Vol 95, No 1 (2019)

Psoriatic onychodystrophy constitutes an important clinical manifestation of psoriasis and is characterised by multiple symptoms of damage to the nail bed and nail matrix. In order to determine the severity of psoriatic onychodystrophy, as well as the therapeutic efficacy of medications, a unified scale is needed. The article describes the most common indices: NAPSI, mNAPSI, target NAPSI, NAS, PNSS, Baran scale, N-NAIL. In this work, the authors present a methodology for working with each of them, as well as a comparative analysis of detectable symptoms. The conducted literature review indicates the absence of a universal index for assessing the severity of psoriatic onychodystrophy and determines the need to search for new diagnostic algorithms.

Aim. In this work, the authors set out to develop an effective method for the intrafollicular delivery of “Ammi majus fructuum furocumarines” photosensitizer (AMFF) followed by UVA irradiation (λ = 320–400 nm). Materials and methods. The proposed delivery method consists in using calcium carbonate particles acting as AMFF carriers. In vivo monitoring of hair follicle filling was carried out via optical coherence tomography, as well as by means of analyzing epilated hair using confocal laser scanning microscopy. Following the administration of free and encapsulated AMFF to three healthy volunteers, the character of UVA-induced skin pigmentation was registered under dermatoscopic examination. Results. The obtained results demonstrate a profuse filling of hair follicles with calcium carbonate particles, thus confirming the possibility of intrafollicular photosensitizer delivery. It was established that exposure to UVA irradiation causes intense pigment accumulation in the area of AMFF carrier administration. Conclusion. The proposed method of the targeted photosensitizer delivery allows photochemical therapy to be improved.

Aim. To evaluate the clinical efficacy of modern atraumatic non-adherent wound dressings in patients with congenital epidermolysis bullosa. Materials and methods. The study involved 9 patients diagnosed with congenital epidermolysis bullosa (EB), including 7 women and 2 men aged 21–50 years. All the patients underwent immunofluorescent antigenic mapping of skin biopsies to confirm the clinical diagnosis. External therapy using modern atraumatic non-adherent wound dressings was performed in all the patients. The evaluation of the clinical efficacy of the applied therapy was carried out on the 14th and 30th day in accordance with the following criteria: complete healing of erosions or ulcers; significant improvement (reduction of erosions/ulceration by at least 75 % compared with the baseline data, reduction of exudate, the presence of granulations, reduction of inflammation signs, reduction of pain); improvement (reduction of erosions/ulceration area by less than 75 %, but more than 25 % compared with the baseline data, reduction of exudate, presence of granulations, reduction of inflammation signs, reduction of pain); without change (reduction of erosions/ulceration by less than 25 % or no change compared with the baseline data, a slight decrease in the amount of exudate, no granulations, a slight decrease in inflammation signs, a slight reduction of pain); deterioration (increase in the area of erosions/ulceration, increase in the amount of exudate, the level of inflammation and subjective estimation either increases or remains the same). Results. On the 14th day, 22 out of 58 (37.9 %) erosions were epithelized. The area of 15 erosions was reduced by more than 75 %. The area of 12 erosions (20.6 %) was reduced by more than 25 %, but less than 75 %. The area of 7 (12.25 %) erosions decreased by less than 25 %. The area of 2 erosions in patients with severe generalised recessive dystrophic epidermolysis bullosa (RDEB) increased (3.45 %). Out of 36 erosions that had not been epithelized by the 14th day, 20 (55.5 %) achieved complete healing by the 30th day. The dimensions and characteristics of 5 (13.8 %) nonhealing erosive-ulcerative defects had remained unchanged by the 30th day. The share of reduction in the area of these defects did not exceed 30 %. Conclusion. The obtained results demonstrate the clinical efficacy of external therapy using modern atraumatic nonadherent wound dressings. The dynamic observation of erosive-ulcerative defects, regular documentation of changes in the parameters of erosive and ulcerative defects allows the development of standardised approaches of efficient external therapy in such conditions, including the selection of non-adherent dressings. Objective assessment of the dynamics of erosive-ulcerative skin defects contributes to the development of individualized plans for treating EB patients.

The paper provides a description of a rare skin condition, erythema dyschromicum perstans (also called ashy dermatosis), in a child. The authors present a literature review on the issue. A particular attention is given to the etiology and pathogenesis, as well as the clinical picture and diagnostics of the disease.

One modern direction of botulinum toxin therapy in aesthetic medicine is its individualization by taking into account patients’ specific characteristics. On the example of using incobotulinumtoxin A (botulinum toxin type A, BTA), this paper considers the possibility of using the entire range of its concentrations in creating a differentiated approach to correcting mimic wrinkles in different zones and muscular levels. This is expected to achieve the required level of individualization for an optimal aesthetic result. Aim. To assess and justify the efficacy of BTA (on the example of incobotulinumtoxin A) in various concentrations for correcting mimic wrinkles in different zones and muscular levels.

The article provides an overview of literature on new data in studying acne pathophysiology. A particular attention is given to modern interpretation of the role played by inflammation in dermatosis development. The author presents an analysis of the most effective modern pathogenetically-based topical preparations, as well as an algorithm for their application.