Vestnik dermatologii i venerologii

Hidradenitis suppurativa (HS) is a chronic recurrent skin disease characterized by development of autoimmune inflammation in the infundibulum of the hair follicle and apocrine sweat glands located in the axillary, inguinal, anogenital regions, submammary folds, near the areola of mammary glands and the umbilical region. HS is difficult to treat and has an extremely negative impact on the quality of life. HS is separated into a distinct clinical entity fundamentally different in etiopathogenesis from acute bacterial hidradenitis. The exact prevalence of HS is unknown, it varies greatly in different studies ranging from 0.03 to 4% in general population. The detection of IL-1β, IL-23, and IL-17 in the lesions indicates the key role of autoimmune inflammation involving Th17-lymphocytes in the pathogenesis of HS. Risk factors include smoking, obesity, mechanical friction, genetic predisposition. The diagnosis of HS relies on three obligatory criteria: characteristic distribution, typical morphology of the lesions and relapsing, chronic disease course. There is no “gold standard” in assessing the severity of the disease, since all available scoring systems have many limitations, therefore many questions regarding this disease remain unsolved at present — from terminology and clear and most objective assessment criteria for the severity of the process to the development of native clinical guidelines.

Background. Acne is one of the most common dermatoses, the presence of which significantly reduces the quality of life of patients. For patients with inflammatory, comedonal or combined acne, the external use of fixed combinations is a first-line therapy.

Aims. To study the efficacy and safety of the Zerkalin Intensive (benzoyl peroxide + clindamycin) in the treatment of acne in comparison with the Effezel (adapalene + benzoyl peroxide).

Methods. An open comparative clinical study included 60 patients with acne of varying severity: group 1 — 30 patients received therapy with Zerkalin Intensive, group 2 — 30 patients received therapy with Effezel 1 time a day in the evening. The effectiveness of therapy was evaluated 2 weeks, 1, 2 and 3 months after the start of treatment.

Results. After 1 month of therapy, there was a significant improvement (resolution of elements by at least 70%) in 9 (30%) patients of the group 1 and in 9 (30%) patients of the group 2 (p = 1.000); improvement (decrease in the severity of the pathological process by at least 25%) — in 12 (40%) and 18 (60%) patients, respectively (p = 0.106). After 2 months of using Zerkalin Intensive and Effezel, complete resolution of rashes was observed in 11 (36.7%) and 6 (20%), respectively (p = 0.395); significant improvement in 13 (43.3%) and 11 (36.7%) patients (p = 0.628); improvement in 6 (20%) and 13 (43.3%), respectively. After 3 months complete resolution of rashes was observed in 24 (80%) patients of the group 1 and in 12 (40%) patients of the group 2 (p = 0.088); significant improvement in 5 (16.7%) and 11 (36.6%) patients (p = 0.236); improvement in 1 (3.3%) and 7 (23.3%) patients, respectively. Against the background of the use of Effezel, 20 (66.7%) patients showed the appearance of slight dry skin and redness. No side effects were detected when using the Zerkalin Intensive.

Conclusions. A comparable high efficiency of Zerkalin Intensive and Effezel in acne therapy has been established. Use of Zerkalin Intensive made it possible to achieve the onset of a full clinical effect and a significant improvement in the clinical picture in a larger number of patients and in a shorter time.

Psoriasis is a chronic immune-associated disease of a multifactorial nature. The prevalence of the disease, chronic course, impact on the patient’s quality of life, as well as the connection with the risk of progression of various comorbid conditions necessitate a detailed and comprehensive approach to the treatment of this group of patients. There has been a correlation of psoriasis with the risk of many comorbid pathologies, such as psoriatic arthritis, metabolic syndrome, liver and kidney disorders. There is evidence in the literature about the relationship between chronic renal failure and psoriasis, but the data are limited and require further study. According to Russian clinical guidelines, for moderate and severe forms of psoriasis, the prescription of systemic immunosuppressive therapy, targeted and genetically engineered biological drugs is indicated. Of particular interest is the determination of management tactics and selection of therapy if a patient with psoriasis has concomitant pathology due to the lack of a sufficient number of safety studies taking into account this or that comorbidity. We present the data known to us from a literature review on the stated problem. In view of the need to expand the data of real clinical practice on the possible risks of managing patients with psoriasis, we present a description of our own clinical experience of using the inhibitor interleukin 17A in a patient with chronic renal failure and hemodialysis.

Kaposi’s sarcoma is a systemic tumor multifocal disease of vascular genesis. In the classic Kaposi’s sarcoma, lesions are most often localized on the skin of the lower extremities, lesions of the mucous membranes are extremely rare. The article presents a rare clinical case of the classic Kaposi’s sarcoma in a 56 years old man with lesions of the oral mucosa. This clinical case is of particular interest due to the difficulties of differential diagnosis of Kaposi’s sarcoma and lichen planus when mucous membranes are involved in the pathological process. The presented case emphasizes the importance of a histological examination of the biopsy in differential diagnosis of Kaposi’s sarcoma. In case when the rash is widespread and the mucous membranes are involved, it is recommended to collect the material from the skin, because the histological picture will be more characteristic. It is important to pay attention to the duration of the elements’ existence, as morphological diagnosis in the early stages of Kaposi’s sarcoma can imitate the pattern of chronic dermatosis.

Perioral dermatitis is a common dermatosis that predominantly affects women aged 25–40 but is also observed in children and adolescents. The distinct localization of this condition in the perioral, perinasal, and periocular zones contributes to apparent psycho-emotional distress, markedly impairing patients’ quality of life. Perturbations in the skin biotope, local immune dysregulation, and topical glucocorticosteroid use are among the primary etiological factors. Effective management involves addressing causative factors, discontinuation of topical steroids, adopting gentle skincare practices, and employing localized treatments like metronidazole, pimcrolimus, and activated zinc pyrithione. Maintenance therapy may be warranted in select cases. The purpose of this work is to review the current literature on the problem and to present original clinical observations concerning the utilization of activated zinc pyrithione in treating patients with this condition. The article presents the results of the use of topical activated zinc pyrithione in patients spanning various age groups and exhibiting diverse degrees of perioral dermatitis severity. Significant clinical evidence substantiates the remarkable efficacy and safety profile of activated zinc pyrithione in managing perioral dermatitis, both as a standalone therapeutic modality and as an integral component of combination therapy. The use of activated zinc pyrithione in the treatment of perioral dermatitis emerges as an efficacious and secure approach for treating mild to moderate forms of the condition.