Vol 96, No 2 (2020)

EDITORIAL

Recommendations Russian Society of Dermatovenerologists and Cosmetologists for systemic treatment of psoriasis during the pandemic COVID-19

Kubanov A.A., Bakulev A.L., Kokhan M.M., Olisova O.Y., Samtsov A.V., Sokolovskiy E.V., Khairutdinov V.R., Khobeish M.M.

Abstract

Below you will find the analysis of the first published data and international clinical recommendations for the systemic treatment of patients with moderate and severe psoriasis in the context of the COVID-19 pandemic in different countries (France, Italy, USA, Spain, and Germany).

Vestnik dermatologii i venerologii. 2020;96(2):9-13
pages 9-13 views

REVIEWS

Сutaneous Vasculitis: Classification, Diagnosis and Differential Diagnosis (Part 2)

Khairutdinov V.R., Belousova I.E., Samtsov A.V.

Abstract

This article is a continuation of the literature review on skin vasculitis. In the first part, information was presented on the current nomenclature and prevalence of vasculitis, pathomorphological changes in the skin, as well as diagnostic algorithms for examining patients with this pathology are reflected.

The second part of the article contains a detailed description of the elements of the skin rash with systemic and organ-specific vasculitis, presents the clinical manifestations observed with damage to other organs and systems, the development of possible complications.

The data on modern treatment tactics are summarized, modern approaches using pathogenetic and symptomatic therapy of patients with various vasculitis are reflected.

Vestnik dermatologii i venerologii. 2020;96(2):14-23
pages 14-23 views

ORIGINAL STUDIES

The Reconstructed Human Epidermis in vitro — a Model for Basic and Applied Research of Human Skin

Beilin A.K., Rippa A.L., Sharobaro V.I., Gurskaya N.G., Vorotelyak E.A.

Abstract

Background. The reconstructed human epidermis (RE) is an in vitro tissue-engineering construct similar to the native epidermis.

Objective. To develop a full-layer RE. Describe its structure: determine the presence of all layers of the epidermal component, including basal, spinous and granular layers and stratum corneum of the epidermis; detect the basement membrane, the border between the epidermal and mesenchymal component.

Materials and methods. Isolation of keratinocytes and fibroblasts from human donor skin. Cultivation of keratinocytes and fibroblasts in vitro under 2D conditions, cell subculturing and 3D modeling of RE, obtaining cryosections, histological staining, immunohistochemical (IHC) study with antibodies to cytokeratins 14 and 10, Ki67 protein, loricrin, laminin 5 and plectin.

Results. A technique was developed for the formation of RE. Histological examination showed that the stratification of keratinocyte layers occurs during the formation of RE. Layers are formed including basal, spinous and granular layers and stratum corneum. The IHC study has shown the proliferative activity of keratinocytes of the basal layer and has detected the presence of marker proteins of keratinocytes at different stages of differentiation. RE basal keratinocytes, like native ones, form hemidesmosomes and synthesize basement membrane proteins.

Conclusions. A full-layer human RE was obtained in vitro. RE meets all the characteristics of the native epidermis and it is suitable for basic and practical research in the field of skin biology, dermatology, and cosmetology.

Vestnik dermatologii i venerologii. 2020;96(2):24-34
pages 24-34 views

CLINICAL CASE REPORTS

Hoffman's Recalcitrant Dissecting Folliculitis — State of the Problem, Approach to Therapy, Demonstration of Clinical Cases

Drozhdina M.B., Bobro V.A.

Abstract

A review of the literature on the etiology, pathogenesis, and evidence base of therapeutic approaches for the management of patients with Hoffman's recalcitrant dissecting folliculitis is presented. The article describes the clinic of the disease, complications and optimal therapeutic tactics at the present stage. Attention is focused on the problem of antibiotic resistance and ways to solve it. A clinical case with a successful therapeutic outcome is presented. The article is illustrated with photos on the patients from the author's archive.

Vestnik dermatologii i venerologii. 2020;96(2):35-43
pages 35-43 views

Trichoteiromania in adults

Mareeva A.N., Pichugina I.M.

Abstract

This paper describes two clinical cases of a rare auto-destructive hair pathology — trichoteiromania. In the literature a few cases of trichoteiromania are described, it leads to non-cicatricial hair loss as a result of their rubbing and is characterized by splitting and damaging of the hair shaft.

The clinical picture features, trichoscopic signs of the disease are presented: foci of baldness in the scalp, hair shafts not more than 1.5 cm long, curved, scaling as a result of scratching the skin. Trichoscopic features: broken hair up to 1,5 сm length, splitting of the distal end of the hair shaft (trichoptilosis), scaling.

The data on the differential diagnosis of the disease with other hair pathologies, the possible symptomatic, psychotherapeutic, psychopharmacological treatment of trichoiteromania are presented.

These clinical cases are of interest in connection with rare descriptions in the literature, the importance of trichoscopy in the differential diagnosis of alopecia, the possibility of interaction between a dermatologist and a psychiatrist, a psychotherapist are indicated.

Vestnik dermatologii i venerologii. 2020;96(2):44-50
pages 44-50 views

DRUG TREATMENT IN DERMATOVENEROLOGY

The Actual Challenges of Biologics Treatment in Patients with Psoriasis

Bakulev A.L.

Abstract

The article contain the main challenges meet doctors in real practice using biologics for treatment patients with psoriasis.Different aspects and concerns have been analised from new point of view: the aims of Bx therapy (incl. control of remission, personalized goals, etc.) primary and secondary responses, immunogenicity, treatment survival, retention rate or long lasting regain of response in psoriasis patients treated by biologics.

Vestnik dermatologii i venerologii. 2020;96(2):51-57
pages 51-57 views

Isotretinoin — 40 Years in Dermatology

Samtsov A.V.

Abstract

The article provides a review of the literature on isotretinoin (Isotretinoin Lidose), which for almost 40 years has been the most effective treatment for moderate forms of acne. The article sets out modern ideas about the mechanism of action of the drug, as well as the evolution of treatment algorithms, as well as the evolution of algorithms for influencing people, which reduces the risk of adverse events. Data on the efficacy and safety of isotretinoin for acne and other dermatoses are provided.

Vestnik dermatologii i venerologii. 2020;96(2):58-63
pages 58-63 views

Comparative study of anti-inflammatory activity of zinc pyrition on a psoriasis laboratory model

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

Abstract

Psoriasis is a chronic immune-mediated inflammatory disease with predominant skin lesions. External therapy is an important area of treatment for such patients. Non-steroidal anti-inflammatory drugs based on zinc pyrithione do not have side effects inherent in the glucocorticosteroid drug and can be an alternative to them. Evaluation of the effectiveness of drugs is not always convenient in humans. The use of laboratory models allows us to study changes in the clinical, histological and immunohistochemical characteristics of the skin during topical therapy.

Goal. On laboratory models of psoriasis, conduct a comparative assessment of the anti-inflammatory effectiveness of Skin-cap in comparison with other drugs.

Materials and methods. In the experiment, 50 Balb / c inbred mice were used, randomized to 5 groups. The formation of a model of psoriasis by listening to them, after which I perform euthanasia with a skin biopsy in mice. Group II mice are treated with activated zinc pyrithione cream (Skin-cap), group III - zinc pyrithione cream (Zinocap), group IV — betamethasone dipropionate cream (Akriderm) — 2 p/d — 14 days. Group V was monitored without therapy. The Clinical PASI Index (mPASI) score is given daily. On the 29 day of studies, group II-V mice undergo euthanasia and skin biopsies, which were examined histologically (epidermal thickness, severe inflammatory infiltrate) and immunohistochemical methods (Ki-67, CD3). The differences were considered significant at p<0.05.

Results. The initial mPASI index value was 7.2 [5.2—9.3]. The mPASI index in the Skin-cap group was 1.8 [1.1—3.2], zinc pyrithione 2.9 [2.1—4.2] and betamethasone dipropionate 1.3 [1.0] —3.1], which is significantly lower than in the group without therapy — 5.8 [5.0—6.8] (p <0.05). A histological examination in mice receiving zinc pyrithione-activated showed a more pronounced decrease in the thickness of the epidermis (2.7 times) than with pyrithione zinc (2 times) and, immunohistochemical analysis showed the most significant decrease in the proliferative activity of the epidermis and the number of T-lymphocytes when using betamethasone and zinc pyrithione activated.

Conclusions: it was found that the use of the drug leads to the suppression of the inflammatory process in the skin, comparable in effectiveness with a strong topical glucocorticosteroid.

Skin-cap has no atrophogenic effect, which allows us to recommend this drug for the treatment of psoriasis patients with any localization of rashes.

Vestnik dermatologii i venerologii. 2020;96(2):64-70
pages 64-70 views


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