Volume 32, Nº 5 (2025)

Itching is a frequent and debilitating symptom of Hodgkin’s lymphoma (HL), significantly reducing the quality of life of patients. This review is devoted to current understanding of the mechanisms of itching in this disease to deepen our understanding of the pathogenesis of this symptom and search for new therapeutic strategies aimed at improving the quality of life of patients.

The role of various factors, including cytokines, histamine and neurotransmitters, in its development is analyzed. Particular attention is paid to the interaction of these mechanisms and their impact on the intensity and duration of itching. Promising research areas that contribute to a deeper understanding of the pathogenesis of this symptom and the development of new therapeutic strategies are also analyzed. The need for an interdisciplinary approach to early diagnostics of Hodgkin’s lymphoma, taking into account itching as one of the possible clinical manifestations, and the importance of timely treatment are emphasized.

Psoriasis is one of the most common dermatological diseases in the world. With a global prevalence of 2–5%, psoriasis can affect all age groups of the population. At the same time, the disease has a significant negative impact on the quality of life of patients, especially when the skin is affected in the anogenital area. The prevalence of isolated anogenital psoriasis (AGP) is estimated at 2 to 5% of all patients with psoriasis. However, generalized plaque or intertriginous psoriasis also affects the genital skin in 29–40% of cases. In addition, the prevalence of AGP is probably underestimated due to the reluctance of both patients and health care providers to discuss anogenital localization and quality of life. As a rule, AGP is associated with significant general and sexual quality of life impairments, higher rates of depression. Sexual dysfunction, decreased frequency of sexual activity and avoidance of intimate relationships are the result of not only objective symptoms (e.g., cracks or pain during/after sexual activity) but also psychosocial effects (embarrassment, fear of stigmatization). It should be noted that AGP symptoms affect the patient’s daily life, social, psychological and work aspects of life. The authors dwell in detail on the features of clinical manifestations of AGP, illustrating them with examples from their own practice. Particular attention in the review is paid to methods of topical and systemic treatment of AGP (including genetically engineered biological drugs). The authors conclude that AGP is often left without due attention, and timely prescription of therapy leads to a significant improvement in the quality of life of patients

Melanoma, a malignant melanocytic tumor, remains one of the most aggressive forms of malignant skin tumors and is a significant public health problem. Despite progress in early diagnosis and treatment, melanoma continues to be the leading cause of death from skin cancer. The development of skin melanoma (SM) is a multistage process involving a complex relationship between genetic mutations, signaling pathways, and the tumor microenvironment. The main risk factors for SM remain unchanged, including ultraviolet radiation, genetic predisposition, phenotype, immunosuppression, and patient age. Advances in molecular biology have identified key signaling pathways involved in the development of SM. Mutations in the BRAF, NRAS, KIT, and NF1 genes are the most common. Melanoma is characterized by a complex interaction with the immune system. The cellular immune response, which involves cytotoxic T lymphocytes (CTLs), is important for tumor control, but melanoma is able to suppress this response. SM is a complex and heterogeneous disease. In recent years, significant progress has been made in understanding the molecular mechanisms and developing new treatments. However, further research to improve treatment outcomes and prevent this disease is required. Early diagnosis is critical for a favorable prognosis. The authors present clinical cases of melanocytic skin cancer from personal practice.

The article presents current literature data on the clinical manifestations and course of generalized pustular psoriasis (GPP), which is one of the most severe forms of psoriasis. The publication briefly presents the main features of the immunopathogenesis of GPP, the role of proinflammatory interleukin IL-17 in the development of the psoriatic process, and also highlights approaches to treating the disease. Clinical cases of GPP therapy using monoclonal antibodies that inhibit proinflammatory IL-17A, which are the active ingredient of secukinumab, are presented. A pronounced clinical effect of treatment is shown. The described clinical cases indicate that the genetically engineered biological drug secukinumab can be the drug of choice in the treatment of patients with GPP when other treatment methods are ineffective, and its use is effective and safe.

Background: The possibilities of modern medicine allow to improve the appearance of a person’s face without resorting to radical surgical interventions. One of the frequent requests in the practice of a cosmetologist is the elimination of aesthetic problems that patients experience after completing orthodontic correction of the dentoalveolar system. As a rule, this changes the volume of soft tissues of the lower third of the face, hypertonicity of the masticatory muscles occurs, nasolabial folds increase, patients note skeletonization of the face, a change in the oval – a feeling of an “aging” face appears. And, of course, these changes cause psychological discomfort to the patient.

Objective: Determination of the incidence of bite pathology in patients with signs of undifferentiated connective tissue dysplasia (UCTD) and the presence of polymorphisms of the genes responsible for the synthesis of collagen and elastin.

Materials and methods: The pilot study involved 71 patients. All patients underwent genetic testing, questionnaires on the presence of phenotypic features of UCTD, assessment of the risk of UCTD and bite pathology.

Results:

1. The results of the study show that the study groups have significant differences in the presence of bite pathology, which is confirmed by low p values for most of the analyzed markers. Particularly pronounced differences were observed for the genetic markers rs7787362_ELN and risk, which may indicate their importance in predicting bite pathology. Significant differences were also found for the marker rs1800012_COL1A1, which may indicate its role in this pathology.
2. Patients without bite pathology have significantly higher chances of having the rs1800012_COL1A1_CC and rs7787362_ELN_TT genotypes. Patients with bite pathology more often have rs7787362_ELN_CC genotypes, a high risk according to the questionnaire. These data highlight the importance of genetic testing for assessing the risk of developing bite pathology and may help in developing individualized approaches to treatment and prevention.
3. Patients with bite pathology malocclusion (group 1) have significantly higher scores on the questionnaire (15.0 [13.0; 16.0]) compared to patients without pathology (group 0, 10.0 [8.0; 10.0]). This indicates that the presence of bite pathology was associated with higher values in the questionnaire, which may reflect more pronounced clinical or demographic features in this group.
4. The conducted correlation analysis showed that there was a significant correlation between bite pathology and undifferentiated connective tissue dysplasia (R=0.619; p<0.001*).
5. Also, the presence of polymorphism in the rs7787362_ELN gene significantly increases the risk of bite pathology, while the rs1800012_COL1A1 and rs7787362_ELN genes with no polymorphisms have a protective value in predicting the absence of bite pathology.

Conclusion: Modern achievements in aesthetic medicine make it possible to effectively correct changes that occur during or as a result of orthodontic correction, which can cause psychological discomfort in the patient. Interdisciplinary interaction between orthodontists and cosmetologists will play a special role in the future. The authors believe that it is especially important to introduce aesthetic and functional prognosis into orthodontic practice in order to minimize aesthetic and psychological problems in patients.

Background: The possibility of vascular damage in syphilis has been considered by scientists for a long time. Currently, the list of mechanisms of influence of Treponema pallidum both on the endothelium in general and on the blood-brain barrier in particular has been significantly expanded. However, the question of the consequences of syphilis for the human body remains debatable even in the case of fully administered specific therapy.

Objective: Retrospective cohort study to confirm the relationship between syphilis and the risk of developing acute cerebrovascular accident.

Materials and methods: A retrospective cohort study of the medical records of 2022 patients hospitalized with suspected acute cerebrovascular accident (ACVA) in 2017–2018 was conducted. The study groups were divided into the following: the main group (n=36) – patients with a history of confirmed syphilis, the comparison group (n=35) – patients without syphilis. Clinical, instrumental (MSCT, MRI) and laboratory research methods (ELISA, CP) were used.

Results: In the main group, ACVA developed 19 years earlier (mean age 51.8±10.5 years). The incidence of ischemic stroke was comparable (66% versus 68.5%), but patients with syphilis more often had combined arterial lesions (12.5% versus 0%) and papilledema (65.3% versus 22%).

Conclusion: Previous syphilis can increase the risk of early development of stroke and contribute to more severe neurological complications, which requires the development of secondary prevention measures.

Background: Psoriasis is a common chronic multifactorial, immune-mediated inflammatory skin disease, often associated with a high risk of developing comorbid cardiovascular diseases, metabolic syndrome, as well as liver pathology, including iatrogenic, ari-sing in the process of systemic therapy, which is reflected in a brief review of domestic and foreign publications.

Objective: Evaluation of the nature and severity of systemic inflammation indicators and the profile of changes in the blood serum lipid spectrum in patients with severe psoriasis, justification of the choice of a hepatoprotective agent with a pathogenetically justified complex effect.

Materials and methods: A clinical and laboratory examination of patients with severe psoriasis (PASI index over 20 points) with an assessment of hemogram indicators, biochemical hepatogram, including peripheral blood lipidogram, group and subgroup data analysis using the Statistica 10 program was conducted.

Results: In patients with severe clinical manifestations of psoriasis (in the absence of joint lesions), a pronounced proinflammatory reaction of the peripheral blood with an increase in the neutrophil/lymphocyte ratio in combination with a high serum CRP-ultra level was established. It was shown that the presence of immune-mediated inflammation in this cohort of patients with psoriasis was combined with high atherogenic lipidogram indices and reduced serum phospholipid levels, which are “predictors” of the formation of comorbid cardiovascular and liver pathology.

Conclusion: The results of the study confirm the need to include a hepatoprotector in the complex therapy of patients with psoriasis and justify the choice of a drug containing essential phospholipids and glycyrrhizic acid, which is determined by the pharmacological properties of this drug providing both a “replacement”, hepatoprotective, and anti-inflammatory effect in psoriasis and comorbid conditions.

Background: Dermatovenereology is a relatively young specialty. As a science, it has existed since the 18th century, and became completely independent only in the second half of the 19th century. At the same time, dermatovenereology has its roots in the origins of medicine. In some nations, dermatovenereology has achieved the greatest development in comparison with other areas of medical science, since skin diseases were much more accessible to the visual and tactile sensations of doctors; there were even separate names for skin diseases.

Objective: Evaluation of the foreign and domestic experience in the development and implementation of medical classifications, including in dermatovenereology.

Materials and methods: Collection, analysis and synthesis of the material were carried out on the basis of previously approved international and domestic classifications of diseases and conditions, as well as clinical classifications of individual dermatovenereological diseases.

Results: When looking retrospectively at the development of dermatovenereology, it is worth noting the influence of various natural history and medical disciplines on its formation. Important foundations of dermatovenereology were laid by such sciences as bacteriology, immunology, the doctrine of the constitution, the endocrine glands, the autonomic nervous system, etc. Each discovery in any of these fields still does not lose its relevance and is used by dermatovenerologists and cosmetologists to this day. The influence of bacteriology and immunology on the development of the classification of skin and venereal diseases is especially great. The material accumulated in this direction brings us closer to the moment when, instead of the existing imperfect classifications of dermatoses, it will be possible to create a single scientifically based etiological and pathogenetic nomenclature, which will significantly contribute to improving the diagnosis and treatment of the corresponding diseases.

Non-syndromic ichthyosis is a genetically determined disorder of keratinization, characterized by universal skin desquamation. The most common type is ichthyosis vulgaris, which is caused by autosomal semi-dominant mutations of filaggrin. Recessive X-linked ichthyosis is more common in boys and is caused by steroid sulfatase deficiency. Autosomal recessive congenital ichthyosis is genetically very heterogeneous. The most common cause is transglutaminase deficiency type 1. Keratinopathic ichthyoses, such as epidermolytic ichthyosis, are caused by mutations in keratin genes. They are evident at birth and often accompanied by blistering. Most of these types are inherited as autosomal dominant traits, but autosomal recessive forms can also occur. The characteristic clinical manifestations of non-syndromic ichthyoses, the heterogeneous clinical course and the imperfect correlation between phenotype and genotype make diagnosis difficult. At the same time, accurate molecular diagnostics are crucial for prognosis and the provision of appropriate genetic counseling. Most non-syndromic ichthyoses have a significant impact on the quality of life of patients and, in severe cases, can lead to significant disability and loss of ability to work. A better understanding of the molecular mechanisms underlying these diseases is necessary to develop innovative therapeutic solutions focused on pathogenesis and taking into account individual patient characteristics.

The problem of topical therapy for patients with chronic dermatoses remains relevant in modern dermatology, despite a significant number of research works. The creation of new combined skin care products for patients with psoriasis allows potentiating the effect of most drugs in the absence of side effects in the form of allergic reactions, drug dependence and effects on other organs.

Psoriasis in approximately 80% of patients manifests itself in a mild or moderate degree and is initially treated with local (topical) therapy. In the spectrum of topical therapy, glucocorticosteroids, betamethasone/calcipotriol, vitamin D3 analogues are effective.

The domestic company Pharmtec has created a series of care products: Depsoriol^® cream and lotion for patients suffering from vulgar psoriasis, including lesions of the scalp. In the study, when using this drug simultaneously with leading topical therapy products, or with subsequent care, a more rapid achievement of the clinical effect, positive dynamics of the psoriasis area and severity index (PASI) and the dermatological quality of life index (DQLI), compared with other skin care products, and the absence of side effects were noted.

Hidradenitis suppurativa (HS) is a chronic inflammatory dermatosis characterized by a recurrent, debilitating course and significantly reducing the quality of life of patients. The disease can lead to irreversible changes in the skin in the form of scars and fistulas. The incidence worldwide is up to 1% of the population, most often affects young people aged 18 to 50 years, although cases have also been registered in adolescence. Women are more often affected, the ratio to men is 3:1. The disease is of an immune-mediated inflammatory nature and is often associated with multiple comorbid pathologies: metabolic syndrome, obesity, diabetes mellitus, arterial hypertension, dyslipidemia, inflammatory bowel disease and joint damage. The genetic factor is currently assigned a leading role in the development of pathology; it has been identified that mutations in 4 genes (PSENEN, NCSTN, TMED10 and WNT10A) can lead to disruption of keratinization processes and be the cause of disruption of cytokine regulation and imbalance in the T-helper cell axis of the 17th type, similar to that in patients with psoriasis. The use of topical and systemic antibacterial drugs, antiseptics, retinoids and steroids often does not lead to stable improvement and remission in patients with severe hidradenitis suppurativa. Genetically engineered biological therapy is a promising direction for the treatment of moderate to severe hidradenitis. Inhibition of the cytokine IL-17 shows good results in this group of patients. This article presents the experience and results of 12-week treatment of a patient with severe hidradenitis suppurativa (stage 3 according to Hurley) with the IL-17A inhibitor secukinumab.

Facial aging is a complex process that results from changes in several layers: skin, subcutaneous fat, superficial muscular aponeurotic system (SMAS), muscles and bone. Facial muscles tend to lose their tone at rest, which leads to a change in the position of tissues. This article presents clinical cases of successful use of a new device that combines the technologies of high-intensity focused electromagnetic stimulation (HIFES) and monopolar radio-wave lifting (RF) to improve skin elasticity and muscle tone, used as monotherapy (HIFES + RF) and as a complex effect (HIFES + RF and botulinum therapy); their safety, effectiveness and patient satisfaction are assessed.

The protocol in the form of a complex effect of HIFES, monopolar radio-wave lifting and botulinum toxin type A shows the highest results in comparison with a monoprocedure, and also allows for personalized cosmetology correction of involutional atrophy of the skin of the lower third of the face and neck.