Vol 93, No 4 (2017)

The data in respect to efficacy of verapamil-containing scar cream for treatment of hypertrophic and keloid scars are presented in the article. Skin scars were simulated in rats by excision of a full-thickness skin flap size 5x4 cm2 in the center of the back. Upon wound healing and scar formation a daily twofold fomentation of verapamil-containing cream was carried out. Treatment efficacy was checked after 10, 30 and 60 days. The following indices were studied: an area of the scar, its type, consistence, color, sensitivity, and scar microcirculation according to biomicroscopy. The proposed novel method for treatment of hypertrophic and keloid scars with verapamil-containing cream allowed to obtain a sustained clinical result demonstrating a reducing area of the scar by 25%, a physiological scar formation, improving the consistence and scar colour changing to the normal skin colour, its softening and flattening, and pain disappearance. Due to the dermal application, the method was painless, safety and did not affect on the surrounding tissues. According to biomicroscopy a scar remodeling approximated the indices to the level of healthy skin in 93% of rats. The most significant clinical effect the cream with verapamil was observed in experimental animals in 60 days after treatment.

The diffuse plane xanthoma (DPX) belongs to the class II of histiocytosis arising from the dermal dendritic cells (Histiocyte Society). The dominate role in the formation of the disease in the skin plays an accumulation of phagocytic immune complexes of macrophages. The clinical picture of the DPX is very specific and characterized by the appearance of periorbital xanthelasma and planar xanthomas on the skin of the trunk and extremities. The disease is often associated with hematological and lymphoproliferative diseases. The diagnosis is confirmed by histological examination.

Choosing appropriate methods for removal of benign skin lesions (BSL) in the cervicofacial area has always been an important and challenging issue. Removal of the BSL is indicated and performed for medical and aesthetic reasons. A method with less painful procedures, a short healing period, without noticeable long-lasting traces (such as scars, dyschromia) and, predictably, fewer repeat procedures is preferred. Objectives. Evaluation of the effectiveness, safety and convenience of BSL plasma ablation using Plexr® (GMV, Italy); Comparison of the reparative processes speed after the BSL removal in the cervicofacial area applying the Plexr® device with other instrumental methods (based on literature reviews). Materials and Methods. We identified a group of patients wishing to remove papilloma, xanthelasma, dermal nevi, dermatofibroma on their face and body. Neoplasms (skin lesions) were assessed visually and by means of the Dermlite 3DN dermatoscope. Patients with atypical skin lesions were excluded from the study and referred to a medical oncologist for consultation. Each patient, having been fully briefed on the nature and course of the medical procedure, as well as required aftercare, submitted their written informed consent. Plasma ablation of BSL was performed using Plexr® device. Re-examination of patients was carried out after the scab from the treated area of the skin had fallen off. Results. We have performed 373 BSL removal procedures, including 212 (57%) — in the cervicalfacial area, among which there have been 47 (13%) cases of acrochordoni, papilloma, xanthelasma, syringoma and upper and lower eyelid milia removals. Complete healing has been recorded in 98% of all cases, with repeated corrective procedure being required only for one patient due to insufficiently deep tissues destruction in the course of multiple syringoma removal in the lower eyelid area. Conclusion. The results obtained allow to consider the method of BSL tissues plasma ablation applying Plexr® device effective, safe, non-traumatic, inexpensive, with a short period of tissue healing (7—10 days). BSL removal with the help of Plexr® — is a good alternative to conventional surgical and laser methods, which can be introduced into medical practice.

Congenital epidermolysis bullosa is a group of hereditary skin diseases caused by mutations in the genes of structural proteins of the dermoepidermal junction of the skin, characterized by formation of blisters and erosions at the smallest mechanical trauma. In patients with severe subtypes of borderline and dystrophic epidermolysis bullosa there are long-term erosive and ulcerative defects with disruption of the healing process. Factors that impede healing include: malnutrition, anemia, pain, inactivity, local factors (presence of infection, prolonged inflammation, extensive nature of the lesion, absence of skin appendages in the affected area, deficiency or lack of formation of type VII collagen). Elimination of healing impeding factors is the main challenge in treatment of severe subtypes of bullous epidermolysis. Modern promising treatment techniques are at the stage of development and have not yet been introduced into clinical practice, and, as of today, skin care and optimal topical treatment with modern non-adhesive dressings remain the most widespread treatment methods that facilitate accelerated healing.

We include a review of modern methods of systemic therapy of psoriasis in children, indications for which are moderate and severe forms of psoriasis with PASI > 10, skin pathological process that is uncontrollable with topical drugs, skin lesions with functional localization (lesions of genitals, palms and soles, facial skin), erythrodermic psoriasis, pustular psoriasis, psoriatic arthritis. We provide information on the techniques of narrow-band phototherapy (UVB 311 nm) that are used in the treatment of psoriasis in children. We provide data on efficacy, safety, necessary monitoring of clinical and laboratory indicators, peculiarities of vaccination during treatment of children with acitretin, methotrexate, cyclosporine.

Systemic retinoids are known to be the most effective means of treating severe forms of acne. However, in spite of longstanding and intensive practice of their application in dermatology, some specialists still avoid prescribing this group of drugs. As a rule, this is due to lack of awareness of health professionals about therapy techniques and means of correcting possible adverse events. We discuss the clinical aspects of administration of isotretinoin in treatment of moderate and severe forms of acne. Practical recommendations are given on how to prevent various myths, misconceptions and prejudices in health professionals and patients. We present our own experience of using isotretinoin with increased bioavailability (Acnecutan®*).

The paper presents the analysis of incidence of sexually transmitted infections and skin disorders in Russian Federation in 2016, the work and resources of dermatovenereologic healthcare organizations.