin cancer (SCSC) is the most dangerous tumor of all non-melanocytic skin neoplasms due to its aggressive course with destructive growth and frequent metastasis. Another characteristic feature of SCSC is the presence of precancerous conditions such as actinic keratosis, arsenic keratosis and PUVA-keratosis. In the gradual increase in the degree of keratinocyte dysplasia to the development of invasive forms of skin malignancies, the following continuum of diseases can be distinguished: actinic keratosis — Bowen’s disease — keratoacanthoma — SCSC. Dermatoscopic signs of each of the listed nosologies can also occur in other diseases of this chain, which can complicate diagnosis and lead to erroneous patient management tactics.

Aim. To determine the consistency of dermatologists’ opinions in assessing dermatoscopic images of actinic keratosis, Bowen’s disease, keratoacanthoma and SCSC, depending on work experience.

Methods. The study was conducted on the basis of the Scientific and Practical Center for the Diagnosis and Treatment of Skin Tumors of the Federal State Budgetary Educational Institution “PIMU” of the Ministry of Health of the Russian Federation. Based on the literature data, we compiled a generalized list of possible dermatoscopic signs of actinic keratosis, Bowen’s disease, keratoacanthoma, SCSC and analyzed dermatoscopic images of 85 elements of actinic keratosis, 28 — of Bowen’s disease, 10 — of keratoacanthoma and 24 — of SCSC. 10 dermatovenerologists participated in the study, half of whom (Group 1) had experience in the field of dermatoscopy for more than 4 years, and the other half (Group 2) — for less than 4 years.

Results. The study reveals statistically significant deviations in the frequencies of dermatoscopic signs between the two groups of specialists when analyzing images of actinic keratosis and Bowen’s disease. Differences in the frequency of detection of keratoacanthoma and SCSC signs between specialists with more than 4 years of experience in the field of dermatoscopy and less than 4 years’ experience have not been found.

Conclusion. Taking into account the average number of signs, the statistically justified result of the analysis is the inference that the average group frequencies in Group 1 and Group 2 are equal. The conclusion is that the opinions of specialists in the field of dermatoscopy are highly consistent, regardless of work experience. This indicates the high diagnostic value of the method, despite its subjective nature.

Background. Today, one of the difficult tasks in modern dermatology is the management of patients with chronic dermatoses, including psoriasis, due to a new coronavirus infection. The general condition of the patients, as well as concomitant therapy for the underlying disease, may subsequently produce severe side effects and complicate the treatment of concomitant skin pathology in patients in this category.

Aim. The purpose of our study was to optimize the treatment of patients with psoriasis against the background of COVID-19 infection.

Methods. Our study included 34 patients with psoriasis who were hospitalized at the Zangiota Clinical Hospital, specializing in patients with COVID-19 infection from 2020 to 2022. Also, all patients were divided according to the severity of the underlying disease according to the “Temporary recommendations for the management of patients infected with COVID-19”, fifth version of 2020. The severity of the psoriatic process was assessed using the PASI index.

Results. If patients have a psoriatic process, it is more rational to use biological drugs for the treatment of COVID-19 infection due to the absence of exacerbation of the psoriatic process in dynamics.

Conclusion. Treatment of patients with COVID-19 infection with casivirimab + imdevimab showed a positive effect on the dynamics of skin elements and the absence of relapses during three months of observation. While standard therapy for coronavirus infection gives a good regression of skin elements on the 10th day of therapy, after a month there is a progression of the skin process, the appearance of itching and new elements of psoriasis.

Data regarding the role of cutaneous microbiome in physiological and pathological conditions, pharmacological properties of fusidic acid and its clinical use for the treatment of skin infections are presented in the article. Incidence of skin infections in children treated in children’s city polyclinic No. 1 of Izhevsk city through 2019–2022 are analyzed. Outcomes of the treatment of these patients with topical fusidic acid preparations are presented. Due to high activity against typical cutaneous bacterial pathogens including MRSA strains of Staphylococcus aureus, favorable safety profile and pharmacokinetic profile when topically applied along with low resistance of the key pathogens fusidic acid preparations are the first line treatment of primary and secondary pyodermas.

A 27-year-old transgender female at the stage of gender transition with bipolar disorder for which she received valproic acid developed multiple petechial rashes on the chest, upper and lower extremities, local erythematous lesions with forming blisters, large-platelet peeling on the face, neck, chest and inguinal area, erosion on the oral mucosa. She was diagnosed with drug eruption, Stevens–Johnson syndrome. The diagnosis was verified on the basis of complaints, medical history, clinical picture, laboratory findings. Treatment included valproic acid withdrawal, dexamethasone, infusion therapy, vancomycin, cyclosporine A. Against the background of the therapy, skin condition was improved: there was the epithelization of ulcerative defects and the absence of new elements.