Chronic pruritis is one of the major symptoms in dermatology and greatly affects a patient's quality of life. Besides dermatological diseases, chronic pruritis is associated with systemic, neurologic, and psychogenic diseases; the skin in aging is considered to become more susceptible to pruritis. Recent epidemiological studies have indicated that 10-20% of adults suffer with chronic pruritus, the disease considerably prevails in older subjects. Old-age group patients have more frequently concomitant diseases that require the use of a few drugs; this all may complicate diagnosis and treatment. A rational approach to choosing a suitable therapeutic method for patients with pruritis is presented in the paper.
Systemic diseases as a cause of pruritis are recorded in 10-50% of patients seeking medical advance for itch. When pruritis appears in the presence of a systemic disease (renal, hepatic, hematological, and endocrine diseases, malignancies), the patient's skin exhibits only secondary morphological elements, such as excoriations, that may be secondarily infected, and dyschromia. Screening laboratory tests and instrumental and additional studies are used to reveal causes of pruritis. Its various causes in systemic diseases are assumed, which makes it difficult to search for adequate and effective medical measures to reduce pruritis.
The paper reports the cutaneous manifestations of the most common endocrine diseases (thyroid disease, diabetes mellitus, hypercorticism, adrenal disease) and their diagnosis. Both literature data and specific clinical examples are presented.
The paper considers some mechanisms that are common to lipoid necrobiosis (LN) and endocrine pathology. It gives two examples of successful treatment for LN developing long before diabetes mellitus and thyroid disease.
The skin is a complex organ closely linked with the whole organism. Many investigators note that some skin disease give rise to visceral changes and others are in contrast a manifestation of primary lesion of various visceral organs, altered metabolism, and shifts in the immune system or central nervous system (CNS). This investigation revealed that are systemic and organ diseases in some chronic dermatoses. Thus, the problems of the development and treatment of chronic dermatoses should be considered in the aggregate with the state of visceral organs and CNS. The visceral organs and lipid peroxidation processes in expired breath condensate were studied in patients with chronic skin diseases.
The paper describes a clinical case of the rare dermatosis folliculitis et perifolliculitis capitis abscedens et suffodiens (Hoffmann) in a 25-year-old man and its treatment using high-intensity laser irradiation in combination with topical agents - gel containing 10% epigallocatechin-3-gallate (Galaderm). A positive result has been first obtained as complete clinical resolution.
The use digital photodermatoscopy (DPDS) (n = 124) and optical coherence tomography (OCT) (n = 8) in patients with scabies has yielded new evidence for morphological skin changes when a Sarcoptes scabiei female mite excavates a tunnel. DPDS detected fluid-filled and dry tunnels. The former are typified by its deeper location and the presence of live active females, eggs in the tunnel, and its roof holes. The latter are located superficially, females die in them, and eggs and holes are absent in the tunnel roof. OCT has supported the data of DPDS and provided a deeper insight into the structure of scabby tunnels - their sizes and roof thickness have been estimated and the signs of inflammation around the female revealed.
The paper considers the epidemiology, etiopathogenesis, clinical manifestations, current methods for the diagnosis and treatment of angiokeratoma corporis diffusum (Fabry's disease) and presents the authors' clinical observations.
The paper presents the literature data showing it expedient to incorporate the vitamin B group into a complex therapy for psoriasis and lichen ruber planus. An intramuscular complex agent containing thiamine hydrochloride, pyridoxine hydrochloride, cyanocobalamin hydrochloride has shown a high therapeutic effect. It is well tolerated and has a beneficial effect on the content of total cholesterol, total bilirubin, and hemoglobin.
According to investigators' data, about 2% of the world's population suffers from allergic contact dermatitis (ACD) now. The incidence of contact allergy reduces at the age of over 40 years, i.e. the most socially active portion of the population is afflicted by this condition, sensitization to a few provoking factors occurs in every 6 patients.The pathogenesis of ACD has been currently inadequately studied; however, ACD is a delayed allergic reaction. As of now, indications for allergy tests have not defined in dermatological practice due to the fact that there are neither clear clinicoanamnestic criteria nor a unified systemized diagnostic approach, which in turn affects the timely choice of a correct treatment method. To study the etiology and pathogenesis of allergic dermatosis and to improve therapy methods remain one of the most urgent tasks for modern dermatology.
The paper presents the data available in the literature on the current notions of formation of seroresistance after effective treatment for syphilis and the clinical and serological characteristics of 284 patients, by generalizing the preliminary results of analysis of the efficiency of various treatments.
The paper gives data on a 42-year-old female patient with vulvar pseudocondyloma (VP), who have been invited to be examined due to her husband having giant condyloma of Buschke-Loewenstein. Polymerase chain reaction of pseudocondyloma tissue has revealed no human papillomavirus DNA. It is emphasized that VP is a variant of the norm.
The clinical features of acne vulgaris (AV) were considered in 80 patients under the conditions of hot climate in the Republic of Tajikistan. Microbiological assay was used to study the skin ecosystem in patients with AV, by taking into account the form of the disease. The detected flora was ascertained to be sensitive to basic antibiotics. There were changes in the pH value of the skin in relation to the severity of its lesion. Ultrasonography was carried out to study visceral pathology in different forms of the disease. The results of treatment for papular, pustular, and nodulocystic/conglobate forms of the disease, by using 15% azelaic acid gel alone and in combination with oral ciprofloxacin, as well as systemic isotretinoin.
The paper presents a currently approach to eximer laser therapy for alopecia areata. It shows changes in the microcirculatory bed in this disease and their trends under the action of eximer laser.