Vol 94, No 6 (2018)

SHORT COMMUNICATION

Psoriatic onychodystrophy: clinical manifestations (part 1)

Platonova A.V., Zhukov A.S., Khairutdinov V.R., Samtsov A.V.

Abstract

Psoriatic onychodystrophy is quite common in patients with psoriasis. Changes in psoriatic nails have a wide range of clinical manifestations, including symptoms of damage of the nail bed and/or nail matrix. The article presents information about clinical and pathological manifestations of psoriatic onychodystrophy, the mechanisms of formation of pathological changes. The existence of the relationship between the change of nail plates in patients with psoriasis and the development of psoriatic arthritis is explained, the prognostic value of individual symptoms is analyzed. The diagnostic criteria for the histological diagnosis of psoriatic onychodystrophy are described. The information about the occurrence of each symptom in patients with psoriasis with dystrophic nail changes is given.
Vestnik dermatologii i venerologii. 2018;94(6):7-14
pages 7-14 views

ORIGINAL STUDIES

Treatment of basal cell cancer in the periorbital area using a pulsed copper vapour laser

Klyuchareva S.V., Ponomarev I.V., Topchy S.B., Pushkareva A.E., Andrusenko Y.N.

Abstract

An increase in life expectancy in developed countries is inevitably accompanied by an increase in the number of nonmelanoma skin diseases, which are primarily represented by basal cell cancer (BCC) occurring in elderly and old-age patients. The pathogenesis of such diseases is associated both with impaired proliferation and differentiation of the keratinocytes of the epidermal basal layer, as well as with the transformation of the vasculature in the papillary dermis in the vicinity of BCC. In recent years, such conditions have been increasingly treated using CO2 , neodymium, diode and pulsed-dye lasers. In many cases, these devices allow malignant BCC cells to be successfully eliminated. However, the use of near-infrared lasers in the periorbital area is limited due to a higher risk of damaging the organs of the visual system. Therefore, a search for new laser surgery methods that can be used for treating malignant skin tumours seems to be a prospective research direction.

Methods. 3 male and 9 female patients diagnosed with primary BCC were treated using a copper vapour laser (Yakhroma-Med). The age of the patients varied from 34 to 77 years. Laser treatment was carried out in one session under the following irradiation parameters: the wavelength of 511 and 578 nm, the average power of up to 3 W and a series of 15 ns pulses. The pause between the pulses was 60 μs, with the exposure time ranging from 200 to 600 ms. The light spot diameter on the skin surface was 1 mm. The follow-up monitoring duration was 24 months.

Results. In all the BCC patients, one session of copper vapour laser treatment allowed malignant cells in the disease area to be completely eliminated without relapses during 2 years after the therapy. The duration of skin healing in the irradiated area was 2 weeks in patients under the age of 40 years, compared to 3–4 weeks in elderly patients. After the treatment, short-term side effects, such as a slight edema, erythema and peeling, were observed.

Vestnik dermatologii i venerologii. 2018;94(6):15-21
pages 15-21 views

CLINICAL PRACTICE GUIDELINES

Prevention of hematomas in the induction of injection cosmetology interventions

Zhuchkov M.V., Bolshakova E.E., Sonin D.B., Zhuchkova U.V.

Abstract

The aim of the study was to assess the preventive efficacy of using topical brimonidine tartrate in individuals who underwent cosmetic cosmetology injections in terms of reducing the risk of skin hematoma formation at injection sites.

Materials and methods. The study included 296 patients; the average age of patients in the study was 36.3 ± 7.4 years. The criterion for the inclusion of patients in the study was either the presence of indications for the use of botulinum toxin type A drugs, or fillers. Patients were divided into groups of preventive use of topical brimonidine tartrate and a control group. The evaluation was carried out to achieve the end for patients — the onset of an episode of hemorrhagic complication of the injection procedure.

Results and conclusions. The study demonstrated a reduction in the risk of hemorrhagic complications in patients who underwent contour plastic with previous preventive prescription of topical brimonidine tartrate.

Vestnik dermatologii i venerologii. 2018;94(6):31-36
pages 31-36 views

Indices of peroxidation of lipids of biological membranes and endogenous intoxication in patients with psoriasis on the background of chronic viral hepatitis С

Marzhokhova M.Y., Hussein A., Marzhokhova A.R.

Abstract

Aim. To study the features of lipid peroxidation of biological membranes and accumulation of toxic metabolites in the body of patients with psoriasis, depending on the presence of concomitant chronic viral hepatitis C.

Materials and methods. In the survey, participated 56 patients with a vulgar form of psoriasis who received in-patient treatment at the Nalchik skin clinic in 2016–2017, divided into 2 groups, depending on the presence of concomitant chronic viral hepatitis C. In patients, the content of malonic dialdehyde in blood was determined as an indicator of the state of the prooxidant system, ceruloplasmin and erythrocyte catalase, as indicators of antioxidant protection, and also for the evaluation of the Intoxication Syndrome; the level of substances of low and medium molecular mass and oligopeptides in the biological environments of the organism in different periods of the disease.

Results. It was found that the presence of concomitant chronic viral hepatitis C in patients with psoriasis was characterized by a more pronounced increase in the concentration of lipid peroxidation products than in the group of patients with hepatitis without psoriasis, accompanied by a decrease in the activity of antioxidant enzymes in the blood plasma and an increase in the activity of catalase in erythrocytes. Simultaneously, the presence of chronic hepatitis C led to a significantly higher content in the body fluids of patients with low and medium molecular weight substances and oligopeptides.

Vestnik dermatologii i venerologii. 2018;94(6):22-30
pages 22-30 views

Actinic reticuloid: case report

Sokolovskiy E.V., Mikheev G.N., Demidova E.I.

Abstract

This article is about the case of actinic reticuloid — the rare dermatosis which clinical presentation is similar to atopic dermatitis, T-cell lymphoma. Good treatment effect was obtained by long cycles (2 cycles for 3 months) of hydroxychloroquine and sun protective therapy included sunscreens SPF 50, nicotinic acid, sun-safe clothes which blocked ultraviolet radiation without any glucocorticosteroid drugs and cytostatic treatment.
Vestnik dermatologii i venerologii. 2018;94(6):37-41
pages 37-41 views

CLINICAL CASE REPORTS

Linear IgA bullous dermatosis

Znamenskaya L.F., Chikin V.V., Nefedova M.A.

Abstract

Aim: to present a clinical case of linear IgA bullous dermatosis.

Materials and methods. A 44 years old patient complaining of skin rashes on the trunk and extremities, accompanied by severe itching was examined. We carried out a morphological investigation of biopsy samples derived from the lesion and apparently unaffected skin areas using the method of indirect immunofluorescence.

Results. The patient having rashes in the form of multiple vesicles and small bubbles with a tight cover, which had been grouped into figures resembling pearl necklaces, demonstrated the presence of focal subepidermal cracks (subepidermal bubble in one location), as well as a linear deposition of IgA along the epidermal basement membrane. According to the clinical picture and following the histological and immunofluorescent investigation of skin biopsies, the patient was diagnosed with linear IgA bullous dermatosis. Lesion regression was achieved as a result of systemic therapy with prednisolone at a dose of 50 mg per day.

Conclusion. The diagnosis of linear IgA bullous dermatosis should be made on the basis of skin biopsy investigation by the method of indirect immunofluorescence. Systemic glucocorticosteroids are seen as an effective approach to the treatment of such patients.

Vestnik dermatologii i venerologii. 2018;94(6):42-51
pages 42-51 views

Сlinical case of a blast plasmocytoid dendritic cell tumor

Milikhina E.N., Chermnykh T.V., Koshkin S.V., Maximov O.D.

Abstract

The reason for writing this article was the difficulty in the differential diagnosis of skin lesions in a patient of 40 years, with a preliminary diagnosis of T-cell lymphoma. During the examination, including histological, immunomorphological, immunohistochemical methods, markers of various cell lines (T, B, myeloid) were detected. This feature is characteristic of lymphomas from plasmacytoid dendritic cells (MAC), a new nosological unit. In the WHO classification (2001), tumors with a similar phenotype were included in the lymphoma section of natural killer cells (NK-blast lymphomas). The clinical case described by us illustrates the need for an integrated approach in the diagnosis of lymphomas, which makes it possible to promptly assign adequate therapy.
Vestnik dermatologii i venerologii. 2018;94(6):52-59
pages 52-59 views

DRUG TREATMENT IN DERMATOVENEROLOGY

Acne therapy in adolescent children

Perlamutrov Y.N., Olkhovskaia K.B., Lyapon A.O.

Abstract

Current knowledge of the pathogenesis of acne determines the need for early use of drugs with antiinflammatory activity.

Aim: to determine the effectiveness of monotherapy using Adaklin cream in the treatment of acne in adolescent children.

Material and methods. All adolescents with acne of light and moderate severity were examined to determine the dermatological index of acne (DIA), determine the level of production of sebaceous glands, testing the parents of patients. Monotherapy was performed using Adaklin cream.

Results. 60 patients with acne were under observation. Formation of clinical remission was registered in 78.33 % of adolescents. A good tolerability of the therapy and a high level of compliance were noted.

Conclusion: the high efficacy and tolerability of therapy with the use of Adaklin cream in adolescents with acne was stated.

Vestnik dermatologii i venerologii. 2018;94(6):60-66
pages 60-66 views

Experience in the treatment of psoriasis patients using Apremilast, a selective signalling pathway inhibitor

Kungurov N.V., Zilberberg N.V., Kokhan M.M., Keniksfest J.V., Grishaeva E.V.

Abstract

The article presents a brief description of Аpremilast — the target synthetic anti-inflammatory drug, which is representative of a new class of agents for the treatment of psoriasis and psoriatic arthritis. The efficiency and safety of the new drug in the treatment of patients with severe psoriasis are shown.
Vestnik dermatologii i venerologii. 2018;94(6):67-76
pages 67-76 views


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