Vol 19, No 6 (2016)

Identification of molecular subtypes of melanoma allowed to use a personalized approach in the treatment of melanoma. One of the most common driver mutations in melanoma is a mutation of the oncogene BRAF, that is determined in 40-60% of all melanomas. However, BRAF-negative tumors require further investigation of mutational status, which can be applied not only to select the means of personalized therapy of tumor, but also for the prediction of disease course. This article presents an analysis of 37 patients with melanoma BRAF-negative for mutations in the genes NRAS and c-Kit. Mutations were identified in the 3 exon of the gene NRAS in 8.1% of cases. In skin melanomas «silent» mutations were identified in 64.7% that confirm the occurrence ofpronounced mutation under the influence of ultraviolet radiation on the skin of the patient. We identified clinical and morphological features ofpatients with NRAS mutation in the 3 exon. This group ofpatients is characterized by a greater thickness of the tumor Breslow. Female gender and older age were dominated clinical characteristics in this group as compared with patients without NRAS mutations (p < 0.05).

The article is devoted to the analysis of methods to assess the degree of atopic dermatitis (AD) severity, of their clinical manifestations and laboratory diagnosis. Treatment and prognosis of atopic dermatitis depends on the assessment of disease severity. The severity of the disease is the main factor for a doctor in the therapy of a child with AD. There are many scientific studies devoted to the objective classification of diseases and the development of the most effective methods of severity assessment. It is not always possible to quickly determine objectively measurable parameters ofpathologic skin process. Because of that assessment methods of skin diseases are often approximate and subjective. The new pathogenetic data of atopic dermatitis and the main types of defects are described. Dermatology indexes of atopic dermatitis severity were considered. The new biochemical methods to assess the degree of atopic dermatitis severity in children by measuring indicators of spontaneous adhesion of neutrophils were analyzed. Immunological method, in which serum of children with atopic dermatitis is determined by the level of total IgE and IgE antibodies to allergens, with using ImmunoCAP 100 and level IgG- and IgE-antibodies against tissue antigens by ELISA, were analyzed. The indicators of oxidative status were examined. The concentration of circulating biological peroxides (PPI) and nukliozida 8-OHdG (8-hydroxy-2’-deoxyguanosine) differed significantly in mild, moderate and severe AD. Bacteriological methods, based on an integrated assessment of microbiological parameters, characterizing the nonspecific resistance of skin and mucous membranes in the assessment of severity and prognosis of atopic dermatitis in children, were performed.

The article describes the modern data on the connection of psoriasis with various comorbidities. It identifies the most frequent comorbid diseases recorded in patients, depending on the severity ofpsoriasis. Among the most common comorbidities, there are cardiovascular diseases, diabetes, metabolic syndrome, that must be considered when choosing the treatment.

The clinical case of flebotodermia, which has arisen on a sting of the tick, is presented. The patient consulted a dermatologist about irritable papilloma in the left armpit. With careful examination and dermoscopy was detected tick in the skin with symptoms of inflammatory reaction around the bite. The tick removal by electrocoagulation was performed. The authors draw the attention of doctors of all specialties on the needfor careful and regular inspection of patients in hospitals for the presence and remove of ticks.

Alopecia areata is a poliethiologic immune mediated condition, associated with lesion of the hair follicles, leading to disruption of growing cycle and subsequent hair loss. Taking into account the different age of patients and repeated recurrence despite of the therapy, as well as changes in the appearance of the individual affecting psychosocial status, patchy hair loss refers to the category of socially important disorders. The introduction of computer technologies facilitated diagnostic approaches through developing of specific criteria for the diagnosis of alopecia areata, which improved its differentiation with similar dermatological conditions. This publication intended to review and analyze of clinical cases of several dermatological disorders which remind clinics of different forms of alopecia areata. The importance of trichoscopy was shown to provide differential diagnosis in various hair-loss conditions to evaluate morphometric hair and skin characteristics.

The literature review of the cellular functioning mechanisms of the hair follicles, the role of stem cells in the life cycle of the hair, the major effects of growth factors are presented. Authors, patented treatment method of non scarring alopecia is described. The technology ofpreparation and method of use of unactivated platelet leukocyte autoplasma in various forms of alopecia are described. Own clinical observation of 60 patients with non scarring alopecia and results of their unactivated platelet leukocyte autoplasma are presented. 80% of patients had a clinical cure. Investigations of platelet concentration, white blood cells and growth factors in platelet-rich plasma and platelet leukocyte unactivated autoplasma were performed. The results are shown in the article.