Vol 97, No 3 (2021)


Ichthyosis (concept, pathohistology, clinical picture, treatment)

Takhtarova T.G., Khismatullina Z.R., Panova L.D., Panova A.N.


Ichthyosis is a skin disease that is hereditary, has pronounced symptoms in the form of a violation of the skin, and the presence of formations resembling fish scales. It is possible to distinguish different approaches to the definition of ichthyosis, based on the modern study of this issue. Ichthyosis is classified by type: congenital and acquired. Congenital ichthyosis has its own classification depending on the manifestation of changes in the skin, the course of the disease, concomitant pathologies. Congenital ichthyosis is divided into ordinary (vulgar autosomal dominant, simple) ichthyosis, lamellar ichthyosis (dry ichthyosiform erythroderma, "collodion child", lamellar ichthyosis), X-linked ichthyosis (ichthyosis associated with the X chromosome, blackening ichthyosis), congenital bullous ichthyosiform erythroderma (erythroderma Broca's disease, ichthyosiform epidermolytic hyperkeratosis), fetal ichthyosis (intrauterine ichthyosis, universal hyperkeratosis, "Harlequin fetus", congenital keratosis), other congenital ichthyosis. Ichthyosiform conditions (the so-called acquired ichthyosis) are divided into symptomatic, age-related (senile), discoid ichthyosis. The causes of acquired ichthyosis can be various diseases, taking medications, improper skin care, unbalanced nutrition. Each form of ichthyosis differs by the type of inheritance, prevalence in the population, clinical picture, verified by histological examination of skin biopsies and electron microscopic examination of the skin. It may be accompanied by seasonality of exacerbation of the clinical picture, association with other diseases (allergic, diseases of the gastrointestinal tract, congenital malformations). There is no specific treatment for ichthyosis. In systemic therapy, derivatives of vitamin A are used, keratolytics, as well as moisturizing and emollient agents are used for external treatment. The use of therapeutic baths, general ultraviolet irradiation is effective.

Vestnik dermatologii i venerologii. 2021;97(3):6-13
pages 6-13 views

Molecular epidemiology and antimicrobials resistance mechanism of Mycoplasma genitlaium

Shedko E.D., Goloveshkina E.N., Akimkin V.G.


Currently, infections caused by Mycoplasma genitalium are ones the most common sexually transmitted infections. Their prevalence is varied from 1.3% to 15.9%. Infections caused by M. genitalium may lead to urethritis in men and a wide spectrum of diseases in women. Antibiotic resistance now is one of the most emerging problems both in the scientific and in the healthcare fields. The usage of antimicrobials inhibiting cell wall synthesis for the treatment of M. genitalium is ineffective, and resistance to macrolides and fluoroquinolones is increasing rapidly. M. genitalium infections diagnostics is complicated due to specific conditions and duration of culture methods. The usage of nucleic acid amplification techniques is the most relevant for laboratory diagnostics, and is used in existing assays. This review compiles current data on the prevalence, molecular mechanisms of pathogenesis and antibiotic resistance, as well as diagnostics methods of M. genitalium.

Vestnik dermatologii i venerologii. 2021;97(3):14-23
pages 14-23 views

Pharmacogenomics of hyaluronic acid

Vaiman E.E., Shnayder N.A., Dyuzhakova A.V., Nikitina E.I., Borzykh O.B., Nasyrova R.F.


Abstract.Introduction: Hyaluronic acid (hyaluronan, HA) has become the most popular tool for improving the skin condition during aging, correcting wrinkles and other cosmetic defects.
Objective: Analysis of the results of studies that reflect the pharmacogenomics of the synthesis, degradation, and reception of HA. Materials and methods: We searched for full-text publications in Russian and English in the E-Library, PubMed, Springer, Clinical keys, Google Scholar databases, using keywords and combined word searches (hyaluronic acid, hyaluronan, synthesis, degradation, reception, receptor, genetics), over the past decade. In addition, the review included earlier publications of historical interest. Despite our comprehensive searches of these commonly used databases and search terms, it cannot be excluded that some publications may have been missed. Results: The lecture examines: the role of ha in normal and aging human; genes involved in the synthesis (HAS1, HAS2, HAS3), degradation (HYAL1, HYAL2, HYAL3) and reception of ha (CD44, HARE, RHAMM); as well as the expression of their encoded proteins and enzymes in the skin. Conclusion: Expanding our knowledge of the pharmacogenomics of endogenous ha and increasing the exogenous HA drugs (used in anti-aging therapy and medical cosmetology) on the pharmaceutical market requires taking into account individual, including genetically determined, characteristics of the body of each individual patient to ensure an optimal balance of effectiveness/safety of exogenous HA from the point of view of personalized medicine

Vestnik dermatologii i venerologii. 2021;97(3):24-38
pages 24-38 views


Development and research of a model for differential diagnosis of latent late syphilis and false-positive serological reactions on immunochips with a panel of 12 Treponema pallidum antigens

Shpilevaya M.V., Katunin G.L., Kubanov A.A.


The aim - to find the optimal attributing rules to  distinguish  groups of latent stages of syphilis   and false positive serological tests of using multivariate discriminant analysis

Material and methods. The objects of the study were serum samples from patients with late latent (N=34) syphilis and false positive serological tests (N=31).

The samples were studied to determine  IgG and IgM levels using indirect immunofluorescent reaction with immunochip containing recombinant antigens T. pallidum

Results  The mathematical model allows  to  differentiate with a high degree of confidence patients with late  latent syphilis and with false-positive serological reactions to syphilis.

Conclusions. . Multivariate discriminant analysis makes possible to create reliable mathematical models to classify patients with late  latent syphilis and with false-positive serological reactions to syphilis.

Vestnik dermatologii i venerologii. 2021;97(3):39-46
pages 39-46 views

The new external drug for the treatment of psoriasis based on inhibition of serine proteases

Zhukov A.S., Zharun E.R., Khairutdinov V.R., Samtsov A.V., Krasavin M.Y., Garabagiou A.V.


Background: Psoriasis is a chronic inflammatory immune-mediated disease characterized by an increased rate of keratinocyte division. The results of recent studies have made it possible to establish that the cytokines of the IL-36 family occupy a significant place in the initiation and regulation of the inflammatory process in psoriasis.

IL-36 is in an inactive form and proteolytic processing is required for its activation in the skin, which is possible with the participation of neutrophilic serine proteases. Localization of these enzymes in the upper layers of the epidermis suggests the clinical efficacy of a topical targeted drug that inhibits serine proteases, sivelestat. On the basis of this active substance, we have created a drug in an external dosage form and conducted an experimental study of its effectiveness on a laboratory model of psoriasis.

Aims: to evaluate the therapeutic efficacy of sivelestat in a laboratory model of imiquimod-induced psoriasis.

Materials and methods: In the experiment, 40 inbred BALB/c mice were used, which were randomized into 4 groups of 10 each. An imiquimod-induced model of psoriasis was used. Mice of group No. I - without therapy (control), No. II - ointment (vaseline) containing 1% sivelestat, No. III - cream (lanolin + olive oil + water in equal proportions) containing 1% sivelestat, No. IV - betamethasone cream dipropionate 0.05%. Clinical assessment of skin rashes was performed using the PASI-modified method (mPASI), as well as histological and immunohistochemical examination of the skin.

Results: When evaluating clinical manifestations, it was found that the total mPASI index when using sivelestat cream decreased by 50%, and sivelestat ointment - by 36%. The histological examination showed that the thickness of the epidermis in the groups where the therapy was applied was 2.4-3.6 times less than in the control group. An immunohistochemical study of the skin found that after treatment with sivelestat, the number of CD3 + cells in the skin was 1.8-2.2 times less, and the level of proliferative activity (Ki-67 + cells) was 2.3-2.9 times less. lower than in the group without therapy

Conclusions: On a laboratory model of imiquimod-induced psoriasis, it was found that a serine protease inhibitor (sivelestat) has a therapeutic efficacy comparable to a strong topical glucocorticosteroid drug (betamethasone dipropionate 0.05%). A pronounced resolution of the elements of the skin rash, a reduction in the thickness of the epidermis, a decrease in skin infiltration with T-lymphocytes and a normalization of the rate of cell division of the epidermis and dermis are shown.

Suppression of the activity of IL-36-mediated inflammation in the skin by means of topical inhibitors of serine proteases is a promising new direction in the treatment of patients with psoriasis.

Vestnik dermatologii i venerologii. 2021;97(3):47-55
pages 47-55 views

Quality of life in patients with psoriatic arthritis

Koreshkova K.M., Khismatullina Z.R.


Currently, the prevalence of PsA in the population is 0.05-1.6%. In terms of the rate of progression, deterioration of the quality of life and disability, PsA patients are comparable to rheumatoid arthritis and ankylosing spondylitis. Purpose: to study the effect of psoriatic arthritis on the quality of life of patients. Materials and methods. A study was conducted with the participation of 75 patients. For the study, we used standardized questionnaires developed to assess the quality of life of patients with PsA. Research method - questioning patients using standardized questionnaires, analysis of the information received. Results. Psoriatic arthritis has a significant impact on the quality of life of patients, affecting the physical, social and emotional spheres. The most important areas of influence of psoriatic arthritis from the point of view of patients are: pain (78%), skin problems (72%), decreased functionality (60%), discomfort (51%) and fatigue (44%). In patients with PsA, pronounced functional disorders are noted. The HAQ index in men averaged 1.98 ± 0.86 (from 1.12 to 2.84 points), in women - 1.77 ± 0.34 (from 1.44 to 2.11 points) (p <0.0001). The pain syndrome according to the VAS averaged 74.34 ± 9.22 mm in men, and 65.77 ± 8.19 mm in women. Patients noted the greatest disturbances in such activities as walking (44%), standing up (37%), hygiene procedures (21%), using transport (36%), housework (47%). Almost 40% of patients use various devices or the help of others (p <0.0001). Psoriatic arthritis also affects the emotional sphere of life. Subclinical emotional disorders were more often detected in women than in men (symptoms of anxiety - 61.9% and 42.2%, depression - 71.4% and 39.4%, respectively); however, approximately the same number of men had clinically expressed signs of depression ( 12.1%) and women (11.9%). Psoriatic arthritis significantly reduces the quality of life, affecting the most important aspects of it - physical, emotional and social.

Vestnik dermatologii i venerologii. 2021;97(3):56-65
pages 56-65 views


Long-term undiagnosed tuberous sclerosis

Varenova T.N., Goshadze V.A., Akutina D.I., Pomerantsev O.N.


The article presents the history, etiology, pathogenesis and variability of the clinical picture of a rare genetic disease – tuberous sclerosis. The clinical and laboratory criteria on the basis of which this diagnosis is made are described. Specialists of the Nizhny Novgorod Branch of the State Research Center of Dermatovenereology and Cosmetology, Ministry of Health of the Russian Federation carried out treatment and observation of the patient K. Patient was born in 1997, repeatedly turned to dermatologists in different cities of Russia with complaints about formations on the face, hands, legs and spots on the skin of the trunk that appeared in early childhood. The diagnosis was not confirmed. The doctors of the consultative and diagnostic center diagnosed with tuberous sclerosis based of four large and two small diagnostic criteria. Treatment of skin manifestations was carried out by laser destruction, it gave a good cosmetic effect. We recommended further examination by doctors of related specialties for identify lesions of other organs. This clinical case is of interest for dermatologists, because the described dermatosis is rarely found in everyday practice.

Vestnik dermatologii i venerologii. 2021;97(3):66-72
pages 66-72 views

Clinical case of papulo-pustular rosacea

Evseeva A.L., Ryabova V.V., Koshkin S.V.


The article presents a clinical case of papulopustular rosacea from our own practice. First of all, the patient's anamnesis is extremely interesting: family history (his brother has episodes of reddening of the face), the onset of rosacea against the background of a stressful situation, the presence of gastric diseases, the connection with nutritional factors. One of the first mentions of rosacea belongs to Avicenna, who in his writings described the clinical picture of rhinophyma ("badschenan", later renamed "abedsamen"). The pineal nose, dotted with "serpentine" vessels, has traditionally been associated with excessive drinking. Currently, the role of alcohol as an etiological factor is not paramount, but its aggravating effect has been proven.

Despite the typical picture of rosacea, our patient has been receiving therapy for seborrheic dermatitis and other diseases several times over the course of several years. Probably, the specialists had doubts about the possible diagnosis of rosacea in a male patient under the age of 30.

Vestnik dermatologii i venerologii. 2021;97(3):73-79
pages 73-79 views

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