Vol 92, No 3 (2016)

Goal. To assess the effect of topical treatment of atopic dermatitis patients with the 0.1% tacrolimus ointment on the itching intensity and skin expression level of growth factor proteins affecting the intensity of cutaneous innervation. Materials and methods. Fifteen patients suffering from atopic dermatitis underwent treatment with the 0.1% tacrolimus ointment. The SCORAD index was calculated to assess the severity of clinical manifestations. The itching intensity was assessed using a visual analogue scale. The skin expression of nerve growth factors, amphiregulin, semaphorin 3A and PGP9.5 protein (a nerve fiber marker) was assessed by the indirect immunofluorescence method. Results. An increased expression of the nerve growth factor and reduced semaphorin 3A expression levels were noted in the patients’ epidermis; there was an increase in the quantity, mean length and fluorescence intensity of PGP9.5+ nerve fibers. As a result of the treatment, the disease severity and itching intensity were reduced, the nerve growth factor expression level was reduced while semaphorin 3A expression level increased in the epidermis, and the mean length and fluorescence intensity of PGP9.5+ nerve fibers was also reduced. A positive correlation among the itching intensity and nerve growth factor expression level, quantity and mean length of PGP9.5+ nerve fibers in the epidermis was revealed, and negative correlation between the itching intensity and semaphorin 3A expression level in the epidermis was established. Conclusion. Topical treatment with the 0.1% Tacrolimus ointment reduces the itching intensity in atopic dermatitis patients, which is related to the therapy-mediated reduction in the epidermis innervation level, decreased expression of epidermal nerve growth factor and increased semaphorin 3A expression level.

The article summarizes the experience in developing, implementing and effectiveness evaluating of the sexually transmitted infection prevention program in the subpopulation of injecting drug users in St. Petersburg, Russia. The preventive intervention was aimed to correct behaviors leading to infection and was based on a multidisciplinary patient-centered approach. Long-term medical, social and psychological support of injecting drug users, combined with the group training sessions based on the peer-to-peer model has allowed to reduce their injecting and sexual risk, as well as to decrease the HIV infection incidence in the intervention group 1.84 times against the control group.

The article describes a case of squamous-cell carcinoma in a female patient aged 30 suffering from a rare inherited disease -recessive dystrophic epidermolysis bullosa (RDEB). RDEB is characterized by a high risk of squamous cell carcinoma in young patients. The most frequent form is a highly differentiated form of cancer characterized by an aggressive course with the early development of metastases and fast progression, which is the most frequent cause of death in RDEB patients. The described case of squamous cell carcinoma in a young female RDEB patient emphasizes the role of early tumor diagnostics.

Bullous scleroderma is a rare type of the focal form of the disease mainly affecting the skin and characterized by induration and sclerosis foci as well as subepidermal blisters containing a transparent matter. The article describes a case study of bullous scleroderma in an adult woman with localized skin eruptions in the area of the left breast, which were completely regressed after a standard therapy with the use of drugs having an effect on collagen synthesis.

Goal. To conduct a comparative assessment of the results of regulated serological tests obtained as a result of blood tests in patients suffering from latent syphilis. Materials and methods. The authors examined 187 patient medical records with newly diagnosed latent syphilis in FGBU GNTsDK (State Research Center for Dermatology, Venereology and Cosmetology), Health Ministry of the Russian Federation, in 2006-2015. The results of patient blood tests were analyzed with the use of non-treponemal (microprecipitation test/RPR) and treponemal (passive hemagglutination test, immune-enzyme assay (IgA, IgM, IgG), IF_abs, immunofluorescence test and Treponema pallidum immobilization test) serology tests. Results. According to the results of blood tests of latent syphilis patients, the largest number of positive results was obtained as a result of treponemal serology tests such as immune-enzyme assay (100%), passive hemagglutination test (100%) and IFabs (100%). The greatest number of negative results was observed in non-treponemal (microprecipitation test/RPR) serology tests: in 136 (72.7%) patients; evidently positive results (4+) test results were obtained in 8 (4.3%) patients only. According to the results of a comparative analysis of blood tests in patients suffering from latent syphilis obtained with the use of treponemal serology tests, the greatest number of evidently positive results (4+) was noted for the passive hemagglutination test (67.9%). Negative treponemal test results were obtained with the use of the immunofluorescence test and Treponema pallidum immobilization test (21.9% and 11.8% of cases, respectively). Moreover, weakly positive results prevailed for the immunofluorescence test: in 65 (34.7%) patients. Conclusion. These data confirm that the following treponemal tests belong to the most reliable ones for revealing patients suffering from latent syphilis: immune-enzyme assay, passive hemagglutination test and IF_abs.

The article presents the results of numerous studies confirming the involvement of bacterial agents in the psoriatic process manifestation as triggering factors. The article discusses potential pathogenic mechanisms of the participation of bacterial superantigens in the initiation of a cascade of immunological reactions resulting in the hyperproliferation of keratinocytes. The expediency of using antibacterial agents as a part of a complex therapy of different forms of the disease is discussed.

The paper contains review of studies on microbiota and cutaneous microbiome using modern techniques of methagenomic analysis. The existing data on microflora of normal skin and among the patients with acne, seborrhoeic dermatitis, rosacea atopic dermatitis are consequently analyzed. The interaction between microbiome and innate/adaptive immunity is presented The perspectives of knowledge on microbiome both in dermatology and cosmetology are pointed out.

This review presents the results of international and Russian clinical studies conducted to assess the efficacy and safety of topical calcineurin inhibitors (TCIs) for the treatment of atopic dermatitis. The main mechanisms of action of TCIs are described. The authors demonstrate the advantages of Tacrolimus belonging to the TCI group. Due to the hydrophilic drug form and pharmacoeconomic index promoting compliance with treatment, it is possible to consider the new drug Tacropic (0.1% and 0.03% Tacrolimus ointments) as the optimum topical drug for the treatment of moderate to severe and severe forms of atopic dermatitis in adults and children.

Relevance. Atopic erythroderma Hill (AEH) is a severe variant of the disease. Its occurrence depends on the examined patients and between 1.9% (young men of military age) to 42% (persons admitted to hospital). The treatment procedure is directly related to the presence of trigger factors, aggravating the disease. The purpose of this publication. To analyze the errors of physicians in the choice of Treatment for patients with AEH. Materials and methods. Use material during the examination and treatment of two patients with AEH aged 5 and 17 years in the allergological center of professor Ado A.D. The detailed analysis of the characteristics of AEH and reasons for the ineffectiveness of traditional treatment methods. Main results. Clinical, immunological, bacteriological methods have made it possible to identify trigger factors contributing to the transformation of the classical course of atopic dermatitis in AEH. Limiting their influence helped improve efficiency. Conclusion. The drug of choice for topical therapy AEH is the methylprednisolone aceponate + ceramides (Komfoderm K), which has a pronounced anti-inflammatory and moisturizing effect with the ability to handle up to 60% of the skin within 12 weeks.

The paper presents the analysis of the work and resources of dermatovenereologic healthcare organizations in Russian Federation, the results of hospital and day hospital beds restructurisation, medical service density, hospital bed usage, incidence of sexually transmitted infections and skin disorders in Russian Federation in 2013-2015.