Vol 99, No 2 (2023)

In the structure of the incidence of skin tumors, melanoma accounts for a relatively smaller percentage, but that disease is associated with higher risk of an adverse outcome compared with many other malignancies.

The study of innovative clinical developments in drug therapy for resectable melanoma, presented at the American Society of Clinical Oncology Annual Meeting — June 2022.

The best clinical developments in drug treatment of patients with resectable melanoma were selected for analysis: 1) phase 3 study KEYNOTE-716; 2) PRADO; 3) Neo Trio; 4) SWOG 1512. The presented developments bring extremely promising results for melanoma therapy workflows.

The use of cutting-edge anti-cancer therapeutics acting on various molecular targets drastically improves the tumor response as well as straitens the appearance of treatment-related adverse events.

Background. There is insufficient data on the antifungal activity of activated zinc pyrithione, which is widely used in practice. Taking into account the reports about a significant role of Malassezia in the pathogenesis of a number of dermatoses, the study of this issue is of scientific, practical interest.

Aims. To evaluate the antifungal activity of external forms of activated zinc pyrithione in the treatment of psoriasis, seborrheic dermatitis, pityriasis versicolor.

Materials and methods. An open prospective study was conducted between March and July 2022. Patients with psoriasis, seborrheic dermatitis, pityriasis were treated with external forms of activated zinc pyrithione for 21 days. Skin scales and circular prints from lesion foci, as well as from skin areas without clinical manifestations before and after therapy were studied. A quantitative assessment of skin colonization by micromycetes of Malassezia was performed using microscopic, cultural methods of examination. Clinical efficacy and drug safety of the therapy was assessed using the Dermatological Symptom Scale Index, by recording adverse events at weeks 0, 1, 2, 3.

Results. 64 patients aged 18 to 65 years with diagnoses of psoriasis, seborrheic dermatitis, and pityriasis versicolor were included. 60 patients completed the study, 4 were excluded due to failure to adhere to the schedule.

In patients with seborrheic dermatitis and pityriasis versicolor in the lesion foci after therapy, a significant decrease colonization level according to the results of microscopic, cultural studies was observed. In psoriasis patients, a significant decrease in the colonization level was obtained only based on the results of microscopic examination.

In all groups, significant differences in comparison to the initial level were registered already at the 1st week of treatment. No adverse events were registered.

Conclusion. Activated zinc pyrithione in the form of cream and aerosol showed moderate antifungal activity against micromycetes of the genus Malassezia.

The incidence of skin melanoma in the world is growing every year. Despite advances in diagnostics, the identification of the primary focus of melanoma in some cases is still difficult. The natural course sometimes manifests only with the appearance of melanoma metastases, which can mimic other diseases. Patient S., 52 years old, was admitted to the FCBRN of FMBA of Russia with complaints on periodic systemic dizziness, headaches of a pressing nature, episodes of speech impairment over the past three months. According to the brain MRI-scan results, a volumetric formation of the left frontal lobe was revealed. Upon examination, two non-pigmented lesions were found on the skin of the scalp and forehead. Due to the presence of focal neurological symptoms, it was decided to remove the brain tumor using neurophysiological monitoring and the scalp skin lesion, with histological verification. Morphological diagnosis of the removed brain tumor was a metastasis of amelanotic epithelioid melanoma. The skin lesion was basal cell carcinoma. Thus, the patient had primarily multiple malignant tumors: metastatic melanoma and basal cell carcinoma. The primary focus of melanoma could not be identified by available noninvasive research methods. The patient was referred to an oncologist to decide on the tactics of further examination and treatment. To date, the patient has been treated according to the scheme sh0876 1 line 1 course of pembrolizumab 400 mg IV, cycle 42 days.

Pyoderma gangrenosum is an autoinflammatory neutrophilic dermatosis. Diagnosis of the disease remains a difficult task to date, due to the lack of a standard of examination and differential diagnostic signs. The primary elements in the development of PG may be papules, pustules or bullae the dissection of which subsequently leads to the formation of ulcers with irregular, violaceous, undermined borders. In rare cases, the diagnosis of the disease can also be complicated by the rapid development of internal organs damage symptoms, which must be regarded as extracutaneous manifestations of PG. Extracutaneous lesions can occur before, during or after the appearance of skin rashes, and the detection of sterile neutrophil infiltrates in the defeat of internal organs confirm the concept of PG as a multisystemic disease. The presented case of a rare course of PG with multiple skin lesions and extracutaneous manifestations, simulating systemic vasculitis, emphasizes the importance of a detailed examination of patients in order to make a correct diagnosis and prescribe timely adequate treatment.