Vol 89, No 4 (2013)

The article presents data on different forms of hospitalization replacement technologies in foreign countries and in the Russian Federation. The author describes an experience of administering medical aid according to individual profiles under the conditions of hospitalization replacement technologies.

Dendritic cells regulate the balance between the immune response and immunotolerance; their role in the pathogenesis of skin lymphomas is underexplored. Goal. To study the number of populations of CD83+ and langerin positive cells in the skin of patients suffering from mycosis fungoides and small plaque parapsoriasis. Materials and methods. The authors determined the content of langerin-positive and CD83+ cells by means of immunohistochemistry of skin biopsy samples taken from patients suffering from mycosis fungoides (17 subjects) and small plaque parapsoriasis (6 subjects). The control group comprised 16 healthy people. Results. The study revealed that langerin positive and CD83+ dendritic cells prevailed in patients suffering from mycosis fungoides as compared to patients with small plaque parapsoriasis and healthy subjects. The share of immature dendritic cells grows in patients with parapsoriasis and mycosis fungoides. Conclusion. The statistically reliable difference between the amount of langerin positive and CD83+ dendritic cells as well as immature to mature dendritic cells ratio in case of mycosis fungoides vs. small plaque parapsoriasis can serve as an additional diagnostics criterion for these diseases.

As a result of studying the sensitivity indices concerning antimicrobial drugs (AMD) for 203 strains of N. gonorrhoeae obtained from patients suffering from the gonococcal infection in the Arkhangelsk region, it was established that the trends of N. gonorrhoeae strains propagation, which are resistant to AMD, match the trends in Russia in general. Ceftriaxone is the drug of choice to treat the gonococcal infection in the territory of the region. It was observed that N. gonorrhoeae strains started developing resistance to the AMD in the territory of the region. The authors conducted a study of 51 N. Gonorrhoeae strains obtained from patients suffering from the gonococcal infection in 2011 using molecular epidemiology methods (sequence and phylogenetic analysis). Heterogeneity in the sample of the N. gonorrhoeae strains circulating in the territory of the Arkhangelsk region as well as high rate of their genetic variability were revealed. It was noted that N. gonorrhoeae strains, which are unique for this geographic region (dominating sequence types No. 343, 5042, 1523, 1152, 387, 6238, 5825 and 6234 as well as single sequence types), are registered in the territory of the Arkhangelsk region. The authors demonstrated the possibility to use molecular methods (PCR and sequence analysis) for individual identification of infection sources and sexual partners of patients suffering from the gonococcal infection and for the purposes of epidemiological monitoring. The authors established associations between the fact that the N. gonorrhoeae strains obtained from patients suffering from the gonococcal infection in the Arkhangelsk region belong to sequence types No. 343, 285, 2625 and 6237, and their multi-resistance, which demands a thorough examination to determine the treatment tactics for such patients. Taking into consideration the results of these studies, the authors prepared recommendations on how to control the propagation of the gonococcal infection in the territory of the Arkhangelsk region.

The rare dermatosis febrile ulceronecrotic Mucha Gabermann’s disease is described. Etiology, pathogenesis, clinical and pathomorphological criteria of diagnosis, treatment of the disease are discussed. Based on the literature review describes the historical and current data classification of the disease and patient management tactics.

Goal of the study: to study the efficacy and tolerance of Acnecutan for the treatment of acne in teenager patients. Materials and methods. The study involved 43 patients aged 12-18 with moderate to severe acne, who received Acnecutan* as a monotherapy. The skin process dynamics was assessed visually based on the Basic Acne Severity Index (BASI). Results. Clinical recovery was achieved in 39 patients (90.7% of all cases), and clinical improvement was observed in 4 patients (9.3%). Conclusion. The results of Acnecutan administration demonstrate a high level of its efficacy and tolerance in teenagers. To assess the stability of the results achieved and to draw final conclusions, the patients will be followed up within a year after the end of the therapy. Therefore, the drug can be recommended as a monotherapy for acne of different clinical forms in teenager patients.

Goal. To assess the efficacy and safety of isotretinoin 0.025% in the form of a solution for external use for the treatment of patients with common acne. Materials and methods. Topical monotherapy with Retasol® (isotretinoin 0.025% solution for external application) was administered to 190 patients suffering from acne aged 12-30. Most of the patients (160 out of 190) suffered from the papulopustular acne while others suffered from the comedonal form. The solution was applied to the skin twice a day; the treatment duration was 3 months. Reduction in the amount of pimple components (comedones, papules, pustules, nodes and spots) and sebum secretion were considered as the key treatment efficacy indices. The drug safety was assessed based on subjective and objective data about any adverse events. Results. Application of the Retasol® drug produced a positive therapeutic effect in 170 patients out of 190 while complete clinical recovery was observed in 25 subjects. Application of the drug resulted in a substantial regression in all of the acne manifestations, in particular, comedones and excessive sebum secretion. Topical treatment with Retasol® did not entail any adverse events (except of the exacerbation reaction characteristic of any retinoid) or changes in blood and urine test. Conclusion. Retasol® (isotretinoin 0.025% solution for external application) is a highly efficient topical retinoid for the treatment of patients with comedonal and papulopustular acne forms and is characterized by a good safety profile.