Vol 92, No 4 (2016)

Drug therapy of leprosy
Kubanov A.A., Karamova A.E., Vorontsova A.A., Kalinina P.A.
Abstract
Leprosy (Hansen’s disease) is a chronic granulomatous bacterial infection mainly affecting the skin and peripheral nervous system yet also involving other organs and systems as a result of a pathological process. The causative agent of leprosy - Mycobacterium leprae - is an obligate intracellular microorganism. Despite the removal of a threat of a leprosy epidemic, European countries still record outbreaks of the disease mainly among migrants coming from endemic areas. A golden standard of the treatment of leprosy is a WHO-recommended combined drug therapy comprising drugs such as dapsone, clofazimine and rifampicin. The article provides current data on the mechanisms of action, efficacy and safety of these drugs and their combined scheme of treatment obtained as a result of clinical trials. Moreover, it also reviews new regimens of the drug therapy of leprosy including those with the use of drugs from the group of fluoroquinols as well as immunotherapy of the disease.
Vestnik dermatologii i venerologii. 2016;92(4):12-19
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Immune pathogenesis of psoriasis
Khairutdinov V.R., Belousova I.E., Samtsov A.V.
Abstract
The article presents current information about the immune mechanisms of psoriasis. Inflammation in the skin of psoriasis patients is considered as an autoimmune process, in which a key role is played by T-cells sensitized to keratinocytes. One of the most probable self-antigens that trigger an immune inflammation in psoriasis may be cytosolic DNA. We describe the functions of the subpopulations of immune cells and the effects of secreted cytokines in the pathogenesis of psoriasis: the dendritic cells - langerhans cells, plasmacytoid dendritic cells, CD11c+ dendritic cells ; T-cells - T helper type 1 and 17, cytotoxic t lymphocytes, T-regulatory lymphocytes. Important role in the development of relapses of psoriasis is plays a formation in the skin of patients with T-cell memory and intradermal proliferation of T-cells.
Vestnik dermatologii i venerologii. 2016;92(4):20-26
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GUIDELINES FOR PRACTITIONERS
PASI (Psoriasis Area and Severity Index) in the evaluation of the clinical manifestations of psoriasis
Kubanov A.A., Karamova A.E., Znamenskaya L.F., Chikin V.V., Kondrashova V.V.
Abstract
Psoriasis is one of the most prevalent chronic inflammatory skin diseases. The severity of its clinical manifestations can vary greatly. Objective assessment of psoriasis severity is required to select an adequate therapy. One of the simplest and most consistent methods used to determine psoriasis severity is to calculate the PASI (Psoriasis Area and Severity Index). This index is based on the doctor’s determination of the sum of indices showing the intensity of the main symptoms of psoriasis: erythema, infiltration and peeling in view of the affected skin area. The PASI can also be used to assess the efficacy of treatment for psoriasis patients.
Vestnik dermatologii i venerologii. 2016;92(4):33-38
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Organization of primary prevention of infections sexually transmitted among orphans and children without parental care in the conditions of children's social institutions
Nikolaeva K.I., Ufimceva M.A., Syrneva T.A.
Abstract
The article presents the results of a survey held among orphaned children and children without parental care with regard to the prevention of sexually transmitted infections as well as results showing the efficacy of awareness-raising workshops regarding reproductive health.
Vestnik dermatologii i venerologii. 2016;92(4):39-41
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Human papilomavirus infection in couples. A discussion
Lysenko O.V., Ziganshin O.R., Shevchenko S.Y.
Abstract
In the Russian literature, insufficient attention is given to the study of the flow of human papillomavirus infection in couples. The aim of the study was to establish the frequency of infection with oncogenic HPV types and clinical manifestations of human papillomavirus infection in regular sexual partners. Surveyed 38 couples who are regular sexual partners in the past three years and denying unauthorized sex. PVI revealed at 70.9 per cent of women who had contact with an infected partner and 79.8 per cent of men. The average age for first sexual intercourse in women was 18.2 years, men - 16.7 years. 80% of men before marriage had more than 5 sexual partners. In 37 of 38 pairs of HPV types of high oncogenic risk coincide. The most frequently detected HPV type 16, are a few less - HPV 51, 31 and 39. Clinical manifestation of HPV infection among sexual partners of the 38 couples not identified, subclinical form of infection in women and men after colposcopy and peniscopy were found with equal frequency (18.4%) and (15,8%), respectively. The descriptions of peniscopy in men with HPV of high oncogenic risk was done.
Vestnik dermatologii i venerologii. 2016;92(4):42-48
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Topical treatment of atopic dermatitis in children: current challenges and answers
Namazova-Baranova L.S., Murashkin N.N., Materikin A.I., Ambarchyan E.T., Epishev R.V.
Abstract
Atopic dermatitis (AD) is the most prevalent skin disease in the early childhood and is a considerable problem both for patients and members of their families and for the society on the whole. In most cases, AD requires a long-term therapy such as the use of anti-inflammatory drugs. Selective inhibitors of the synthesis and release of proinflammatory cytokines - topical calcineurin inhibitors (Tcis) - are now used to solve this problem, with pimecrolimus being one of them. Pimecrolimus has been thoroughly examined for the past decade in different clinical studies involving a total of over 4,000 infants (below 2 years of age). These studies demonstrated the efficacy and safety of pimecrolimus for AD in children provided it is used in a long-term therapy on an intermittent basis. Unlike topical corticosteroids, the long-term use of pimecrolimus is not associated with any risk of development of systemic immunosuppression, skin atrophy, skin barrier dysfunction or systemic absorption so it is safe even if applied to the most sensitive skin areas. In view of this, the authors make a conclusion that pimecrolimus used in the form of a cream is a safe and efficient drug for the treatment of infants aged over three months suffering from atopic dermatitis.
Vestnik dermatologii i venerologii. 2016;92(4):59-67
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Systemic therapy in patients with severe rosacea
Bakhlykova E.A., Filimonkova N.N., Matusevich S.L.
Abstract
Rosacea is a polietiologic disease with a complex pathogenesis, resulting in the problem is the selection of therapeutic tactics, especially in severe disease. The result of the study revealed that the isotretinoin treatment for rosacea had a positive result, even in the absence of the effect of previous systemic antibiotic therapy. Aim of the study. To study the effect and tolerability of systemic isotretinoin treatment for severe rosacea that is resistant to antibiotic therapy. Materials and methods. Under the supervision and treatment were 16 patients with severe course of rosacea, 14 of them had pustules and papules and 2 - fimatodes subtype. The severity was estimated by the method a 4-point scale proposed by V.P. Adaskevich, and was in average 18.6 points. All patients had a duration of 3 ± 1.2 years for systemic antibacterial therapy (clarithromycin, Ornidazole) with insufficient effect in the past. All patients (n = 16) was conducted therapy with isotretinoin (using Aknekutan). Daily dose was calculated on body weight, the initial dose was 0.2-0.3 mg/ kg, with subsequent dose reduction. Topically patients received clindamycin phosphate gel 1% treatment (5-7 days), then metronidazole 1% cream (Rosamet) 1-2 times a day. The duration of therapy ranged from 3 to 5 months. Results. After the course of therapy using Aknekutan remission or significant improvement was achieved in 87.5% of cases. The severity of the disease fell to 6.5 points, i.e. 2.8 times. Conclusion. Aknekutan showed a high therapeutic effect in severe rosacea, so it can be recommended to patients with resistance to conventional therapy. As external therapy, and supportive treatment patients are recommended - cream metronidazole 1% (Rosamet) and adequate skin care, photoprotective creams.
Vestnik dermatologii i venerologii. 2016;92(4):68-74
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Topical formulations used in the treatment of acne
Khairutdinov V.R., Statsenco A.V., Samtsov A.V.
Abstract
The article presents 2 clinical observations of patients with papules-pustular form of acne of moderate severity. In both cases the use of combined topical therapy - topical clindamycin and azelaic acid. The therapeutic effect of clindamycin is faster than other topical preparations. Azelaic acid strengthens the anti-bacterial action of clindamycin, prevents the development of resistance. The results indicate the feasibility of the combined use of these drugs in the treatment of acne.
Vestnik dermatologii i venerologii. 2016;92(4):75-79
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MEDICAL HISTORY
100 years of the clinic and the 140th anniversary of the Department of skin and sexually transmitted diseases of Rostov state medical University
Kuzina Z.A., Sidorenko O.A., Anisimova L.A., Opruzhenkova E.P., Grebennikov V.A., Temnikov V.E., Starostenko V.V.
Abstract
The article describes the stages of development and formation of the national dermatovenereology, history of one of the oldest department of skin and sexually transmitted diseases in Russia. Discusses national and global role of the P.V. Nikolsky, Z.N. Grjebine, N.A. Torsuev, L.M. Khasabov and other colleagues of clinic and chair in the learning and teaching of dermatology and venerology, their contribution to the fight against leprosy, skin and venereal diseases.
Vestnik dermatologii i venerologii. 2016;92(4):80-88
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Disseminated induced pseudolymphoma DTP vaccine
Harchilava M.G., Atayan E.A., Benedik N.A., Hayrutdinov V.R., Belousova I.E., Samtsov A.V.
Abstract
This article considers the variant of disseminated vaccine-induced pseudolymphoma (VIP), which appeared after the introduction of the DTP vaccine. The article describes features of the observed case: common skin rashes affecting the skin of the face, left and right shoulder, chest and upper back. The effectiveness of topical corticosteroids, calcineurin inhibitors and intralesional injections of betamethasone dipropionate and betamethasone sodium phosphate solution has been shown.
Vestnik dermatologii i venerologii. 2016;92(4):49-53
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Anti-cytokine therapy of a patient suffering from psoriatic arthritis
Onipchenko V.V., Sergeeva I.G., Krinitsyina Y.M., Kondrashova A.A., Pahomova V.V., Hismatulina N.V.
Abstract
The article presents a clinical case study of an efficient therapy with infliximab used for a 33-year-old patient with a severe course of psoriasis, psoriatic arthritis, psoriatic onychopathy; chronic hepatitis C with the minimum activity, replication phase; hyper- and normatrophic scars affecting 40% of the body surface; cicatricial contractures; complicated posterior polar cataract of both eyes; secondary amyloidosis of the kidneys with a nephrotic syndrome. It also demonstrates the significance of the anti-cytokine therapy as a method of choice in a complicated clinical situation.
Vestnik dermatologii i venerologii. 2016;92(4):54-58
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Lichen planus and associated psychosomatic disorders
Dorozhenok I.Y., Snarskaya E.S., Shenberg V.G.
Abstract
The urgency is due to a wide range of psychosomatic comorbidity lichen planus (LP). Objective: to determine the clinical relationships of the LP with comorbid psychosomatic disorders. The present prospective clinical study 93 (58 women, 35 men; middle age. 47, 6 years) of patients with LP predominantly dermal localization clinical-dermatological (using scales: the index of clinical symptoms -ICS and questionnaire dermatology quality of life index - DIQL), psychopathological, experimental-psychological, clinical and follow-up, statistical methods. Identified and clinically verified psychogenic manifestation of skin lesions in 28 (30.1%); nosogenic reactions (F43) 56 (60,2%); recurrent depression (F33) - in 9 (9.7%) cases. Defined clinical the relationship of various forms of the LP, the nature of the flow, severity, location and extent of the severity and structure of comorbid psychosomatic disorders.
Vestnik dermatologii i venerologii. 2016;92(4):27-32
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