Vol 98, No 1 (2022)

REVIEWS

Bacterial vaginosis: controversial issues

Khryanin A.A., Knorring G.Y.

Abstract

The purpose of the review. Consideration of the most controversial issues regarding the possibility of sexual transmission of BV-associated microorganisms (bacterias) in women and men.

Basic provisions. Bacterial vaginosis (BV) is a common disease associated with an increased risk of contracting sexually transmitted infections (including human papillomavirus and human immunodeficiency virus) in women and their male sexual partners. BV is characterized by polymicrobial transformations caused by Gardnerella vaginalis, which is the main etiological microorganism of this disease. G. vaginalis has a proven ability to form microbial biofilms on the mucosal surface. As a rule, from 10 to 12 different G. vaginalis genotypes can simultaneously reside in one biofilm, which provides it with a longer lifespan and viability. It has been shown that microorganisms in the biofilm acquire properties that reduce sensitivity to standard etiotropic therapy even at high doses of antibiotics. It was found that the cause of BV is a polymicrobial gardnerella biofilm, all components of which are transferred as a whole (for example, with the help of “key” cells), including during sexual contact. In this regard, the article discusses the possibility of using a new term — “biofilm gardnerellosis”, which more accurately reflects the essence of this problem. Microbial biofilms organized by G. vaginalis are found in a significant number of women with BV and their sexual partners.

Vestnik dermatologii i venerologii. 2022;98(1):13-18
pages 13-18 views

Connective tissue disease in the practice of a cosmetologist and dermatologist. Features of diagnosis and management of patients

Borzykh O.B., Petrova M.M., Karpova E.I., Shnayder N.A.

Abstract

In the practice of a cosmetologist and a dermatologist, the functional features of the skin are of extremely important. At the same time, monogenic connective tissue disorders (hereditary connective tissue dysplasia) that underlie hereditary syndromes have been known for a long time, but in recent years more attention has been paid to genetic defects that, together with other internal and external factors, lead to manifestations of connective tissue dysfunction. Such disorders are called multifactorial, as a result, a general clinic of connective tissue dysplasia can develop. It is important for dermatologists and cosmetologists to diagnose the presence and risk of connective tissue pathology in time, since these disorders require special features in the clinical management of such patients. To date, there is a slight difference in the understanding of connective tissue pathology in Russia and abroad. Thus, the purpose of this review was to integrate ideas about connective tissue dysplasia in Russia and abroad, as well as to provide dermatologists and cosmetologists with an algorithm for diagnosing and managing patients with connective tissue dysfunction.

Vestnik dermatologii i venerologii. 2022;98(1):19-32
pages 19-32 views

ORIGINAL STUDY ARTICLES

Epidemiology of psoriasis in the Russian Federation according to the patient registry

Kubanov A.A., Bogdanova E.V.

Abstract

Background. Psoriasis is a chronic skin disorder that impairs patients’ health-related quality of life. It is associated with patients’ need in specialized medical care and with essential medical costs. Psoriasis may be the reason for temporary or permanent disability. Patient registries are important sources of epidemiological and clinical data on patients with psoriasis and medical care provided.

Aims. To describe demographic characteristics, characteristics of the disease, prevalence of concomitant and past diseases in adult (18 years and older) patients with moderate and severe psoriasis included in the patient registry of the Russian Society of Dermatovenereologists and Cosmetologists.

Materials and methods. The data of 3,268 patients with psoriasis aged 18 years and older were analyzed as of inclusion in the registry. Data lock point was June 3, 2021. Descriptive statistics methods were applied in data analysis.

Results. The mean (± SD) age of adult patients at inclusion in the registry was 46.1 ± 14.4 years. Male patients accounted for 60.5%. The mean age of onset of psoriasis is 31.1 ± 16.1 years. Most of the patients (89.5%) have psoriasis vulgaris. The mean body surface area at inclusion was 43.3% ± 24.7%. 28.9% of patients had psoriatic arthritis at inclusion in the registry.

A high prevalence of cardiovascular diseases was revealed: arterial hypertension — 28.5%, coronary heart disease — 5.4%, myocardial infarction and acute cerebrovascular accident — 0.9% each.

More than half of patients are pre-obese or obese according to the WHO body mass index classification. 2.2% of patients have impaired glucose tolerance, 6.7% of patients have type 2 diabetes mellitus. 3.8% of patients have diseases or dysfunction of the thyroid gland.

The prevalence of diseases of the digestive system is high: any disease of the esophagus, stomach and duodenum was noted in 10.2% of patients, any disease of the liver, gallbladder, biliary tract and pancreas — in 11.8% of patients.

The prevalence of viral hepatitis C among patients with psoriasis was 2.6%.

Conclusions. The prevalence of comorbidities is high among Russian patients with moderate and severe psoriasis.

Vestnik dermatologii i venerologii. 2022;98(1):33-41
pages 33-41 views

Prospective study of the cytokine profile and antioxidant status of patients with pyoderma

Gizinger O.A., Ziganshin O.R.

Abstract

Background. The importance of studying the pathogenetic features of pyoderma associated with Streptococcus pyogenes is associated with the severity of the course of the disease, frequent relapses with a short inter-relapse period, and long-term disability.The severity of the course, long-term disability, violations of the pro-oxidate mechanisms recorded in patients with poidermias associated with Streptococcus pyogenes are priority and timely.

Aims. Study of the cytokine, prooxidant and antioxidant profiles of patients with pyoderma associated with Streptococcus pyogenes.

Мethods. А prospective study of the cytokine profile, the level of antioxidant defense enzymes, and lipid peroxidation factors in patients with pyoderma, lasting more than 2 years, associated with Streptococcus pyogenes, was carried out. The study included 100 people with diffuse lesions of smooth skin, identified on the skin surface of Streptococcus pyogenes, at the age of 28.76 ± 6.24 years; in blood serum, the content of cytokines IL-2, IL-8, IL-10, TNF-α, IFN-γ, IL-1β was studied by enzyme immunoassay, in whole blood the content of primary, secondary and final products of lipid peroxidation, antioxidant enzymes protectionsuperoxide dismutase and catalase.

Results. Analysis of the content of cytokines showed a significant decrease in the concentration of IL-2, an increase in IL-10, TNF-α, IL-8, IL-1β in the blood serum of patients with streptoderma compared with the reference values of healthy people (p < 0.05). In whole blood plasma, an increase in the concentration of primary, secondary and final products of lipid peroxidation was registered with a significant decrease in the activity of antioxidant enzymes of superoxide dismutase and catalase relative to the indicators of healthy volunteers (p < 0.05).

Conclusions. In patients with streptoderma, an increase in the production of cytokines with pro-inflammatory and chemotactic properties in response to the invasion of the pathogen and its persistence was revealed. The intracellular nature of the parasitization of Streptococcus pyogenes contributes to the enhancement of the systemic and local inflammatory process, the formation of oxidative stress, the accumulation of primary, secondary and final products of lipid peroxidation, and a decrease in the activity of antioxidant enzymes. A decrease in the content of interleukin 2, which has immunoregulatory properties in patients with streptoderma, leads to impaired immune homeostasis, a decrease in the processes of differentiation in the direction of the Th1 immune response, proliferation of T-lymphocytes, a violation of the qualitative and quantitative composition of the main subpopulations of peripheral blood lymphocytes, which is clinically expressed in this occurrence of relapses in categories of patients.

Vestnik dermatologii i venerologii. 2022;98(1):42-49
pages 42-49 views

Evaluation of the effectiveness of the use of Postacnetin gel in the therapy of the postacne symptom complex using the device ANTERA 3D

Skrylova K.A., Khardikova S.A., Portnyagina N.E.

Abstract

Background. The postacne symptom complex occurs in the outcome of vulgar acne in 40% of cases. Recently, there has been a tendency to “grow up” acne. Currently, there are many methods in the arsenal of a dermatologist and a cosmetologist for correcting post-acne elements, but most of the procedures for correcting postacne elements have age restrictions, some of the procedures are accompanied by severe pain and the presence of a rehabilitation period, and the economic component of these procedures is also of great importance. Therefore, for the treatment of the post-acne symptom complex, there should be methods that are highly effective and accessible to patients. In most cases, the assessment of the clinical effectiveness of treatment is subjective, both for the doctor and for the patient. Photo documentation is also not in all cases a reliable way to represent the quality and effectiveness of treatment. Consequently, the use of hardware methods for quantifying the severity of disease indicators to confirm the effectiveness of treatment increases the patient's compliance.

Aims. Evaluation of the effectiveness of Postacnetin gel in the treatment of postacne symptom complex, using the ANTERA 3D device.

Materials and methods. 12 patients aged 18 to 28 years with the presence of postacne symptoms were under observation. The study was conducted on the basis of the Department of Dermatovenereology of SibSMU and the medical center “Estetik” in Tomsk. During the entire study period, patients applied Postacnetin gel to one half of the face. Treatment regimen: Postaknetin gel was applied in a thin layer, point-by-point on the postakne elements 2 times a day. The duration of treatment was 28 days. To assess the clinical effectiveness, photo documentation, three-dimensional analysis of the skin surface on the ANTERA 3D device and statistical analysis were performed.

Results. The average level of redness in 12 patients on the side of using Postacnetin gel before the study was 117.200 ± 0.424, 1 month after using the gel, there was a significant decrease in the level of the indicator to 95.900 ± 0.849 (р < 0.05). The average value of the pigmentation level before using the Postacnetin gel and 1 month after use was 56.950 ± 0.919 and 46.600 ± 0.424, respectively (р < 0.05). This indicates a significant decrease in the level of pigmentation. The average value of the volume index before the study was 9.350 ± 0.212, after 28 days the volume index decreased to 6.750 ± 0.071, respectively (р < 0.05).

Conclusions. As a result of the conducted research, it was established with the help of the ANTERA 3D device that the use of Postacne gel for 28 days leads to a regression of the indicators of postacne elements.

Vestnik dermatologii i venerologii. 2022;98(1):50-57
pages 50-57 views

GUIDELINES FOR PRACTITIONERS

A rare case of follicular sarcoidosis

Gritskova I.A., Gorbunov Y.G., Alferov K.I., Belousova I.E.

Abstract

The article is devoted to a rare variant of skin sarcoidosis — the so-called follicular sarcoidosis. According to the literature, the follicular form of sarcoidosis is extremely rare, several isolated cases are described in foreign literature, there are no publications in the russian literature. A 30-year-old female patient came to the clinic of the Military Medical Academy with a skin rash of the upper extremities, trunk and neck that lasted for one year. Anamnesis: repeated use of topical corticosteroids for the treatment with a temporary positive effect. The skin process was represented by common follicular papules; a histological examination of one of the elements revealed granulomas of the sarcoid type, which were located perifolliculary, mainly around the infundibular sections of the hair follicles. The rash resolved after a course of external corticosteroid therapy. The clinical case described by us illustrates the need for histological examination to verify the diagnosis.

Vestnik dermatologii i venerologii. 2022;98(1):58-63
pages 58-63 views

Rhinophyma: patient management

Drozhdina M.B., Bobro V.A.

Abstract

Rhinophyma is a rare subtype of rosacea, which is a thickening of the skin in the nasal area due to an overgrowth of the sebaceous glands and the underlying connective tissue. The exact pathogenesis of rhinophyma is unknown, but potential factors include a combination of neurovascular disorders, innate immune responses, and the presence of microorganisms. The article presents current data on the treatment of rosacea, in particular, rhinophyma. A clinical case of a 67-year-old patient with a combination of papulo-pustular subtype of rosacea and rhinophyma is presented. The high effectiveness of the therapy with systemic isotretinoin was demonstrated.

Vestnik dermatologii i venerologii. 2022;98(1):64-71
pages 64-71 views

CLINICAL CASE REPORTS

Herpes zoster following COVID-19 vaccination: about 2 cases

Ben Salah N., Lahouel I., Manaa L., Soua Y., Youssef M., Belhadjali H., Zili J.

Abstract

The COVID-19 vaccine often well tolerated in healthy adults at the same time, different cutaneous reactions have been reported. Two cases presented of developed a first episode of Herpes zoster (HZ) following the first dose of vaccination against COVID-19. The pathogenetic mechanism suggested that SARS-CoV-2 infection can induce a decrease of blood absolute lymphocyte number, especially CD3+ CD8+ lymphocyte. The COVID-19 vaccine, by stimulation of inflammatory cytokines, may negatively affect the antigen expression and contribute to HZ reactivation. It is also possible that the vaccine induces some kind of immunomodulation that allows VZV to revert an infectious state.

Vestnik dermatologii i venerologii. 2022;98(1):72-74
pages 72-74 views

Linear IGA-dependent bullous dermatosis in a 2-year-old child

Karacheva Y.V., Ruksha T.G., Naumova A.S., Motorina A.V.

Abstract

Linear IgA-dependent bullous dermatosis is a rare subepidermal bladderworm disease that occurs in both adults and children. The pathogenesis of the disease, regardless of age, is the same, where the basis is the autoimmune response to antigens of the basal membrane zones of the skin, the clinical picture in childhood differs from the manifestations at an older age, having a clear picture and localization of manifestations. The causes of the onset of the disease in older people are most often associated with taking medications, manifested as a side effect of the therapy being taken, cancer, and in children, both an acquired character and a genetic predisposition are responsible for the manifestation of linear IgA-dependent bullous dermatosis. The diagnosis can be confirmed by histological and immunofluorescence analysis.

Vestnik dermatologii i venerologii. 2022;98(1):75-80
pages 75-80 views

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