Vol 100, No 4 (2024)

The article presents information on dynamics of dermatovenerological service resources, indicators of the population of the Russian Federation provision with dermatovenerologists and dermatovenerological beds, main performance rates and results of dermatovenereological medical care providing in outpatient, inpatient and day hospital conditions for the period 2019–2023. The dynamics of sexually transmitted infections (syphilis, gonococcal infection, trichomoniasis, chlamydial infection, anogenital herpetic viral infection and anogenital venereal warts) incidence in the Russian Federation, as well as contribution of foreign citizens to the syphilis incidence rates are analyzed. The dynamics of prevalence and incidence rates of diseases of the skin and subcutaneous tissue in the Russian Federation in 2019–2023, as well as dynamics of prevalence and incidence of atopic dermatitis, psoriasis, contact dermatitis, localized scleroderma, discoid lupus erythematosus among children aged 0–17 years and adults 18 years and older are presented.

Sjogren’s syndrome is a chronic autoimmune disease with a predominant involvement in the pathological process of secreting cells of the glands and their excretory ducts, which is accompanied by the development of generalized dryness of the skin and mucous membranes. This syndrome is one of the most common systemic diseases, but in dermatological practice it remains undiagnosed in almost half of patients with clinical manifestations. The article discusses current aspects of the pathogenesis of dermatological manifestations of Sjögren’s syndrome, which will allow a deeper understanding and systematization of the various mechanisms of development of this pathology for the formation of the correct clinical tactics with the choice of pathogenetically based treatment approaches, determining the individual prognosis for the patient, as well as helping to alleviate the course of the disease and in many ways improving the quality of life of patients.

Background. The most common type of pathological hair loss in women is androgenetic alopecia (AGA), arises due to hormonal and micronutrient imbalances. During the COVID-19 epidemic, there has been an increase in the number of female patients with alopecia as a complication, with some individuals experiencing alopecia the sole indication of asymptomatic COVID-19.

Aims. The search for objective criteria for the differential diagnosis of AGA and post-COVID alopecia in women based on trichological and laboratory markers.

Methods. The including criteria for AGA were elevated dihydrotestosterone (DHT) levels, for the post-COVID alopecia — a diagnosis of COVID-19 using RT-PCR and the presence of alopecia symptoms for both conditions. Quantitative characteristics of hairs were analyzed based on trichogram and phototrichogram. Levels of DHT, vitamins B₉, B₁₂, D, E, Ca, Fe, Mg, Se, Cu, and Zn were evaluated in serum. CART algorithm (Classification and Regression Trees) was applied to determine criteria to differentiate between patients with androgenetic and post-COVID alopecia.

Results. Analysis revealed the change in telogen/anagen ratio in the androgen-dependent zone in in AGA, and in androgen-dependent (parietal) area in post-COVID. Notably, patients with post-COVID alopecia exhibited elevated DHT levels compared to reference, with no significant difference in comparison to AGA. There was a significant 46.4% reduction in Cu content (p = 0.006) alongside an 24.7% increase in Se levels (p = 0.003) in post-COVID alopecia.

Conclusion. The percent of telogen hair and serum Se level as the objective criteria for the differential diagnosis of AGA and post-COVID alopecia in women are presented.

Background. In case of recurrent forms of the disease, combination therapy with the use of inducers interferons may be recommended.

Aims. To study the effectiveness of polysaccharides of Solanum tuberosum shoots (Panavir gel 0.002%) in the combined therapy of recurrent anogenital warts.

Methods. 60 patients: group 1 (n = 30) underwent radiowave destruction with Panavir gel 0.002% externally 2 times a day for 5 days before and 10 days after destruction, group 2 (n = 30) — radiowave destruction.

Results. Absence of itching and pain by day 5 was recorded in 27 (90.0%) patients of group 1 and 12 (40.0%) of group 2, after 10 days — in 30 (100%) and 26 (86.7%) (χ² = 4.285). Inflammatory erythema, edema and infiltration were absent after 10 days in all patients of group 1, but persisted in 7 (23,3%),12 (40.0%) and 2 (6.7%) patients of group 2 (χ² = 7.924). Epithelialization was observed for 5 days in 18 (60.0%) patients of group 1 and 10 (33.3%) patients of group 2, after 10 days — in 30 (100%) and 28 (93.3%) patients (χ² = 4.285). 90 days after therapy, relapses of the disease were recorded in 2 (6.7%) patients of group 1 and 6 (20.0%) patients of group 2 (p = 0.499), HPV elimination was observed in 11 (36.7%) and 10 (33.3%) patients (p = 0.967).

Conclusion. The effectiveness of Panavir gel 0.002% in the complex therapy of anogenital warts has been established in terms of reducing the severity of subjective and objective symptoms of the disease, as well as reducing the frequency of recurrence of rashes.

The article presents two clinical cases of lymphogranuloma venereum with classic manifestations of the disease. In the first case, the stages of lymphogranuloma venereum can be traced: the appearance of a primary affect (ulcer on the penis), the development after a few weeks of regional (inguinal) lymphadenitis and proctitis (anorectal syndrome). On the background of prescribed antibiotic therapy according to the regimen: doxycycline at a dose of 100 mg twice a day for 21 days, the clinical manifestations completely resolved. The second case is interesting in the development of the clinical picture of lymphogranuloma venereum from the second stage of the disease (inguinal syndrome) and the ineffectiveness of treatment with doxycycline, which subsequently required surgical intervention. In addition, in this case, Chlamydia trachomatis DNA was initially detected in a urethral scraping without evidence of urethral inflammation, which is rare for this disease. To treat a patient with “inguinal syndrome” as a clinical manifestation of lymphogranuloma venereum, a fluoroquinolone antibiotic, levofloxacin, was successfully used according to the regimen 500 mg twice a day for 28 days.

Paraneoplastic pemphigus is an autoimmune dermatosis following against the background of neoplasia. It can occur before cancer is diagnosed, during or shortly after treatment, and even during remission of the underlying disease. Typically, paraneoplastic pemphigus only refers to the deposition of IgG. The article is devoted to paraneoplastic IgA/IgG pemphigus, which is one of the rare forms of paraneoplastic pemphigus in which deposition of IgA together with IgG is observed. We have described a clinical case of a patient who developed various rashes during the period of remission of chronic lymphocytic leukemia. Diagnosis of paraneoplastic IgA/IgG pemphigus based on clinical and anamnestic data, the results of a diagnostic skin biopsy, immunofluorescence test, consultation with a hematologist and lab tests. Difficulties in diagnosing paraneoplastic pemphigus are due to the polymorphism of rashes and the variety of clinical and laboratory parameters, which may depend on concomitant oncological pathology. A diagnostic search requires an assessment of the clinical picture of the disease, a carefully collected anamnesis, and a complete diagnostic algorithm for patients with bullous dermatoses.