Vol 94, No 3 (2018)

Analysis of the prevalence and incidence of the dermatosis in workers of the Altay region, of the West-Siberian Railways

Karpova O.A.

Abstract

In article presents the results a comparative analysis of the prevalence and incidence of the skin and subcutaneous tissue diseases in the railway transport workers of the Altay region, of the West-Siberian Railways, of JSC Russian Railways and the local population of the Siberian Federal district, and the Russian Federation.

Vestnik dermatologii i venerologii. 2018;94(3):13-19
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Origin, function and role in the development of skin diseases CLA+T-lymphocytes

Patrushev A.V., Samtsov A.V., Nikitin V.Y., Ivanov A.М., Gumilevskaya O.Р., Sukharev A.V., Sukhina I.A.

Abstract

The idea of CLA+T-lymphocytes, which are a special subpopulation of cells with a tropic to the skin, is given. The issues of maturation, migration and functional features of CLA+T-cells are considered. Special attention is paid to the different phenotype of memory T-cells. Modern data concerning the role of CLA+T-cells in the pathogenesis of autoimmune and allergic dermatoses, as well as malignant skin tumors are also presented. The conclusion about the necessity of further study of CLA +T-lymphocytes for detailed understanding of pathogenesis and search of variants of targeted therapy in psoriasis, atopic dermatitis, skin lymphomas and other skin diseases is made.

Vestnik dermatologii i venerologii. 2018;94(3):20-29
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Prevalence of chronic infection foci in patients with dermatoses

Patrushev A.V., Samtsov A.V., Ivanov A.M., Sukharev A.V., Asfendiarov D.D.

Abstract

This paper presents the results of a retrospective epidemiological study carried out to detect chronic infection foci (CIF) in patients affected by T-cell mediated dermatoses. The values obtained for the CIF prevalence are compared with those in the general population, as well as in the control group. The latter comprised generally healthy people according to the results of in-depth medical examination. It is found that patients with psoriasis demonstrate a higher prevalence of chronic tonsillitis compared to the values both in the general population and in the control group (p = 0.001). Patients with eczema are characterized by an increased prevalence of chronic granulomatous periodontitis, but only in comparison with generally healthy individuals (p = 0.046). The results obtained for patients with atopic dermatitis, lichen planus and alopecia areata are found to be statistically significant for chronic tonsillitis, which occurs therein more frequently than in the general population and in the group of generally healthy people (p = 0.001).

Vestnik dermatologii i venerologii. 2018;94(3):30-38
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тестовая статья

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Abstract

аннотаци1
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GUIDELINES FOR PRACTITIONERS

Dermatoscopic diagnostics of nevus sebaceous of Jadassohn

Zhuchkov M.V., Bolshakova Е.E., Sonin D.В., Rodionova S.A.

Abstract

Aim. The aim of this study was to examine the dermatoscopic signs of nevus sebaceous in its different age periods.

Materials and methods. The study sample included 49 patients diagnosed with nevus sebaceus of Ja dassohn, seeking medical assistance in the Ryazan Region Clinical Dermatological and Venerealogical Dispensary during the 2014–2018 period. The age of the patients ranged from 1 month to 69 years.

Results. The study describes the main dermatoscopic manifestations of nevus sebaceous of Jadassohn in its different age periods.

Conclusions. The results of the study are significant for the differential diagnostics of nevus sebaceous of Jadassohn.

Vestnik dermatologii i venerologii. 2018;94(3):39-44
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CLINICAL CASE REPORTS

A favorable pregnancy outcome in women with secondary syphilis

Evseeva A.L., Koshkin S.V., Ryabova V.V., Bazhina I.I., Kovrova O.S.

Abstract

A clinical case of secondary fresh syphilis in a pregnant woman at 36 weeks is presented. A ttention deserves infection of a woman in the second half of pregnancy, which was resolved by the birth of a healthy child.

Vestnik dermatologii i venerologii. 2018;94(3):45-50
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Martorell’s ulcers

Fistal’ E.Y., Vatutin N.Т., Taradin G.G., Goncharuk M.S., Grischenko I.S., Vasilenko I.V.

Abstract

There is description in the article of a case of hypertensive ulcer pathology of legs or Martorell’s ulcers diagnostics, which are complications of long-standing and poor-controlled essential hypertension. The patient 42 years old male presented with complaints of long-standing, non-healing and painful ulcer on the left leg, sustained blood pressure elevation (up to 230/120 mm Hg). History disease revealed blood pressure elevations since 16 years old age, but the patient sought medical advice extremely seldom and did not take antihypertensive treatment in fact. He noted when was 35 years old a painful ulcer located on anterolateral surface of the leg. Concerning it he treated by himself unsuccessfully and then — in differ ent health care centers. The condition deteriorated in 2016, when ulcer defect become larger and more painful. On admission at examination the ulcer of oval shape (size 7 × 4 cm and depth 0.6 cm) on anterolateral surface of the lower third of left leg is present. In clinical and biochemistry analyses no pathology was found. There were signs of left ventricle hypertrophy on the data of electroand echocardiographic inves tigations. No alterations during complex ultrasound examination of vessels of both lower extremities were revealed. Examination of angiosurgeon: no pathology. With the purpose to diagnosis specification path omorphologic study of tissue fragments of injured zone was performed. The results of this study showed that revealed changes are relevant for hypertensive ulcers of legs or Martorell’s ulcers. The presented case illustrates the necessity of more broad informing medical community about possibility of incidence of Martorell’s ulcers that in turn assumes application of adequate measures of local treat ment, including dermatoplasty, and effective antihypertensive therapy.

Vestnik dermatologii i venerologii. 2018;94(3):51-55
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Eczema: tactics of choice external therapy

Zaslavsky D.V., Tulenkova Е.S., Monakhov K.N., Kholodilova N.A., Kondratieva Y.S., Tamrazova O.B., Nemchaninova O.В., Guliev M.O., Shlivko I.L., Torshina I.Е.

Abstract

The therapeutic effects of synthetic tannins are based on their binding action, as well as on their anti-pruritic, antimicrobial and anti-inflammatory effects. Materials and methods. A clinical study of Neotanin spray, Neotanin lotion (suspension) and Neotanin cream was carried out in 8 clinical centres during the period from June, 2017 to January, 2018. The study had an open and non-comparative character. The study included 68 patients of both sex es aged from 1 month to 80 years suffering from eczema dermatosis in the acute weeping phase, including cases with complications after secondary infections (including eczema elements localized on the face). Before the study, information on the clinical history, demographic data, co-morbidities, physical examination data of the patients was collected. The treatment regimen included 2 stages: 1) Neotanin in the spray or lotion (suspension) form 3–4 times per day during 1–5 days, up to the full drying of eczema elements; 2) Neotanin in the cream form 3 times per day, up to the disappearance of the clinical manifestations of skin dermatosis. The duration of the study ranged from 5 to 14 days: the study was completed when a patient had achieved remission. The criteria for assessing the drug efficacy were as follows: dynamics of subjective complaints, objective assessment of the patient's condition (the presence and severity of clinical symptoms), dynamics of the Dermatology Life Quality Index (DLQI). Results. Neotanin preparations showed a high efficacy in the acute and subacute stages of the inflammatory process as an antipruritic agent. Itching stopped within 5 minutes after the drug application, with the antipruritic effect lasting for an average of 3–4 hours. In 85 % of the patients, marked excoriations were absent on the 3rd day of treatment. Neotanin demonstrated a pronounced anti-inflammatory effect. In 92 % of the patients, the symptoms of erythema and edema were significantly reduced one week after the beginning of treatment, with the manifestations of inflammatory exudation being conclusively decreased. One week following the beginning of treatment, 100 % of the patients demonstrated no oozing lesions. The absence of serious undesirable effects in the patients during the study evidences to the good tolerability and safety of this drug.

Vestnik dermatologii i venerologii. 2018;94(3):56-66
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Psoriasis: clinical and epidemiological features and therapy issues

Bakulev A.L., Fitileva T.V., Novodezerkina E.А., Gilloteau I., Tian Н., Howe T., Pietri G.

Abstract

Aim. This study sets out to establish the demographic and clinical features of psoriasis and its co-morbidities; to describe approaches to treating patients in Russia, to whom the systemic therapy of drugs has been recommended; to assess the effects of this dermatosis on the patients' quality of life and work productivity; to assess the degree of consistency between dermatologists' and patients' estimates concerning the severity of the disease, complaints/objective manifestations and treatment satisfaction.

Methods. Data from the GfK Disease Atlas was used. This ATLAS was filed within a global programme Growth from Knowledge that collected reliable data in the context of everyday clinical practice in 9 countries. The paper presents the results solely for the Russian sample. The study involved patients with moderate or severe psoriasis who were receiving systemic therapy for this disease. Using specially developed forms, ATLAS specialists registered data about patients, their disease and received treatment. The patients affected by psoriasis, who participated in the study, were questioned about their disease. Dermatologists assessed the severity of psoriasis, the patients' complaints, co-morbidities and received treatment. The patients completed questionnaires aimed at assessing the quality of their life [Dermatology Life Quality Index, DLQI] and their work productivity [Work Productivity and Activity Impairment, WPAI]. The concordance between the patients' and the dermatologists' estimates was assessed using Cohen's kappa coefficient.

Results. Overall, 3,821 patients participated in the ATLAS programme, out of whom 300 patients were Russians. The average time since psoriasis diagnosis amounted to 9.9 years. 51 % of the patients complained about itching in the lesion areas. Psoriatic arthritis was registered in 19 % of the cases. Among co-morbidities, anxiety or depression was most often recorded (11 %, respectively). The proportion of patients with pruritus and related comorbid conditions increased with psoriasis severity. The disease negatively affected the quality of patients’ life (the average value of DLQI was 7.1) and their work productivity (a decrease in the work productivity reached 33.2 %), with these indicators deteriorating with psoriasis severity. Despite the dominance of moderate and severe psoriasis forms among the participants, 60 % of the patients received therapy only with topical medications. The concordance rate between the patients and the dermatologists concerning the estimation of psoriasis severity and treatment satisfaction was low.

Conclusion. Despite the therapy with systemic drugs, the patients' quality of life affected by severe or moderate psoriasis forms remained low. The consistency between the views on the treatment success between the patients and the dermatologists was low.

Vestnik dermatologii i venerologii. 2018;94(3):67-76
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Successful sequential immune epigenetic therapy of erythrodermic mycosis fungoidesessful sequential immune epigenetic therapy with the resistant course of erythrodermic mycosis fungoides

Gorenkova L.G., Kravchenko S.K., Kovrigina A.M., Kolomeitsev O.A.

Abstract

Mucosis fungoidea (МF) belongs to the class of epidermotropic T-cell lymphomas. MF is represented by over 10 sub-types only in terms of its clinical manifestations, with one of them being erythrodermic MF (EMF). This disease is characterized by diverse symptomatology in the form of erythroderma and intense skin itch, aggressive сlinical course and unfavorable prognosis. The disease prognosis also correlates with age, previous history of long-term systemic gluco-corticosteroid treatment (GCS), increased activity of lactate dehydrogenase (LDH) and hypereosinophilia. The choice of MF treatment is determined by the disease stage and somatic status of the patient. In EMF, a therapy combining various effective preparations and taking into account the specifics of the given case is required. Extracorporeal photopheresis (ECP) is frequently an approach of choice; however, it has demonstrated the highest efficacy in Sezary disease or in EFM associated with leucemization. Application of new pharmaceuticals (monoclonal antibodies, epigenetic agents) in combination or in sequence with immune therapy is a promising direction, particularly for treating patients older than 75 years. In this paper, we describe the clinical case of an elderly patient suffering from EMF without peripheral blood leukemia with multimodal factors of unfavorable prognosis, such as age, increased lactate dehy drogenase activity, history of prolonged inefficient treatment with gluco-cortecosteroid preparations and eosinophilia. A long-term positive response to the treatment using sequential immune epigenetic therapy has not been achieved, although the treatment tolerability and the patient's life quality were satisfactory.

Vestnik dermatologii i venerologii. 2018;94(3):77-84
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ORGANIZATION OF HEALTH CARE AND EPIDEMIOLOGY

DERMATOLOGICAL PATHOLOGY IN THE HOSPITAL OF THE EMERGENCY MEDICAL SERVICE: CONDITION OF THE PROBLEM

Bagretsova I., Sukharev A., Barsukova I.

Abstract

Development of system of rendering an emergency medical service in a hospital inevitably brings up questions of its availability and quality. And, if the leading pathological syndrome which is a reason for hospitalization and posing threat for the patient's life deserves priority attention, the accompanying pathology often remains in the shadow. Thus skin diseases often are epidemiologically dangerous as for the patients having this illness and for the patients surrounding them and the medical personnel which is carrying out medical process. The assessment of a current state of a problem of delivery of health care by the patient with dermatological pathology in a hospital of an emergency medical service was a research objective. By results of research - surgical activity at patients with skin diseases made 88,3% that is much higher than the average level of surgical activity on a hospital (33,9%), they needed large volume of the most various laboratory diagnostic testings. Skin diseases or are a serious illness and conduct to a treatment failure, or significantly make heavier a condition of patients with various diseases (the hospital lethality in this group by 4-5 times exceeded an average value and I made 23,8%). Development of new models and the principles of the organization of medical and diagnostic process, introduction of methods of express diagnostics is required; obvious is also a role of the dermatovenereologist that will allow to increase availability and quality of the help to patients with dermatovenerologichesky pathology in a hospital of an emergency medical service.
Vestnik dermatologii i venerologii. 2018;94(3):
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