Vol 92, No 3 (2016)

ORGANIZATION OF HEALTH CARE AND EPIDEMIOLOGY
Dermatovenereologic healthcare delivery in Russian Federation. Incidence of sexually transmitted infections and skin disorders, 2013-2015
Kubanova A.A., Kubanov A.A., Melekhina L.E., Bogdanova E.V.

Abstract

The paper presents the analysis of the work and resources of dermatovenereologic healthcare organizations in Russian Federation, the results of hospital and day hospital beds restructurisation, medical service density, hospital bed usage, incidence of sexually transmitted infections and skin disorders in Russian Federation in 2013-2015.
Vestnik dermatologii i venerologii. 2016;92(3):12-28
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GUIDELINES FOR PRACTITIONERS
Using standard serology blood tests to diagnose latent syphilis
Katunin G.L., Rubtsov A.B.

Abstract

Goal. To conduct a comparative assessment of the results of regulated serological tests obtained as a result of blood tests in patients suffering from latent syphilis. Materials and methods. The authors examined 187 patient medical records with newly diagnosed latent syphilis in FGBU GNTsDK (State Research Center for Dermatology, Venereology and Cosmetology), Health Ministry of the Russian Federation, in 2006-2015. The results of patient blood tests were analyzed with the use of non-treponemal (microprecipitation test/RPR) and treponemal (passive hemagglutination test, immune-enzyme assay (IgA, IgM, IgG), IFabs, immunofluorescence test and Treponema pallidum immobilization test) serology tests. Results. According to the results of blood tests of latent syphilis patients, the largest number of positive results was obtained as a result of treponemal serology tests such as immune-enzyme assay (100%), passive hemagglutination test (100%) and IFabs (100%). The greatest number of negative results was observed in non-treponemal (microprecipitation test/RPR) serology tests: in 136 (72.7%) patients; evidently positive results (4+) test results were obtained in 8 (4.3%) patients only. According to the results of a comparative analysis of blood tests in patients suffering from latent syphilis obtained with the use of treponemal serology tests, the greatest number of evidently positive results (4+) was noted for the passive hemagglutination test (67.9%). Negative treponemal test results were obtained with the use of the immunofluorescence test and Treponema pallidum immobilization test (21.9% and 11.8% of cases, respectively). Moreover, weakly positive results prevailed for the immunofluorescence test: in 65 (34.7%) patients. Conclusion. These data confirm that the following treponemal tests belong to the most reliable ones for revealing patients suffering from latent syphilis: immune-enzyme assay, passive hemagglutination test and IFabs.
Vestnik dermatologii i venerologii. 2016;92(3):69-74
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Potential of confocal laser scanning microscopy for non-invasive diagnostics of malignant epithelial skin tumors in the course of dermatoheliosis progression
Snarskaya E.S., Tkachenko S.B., Kuznetsova E.V., Allenova A.S.

Abstract

Most cases of malignant epithelial skin neoplasms including actinic keratosis and basal cell carcinoma, which are characterized by the most complicated course and numerous clinical and morphological options, involve dermatoheliosis progression. The risk of actinic keratosis transformation into basal cell carcinoma varies from 0.1% to 20% and up to 80% in cases of multiple AK lesion foci. A non-invasive method known as reflectance confocal laser scanning microscopy is the most promising one for the purposes of early diagnostics of signs pointing at epithelial skin neoplasm development and makes it possible to monitor the tumor in progress in vivo to diagnose the presence of a pool of squamous cells on a timely basis. The confocal laser scanning microscopy method provides high-contrast images of for any horizontal-oriented morphologic structures in the epidermis and upper dermis with a resolution comparable to those characteristic of traditional optical microscopy of skin tissue samples. According to our data obtained as a result of studying dynamic changes and morphologic structures in actinic keratosis foci (50 cases) using the confocal laser scanning microscopy method, we discovered a number of morphologic features, and their further analysis will distinguish the signs of progressing carcinogenesis in case of dermatoheliosis.
Vestnik dermatologii i venerologii. 2016;92(3):75-82
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Microbiome: a new era in normal and pathological changes skin studies
Araviiskaia E.R., Sokolovskiy E.V.

Abstract

The paper contains review of studies on microbiota and cutaneous microbiome using modern techniques of methagenomic analysis. The existing data on microflora of normal skin and among the patients with acne, seborrhoeic dermatitis, rosacea atopic dermatitis are consequently analyzed. The interaction between microbiome and innate/adaptive immunity is presented The perspectives of knowledge on microbiome both in dermatology and cosmetology are pointed out.
Vestnik dermatologii i venerologii. 2016;92(3):102-109
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Using clobetasol propionate in the form of a shampoo for the treatment of patients suffering from psoriasis localized in the scalp area
Bakulev A.L., Kravchenya S.S., Igonina I.A., Utz S.R.

Abstract

The study involved 80 adult psoriatic patients with scalp affections at the dermatosis progressing stage. The authors compared scalp psoriasis topical treatment options such as using 0.05% clobetasol propionate in the form of a shampoo, and successive administration of the 2% salicylic acid ointment and aforesaid short-term topical product in patients with vulgar or exudative dermatoses using dynamic scores such as mPASI, DLQI and itching intensity degree. It was demonstrated that 0.05% clobetasol propionate used in the form of a shampoo is characterized by a high efficacy and safety profile for patients with vulgar or exudative psoriasis of the scalp. At the same time, in case of exudative dermatosis successive topical treatment with the use of the 2% salicylic acid ointment and 0.05% clobetasol propionate in the form of a shampoo contributes to the clearance of psoriatic foci from accumulated scales and enables a potent topical corticosteroid such as clobetasol to efficiently reduce principal clinical symptoms of scalp psoriasis such as erythema, infiltration, exfoliation and itching. Using the clobetasol shampoo reduces the scalp itching intensity as the key psoriatic symptom preventing an isomorphic reaction as a result of foci traumatization related to scratching.
Vestnik dermatologii i venerologii. 2016;92(3):110-116
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Experience of using tacrolimus as a part of a complex therapy of atopic dermatitis
Filimonkova N.N., Kascheeva Y.V., Kolbina M.S.

Abstract

This review presents the results of international and Russian clinical studies conducted to assess the efficacy and safety of topical calcineurin inhibitors (TCIs) for the treatment of atopic dermatitis. The main mechanisms of action of TCIs are described. The authors demonstrate the advantages of Tacrolimus belonging to the TCI group. Due to the hydrophilic drug form and pharmacoeconomic index promoting compliance with treatment, it is possible to consider the new drug Tacropic (0.1% and 0.03% Tacrolimus ointments) as the optimum topical drug for the treatment of moderate to severe and severe forms of atopic dermatitis in adults and children.
Vestnik dermatologii i venerologii. 2016;92(3):117-122
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The experiment of using loratadinum in pregnant women with pruritic dermatoses
Monakhov K.N., Kholodilova N.A.

Abstract

Results of examination of 64 pregnant women with allergic dermatosis. Provides results of the efficacy, tolerance and safety study of the loratadinum drug in pregnant women with allergic dermatosis.
Vestnik dermatologii i venerologii. 2016;92(3):123-127
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The course and treatment of atopic erythroderma Hill (case study)
Sokolova T.V., Safonova L.A.

Abstract

Relevance. Atopic erythroderma Hill (AEH) is a severe variant of the disease. Its occurrence depends on the examined patients and between 1.9% (young men of military age) to 42% (persons admitted to hospital). The treatment procedure is directly related to the presence of trigger factors, aggravating the disease. The purpose of this publication. To analyze the errors of physicians in the choice of Treatment for patients with AEH. Materials and methods. Use material during the examination and treatment of two patients with AEH aged 5 and 17 years in the allergological center of professor Ado A.D. The detailed analysis of the characteristics of AEH and reasons for the ineffectiveness of traditional treatment methods. Main results. Clinical, immunological, bacteriological methods have made it possible to identify trigger factors contributing to the transformation of the classical course of atopic dermatitis in AEH. Limiting their influence helped improve efficiency. Conclusion. The drug of choice for topical therapy AEH is the methylprednisolone aceponate + ceramides (Komfoderm K), which has a pronounced anti-inflammatory and moisturizing effect with the ability to handle up to 60% of the skin within 12 weeks.
Vestnik dermatologii i venerologii. 2016;92(3):128-138
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Experience of applying azelaic acid in dermatology
Kondratyeva Y.S., Kokina O.A.

Abstract

The article presents current published data on 30 years of experience in applying of azelaic acid in dermatology. Data on pharmacokinetics, efficacy and safety in the international practice; results of study and therapeutic efficacy of different dosage forms are presented.
Vestnik dermatologii i venerologii. 2016;92(3):139-144
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Squamous-cell carcinoma in a female patient suffering from recessive dystrophic epidermolysis bullosa
Karamova A.E., Chikin V.V., Albanova V.I., Smolyannikova V.A., Nefedova M.A., Monchakovskaya E.S.

Abstract

The article describes a case of squamous-cell carcinoma in a female patient aged 30 suffering from a rare inherited disease -recessive dystrophic epidermolysis bullosa (RDEB). RDEB is characterized by a high risk of squamous cell carcinoma in young patients. The most frequent form is a highly differentiated form of cancer characterized by an aggressive course with the early development of metastases and fast progression, which is the most frequent cause of death in RDEB patients. The described case of squamous cell carcinoma in a young female RDEB patient emphasizes the role of early tumor diagnostics.
Vestnik dermatologii i venerologii. 2016;92(3):83-89
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A case of psoriasiform syphilid (from clinical practice)
Koshkin S.V., Chermnykh T.V., Kovrova O.S., Ryabov N.Y.

Abstract

The current article analyzes a clinical case of general psoriasis-form syphilid in a 28-year patient. Attention is paid to combination of exudative psoriasis and syphilis in in a sex partner. Problems of differential diagnosis for clinical evidence of secondary syphilis and psoriasis were analyzed.
Vestnik dermatologii i venerologii. 2016;92(3):90-96
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A case of localized bullous scleroderma
Bakulev A.L., Galkina E.M., Karakaeva A.V., Litvinenko M.V.

Abstract

Bullous scleroderma is a rare type of the focal form of the disease mainly affecting the skin and characterized by induration and sclerosis foci as well as subepidermal blisters containing a transparent matter. The article describes a case study of bullous scleroderma in an adult woman with localized skin eruptions in the area of the left breast, which were completely regressed after a standard therapy with the use of drugs having an effect on collagen synthesis.
Vestnik dermatologii i venerologii. 2016;92(3):97-101
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Assessing the itching intensity using visual analogue scales in atopic dermatitis patients against the background of a therapy with calcineurin inhibitors
Chikin V.V., Smolyannikova V.A., Proshutinskaya D.V., Nefedova M.A.

Abstract

Goal. To assess the effect of topical treatment of atopic dermatitis patients with the 0.1% tacrolimus ointment on the itching intensity and skin expression level of growth factor proteins affecting the intensity of cutaneous innervation. Materials and methods. Fifteen patients suffering from atopic dermatitis underwent treatment with the 0.1% tacrolimus ointment. The SCORAD index was calculated to assess the severity of clinical manifestations. The itching intensity was assessed using a visual analogue scale. The skin expression of nerve growth factors, amphiregulin, semaphorin 3A and PGP9.5 protein (a nerve fiber marker) was assessed by the indirect immunofluorescence method. Results. An increased expression of the nerve growth factor and reduced semaphorin 3A expression levels were noted in the patients’ epidermis; there was an increase in the quantity, mean length and fluorescence intensity of PGP9.5+ nerve fibers. As a result of the treatment, the disease severity and itching intensity were reduced, the nerve growth factor expression level was reduced while semaphorin 3A expression level increased in the epidermis, and the mean length and fluorescence intensity of PGP9.5+ nerve fibers was also reduced. A positive correlation among the itching intensity and nerve growth factor expression level, quantity and mean length of PGP9.5+ nerve fibers in the epidermis was revealed, and negative correlation between the itching intensity and semaphorin 3A expression level in the epidermis was established. Conclusion. Topical treatment with the 0.1% Tacrolimus ointment reduces the itching intensity in atopic dermatitis patients, which is related to the therapy-mediated reduction in the epidermis innervation level, decreased expression of epidermal nerve growth factor and increased semaphorin 3A expression level.
Vestnik dermatologii i venerologii. 2016;92(3):46-55
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Osteoporosis as a result of the long-term administration of glucocorticoids in patients suffering from acantholytic pemphigus
Ufimtseva M.A., Bochkarev Y.M., Gurkovskaya E.P., Puhtinskaya P.S., Nikolaeva K.I., Lesnaya O.D.

Abstract

Goal. To study the prevalence of glucocorticoid-induced osteoporosis in patients suffering from acantholytic pemphigus and risk of osteoporosis-related fractures. Materials and methods. The study involved 26 patients including 12 patients suffering from acantholytic pemphigus. The patients underwent dual-energy X-ray absorptiometry (DXA) for calculating bone mineral density (BMD) as well as T and Z scores. To assess the ten-year probability (absolute risk) of fractures, the FRAX model was applied. Major results. Glucocorticoid-induced osteoporosis was diagnosed in 33.3% of the AP patients receiving a glucocorticoid therapy, and osteopenia was also diagnosed in 33.3% of them; an increased risk of osteoporosis-related fractures was observed in all of the patients over 40, which entails the need in early diagnostics of pathologic bone changes and prevention of complications such as osteoporosis-related fractures. Conclusion. A high share of complications (83.3%) related to systemic GCS stipulates the need in increased cooperation between dermatologists and allied specialists.
Vestnik dermatologii i venerologii. 2016;92(3):56-61
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Multidisciplinary model of sexually transmitted infection prevention in the group of injecting drug users
Krasnoselskikh T.V., Shaboltas A.V., Skochilov R.V., Uraeva G.E.

Abstract

The article summarizes the experience in developing, implementing and effectiveness evaluating of the sexually transmitted infection prevention program in the subpopulation of injecting drug users in St. Petersburg, Russia. The preventive intervention was aimed to correct behaviors leading to infection and was based on a multidisciplinary patient-centered approach. Long-term medical, social and psychological support of injecting drug users, combined with the group training sessions based on the peer-to-peer model has allowed to reduce their injecting and sexual risk, as well as to decrease the HIV infection incidence in the intervention group 1.84 times against the control group.
Vestnik dermatologii i venerologii. 2016;92(3):62-68
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The role of bacterial infection in the pathogenesis of psoriasis
Slesarenko N.A., Utz S.R.

Abstract

The article presents the results of numerous studies confirming the involvement of bacterial agents in the psoriatic process manifestation as triggering factors. The article discusses potential pathogenic mechanisms of the participation of bacterial superantigens in the initiation of a cascade of immunological reactions resulting in the hyperproliferation of keratinocytes. The expediency of using antibacterial agents as a part of a complex therapy of different forms of the disease is discussed.
Vestnik dermatologii i venerologii. 2016;92(3):29-35
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Using clinical and diagnostic indices to assess the severity of pemphigus (a comparative analysis)
Kubanov A.A., Abramova T.V.

Abstract

The article discusses clinical indices suggested for the assessment of the severity of the course of autoimmune bullous dermatosis - pemphigus. These indices make it possible to assess the severity of the disease in view of the localization and prevalence of blisters and/or erosions and patient’s subjective sensations as well as efficacy of the therapy, and to compare the study results. In spite of the great number of indices suggested for the assessment of the severity of pemphigus, none of them are generally recognized. The following indices are currently considered as the best known and most convenient for application in clinical practice: Pemphigus Disease Area Index (PDAI), Autoimmune Bullous Skin Disorder Intensity Score (ABSIS) and Pemphigus Vulgaris Activity Score (PVAS). A number of studies demonstrated mutual correlation among ABSIS, PDAI and PVAS. However, the group of patients under examination mainly comprised people suffering from light to moderate forms of pemphigus, which makes it difficult to interpret the results of comparative studies. It is expedient for leading dermatovenerologists to carry out clinical studies based on a large group of patients with pemphigus of different severity to elaborate a common tool to assess the severity of pemphigus in the Russian Federation to be recommended by the Russian Society of Dermatovenerologists.
Vestnik dermatologii i venerologii. 2016;92(3):36-45
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