Vol 90, No 5 (2014)

The pathogenesis of mycosis fungoides (MF) is not fully understood, nevertheless it is believed that the microenvironment of the tumor cells could influence the development of malignant lymphocytes. T-regulatory cells are a specialized subpopulation of T-lymphocytes, which can have an immunosuppressive effect and thus affect the immune response. Goal. The study population of regulatory T-cells in the skin of patients with mycosis fungoides and llaque parapsoriasis. Materials and methods. The content of Foxp3+ and CD3+ cells by immunohistochemical studies of skin biopsy specimens from patients with patch stage mycosis fungoides (10 patients) and plaque parapsoriasis (10 patients). The control group consisted of 16 healthy individuals. Results. Relative expression area Foxp3+ cells in patients with mycosis fungoides patch stage (0.44%) 2.6 times greater than in patients with plaque parapsoriasis (0,14%; p < 0,05). Part the Foxp3+ cells of the total number of T lymphocytes in patients with patch stage mycosis fungoides (5.9%) and plaque parapsoriasis (4.7%) were not significantly different (p > 0,05). Conclusion. In the initial stage of patients with mycosis fungoides determined a statistically significant predominance of the absolute number of T-regulatory cells in the epidermis and in the dermis. Part T-regulatory cells from all of T-lymphocytes in patients with skin patch stage mycosis fungoides and plaque parapsoriasis not statistically significantly different.

The article presents a case study of cutaneous leishmaniasis in a child. The patient stayed for several months in a leishmaniasis endemic area - in Tajikistan. This case is interesting from the point of view of verification of the infection that is not endemic in Russia.

Literary and own data on trichoskopy opportunities are presented with differential-diagnostic tools of non-cicatricial alopecia. Clinical data are discussed, the importance of a trichoskopy is established at diagnosis of patients with alopecia of different etiology.

Mainly elderly people with pale skin are affected by actinic keratoses (AK). Due to the demographic change, the prevalence of AK increased over the last years. An established risk factor is chronic UV-exposure (outdoor workers) inducing mutations of the tumor suppressor gene TP53 and the oncogene H-Ras. This leads to an intraepidermal proliferation of atypical keratinocytes. The term “field cancerization” characterises the presentation of multiple AK in UV-exposed areas. AK are also termed squamous cell carcinoma (SCC) in situ. The risk for AK turning into a SCC is 6-10%. In order to avoid invasive growth, an early treatment is recommended. During the last years multiple therapeutic options have been established. Depending on the clinical extent, lesion- or field-directed therapies with excellent clinical response and cosmetic results are available.

The article discloses current concepts of mechanisms of development of skin photoageing caused by UV irradiation (UVA and UVB). Chronic exposure of skin to UV irradiation results in damage of genome DNA, development of DNA mutations, damage of proteins, membrane lipids, collagen and yellow fibers, degradation of the intercellular substance of the skin, development of a chronic inflammation, immunosuppression, melanogenesis disorders and increased angiogenesis. The authors described major clinical manifestations of skin photoageing and their histological characteristics.

Treatment of acne is one of the important problems of modern dermatology. The goal of the research. The study of clinical efficacy and safety of the 15% azelaic acid in the form of Azelik-gel in the treatment of patients with papulo-pustular acne, mild to moderate in severity. Material and methods. Open comparative study of 8 weeks, which was attended by 75 patients. To assess the safety and efficacy of the therapy was performed clinical and biochemical blood and urine tests, evaluation of dermatological status, measurement of pH, moisture and oiliness of skin and analysis of DLQI. Results. 82% of patients receiving the Azelik-gel, marked clinical improvement or significant improvement. Conclusions. The results of the study indicate a high level of safety and tolerability of the Azelik-gel and obtained clinical results have shown its therapeutic efficacy in the treatment of papulo-pustular acne mild to moderate in severity.

The goals of the topical treatment of patients suffering from atopic dermatitis are suppression of the inflammatory reaction in the skin, elimination of itching, and recovery of the damaged protective lipid barrier of the epidermis. In this connection, topical glucocorticosteroids and skin moisturizers are used in the therapy of patients suffering from atopic dermatitis. Methylprednisolone aceponate (MPA, Advantan) being a topical glucocorticosteroid is characterized by high efficacy and safety. MPA is marked by the fast development of the therapeutic effect. This drug can be used for children older than 4 months and can be applied once a day. The availability of four dosage forms of MPA (emulsion, cream, ointment and fatty ointment) enables physicians to select a therapy with the use of this drug depending on the stage and localization of the skin lesion. Dexpanthenol (Bepanthen) being a tissue repair stimulator moisturizes the skin, protects the skin against an irritant effect, and restores the protective lipid barrier of the epidermis. The use of a combination of MPA being a topical glucocorticosteroid and dexpanthenol being a tissue repair stimulator can enhance the efficacy of the treatment of patients suffering from atopic dermatitis.

The article presents the results of a survey of the lines of development for specialized medical aid including high-end one taking into consideration the provisions set out in the Order issued by the President of the Russian Federation under No. 598 “On the improvement of the state policy in the field of health care” on May 7, 2012.

A lifelong path of glory: on the 70th anniversary of the Chair of Dermatovenerology, South Ural State Medical University