Vol 87, No 5 (2011)

About specialists

The authors present the results of a detailed analysis of information and telecommunications resources of regional dermatovenerological institutions, describe major principles for establishing a common information system in the health care system of the Russian Federation, and substantiate organizational and medical efficiency of introduction of an information analytical system for monitoring the incidence of sexually transmitted diseases.

The authors present a review of up-to-date non-invasive visualization methods used in diagnostics of diseases of skin and its appendages. They describe physical principles forming the basis for non-invasive visualization methods such as dermatoscopy, confocal laser scanning microscopy, optical video monitoring, optical topometry, optical coherent tomography, ultrasound scanning, 3D-modeling. They also describe the potential of practical application of these diagnostics methods at the current stage of their development. The authors have demonstrated that it is possible to reduce the clinicians need in biopsy diagnostics due to the high information value of non-invasive visual diagnostics methods.

The article presents the results of molecular and genetic studies aimed at determination of molecular markers for forecasting the clinical response of psoriasis patients to treatment with Infliximab. The authors revealed that it is possible to forecast high efficacy of treatment with Infliximab in case TT genotype is revealed at the 676 locus of exon 6 of the TNF-RII gene and IL-10 is present in the blood serum prior to the onset of treatment in the amount of more than 2.7 pg/ml.

T-regulatory cells control the strength and duration of immune response and play an important role in the pathogenesis of psoriasis. The goal of the study was to examine the content of T-regulatory cells in peripheral blood and affected skin of psoriasis patients, the level of FOXP3 mRNA expression in psoriatic skin. Determination of subpopulations of T-regulatory lymphocytes in peripheral blood was performed using flow cytometry. The median level of FOXP3 mRNA expression was determined in biopsies of the skin by PCR in real time. Immunohistochemistry was performed with monoclonal anti- FOXP3 antibodies. Revealed an increase in the relative content of T-regulatory cells in the peripheral blood of patients with psoriasis in the progressive period, compared with healthy people. The level of FOXP3 mRNA expression in psoriatic foci was 3.1 times higher than in healthy individuals. Was noted a 10-fold increase in the number of T-regulatory lymphocytes in the skin of psoriasis patients in the progressive period, compared with skin from healthy donors.

The article is devoted to the development and validation of a standard operating procedure entitled «Molecular typing of С. trachomatis for assessment of the clonal structure and extent of genetic diversity of С. trachomatis strains circulating in the territory of the Russian Federation.» The studies that involved the typing of C. trachomatis strains obtained from regions of the Russian Federation with the use of six c. trachomatis genes (ompA, СТ046, cT058, cT144, cT172 and pbpB) revealed their significant heterogenicity with the prevalence of the E serotype. However, the typing of c. trachomatis for six genes at one time seems to be too time-consuming and long-lasting and is hard to be interpreted, which explains the need to develop other typing protocols using a smaller number of relevant genes (not more than two or three - by analogy with NG-MAST).

Goal: to assess the impact of environmentally hazardous factors on the formation of atopic dermatitis (AD) in children. Materials and methods: 108 children aged 1-18 were engaged in the study. The AD severity was analyzed based on the SCORAD index, data from the medical history and frequency of development of complications in children depending on the place of their residence. The elemental composition of hair was analyzed to assess the impact of anthropogenic pollution on childrens organisms. The Southeastern Administrative District (SEAD), which is unfavorable in terms of ecologic environment, and Western Administrative District (WAD) in Moscow, which is free of any human-induced pollution, were chosen as comparison areas. Results: More severe forms of AD in terms of clinical manifestations prevailed in children residing in the SEAD. The number of exacerbations per year was three times as high as the same index in children from the WAD, and there was no trend towards seasonality. The course of AD in children permanently residing in the district with human-induced pollution was characterized by complications with the accumulation of toxic elements in hair against the background of deficiency of essential elements as well as increased elimination of calcium from organisms resulting in low adaptive regulatory mechanisms. Conclusion: when children suffering from AD reside in a highly polluted area on a regular basis, this results in chronic intoxication of their organisms with heavy metals, which leads to deficiency of essential elements, reduction of adaptive mechanisms and severe course of dermatitis.

The authors characterized a heterogeneous group of a rare disease - Langerhans and non-Langerhans cell histiocytosis, and analyzed key differential and diagnostic differences between these forms of the disease. A very rare case of non- Langerhans cell histiocytosis (Rosai-Dorfman disease) in a female patient aged 63 with the subsequent spontaneous regression of eruptions was described. Key skin manifestations of the Rosai-Dorfman disease included papular eruptions of the typical intense pink color with a yellowish and brown tint. Morphologic changes were characterized by proliferation of histiocytes and accumulation of different lipids and pentalamellar markers (S-100 protein, СD 14, СD 68, lysozyme) in their cytoplasm. Though the Rosai-Dorfman disease usually involves lymph nodes, this case was characterized by unaffected nodular structures.

Combination treatment of onychomycosis is based on supplementation of systemic antifungal therapy with different topical techniques, which now include antifungal nail lacquers. Controversies in establishing potential and efficacy of combination treatment in onychomycosis may be overcome by rational administration of any treatment modality after careful evaluation of both the disease and the patient. Application of antifungal nail varnishes such as 8% ciclopirox offers several benefits in treating onychomycosis. With improved efficacy and safety, onychomycosis combination therapy appears to be less expensive and more reliable in terms of reduced rates of relapse and re-infection. Russian and international clinical trials and studies with ciclopirox nail lacquer have revealed the indications and proved the high effectiveness of certain algorithms of combination treatment.

There has been an increase in the number of dermatology patients suffering from several concomitant skin diseases of different etiology for the past decade. A special term - dermatoses of mixed etiology (DME) - was suggested to describe this group of diseases. According to the authors, long-term uninterrupted treatment with one-component topical drugs or unreasonable administration of three-component combination agents is the most frequent reason for DME. The authors describe their positive experience of administering Travocort as a part of DME treatment. The effect of the drug was observed as early as on the second day of its administration: there was an active regression of hyperemia, edemas and skin oozing lesions in the foci. Itching and stinging disappeared almost completely, which also alleviated the patients condition. On Days 3-4, no formation of new vesicles was observed, there were no oozing lesions, and erosion cuticularization began on an active basis. Therefore, Travocort is a highly efficient drug for treatment of infectious dermatoses complicated with eczematization as well as chronic inflammatory diseases exacerbated by a concomitant fungous and bacterial infection.

Sixty women (average age: 44.8+1,1) underwent examination with the use of Skin XP Pro software, laser Doppler flowmetry and CAH psychological test for assessment of the effect of mesotherapy (MT) with the use of Ekyced P.I. cream on age-related changes in facial skin. A course of MT with the use of Ekyced P.I. cream, which was applied prior to and after mesotherapy, as well as Ubichinon Compositum and Placenta Compositum resulted in an evident reduction in the intensity of wrinkles, increase in the level of elasticity and hydration as well as normalization of the level of skin oiliness. The use of Ekyced P.I. regenerating cream resulted in a considerable reduction in the frequency of development of MT side effects such as edemas, erythema, purpura. Mesotherapy with the use of Ekyced P.I. in women older than 45 was accompanied by a more evident increase in the level of skin hydration and elasticity than in women younger than 45.