Vol 101, No 1 (2025)

The problem of syphilis incidence has been relevant throughout all times and remains so to this day. The level of incidence is a key indicator of the epidemiological situation regarding the spread of syphilis among the population. Over the past five years, the Russian Federation has experienced variability in syphilis incidence rates after a prolonged decline from 2009 to 2020. The assessment of the epidemiological situation regarding syphilis allows us to state that, overall, there is a stabilization of the epidemiological process in the country, characterized by a regression in incidence rates and a restoration of the trend towards further reduction. It is also evident that the observed increase in syphilis incidence in the Russian Federation was associated with a rise in the number of foreign nationals, including migrants, infected with syphilis, against the backdrop of a decrease in syphilis incidence among Russian citizens.

The article contains a review of modern literature data and the authors’ personal long-term experience in treating patients with psoriasis and psoriatic arthritis. The possibilities of prescribing various drugs for systemic therapy based on the clinical situation, issues of monitoring and evaluating the effectiveness of therapy, and the mechanism for switching therapy from one pharmacological medication to another are discussed in detail. Therapy of patients with psoriasis requires solving the complex issue of drug selection, which depends on many factors. The choice of systemic therapy algorithm is an important issue that determines the effectiveness and safety of treatment, influences the prognosis of the disease and the patient’s quality of life.

Background. Despite the proven efficacy and safety of biologics in the treatment of psoriasis (Ps), a number of patients experience heterogeneity in response to therapy in both the short-term and long-term perspectives.

Aims. To identify correlations between the blood cytokine levels, clinical severity indices and the effectiveness of the IL-12/IL-23 inhibitor (ustekinumab) therapy.

Methods. The study enrolled 25 patients with psoriasis. The severity of the disease was assessed using PASI, BSA, sPGA. The clinical efficacy of ustekinumab was determined by the percentage of PASI reduction: good response(≥90) moderate response (≥75) and low efficacy (≤50). Blood cytokine levels were determined by multiplex immunological analysis (xMAP) technology. Statistical analysis was performed using RStudio and the R programming language.

Results. Moderate Ps was diagnosed in 15 patients (60%), severe — in 10 (40%). The baseline levels of IL31, sCD40L and VEGF were respectively 2.3 (p = 0.018),2.3 (p = 0.010), and 2.0 (p = 0.033) times higher in severe Ps. By the 16th week, therapy was effective in 92% of patients and was accompanied by a 3.47 fold decrease in IL-31 (p = 0.002) and an increase in ICAM1 and VEGF by 35.8% (p = 0.026) and 4.2 times (p < 0.001) respectively. A correlation between ∆PASI and IL-12, IL-17F, IL-20, IL-22, IL-31, sCD40L, VEGF was found. Ustekinumab significantly modified cytokine interactions and neutralized their correlation with ∆PASI.

Conclusion. IL-31, sCD40L and VEGF baseline levels correlate with Ps severity, IL-17F, IL-20 and IL-31 — with ∆PASI, demonstrating their potential use in objectively determining Ps severity and predicting the ustekinumab therapy effectiveness.

Background. Bullous dermatoses are a group of severe heterogeneous diseases that are potentially life threatening and significantly worsen its quality.

Aims. To establish an associative relationship of HLA class II histocompatibility gens with bullous dermatoses using the example of pemphigus vulgaris, bullous pemphigoid and benign familial pemphigus.

Methods. A prospective open, simple, comparative, scientific study included 101 patients (men — 33, women — 68) with bullous dermatoses. The study was conducted from 2017 to 2023.

Results. Statistically significant differences were revealed for a number of HLA class II indicators. Carriers of HLA-DRB1*3, DRB1*4, DRB1*14, DRB1*16, DQB1*0304, DQB1*0502-4, DQB1*0503, DQB1*02 and DQA1*0301 should be identified as a risk group for the development of pemphigus vulgaris, benign familial pemphigus and bullous pemphigoid. Patients carrying histocompatibility gens HLA-DRB1*15, DRB1*17, DQB1*201, DQB1*303, DQB1*602-8 have increased resistance to the above-mentioned bullous dermatoses.

Conclusions. An association was found between histocompatibility gens HLA class II, pemphigus vulgaris, bullous pemphigoid and benign familial pemphigus. The data obtained can be used to predict the development of the above-mentioned diseases, develop a set of preventive recommendations, verify the correct diagnosis in the early stages of diseases.

Background. Tinea pedis is a common superficial fungal skin infection. Amorolfine is one of the topical agents that have demonstrated efficacy in the treatment of mycoses.

Aims. To assess and compare the efficacy of a new agent amorolfine 0.25% cream (Glenmark Pharmaceuticals Ltd., India), versus amorolfine 0.25% cream (Galderma Laboratory, France), registered in the European Union, in the treatment of tinea pedis.

Methods. This open-label, randomized, multicenter, phase III study was conducted with adult patients with tinea pedis. Patients had once-daily amorolfine 0.25% cream (Glenmark Pharmaceuticals Ltd., India) or amorolfine 0.25% cream (Galderma Laboratory, France) applications to the affected skin areas for 28 days. The primary efficacy analysis was performed on the 42nd (± 4) day from the start of therapy, evaluating mycological (based on the results of a potassium hydroxide examination of skin scraping) and clinical (based on the results of symptoms and signs severity assessment) recovery.

Results. In this clinical study,101 patients were randomized to the group 1 — amorolfine 0.25% cream (Glenmark Pharmaceuticals Ltd., India) and 99 patients to the group 2 — amorolfine 0.25% cream (Galderma Laboratory, France). The therapeutic equivalence of the study drugs was confirmed by the percentage of participants recovering as a result of therapy (mycological and clinical) by day 42, amounted to 95.0% in the group 1 and 97.0% in the group 2. The intergroup difference was –1.97% (90% confidence interval: –6.54; 2.60). The upper and lower limits of 90% confidence interval were within the established equivalence margin of 0.2 (р < 0,0001). Among all registered adverse events, there were only 3 treatment-related associated: reaction at the site of application, erythema, and itching in group 2. There were no statistically significant differences between the groups in the incidence of adverse events.

Conclusions. This study demonstrated the therapeutic equivalence of amorolfine 0.25% cream (Glenmark Pharmaceuticals Ltd., India) and amorolfine 0.25% cream (Galderma Laboratory, France). The safety profiles of the study drugs were acceptable and comparable.

Scarred alopecia of the scalp is an urgent problem for both dermatologists and trichologists and accounts for approximately 5% of all cases of alopecia. A clinical case of a 47-year-old patient manifesting as foci of scar alopecia on the scalp is presented. According to the results of clinical, histological and dermatoscopic studies, the diagnosis of discoid lupus erythematosus was established. The patient was also examined by a rheumatologist (systemic lupus erythematosus was excluded, dynamic observation was shown). He received treatment with hydroxychloroquine, aevit and venarus; externally — Lorinden A ointment, bepanten plus cream, shampoos containing zinc, ultraphonophoresis with hydrocortisone ointment course. Because of the treatment, there is a clinical improvement. Observation by a dermatovenerologist and repeated examination by a rheumatologist after 6 months are indicated. Due to the complex diagnosis and the similarity of the clinical picture, timely and complete examination and treatment is important in order to prevent or stop the formation of foci of alopecia. In turn, they also affect the psychoemotional background of a person and the formation of psychosocial maladaptation.