Vol 97, No 4 (2021)

The article presents an analysis of the resources and activities of medical organizations providing medical care in the field of dermatovenereology for the period 2015–2020. Up-to-date data on the number of medical organizations and units providing specialized medical care in the field of dermatovenereology are provided. A description of the main changes in the provision of the population of the Russian Federation with dermatovenereologists, staffing with dermatovenereologists of medical organizations is given. Changes in the number of outpatient visits in 2020 are given. The dynamics of the bed fund of 24-hour and day hospitals of a dermatovenereological profile, the bed occupancy, the number of patients treated is described. The data on the incidence of sexually transmitted infections, infectious skin diseases are presented. Prevalence and incidence rates of diseases of the skin and subcutaneous tissue, including atopic dermatitis and psoriasis, are given. The impact of measures aimed at preventing the spread of a new coronavirus infection and organizing the provision of medical care to patients with COVID-19 on the performance rates of dermatovenereologic medical organizations has been demonstrated.

Psoriatic arthritis often develops in patients with psoriasis and can lead to joint deformity, stiffness, dysfunction, and disability. Psoriatic arthritis is a polygenic disease. and the issue of personalizing the prognosis of its development can only be resolved taking into account the variability of plenty genomic loci associated with the development of the disease. The personification of the prognosis of the disease can be solved taking into account the variability of the set of genomic loci with which its development is associated. The review examines genomic polymorphisms associated with the development of psoriatic arthritis not psoriasis, except of HLA polymorphisms. Genome regions containing polymorphisms, allelic variants of which are associated both with the development of psoriatic arthritis and reducing the likelihood of its occurrence, are described. It has been reported that the predisposition to the development of psoriatic arthritis in patients with psoriasis is determined by genes encoding proteins involved in inflammation and bone metabolism.

Skin aging is a complex process involving both internal (chronological aging) and external (biological aging) factors. Slowing down the proliferative and immune processes in the epidermis, reducing the activity of fibroblasts and vascularization of the dermis during chronological aging lead to thinning, dryness, hypersensitivity, vulnerability and superficial wrinkles. Exposure to ultraviolet rays, pollutants, climate, and thermal factors cause keratinocyte disorganization, enhanced melanogenesis, collagen dystrophy, solar elastosis, and disorder of microcirculation. The main signs of external skin aging are deep wrinkles, sagging, pigmentation, telangiectasia, skin neoplasms.

Among the local anti-aging agents, retinoids occupy a leading place, as they eliminate the main signs of skin aging. Of the entire group of retinoids, retinoic acids are the most active. However, the possibility of skin irritation limits their use. Therapeutic and cosmetic products with retinol esters (retinol palmitate) have a minimal irritating effect and can be used both for the prevention of skin aging and the elimination of its signs. Oral use of isotretinoin as an anti-aging agent is undesirable due to the many side effects and contraindications.

Background. The article considers the possibility of raising awareness among young people about STIs and HIV infection. It presents the development of the mobile application “Personal Sexual Health”, which includes the following sections: “Sexual Infections”, “Protect Yourself”, “Frequently Asked Questions”, “Get help” and etc.

Aim. Improving methods of primary prevention of STIs and HIV infection among young people using a mobile app.

Materials and Methods. The mobile application (“Personal Sexual Health”) was developed taking into account previously conducted scientific (sociological) research on the level of awareness of STIs and HIV infection among young people in Novosibirsk. The development of the mobile application was carried out using Agile (agile software development) methodology.

Results. It was found that young people trust online information and view the Internet as a reliable source of sexual health advice. In fact, the Internet is a useful tool for spreading the reliable information about sexual health and different events detecteded to prevention of STIs and HIV-infection. The concept of the mobile application “Personal Sexual Health” implies raising the awareness of young people on the prevention of STIs and HIV infection. The informational component of the mobile application “Personal Sexual Health” was developed taking into account the previously obtained results from a sociological survey of young people.

Conclusion. The modern generation of young people is forming a new ethics of communication, and the Internet is a basic source of information about sexual health for most teens and young adults. However, the information from Internet is not always correct or sufficient. Using modern, relevant, and still gaining in popularity technology (mobile apps and social media) will help to better absorb information about STIs and HIV prevention programms among young people. “Personal Sexual Health” is the first mobile application in Russia dedicated to sexual health and primary prevention programms of STIs and HIV-infection among young people.

Background. The article considers the possibility of raising awareness among young people about STIs and HIV infection. It presents the development of the mobile application “Personal Sexual Health”, which includes the following sections: “Sexual Infections”, “Protect Yourself”, “Frequently Asked Questions”, “Get help” and etc.

Aim. Improving methods of primary prevention of STIs and HIV infection among young people using a mobile app.

Materials and Methods. The mobile application (“Personal Sexual Health”) was developed taking into account previously conducted scientific (sociological) research on the level of awareness of STIs and HIV infection among young people in Novosibirsk. The development of the mobile application was carried out using Agile (agile software development) methodology.

Results. It was found that young people trust online information and view the Internet as a reliable source of sexual health advice. In fact, the Internet is a useful tool for spreading the reliable information about sexual health and different events detecteded to prevention of STIs and HIV-infection. The concept of the mobile application “Personal Sexual Health” implies raising the awareness of young people on the prevention of STIs and HIV infection. The informational component of the mobile application “Personal Sexual Health” was developed taking into account the previously obtained results from a sociological survey of young people.

Conclusion. The modern generation of young people is forming a new ethics of communication, and the Internet is a basic source of information about sexual health for most teens and young adults. However, the information from Internet is not always correct or sufficient. Using modern, relevant, and still gaining in popularity technology (mobile apps and social media) will help to better absorb information about STIs and HIV prevention programms among young people. “Personal Sexual Health” is the first mobile application in Russia dedicated to sexual health and primary prevention programms of STIs and HIV-infection among young people.

Background. Acne has a net detrimental effect on the quality of life of patients, which is due not only to long-term treatment and predominance of dermatosis on the face, but also due to substantial risk of development of enduring post-inflammatory skin changes. The main part of treatment methods for post-acne marks is currently aimed at correction of already formed rash, and not at prevention of its development. In this respect, studies aimed at development of new methods for prevention and treatment of post-inflammatory skin changes in acne are particularly topical.

Aim. To evaluate clinical efficiency and tolerability of Postacnetin gel at prevention and correction of significant post-inflammatory skin changes in patients with severe forms of acne vulgaris.

Methods. 60 patients with severe forms of acne were under observation and were prescribed isotretinoin and topical medications in accordance with the Federal Guidelines of Treatment. Depending on the planned supporting therapy, the patients were divided into main and control groups of 30 people. Patients of the control group used only adapalene cream after the end of the course of systemic treatment with isotretinoin. Patients of the main group were additionally prescribed Postacnetin gel 2 months before reaching the cumulated dose of isotretinoin, and were also recommended to use it within 4 months after termination of isotretinoin therapy alongside with the use of adapalene cream. The effect of Postacnetin gel on post-inflammatory skin changes was assessed over time by counting post-acne elements, mexametry data and results of assessment of cicatrical changes according to the scale of G. Goodmann et al. Tolerability of the therapy was studied by means of monitoring of adverse reactions and calculation of the dermatology life quality index (DLQI).

Results. By the end of application of the systemic medication, persistent erythema developed less often in patients of the main group, and pigmentation and scars were clinically less severe according to the data of the mexametry and the scale of G. Goodman et al. Subsequent dynamic observation of patients of the main group revealed more significant regression of post-inflammatory changes in them. Thus, dark spots were less common in these patients in the 2nd and 4th months in comparison with the control group, and according to mexametry data, they were less severe. They also had lower severity of scars and level of the total index of the quantitative scale of G. Goodman et al. According to the results of monitoring of side effects and DLQI, both treatment regimens were well tolerated.

Conclusion. The use of Postacnetin gel in the complex therapy of patients with severe forms of acne vulgaris is an effective method for prevention and correction of persistent post-inflammatory skin changes and is well tolerated by patients.

Introduction. Speckled lentiginous nevus or Nevus Spilus (NS) is a congenital or acquired melanocytic nevus. NS appears as dark hyperpigmented macules or papules interspersed in the lentigo-like hyperpigmentation patch. Surgical methods for removing NS, primarily on the skin with a thin dermis, are associated with the risk of disruption of its structure or scarring. The use of single wavelength laser irradiation allowed achieving pronounced bleaching of the NS area with such side effects as scars, post-inflammatory hyperpigmentation, and relapses in some cases. Side effects could occur due to the lack of complete blood flow in the microvascular bed near the NS. The study aimed to evaluate the efficacy of NS treatment with a dual-wavelength copper vapor laser (CVL).

Description of patients and the method of the treatment. Two fair-skinned adult female patients with NS, of medium size and different location, asked to restore the natural colour of the skin in order to get rid of cosmetic defects. NS treatment was carried out using CVL (Yakhroma-Med model, P.N. Lebedev Physical Institute of the Russian Academy of Sciences) during six procedures, an interval of 4–6 weeks. For treatment, we used two-wavelength CVL radiation with average power in the range of 0.6–0.8 W with a power ratio of 3:2 at wavelengths of 511 nm and 578 nm; exposure time: 0.2–0.3 s. The diameter of the light spot on the skin accounted for 1 mm. Both patients were satisfied with the result of the treatment due to the noticeable blanching of the pigmented skin area after the NS removal. During the following two years, no dark spots or scarring was observed at the NS removal site.

Conclusion. Treatment of medium-sized NS using two-wavelength CVL radiation made it possible to eliminate the cosmetic defect without side effects.

The article describes a clinical case of vaccination with the drug "Kovivac" of a patient of an older age group with an established diagnosis of bullous pemphigoid. Scientific data on the prevalence of bullous dermatoses in the Russian Federation (true pemphigus, Lever's bullous pemphigoid, Dühring's herpetiformis dermatitis) are presented. There is a good tolerance of the Kovivac vaccine in a patient suffering from bullous pemphigoid, which allows vaccination, in fact, without interrupting patients from their daily activities and without diverting the resources of the healthcare system to unreasonable inpatient care. The decision to vaccinate should be made on the basis of data on the available indications / contraindications for drugs, taking into account the individual anamnestic data of patients. In addition, it should be borne in mind that until now, all links of the infectious process caused by SARS-CoV-2 have not been fully studied. In this regard, before vaccination, patients must be informed of the need to comply with the anti-epidemic measures recommended for the prevention of coronavirus infection (COVID-19), even after full vaccination, as well as dynamic observation by specialist doctors.