Vol 88, No 5 (2012)

Order

The article presents materials and analyzes the main trends in the epidemiology of psoriasis and follow-up of patients from this category in the Russian Federation for 2009—2011.

The authors present a review of current approaches to studying the pathogenesis of true acantholytic pemphigus that may reveal new targets for therapeutic treatment. They discuss methods used for the first time to study this lethal dermatosis, and the development of previously used methods that are still important for studying true acantholytic pemphigus.

Objective. Study of the chemotactic activity of macrophages and local production of cytokines in sterile skin inflammatory exudate in patients with generalized vitiligo (vitiligo vulgaris). Materials and methods. The authors conducted a study of 22 patients with generalized vitiligo and 22 healthy volunteers. The functional activity of macrophages was assessed with the use of the skin window method based on the method of D.N. Mayansky as amended by V.V. Klimov. The composition of sterile cell exudate was examined with the use of impression smears taken after 6 hours from an epidermis scarification section on the healthy and depigmented skin colored according to the Romanovsky-Gimza method with the use of light microscopy. In addition, cytokines were determined in the supernatant fluid of the skin window exudate from the vitiligo focus obtained by means of centrifugation. Results. The prevalence of mononuclear phagocytes over polymorphonuclear leukocytes was revealed in the depigmentation site, which confirms that macrophages take an active part in the disease pathogenesis (along with a high level of interleukin-18). A low level of IL-10 in the skin window exudate confirms that the suppressor effect in the melanocyte damage zone is weak. These results confirm the important role played by such cells of the immune system as phagocytes in vitiligo pathogenesis, which makes it possible to consider them as potential target cells for developing pathogenetically substantiated approaches to the treatment of the disease.

Objective. To compare the efficacy of the treatment of patients suffering from common warts with the use of laser destruction methods using a diode laser with the wavelength of 0.81 μm, electrocoagulation and liquid nitrogen cryosurgery. Materials and methods. The sample comprised 75 patients suffering from common warts on their wrists. The patients were allocated to three groups, and their therapy included treatment with diode laser irradiation with the wavelength of 0.81 μm electrocoagulation and liquid nitrogen cryodestruction. The treatment efficacy was assessed by the frequency and terms of relapses, nature of the developing scar and presence or absence of dyspigmentation. Results. A positive effect was registered in 76% of the patients in case of laser destruction, in 56% of the patients in case of electrocoagulation and in 44% of the patients in case of treatment with liquid nitrogen; a satisfactory effect was registered in 16, 20 and 32% of the patients, respectively. Relapses were observed in 8, 24 and 24% of the patients, respectively. The following benefits of the treatment of common warts with diode laser irradiation vs. electrocoagulation and liquid nitrogen cryodestruction were revealed: less painful procedure, rare adverse reactions and shorter terms of operative wound epithelialization.

The authors describe a clinical observation of a case of the atypical form of Erythema Annulare Centrifugum in an eight-year-old girl. They also present literature data concerning the etiology, clinical features and dermatosis differential diagnostics and treatment methods.

Long-term studies contributed to the formation of a separate line of dermatology - corneobiology. Studies of the composition and functions of the corneous layer defined the key directions in the therapy of dermatoses accompanied by an epidermal barrier failure. Corneal protectors formed on the basis of the dermal and membrane structure meet the key principles of corneotherapy while absence of emulsifying agents provides for the physiologic restoration of the epidermal barrier without its additional damage in the course of lipid delivery.

Objective: to assess the efficacy and safety of 0.1% Tacrolimus ointment in case of atopic dermatitis in adults during the period of exacerbation. Materials and methods. The authors conducted a study of 60 patients (37 male and 23 female patients) with atopic dermatitis aged 22—45 during the period of exacerbation. Topical therapy with Tacrolimus (0.1% ointment) was administered to 22 patients once a day for 14 days. A topical glucocorticosteroid belonging to the 3rd bioactivity class according to the European classification of topical glucocorticosteroids (Miller, Munro) (0.1% methylprednisolone aceponate ointment) was administered for the treatment of 38 patients suffering from atopic dermatitis. For the purposes of unbiased assessment of the efficacy and safety of the topical therapy with different drugs, the authors performed an ultrasonic skin examination using a digital ultrasonic high-resolution system, DUB (manufactured by TPM GmbH). Results: In the course of the therapy, the authors observed a reliable reduction in the prevalence and severity of dermatosis as well as normalization of a number of ultrasonic indices of epidermis and derma. Conclusion: The therapeutic efficacy of short-term administration of Tacrolimus is comparable by its anti-inflammatory action to such potent topical glucocorticosteroid as methylprednisolone aceponate. Unlike the topical glucocorticosteroid, administration of Tacrolimus for exacerbated atopic dermatitis does not accelerate any skin atrophy phenomena.

Objective. To assess clinical and morphological changes in the skin in patients with severe to moderate acne in the course of systemic treatment with isotretinoin in the form of LlDoSE. Materials and methods. The authors conducted a study of the clinical and morphologic state of the skin in 40 patients with severe to moderate acne, who were administered the treatment with systemic retinoids. Previous external therapy was inefficient in 70% of the patients. As many as 45% of the patients developed scars as a result of the regression of acne vulgaris. To visualize the structure of the epidermis, derma and subcutaneous layer, the authors used the ultrasonic skin scanning method at the frequency of 75 M. Results. The skin scanning images obtained as a result demonstrated the possibility of visualizing inflammatory components in the derma, differences in the skin density indices in different facial zones prior to the therapy and reduction in these indices against the background of the systemic therapy with isotretinoin by the third month of the treatment.

Objective. Assessment of the efficacy and safety of the correction of age-related neck skin changes with the use of botulinus toxin type A (Xeomin). Materials and methods. The study involved 25 women aged 39—65 enrolled according to the inclusion and exclusion criteria. The patients were administered a single subcutaneous injection of Xeomin 60 U in the neck. The efficacy and safety of this procedure was assessed based on the Global Aesthetic Improvement Scale (GAIS) on Day 14 as well as after 2 and 3 months. Results. High efficacy and safety of intracutaneous Xeomin injections at the submaximum dose of 60 u in the medial and lateral platysma bands have been confirmed clinically. The authors suggest an experimental gradining of the age-related neck making it possible to assess and statistically process clinical results of the new method.