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Vol 27, No 8 (2020)

Articles

NEWS OF MEDICINE

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Pharmateca. 2020;27(8):6-7
pages 6-7 views

Skin lesions associated with new coronavirus infection (COVID-19)

Kosheleva I.V., Bitkina O.A., Shadyzheva L.I., Nikolaeva A.Y., Andriyakhina O.V., Pankova O.A., Udalova E.S., Tsyganova A.A.

Abstract

The review provides detailed descriptions of the various rashes associated with the new coronavirus infection (COVID-19) that occur in patients with laboratory-confirmed disease, and also analyzes the diagnostic value of the rashes. The features of immunosuppressive therapy of severe chronic dermatoses against the background of coronavirus infection are described. The approaches to neutralizing the negative effects of the constant use of personal protective equipment on the skin and the experience of organizing a dermatological service against the background of the COVID-19 pandemic are summarized.
Pharmateca. 2020;27(8):8-17
pages 8-17 views

Clinical and microbiological features of atopic dermatitis in HIV-positive patients (literature review)

Evdokimov E.Y., Ponezheva Z.B., Sundukov A.V., Svechnikova E.V.

Abstract

Atopic dermatitis (AtD) is a chronic, recurrent, multifactorial, inflammatory skin disease, which is characterized by skin itching, the formation of foci of lichenification in places of chronic skin inflammation. The review article presents data from studies carried out on different continents of the world regarding differences in the course of AtD in patients with and without HIV infection. According to researchers, to date the incidence of AtD has increased several times since the 1960s, and it occurs in 20% of children and 3% of adults, more often in women than in men. At the same time, the prevalence and severity of the course of AtD is higher in industrialized cities relative to rural areas. In HIV-infected patients, AtD is recorded 30% more often than in the population; attention is also paid to some pathogenetic features of the disease in patients of this category [3]. Differences in individual immunological aspects of the pathogenesis of AtD associated with the influence of HIV virus proteins on immunocompetent cells of patients are noted. Further, modern studies on the effect of skin and intestinal microbiota on the course of AtD, their features in HIV-positive and HIV-negative patients are presented. In addition to the clinical features of AtD, fundamental issues of diagnosis and treatment of AtD accepted to date are also discussed.
Pharmateca. 2020;27(8):18-23
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On the issue of assessing the quality of life of patients with acne scars

Ufimtseva M.A., Simonova N.V., Bochkarev Y.M., Zhunisova D.S., Mylnikova E.S.

Abstract

The article presents a review of literature on the effect of atrophic acne scars on the quality of life of patients, as well as on modern methods for assessing the quality of life of patients with acne scars, which are used also for the assessment the effectiveness of therapeutic measures.
Pharmateca. 2020;27(8):24-27
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Malignant melanoma in 2019: clinical and dermatoscopic features today

Sergeev Y.Y., Sergeev V.Y., Mordovtseva V.V., Shlivko I.L., Sinelnikov I.E., Dobrovolsky V.E., Getman A.D., Luchinina D.G., Garanina O.E., Grishko R.V., Beinusov D.S., Yakushenko S.S., Evdokimov M.Y., Uskova K.A.

Abstract

Background. Clinical presentation of malignant melanoma (MM) are characterized by pronounced polymorphism and depend heavily on the stage of development and histological variety of the tumor. Objective. Evaluation of the clinical and dermatoscopic features of cases of MM identified in 2019. Methods. A retrospective evaluation of the clinical and dermatoscopic manifestations of 113 MM cases was performed; individual tumor signs were compared depending on the type of detection (active - by the physician, by complaints - by the patient), the maximum size of the lesion and the morphological phase of growth. Results. MM was detected in 84 (74.3%) women and 29 (25.7%) men. The mean age of patients was 50.4±14.7 years. Physicians revealed 23% of tumors. Only 26.5% of melanomas fully met the criteria for the ABCD clinical rule, 62.8% of patients noted a change in pigmented lesion. The sensitivity of the dermatoscopic ABCD rule and the 7-point Argenziano algorithm were 76.1 and 75.2%, respectively. Tumors detected by physicians more often imitated dermatoscopic patterns of melanocytic nevi (p<0.05). Small melanomas with a diameter of up to 6 mm were diagnosed at a younger age (p<0.001), did not meet ABCD clinical rule, and showed less color polymorphism and variegation during dermatoscopic examination (p<0.05). A blue-white veil and linear vessels were significantly more frequently detected in tumors identified by patients and were associated with a melanoma size of >6 mm and vertical growth phase. Conclusion. The study showed that a number of clinical characteristics of MM today differ significantly from the usual idea of this malignant tumor. Given the low efficiency of the ABCD clinical rule, proposed for self-assessment of skin tumors, informing the population about the problem of skin cancer should be directed to the need for routine check-ups and an early visit to a specialist if any changes in the «moles» are detected.
Pharmateca. 2020;27(8):28-35
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The experience of use of the minocycline at a daily dose of 50 mg and topical therapy in patients with acne vulgaris

Kruglova L.S., Gryazeva N.V.

Abstract

Background. Acne vulgaris is a chronic inflammatory disease, manifested by open or closed comedones and inflammatory skin lesions in the form of papules, pustules, nodes. Objective. Improvement of the effectiveness and safety of the therapy of severe papulopustular acne by inclusion of systemic antibiotic minocycline at a minimal daily dose of 50 mg in combination with topical fixed combination of adapalene+benzoyl peroxide in the treatment regimen in accordance with clinical guidelines. Methods. 20 patients (16 women and 4 men) with severe papulopustular acne aged 14 to 39 years were followed-up. Depending on age, patients were divided into 2 groups: group 1 (n=11) - acne vulgaris (14-24 years old patients), group 2 (n=9) - adult acne (patients over 25 years old). All patients received a course of peroral minolexin (minocycline) at a daily dose of 50 mg for 6-8 weeks, a topical preparation (adaptalen+benzoyl peroxide) and specialized dermatocosmetics (cleansing, moisturizing). As control methods, IGA and HRQOL scales were used, as well as laboratory analysis data (complete blood count, biochemical blood test - ASAT, ALAT, GGTP, ANA). Results. Against the background of the therapy, 7 (64%) patients of the first group achieved complete clearance of the skin - IGA=0,4 (36%) - practically clear skin - IGA<1. In 5 (56%) patients of the second group, complete clearance of the skin was achieved - IGA=0, in 4 (44%) - practically clear skin - IGA<1. According to the HRQOL questionnaire, in patients of first group self-perception indicators improved by 42.7%, emotional sphere indicators - by 37%, social sphere ones - by 38.7%, acne symptoms - by 44%. In patients of the second group, self-perception indicators improved by 53%, emotional sphere indicators - by 41.7%, social sphere indicators - by 47.4%, acne symptoms - by 51.6%. In general, according to the HRQOL scale, there was an improvement in patients of the first group by 40.5%, in patients of the second group by 48.6%. During the whole follow-up period, there were no adverse events requiring cancellation or correction of the prescribed therapy. Conclusion. Minolexin (minocycline) at a daily dose of 50 mg is a highly effective and safe drug for the treatment of patients with severe papulopustular acne and can be recommended for widespread use in clinical practice, including in combination with topical therapy with a fixed combination of adapalene+benzoyl peroxide.
Pharmateca. 2020;27(8):36-41
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Modern approaches to the correction of the pathology of the digestive system in patients with atopic dermatitis

Kosheleva I.V., Shadyzheva L.I., Yatsyna I.V.

Abstract

Background. Atopic dermatitis (AtD) is one of the most common chronic recurrent dermatoses with multifactorial pathogenesis. It is known that increased absorption of food allergens is supported by the pathology of the digestive system, which in turn supports the chronic course of AtD and the progression of skin manifestations. Objective. Assessment of the presence and severity of pathological changes in the digestive system, as well as monitoring of the effectiveness of the treatment by determining the blood serum levels of natural autoantibodies (AB) against tissue-specific antigens of digestive system using enzyme-linked immunosorbent assay (ELISA) in patients with AtD. Methods. The study included 102 patients of adolescence and young age (15 to 44 years old) with disease duration from 15 to 44 years, 55 (54%) women and 47 (46%) men with mild (49 people) and moderate (53 person) course of disease, without complaints and history of the pathology of the digestive system. Patients were divided into two groups, matched by gender and age composition and clinical manifestations of AtD. To determine the blood serum levels of natural antibodies against tissue-specific antigens of digestive system in patients with AtD, solid-phase ELISA was used. Treatment of patients with AtD was carried out in accordance with the Federal clinical guidelines for the management of patients with AtD. Results. As a result of the study, it was found that patients with AtD have significant deviations in the levels of natural antibodies to membrane antigens of the digestive system (liver, stomach and small intestine), indicating the likely presence of subclinical metabolic disorders, and in adolescent patients (15-18 years) they are most pronounced. Conclusion. Violations identified by ELISA confirm the feasibility of a comprehensive treatment of patients with AtD without clinical manifestations of pathology of the digestive system.
Pharmateca. 2020;27(8):42-46
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Experience in the combined use of autologous platelet-rich plasma and CO2 laser in the treatment of vulvar lichen sclerosus atrophicus

Ignatovsky A.V.

Abstract

Background. Lichen sclerosus atrophicus (LSA) is a chronic recurrent inflammatory dermatosis of unknown etiology, mainly occurring in women before menarche and after menopause. Today, much in the pathogenesis and treatment of drugs remains uncertain, which necessitates the search for new effective ways to treat this pathology. Objective. Evaluation of the effectiveness of the combined treatment of vulvar lichen sclerosus atrophicus (VLSA) by administering autologous platelet-rich plasma with and CO2 fractional laser radiation in a small group of patients diagnosed with VLS as an alternative to long-term use of topical glucocorticosteroids (GCS). Methods. The observed group consisted of 12 women aged 25 to 66 years with a histologically verified diagnosis of VLSA. Using the assessment of the lesion area by the LSS index, the patients were distributed as follows: 1 woman with an area estimated at 9 points, 3 women had 8 points, 6 patients -7 points, and 2 women had 5 points. The activity of skin manifestations was assesed using the LSA index before treatment and 3 months after the end of treatment. Assessment of quality of life was carried out using the Dermatological Life Quality Index (DLQI) and in 9 women it corresponded to an interval of 11-20 points, and in 3 women - 21-30 points. The treatment consisted of injection of autologous platelet-rich plasma into the VLSA foci for the course of 4 procedures, alternating with CO2 laser fractional exposure - for the course of 3 procedures. Results. The treatment showed a positive trend reflected in the DLQI, as well as in the assessment using lichen sclerosus atrophicus indices, which demonstrated a decrease in the lesion area and the severity of clinical manifestations: in 1 woman who had an LS-A score of 19 points before the treatment, the dynamics was up to 7 points after treatment; 3 women - before treatment 20, after treatment - 6 points, 6 patients - 18 before treatment and 8 points after treatment, and 2 women - 17 before treatment and 7points after treatment. Conclusion. The combined use of autologous platelet-rich plasma with and CO2 fractional laser exposure has demonstrated good efficiency, allowed patients to refuse the use of topical corticosteroids, and also improved indicators of quality of life. Further research in order to assess the long-term effect of the therapy is reasonable.
Pharmateca. 2020;27(8):47-51
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The effectiveness of using different doses of systemic isotretinoin in adolescents with acne and overweight

Gryazeva N.V., Kolody A.A., Gensler E.M.

Abstract

Background. Acne is one of the most common dermatological diseases in the world. In terms of prevalence, it is in the top ten along with diseases such as atopic and seborrheic dermatitis, psoriasis and rosacea. The article includes an overview of the incidence of acne vulgaris in children and adolescents from different countries. Objective. Evaluation of the effectiveness of various regimens of therapy with isotretinoin in adolescents with acne vulgaris and overweight. Methods The study involved 20 patients aged 12 to 18 years with varying degrees of severity of acne and overweight. Depending on the isotretinoin regimen, patients were divided into 2 groups of 10 patients. The first group received a course of treatment with a gradual dose reduction, the initial daily dose of isotretinoin was 20-40 mg; the second received a course of isotretinoin without reducing the dosage. Results. It has been established that for severe nodular, conglobate and severe papulopustular acne in overweight adolescents, a course of treatment with isotretinoin is indicated. Isotretinoin is recommended at a dose of 20-40 mg until the stabilization of the process, then a dose should be reduced to 10-20 mg prescribed for 4-6 months, followed by drug withdrawal; for moderate papulopustular acne, it is possible to conduct a course of therapy with isotretinoin without reducing the dosage: the daily dose is 20-40 mg. Side effects from the skin and mucous membranes occur quite often, but have a temporary nature. Conclusion. For severe nodular, conglobate, and severe papulopustular acne in overweight adolescents, a course of treatment with isotretinoin at a dose of 20-40 mg until stabilization of the process with a subsequent reduction in dosage is indicated. For moderate papulopustular acne, a course of isotretinoin therapy without reducing the dosage can be recommended.
Pharmateca. 2020;27(8):52-55
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Acneiform rash - dermatological adverse event in the therapy with anti-EGFR monoclonal antibodies

Shatokhina E.A., Kruglova L.S., Polonckaia A.S., Nosikova P.G.

Abstract

Background. Targeted anticancer agents lead not only to higher treatment efficacy, but also to various specific side effects. EGFR overexpression is often associated with the metastatic cancer phenotype and correlates with poor prognosis. Monoclonal antibodies are used to suppress the EGFR-dependent signaling cascade, and have a good therapeutic effect, but with dermatological adverse event in the form of an acneiform rash (AR) in 90% of cases. Objective. Evaluation of the dynamics of AR development in oncological patients receiving treatment with panitumumab, an anti-EGFR monoclonal antibody in infusion form. Methods. Evaluation of the dynamics of the clinical manifestations of AR was carried out in a group of 15 patients with colorectal cancer undergoing therapy with the inclusion of panitumumab in the form of intravenous infusions once every 2 weeks. The follow-up period was 10 weeks. Assessment of the severity of manifestations was performed using the IGA (Investigator's Global Assessment) index on a 5-point scoring system (0-5) daily for 56 days. Results. Acneiform rush developed after the second panitumumab infusion on average of 17.5±3.8 days of treatment with EGFR inhibitors. The undulating dynamics of the skin reaction depending on the infusions of monoclonal antibodies was revealed. The severity of acneiform rash gradually increased, and the tendency to worsen after infusion on the 3-4th day continued. The severity continued until the 7th day after the infusion; then there was a decrease in the activity of the skin reaction and its resumption after the next session of targeted therapy with a gradual increase in severity after each infusion of monoclonal antibodies. Conclusion. The revealed features of the course of AR depending on the infusion of monoclonal antibodies allows prescribing maintenance therapy for AR in the intermittent mode during the period of the expected exacerbation and canceling it before chemotherapy to reduce the drug load.
Pharmateca. 2020;27(8):56-60
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Clinical and mycological problems of the use of decorative cosmetics

Yakovlev A.B., Golanova O.A.

Abstract

Background. Onychomycosis is the most common pathology among all nail diseases. The frequency of complaints of mycotic lession of the nail plates is 5% of all visits to a dermatologist in Russia. The increase in the incidence of onychomycosis is partly due to the increased demand for nail salons. Attention is drawn to the danger posed by cosmetics intended for decorative coating of nail plates (NP). Objective. Evaluation of the spectrum of pathogens complicating the course of onychodystrophy induced by the use of shellac varnish with the development of recommendations for the treatment of complications caused by the use of shellac varnish. Methods. 29 patients who visited to a dermatologist with changes in the NP of the hands found after removing the shellac varnish were followed-up. All patients underwent microscopy with preliminary clearing of the material by the KOH method, inoculation of pathological material on Sabouraud’s medium. Results. 20 of 29 patients had multiple lesions (Z2) of NP and only 9 women had single lesions of the terminal phalanges of the hands. Nail damage with non-dermatomyceous filamentous fungi was detected more often than with classic dermatomycetes. Candidiasis lesions as a complication of the use of shellac varnish were less common. Conclusion Despite the increased popularity of nail salons, it is important to remember the threat hidden under the “mask" of nail coatings. A dermatologist should pay special attention to the health of the NP and conduct preventive examinations with preliminary removal of cosmetic coatings.
Pharmateca. 2020;27(8):61-67
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Changes in type 1 and 3 collagen in photodamaged skin after photodynamic therapy: review and experience

Surkichin S.I., Kogan E.A., Kholupova L.S.

Abstract

Background. Skin aging occurs in accordance with the general patterns of age-related involution (biological or chronological aging), as well as under the influence of environmental factors, the most important of which is ultraviolet radiation (photodamage and photoaging of the skin). Objective. Evaluation of the amount of type 1 and 3 collagen before and after a course of photodynamic therapy (PDT) sessions using a chlorin E6-based photosensitizer. Methods. Punch biopsy samples of the parotid region of 3 women 38-45 years old with stage II-III photoaging of the skin (before and after the course of PDT sessions using chlorin E6 once every 7 days No. 5) were examined. Immunohistochemical parameters (type 1 and 3 collagen) were determined. Results. In histological samples taken after exposure, a thin keratinizing epidermis was observed; angiogenesis increased in comparison with the «before» sample; there was an infiltrate of lymphohistiocytic elements. According to the immunohistochemical examination, the expression of type 1 collagen had a strong intensity (4 points), and the expression of type 3 collagen had a weak intensity (2 points). Conclusion. Thus, it can be concluded that the PDT effect in photoaging leads to the normalization of the types 1 and 3 collagen ratio. The application of chlorin E6 derivatives as a photosensitizer leads to changes similar to the use of 5-aminolevulinic acid for type 1 and 3 collagen and can be recommended for clinical use.
Pharmateca. 2020;27(8):68-72
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Review of comparative microbiological study of original and generic drugs (betamethasone+ gentamicin+clotrimazole)

Kruglova L.S.

Abstract

The results of an experimental evaluation of the antimicrobial activity of combined topical dosage forms of betamethasone, gentamicin and clotrimazole (Triderm® and Akriderm® GK in dosage forms of cream and ointment for external application) are presented. The minimum inhibitory concentration (MIC) of Triderm® and Akriderm® GK dosage forms in relation to 20 out of 25 bacterial and fungal strains was 2-4 times lower for Triderm® ointment and cream than for Akriderm® GK. Since the in vitro activity of the original and generic drugs had significant differences, differences in their clinical efficacy should be expected when used in the treatment of allergic dermatoses complicated by bacterial and fungal infections.
Pharmateca. 2020;27(8):73-77
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The role of copper tripeptide (GHK-Cu) in the process of skin regeneration

Polonskaia A.S., Shatokhina E.A., Kruglova L.S.

Abstract

Wound healing is a complex process that maintains the integrity of skin. Any aberration in this process leads to the disruption of skin barrier. The research for effective and safe substances that are able to accelerate and improve skin regeneration is an important problem in medicine. Copper is an important microelement for normal skin functioning and regeneration, but not all of the copper compounds may be used in clinical practice. One of the widely used methods for copper delivery is its complexation with different ligands, among which aminoacids and small peptides play the most important role. Copper binding tripeptide GHK is a small molecule with [Gly-His-Lys] aminoacid sequence. The distinctive biochemical feature of this tripeptide is its small size, that lets the molecule to reach cell membranes easily comparing to larger substances. Moreover, GHK is characterized by the unique copper-binding properties. The aim of this review is to evaluate the possible mechanisms of GHK effects on skin regeneration processes as well as the assessment of its effectiveness in clinical practice.
Pharmateca. 2020;27(8):78-82
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Predictors of acne scar development, methods of prevention and treatment

Talybova A.M., Stenko A.G., Kruglova L.S.

Abstract

Acne scars develop in 30-40% of patients and require active therapy, as they significantly reduce the quality of life of patients, affect self-esteem and social adaptation. The mechanism of the occurrence of acne scars is caused by a deep inflammatory process (or mechanical damage, as, for example, with excoriated acne), when destructive and then reparative changes in the dermal layers occur in response to inflammation, the outcome of which can be both atrophic scars and hypertrophic ones (less frequently keloid), which is determined by the reactivity of the dermal matrix. Despite the availability of effective drugs for the treatment of acne, their effectiveness in relation to the prevention of the formation of acne scars has not been fully studied. When choosing a method of therapy in patients with formed scars and an ongoing inflammatory process, preference should be given to those methods that contribute to the relief of inflammation and at the same time allow to act on cicatricial deformities. For the correction of scars, the following methods are used: fractional needle RF therapy, laser fractional ablative technologies (hot modes ER:YAG, CO2 lasers 2940,10 600), laser fractional nonablative technologies (1540 nm, 1470, 1440, 1330, 2940 nm), Nd:YAG 1064 nm, ILP.
Pharmateca. 2020;27(8):83-88
pages 83-88 views

The effectiveness of the treatment of psoriasis with IL-17 inhibitor in a patient with concomitant obesity: a clinical case

Vladimirova I.S., Smirnova I.O.

Abstract

Background. Obesity is one of the most common comorbid diseases in patients with psoriasis. It is assumed that systemic inflammation in obesity is accompanied by the release of adiponectin and pro-inflammatory cytokines, including key cytokines of psoriasis - interleukin-17 (IL-17) and IL-23, which in turn act as triggers for psoriasis and thereby can provoke its more severe course. In addition, obesity can reduce the effectiveness of drugs, including genetically engineered biologic drugs. Description of the clinical case. The article describes the observation of a patient with severe plaque psoriasis and concomitant obesity treated with IL-17 inhibitors with a good clinical effect. Against the background of a decrease in body weight, a stable remission of the disease for a year and a half after the cessation of therapy was noted. Conclusion. The treatment of psoriasis requires an integrated approach and the choice of treatment method. Obesity, one of the most common concomitant diseases, can not only interfere withthe achievement of the drug effect, but also aggravate the course of other comorbid conditions. It is important to choose a method of therapy that can pathogenetically affect psoriasis and obesity, for example, IL-17 inhibitors.
Pharmateca. 2020;27(8):89-92
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Pyoderma gangrenosum in a patient with acantholytic pemphigus

Rodin A.Y., Serdyukova E.A.

Abstract

Background. Currently, the nosological entity of pyoderma gangrenosum (PG) is not defined. This disease is supposed to be neutrophilic vasculopathy, severe autoimmune dermatosis associated with systemic or chronic inflammatory diseases, or severe angiitis due to sensitization to various microorganisms. Due to the indefinite nosological entity, therapy of PG presents significant difficulties. The use of systemic glucocorticosteroids (sGCSs), cytostatics, bioengineered drugs, vasoactive drugs, laser and magnetotherapy, and efferent methods is often ineffective. In the literature there are a sufficient number of publications on the development of PG against the background of various, including severe systemic autoimmune diseases. However, in the literature available to us, we did not find descriptions of cases of its development against the background of such a serious autoimmune disease as acantholytic pemphigus (AP). Description of the clinical case. The article provides a clinical case of the development of PG in a 42-year-old patient suffering from vulgar AP. According to the authors, the isolated use of high doses of cGCS, the addition of cytostatic drugs and efferent methods to therapy were ineffective. At the same time, the appearance of ulceration in the area of AP foci does not indicate the ineffectiveness of pemphigus therapy and, most importantly, does not serve as an indication for increasing the daily dose of systemic corticosteroids, but indicates the development of PG against the background of severe immunosuppression caused by massive corticosteroid therapy. Conclusion. The effectiveness of the combined treatment, including cGCS, cytostatics, the use of two antibacterial drugs that potentiate the effect of each other, and local use of chymotrypsin, has been shown.
Pharmateca. 2020;27(8):93-96
pages 93-96 views

Description of the clinical case of the use of the apremilast in a patient with an oncological history

Khotko A.A., Pomazanova M.Y.

Abstract

Background. Apremilast is the first representative of low-molecular targeted disease-modifying anti-inflammatory drugs for the treatment of psoriasis and psoriatic arthritis (PsA). Apremilast is selective phosphodiesterase-4 (PDE-4) inhibitor. Obviously, in the future, apremilast will occupy an important place in the treatment of psoriasis and PsA due to its oral form, proven effectiveness in relation to various forms of psoriasis and a favorable safety profile. Description of the clinical case. An example of the successful use of amremilast therapy in the treatment of a patient with vulgar psoriasis, PsA and an oncological history (breast cancer) is presented. A fast and stable normalization of PASI parameters with the disappearance of skin elements was achieved. The treatment was well tolerated; no adverse events were observed during therapy. Conclusion. It can be concluded that the use of the PDE-4 inhibitor apremilast allows to control psoriasis and improve the quality of life of patients, including with concomitant pathology.
Pharmateca. 2020;27(8):97-101
pages 97-101 views

The possibilities of fractional laser therapy and physiotherapy in the treatment and prevention of hyperpigmentation

Ikonnikova E.V., Avagumyan M.A.

Abstract

Background. In modern dermatology and cosmetology, correction of hyperpigmentation occupies a significant place in practical activities. Laser therapy with fractional photothermolysis is one of the most popular methods for correcting various types of hyperpigmentation. Description of the clinical cases. Two cases of use of the fractional laser therapy with CO2 laser system in patients with complex cases of hyperpigmentation (melasma and post-inflammatory hyperpigmentation) are presented. In both cases, pronounced lightening of the foci of pigmentation and a general improvement of skin tone were noted. Conclusion. Modern laser technologies provide the most effective and safe treatment of not only standard age-related pigmentation and senile lentigo, but also post-inflammatory pigmentation, as well as such a difficult nosology for therapy as melasma.
Pharmateca. 2020;27(8):102-105
pages 102-105 views

Clinical case of mycosis fungoides

Svechnikova E.V., Marshani Z.B.

Abstract

Background. The group of cutaneous T-cell lymphomas is a heterogeneous group of non-Hodgkin lymphomas, which are a malignant transformation of resident skin T-lymphocytes. Mycosis fungoides (MF) is the most common form of cutaneous T-cell lymphomas and accounts for almost 50% in their structure. This disease has a staged course and is characterized by the evolution of a rash - from spots to plaques and tumors. The course of the disease is quite indolent, and can last for years and even decades. Prior to diagnosis, patients usually have a history of nonspecific eczematous or psoriasiform dermatitis with nonspecific histological characteristics. Description of the clinical case. This article presents the clinical case of a patient with an established diagnosis of MF who has been followed-up by a dermatologist and allergologist for a long for toxicoderma. Conclusion. Thus, the role of related specialists in the diagnosis remains undeniably high, and the diagnosis of MF should be established on the basis of a comprehensive assessment of the clinical picture, histological and immunophenotypic studies.
Pharmateca. 2020;27(8):106-109
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