Vestnik dermatologii i venerologii

Nail dystrophies (onychodystrophies) are non-infectious processes characterized by changes in the structure, surface, color, and consistency of the nail. The wide variety of onychodystrophies is determined by their etiopathogenesis and the anatomical and physiological characteristics of the nail system. Onychodystrophies can occur both as an underlying disease and as clinical manifestations of certain skin and systemic disorders. Striking clinical examples include hypertrophic osteoarthropathy (Hippocratic nails) associated with severe systemic pathology or abnormal nail changes associated with lichen planus, which begin with the appearance of longitudinal grooves and onychorrhexis and subsequently have variable outcomes and prognoses. Many types of onychodystrophies are often nonspecific and cannot serve as pathognomonic signs of a specific disease, which, in turn, negatively impacts differential diagnostic testing and timely diagnosis. Of note is that the time a patient seeks dermatological attention does not always coincide with the onset of onychodystrophies, which directly impacts the assessment of the nail lesion severity. Like any pathological condition, onychodystrophies tend to change over time, which may be due to the duration of the pathological process and/or the action of a trigger factor, its nature, and possible associated conditions. Understanding the development of pathological nail changes can be crucial for clinical assessment and diagnosis of existing changes, selection of patient management strategies, and determining the prognosis and outcome of the disease.

This overview examines the clinical presentation of certain types of onychodystrophies depending on their severity, with the transition from one type to another, and discusses possible causes and aspects of the etiopathogenesis of these changes. The authors also attempted to systematize the severity of certain types of onychodystrophies to simplify the clinical assessment of abnormal nail changes and adequately evaluate the outcome of the disease.

BACKGROUND: Androgenetic alopecia is a widespread disorder that presents therapeutic challenges due to patients' inflated expectations, low treatment adherence associated with inconvenient topical application, and concerns regarding adverse effects. Therefore, exploring new non-invasive approaches to managing hair loss and stimulating hair growth has become particularly relevant.

AIM: To evaluate the efficacy and tolerability of the needle-free JetPeel hydro-dermabrasion technology combined with a serum containing DHQG (dihydroquercetin-glucoside), glycine, zinc chloride, EGCG (epigallocatechin-gallate-glucoside), acetyl tetrapeptide-3, and biochanin A (from red clover extract) in women with androgenetic alopecia in a real-world clinical setting.

METHODS: A prospective, uncontrolled, pragmatic study was conducted, blinded to the trichogram assessor. It enrolled 22 women with Ludwig stage I–III androgenetic alopecia. The patients received JetPeel procedures with serum once weekly for 5 weeks, along with daily home application of the serum. The analyzed trichoscopic parameters included the proportion of terminal/vellus hairs, single/double/triple follicular units, hair diameter. Subjective satisfaction and comfort were assessed using a 5-point Likert scale and a Visual Analogue Scale, respectively.

RESULTS: After 5 weeks, a statistically significant reduction in the proportion of single follicular units by 20% (p = 0.001) and an increase in the proportion of double units by 11.8% (p = 0.003) were observed. Median satisfaction was 4.5 points (86.4% of patients rated the outcome as 4 or 5). Comfort according to Visual Analogue Scale was 8.9 ± 1.2 out of 10. No serious adverse events were reported.

CONCLUSION: The JetPeel technology with complex serum demonstrates early positive trichoscopic changes, high subjective satisfaction, and a favorable safety profile, supporting its recommendation as an additional treatment option for androgenetic alopecia in women.

BACKGROUND: The absence of a unified dermatoscopic terminology in the Russian language limits the descriptive capabilities of dermatoscopic findings, which complicates interdisciplinary interaction and reduces the possibilities for dynamic monitoring of patients with skin and adnexal lesions, primarily neoplasms. In 2016, the International Dermoscopy Society proposed a standardized terminology. Its implementation into everyday clinical practice in the Russian Federation required adaptation and expert validation taking into account linguistic features.

AIM: To develop and validate a Russian-language version of the universally accepted dermatoscopic terminology by conducting an expert consensus.

METHODS: The study was conducted in the format of a single-stage expert consensus with elements of quantitative agreement assessment (Delphi method). The experts were dermatovenereologists and oncologists with experience in using dermoscopy in clinical practice.

A standardized questionnaire based on English terms adopted at the 3rd Consensus Conference of the International Dermoscopy Society (2016) was used for the study. It also included corresponding Russian adapted terms, schematic images of dermatoscopic structures, definitions, histopathological correlations and clinical significance, as well as the "agree", "disagree", and "comments" fields.

RESULTS: The study was conducted from December 15, 2025, to February 15, 2026. A total of 67 specialists participated in the expert consensus, including 48 dermatovenerologists (71.6%), 16 oncologists (23.9%), and 3 physicians who reported having both specialties (4.5%). Consensus was defined as agreement of ≥ 70% of experts. A high level of agreement was observed among both oncologists (agreement coefficient 0.84) and dermatovenerologists (0.82). Specialists reporting both specialties demonstrated the highest activity in proposing alternative options (proposal coefficient 0.13). Regarding vascular structures, consensus was reached on all proposed terms with minimal need for adjustments. Alternative terms and comments proposed by experts were subjected to quantitative and qualitative analysis, identifying linguistic and clinical remarks.

CONCLUSION: A terminology in the Russian language has been developed and validated, ensuring unification of the dermatoscopic vocabulary in the Russian Federation. The multidisciplinary approach using the Delphi method enabled achieving high expert consensus on dermatoscopic terms. The obtained results provide a methodological basis for standardizing dermatoscopic diagnosis, developing unified protocols for dermatoscopic examination, and implementing educational programs on dermatoscopy.

Pyoderma gangrenosum is a rare, immune-mediated skin disease that belongs to neutrophilic dermatoses. It typically affects the lower extremities, making isolated involvement of the axillary regions a significant diagnostic challenge.

We present a clinical case of a 34-year-old patient with a nine-month history of the disease, manifested by painful ulcerative-erosive eruptions in the axillary areas. At the pre-hospital stage, pyoderma, allergic contact dermatitis, dermatophytosis, and pemphigus vegetans were incorrectly diagnosed, which is confirmed by the lack of therapeutic effect from antibacterial and antimycotic therapy. The diagnosis of pyoderma gangrenosum was verified based on the characteristic clinical presentation (multiple deep ulcerative defects with undermined edges of a bright red-pink color with a bluish tinge, the bases of the ulcers are covered with a purulent-necrotic scab) and histological examination results. Systemic glucocorticosteroid therapy (prednisolone 85 mg/day) was effective and led to regression of the lesions; however, disease recurrence occurred when the dose was reduced to 35 mg/day.

This case underscores the critical importance of early differential diagnosis of pyoderma gangrenosum in intertriginous zones to prevent iatrogenic complications and the pathergy phenomenon.

BACKGROUND: Androgenetic alopecia is a widespread disorder that presents therapeutic challenges due to patients' inflated expectations, low treatment compliance associated with inconvenient topical application, and concerns regarding adverse effects. Therefore, investigating the efficacy of non-drug multi-component agents for managing hair loss and stimulating hair growth appears highly relevant.

AIM: Evaluation of the efficacy of a corrective and stimulating serum combining a minoxidil derivative and high-concentration niacinamide in women with androgenetic alopecia.

METHODS: The study involved 38 female patients who applied the serum daily for 4 months. The outcomes were assessed clinically and using phototrichogram analysis.

RESULTS: Upon completion of the treatment course, clinical recovery was observed in 25 patients (65.8%), significant improvement — in 4 (10.5%), and improvement — in 3 (7.9%). No effect was reported in 6 cases (15.8%). The proportion of telogen hair normalized (≤ 10%) in 27 women (71.1%).

CONCLUSION: The multi-component serum applied in the study showed high efficacy and good tolerability in the treatment of female androgenetic alopecia. Its ease of use promotes better treatment compliance, allowing this product to be recommended for long-term application in the comprehensive management of this condition.

The article describes a 57-year-old female patient with lesions on the scalp, trunk and extremities, who was diagnosed with scleromyxedema (myxedematous lichen) by a dermatovenereologist based on clinical data and histopathological examination of a skin specimen. An immunochemical study of serum proteins revealed an M-gradient in the g3 zone, formed by a Gk clone and amounting to 4.9 g/L. Immunophenotyping of blood cells revealed a population of clonal plasma cells with the CD138⁺CD38⁺CD56^–CD10^–CD117–kappa⁺ immunophenotype (2.26% of all studied events).

Upon further examination by a hematologist, 2% of plasma cells were detected in the myelogram. Immunophenotyping of bone marrow cells by flow cytometry revealed 0.144% of plasma cells from all cells with the aberrant immunophenotype CD38dimCD138⁺CD319⁺CD19^–CD45⁺/^–CD56⁺/^–CD27⁺/^–CD117^–/⁺CD200⁺CD20^–/⁺. No criteria for symptomatic multiple myeloma or smoldering myeloma were found. The patient was diagnosed with monoclonal gammopathy of clinical significance, with predominant generalized skin involvement, associated with a monoclonal IgG secretion. VRD-based therapy (bortezomib, lenalidomide, dexamethasone) followed by autologous hematopoietic stem cell transplantation led to significant improvement. Gk secretion decreased to a trace, the bone marrow was sanitized, and a significant improvement in the patient’s skin condition was noted.

The presented case demonstrates the association of scleromyxedema with monoclonal gammopathy and indicates the need for patients with scleromyxedema to be examined by a hematologist.