Vol 89, No 3 (2013)

Epidemiological aspects of gonococcal infection in the arkhangelsk region

Baryshkov K.V., Prib I.D., Frigo N.V., Solomka V.S.


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.
Vestnik dermatologii i venerologii. 2013;89(3):5-16
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Current concepts of genetic variability of genital mycoplasmas and their role in the development of inflammatory diseases of the urogenital system

Rakhmatullina M.R., Kirichenko S.V.


The authors disclose current concepts of the taxonomic and morphologic characteristics of genital mycoplasmas and their role in the development of inflammatory urogenital diseases and reproductive disorders. They also discuss such issues as genetic variability of genital mycoplasmas and possible interrelation with different variants of the clinical course of inflammatory processes in the urogenital tract.
Vestnik dermatologii i venerologii. 2013;89(3):17-25
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Distinctive features of steroid hormone metabolism in female patients with androgenic alopecia

Mareyeva A.N., Rotanov S.V., Chernukha G.Y.


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.
Vestnik dermatologii i venerologii. 2013;89(3):27-32
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First experience of molecular typing and determining the antibiotic resistance of syphilis pathogen Treponema pallidum in the Russian Federation

Kubanova A.A., Kubanov A.A., Frigo N.V., Volkov I.A., Rotanov S.V., Suvorova A.A.


The authors present the results of molecular typing and determining the antibiotic resistance of 190 T. pallidum strains sampled from primary and secondary syphilitic patients in the russian Federation in 2011—2012. molecular typing of T. pallidum strains was based on two variable gens: arp, tpr, and was supplemented with an analysis of gene tp0548 reading frame. Antibiotic resistance of syphilis strains was determined by means of sequencing the gene encoding 23S rRNA T. pallidum in such loci as A2058G and A2059G/C (resistance to macrolides), gene encoding 16S rRNA T. pallidum in locus G1058C, and determinant tetB (resistance to tetracyclines) as well as full-scale sequencing the genes encoding target proteins of β-lactams Tp47 and Tromp. As a result of molecular typing in the territory of the Russian Federation, ten subtypes of T. pallidum were revealed. Type 14 (98.4%) predominates; the share of subtype 14d/f is 91.03%; the share of subtypes 14d/Tand 14b/f, Type 14, was 2.10 and 3.16%, respectively; the share of all other subtypes (11d/f, 13d/f, 14a/a, 14a/f, 14d/g, 14d/c, 20d/f) was 0.53%. molecular markers of T. pallidum antibiotic resistance were revealed among the strains coming from the Central, Siberian and Volga federal regions of Russia: macrolides - three strains sampled in 2011; tetracyclines - two strains sampled in 2011 and one strain sampled in 2012.
Vestnik dermatologii i venerologii. 2013;89(3):34-46
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Information value of treponema-specific class M antibodies for syphilis diagnostics

Rotanov S.V., Ermatova F.A.


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).
Vestnik dermatologii i venerologii. 2013;89(3):48-55
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Assessment of the efficacy of Betamethasone with Calcipotriol for isolated psoriatic nail affections based on optical coherent tomography

Neznakhina M.S., Petrova G.A., Garanina O.Y., Shlivko I.L.


Psoriatic nail affection is difficult to diagnose, especially if there are no specific skin changes, and is resistant to traditional treatment methods. The absence of any reliable diagnostics criteria often results in diagnostics errors, inadequate treatment and reduced life quality. Goal. To assess the efficacy of Daivobet for isolated psoriatic nail affections based on optical coherent tomography. Materials and methods. The study involved 10 patients (4 male and 6 female) aged 19—38 (mean age: 27.5 years) including four subjects with isolated psoriatic nail affections (oil spots and dotty cavities on the nail plate) and six subjects with psoriatic nail affections with paronychias (psoriatic plaques and thimble symptom on the nail folds and adjacent skin). The area of the psoriatic affection of the nail plate was 30%—70%. The efficacy of Daivobet and nail condition was clinically monitored by using the optical coherent tomography method and recording the NAPSI index. Tests were performed prior to the treatment and 3 and 6 weeks after the treatment onset. Results. A positive trend with regard to psoriatic paronychia in the form of regressed infiltration was observed against the background of treatment by Week 3 of the treatment, and complete regression of eruptions was observed by Week 6. In all of the subjects, a healthy nail plate grew by 2—3 mm and complete regression of the dotty cavities was observed during Week 6 of the study, which correlated with the reduced PASI index and positive trends based on optical coherent tomography data.
Vestnik dermatologii i venerologii. 2013;89(3):56-62
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Pityriasis rubra pilaris with the concomitant Leser — Trelat syndrome

Butareva M.M., Znamenskaya L.F., Bezyayeva Y.S., Kappusheva I.A.


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.
Vestnik dermatologii i venerologii. 2013;89(3):64-71
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Atypical manifestation of idiopathic atrophoderma of Pasini and Pierini

Grebennikov V.A., Anisimov L.A., Gursky G.E.


The authors describe a case of idiopathic atrophoderma of Pasini and Pierini, which was difficult to diagnose, had no clinical signs of skin atrophy and was diagnosed only as a result of histopathology. A female patient aged 25 developed small-size spots of cyanochroic and brown color in the left-hand lumbar area, which formed a focus of irregular shape with the marble pattern without any signs of skin atrophy or compression. Similar foci later affected skin in the area of the left bladebone and left shoulder. However, histopathology revealed atrophic manifestations and a light form of sclerosis in the subepidermal zone of the affected skin, which made it possible to diagnose the condition, and the administered treatment demonstrated positive clinical dynamics.
Vestnik dermatologii i venerologii. 2013;89(3):72-75
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New potential of the treatment of atopic dermatitis in children and adults

Proshutinskaya D.V., Butareva M.M., Inoyatova L.A.


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.
Vestnik dermatologii i venerologii. 2013;89(3):78-82
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Clinical experience of using 0.1% mometasone furoate cream for external treatment of steroid-responsive dermatoses

Statsenko A.V., Belousova I.E., Khairutdinov V.R., Parfenova M.A.


An up-to-date synthetic non-fluorated topical glucocorticosteroid, Histan-N (0.1% mometasone furoate cream), has an evident antiinflammatory, anti-allergic, immune-suppressive and antiproliferative action. Goal. To assess the efficacy, safety and tolerability of Histan-N for the treatment of patients with steroid-responsive dermatoses. Materials and methods. As many as 80 patients with eczema, psoriasis, atopic dermatitis, dermatitis and allergic dermatitis as well as lichen acuminatus underwent treatment. All of the patients received general pathogenetic therapy and external treatment with Histan-N. The treatment efficacy was assessed based on the trends of such dermatological indices as PASI, SCORAD and EASI as well as visual analog scale. Results. Dermatological indices reduced by 70%—90% as compared to the baseline against the background of treatment. Conclusion. The clinical results obtained for Histan-N demonstrate a substantial clinical effect of the drug, absence of adverse effects and high safety of the drug.
Vestnik dermatologii i venerologii. 2013;89(3):84-87
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Systemic therapy of acne in teenagers

Sergeyeva I.G., Krinitsyna Y.M., Makarova N.G., Dyagileva A.A.


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.
Vestnik dermatologii i venerologii. 2013;89(3):89-94
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Treatment of localized scleroderma with hyaluronidase

Dvornikov A.S.


Goal. To evaluate the efficacy of treatment of patients suffering from localized scleroderma with Longidaza. Materials and methods. The study sample included 300 patients with localized scleroderma (158 with the plaque form and 142 with white spot disease) treated with Longidaza in 2002—2010. Results. Complex therapy of patients suffering from localized scleroderma with Longidaza proved to be efficient in 71.3% of the patients. Conclusion. These results confirm that inclusion of the Russian enzymatic drug Longidaza into the complex treatment of patients suffering from the aforesaid pathology seems to be expedient.
Vestnik dermatologii i venerologii. 2013;89(3):96-100
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Atopic dermatitis: optimizing the topical therapy

Batyrshina S.V., Khaertdinova L.A., Malanicheva T.G., Khalilova R.G.


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.
Vestnik dermatologii i venerologii. 2013;89(3):102-111
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Photoprotection in contemporary dermatology and cosmetology: traditional issues and new data

Aravijskaya E.R., Sokolovsky E.V.


The paper contains information of UVB and UVA influence on the various structures of the skin. Main principles of modern photoprotection, sunscreens as well as photoprotective role of clothes are discussed.
Vestnik dermatologii i venerologii. 2013;89(3):114-118
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Russian Dermatovenerology in 1940—1949

Prokhorenkov V.I., Belova-Rakhimova L.V., Guzey T.N.


The history of development of dermatology in Russia and in the USSR in 1940—1949 is described.
Vestnik dermatologii i venerologii. 2013;89(3):120-125
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A.V. Samtsov. On the 60th anniversary

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Vestnik dermatologii i venerologii. 2013;89(3):126-127
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K.N. Monakhov. On the 55th anniversary

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Vestnik dermatologii i venerologii. 2013;89(3):128-129
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