Vol 96, No 3 (2020)


Systemic treatment of psoriasis: from methotrexate to biologics

Olisova O.Y., Anpilogova E.M.


Psoriasis is one of the most frequent chronic inflammatory skin diseases and it has been of interest to many scientists for ages. The review presents data on all systemic treatment options, that are to date officially registered in Russian Federation for moderate-to-severe psoriasis. Aspects of the mechanism of action, efficacy and tolerability of both basic drugs (methotrexate, cyclosporine, acitretin) and biologics (infliximab, adalimumab, etanercept, certolizumab pegol, ustekinumab, guselkumab, secukinumab, ixekizumab, netakimab) and small molecules (tofacitinib, apremilast) are considered in detail. Special emphasis is placed on the important nuances of biological therapy: immunogenicity, drugs' survival and switch due to lack of efficacy. Invention of biologics signified a new era of moderate-to-severe psoriasis treatment. It became possible to achieve complete clinical remission more safely, which significantly improved the quality of life of patients. However, due to the unknown etiology of psoriasis, there is still no universal remedy that would allow to cure every patient, this fact makes scientists from all over the world keep conducting numerous clinical trials to find even more effective and safe therapeutic options.

Vestnik dermatologii i venerologii. 2020;96(3):7-26
pages 7-26 views


A new index to assess the severity of Lichen planus in clinical practice

Patrushev A.V., Samtsov A.V., Sukharev A.V., Minchenko A.A., Mamunov M.V.


Purpose. Development and validation of the severity index of lichen planus (LP).

Materials and methods. At the first stage, by means of theoretical substantiation, the main parameters and signs were identified that affect the severity of the disease and the quality of life of patients, which culminated in the derivation of the final index formula, which was called the lichen area and severity index (LPASI). At the second stage, LPASI was validated during the examination of 45 LP patients who were treated in the clinic of skin and venereal diseases of the Military Medical Academy in 2018—2019. Determination of LPASI was carried out by five dermatovenerologists independently of each other twice with an interval of one week.

The analysis of the results was carried out using STATISTICA 10.0 programs and SPSS Statistics 17.0. The Spearman — Brown and Pearson correlation coefficients were used to evaluate the intra-expert and inter-expert reliability of the index, and the Cronbach's alpha coefficient was calculated to assess the internal consistency of the scale.

Results. The final formula for calculating LPASI is as follows: 0.2 × A + 2 × B + 5 × С + D, where A is the area of skin lesions in percentage, B is the severity of clinical manifestations on the skin, C is the severity of clinical manifestations on the oral mucosa and D is the severity of subjective sensations. The index can range from 0 to 82.

The LPASI values for the whole group (n = 45) were characterized by a normal distribution of the trait (p > 0.05), the minimum and maximum values varied from 7.2 to 42 points, the median was 22 points, the interquartile span from 14 to 27 points. The values of the Spearman — Brown and Pearson coefficients were equal to 0.91 (95% CI — 0.89—0.99) and 0,87 (95% CI — 0.86—0.93), which indicates the reproducibility of the results and the reliability of the index. In this case, a high consistency between the selected features within the scale (Cronbach's alpha criterion — 0.93) was established.

Conclusion. Objectification of the severity of the disease using LPASI should become an integral part of the clinical examination of patients. The use of LPASI will allow to control the effectiveness of prescribed therapy, as well as to compare the results of scientific research.

Vestnik dermatologii i venerologii. 2020;96(3):27-33
pages 27-33 views

Assessment of knowledge of Novosibirsk students in the prevention of HIV infection and other STIs

Khryanin A.A., Shpiks T.A., Russkih M.V., Bocharova V.K.


The article presents information about a survey of 394 students from medical university and non-specialized institutions in Novosibirsk, in order to analyze the level of awareness about risky sexual behavior and prevention of HIV infection and STIs. The obtained information indicates a lack of awareness among young people about HIV/STIs. Students showed low alertness about their own safety. There was revealed a high degree of communicative tolerance among students. It was established, that students have a sense of tolerance for the uncomfortable feelings of the partner during communication, and the lack of ability to hide their negative emotions about non-communicative qualities of the partner.

Vestnik dermatologii i venerologii. 2020;96(3):34-42
pages 34-42 views


Treatment of сongenital melanocytic nevus in infants and children by a dual-wavelengths copper vapor laser

Ponomarev I.V., Topchy S.B., Pushkareva A.E., Andrusenko Y.N., Shakina L.D.


Introduction. Congenital melanocytic nevus (CMN) is detected at birth or shortly after birth in 1% of infants. The localization of CMN in aesthetically significant areas causes a decline in child self-esteem and causes concern for his parents. Surgical excision of skin areas with CMN is associated with an increased risk of cosmetic side effects and is often followed by long-term stress conditions after the invasive intervention.

Aim of the study. To evaluate the efficacy of the CMN removal in infants, children and adolescents with the dual-wavelengths copper vapor laser (CVL) radiation.

Patients and Methods. Medium-sized (up to 9 cm) single CMN was treated in nine fair-skinned patients: seven girls and two boys, aged from 2 months to 16 years. The procedures were carried out at an average CVL power of 0.6—1.0 W, with a power ratio of 3:2 at 511 nm and 578 nm wavelengths, and an exposure time of 0.2—0.3 s. Light spot diameter — 1 mm. The treatment was carried out during 2—10 sessions with an interval of 1—2 months between sessions.

Results. In children and adolescents, the treatment of CMN with CVL dual-wavelengths radiation made it possible to achieve significant clarification of the involved area without hypertrophic scars. The duration of the healing of the irradiated area lasted 2—3 weeks. Side effects were manifested with subtle skin atrophy.

Conclusion. The high efficacy of CVL removal of medium-sized CMN in infants and children using the dual-wavelengths CVL radiation without pronounced side effects allows introducing such an approach in the clinical practice of pediatric dermatologists and cosmetologists.

Vestnik dermatologii i venerologii. 2020;96(3):43-52
pages 43-52 views

Skin manifestations of a new coronovirus infection COVID-19 caused by SARS-CoV-2

Khryanin A.A., Sturov V.G., Nadeev A.P., Bocharova V.К.


The review is devoted to the skin manifestations of new coronovirus infection (SARS-CoV-2), information about which is constantly updated. However, this information has not been systematized yet. The purpose of this review is to analyze the dermatological manifestations of a new coronavirus infection. On average, 12.5—20.4% of patients with confirmed COVID-19 have developed skin manifestations. The question of whether the skin symptoms are a secondary consequence of a respiratory infection or a primary infection of the skin itself remains open at the moment. The possible mechanisms of development of skin lesions and the role of diseases of complement system and blood hypercoagulation in the pathogenesis of the disease are discussed in the article. The review also provides descriptive and clinical examples of skin manifestations in COVID-19. Since COVID-19 tends to be asymptomatic within 14 days, skin manifestations can be an indicator of infection, which leads to the timely diagnosis. In addition, doctors' awareness about skin symptoms associated with COVID-19 infection plays a big role in preventing misdiagnosis of the disease. The authors cite their own clinical сase of a patient with COVID-19 and associated skin angiitis.

Vestnik dermatologii i venerologii. 2020;96(3):53-62
pages 53-62 views


New technologies in topical acne therapy

Samtsov A.V.


The article is of an overview nature, it outlines the current understanding of the pathophysiology of acne, provides data on the role of retinoids in the treatment of dermatosis, discusses the advantages of combination therapy and new technologies in the treatment of acne.

Vestnik dermatologii i venerologii. 2020;96(3):75-79
pages 75-79 views


Clinical case of Bloch — Sulzberger syndrome

Krasnova N.V., Chernova T.A., Alekseeva I.V., Gimalieva G.G., Misyakova T., Sinitsyna L.G.


Purpose. To present a clinical case of Bloch — Sulzberger syndrome.

Material and methods. The examinations were performed to diagnose the disease: а visual examination of the skin, cytological analysis of the gallbladder fluid, general and biochemical blood tests, genetic research.

Results. During a visual examination of the skin, a differential diagnosis was made with infectious dermatitis, toxic-allergic dermatitis, epidermolysis bullosa and linear IgA-dependent dermatosis in children. Crucial in the diagnosis belonged to a genetic study, after which a deletion of exons 4—10 of the IKBKG gene was detected, which confirmed Bloch — Sulzberger syndrome.

Conclusion. Newborns with vesicle-bullous rashes entering the neonatal pathology department and observed by neonatologists require a thorough examination, a mandatory consultation of a dermatologist in order to determine further management tactics.

Vestnik dermatologii i venerologii. 2020;96(3):63-67
pages 63-67 views

Erythema nodosum as Leprosy reaction

Semenova V.G., Makarova L.L., Karamova A.E.


Purpose. To present a clinical case of leprosy exacerbation on the background of ongoing therapy.

Materials and methods. A 52-year-old patient with a diagnosis of "lepromatous (cutaneous) leprosy, leprosy LL" (multi-bacterial leprosy, lepromatous form, active stage), has an exacerbation in the form of nodular erythema at 3.5 years after the start of treatment. Due to the exacerbation of the leprosy process, dexamethasone therapy was performed intravenously in a dose of 4 mg/ml — 3.0 ml + 0.9% NaCl 200.0 ml daily No. 10.

Results. An exacerbation was diagnosed — leprosy nodular erythema. The prescription of adequate therapy led to a complete regression of clinical manifestations.

Conclusion. The described case is presented in connection with the rarity of this dermatosis.

Vestnik dermatologii i venerologii. 2020;96(3):68-74
pages 68-74 views

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