Vol 101, No 3 (2025)

The paper discusses the epidemiological and clinical aspects of syphilis in the Russian Federation and the Republic of Tajikistan, as well as the main key trends and challenges associated with this infection. In 2021 and 2022, after a long period of decline, there was a significant rise in the incidence of syphilis in Russia, with a 69.7 % increase compared to 2020. Increased incidence in 2021–2022 was largely due to the increased incidence among foreign citizens: 2,801 in 2020, 7,710 in 2021, and 12,748 in 2022. In 2023, 10,160 cases of syphilis were detected among foreign citizens in Russia, of which 1,875 (18.5%) were from Tajikistan, whereas only 368 cases were reported in Tajikistan. In Russia, the proportion of advanced and unspecified syphilis increased from 2015 to 2023 due to increased incidence among foreign citizens. Since 2019, advanced forms of syphilis that were previously undetected have also been reported in the Republic of Tajikistan. The effective work of dermatovenereological services in the Russian Federation and the Republic of Tajikistan has contributed to a significant decrease in the incidence of syphilis among children and adolescents. In Russia, the incidence rate among children aged 0 to 14 decreased from 228 cases in 2015 to 34 in 2023, and among adolescents aged 15 to 17, it decreased from 391 to 159 cases. No syphilis cases in these age groups have not been reported in Tajikistan. The number of cases of congenital syphilis in Russia decreased from 63 to 12, while in Tajikistan this value varied from 0 to 5 cases. The article highlights the differences in the algorithms for diagnosing syphilis in specific target populations and in advanced forms of the disease, which can lead to undiagnosed cases of the disease.

Mycosis fungoides is a primary epidermotropic cutaneous T-cell lymphoma characterized by proliferation of small and medium-sized T-lymphocytes with cerebriform nuclei. The pathogenesis of this disease is complex and has not been completely investigated, but angiogenesis plays a significant role. Angiogenesis is the process of forming new blood vessels based on an existing vascular network, which includes extracellular matrix remodeling, endothelial cell migration and proliferation, capillary bed cell differentiation, and formation of anastomoses. In case of mycosis fungoides, the best investigated markers of angiogenesis include CD31, CD34, angiogenin, angiopoietin-1, angiopoietin-2, VEGF-A, VEGF-C, PlGF, MMP-2, and MMP-9. The current data on the pathogenetic aspects of angiogenesis in patients with mycosis fungoides are encouraging, however the small and heterogeneous patient populations and the limited number of the pro- and anti-angiogenic factors investigated necessitate further researches. Angiogenesis markers can be considered as potential additional differential diagnostic criteria, prognostic signs, and therapeutic targets in patients with mycosis fungoides.

Background. Standardization of the approach to the prescription of UVB-311 in mycosis fungoides is an urgent problem that requires prospective studies aimed at finding the most effective and safe treatment regimens.

Aim. To assess the efficacy of an optimized regimen of narrow-band medium-wave ultraviolet therapy in the treatment of patients with mycosis fungoides compared to PUVA therapy.

Methods. The authors performed a prospective non-randomized comparative study. The study enrolled 30 patients with early-stage mycosis fungoides (IA–IIA): 15 patients received UVB-311, 15 received PUVA therapy with oral administration of the photosensitizer Ammi majoris fructuum furocumarini. Therapeutic efficacy was assessed at the 10th, 20th, and final treatment sessions using the mSWAT and BSA criteria.

Results. A comparative analysis of therapeutic efficacy showed no statistically significant differences in changes in BSA and mSWAT clinical indices between UVB-311 and PUVA therapy (p > 0.05). The proportion of total response (the sum of complete and partial remission) did not differ between the treatment groups, it constituted 93.3% (n = 14).

Conclusion. In the proposed regimen, UVB-311 is comparable to PUVA in patients with early-stage mycosis fungoides.

Background. Proper medical care for pemphigus patients using the necessary diagnostic and therapeutic methods can prevent severe disease progression and death.

Aim. To analyze diagnostic and therapeutic approaches for pemphigus in medical institutions specializing in dermatovenereology and assess their compliance with clinical guidelines.

Methods. A questionnaire was developed to collect data on the number of pemphigus patients treated in medical institutions specializing in dermatovenereology across the federal subjects of the Russian Federation in 2023 and on the diagnostic and therapeutic methods employed.

Results. Sixty eight medical institutions specializing in dermatovenereology in 66 (74.2%) federal subjects of the Russian Federation (RF) provided data on 1,480 pemphigus patients. Their diagnostic approaches (based on their own or other facilities) comprised: cytological examination of the smear print from the base of erosions (66 federal subjects); histopathological analysis of skin biopsies (46 federal subjects; 69.7%); ELISA blood test for anti-desmoglein type 1 and/or 3 autoantibodies level (29 federal subjects; 43.9%); immunofluorescence testing of skin biopsies (16 federal subjects; 24.2%), serological diagnostics by indirect immunofluorescence using monkey esophagus substrate to determine anti-desmoglein type 1 and/or 3 autoantibodies in blood (11 federal subjects; 16.7%). Systemic glucocorticoids were used to treat patients with pemphigus in 66 (100.0%) federal subjects of RF, though the medical institutions from 21 federal subjects (31.8%) restricted therapy to parenteral corticosteroids only.

Conclusion. The conducted study identified quality issues in specialized pemphigus care and suboptimal adherence to clinical guidelines.

To study the clinical, morphological, and immunohistochemical characteristics of desmoplastic melanoma and the use of modern diagnostic technologies to refine the classification criteria for this rare subtype of malignant neoplasms. The study included 5 patients (4 men and 1 woman, median age 62.5 years) diagnosed with malignant neoplasms of the skin on the back (3 cases) and the buccal area of the face (2 cases). Morphological and immunohistochemical studies were performed using markers S100 and Melan-A to confirm the diagnosis. Modern technologies were applied to improve diagnostic accuracy. Morphological analysis revealed the characteristic dense collagenized stroma and low cellular density of desmoplastic melanoma tumors. Immunohistochemical analysis confirmed the melanocytic origin of the tumors. The use of modern diagnostic methods allows us to determine diagnostic and classification criteria for desmoplastic melanoma. A comprehensive approach, including morphological and immunohistochemical methods with markers S100 and Melan-A, enhances diagnostic accuracy and refines the classification criteria for this disease.

Basal cell carcinoma is one of the most common types of skin cancer among adults, but in children it is extremely rare and is usually associated with genetic syndromes (for example, Gorlin–Goltz syndrome or xeroderma pigmentosum) or with the consequences of radiation therapy performed in children. We present a clinical case of a 10-year-old child diagnosed with basal cell carcinoma. The child’s parents consented to the publication of the data. A 10-year-old patient, accompanied by his mother, came to the outpatient department of the St. Petersburg Clinical Scientific and Practical Center for Specialized Types of Medical Care (Oncology) named after N.P. Napalkov (KNPC SVMP) with complaints about a formation that was detected 4 months ago and was increasing in size. From the family history it is known that the boy’s mother was diagnosed with Hodgkin’s lymphoma at the age of 13, for which chemoradiotherapy was performed. At the age of 30, she was diagnosed with multiple basal cell carcinomas in the area of radiation.