Vol 96, No 5 (2020)

Background. Population ageing is ongoing in the Russian Federation. Demographic changes may influence the age structure and dynamics of epidemiological rates of chronic skin disorders, as well as the need of elderly patients in specialized medical care.

Aims. To study the dynamics of number of cases, incidence and prevalence of psoriasis, and the dynamics of the number of hospital admissions for psoriasis among elderly population (males 60 years and older, females 55 years and older) in 2010–2019 in the Russian Federation.

Materials and methods. Analysis of federal statistic surveillance data, psoriasis prevalence and incidence rates among different age groups of population.

Results. In the Russian Federation there is an increase in absolute number of cases, prevalence and incidence rates of psoriasis among elderly population. There is an increase in the number of hospital admissions due to psoriasis among patients with psoriasis of this age.

Conclusions. An increase of the number and proportion of cases of psoriasis among elderly population is due to both, an increase of prevalence and incidence rates in this age group and population ageing. There is a high need in specialized medical care among elderly population with psoriasis.

The desire to maintain youth as long as it possible in modern society, especially among women of working age, is primarily due to the desire to be in demand, well-groomed and attractive. Currently, there are 5 main methods that contribute to improving the condition of the skin of the face, namely: the method using professional cosmetics, chemical peels, mesotherapy, treatment with an injection of botulinum toxin type A (BTA) and intradermal implants based on hyaluronic acid.

The aim of the literature review was to analyze the latest scientific data on the possibility of botulinum therapy in cosmetology.

Wrinkles of open areas of the body (primarily on the face and in the decollete) have a negative effect on the emotional background and quality of life of women. In this regard, recently there has been a significant increase in demand for aesthetic medicine services, one of the areas of which is botulinum therapy (BT). Botulinum toxin type A (BTA) is a powerful neurotoxin that inhibits the release of acetylcholine in the neuromuscular junction. Injections of small doses of botulinum toxin type A into targeted mimic muscles cause their relaxation, which smoothes the underlying layer of the skin, thereby regressing mimic wrinkles. Today, according to officially approved indications, it is used in cosmetology, botulinum therapy is used to correct mimic wrinkles in the upper third of the face, drooping corners of the mouth, in the complex correction of the face oval, in the treatment of axillary and palmar hyperhidrosis. Blocking a tear mediator like acetylcholine, not only the presynaptic membranes of neuromuscular synapses are rich, but also many anatomical structures, such as glandular tissue (sweat, other glands, etc.). This commonality of the mechanism of action on various physiological processes in our body allows us to make an assumption about the great potential of botulinum therapy in the treatment of a number of diseases associated with impaired neuromuscular conduction.

Background. Acne is one of the most common chronic dermatoses, which occurs in almost 85–90% of the population. The disease manifests itself as polymorphic eruptions and is characterized by a recurrent and torpid course. Acne treatment is constantly improving, requires an integrated approach and long courses of therapy.

Aims. To increase the effectiveness of acne therapy using new opportunities and promising methodological approaches using a combination of the therapeutic effects of platelet-rich plasma (PRP) and topical bacteriophage therapy.

Materials and methods. The study included 30 patients with papulopustular acne of mild and moderate severity. Patients with mild acne were treated with PRP procedures as monotherapy. For moderate acne, PRP therapy was combined with regular applications of a staphylococcal bacteriophage (NPO “Microgen”, Nizhny Novgorod, Russia). The treatment was carried out on an outpatient basis: at least 3 procedures with an interval of 1–2 weeks (up to a maximum of 6 procedures within one year). The results were analyzed using descriptive statistics and the parametric Student's t-test. Data processing was carried out using the Biostat software. The value of the level of statistical significance of differences was taken as p ≤ 0.05.

Results. Evaluation of the effectiveness of treatment was carried out on the basis of an analysis of the immediate outcomes of the disease, the dynamics of clinical symptoms and the severity of acne: regression of inflammatory elements of acne, a decrease in the phenomenon of seborrhea, improvement of the skin relief. As a result of the therapy, a transition to remission was noted in 16.6% of patients, an improvement in their condition — 36.7%, a significant improvement — 46.7%.

Conclusions. An integrated approach combining PRP procedures and bacteriophage therapy can serve as a pathogenetically substantiated strategy for treating acne. A promising direction for further research is the development of new regimens and combinations of alternative therapeutic strategies using bacteriophages.

The relationship between disorders of iron metabolism and alopecia, in particular telogen hair loss (THL), remains poorly understood and requires further research.

Goal. To assess changes in the dynamics of growth and hair condition in women with an iron deficiency state during systemic therapy with iron supplements in combination with and without physiotherapy.

Methods. An open-label, randomized, comparative interventional study with a duration of 6 months included 26 female aged 19 to 54 years (38.8 ± 8.9 years) with complaints of hair loss, changes in their structure, dryness and / or hair brittleness; with preserved menstrual cycle and mild iron deficiency anemia (IDA, Hb 101–120 g/l). Trichoscopy and phototrichogram were performed with processing of the results in the TrichoScienceProv1.1 program. The changes in the dynamics of hair growth and condition were assessed against the background of the use of iron supplements in combination with physiotherapy and without physiotherapy. Pulsed alternating sinusoidal current of high frequency, high voltage and low strength was chosen as a physiotherapeutic method for the treatment of THL.

Results. Against the background of the therapy, an increase in the Hb level (p < 0.001) and a positive dynamics of trichological parameters in all patients were noted, the severity of which was higher when the therapy with iron supplements was combined with physiotherapy.

Conclusion. Our findings confirm that the complex treatment of patients with telogen alopecia on the background of an iron deficiency state may achieve positive dynamics of trichological indicators.

Despite the low number, the cases of leprosy continue to be detected, more often on endemic territories. In Russian Federation one of the endemic territories is located in Astrakhan region. The long incubation period eventually leads to inability to identify the source of infection. The combination of the leprosy with other dermatoses complicates the diagnosing. The isolated and early skin manifestations of leprosy can be mistaken for the clinical features of other dermatoses. This article presents the description of a case study of border line lepromatosis leprosy in a patient with a long-term dermatological background. A 66-year-old male was followed up for 14 years under different dermatological diseases. In 2017, after a change in the nature of rashes, atypical for supervised nosological forms, and in connection with the resistance of clinical manifestations of diseases to the therapy, a clinical diagnosis of leprosy was established. To verify this diagnosis, the patient was sent to the Federal State Budgetary Institution "Research Institute for the Study of Leprosy". At admission, he complained of rashes on the skin of the face, trunk, extremities, accompanied by itching, swelling, weakness and numbness in the distal extremities. As a result of clinical, laboratory examination (bacterioscopic examination of scarification from the skin, serological examination, pathomorphological examination of skin biopsies), the diagnosis of the underlying disease was made: leprosy, borderline lepromatous form, active stage. Complications of the underlying disease: chronic specific polyneuropathy with sensitive disorders. The described clinical situation illustrates the problem of early diagnosis of leprosy due to the variety of manifestations and low alertness of clinicians.

The article is of an overview nature. It provides various classifications of pyoderma and infections of the skin and soft tissues, epidemiological data on pyoderma in our country and abroad, discusses in detail local and systemic risk factors for the development of the disease, environmental risk factors. Much attention is paid to comparative studies on the efficacy and safety of mupirocin (Supirocin) in comparison with systemic antibiotics and topical antibacterial agents, indicating the benefits of mupirocin.