Russian Journal of Skin and Venereal Diseases

According to published data, the incidence of cutaneous melanoma is the highest after 50 years of age; the mortality is almost 80%, because of high metastatic potential of the tumor and low level of diagnosis of amylolytic forms of the disease. Melanoma is a familial disease in 5-12% cases; some data indicate an autosomal dominant inheriting with incomplete penetration or more intricate mechanisms of melanoma inheriting. Mutations in CD-KN2A and CDK genes are responsible for 20-25% high risk cases in families. According to modern concepts, the mechanisms of accumulated genetic mutations modulate significantly the signal route cascades and stimulate the production of adhesion molecules E- and N-cadherins, a- and b-integrin, and b-catenin, which are assumed to be the main molecular processes in the pathogenesis of melanoma. A rare clinical case is presented: afemale patient with positive oncological family history developed amylolytic nodular melanoma on the skin of the shin.

Some patients with autoimmune pemphigus (AP) are resistant to systemic glucocorticoid monotherapy, that is, are steroid-resistant. A retrospective analysis of case histories of 118 AP patients was carried out to detect the probable trigger factors promoting the manifestation of steroid resistance during the first year of therapy and showed that steroid-resistant patients could not indicate the cause of AP exacerbation 5 times more often than other patients. It seems that steroid resistance of these patients was caused by genetic factors. Steroid resistance was detected in all patients with paraneoplastic pemphigus. A relationship between stress and exacerbation was detected in only steroid-resistant patients. Frequent exacerbations of AP because of insufficiently hight dose of systemic glucocorticoids (SGC) and rapid reduction of SGC dose were detected in steroid-resistant patients and in patients without steroid resistance. No significant relationships between steroid resistance and clinical manifestations of AP, location of efflorescence, and Nikolsky’s symptom were detected.

The efficiency and safety of Neoton serum and cream in therapy of hyperpigmentation of different origin were evaluated. A total of 20 women of 25-74 years of age with hyperpigmentation of different etiology were treated by neoton preparations (neoton cream in the morning and neoton serum at night). 12 patients presented with chloasma, 5 with postinflammatory hyperpigmentation, 2 with freckles, and 1 with photophytodermatitis. Therapy was continued for 3 months. Melanin levels in the foci were measured before, during, and after therapy by the Multi Skin Test Center MC 750 system (Germany). The foci regressed completely after 1 month of neoton therapy in 33% patients, significant improvement was attained during this period in 40%, and improvement in 27% of patients. Clinical recovery was attained after complete course (3 months) in 47%, significant improvement in 53% patients. The reduction of melatonin level served as an objective evidence of the treatment efficiency. Before therapy its levels were 90-125 arb. units (vs. 6-40 arb. units in normal skin), after 1 month of therapy melatonin levels reduced to 30-70 arb. units, and the levels after a complete course of 3 months were 15-55 arb. units. Only one patient developed a side effect (desquamation) which spontaneously regressed within several days. Neoton serum and cream were well tolerated and proved to be effective means for therapy of hyperpigmentations of different etiology.

Modern data on the cutaneus Larva migrans is reviewed. The etiology, course, and clinical manifestation of the parasitic disease and the probable therapies are presented. A clinical case with cutaneus Larva migrans in a female resident of the Primorye territory is presented: disease history, clinical picture, and treatment protocol are described. Albendasole therapy (400 mg daily during 7 days) was effective.

Modern data on classification of vitiligo are presented. The following types are distinguished: nonsegmental vitiligo (NSV) with the focus beyond one segment, with symmetrical bilateral location; segmental vitiligo (SV) with the focus within one segment with unilateral location; mixed vitiligo with a combination of the segmental and nonsegmental types; and an unclassified type. Based on this classification, the authors describe the characteristic intrinsic features of these vitiligo types from pathophysiological and clinical viewpoints, in order to promote the development of different approaches to therapy of this disease.

A total of 160 patients with acne of different severity were examined. Their quality of life was evaluated. Lipid peroxidation processes were evaluated by malonic dialdehyde and conjugated dienes, antioxidant system activity was evaluated by catalase and glutathione peroxidase, which were measured by UVspectrophotometry before and after therapy. The patients were treated by nutriceutics (linseed oil) and antioxidants (selenium, tocopherol acetate). No unwanted side effects were recorded.

The number of sexually active women with chronic inflammatory diseases of pelvic organ has increased recently. Cytomegalovirus (CMV) is detected in scrapings off the cervix uteri and endometrium of these patients. We studied the forms of CMV infection in sexually active women of reproductive age. A total of356patients were observed. The CMV infection was studied by enzyme immunoassay for detection of specific serum anti-CMV IgM (qualitative analysis) and IgG. Virological isolation of CMV from the blood, saliva, urine, cervical and vaginal discharge was carried out on human embryo lung fibroblast culture. Indirectfluorescent test for detection of CMV antigen was carried out with monoclonal antibodies to pre-early (pp27) and early (pp65) antigens. The CMV DNA was detected by polymerase chain reaction. Opportunistic and pathogenic urogenital flora was detected by the common methods: microscopic, bacteriological, and molecular genetic. The basic clinical laboratory characteristics of various forms of urogenital CMV infection were identified; this will promote optimization of the diagnosis and therapeutic strategy in this category ofpatients. Combined therapy including panavir in patients with latent and reactivated CMV infection was highly effective.