[Evaluation of the effectiveness of ultratonotherapy in patients with microbial eczema]

Microbial eczema is a chronic dermatosis with a complex pathogenesis. The result of exposure to various endo- and exogenous trigger factors is the formation of skin dysbiosis in lesions with a predominance of opportunistic and pathogenic flora and, as a result, the development of sensitization. As the main therapy for dysbiotic disorders, it is customary to use antibacterial drugs. However, often the use of systemic antibacterial drugs is not justified and leads to an aggravation of the problem of antibiotic resistance.

PURPOSE OF THE STUDY

To evaluate the effectiveness of the use of alternating current on the skin microbiome in the complex therapy of patients with microbial eczema.

MATERIAL AND METHODS

2 groups of 30 patients with chronic moderate course of microbial eczema in the acute stage were examined. In the comparison group, therapy was carried out in accordance with the Federal Clinical Guidelines (antihistamines, detoxification, systemic antibacterial drugs, external combined agents, including a corticosteroid and an antibiotic). Patients of the main group received similar therapy without systemic antibiotics. In addition, to influence the pathogenic microflora of the skin in the lesion in the main group, procedures with supratonal alternating current of low strength were also used. The control group consisted of 30 healthy volunteers. The results were evaluated according to the clinical picture, laboratory parameters of bacteriological examination.

RESULTS

During therapy, in patients of the main group and in the comparison group, a positive dynamics of the skin pathological process was noted, and a decrease in microbial colonization of the skin in the lesions of microbial eczema was observed by 4 and 3 times, respectively (p<0.05).

CONCLUSION

The proposed method of treatment is not inferior in terms of the effectiveness of traditional therapy, allows to achieve positive clinical dynamics in similar terms, as well as to avoid the widespread use of systemic antibacterial drugs in cases of moderate dermatosis.

[Mechanisms of action and clinical effectiveness of ultratonotherapy in the complex treatment of foot onychomycosis]

INTRUDUCTION

A long course of onychomycosis, severe hyperkeratosis, slow growth of the nails of the feet, somatic burden, as well as an increase in the resistance of pathogens often lead to a decrease in the effectiveness of traditional antimycotics, dictating the need to create new methods of therapy. A promising direction of treatment is the use of alternating current of supratonal frequency of high voltage and low power - ultratonotherapy (UT) in combination with antifungal drugs. The article presents data on the mechanisms of action and clinical effectiveness of this method in the complex treatment of foot onychomycosis.

AIM OF STUDY

To study the mechanisms of action and evaluate the clinical effectiveness of UT in the complex treatment of foot onychomycosis.

MATERIAL AND METHODS

The antifungal effect of UT was studied in the colonies of Trichophyton rubrum and Candida albicans. The distribution of ozone released during the procedure on the affected nail plate was evaluated in vitro using a qualitative chemical reaction and photodermatoscopy. The state of tissue blood flow in the periungual tissues under the influence of UT was studied in vivo by means of ultrasound dopplerographic scanning (USDGS). The clinical effectiveness of the method was evaluated according to the results of complex treatment of patients with foot onychomycosis in comparison with traditional methods of therapy.

RESULTS

UT has both fungicidal and fungistatic effects. With a qualitative reaction to ozone, coloring of the surface and small structures of the nail plate was noted. According to the USDGS, after the use of UT, a significant increase in blood supply to the periungual tissues was recorded. The combined use of alternating current of a high voltage ultrasonic frequency with antifungal drugs in patients with foot onychomycosis contributes to the rapid growth of the nail and shorten the duration of mycological cure.

CONCLUSION

UT has an antifungal effect and improves microcirculation in the area of the nail bed. In the complex treatment of patients with foot onychomycosis, the method accelerates clinical and mycological cure, stimulates nail growth, which reduces the rate of systemic and local antifungal therapy.

[Features of dermatological pathology on the background of HIV-infection]

Over the past decade, there has been an increasing number of patients infected with HIV. The disease gradually leads to a pronounced immunodeficiency and death. In the vast majority of patients, polymorbidity phenomena are noted, which leads to the need for a differentiated interdisciplinary approach to their management. The knowledge of dermatologists of other dermatological aspects of HIV-infection by dermatologists and doctors will allow timely early detection of HIV-infected patients and avoid diagnostic errors. A clinical follow - up was carried out which showed issues of diagnostics while examining patients with HIV infection in outpatient practice.

Progressive symmetric eritrocarotodermia Gottron: A rare case

The article deals with ethiopathogenetic factors of origin of progredient symmetric erythrokeratodermia of Gottron which is mainly characterized by autosomal dominant mode of inheritance and is classified as a disorder of cornification with extra epidermal cellular proliferation.

Clinicopathologic criteria on the basis of which this pathology can be verified are described here, such as: onset of a disease at an early age, strictly divided polycyclic, fixed, hyperkeratotic plaques with a narrow erythematic crown and a clean-cut, sometimes hyper pigmented edge, which are symmetrically located on skin on head, buttocks, limbs and are not prone to quick peripheral growth; large frequency of palmoplantar keratoderma and also histological changes typical of erythrokeratodermia.

The article describes a rare clinical case of autosomal-recessive progredient symmetric erythrokeratodermia of Gottron which is distinguished by seasonal changes of skin pathological process — emergence of rash in winter and complete remissions in summer.

Modern approaches to the prevention and correction of complications caused by systemic treatment of severe acne forms

Background. According to European and RF clinical guidelines, only the systemic use of isotretinoin in severe acne has a high level of evidence. However, this therapy is frequently associated with the development of retinoid dermatitis, the prevention and correction of which requires the application of emollients. Aim. To evaluate the efficacy and tolerability of the Perfectoin cream during treatment and prevention of retinoid dermatitis in patients with severe acne receiving systemic treatment with isotretinoin.

Materials and methods. Two groups of patients each comprising 38 people with moderate, severe and resistant to standard therapy forms of acne were observed. Each group included 22 patients with retinoic dermatitis manifestations and 16 without such symptoms. The patients in the main and comparison groups were prescribed the Perfectoin cream and the dexpanthenol cream, respectively. Control of the skin condition was performed prior to the study and following 1, 3 and 6 months of therapy. Assessment parameters were the main symptoms of retinoid dermatitis (erythema, lichenification, excoriation, itching, feeling of dryness/tightness of the skin), indicators of the hydration of the horny layer of the epidermis and the transepidermal loss of moisture, as well as the dermatology life quality index.

Results. The study has shown that the Perfectoin cream in patients with acne receiving isotretinoin therapy helps to restore skin hydration and leads to a rapid regression of the main dermatological symptoms of retinoid dermatitis, thus improving the overall quality of patients’ life.

Relapsing polychondritis in medical practice of dermatovenerologist

Recurrentpolyhedritis is a rare rheumatic disorder with a wave-like course, presumably ofautoimmune nature,characterizedbya widespread inflammatorylesion of the cartilaginous structures and other connective tissue of the ears, joints, nose, larynx, trachea, eyes, valvular heart, kidneys and blood vessels.The description of the own observation of recurrent polychondritis.

Microbial eczema: possibilities of correction at the present stage

Microbial eczema is a chronic recurrent dermatosis characterized by evolutionary polymorphism of the elements of the rash, sputum, itching, allergic reaction of the sensitized skin to the products of the decay of microorganisms and their toxins, developing against the background of a long-existing pyogenic focus in violation of the most important regulatory systems of the body.Purpose: to study the biocenosis of the skin in patients with microbial eczema and to evaluate the clinical efficacy and safety of the cream “Tetraderm” in such patients.Materials and methods. Patients with microbial eczema were observed, randomly selected into two groups. All patients studied biocenosis of the skin before and after treatment. Patients of the study group received topical therapy with the cream “Tetraderm”. External therapy for patients of the comparison group was carried out with cream of mometasone furoate in combination with erythromycin and clotrimazole ointments. The effectiveness of the therapy was evaluated taking into account the clinical dynamics of the skin process, bacteriological data on the content of pustules and detachable erosion, calculation of the EASI and DIJ indices.Results. A comparative analysis of the biocenosis of microbial eczema foci in patients of both groups at the end of therapy showed a higher severity of disbiotic changes in the comparison group. As a result of our study found that patients who used the cream “Tetraderm”, there was a more rapid regression of dermatosis, almost complete suppression of pathogenic bacterial flora, a significant improvement in the quality of life.Conclusion. The biocenosis of the skin of patients with microbial eczema was characterized by a high degree of contamination of Staphylococcus aureus and Staphylococcus epidermidis, against the background of the average verification of Streptococcus spp., Candida spp. The combination of pronounced anti-inflammatory, antibacterial, antimicotic and regenerating effects of the cream “Tetraderm” causes its high efficiency and prospects of use as a drug of choice of topical monotherapy of microbial eczema.

ASSOCIATED PATHOLOGY: CLINICAL ОBSERVATION

The article analyzes the literature on polymorbidity of immune dermatoses. They confirm the possibility of combining with each other immune diseases, due to the presence of immune and metabolic abnormalities that are characteristic for the majority of chronic dermatoses and may indicate the possibility of combining several nosology. We present 2 clinical cases polymorbidity. In the first case — a combination demonstrated in one patient planus, idiopathic atrophoderma Pasini — Pierini and multi-colored lichen. In the second case detected combination of 4 kinds of dermatological diseases — horny eczema, psoriasis vulgaris, scleroderma, and rosacea. Patients underwent complex clinical examination and histomorphological examination of skin biopsies. The presented clinical cases demonstrate the possibility of a combination of several skin diseases in one patient with common etiopathogenic mechanisms

ISOTRETHINOINE IN ACNE THERAPY

Systemic retinoids are known to be the most effective means of treating severe forms of acne. However, in spite of longstanding and intensive practice of their application in dermatology, some specialists still avoid prescribing this group of drugs. As a rule, this is due to lack of awareness of health professionals about therapy techniques and means of correcting possible adverse events. We discuss the clinical aspects of administration of isotretinoin in treatment of moderate and severe forms of acne. Practical recommendations are given on how to prevent various myths, misconceptions and prejudices in health professionals and patients. We present our own experience of using isotretinoin with increased bioavailability (Acnecutan®*).

Etiological features of onychomycosis in the Krasnodar territory. Choice of method systemic therapy

Successful treatment of onychomycosis associated with the necessity of microbiological research aimed at the selection of culture with proven etiological significance. Features of morphological and functional characteristics of the nail, poly etiology of onychomycosis, the availability of labor input in the use of topical antifungal drugs and irrational approaches to the treatment of various forms of the disease, as well as the duration and high cost of treatment create difficulties in the treatment of this contingent of patients . Goal. To study the etiology of onychomycosis in the Krasnodar region, and a comparative analysis of the efficacy and tolerability of antifungal drug regimens "Irunine". Materials and methods. A total of 64 patients (39 men and 25 women) with complaints about the change of nail plates in the hands and feet. The diagnosis of onychomycosis was established for 46 (71.88%) patients, of which 2 patients in the study group were not included. The rest were randomly selected and divided into 2 equivalent groups of 22 patients. Patients of the 1st group received "Irunine" by the method of pulse - therapy, and the patients in group 2 on continuous therapy scheme. Results. In the study of the samples from the nail plates, the major causative agent of onychomycosis was T. rubrum - 61,37%. Candida spp. was diagnosed in 11%. Equally often - at 9.09%, were the growth of T. mentagrophytes var. interdigitale and T. tonsurans. Furthermore, associations have been identified T. rubrum and Candida albicans - 6,82%, T. rubrum and Aspergillus versicolor - 2,27%. The result of our study showed a high clinical and mycological efficacy of the drug "Irunine" in the treatment of onychomycosis. Comparative analysis of this drug therapy results showed that the method of pulse therapy, compared with continuous therapy scheme is more efficient and economically advantageous, since it allows to reduce the amount of drugs, and therefore significantly reduce the risk of adverse reactions and improve its tolerability. Conclusion. The findings suggest that the leading position in patients with onychomycosis mycobiota hold dermatomitsetami genus Trichophyton. Pulse therapy with "Irunine" is a priority and can be recommended for use as a systemic drug for the treatment of onychomycosis, as a highly effective and safe drug.

Atopic dermatitis in children: prospects of using innovation products as an external therapy

Goal of the research: to determine the efficacy of a new line of Atopic cosmetic products for skin care in children suffering from atopic dermatitis. Materials and methods: The study involved three groups of 15 children aged 3-12 suffering from atopic dermatitis in each group. Subjects from Group 1 were treated with Atopic Soothing Cream, from Group 2 with Atopic Soothing Stick Cream and from Group 3 with Atopic Everyday Care Cream. Different inclusion and exclusion criteria were developed for each group, and the algorithm for the product application and efficacy criteria were determined. According to recommendations, Atopic Soothing Cream and Atopic Soothing Stick Cream were applied to clean and dry skin in the morning and in the evening for the study period of 14 days. The patients’ skin condition was assessed prior to the study and on Day 14 of the therapy; the assessment covered parameters necessary for calculating the SCORAD Index. Atopic Everyday Care Cream was applied to clean and dry skin in the morning and in the evening for 28 days. The patients’ skin condition was assessed prior to the study and on Days 14 and 28 of the therapy including the SCORAD Index and assessments of the skin hydration level of the epidermal corneous layer and transepidermal waster loss (TEWL) using the DermaLabCombo CORTEX device. According to the study results, the line of Atopic cosmetic products fully complies with the properties specified by the manufacturer, reliably improves the skin condition in children suffering from atopic dermatitis, has no irritant or sensitizing effect, and can be recommended for the complex treatment and rehabilitation of patients suffering from the pathology.

Ultratone therapy for the complex treatment of localized scleroderma

The examination and treatment of 48 patients with circumscribed scleroderma were conducted. Two groups of these patients were formed with method of adaptive randomization. In the control group complex treatment underwent according to the standards in this nosology. In the study one, we conducted ultratonotherapy. The course of treatment was 21 days in both groups. Treatment results were evaluated in accordance with the dynamics of cutaneous pathological process and microcirculation in the area of lesions. In the process of treatment positive clinical dynamics appeared in the study group earlier and were accompanied by increased blood flow. The results indicate that ultrasonotherapy increases the efficiency and reduces the treatment time of patients with circuscrimbed scleroderma.

Prevalence of localized scleroderma in the Krasnodar territory

The authors conducted a study of particular features of the course of localized scleroderma in the south of Russia (Krasnodar territory). 65 case histories were analyzed. Women suffered from the disease 2.8 times more often than men; one half of the sample (55.4%) included patients aged 35-55; the disease duration of over a year prevailed (69.8%); the disease occurred against the background of an endocrine pathology in one third of all cases; one third of all women developed the disease during the postmenopausal period. Plaque scleroderma (56.9%), white spot disease (von Zumbusch psoriasis) (16.9%) and idiopathic atrophoderma of Pasini and Pierini (12.3%) belonged to the key clinical forms. The average number of lesions was 2.4 ± 1.2 while almost a half of the patients (47.7%) had three or more lesions. The clinical manifestations localized mostly on the back (46.5%) and stomach (34.9%).

Actinic reticuloid: сase study

A rare case study of actinic reticuloid is presented. Analysis of literature, clinical and pathomorphological criteria of I diagnostics are described.

Practical aspects of administering Acnecutan for the treatment of acne in teenagers

Goal of the study: to study the efficacy and tolerance of Acnecutan for the treatment of acne in teenager patients. Materials and methods. The study involved 43 patients aged 12-18 with moderate to severe acne, who received Acnecutan* as a monotherapy. The skin process dynamics was assessed visually based on the Basic Acne Severity Index (BASI). Results. Clinical recovery was achieved in 39 patients (90.7% of all cases), and clinical improvement was observed in 4 patients (9.3%). Conclusion. The results of Acnecutan administration demonstrate a high level of its efficacy and tolerance in teenagers. To assess the stability of the results achieved and to draw final conclusions, the patients will be followed up within a year after the end of the therapy. Therefore, the drug can be recommended as a monotherapy for acne of different clinical forms in teenager patients.

Innovations in the external therapy of acne

Goal. To assess the clinical efficacy of a monotherapy with the use of products belonging to the Hyseac line for the treatment of light acne. Materials and methods. The study involved 28 patients with light acne, who were administered products belonging to the Hyseac line as a monotherapy. The dynamics of the skin processes was assessed visually (S. Liden’s acne general severity scale) and with the use of instrumental methods — sebometry (Callegari SOFT 5.5). Results. High efficacy of the administered therapy was registered in 39% of the subjects, substantial improvement was recorded in 53% of the subjects, improvement — in 8% of the subjects while no effect was registered in 0% of the subjects. Conclusion. The drug demonstrated high clinical efficacy, good tolerance and absence of any adverse effects, which makes it possible to recommend products belonging to the Hyseac line as a monotherapy and concomitant treatment of light acne.

Necrolytic erythema: oddities

Powered by monitoring a patient with clinical manifestations of erythema associated with nekroliticheskoyglyukagonomoy. The attention to the diagnostic criteria of the disease. Formation of cutaneous syndrome glyukagonomelets talk about its nosological specificity.

Experience of treating acne patients with acnecutan

The author describes her own positive experience of using a new innovation form of isotretinoin, the Acnecutan drug, for the treatment of acne patients. The author provides the drug efficacy and tolerability assessment, describes the frequency and intensity of adverse effects and discloses the methods for their prevention and elimination

A case study of acrokeratosis paraneoplastica (Bazex syndrome)

This article presents data about the etiology, pathogenesis, clinical course and methods of treatment for a rare obligate paraneoplastic dermatosis - the Bazex syndrome. The authors share their own observations.