Vol 90, No 2 (2014)

The goal of the study is to determine the particular features of pemphigus vulgaris (PV) morphogenesis and keratinocytes in the patients’ skin having morphological signs of acantholysis and apoptosis as well as changes in Langerhans cells. Materials and methods. Skin tissue samples taken from 46 PV patients were examined. The skin tissue samples underwent cytology, histopathology and immunohistochemistry examinations as well as transmission electronic microscopy. An increased number of CD1a+ (dendritic) cells and apoptotic Cpp3+ keratinocytes was revealed in the skin of the PV patients. According to the electronic microscopy data, keratinocytes with signs of apoptosis are present in fresh vesicles in the acantholysis area at early PV stages quite seldom; at the same time, Langerhans cells had morphologic signs of activation. As the number of keratinocytes with desmosome lysis signs grew, the number of apoptotic keratinocytes was increasing reliably. Conclusion. In case of PV, apoptosis has a secondary nature and develops as anoikis.

Current data on the acne pathogenesis are given. According to the authors, dermatosis is becoming more prevalent among women of mature age. Issues related to the clinical picture, effect of exogenous and endogenous factors on the course of acne, and psychosocial characteristics of delayed acne manifestations in women are described in detail. The essential role of medical and cosmetic products for the complex therapy of acne is discussed. The authors describe their own experience of treating delayed acne using the Hyseac line of medical and cosmetic products in a combination with microdermabrasion and no-needle mesotherapy using the vitaPeel/vital О₂ device.

Goal. To study the dependence between the recurrent balanoposthitis of mixed etiology and oral sex. To assess the efficacy, tolerance and cosmetic acceptability of a combination topical drug on the basis of a cream for the treatment of balanoposthitis of Candida and bacterial etiology. Materials and methods. An open-label single-arm non-randomized study involved 48 men aged 22-43 suffering from recurrent balanoposthitis of mixed etiology and their long-term sex partners. All of the subjects underwent the following tests: complete blood count, clinical urine test, blood biochemistry (AST, ALT, total bilirubin, thymol test and blood glucose), MRSA, blood tests for anti-hepatitis B and C virus antibodies, HIV-1/-2 antibody screening test, microscopy of urethral, vaginal and cervical canal materials, PCR for Chlamydia trachomatis, Trichomonas vaginalis, N. gonorrhoeae, Mycoplasma genitalium, Ureaplasma spp, bacterial swab tests based on urethral materials (in men), vaginal materials (in women) and throat (in subjects of both sexes), and microscopy of tongue scrapings. 46 male patients used the Candiderm cream (Glenmark Pharmaceuticals Ltd.) for 10-14 days. Physicians assessed the efficacy based on the symptom intensity and patient’s opinion. Results. In people who practiced unprotected oral sex, a high contamination of mucous coats in the oral cavity, throat and genitals with yeast fungi and opportunistic bacteria was revealed. C. Аlbicans was often found in diagnostically significant amounts in couples. The authors substantiate the possibility of a contact-type transmission of opportunistic bacteria during oral sex resulting in balanoposthitis of mixed Candida and bacterial etiology or exacerbation of their condition after sexual contacts in men practicing unprotected oral sex. Evident clinical efficacy and safety of the combination as well as good tolerance and convenience of application of the combination topical drug comprising beclomethasone dipropionate, gentamicin and clotrimazole for the treatment of balanoposthitis of Candida and bacterial etiology.

Goal of the study. To compare the efficacy of antihistamine drugs for the therapy of chronic urticaria taking into consideration their effect on the patients’ cognitive functions. Materials and methods. The study involved 178 patients with chronic urticaria who were divided into six groups taking second generation antihistamine drugs: Cetirizine (n = 38), Levocetirizine (n = 27), Fexofenadine (n=26), Ebastine (n = 33), Loratadine (n = 26) and Desloratadine (n = 28). The patients recorded dynamic changes in clinical symptoms of the disease (number of urticarial components, skin itching intensity, availability or absence of urticarial derniographism, angioedema signs and signs of the shortness of breath and reduced blood pressure) in their individual diaries. Baseline signs of the patients’ cognitive condition and those recorded during the treatment were studied using the Kraepelin’s arithmetic test (modified by Schulte), I.M. Lushchikhina’s verbal and visual thinking assessment method and method for memorizing ten words. The control group comprised 31 subjects without chronic urticaria. Results of the study. Ebastine and Fexofenadine are the most efficient antihistamine drugs for the treatment of chronic urticaria. At the same time, they do not have any negative effect on the patients’ cognitive functions so they can be recommended for long-term treatment of chronic urticaria. In spite of its evident positive therapeutic effect, Cetirizine reduces mental alertness and deteriorates thinking in patients with chronic urticaria. Because of this, the drug must be prescribed with care for long-term administration to those patients whose professional activities demand increased attention concentration. Loratadine has a positive effect on the patients’ attention and thinking. However, taking into consideration its low efficacy, the drug can be prescribed as the basis therapy for the treatment of light forms of chronic urticaria.

Acne is a socially significant disease affecting an overwhelming majority of teenagers, which often results in serious social disadaptation. The problem of acne treatment remains urgent especially taking into consideration the fact that the respective pathogen, P. acnes, demonstrates a growth in its resistance. The problem can be solved by using a combination therapy comprising resistance inhibiting drugs along with antibiotics. The erythromycin and zinc solution is one of the most promising combinations.