Vol 89, No 3 (2013)

The authors studied the incidence of gonococcal infection in the Arkhangelsk region in 2001—2011. They also analyzed gender and age distribution, social set-up, education level and marital status of patients. In areas with the low to moderate (Group I) and high (Group II) incidence, the authors analyzed such indices as density of the population, number of dermatovenerologists, territorial profile (agricultural or industrial depending on the branch) and transportation quality. In 2001—2011, the incidence of gonococcal infection in the Arkhangelsk region was falling down — from 187.4 per 100,000 people in 2001 to 78.9 per 100,000 people in 2011 (by 2.4 times). Substantial difference in the incidence rate was observed in different districts of the region. The authors revealed that young men aged 20—29 with secondary education, not engaged in public production, clerks or workers from industrial enterprises, not married, practicing often and sometimes unsafe sexual contacts with women belong to the risk group in terms of incidence of gonococcal infection in the Arkhangelsk region. The authors also revealed that living in big towns with well-developed heavy (machine building, shipbuilding), oil extraction and oil processing industry as well as transportation (in particular, marine and river transport) where young men are employed, and high migration of the population is observed (tourism, business travels, labor migration) may be a risk factor in terms of incidence and propagation of gonococcal infection in the Arkhangelsk region.

Goal of the study. To study the role of metabolic disorders related to steroid hormones for the genesis of androgenic alopecia in women. Materials and methods. The authors disclose the results of a study of blood serum and saliva concentrations of steroid hormones in 87 female patients suffering from androgenic alopecia and 30 healthy women. Results. A regular menstrual cycle in most of the patients with androgenic alopecia (87.8%) and low (10.3%) rate of the polycystic ovary syndrome confirm the low prevalence of clinical manifestations related to endocrine disorders in female patients with alopecia. An increased level of dihydrotestosterone was revealed in 44.8% of the female patients with androgenic alopecia while total and free blood serum testosterone levels were increased only in 11.5% and 12.6% of the patients, respectively. These data may serve as an indirect indication at the increased activity of 5-alpha-reductase promoting conversion of testosterone into dihydrotestosterone. The authors confirmed the information value of the free testosterone saliva level for assessing the hormonal background in the patients under examination. Conclusion. Based on the study results, it is recommended to determine the concentration of dihydrotestosterone, free androgen index and free testosterone saliva level as a part of examinations of women suffering from androgynous alopecia to evaluate their hormonal background.

The authors conducted a comparative study of 474 blood samples collected from patients suffering from different clinical forms of syphilis and 152 healthy subjects using four present-day laboratory methods intended to reveal anti T. pallidum antibodies (EIA IgG+IgM+IgA, EIA IgM , IF abs (IgG) and IF abs-IgM). The study results helped assess the information value of the new medical technologies based on State Standard GOST R 53022.3-2008: EIA IgM and IF abs-IgM as applied to diagnostics of clinical forms of syphilis. For early syphilis diagnostics, it is recommended to determine specific IgМ to T.pallidum in EIA IgM and IF abs-IgM characterized by high clinical sensitivity (97.26% and 95.89% for primary syphilis; 93.50 and 89.50% for secondary syphilis, respectively) and specificity (98.37% and 86.30%, respectively). It is not recommended to use EIA IgM and IF abs-IgM for latent forms of syphilis due to low clinical sensitivity of these tests (16.67-61.61% and 26.09-53.93%, respectively).

The authors describe a rare case of pityriasis rubra pilaris with the concomitant Leser — Trelat syndrome. Taking into consideration contra-indications for UV therapy, Neotigason (acitretin) was prescribed in the dose of 25 mg a day. Nearly absolute regression of eruptions characteristic of pityriasis rubra pilaris and multiple seborrheic keratomas was observed.

Goal. To study the efficacy and safety of local administration of Tacrolimus in the form of 0.03% and 0.1% ointment for patients with moderate to severe atopic dermatitis. Materials and methods. The study involved 32 patients suffering from atopic dermatitis and aged 2—64. The first group comprised 17 children aged 2—15 (7 girls and 10 boys). The second group comprised 15 patients (8 female and 7 male) aged 18—64. All of the patients suffered from moderate to severe atopic dermatitis. Patients from both treatment groups received external therapy in the form of 0.03% of ointment for children and 0.1% of ointment for adults. The daily ointment amount was calculated as FTU (Finger Tip Units) for separate body parts. To ensure objective assessment of the severity of clinical manifestations of atopic dermatitis and treatment efficacy, SCORAD (Severity Scoring of Atopic Dermatitis) score was used for all of the patients. Results. The treatment resulted in a statistically significant reduction in the medial SCORAD index from 67.2 (54.8; 70.4) points to 14.0 (3.5; 22.1) points (р < 0.0001), Group 1, and from 52 (43.5; 75.5) points to 11.7 (0.0; 26.2) points (р < 0.0001), Group 2. Clinical recovery was achieved in 30% of children and 40% of adults. Conclusion. Protopic ointment for the treatment of patients with moderate to severe atopic dermatitis proved to be highly efficient, which was confirmed by a positive therapeutic effect on the course of the disease. There were no adverse effects characteristic of topical corticosteroids, which widens horizons in terms of treating patients with this type of dermatosis.

The goal was to determine clinical and anamnestic features of acne patients aged up to 18 years needing systemic isotretinoin treatment, and to assess the treatment dynamics. Materials and methods. The authors conducted a study of 27 patients with moderate to severe acne (with the mean age of 16.2 ± 1.2 years) receiving isotretinoin in the form of LIDOSE (Acnecutan) in the dose of 0.33 ± 0.06 mg/kg. Results. A steady improvement of the skin condition was observed when the dose of isotretinoin in the form of LIDOSE of 60.3 ± 2.8 mg/kg was used. Clinical recovery was observed in all of the patients (the cumulative dose amounted to 100 mg/kg). Teenagers demonstrated good tolerance to the drug and had no systemic adverse effects.

Goal. Determination of the skin microbiocenosis in patients with atopic dermatitis (AtD) and evaluation of the treatment efficacy for AtD patients using isoconazole nitrate and diflucortolone valerate. Materials and methods. The authors assessed skin microflora in 168 AtD patients. Skin scrapes were obtained for further microscopy, and inoculation tests were performed. As many as 59 secondary AtD patients were treated with a combination of isoconazole nitrate and diflucortolone valerate as well as methylprednisolone aceponate, drugs from the DARDIA line. The treatment efficacy was evaluated clinically based on the SCORAD index as well as skin microrelief assessed with the use of the Visioscan BW30 video camera. After the treatment with Travocort, the nature and degree of skin colonization with AtD microorganisms were also assessed. Results. The efficacy of topical administration of isoconazole nitrate and diflucortolone valerate as well as methylprednisolone aceponate, drugs from the DARDIA line, was confirmed for the treatment of secondary AtD patients. Conclusion. Making antibiotics and antimycotic agents a part of the complex therapy of secondary AtD patients seems to be expedient for eliminating pathogenic microorganisms.

The history of development of dermatology in Russia and in the USSR in 1940—1949 is described.