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Issue. Articles

1(60) // 2016



1. Scientific researches


Differentiated treatment of acne in females of young and middle age depending on hormonal disorders

L.O. Naumova, Ya.O. Sulik

O.O. Bogomolets National Medical University, Kyiv

Objective — to improve the efficiency of acne treatment in women on the basis of new scientific data about the features of endocrine status, hormonal status of the organism and the clinical course of the disease.
Materials and methods. The study involved 126 women with inflammatory form of acne of varying degrees of severity. The patients’ age ranged from 19 to 37 years. The following indicators were determined to evaluate the hormonal female body’s status: free testosterone, follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), thyroid stimulating hormone (TSH), free thyroxine (4), dehydroepiandrosterone sulfate (DHEAS).
Results and discussion. The prevalence of acne in the age group from 19 to 25 years was 32 %, 25 to 30 years — 39 %, 30 to 37 years — 29 % of women. Easy clinical course — inflammatory process of second degree was established in 53 (42%) patients, moderate severity clinical course of third degree — in 64 (51 %), severe clinical course of the fourth severity — in 9 (7 %) of the women surveyed. Clinically, the condition of hyperandrogenism in women with acne in the presence of hirsutism, androgenic alopecia and acantosis nigricans was diagnosed in 57.3 % during the study of blood hormones, hyperandrogenism condition was diagnosed in 88 % of surveyed women with acne. The manifestation of hyperandrogenism syndrome at visual examination was present only in half of the women with confirmed laboratory hormonal disorders.
Conclusions. According to the results of the research, various endocrine disorders, such as hyperandrogenism syndrome, play an important role in the development of acne in women of reproductive age. Clinical examination of women with acne is not enough for establishing the condition of hyperandrogenism. An integrated laboratory and special study is necessary to establish the genesis of hyperandrogenism, which contributes to the development of pathogenetically­based, individualized treatment of female patients with acne. Complex differentiated systemic and local therapy contributes to interruption of drive links important in the pathogenesis of acne in women, which improves the effectiveness of treatment and prevents relapses.

Keywords: acne, clinical forms of acne, women of reproductive age, hormonal status disorders, hyperandrogenism.

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Original language: Ukrainian

2. Scientific researches


Investigation of cytokine profile indicators of immune status (TNF-α, IL-17, IL-23) in patients with psoriasis and their significance in pathogenesis of dermatosis

R.L. Stepanenko

O.O. Bogomolets National Medical University, Kyiv

Objective — to investigate the levels of cytokines in patients with psoriasis, which play a role in the formation of immune inflammation FNO-α, IL-17, IL-23, and to determine their significance for the pathogenesis of this dermatosis.
Materials and methods. Performance levels of proinflammatory cytokines, TNF-α, IL­-17 and IL-23 in psoriasis patients’ blood (n = 139) by ELISA before and after a course of systemic immunosuppressive therapy were determined.
Results and discussion. Indicators of TNF-α, IL-­17 and IL-­23 in psoriasis patients were significantly higher than those in the control group. After completing the course the systemic immunosuppressive therapy with etanartsept, all 139 pso­riasis patients manifested the reduction in the levels of TNF-α, IL­-17 and IL-­23, and the approximation of their values to the corresponding parameters in healthy patients (control group).
Conclusions. Significant increase in indicators of FNO-α proinflammatory cytokines, IL-17, IL-23 in the blood of patients with psoriasis vulgaris of progressive or stationary stage in comparison with indicators of healthy individuals indicates their role in the pathogenesis of this dermatosis.
Violation of the levels of immune response mediators, which participate in the formation of immune inflammation, cytokines directly in the body of patients with psoriasis, can serve as an additional test for the prediction of the clinical course of this dermatosis.

Keywords: psoriasis, TNF-α, IL-17, IL-23, systemic immunosuppressive therapy.

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Original language: Ukrainian

3. Scientific researches


Gradual steps for interpretation of itching in atopic dermatitis

A.. Reznikova

P.L. Shupyk National Medical Academy of Postgraduate Education, the Ministry of Health Care of Ukraine, Kyiv

This article presents the selected results of survey of 10 patients with atopic dermatitis. The detailed analysis of allergic history and SCORAD index in various forms of the disease were determined. Interleukin­-2, -4 and -6 were defined. Immunological examination was conducted with determination of cellular and humoral immunity by investigating major subpopulations of lymphocytes: T-­lymphocytes (CD3), T-­lymphocyte helpers (CD4), T-­cytotoxic lymphocytes (CD8), ­-lymphocytes (CD20), NK-­cells (CD16) aimed at correction of diagnosis and improvement of treatment of atopic dermatitis.

Keywords: atopic dermatitis, itching, interleukin, immunity, immunogram.

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Original language: Ukrainian



Experience of use of Acnetine in treatment of rosacea

Zh.V. Koroliova, V.M. Borovikov

P.L. Shupyk National Medical Academy of Postgraduate Education, the Ministry of Health Care of Ukraine, Kyiv

Objective — to study the clinical efficacy of «Acnetine» in the treatment of rosacea.
Materials and methods. Patients with rosacea were under the supervision during the period of 4 years. The duration of treatment with «Acnetine» ranged from 16 to 24 weeks.
Results and discussion. Stable clinical remission in all patients under survailance was achieved as a result of treatment with «Acnetine». The drug showed good tolerability with no significant changes in blood test and urinalysis after completion of therapy.
Conclusions. «Acnetine» has been proved to be effective for the treatment of papulopustular, nodulopustular rosacea and rosacea conglobata. It is safe, well absorbed, it does not cause severe side effects during long­term administration. Side effects of the drug are dose­dependent, and they can be eliminated completely with the decrease in dosage, symptomatic therapy or in case of cancellation of the drug.

Keywords: rosacea, Acnetine, isotretinoin, combined treatment schemes, optimization of rosacea therapy.

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Original language: Russian



Local treatment of allergic contact dermatitis from perspective of evidencebased medicine

L.A. Bolotna

Kharkiv Medical Academy of Postgraduate Education, the Ministry of Health Care of Ukraine

This article provides information about the causes and mechanism of development of allergic contact dermatitis, the principles of evidence­based medicine. We present the means for treatment of dermatitis, and focus attension on the role of modern topical corticosteroids (mometasone furoate) in the treatment of disease.
Approaches to treatment of allergic contact dermatitis are presented with regard to the principles of evidence-based medicine. The analysis of several clinical practice guidelines of European countries, domestic and foreign publications allowed the author to conclude that there is a common coherent opinion about the medical tactics at ACD. Local steroids are the first line of symptomatic treatment of localized ACD lesions not exceeding 20% of the skin. Principles and means of treatment of dermatitis are specified; attention is focused on the role of contemporary topical glucocorticosteroids (mometasone furoate) in the treatment of disease.

Keywords: allergic contact dermatitis, etiology, pathogenesis, evidencebased medicine, treatment guidelines, mometasone furoate.

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Original language: Russian



Drug correction of elevated concentrations of leukocyte adhesins in urogenital chlamydiosi

M.R. Anfilova

National Pirogov Memorial Medical University, Vinnytsya

Objective — to evaluate the effect of combined therapy on the dynamics of the content of intercellular adhesion molecules sICAM­1 and sVCAM in patients with urogenital chlamydiosis.
Materials and methods. After obtaining informed consent, the study included 60 patients (30 females and 30 males) with a diagnosis of urogenital chlamydiosis and 30 persons without sexually transmitted diseases that composed the control group. The concentration of leukocyte adhesins sICAM­1 and sVCAM in serum was determined by enzyme­linked immunosorbent assay (ELISA) with the use of standard test systems of company Bender MedSystems GmbH (Austria).
Results and discussion. As a result of research it was found that the concentration of sVCAM was increased by 3.7 times as compared with the control group, and the concentration of ­1 — by 6.5 times. In order to determine the effectiveness of drug correction of elevated leukocyte adhesins concentration in blood plasma, all the patients before treatment were divided into two equivalent groups: main (n = 30) and comparison group (n = 30). Patients of the main group received comprehensive treatment, which, besides the antibiotics, included lipid­lowering drugs and a complex of probiotics, vitamins and minerals that has imunotropic properties. The patients of the comparison group received only an antibiotic. The concentration of soluble molecules of cell adhesion (sICAM­1 and sVCAM) in the blood serum of patients with urogenital chlamydiosis, who took only antibiotic therapy, did not change significantly in spite of the treatment. Concentration of sVCAM decreased by 1.1 times, and concentration of ­1 decreased by 1.2 times. Significantly better results were obtained in patients who, in addition to the antibiotic, took a combined therapy including lipid­lowering drugs, and a complex of probiotics, vitamins and minerals. Concentration of SAM­1 decreased by 2.6 times, and concentration of sVCAM — by 1.7 times, respectively.
Conclusions. The proposed comprehensive treatment helps to reduce the concentration of leukocyte adhesins, recover the urogenital barrier epithelial and improve the effectiveness of treatment of urogenital chlamydiosis.

Keywords: urogenital chlamydiosis, intercellular adhesion molecules, ̭1, sVCAM, drug correction.

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Original language: Ukrainian



Experience of using Lourdes preparation in treatment of allergic dermatites in adults and children

Zh.V. Korolova

P.L. Shupyk National Medical Academy of Postgraduate Education, the Ministry of Health Care of Ukraine, Kyiv

Objective — to evaluate the clinical efficacy and safety of «Lourdes» (pharmaceutical form — syrup with 5 ml of syrup containing 2.5 mg of desloratadine and tablets containing 5 mg of desloratadine) in the treatment of allergic dermatitis.
Materials and methods. We observed 46 patients with allergic dermatitis (18 males and 28 females), duration of 1—3 days.
Results and discussion. Most patients on 2—3-rd day of therapy with «Lourdes» had no complaints, noted good health, regressed inflammatory skin rash, decreased infiltration. Clinical manifestations to 5—7-th days of treatment completely disappeared. The introduction of the drug «Lourdes» in the treatment of patients with allergic dermatitis enabled to achieve clinical cure in all 46 patients.
Conclusions. The pharmacological characteristics of desloratadine, its high therapeutic efficacy and safety, wide range of indications, and the experience of use in the clinical practice allow recommending «Lourdes» as a drug of choice for treatment of allergic dermatitis in children and adults.

Keywords: desloratadine, allergic dermatitis, Lourdes preparation.

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Original language: Russian



Unilateral dermatoses, optimization of treatment with the use of pulse mesotherapy

D.S. Polishchuk1, 2, S.I. Polishchuk2, V.S. Komarnytska2

1 National Pirogov Memorial Medical University, Vinnytsya
2 PE «Dermatovenereological center of doctor Polishchuk S.I.», Khmelnitsky

Generalized literary data about unilateral dermatoses and personal observations of dermatological patients have been offered. For the first time the method of treating acquired unilateral dermatoses by means of the pulse corticosteroid mesotherapy has been suggested.

Keywords: unilateral dermatoses, pulse mesotherapy, Blashkos lines.

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Original language: Ukrainian

9. Reviews


New Insights into Rosacea Part II. Treatment

C. Diehl

Universitá Degli Studi Guglielmo Marconi, Rome, Italy

Rosacea is a chronic skin disease which often tends to be underdiagnosed or misdiagnosed.
However, rosacea strongly impacts the quality of life of sufferers, both in their social and professional life and for this reason advice is sought from the dermatologist. Rosacea is a treatable, but not curable disease, which implies long term treatments in order to alleviate signs and symptoms and improve the skin appearance. Besides the treatment itself, education of the patient is compulsory, in order to teach the importance of sun protection, skin care and make up, but also avoidance of the well-known triggering factors. Regarding therapies, new options have recently appeared in our armamentarium which are described, along with the clinical evidences supporting them. They must be taken into account at the time of prescribing an adequate treatment to the patient, the prescription being primarily based on the clinical experience.

Keywords: Rosacea, treatment, metronidazole, azelaic acid, retinoids, ivermectin, brimonidine.

Dr. Christian Diehl, Department of Dermatology, Universitá Degli Studi Guglielmo Marconi
Via Plinio, 44, 00193, Rome, Italy
-mail: chdiehl@hotmail.com

Original language: English

10. Reviews


Urogenital mycoplasmosis: difficult choice of antibacterial therapy (literature review and own research)

G.I. Mavrov1, 2, T.V. Fedorovich2

1 SI «Institute of Dermatology and Venereology of NAMS of Ukraine», Kharkiv
2 Kharkiv Medical Academy of Postgraduate Education, the Ministry of Health Care of Ukraine

The paper presents the current data on the treatment of genital mycoplasmas, especially Mycoplasma genitalium. Review of modern literature and clinical trial data led to the conclusion about high efficacy and safety of josamycin in patients with urogenital mycoplasmosis. This allows us to recommend it for the treatment of urogenital infections caused by M. genitalium.

Keywords: Mycoplasma genitalium, urogenital mycoplasmosis, antibiotic therapy, josamycin.

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Original language: Russian

11. Reviews


Certain aspects of epigenetic control of inflammation processes in patients with psoriasis

I.B. Popova, I.P. Kaidashev

Ukrainian Medical Stomatological Academy, Poltava

In clarifying the etiopathogenesis of psoriasis, of special interest is the role of sirtuins — NAD+ (nicotinamide adenine dinucleotide)-dependent protein deacetylases. The results of current research of sirtuins prove that they constitute a complex system which has an impact on many other molecules and pathways. At present, changes in sirtuins under the influence of external factors, as well as their role in the development of certain diseases, such as psoriasis, have not been adequately investigated. Several studies have tried to find out whether there is an association between the genetic variability of sirtuins and health condition. At this time, there is evidence about the possible association of genetic variation of sirtuins and the risk of obesity. The necessity for activation of metabolic processes, lipolysis in psoriatic patients have triggered the need to use sirtuin activators such as resveratrol.

Keywords: tiopathogenesis of psoriasis, sirtuins, epigenetic control, resveratrol.

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Original language: Ukrainian

12. Reviews


Dermatitis associated with incontinence of urinary physiological functions: a new approach to the old problem

S.. Galnikina1, I.I. Kogut1, 2

1 I.Ya. Horbachevsky Ternopil State Medical University
2 Petrykiv Regional Heriatric Pansionate

The article provides an overview of literature on dermatitis associated with incontinence of urinary physiological functions. The publication aims to introduce the modern terminology of the disease and to highlight the topicality of this problem. The application of special diagnostic tools is reviewed for assesment of dermatitis associated with incontinence of urinary physiological functions and determination of patient surveillance. Best practical guidelines for skin care, prevention and treatment of the disease are presented.

Keywords: dermatitis associated with incontinence of urinary physiological functions; irritative contact dermatitis, geriatrics, medical care, treatment and prevention.

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Original language: Ukrainian

13. History of medicine


Optimization of teaching skin and venereal diseases in higher medical institutions relying on experience of teaching this discipline at the medical faculty of St. Vladimir university at the end of XIX beginning of XX century

K.V. Kolyadenko

O.O. Bogomolets National Medical University, Kyiv

Data are presented about organization of learning programs on dermatology and venereology for students at the medical faculty of St. Vladimir university at the end of XIX — beginning of XX century. Some aspects of that system could be of interest in our time for optimization of training qualified specialists.

Keywords: skin and veneral diseases, medical students, learning programs.

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Original language: Ukrainian