Vol 91, No 1 (2015)

The article presents the results of the studies on the effectiveness of treatment basal cell carcinoma of the skin with photodynamic therapy with 5-aminolevulinic acid and methyl aminolevulinate. The results of the comparing trials between photodynamic therapy with methyl aminolevulinate and different other treatment modalities are presented.

The article describes modern methods for diagnostics of clinical, subclinical and latent forms of the papilloma viral infection. The authors reviewed different methods of the destruction of anogenital warts and described their advantages and shortcomings. They provide the results of studies of the efficacy of Imiquimod for the treatment of anogenital warts.

Goal. To develop a personalized approach to the administration of an anti-cytokine therapy to patients suffering from moderate to severe and severe forms of psoriasis based on clinical and immunological parameters. Materials and methods. The authors treated 79 patients suffering from moderate to severe and severe forms of psoriasis vulgaris using anti-cytokine drugs; they assessed the clinical efficacy of the therapy taking into account changes in the PASI index and assessed the levels of cytokines (IL-4, IL-6, IL-17, TNF-α, IL-20, IL-22, IL-31, IL-12, IL-11, IL-18), intercellular adhesion molecules, vascular endothelial growth factor (ICAM-1,VEGF) in the blood serum of patients prior to and in the process of treatment. Results. The authors determined the criteria for a personalized approach to the administration of anti-cytokine drugs.

Goal. To assess the therapeutic efficacy of the rotation of mid-wavelength ultraviolet therapy (311 nm) and PUVA therapy in patients with moderate to severe forms of psoriasis, and to assess the efficacy of mid-wavelength ultraviolet therapy (311 nm) in a multiple-course therapy. Materials and methods. The study involved 66 patients with moderate to severe forms of psoriasis who received multiple courses of treatment by methods of the PUVA therapy and narrowband mid-wavelength phototherapy (311 nm). The patients were divided into three groups: Group 1 (n = 20) - patients who received treatment in the form of mid-wavelength ultraviolet therapy (311 nm) after multiple courses of PUVA therapy; Group 2 (n = 26) - patients who received only multiple courses of PUVA therapy; Group 3 (n = 20) - patients who received only multiple courses of mid-wavelength ultraviolet therapy (311 nm). Results. The authors determined high efficacy (82.8%) of mid-wavelength ultraviolet therapy (311 nm) in patients with moderate to severe forms of psoriasis vulgaris who had previously received multiple courses of PUVA therapy. After multiple courses of long-term treatment by mid-wavelength ultraviolet therapy (311 nm), patients with moderate to severe forms of psoriasis had high efficacy of such multiple courses of treatment (85.78%). Conclusion. Patients with moderate to severe forms of psoriasis who had previously received multiple courses of PUVA therapy can be switched to mid-wavelength ultraviolet therapy (311 nm) with the maintenance of high efficacy of such treatment. The authors observed the absence of any adaptation to the spectral range of mid-wavelength ultraviolet therapy (311 nm) in case of multiple courses of treatment.

Goal. To obtain information on typical errors in medical aid rendered to acne patients in dermatovenerology dispensaries in St. Petersburg in order to develop measures to improve the quality of medical aid rendered to this group of patients. Materials and methods. The authors conducted a special expert examination of 55 patients with acne who received treatment at St. Petersburg dermatovenerology dispensaries in 2013. The quality of medical aid was assessed using the Automated Expert Examination Technique (hereinafter referred to as AEET). Major results. The percentage of cases when medical aid of due quality was rendered to acne patients was 49%. Treatment and diagnostics errors prevailed in the structure of errors in medical aid. Errors in treatment were mainly a wrong combination of drugs, simultaneous administration of external and systemic antibacterial drugs, delayed comedolytic therapy and pathogenically infeasible therapy. Errors in diagnostics included absence of indications of the form and/or severity of acne. The most important error in the collection of information was absence of gynecology examinations for women to determine whether peroral contraceptives were necessary including in case of the administration of isotretinoin. Conclusion. The similarity of errors in medical aid rendered for acne as well as high percentage of errors relating to medical aid rendered to patients demand the development of consistent measures to improve the quality of medical aid rendered to such patients and repeated expert examination using preliminary (prompt) control of the quality of medical aid.

The authors present a clinical case study of squamous cell carcinoma in a psoriasis patient after 24 courses of phototherapy (22 courses of PUVA therapy and two courses of mid-wavelength ultraviolet therapy (311 nm)). The malignant neoplasm developed against the background of signs of a chronic photodamage of the skin: lentigo, actinic elastosis, diffuse hyperpigmentation, spotty skin pigmentation.

Objective. To assess the duration of the therapy needed for complete eradication of clinical manifestations of allergic contact dermatitis (ACD) and evaluate how patients perceive cosmetic properties of Locoid, and to assess etiological factors of ACD based on the medical history. Materials and methods. The authors performed an open multicenter prospective observational program of observations of ACD patients receiving treatment with Locoid (in the form of Lipocream or Crelo). As many as 149 patients were involved. The patients received treatment with Locoid according to the routine practice until complete eradication of the lesions but for not more than 30 days. Prior to the onset of treatment, the etiological factor that caused ACD was evaluated. Upon the completion of the therapy, patients completed questionnaire forms to assess the cosmetic properties of the drug. Results. The authors demonstrated high clinical efficacy of the drug: ACD symptoms were eradicated in 96.64% of the patients; the median treatment duration amounted to 7 days. Cosmetic properties of the drug and general satisfaction with treatment were high regardless of the drug form (Lipocream or Crelo). In the sample under observation, the use of different cosmetic products was the most frequent reason of ACD. High safety of Locoid was demonstrated: adverse events were observed in one patient only. Conclusion. The duration of the therapy needed for complete eradication of clinical manifestations of allergic contact dermatitis is 7 days (median: quartiles of 5-9 days). The perception of cosmetic properties of both Locoid drug forms (Lipocream or Crelo) is positive; general satisfaction with treatment is high and does not depend on the drug form.

The article presents data on clinical forms of warts associated with different types of human papillomavirus. The authors analyze the following wart treatment methods: excision, chemical and immune. Based on literature sources, the authors assess the efficacy, advantages and disadvantages of well-known treatment methods. The authors describe their own experience of treating primary and recurrent vulgar and plantar warts with an up-to-date chemical destruction drug - Mardil Zinc Max, a solution containing a complex compound of 1.5% zinc 2-chloropropionate in 2-chloropropionic acid. The efficacy of treatment of vulgar warts was 100%, and that of plantar ones - 62.5%. Clinical recovery was observed both in case of primary and recurrent processes. The treatment had no adverse effects or complications and was characterized by a low injury rate, good tolerance and full tissue recovery without any cosmetic defects.