Russian Journal of Skin and Venereal Diseases

BACKGROUND: Erythroplasia of Queyrat (ICD-10 code: D07.4) is an intraepithelial neoplasia affecting the glans penis and inner preputial leaf. It is classified as a squamous cell carcinoma in situ. However, available publications lack data on its prevalence across age groups.

AIM: The work aimed to examine the clinical and epidemiological aspects of erythroplasia of Queyrat and assess the efficacy of various diagnostic approaches.

METHODS: A retrospective, cross-sectional case history study in patients who sought medical advice for penile lesions of various origins (n = 327) and a prospective observational study in patients with erythroplasia of Queyrat (n = 49) were conducted. Toluidine blue staining, dermatoscopy, and cytological and histological examinations were used in the diagnosis of erythroplasia of Queyrat. Additionally, an ultrasound of the penis and inguinal lymph nodes, tests for sexually transmitted infections, and a transrectal prostate ultrasound were performed.

RESULTS: The observational study in patients with erythroplasia of Queyrat revealed a trend towards younger onset. The majority of patients (30.61%) were aged 50–59 years, with the disease detected before the age of 29 in 12.24% of cases and at the age of 30–39 in 20.4% of cases. A total of 89.8% of patients saw physicians of various specialties (urologists, dermatovenerologists, oncologists, etc.), whereas 10.2% self-medicated. The time between the onset of penile rashes and seeking medical advice is particularly concerning, ranging from 1 week (4.0%) to more than 5 years (2.0%). Thus, patients with a disease duration of ≥ 1 year (12.1%) are at the highest risk of penile squamous cell carcinoma. The majority of patients with erythroplasia of Queyrat consult with a dermatovenerologist, with the final diagnosis made on the initial or follow-up visit in 93.87% of cases, indicating that dermatovenerologists are familiar with clinical signs and diagnostic approaches in this condition.

CONCLUSION: This work addresses the gaps in the modern assessment of clinical and epidemiological aspects and diagnostic efficacy in patients with erythroplasia of Queyrat, facilitating the selection of effective therapeutic options.

BACKGROUND: Atopic dermatitis is a chronic, relapsing, immune-mediated inflammatory pruritic skin disease that substantially impairs patients' quality of life. In some patients with moderate to severe disease that is resistant to standard therapy, pronounced pruritus and high disease activity persist, prompting the search for pathogenetically justified combination treatment approaches.

AIM: The study aimed to evaluate the clinical efficacy and safety of combination therapy with azathioprine and narrowband UVB 311-nm in patients with moderate to severe refractory atopic dermatitis.

METHODS: This non-controlled clinical study involved 20 patients (14 men and 6 women aged 18–60 years) diagnosed with atopic dermatitis according to the Hanifin and Rajka criteria. Patients received oral azathioprine 50 mg twice daily for 3 to 4 weeks in combination with narrowband UVB 311-nm therapy (4 procedures per week, 12–16 sessions; initial single dose, 0.1–0.2 J/cm², with increments of 0.1 J/cm²). Clinical efficacy was assessed using the Scoring Atopic Dermatitis (SCORAD) index, the Dermatology Life Quality Index (DLQI), and the Pruritus Index for patients with various dermatoses (Prurindex). Laboratory monitoring included complete blood count, biochemical parameters (alanine aminotransferase, aspartate aminotransferase, bilirubin, and creatinine), and thiopurine methyltransferase activity.

RESULTS: By the end of the treatment course, a marked reduction in pruritus was observed. The mean morning Prurindex score decreased from 8.2 ± 0.7 to 1.8 ± 0.4; daytime values decreased from 8.4 ± 0.6 to 2.0 ± 0.3; and evening values decreased from 9.2 ± 0.8 to 2.3 ± 0.5. After 1 month of follow-up, the mean SCORAD score decreased from 48.5 ± 3.2 to 18.2 ± 2.8 (transition from moderate to mild disease severity); the mean DLQI score decreased from 19.5 to 6.0 (transition from a strong to a moderate effect). Laboratory parameters remained within reference ranges.

CONCLUSION: Combination therapy with azathioprine and narrowband UVB 311-nm in patients with atopic dermatitis resulted in a relatively rapid and pronounced clinical response, including a marked reduction in pruritus, and may be considered a valuable alternative treatment strategy for refractory atopic dermatitis with a manageable safety profile.

Chronic spontaneous urticaria and prurigo are debilitating skin conditions characterized by persistent pruritus and inflammation, often leading to significant reductions in quality of life. Conventional treatments, including antihistamines, corticosteroids, and immunosuppressive therapies, may prove ineffective, leading to the need for alternative treatment approaches. Innovative methods such as general aerocryotherapy, in which cold air is applied to the skin site, have attracted much attention. It is believed to work through vasoconstriction, inhibition of mediator release from mast cells, and modulation of sensory nerve impulses, ultimately reducing inflammation and itching. Early research has revealed positive signs that aerocryotherapy could help reduce the itch intensity and inflammation in individuals with a range of skin disorders. In the present systematic literature review, the use of general aerocryotherapy as an additional treatment approach for chronic spontaneous urticaria and prurigo will be explored in terms of contribution to reduction in symptoms and the quality of life of a patient. Finally, we summarize clinical evidence from clinical trials, review the rationale of aerocryotherapy in terms of pathophysiology, and list the therapeutic strategies for its application in the practice of dermatology. Further studies are needed to refine aerocryotherapy treatment regimens and investigate its long-term effects, particularly in post-traumatic chronic wounds and other skin diseases.

The etiopathogenesis of hyperandrogenism in women has recently received considerable attention, given its relevance and significance in modern dermatology. Elevated androgen levels are associated with a variety of skin changes, such as androgenetic alopecia, acne, and hirsutism, which affect quality of life. These symptoms not only cause physical discomfort but also frequently result in reproductive dysfunction and psychoemotional disorders, impairing overall well-being and social adjustment. There are currently no specific guidelines for treating women with symptoms of hyperandrogenism, making standardized therapy difficult.

This review summarizes recent publications on the pathogenesis, clinical signs, diagnosis, and treatment of hyperandrogenism in women, with an emphasis on skin manifestations (acne, androgenetic alopecia, hirsutism), their pathogenesis, diagnosis, and therapeutic strategies. These multifaceted conditions with diverse skin manifestations and complex clinical presentation require a deep understanding of etiopathogenesis and clinical features, necessitating a personalized, interdisciplinary approach to the diagnosis and treatment of hyperandrogenism in women.

The work includes reviews, guidelines, original studies, and case reports published in the recent decade in leading databases (PubMed, MEDLINE, UpToDate) and websites (eLIBRARY.RU, disserCat.ru, Cochrane Library, Scopus).

The diagnosis and treatment of livedoid vasculopathy continue to be one of the major challenges in modern dermatovenereology. The etiological and pathogenetic mechanisms underlying this condition are insufficiently studied; however, they are critical for distinguishing between livedoid vasculopathy and similar skin diseases and developing effective therapeutic strategies. Clarifying the pathogenesis and developing precise diagnostic criteria will improve differential diagnosis, accelerate its verification, and thereby promote quality of life through combination therapy.

The paper presents a clinical case in a 56-year-old female patient with long-term livedoid vasculopathy secondary to insulin-independent diabetes mellitus and genetically determined thrombophilia caused by numerous mutations in hemostasis genes. The diagnostic workup included a differential diagnosis with ulcerative necrotic polymorphic dermal angiitis and chronic varicose ulcers. A comprehensive examination confirmed the final diagnosis of livedoid vasculopathy.

This case highlights the critical role of extended diagnostic workup in patients with chronic skin ulcers, which is essential for a timely, accurate diagnosis and pathogenetically appropriate therapy, with a special focus on concomitant thrombophilia.

BACKGROUND: Despite the high efficacy of targeted therapy in psoriasis, there is an increase in loss of response (escape phenomenon), including due to the formation of antibodies against biologicals. At the same time, the role of other factors is insufficiently studied. These include comorbidities that are common in psoriasis, such as gastrointestinal diseases, bacterial endotoxemia, and intestinal or skin microbiocenosis disorders.

AIM: The work aimed to assess the effect of netakimab, an IL-17A inhibitor, on the long-term efficacy of psoriasis therapy by targeting bacterial endotoxemia and abnormal intestinal and skin microbiocenosis.

METHODS: The study included 30 patients with severe plaque psoriasis who received netakimab, an IL-17A inhibitor, between 2021 and 2024. The Psoriasis Area and Severity Index (PASI) was measured at baseline and weeks 12, 28, and 52 to assess treatment efficacy (PASI 75/90/100). At weeks 28 and 52, bacterial endotoxin levels in peripheral blood were measured, and intestinal and skin microbiota parameters were assessed using chromatography–mass spectrometry. In patients with a relapse (escape phenomenon) and abnormal markers of bacterial endotoxin and intestinal and skin microbiota, treatment was prescribed to improve microbiocenosis, and its impact on the efficacy of targeted therapy was assessed.

RESULTS: At baseline, the mean PASI, Dermatology Life Quality Index, and endotoxin level were 38.4 ± 2.7, 29.3 ± 3.5, and 2.7 ± 0.35 nmol/mL, respectively. By week 52, the majority of patients (24; 80%) reached PASI 90/100. At week 28, 6 (20%) patients had a loss of response with persistent endotoxemia (2.5 ± 0.4 nmol/mL) and signs of dysbiosis. Following treatment to improve microbiocenosis, the endotoxin level decreased to 0.5 ± 0.1 nmol/mL, resulting in clinical remission with PASI 90 by week 52. By week 104, 70% of patients remained in remission (PASI 90/100), and 30% had PASI 75.

CONCLUSION: Persistent endotoxemia and dysbiosis were associated with the escape phenomenon on netakimab therapy; the treatment restored the response to PASI 90 and provided sustained remission. To maintain netakimab’s long-term efficacy, it is advisable to re-evaluate endotoxemia and microbiota by chromatography–mass spectrometry at weeks 28 and 52, and initiate treatment as needed.

Cutaneous amyloidosis is a condition caused by impaired protein metabolism due to the formation and extracellular deposition of amyloid, a specific protein-polysaccharide complex, in the skin. Cutaneous lichen amyloidosis is a form of primary localized cutaneous amyloidosis. This is a rare condition with comparable incidence rates in males and females. Cutaneous amyloidosis affects the psychological state and quality of life due to its chronic course, severe subjective discomfort, and limited efficacy of existing therapeutic options. Cutaneous amyloidosis is frequently associated with chronic pruritus, the most bothersome subjective symptom that causes irritable mood and sleep disorders, as well as secondary hyperpigmentation, which enhances esthetic discomfort and psychological stress, especially in young women. The low treatment efficacy is associated with the nature of this condition and the mechanisms of amyloid deposition in the skin. Localized amyloidosis is easier to treat than generalized amyloidosis. Quinolines, dimercaprol, aromatic retinoids, topical glucocorticoids, topical calcineurin inhibitors, and other commonly prescribed drugs are not always effective. Laser dermabrasion (ablative and non-ablative) with mechanical removal or destruction of amyloid deposits in the skin is a promising therapeutic option in cutaneous amyloidosis. In this clinical case of primary cutaneous lichen amyloidosis, a CO₂ laser was used as additional therapy with favorable outcomes, including a reduction in skin rash and discoloration.

Given the growing interest in laser therapy for various dermatoses, it is relevant to explore and apply selective laser photothermolysis in the treatment of cutaneous amyloidosis to transform the therapy of metabolic skin diseases.

On October 21, 2025, the 1164^th meeting of the A.I. Pospelov Moscow Society of Dermatovenerologists and Cosmetologists (MSDC) was held. An in-person meeting was held at the V.A. Rakhmanov Clinic of Skin and Venereal Diseases, Sechenov University. A total of 110 participants attended. Between May and October 2025, 84 applications were submitted for membership in the MSDC by physicians and residents from various dermatology and esthetic medicine clinics in Moscow.

In the clinical section of the meeting, two reports were presented. The first report addressed the differential diagnosis of follicular lichen planus of the scalp. The authors suggest a differential diagnosis with discoid lupus erythematosus, folliculitis decalvans, dissecting cellulitis, and other types of cicatricial alopecia for which the umbrella term “pseudopelade of Brocq” is frequently used. The second report discussed IgA pemphigus, using a clinical case to demonstrate an exacerbation caused by self-discontinuation of treatment.

The scientific section of the meeting featured reports on novel synthetic retinoids, modern concepts of microsporosis, and new phototherapy options in dermatology. Lidose® isotretinoin resulted in clinical remission in 100% of patients treated at the V.A. Rakhmanov Clinic of Skin and Venereal Diseases; the rash was fully eliminated, and skin greasiness was reduced. The report “Modern Concepts of the Clinical Course, Diagnosis, and Treatment of Microsporosis” addressed contact infections of the skin, hair, and nails caused by various Microsporum fungi. The report on new phototherapy options in dermatology explored the multifaceted effects of ultraviolet radiation in the skin.

Lymphoproliferative diseases are characterized by abnormal production and accumulation of lymphocytes in the bone marrow, blood, and lymphoid organs/tissues and most often develop in individuals with a weakened immune system.

Despite significant progress in the study of lymphoproliferative diseases, the diagnosis and especially the differential diagnosis of skin changes in leukemia present considerable difficulties. These difficulties are associated not only with the diversity of clinical symptoms but also with the external similarity of lesions to those seen in inflammatory dermatoses, as well as the absence of distinct cellular atypia in some cases, particularly at the disease onset.

In the vast majority of patients, skin lesions occur simultaneously with the appearance of objective symptoms of the underlying disease or during its advanced clinical stage.

Unlike primary cutaneous malignant lymphomas, in leukemia, regardless of the time of onset, skin symptoms are considered secondary to the underlying disease, i.e., caused by systemic involvement of the hematopoietic or lymphoid tissue.

Skin lesions in leukemia are typically divided into specific and nonspecific types due to their substantial differences in pathogenetic, clinical, and morphological features.

At the same time, this division, while convenient in clinical practice, is somewhat conditional because it is based on histological structure rather than morphological characteristics.

This article presents various types of skin lesions in lymphoproliferative diseases to improve diagnosis, including differential diagnosis, and to ensure timely administration of appropriate treatment.