Vol 99, No 6 (2023)

PUVA therapy (photochemotherapy) has anti-inflammatory, immunosuppressive and antiproliferative effects, which makes it possible to use it for the treatment of patients with chronic inflammatory skin diseases, including atopic dermatitis. At the same time, there are no summarized data on the results of PUVA therapy in patients with atopic dermatitis. In this regard, the effectiveness and safety of PUVA therapy in patients with atopic dermatitis was evaluated according to the scientific literature. Literature search was carried out using the keywords “atopic dermatitis” “PUVA therapy”, “photochemotherapy” in the databases of scientific publications PubMed and RSCI. The methods of irradiation used, as well as the effectiveness and safety of PUVA therapy in patients with atopic dermatitis were analyzed. 14 publications were found describing the results of 13 studies that evaluated the effectiveness of various methods of PUVA therapy in patients with atopic dermatitis — photochemotherapy with peroral use of a photosensitizer, photochemotherapy with its topical use, and PUVA baths. All studies have shown the effectiveness of PUVA therapy in patients with atopic dermatitis. Nevertheless, the limitations of using this method are noted — the possibility of the development of adverse events caused by ultraviolet irradiation and taking a photosensitizer, which requires a careful assessment of the benefit-risk ratio for the patient when prescribing PUVA therapy to patients with atopic dermatitis. According to the available literature data, PUVA therapy should be prescribed to adult patients with severe atopic dermatitis who have had insufficiently effective other therapy.

Background. Inherited epidermolysis bullosa is a group of genetic skin disorders caused by mutations in genes encoding structural proteins of epidermis and dermo-epidermal junction. Clinical manifestations are characterized by spontaneous or trauma-induced skin and/or mucosal blistering, and extensive wounds. The use of tissue-engineered skin substitutes composed of allogeneic human skin cells is considered to be a perspective therapeutic approach in improving wound healing process.

Aims. To assess safety and efficacy of human skin equivalent in the treatment of inherited epidermolysis bullosa patients

Methods. 7 patients (5 female and 2 male subjects) from the age of 20 to 55 with inherited epidermolysis bullosa with different clinical subtypes were enrolled in the study: 3 patients with intermediate recessive dystrophic epidermolysis bullosa, 2 patients with severe recessive dystrophic epidermolysis bullosa, 1 patient with dominant dystrophic epidermolysis bullosa and 1 patient with junctional epidermolysis bullosa. Transplantation of composite allogeneic living skin equivalent comprising allogeneic keratinocytes and fibroblasts in low concentration (5 mg/ml) embedded within a type I collagen gel matrix was performed. The living skin equivalent was developed at N.K. Koltsov Institute of Developmental Biology. 19 erosions and ulcers with a surface area between 0.4 and 120 cm2 were evaluated. At day 14 clinical assessment was performed. To assess level of expression immunofluorescence antigen mapping was used.

Results. At day 14 complete erosion closure was achieved in 10 (53%) erosions. 4 (21%) erosions reduced in size > 75%. Size reduction between 25 and 75% was shown in a single (5%) case, no clinical efficacy was demonstrated in 4 (21%) cases. Collagen VII expression increased comparing to baseline level and accompanied clinical improvement.

Conclusions. The obtained data showed clinical efficacy of topical treatment with living skin equivalent, although no statistically significant difference was seen between living skin equivalent and atraumatic non-adhesive dressings.

Background. Globally, the incidence of HIV infection among young people has declined over the past 30 years due to the introduction of antiretroviral therapy and pre-exposure prophylaxis. However, the incidence of STIs in this population is declining at a much slower rate than HIV incidence. As a consequence, analyzing young people’s awareness of HIV and STIs is of particular importance for primary prevention.

Aims. To assess the specifics of sexual behavior and awareness among young people regarding STIs and HIV infection, as well as to study the attitude and degree of readiness to help HIV-infected patients among medical university students.

Methods. To assess the level of awareness on STI and HIV prevention and risky sexual behavior, a sociological survey was conducted through an anonymous questionnaire with the signing of voluntary anonymous consent. The respondents used a questionnaire consisting of 23 questions developed by the staff of the Department of Dermatology and Venereology of the Pavlov State Medical University, St. Petersburg. The Center for the Sociology of Deviancy and Social Control of the Institute of Sociology of the Russian Academy of Sciences, as adapted by the authors. The questionnaire consisted of two parts; the first part contained questions characterizing students’ knowledge of STI/HIV transmission routes and prevention methods. The second part of the questionnaire focused on students’ risky sexual behavior. Students’ attitudes towards HIV-positive people themselves were also assessed, using an adapted questionnaire based on the UNAIDS (Joint United Nations Programme on HIV/AIDS) model questionnaire. To identify the psychological features of the students, which may influence the behavior, the propensity to risk, the attitude towards the disease, the method of assessing the level of communicative tolerance of V.V. Boyko was used. The distribution of responses was analyzed for the entire population of respondents, a representative appropriate volume for each questionnaire. Statistical analysis was performed using Microsoft Excel and SPSS. The χ2 criterion and Student’s independent t-criterion were assessed. Statistical significance was set as p < 0.05.

Results. A total of 565 4th year NSMU students participated in the study which was conducted from 2022–2023: 312 people from the Faculty of Medicine, 172 people from the Faculty of Pediatrics, 18 people from the medical and preventive faculty, and 63 students from the Faculty of Dentistry. The results of the study demonstrated that the use of the Internet among young people as a source of information about STIs and HIV infection is becoming more popular year by year. The sexual behavior of the students participating in the study was characterized as risky. It was found that medical students (20.5%) experience fear of HIV infection when providing medical care to HIV-infected patients. The level of professional communicative tolerance of future physicians is assessed as high.

Conclusions. The low level of awareness among young people with regard to sexual health requires strengthening the implementation of existing activities on primary prevention of STIs and HIV infection, as well as the introduction of new preventive measures for these infections, adapted to the needs of young people.The ignorance of the legal aspects of providing care to HIV-infected patients, which was revealed in the course of the survey among medical students, requires more detailed study of these issues during the preparation of future doctors for professional activities.

The article presents a description of the poikilodermic form of mycosis fungoides in a young patient. At the time of presentation, the skin lesion had existed for about 4 years and was slowly progressing. A skin biopsy was performed with histological examination, based on the results of which a diagnosis of lichen sclerosus was established. Subsequently, the skin process progressed, and rashes appeared that were not typical for lichen sclerosus. There was an assumption that the patient had a poikilodermic form of mycosis fungoides. The diagnosis was confirmed after performing histological and immunohistochemical studies of a skin biopsy. General narrow-band mid-wave ultraviolet therapy was performed with good clinical results.

A case of idiopathic eruptive macular pigmentation in a child demonstrates a variant of skin hyperpigmentation of uncertain etiology. We described an 11-year-old boy with light brown spots in the torso and limbs that developed against the background of normal skin without an established provoking factor. On examination, it was found that the disease had developed within one year. Initially, the process was localized to the elbow folds and axillary areas, but later the rash spread to the trunk, neck and extremities. No inflammatory changes were observed at the base of the rash elements. The patient was examined for the presence of diseases that could underlie the skin manifestations, and histological examination was performed to verify the diagnosis. The established diagnosis of idiopathic eruptive macular pigmentation made it possible to choose a wait-and-see approach in treating the patient, due to the available literature data on the self-resolution of this pathology and ineffectiveness of the availabledermatosis treatment options.