Vol 89, No 5 (2013)

The article describes the key achievements and problems related to studying neurosyphilis. It also shows the dynamics of neurosyphilis incidence in Russia and abroad from the early twentieth century and up to present. The article also describes issues related to the pathogenesis, clinical course and pathomorphism of the disease. The authors present current approaches to the laboratory diagnostics of neurosyphilis.

Goal. To determine the nucleotide protein-coding PERP gene sequence and assess the relation between the revealed mutations/polymorphisms and development of true acantholytic pemphigus as well as particular features of its course. Materials and methods. The protein-coding PERP gene DNA sequence was studied by the sequence analysis method in 18 patients with true acantholytic pemphigus. Results. Two polymorphisms were discovered in patients with true acantholytic pemphigus in Exon 3 of the PERP gene for the first time: rs648802 (non-synonymous) and rs648396 (synonymous). The incidence of wild type genotypes in the revealed polymorphisms (С/С genotype rs648802 and Т/Т genotype rs648396) in healthy volunteers reliably exceeded that in patients (p = 0.049). Patients with true acantholytic pemphigus are characterized by a higher incidence rate of mutant heterozygous genotypes С/G rs648802 and Т/C rs648396 (p = 0.09). Mutant heterozygous genotypes of the polymorphisms (G/G genotype rs648802 and С/С genotype rs648396) were revealed in patients with the earlier onset of the disease (41-60 years) (p = 0.025) more often while heterozygous genotypes (С/G genotype rs648802 and T/С genotype rs648396) were revealed when the disease developed at the age of 61 or older more often (p = 0.01). Conclusion. Identification of the polymorphous genotype by the sequence method or other molecular methods (e.g. PCR) can be used to forecast the terms when true acantholytic pemphigus can emerge in genetically inclined patients. However, it should be noted that it is necessary to specify the preliminary results obtained based on a greater sample of patients with true acantholytic pemphigus.

Neurotransmitters such as neuropeptides and neurotrophins can have an effect on the development of a skin inflammatory reaction and itching as well as condition of nerve fibers. Goal. To assess the expression of neuropeptides and neurotrophins in the skin of patients with atopic dermatitis. Materials and methods. Expression of neuropeptides of substance P and SP-R receptor, calcitonin gene-related peptide (CGRP) and CGRP-R receptor, neurotrophin (nerve growth factor) and TrkA receptor as well as amphiregulin enhancing the growth of nerve fibers and semaphorin-3A terminating the growth of nerve fibers was determined in the skin of patients with atopic dermatitis based on the immunohistochemistry analysis method. Expression of protein PGP9.5 being a marker of nerve fibers was also determined. Results. The authors discovered penetration of nerve fibers expressing substance P and CGRP into the epidermis in patients with atopic dermatitis. Expression of the nerve growth factor and amphiregulin was discovered in epidermis but no expression of semaphorin-3A was discovered. Conclusion. Nerve fibers expressing neuropeptides such as substance P and CGRP can penetrate into the epidermis in patients with atopic dermatitis, which can maintain the inflammatory reaction and itching in such patients. Expression of the growth factors (nerve growth factor and amphiregulin) can contribute to the growth of nerve fibers and their penetration into epidermis against the background of the absence of any expression of semaphorin-3A inhibiting their growth.

The article discusses problems related to optimizing differential diagnostics of Kaposi’s sarcoma using the immunohistochemistry analysis, in particular, identification of human herpes virus of the 8th type being the causative agent of the development of the disease.

Materials and methods. The composition of glyzyrrhizic acid and glutamyl-tryptophane in the form of cream was studied using white rats. ACD was induced by application of the ethanol-acetone solution of 2,4-dinitrochlorobenzene (DNCB) during 4 days. The investigational drug was applied to the ACD lesions once a day during 14 consecutive days. The severity of ACD was assessed by the condition of the lesion focus, morphological composition of blood and apoptosis rate in the lesion. Results. It was shown that 4 days application of DNCB causes typical skin lesion manifesting in local papulovesicular eruptions, excoriations, and forming crust on the surface of the lesion. Application of the topical drug Tiladerm in the form of cream on the lesion induces significant acceleration of the lesion focus rehabilitation as early as on the end of 14 day of treatment. The activation of the markers of apoptosis (Ki-67, to a less extend p-53, caspase-3, Bcl-2) in the ACD lesion was shown. During treatment with Tiladerm, Ki-67 expression was reduced while expressions of p-53 and caspase-3 were enhanced. Conclusion. Thus, Tiladerm showed prominent positive effect on experimental ACD in rats.

The article presents the results of the efficacy and safety assessment of the treatment of adult patients suffering from allergic dermatoses with different drug forms of methylprednisolone aceponate 0.1% (Advantan). The authors revealed high efficacy of the treatment of patients with atopic dermatitis and generalized eczema with the achievement of clinical remission and regression of the EASI index by 88.6-88.8% from the baseline level after three weeks of the drug administration; in patients with hand eczema after four weeks of treatment, and in patients with allergic dermatitis - after external treatment with methylprednisolone aceponate (MPA) 0.1% for two weeks; the patients' life quality improved after the treatment. Four weeks after the completion of the treatment, the skin of all the patients was nearly free from any eruptions while itching was negligible or absent. The efficacy of the differential administration of different drug forms of MPA 0.1% (Advantan) was demonstrated to localize eruptions in problem areas, on the skin in the area of the body and limbs, and according to particular features of clinical manifestations of dermatoses. The authors confirmed the safety of MPA 0.1% (Advantan) for the treatment of patients with allergic dermatoses as well as absence of any adverse effects in patients with AD, generalized eczema, hand eczema and allergic dermatitis within the aforesaid terms.