Vol 96, No 4 (2020)

Dermatovenerological service of the Republic of North Ossetia — Alania: legal, medical, social problems and their solutions
Bazaev V.T., Kobaidze L.M.
Abstract

Analysis of the legal framework of the dermatovenerological service showed that it needs some adjustment. In the republican KVD, beds were not used rationally; in 2017, an increase in the incidence of infectious dermatoses was noted.

Vestnik dermatologii i venerologii. 2020;96(4):5-11
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DERMATOLOGY: Reviews
Physiological changes of the skin during pregnancy
Albanova V.I.
Abstract

The appearance of skin changes during pregnancy is inevitable and physiologically determined. This period is characterized by hormonal, immunological and metabolic changes and associated physiological changes in the skin. These include pigmentation (linea nigra, melasma, pseudoacanthosis, growth and appearance of pigmented nevi), changes in connective tissue (striae distensae, skin tags), blood vessels (stellate hemangiomas, erythema of the palms, vasodilatation, edema, cutis marmorata) and skin appendages (increased sebaceous and eccrine glands activity, reduced hair loss and increased hair density, onychodystrophy). It is important to inform women about possible changes, to recognize them in time to reduce the impact of their appearance on the health and course of pregnancy, as well as to avoid unnecessary tests and interventions.

Vestnik dermatologii i venerologii. 2020;96(4):12-21
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Assessment of CLA+T-cell subpopulations in the blood of patients with chronic dermatoses
Patrushev A.V., Samtsov A.V., Nikitin V.Y., Soukharev A.V., Gumilevskaya O.P., Sukhina I.A.
Abstract

Background. CLA+T-cell are an important component of skin-associated lymphoid tissue, and thus determine the pathogenesis of many immuno-mediated dermatoses.

Aims. Determine the relative number of CLA+T-cell subpopulations in the peripheral blood of patients with psoriasis, lichen planus and atopic dermatitis, as well as assess their impact on the severity of dermatoses.

Materials and methods. We examined 82 patients with psoriasis aged 19 to 62 years, 54 patients with lichen planus (LP) aged 18 to 54 years, 44 patients with atopic dermatitis (AD) aged 18 to 44 years, as well as 20 practically healthy individuals aged 18 to 52 years who were admitted to the clinic for the removal of benign skin neoplasms.

All patients underwent a standard clinical examination with the determination of indicators that characterize the severity of dermatosis: PASI (Psoriasis Area and Severity Index) — for patients with psoriasis, IPSLP (index of prevalence and severity of lichen planus) — for patients with lichen planus and SCORAD (Scoring of Atopic Dermatitis) — for patients with atopic dermatitis. Defining subpopulations CLA+T-lymphocytes were carried out on a flow cytometer «Cytomics FC500» by Beckman Coulter using appropriate combinations of direct monoclonal antibodies and isotopic controls. The groups were compared using the nonparametric Mann — Whitney test, and the differences were considered significant at p<0,05. To analyze the relationship between the severity of dermatosis and the relative content of subpopulations CLA+T-cells used Spearman's rank correlation coefficient.

Results. In patients with psoriasis, a significant increase in the percentage of the total number of T-lymphocytes positive for CLA (CLA+CD3+) and T-helpers positive for CLA (CLA+CD4+) (p=0,002 and 8,5×10–4, respectively), in patients with PL and AD only CLA+CD4+ lymphocytes (p=0,028 and 0,003, respectively). In the progressive period of psoriasis, a direct moderate correlation was found between the circulating subpopulation of cytotoxic T lymphocytes positive for CLA (CLA+CD8+) and the PASI index (rs=0,47; p<0,001), in the acute period of AD — between the CLA+CD3+ subpopulations and CLA+CD4+ cells and the SCORAD index (rs=0,53; p < 0,001 and rs=0,57; p<0,001, respectively). In PL, the severity of the course of dermatosis was not accompanied by any significant changes in the CLA-positive T-cell subpopulations.

Conclusion. The results of the study confirmed the important role of CLA+T cell subpopulations in the development of chronic dermatoses. In all groups (psoriasis, LP and AD), an increase in the relative number of CLA+CD4+ T-helpers was noted compared with the control group. The relationship between the severity of psoriasis and the relative number of CLA+CD8+ cytotoxic T-lymphocytes, and the severity of AD — with CLA+CD3+ and CLA+CD4+ T-helpers is also shown.

Vestnik dermatologii i venerologii. 2020;96(4):22-31
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Age correlations of acne vulgaris. Comparative study of microbiome and acne exposom at students of Kirov state medical university. Analysis of the results of therapy applicable to indicators of quality of life
Drozhdina M.B., Kolevatikh E.P., Trubnikova M.A., Kriazheva P.A.
Abstract

A modern review of the pathogenetic factors underlying acne vulgaris, genetic determinism, and the influence of exposure factors on the formation of the disease are presented. The features of the microbiome and immunity indicators of this category of patients in the student population were studied. The clinic of various forms is described depending on the age gradation. The optimal therapeutic tactics, including those preventing the formation of antibiotic resistance, are substantiated. Clinical cases with a successful therapeutic outcome are presented.

Vestnik dermatologii i venerologii. 2020;96(4):32-42
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GUIDELINES FOR PRACTITIONERS
Treatment of the nevus sebaceous of Jadasson by a copper vapor laser
Ponomarev I.V., Topchy S.B., Andrusenko Y.N., Shakina L.D.
Abstract

Introduction. Nevus sebaceous of Jadassohn (synonym: nevus of the sebaceous glands) (NSG) presents the congenital malformation of the skin with possible transformation into benign or malignant tumors during the adolescence or adulthood. Commonly appeared on the scalp or neck NSG is frequently concern with cosmetic problems making patients look for opportunities for its removal. Surgical removal of the NSG is related to an elevated risk of scarring. Using ablative lasers has proven to be effective in the removal of small NSG. However, the removal of medium and large NSG with ablative lasers was reported to be linked with a high risk of scarring and recurrence. The removal of the medium-sized NSG with a copper vapor laser (CVL) is described here for the first time.

Case report and procedure. Laser removal of NSG (linear sized of 27 mm) was performed in a 25-year-old female patient with Fitzpatrick skin type II during eight CVL treatments. Laser settings were selected as follows: the average power of 1 W at the power ratio of 3:2 radiation at a wavelength of 511 and 578 nm. Pulse duration — 20 nanoseconds, reprate — 16.6 kHz, exposure duration — 200 ms, and the light spot's diameter on the skin — 1 mm.

Results. After 8 procedures, the skin in the area of the removed NSG acquired a natural color and appearance. During 24 months of follow-up, there was no hyperpigmentation or signs of scars in the irradiated area. No relapses were observed for 24 months after the CVL removal of NSG.

Conclusion. The application of non-ablative CVL removal of NSG ensured a desired cosmetic result without side effects.

Vestnik dermatologii i venerologii. 2020;96(4):43-48
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Targeted therapy of psoriasis: inhibition of the IL-23 signaling pathway — evidence from clinical studies and real practice
Hotko A.A., Pomazanova M.Y., Kruglova L.
Abstract

The article presents the results of clinical studies of the efficacy and safety of the use of a new drug of genetically engineered biological therapy guselkumab. Guselkumab is the first representative of the interleukin-23 (IL-23) inhibitor class and has a number of advantages over existing therapy.

According to direct comparative randomized clinical trials, guselkumab is superior in the short-term and, most importantly, in the long-term to most genetically engineered biologic drugs, including TNF-á inhibitors, secukinumab and ustekinumab.

In phase 3 studies (VOYAGE 1 and VOYAGE 2), the ECLIPSE study shows that guselkumab can achieve complete (PASI 100) and almost complete (PASI 90) skin cleansing by 16 weeks from the start of therapy in 37.4 and 73.3% of patients, respectively, with a subsequent increase in the proportion of patients with clean and almost clean skin by 24 weeks to 44.4 and 80.2%, respectively, and maintaining the achieved performance indicators for 4 years at the level of 51.7 and 84.0% respectively.

One of the potential advantages of IL-23 inhibitors is also the long-term maintenance of the achieved effect after treatment cessation. Guselkumab therapy is characterized by a favorable safety profile comparable to ustekinumab. During the follow-up period of patients in the course of randomized controlled trials of phase 3, data were obtained on the high safety of the drug and the absence of significant risks for serious infections, cardiovascular events, malignancies or suicidal tendencies. The drug is effective for insufficient response to adalimumab and ustekinumab.

The article presents 3 clinical cases of guselkumab use in patients with severe, including "problematic" psoriasis, comorbid pathology, with inefficiency or intolerance to systemic therapy, with secondary inefficiency of adalimumab. All patients managed to achieve a PASI of 90/100. No adverse events were observed.

Vestnik dermatologii i venerologii. 2020;96(4):49-59
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Vulgar psoriasis and squamous cell carcinoma in a patient with discoid lupus erythematosus
Dubensky V.V., Nekrasova E.G., Alexandrova O.A., Muraveva E.S.
Abstract

A rare case of a combination of vulgar psoriasis and squamous cell carcinoma of the penis in a patient with discoid lupus erythematosus is described. The literature data on the comorbidity of dermatoses are given.

Vestnik dermatologii i venerologii. 2020;96(4):60-66
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Disease of the island of Meleda or keratoderma of Meleda
Abduvaxitova I.N., Toxtayev G.S., Safarov K.K.
Abstract

Keratoderma is a group of dermatoses characterized by a violation of keratinization processes, excessive horn formation mainly in the area of the palms and soles. Under our supervision in the Tashkent regional skin and venereal clinic in the Department of dermatology was a patient Z. born in 2007, who was undergoing inpatient treatment for Meleda island disease. The rash is localized in the area of the palm and soles, changes and dystrophy of the nails. As a result of inpatient treatment (12 days), the Horny layers on the palms and soles decreased, especially in the Central part. All the cracks have fused, no new ones have been found. The severity of inflammatory phenomena, hyperkeratotic layers decreased, the area of the lesion and the intensity of itching decreased. The patient was discharged from the hospital with clinical improvement. This case is of particular interest to practical dermatovenerologists as a rare dermatosis

Vestnik dermatologii i venerologii. 2020;96(4):67-71
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