Vol 96, No 1 (2020)

Congenital epidermolysis bullosa is a clinically and genetically heterogenous group of hereditary skin diseases characterized by the formation of bullae and/or erosions in response to insignificant mechanical effect. The variety and severity of clinical manifestations of the disease determine the early disablement of patients and the decrease in the quality of life, which requires the development of pathogenetic and etiological methods of treatment. Methods of gene therapy are the most promising direction to study, since they can affect the cause of congenital epidermolysis bullosa.

Purpose. To present the results of the treatment of disseminated form of granuloma annulare with remote long-wave ultraviolet therapy and low level laser therapy.

Material and methods. Two female patients at the age of 50 and 53 years with complaints of generalised eruptions on the skin of the trunk, upper and lower limbs and a histologically confirmed diagnosis were treated using a combination of remote long-wave ultraviolet therapy and low level laser therapy of infrared spectrum. 16 sessions of remote long-wave ultraviolet therapy and 10 sessions of low level laser therapy were conducted directly on the lesions. Considering the multidirectionality of the mechanisms of action of phototherapy and laser therapy, the procedures were carried out on different days or with many hours long intervals.

Results. Combined use of the remote long-wave ultraviolet therapy and laser therapy led to a significant improvement by the 21st day of the treatment. No side effects were noticed during the treatment, tolerance of the sessions was good.

Conclusion. Combined use of the remote long-wave ultraviolet therapy and low level laser therapy of infrared spectrum is effective in treatment of disseminated form of granuloma annulare.

The main trends in the incidence of syphilis, including its late forms, are analysed in Novosibirsk in 2013—2017. It was found that during this period there was a trend to a decrease in the incidence of syphilis in Novosibirsk, but there was an increase in cases of detection of late forms of syphilis, in particular late latent syphilis and neurosyphilis, mainly in men at the age of 40 years and older. A unique clinical case demonstrating the complexity of differential diagnosis of neurosyphilis is also presented.

Psoriasis is a chronic immune-mediated disease with predominant damage to the skin and musculoskeletal system.

This paper describes the clinical manifestations of psoriasis requiring a special therapeutic approach. The profiles of patients who showed the early assignment of genetic engineering biological therapy: patients with moderate and severe psoriasis, with rashes of “problem localization” (skin of the face, scalp, genital area and palmar-plantar region), with severe psoriatic lesion of the nail plates, as well as psoriatic arthritis.

Clinical cases of rapid and pronounced resolution of rashes with the use of the new drug netakimab (Efleira) in a dosage of 120 mg according to the standard regimen psoriasis patients with indications for systemic or phototherapy.

Purpose. To present a clinical case of IgG/IgA pemphigus in a 32-year-old woman.

Material and methods. Clinical and laboratory examinations were performed to diagnose the disease: cytological examination of an impression smear from the bottom of the erosion, histological examination of a skin biopsy sample from the lesion, immunofluorescent examination of a biopsy sample of visually accessible unaffected skin.

Results. Clinical manifestations of the disease were similar to Duhring's dermatitis herpetiformis, morphological ones — to pemphigus vulgaris, but immunofluorescent examination of the skin biopsy sample in equal measure revealed deposits of both IgG and IgA in the epidermis, which allowed to determine a diagnosis of IgG/IgA pemphigus. Dapsone therapy at a dose of 100 mg per day led to a significant improvement in the patient's condition.

Conclusion. Diagnosis of bullous dermatoses requires immunofluorescent examination of a biopsy sample of visually accessible unaffected skin. Dapsone was an effective medication for the patient with IgG/IgA pemphigus.