Vol 96, No 6 (2020)

Historical aspects of etiopathogenesis and treatment of syphilitic infection in Russia (report I)
Chebotarev V.V., Zemtsov M.A., Odinets A.V., Chebotareva N.V.
Abstract

In the historical aspect, experimental studies conducted by domestic and foreign researchers on the study of T. pallidum are presented. The incubation period and its progress through the lymphatic and circulatory pathways are established. We studied the clinical manifestations of syphilis in monkeys and rabbits corresponding to the stage manifestation in a patient with syphilis. The nature of immunity, concepts of super-and reinfection, hidden forms of syphilis, generalization of infection with damage to the nervous, cardiovascular system and visceral organs. Drugs for the treatment of patients with syphilis in the pre-penicillin period are highlighted.

Vestnik dermatologii i venerologii. 2020;96(6):7-13
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DERMATOLOGY: Original Studies
Skin cytokine profile in patients with mycosis fungoides
Karamova A.E., Nikonorov A.А., Verbenko D.A., Znamenskaya L.F., Vorontsova A.
Abstract

Aim of the study. To determine the concentration of cytokines in the skin of patients with mycosis fungoides and correlations between their concentration and the value of the modified scale for assessing the severity of skin lesions mSWAT.

Methods. The concentration of cytokines was simultaneously determined using xMAP technology: IL-1â, IL-4, IL-6, IL-10, IL-17A, IL-17F, IL-21, IL-22, IL-23, IL-25, IL -31, IL-33, IFN-ã, sCD40L, TNF-á in skin biopsies of 21 patients with early (IA—IIA) stages of mycosis fungoides and 4 healthy individuals. Analysis and visualization of the obtained data were carried out using R Statistical Software for MacOS (version 1.3.1056), a free open source software development environment for the R programming language.

Results. An increase in the level of IL-4 and TNF-á in the lesions in patients with mycosis fungoides compared with healthy individuals was shown (p = 0.025 and p = 0.012, respectively). Correlation analysis revealed the formation of cytokine networks in the skin of patients with mycosis fungoides that were not associated with the value of the modified scale for assessing the severity of skin lesions mSWAT. A tendency towards a negative relationship between the mSWAT and IFNã scales was found (p = 0.056).

Conclusion. None of the cytokines in lesions and visually unaffected skin from patients with mycosis fungoides were associated with mSWAT values.

Vestnik dermatologii i venerologii. 2020;96(6):14-19
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Treponema pallidum tprII subfamily genes internal fragments sequencing
Plakhova X.I., Chestkov A.V., Abuduev N.K., Vasiliev M.M.
Abstract

Background. The modern system of molecular typing of the Russian population of T. pallidum makes it possible to obtain results with a significant dominance of the 14d/f type, which determines the need to increase the differentiating ability of the applied methods of molecular typing of T. pallidum.

Aim. Identification and analysis of nucleotide sequence variability of internal gene fragments of the tprII family of Russian T. pallidum subsp. pallidum strains.

Material and methods. The study of internal variable fragments of genes of the tprII family was carried out among 240 clinical isolates of T. pallidum obtained from the Central (Kaluga Region, Moscow), North Caucasian (Stavropol Territory), Far East (Republic of Sakha), Volga (Chuvash Republic), Southern (Astrakhan Region) and Siberian (Novosibirsk and Omsk Regions, Republic of Tyva) federal districts in 2014–2020. The sequence of internal variable fragments of genes of the tprII family was determined using capillary sequencialng technology.

Results. The primers allowing both direct amplification of the internal variable region of the tprII genes subfamily and correct sequencing of their internal regions have been proposed. It was found one SNP at positions 1340 of tprG gene. The polymorphism differs the reference Nichols strain from globally distributed Street 14 genogroup variants.

Conclusion. The variability of tprII subfamily genes nucleotide sequences in modern Russian strains of T. pallidum subsp. pallidum is an additional fund to increase the efficiency of the modern T. pallidum molecular typing system.

 

Vestnik dermatologii i venerologii. 2020;96(6):20-28
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Experience of using an emollient with an anti-inflammatory effect based on ammonium glycyrrhizinate in the complex therapy of patients with atopic dermatitis
Khairutdinov V.R., Samtsov A.V.
Abstract

Background. Despite the advances achieved in recent years in the treatment of AD, prevention and rehabilitation of patients, who suffering from this disease, belong to the most difficult tasks of practical dermatovenerology.

Objective. The aim of this study was to assess the efficacy, safety and tolerability of Reglisam Cream in the complex therapy of patients with atopic dermatitis.

Methods. The study involved 48 patients with atopic dermatitis, who were divided into two groups. There were two observation periods for each patient: 28 days — the period of exacerbation therapy, and 6 months — basic care and prevention of relapses.

In exacerbation period all patients used external moisturizers in addition to topical glucocorticosteroids: in group I (study group) patients applied Reglisam Cream to the skin; in group II (control group) — cold cream. After the period of exacerbation patients of group I were prescribed basic therapy Reglisam Cream for 6 months, patients of group II — cold cream. In each group were assessed the therapeutic efficacy, safety and tolerability of treatment. During the study were conducted registration of adverse events, assessment of the dermatological status with the determination of the intensity of pruritus according to the visual analogue 10-point scale, the calculation of the severity index of the disease and the area of the lesion in eczema / atopic dermatitis (EASI) and the dermatological index of quality of life (DLQI), measurement of skin moisture, general clinical research.

Results. In the first 28 days of acute atopic dermatitis period therapy, the EASI index decreased on average by 76% — from 20.4 to 4.8 points (p < 0,05), in group II — by 57% — from 19.7 to 8.4 points (p < 0,05); the intensity of pruritus after treatment with Reglisam Cream in the dynamics decreased by 70% and amounted to 2.3 points, which was lower than in the comparison group — 4.1 points (p < 0,05); the level of skin hydration in group I was 36.8 units, during the treatment period increased by 80%, and was higher than in group II — 26.7 units. (p < 0,05); DLQI in group I decreased by 68%, amounting to 4.7 points, and was almost 2 times less than in group II — 9.2 points (p < 0.05).

In group I for 6 months were registered a statistically lower frequency of exacerbations of atopic dermatitis (28%) than in group II (63%). The average duration of atopic dermatitis remission in group I was 22.4 weeks, for 4 weeks more than in group II (p < 0,05). Meanwhile the average duration for the exacerbation period of atopic dermatitis in group I was more than 3.5 times less in comparison with group II; the average EASI in group I did not exceed 6.4 points and was significantly lower than that in group II (p < 0,05).

Conclusion. The use Reglisam Cream as basic skin care in patients with AD increases the duration of remission and reduces the frequency and duration of relapses of the disease, leads to an improvement the quality of life, a decrease in the intensity of pruritus and a significant increase in the moisture content of the stratum corneum of the epidermis. The obtained clinical results allow us to recommend Reglisam Cream as an effective external agent in the complex therapy of patients with AD.

Vestnik dermatologii i venerologii. 2020;96(6):29-35
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CLINICAL CASE REPORTS
Exceptional case of a granuloma faciale with extrafacial involvement
Shpiliyuk R.G., Antonova O.V., Belousova I.E., Samtsov A.V.
Abstract

The description of obsevation of rare dermatosis granuloma faciale is presented. Modern view about etiology, clinical picture, pathogenesis of GF is mentioned. Modern ways of treatment are considered.

Vestnik dermatologii i venerologii. 2020;96(6):36-41
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Syphilis in the practice of doctors of related specialties
Evseeva A.L., Ryabova V.V., Koshkin S.V., Kovrova O.S.
Abstract

The article presents clinical cases of syphilitic infection from our own practice, which were not recognized by doctors of related specialties at the early stages of the development of the disease. In the first observation, the manifestations of syphilis were regarded as a surgical pathology in the patient, which entailed surgical intervention, which was not necessary as such. The following clinical case demonstrates lesions of the mucous membranes in syphilis, mistakenly recognized by the therapist as streptococcal angina. The atypical hard chancre in the final observation disorientated the surgeon, that led to a delay in the correct diagnosis and, accordingly, in the appointment of adequate treatment. Regardless of the specialty, everyone should not forget about the variety of manifestations of syphilis in all periods. The lack of alertness among doctors of related specialties contributed to the delayed diagnosis and the appointment of specific anti-syphilitic therapy.

Vestnik dermatologii i venerologii. 2020;96(6):42-47
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Study of the psychoemotional status of patients with medium and severe acne severity on the background of isotretinoin monotherapy (Sotret)
Konnov P.E., Arsenieva A.A., Tokarev Y.A.
Abstract

Rationale. Acne vulgaris is a widespread chronic disease with no age, gender, or race restrictions. It does not pose a direct threat to the patient's life, but is reflected in his psycho-emotional status, which requires appropriate medical intervention.

Purpose of the study. To study the psychoemotional status of patients aged 22–24 years with moderate and severe acne and its changes during monotherapy with isotretinoin (Sotret).

Methods. In an open, non-randomized study lasting 12 months, 310 students of the Samara State Medical University were included (52% — healthy, 33% — with mild acne, 13% — with a moderate degree, 2% — with a severe degree). All patients in the study before treatment and after 3, 6, 12 months were assessed the severity of the course using the dermatological index of acne (DIA); quality of life assessment — using the Cardiff Acne Disability Index (CADI scale); assessment of the psychological and social impact of acne using the APSEA questionnaire. All patients received monotherapy using the drug Erase. The median and interquartile distance Me (Q3-Q1) were indicated as descriptive statistics. The Wilcoxon signed rank test was used to compare related groups. The comparison was carried out with 95% confidence.

Results. An analysis of the assessment of the psychological and social status of patients with moderate and severe acne before treatment, 3, 6, 12 months after the start of treatment with isotretinoin (Erase) is presented. The study included 36 people (20 women and 16 men) aged 22 to 24 years with a disease duration from 1 to 10 years. The results of psychological testing at various intervals gave comparable data: all patients had a pronounced persistent level of social maladjustment. An important indicator of the effectiveness of acne therapy with isotretinoin is the frequency of cases of the formation of a persistent clinical effect from treatment, which is clearly expressed in the restoration of the psycho-emotional background of patients, improving the quality of life of patients.

Conclusion. An important indicator of the effectiveness of acne therapy with Erase is the frequency of cases of the formation of a stable clinical effect of treatment, which is clearly expressed in the restoration of the psycho-emotional background of patients, improving the quality of life of patients. The treatment allowed us to change the psychoemotional background of our patients for the better, which increased their motivation to study, communication, and the desire for self-development.

Vestnik dermatologii i venerologii. 2020;96(6):48-55
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Seborrheic dermatitis: comparative effectiveness of standard and intermittent external therapy
Vasiliev-Stupalsky E.A.
Abstract

Background. The chronic and recurrent nature of seborrheic dermatitis, its wide prevalence and multifactorial etiopathogenesis require a comparison of the effectiveness of different treatment strategies.

Aim. In a randomized controlled trial to evaluate the effectiveness of standard and intermittent therapy with topical corticosteroids and activated zinc pyrithione (Skin-cap cream) in reducing the severity of clinical manifestations, the duration of remission of the disease, and compliance with treatment.

Methods. The effectiveness of external therapy in patients with seborrheic dermatitis of the face and scalp was studied. All the examined patients had at least two episodes of exacerbation per year. Doctor's prescription — Mometasone furoate cream 0.1% 1 time/day externally for 14 days, activated zinc pyrithione (Skin-cap cream) 2 times/day externally for 14 days, further 1 time a day 2 times a week for 14 days.

Results. There was a comparable clinical effectiveness of antiinflammatory therapy in the short term with more stable results of intermittent therapy with the use of (Skin-cap cream) in the long term.

Conclusions. Usage of activated zinc pyrithione (Skin-cap cream) according to the intermittent scheme in the treatment of seborrheic dermatitis of the face with the transition to the scalp is associated with long-term results. Safety of medicine allows to use it pro re nata by patients, e.g., in case of increased stress levels, diet incompliance, with no risks of adverse events, specific to topical corticosteroids, those increases treatment compliance.

Vestnik dermatologii i venerologii. 2020;96(6):56-64
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