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Vol 20, No 6 (2017)

Articles
CONFOCAL LASER SCANNING MICROSCOPY FOR DIAGNOSES OF MELANOCYTIC SKIN NEOPLASMS
Sokolova A.V., Malishevskaya N.P.
Abstract
In cases of complicated differential diagnosis of benign melanocytic neoplasms and skin melanoma, clinical visual examination and superficial dermatoscopy do not always allow to make an accurate diagnosis, which is especially important in cases of suspected skin melanoma. In recent years the method of confocal microscopy (CM) has been used for non-invasive skin examination. In the present study 15 patients with suspected skin melanoma were examined by confocal laser microscopy in cases of complex differential diagnosis (18 melanocytic neoplasms in total). Ten patients were diagnosed with skin melanoma, including two amelanotic melanomas, which were subsequently confirmed by histological examination of the material obtained after surgical excision. The results of the study to determine the effectiveness of differential diagnosis of skin melanoma by laser confocal microscopy showed that differential diagnosis of skin melanoma is possible in the presence of the main criteria of malignancy: cellular atypia at the site of the dermo-epidermal junction (the first main criterion) and abnormality of papillary architecture (the second main criterion). At detection at least one of these criteria, a diagnosis of skin melanoma was made, which in all cases was confirmed by the results of histological examination. Inclusion of CM in the diagnostic algorithm of examination of patients with melanocytic neoplasms, suspicious of melanoma, makes it possible to improve the diagnosis of melanoma at early stages.
Russian Journal of Skin and Venereal Diseases. 2017;20(6):324-331
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SURFACE FORM OF BASAL CELL CARCINOMA OF THE SKIN: BIOLOGICAL BEHAVIOR, MORPHOLOGY AND CLINICAL VARIANTS
Snarskaya E.S., Ibrahim A.
Abstract
The superficial form of basal cell carcinoma (BCC) is a malignant skin epithelial tumor with the most favorable flow profile and the least aggressive morphological structure among all known forms of BCC. Surface variants of BCC are characterized by a long and more benign course, slow, long-term growth. However, in the late stages of development, some researchers note the appearance of severe infiltration and destructive changes, ulceration of the BCC foci. Despite the fact that the surface form of the BCC is characterized by a long-term benign course, data have been obtained according to which the histologically confirmed surface multicentric form of BCC initially localized on the trunk increases the number of foci considerably faster than other localization and histological pattern. Objective: To study clinical and morphological features of the surface form of basal cell carcinoma based on monitoring 2500 cases of basal cell carcinoma. Material and methods. The authors analyzed literature sources and their own clinical and morphological data for 2500 clinical observations of patients with different clinical variants of BCC. Results. 2500 cases of BCC were analyzed. Among them 522 cases of clinical variants of surface form of BCC were revealed. Clinical and morphological monitoring was carried out taking into account the sex and age of patients, the variety and the primary localization of the disease, as well as the number and size of lesions. According to our monitoring data, 2500 cases of BCC registered in Moscow and the Moscow Region over the past 10 years, the frequency of the surface form in the overall structure of all BCC cases is 22.3% (557.5 cases), which is generally consistent with the reports of other authors. According to our data, the surface form of the BCC is localized mainly on the skin of trunk, extremities and much less often on the face. Women suffer from this form of BCC 2 times more often than men (371.6 and 185.8, respectively). We have not received convincing data on the predominant morbidity of this type of BCC of younger age groups, which, however, can be explained by the peculiarities of the patients’ mentality (often long unsuccessful self-treatment, rare medical attention), as well as the long practically asymptomatic course of the disease. The majority (80.3%) of the tumors corresponded to the TIN0M0 characteristic. On the body and limbs, the foci are more localized in men than in women (38.8 and 27.3%, respectively), while in the head (face, neck) - in women (72.7 and 61.2%, respectively). A rare type of surface form is a self-scaring BCC (Pejetoid epithelioma of Little). It is characterized by pronounced centrifugal growth. It is possible to transform the surface form of BCC into a more aggressive - nodular form.
Russian Journal of Skin and Venereal Diseases. 2017;20(6):332-341
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ERYTHRODERMA AND ANTITUBERCULOUS THERAPY: CLINICAL CASE
Zaslavsky D.V., Yakushenko S.S., Koroleva M.A., Chuprov I.N., Sidikov A.A.
Abstract
Erythroderma represents one of the most complex problems of dermatology. First of all, it is explained by variety of reasons, a pathogenesis ambiguity, monotonous clinical picture, tendency of many forms of an erythroderma to a long and heavy current and resistance to therapy. The erythroderma doesn’t represent a certain disease, it is, most likely, clinical implication of set of various diseases. The majority of erythroderma cases described in literature have been induced by different types of medicines and dietary supplements. In English-speaking literature more than ten cases of erythroderma induced from various components of anti-tuberculous therapy are described. The first case of eryhtroderma in Russian-speaking scientific literature which appeared in five months from the beginning of anti-tuberculous therapy is presented.
Russian Journal of Skin and Venereal Diseases. 2017;20(6):342-346
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ETIOPATHOGENETIC FEATURES OF ATOPIC DERMATITIS IN PRESCHOOL CHILDREN
Akhrorov K.K., Nabieva D.D.
Abstract
Objective. To determine the most important etiopathogenetic factors of formation, with their subsequent influence on the severity of atopic dermatitis (AD) in preschool children. Material and methods. 58 children aged 2 to 5 years with AD were examined. Clinical examination of patients, a general analysis of blood and urine, koproovocystoscopy, the determination of specific IgE (to food, household, epidermal, pollen allergens) by ELISA, examination of feces for dysbiosis were performed. Assessment of clinical manifestations of AD was carried out on the bases of the SCORAD system (1997). Results. The obtained data indicated that in the severe course of the disease the first clinical signs of AD were observed already in early childhood (up to a year). Hereditary burden for allergic diseases was determined on average 74.1%, but with moderate and severe pollen sensitization was recorded - in 46.6%, epidermal - in 13.8% of patients. Factors contributing to AD aggravation in pre-school children are the food factor (72.4%), contact with plant dust (43.1%) and stressful situations (17.2%). In patients with severe disease the rates of these factors were higher from 9 to 35%. The highest incidence of co-morbidity noted among children with severe AD was 2 times higher in patients with moderate severity. Conclusion. The AD severity in children of preschool age depends directly on the simultaneous presence of several major etiopathogenetic factors. In particular, the presence of food (72.47%) and pollen (54.5%) sensitization of the organism against the background of hereditary burden on allergic diseases (90.9%) leads to disease complication, which is 9% to 35% higher than in patients with moderate to mild severity.
Russian Journal of Skin and Venereal Diseases. 2017;20(6):347-351
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THE CASE OF EPIDERMAL CYST IN A TEENAGER
Dumchenko V.V., Shashkova A.A., Kislitsa T.N., Petrova I.V.
Abstract
A case of an epidermal cyst in a fifteen-year-old girl is described. The clinical picture was characterized by the changes on the foot skin for ten months. Several surgical operations were performed. The diagnosis of the soft tissue foot abscess was established. The data on pathogenesis, clinical forms and treatment are presented.
Russian Journal of Skin and Venereal Diseases. 2017;20(6):352-354
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PSORIASIS ADJUVANT THERAPY
Bakulev A.L., Krachevnya S.S., Igonina I.A., Galkina E.M., Utz S.R.
Abstract
60 adult patients with moderate severity of psoriasis in progression phase of dermatosis were observed. In the combined therapy of methotrexate and topical glucocorticosteroid, the patients were additionally treated with Cetaphil® Restoraderm™ Skin restoring moisturizing lotion (hereinafter referred to as Cetaphil® RestoradermTM moisturizing lotion). In the course of treatment a multivariate evaluation of the functional and morphological parameters of the skin using the SOFT PLUS TOP apparatus (sebumetry, corneometry and elastometry), as well as assessment of severity, prevalence of psoriasis (PASI), quality of life of patients (DLQI) on the 14th and 28th days of observation was performed. It was found that the inclusion of moisturizing lotion in the combined therapy led to an earlier beginning of stabilization and regression of the psoriatic process, relief of subjective disorders, improvement of the quality of life of patients with psoriasis. Also statistically significant reduction of skin dryness and normalization of moistness and elasticity, which testifies to the expressed sebouregulating, elastogenic and moisturizing effects of this topical remedy, were observed.
Russian Journal of Skin and Venereal Diseases. 2017;20(6):355-359
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THE EFFECT OF INDIRECT ANTICOAGULANTS IN THE COMBINED USE WITH Β-BLOCKERS AND VASODILATORS ON THE FORMATION OF ROSACEA WITH ANTIHYPERTENSIVE THERAPY
Karpova A.V., Ogurtsov P.P., Batkaev E.A.
Abstract
There are vascular changes in the skin of patients in the combined antihypertensive therapy with β-blockers, vasodilators and indirect anticoagulants. Coagulation and the character of pharmacotherapy directly affect physical parameters of the skin and the formation of rosacea.
Russian Journal of Skin and Venereal Diseases. 2017;20(6):360-363
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OPTIMIZATION OF THERAPEUTIC MEASURES IN PATIENTS WITH NUMMULAR ECZEMA
Udzhukhu V.Y., Korotkiy N.G., Davtyan E.V., Kubylinskiy A.A.
Abstract
Constant cellular and humoral immunity disorders promote the development of nummular eczema. Severe refractory cases of eczema represent a complex therapeutic problem. Increasingly eczema resistance to standard methods of therapy forces specialists to use systemic drugs with immunosuppressive action and a high risk of serious complications. Material and methods. The therapeutic possibilities and safety of the new domestic immunoactive agent L-isoleucyl-L-glutamyl-L-tryptophan sodium salt in patients with nummular eczema and its effect on the immune homeostasis were analyzed. The drug was included in complex treatment in 34 patients with nummular eczema. The comparison group composed 20 patients who received standard therapy. The highly sensitive methods for assessing the immune status: the cytokine system, the relative affinity of antibodies and the expression of Toll-like receptors (TLRs) are used. Results. 24 (70.6%) patients had a clinical cure and 9 (26.5%) patients had a significant improvement after L-isoleucyl-L-glutamyl-L-tryptophan sodium salt treatment. Only 1 (2.9%) patient had no effect from the therapy. There were no any side effects and complications in the course of the therapy. In the comparison group, clinical cure was achieved in 11 (55%) patients, the effect of the therapy was not observed in 2 (10%) patients. Conclusion. After the termination of the course of therapy, 15 (44.1%) patients had a clear tendency to normalize the affinity of immunoglobulins, The intensity of TLR4 expression was significantly reduced and did not differ from those in healthy donors. The use of this drug quickly allowed to stop the clinical manifestations of nummular eczema with the preservation of long-term remission, to normalize the processes of interleukin-dependent regulation of the immune response and nonspecific resistance. The advantage of the proposed method of treatment is the possibility of using in outpatient settings.
Russian Journal of Skin and Venereal Diseases. 2017;20(6):364-367
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USE OF AUTOLOGOUS PLATELET-RICH PLASMA WITH THROMBOCYTES IN DERMATOCOSMETOLOGY (REVIEW)
Karagadyan A.D.
Abstract
The literature review on use of the autologous platelet-rich plasma (auto-PRP) in dermatocosmetology is presented. The use of PRP is a very perspective method of correction of cosmetology problems associated with involutional skin changes, as well as in the treatment of dermal diseases, such as alopecia, psoriasis, eczema, palmar and plantar warts, photodermatoses, acne, cankers of the lower extremities, vitiligo and rosacea. The strategy of PRP use is to improve and accelerate the processes caused by the stimulating growth factors contained in platelets.
Russian Journal of Skin and Venereal Diseases. 2017;20(6):368-372
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ANALYSIS OF THE INCIDENCE AND MAIN CLINICAL FORMS OF SYPHILIS IN SOME AREAS OF THE MOSCOW REGION AGAINST THE BACKGROUND OF MIGRATION FROM EPIDEMIOLOGICALLY DANGEROUS COUNTRIES
Fetisova N.V., Snarskaya E.S.
Abstract
Purpose: to conduct a clinical and epidemiological analysis of the incidence of syphilis in the Moscow Region for the period from 2010 to 2017. Material and methods. Assessment of the incidence of various population groups and the manifestation of the epidemic process was carried out on the basis of an analysis of statistical data on the Moscow Region and statistical charts of patients. A comprehensive clinical examination of patients with syphilis was conducted to identify early signs of syphilitic infection and the presence of late forms of nervous system damage. Results. The analysis of the epidemic situation in Moscow region for the indicated observation period showed that the incidence of late forms of syphilis has increased. Conclusion. Analysis of the epidemic situation in the Moscow Region for the period 2010-2017 showed that the incidence of syphilis in the region’s population has increased, The incidence of asymptomatic neurosyphilis also has increased. The influx of migrants from epidemiologically dangerous countries and the availability of sex services support the consistently high level of incidence of syphilis in the Russian Federation.
Russian Journal of Skin and Venereal Diseases. 2017;20(6):373-377
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HISTORY OF VITILIGO EXPERIMENTAL STUDY
Lomonosov K.M., Rem M.A., Gorb V.A.
Abstract
The history of the experimental study of vitiligo on animal models is studied. Effective analysis of any disease is not possible without conducting biomedical research on animal models. The models of both spontaneous and induced vitiligo in animals are described, which allows to study the etiology and pathogenesis of this disease in vivo, as well as to investigate the effectiveness of various drugs.
Russian Journal of Skin and Venereal Diseases. 2017;20(6):378-380
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