Vol 91, No 3 (2015)

The article provides a review of regulatory documents providing for the establishment of a universal governmental healthcare information system in the Russian Federation, describes the key goals and tasks for the register of patients with chronic skin disorders and characterizes different types of registries and their use.

The authors conducted a study of particular features of the course of localized scleroderma in the south of Russia (Krasnodar territory). 65 case histories were analyzed. Women suffered from the disease 2.8 times more often than men; one half of the sample (55.4%) included patients aged 35-55; the disease duration of over a year prevailed (69.8%); the disease occurred against the background of an endocrine pathology in one third of all cases; one third of all women developed the disease during the postmenopausal period. Plaque scleroderma (56.9%), white spot disease (von Zumbusch psoriasis) (16.9%) and idiopathic atrophoderma of Pasini and Pierini (12.3%) belonged to the key clinical forms. The average number of lesions was 2.4 ± 1.2 while almost a half of the patients (47.7%) had three or more lesions. The clinical manifestations localized mostly on the back (46.5%) and stomach (34.9%).

This literature review examines principal aspects of rosacea prevalence in the Russian Federation and abroad, shows present-day opinions about the pathogenesis and histological picture of rosacea and presents actual classification and a number of key clinical forms of the disease.

The article presents current data on the role growth factors play in hair physiology. Based on a review of literature, the authors described the role growth factors play for initiating, suppressing the growth and differentiating hair follicles. According to them, each morphologic development stage of hair follicles is characterized by its own factor expression pattern. Referring to experimental and clinical studies, the authors describe the role some growth factors play for mechanisms promoting the development of androgynous and focal alopecia.

The confocal laser scanning microscopy in vivo is a promising study method to visualize cell structures of epidermis and papillary dermis without affecting the skin integrity, which provides for a resolution and contrast similar to those characteristic of the classical histology examination. Goal. To assess the confocal laser scanning microscopy in vivo (CLSM) technique for diagnosing actinic keratosis, psoriasis vulgaris and rosacea vs. the classical histology examination. Study materials. The article describes the results obtained by using the confocal laser scanning microscopy in vivo technique vs. the histology examination in 10 patients with erythematous actinic keratosis, 10 patients with extensive psoriasis and 10 patients with erythematous and papulous rosacea. Results. The article describes diagnostically significant signs of the diseases detected by using the confocal laser scanning microscopy in vivo as well as the potential of this method in terms of diagnosing inflammatory skin diseases.

Goal. To study the dynamics of expression rates of growth factor proteins in psoriatic patients receiving the PUVA therapy. Materials and methods. The authors conducted a study of 30 patients with psoriasis vulgaris treated with the PUVA therapy. The psoriasis severity and extent of itching were assessed prior to and after the treatment by the PASI index and visual analogue scale, respectively. The expression of semaphorin 3A, amphiregulin, nerve growth factor and PGP 9.5 protein (a nerve fiber marker) in the skin was assessed by the indirect immunofluorescence method. The expression of PGP 9.5 protein was used to assess the quantity and mean length as well as average and total fluorescence intensity of nerve fibers. Results. An increased expression of amphiregulin and nerve growth factor as well as increase in the quantity, mean length and average and total fluorescence intensity of nerve fibers were revealed in the epidermis of psoriatic patients. Following a course of the PUVA therapy, a decrease in the PASI index and extent of itching, reduced expression of amphiregulin and nerve growth factor as well as reduced quantity, mean length and average and total fluorescence intensity of nerve fibers in the epidermis were observed. Direct correlation dependence between the extent of itching, amphiregulin and nerve growth factor expression level and quantity and length of nerve fibers in the epidermis was discovered. Direct correlation dependence between the amphiregulin and nerve growth factor expression level, and average length of nerve fibers in the epidermis was discovered. Conclusion. The itching intensity in psoriatic patients receiving the PUVA therapy is reduced due to the decreased skin expression of the nerve growth factor and amphiregulin.

The authors describe a rare clinical observation of the cutaneous manifistation of Lyme Borreliosis: primary borrelial lymphocytoma and surrounding secondary erythema chronicum migrans. The review of clinical features, histology, is also present.

Skin melanoma is a malignant tumor originating in the cells of the melanocytic system, which is characterized by an aggressive clinical course, significant metastatic potential and unfavorable prognosis. These features of the tumor stipulate the need to improve measures to optimize early diagnosis of tumors. The article presents cases of pigmented skin melanoma to demonstrate the variability of clinical manifestations of this tumor requiring dermatologist skills in the differential diagnostics of neoplasms.

Short summary and results of the own clinical observations on efficacy of developed complex method on the treatment of true acantholytic pemphigus composed of traditional immunosuppressive therapy and antiviral remedy - gancyclovir are presented. The etiology of herpesvirus infection had been discussed in the pathogenesis of the disease.

The goal of this study was to compare the efficacy and safety of Azelic (15% gel of azelaic acid), 1% Clindamycin gel and 0.1% Adapalene gel as a complex therapy in patients suffering from mild to moderate acne. Materials and methods. An open-label comparative study involving 40 patients suffering from mild to moderate papulopustular acne. The study was based on the medical history, a questionnaire form, physical examination results, assessment of morphological and functional skin parameters and dynamics of the life quality index (DLQI). Key findings and conclusions. Positive dynamics of the skin process was observed by the end of Week 6 of the treatment depending on the combination treatment type. The administration of Azelic gel resulted in an increased moisture level of the skin and reduced sebometry indices, skin relief intensity and pigmentation level.

Objective. To determine the effectiveness and safety ot the drug Sotret when treating patients with severe or moderate acne resistant to other therapies. Material and methods. The study included 30 people. Determining the severity ot acne was conducted using the DIA, the assessment ot quality ot lite - the scale ot CADI. In the acne treatment patients were using the drug Sotret as monotherapy. Results of the study. Sortret drug therapy contributed to erase the severe and rapid dynamics ot indicators DIA, the tormation ot clinical remission was reported in 93.33% ot patients. Adverse events were dose dependent and primarily recorded in the tirst three months ot the treatment. Use ot the drug by patients erase acne contributed to improving the quality ot lite at an average degree ot severity ot the disease at 93.53%, with a heavy - at 82.74%. Conclusion. The clinical etticacy expressed Sotret demonstrates its wide application

Goal of the study. To compare the etticacy ot nattitine hydrochloride (Exoderil® cream) and combination cream comprising betamethasone dipropionate, clotrimazole and gentamicin sultate in treatment ot toot mycosis complicated with a bacterial intection and signiticant intlammatory reaction. Materials and methods. A single-center, prospective, randomized, open-label comparative study involved 75 patients aged 23-80 suttering trom toot mycosis complicated with a bacterial intection and signiticant intlammatory reaction. The patients were randomized in two groups. The tirst group comprised 36 patients receiving nattitine hydrochloride while the second one included 39 patients treated with a combination drug comprising betamethasone, clotrimazole and gentamicin. Results. The anti-bacterial etticacy ot nattitine and combination drug comprising betamethasone, clotrimazole and gentamicin was comparable. Complete sanitation ot the bacterial intection was achieved in 94% ot the patients in both groups. The antimycotic etticacy ot nattitine (Exoderil® cream) was reliably higher than that ot the three-component drug to amount to 97% and 82%, respectively (p = 0.03). Complete recovery was achieved in 92% ot the patients treated with nattitine hydrochloride cream and 82% ot the patients treated with the three-component drug (p = 0.22). Conclusion. Exoderil® cream (active substance: nattitine) is a highly etticient drug tor treatment ot ditterent clinical torms ot skin mycosis including those accompanied by a signiticant intlammatory reaction and/or concomitant bacterial intection.