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The phenotype of systemic lupus erythematosus as a factor in rational therapy choosing 系统性红斑狼疮的表型是选择合理疗法的一个因素
Pub Date : 2024-07-21 DOI: 10.33667/2078-5631-2024-10-7-12
A. Babaeva, E. V. Kalinina, V. P. Goloskova
Systemic lupus erythematosus (SLE) is characterized by a variety of clinical manifestations, which are defined as separate phenotypes of the disease. Despite the universality of immunopathological reactions, which are based on the formation of anti-nuclear antibodies and antibodies to native DNA, the spectrum and severity of immunological disorders in individual phenotypes are different. The role of type I interferons (IFN) in the SLE pathogenesis has now been proven. Hypersecretion of IFN-α and IFN-β leads to the production of antibodies against the components of the cell nucleus through activation of the native and adaptive immunity system. The current treatment strategy provides for achieving remission or low activity with immunosuppressants, including selective ones, such as biological agents. According to the updated international recommendations, anifrolumab, monoclonal antibodies against type I IFN, which has demonstrated high efficacy in the treatment of SLE with skin-mucous and joint lesions., can be used for the treatment of SLE along with rituximab and belimumab. The article presents our own clinical observation on the analysis of the effecacy and safety of anifrolumab in the treatment of a young patient with high-activity SLE and pronounced skin manifestations. It was shown that after the first injections of the drug, there was a rapid dynamics of skin and joint syndrome, the activity of SLE decreased from maximum to minimum according to the SELENA-SLEDAI index. The results obtained confirm the rationale of including anifrolumab in the treatment regimen in cases of insufficient previous therapy.
系统性红斑狼疮(SLE)有多种临床表现,被定义为不同的疾病表型。尽管免疫病理反应具有普遍性,其基础是抗核抗体和本地 DNA 抗体的形成,但不同表型的免疫紊乱的范围和严重程度却各不相同。I 型干扰素(IFN)在系统性红斑狼疮发病机制中的作用现已得到证实。IFN-α 和 IFN-β 的分泌过多会通过激活原生和适应性免疫系统,导致产生针对细胞核成分的抗体。目前的治疗策略是使用免疫抑制剂(包括生物制剂等选择性免疫抑制剂)来达到缓解或低活性的目的。根据最新的国际建议,抗I型IFN的单克隆抗体阿尼罗单抗(anifrolumab)在治疗伴有皮肤-粘膜和关节病变的系统性红斑狼疮方面具有很高的疗效,可以与利妥昔单抗(rituximab)和贝利姆单抗(belimumab)一起用于系统性红斑狼疮的治疗。文章介绍了我们自己的临床观察结果,分析了阿尼单抗在治疗一名患有高活动性系统性红斑狼疮和明显皮肤表现的年轻患者时的有效性和安全性。结果表明,在首次注射该药物后,皮肤和关节综合征出现了快速的动态变化,根据 SELENA-SLEDAI 指数,系统性红斑狼疮的活动度从最大值降至最小值。研究结果证实了在既往治疗不足的情况下将阿尼单抗纳入治疗方案的合理性。
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引用次数: 0
Intense pulsed light is a promising way for telangiectasias / reticular veins treatment: from pathogenesis to pronounced clinical outcomes 强脉冲光是治疗毛细血管扩张症/网状静脉的有效方法:从发病机制到显著的临床效果
Pub Date : 2024-07-21 DOI: 10.33667/2078-5631-2024-9-91-94
D. V. Demidion, D. A. Koryakin
Varicose veins are the most common pathology of peripheral vessels. A broader concept is the term chronic venous insufficiency (CVI), which, in addition to varicose veins, includes telangiectasias and reticular veins. Sclerotherapy is considered as the basis of treatment for reticular veins. However, the procedure has its drawbacks and side effects, which indicates the importance of implementing safer treatment methods. An alternative treatment for reticular veins is intense pulsed light. To illustrate the effectiveness and safety of IPL treatment for reticular veins, we present a clinical case of a patient aged 73 years with complaints of dark purple and bluish vessels. After clinical evaluation, diagnosis of reticular veins/telangiectasias was made (C 1 according to the CEAP 2020 classification). Due to the patients’ refusal to undergo sclerotherapy, it was decided to perform IPL procedures (M22, Lumenis). The patient’s reticular veins and telangiectasias were almost completely leveled out after the second session of IPL therapy; there was also no progress of CVI. No side effects were noted. The pathogenetic application of intense pulsed light in the treatment of reticular veins can be explained by decreasing the inflammatory process, integrating extracellular matrix, as well as inhibition of mast cell degranulation.
静脉曲张是外周血管最常见的病变。除静脉曲张外,还包括毛细血管扩张和网状静脉。硬化疗法被认为是治疗网状静脉的基础。然而,这种治疗方法有其缺点和副作用,这表明采用更安全的治疗方法非常重要。强脉冲光是治疗网状静脉的另一种方法。为了说明强脉冲光治疗网状静脉的有效性和安全性,我们提供了一个临床病例,患者 73 岁,主诉血管呈深紫色和淡蓝色。经过临床评估,患者被诊断为网状静脉/网状血管瘤(根据 CEAP 2020 分类,为 C 1)。由于患者拒绝接受硬化剂治疗,因此决定进行强脉冲光治疗(M22,Lumenis)。第二次强脉冲光治疗后,患者的网状静脉和毛细血管扩张几乎完全消失,CVI 也没有进展。没有发现任何副作用。强脉冲光治疗网状静脉的病理应用可以通过减少炎症过程、整合细胞外基质以及抑制肥大细胞脱颗粒来解释。
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引用次数: 0
COVID-19 in patients with rheumatic diseases: frequency and course 风湿病患者中的 COVID-19:频率和病程
Pub Date : 2024-07-21 DOI: 10.33667/2078-5631-2024-10-13-18
A. N. Kulikov, N. Muravyeva, B. Belov
Objectives. The aim of the study was to assess frequency and severity of COVID-19 in patients with rheumatic diseases (RD).Patients and methods. The study included information on the presence or absence of COVID-19 in the medical history of 9185 patients with immunoinflammatory RD (IIRD) and 491 patients with osteoarthritis (OA) who were observed at the V. A. Nasonova Research Institute of Rheumatology from September 21, 2021 to December 28, 2023.Results. The incidence of COVID-19 in the analyzed IIRD was significantly higher compared to OA (p<0.02). All IIRD included in the analysis are characterized by an increased risk of COVID-19 incidence when compared with OA by 1.7–3.5 times. Patients with rheumatoid arthritis, ankylosing spondylitis, Sjögren's disease, systemic sclerosis, psoriatic arthritis, systemic lupus erythematosus, microcrystalline arthritis, ANCA- associated vasculitis and poly/dermatomyositis were significantly more likely (p<0.009) to receive COVID-19 therapy compared with the control group. Patients with these diseases are characterized by an increased risk of treatment for COVID-19 by 1.7–6.5 times compared with OA. Also, patients with inflammatory joint diseases (IJD), connective tissue diseases (CTDs) and systemic vasculitis (SV) were hospitalized with COVID-19 more often than patients with OA (p=0.013, p=0.003 and p<0.001, respectively). Patients with IJD, CTDs and SV are characterized by an increased risk of hospitalization with COVID-19 by 3.5–6.8 times compared with OA. In addition, elderly patients with IIRD are characterized by an increasing risk of treatment, hospitalization and use of biologics or targeted synthetic disease-modifying drugs for COVID-19.Conclusion. According to the data obtained, the problem of COVID-19 remains very significant for patients with RD. This dictates the need to continue studying risk factors for adverse outcomes of the disease and vaccine prevention of this infectious pathology.
研究目的研究旨在评估COVID-19在风湿性疾病(RD)患者中的出现频率和严重程度。研究包括 2021 年 9 月 21 日至 2023 年 12 月 28 日期间在 V. A. Nasonova 风湿病学研究所观察的 9185 名免疫炎症性风湿病(IIRD)患者和 491 名骨关节炎(OA)患者病史中是否存在 COVID-19 的信息。在分析的 IIRD 中,COVID-19 的发病率明显高于 OA(P<0.02)。与 OA 相比,所有纳入分析的 IIRD 的 COVID-19 发生风险均增加了 1.7-3.5 倍。与对照组相比,类风湿性关节炎、强直性脊柱炎、Sjögren's 病、系统性硬化症、银屑病关节炎、系统性红斑狼疮、微晶关节炎、ANCA 相关性血管炎和多发性/皮肌炎患者接受 COVID-19 治疗的几率明显更高(p<0.009)。与 OA 相比,这些疾病患者接受 COVID-19 治疗的风险增加了 1.7-6.5 倍。此外,炎症性关节病(IJD)、结缔组织病(CTD)和系统性血管炎(SV)患者接受 COVID-19 治疗的住院率也高于 OA 患者(分别为 p=0.013、p=0.003 和 p<0.001)。与 OA 相比,IJD、CTD 和 SV 患者因 COVID-19 住院的风险增加了 3.5-6.8 倍。此外,IIRD 老年患者的特点是,COVID-19 的治疗、住院和使用生物制剂或靶向合成改良疾病药物的风险增加。根据所获得的数据,COVID-19 的问题对于 RD 患者来说仍然非常严重。因此,有必要继续研究该疾病不良后果的风险因素以及该传染病的疫苗预防。
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引用次数: 0
Efficiency and safety of thread implantology in the long term: data from a pathomorphological study 螺纹植入术的长期效率和安全性:病理形态学研究数据
Pub Date : 2024-07-21 DOI: 10.33667/2078-5631-2024-9-87-90
D. N. Serov, M. S. Kruglova
The evolution of methods used in aesthetic medicine includes a transition to less invasive procedures with high safety and minimal recovery time. That is why numerous non-invasive methods for correcting involutive changes in facial skin (thread lifting, hardware techniques) have been studied for effectiveness and safety over the past decades. Such techniques can improve treatment results and avoid or delay surgical intervention.Material and methods. The work involved a pathomorphological study of material taken by biopsy at the sites of thread implantation and surrounding tissues (1 cm indentation) (Nano spring, Excellence Visage, Excellence Visage HA) within 12 months after thread lifting. Paraffin sections with a thickness of 5–7 microns were made from ready-made paraffin blocks and stained with: hematoxylin – eosin; according to the Weigert-Van Gieson method; Sirius Red paint. Using a microscope with a Sony digital photo attachment with a resolution of 12 megapixels, five photographs were taken from each histological specimen.Research results. As a result of a pathomorphological study of a flap of skin and subcutaneous fat with a synthetic thread in the adipose tissue, it was revealed that along the periphery of the studied material there was moderate chronic inflammation (giant cells of the type of foreign body cells, lymphocytes, fibroblasts) and weak fibrosis, as well as a predominance type I collagen in the skin, and type III collagen predominated in subcutaneous fat tissue.
美容医学方法的发展包括向安全性高、恢复时间短的微创手术过渡。因此,在过去几十年中,人们对许多用于矫正面部皮肤内卷变化的非侵入性方法(线提升、硬件技术)的有效性和安全性进行了研究。这些技术可以改善治疗效果,避免或推迟手术干预。这项工作涉及对线状提拉术后 12 个月内植入线状部位和周围组织(1 厘米压痕)(纳米弹簧、卓越 Visage、卓越 Visage HA)的活检材料进行病理形态学研究。用现成的石蜡块制作厚度为 5-7 微米的石蜡切片,并用苏木精-伊红染色;根据 Weigert-Van Gieson 法;天狼星红染色。使用分辨率为 1200 万像素的索尼数码照片附件显微镜,为每个组织学标本拍摄了五张照片。对皮瓣和皮下脂肪进行病理形态学研究的结果显示,所研究材料的外围存在中度慢性炎症(异物细胞、淋巴细胞、成纤维细胞类型的巨细胞)和微弱纤维化,皮肤中以 I 型胶原蛋白为主,皮下脂肪组织中以 III 型胶原蛋白为主。
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引用次数: 0
Analysis of experience in the clinical use of dual-energy computed tomography in patients with undifferentiated arthritis 未分化关节炎患者双能计算机断层扫描临床应用经验分析
Pub Date : 2024-07-21 DOI: 10.33667/2078-5631-2024-10-19-24
M. S. Eliseev, Y. I. Kuzmina
Dual-energy computed tomography (DECT) is a radiation diagnostic method that is used in rheumatology to verify microcrystalline arthritis, but in Russia this method is little known and the experience of its use is rather scarce.Objective of the research. To analyze the experience of using DECT in patients with undifferentiated arthritis and lesions of the axial skeleton in clinical practice.Material and Methods. The retrospective study included 20 patients (14 men and 6 women) observed at the V. A. Nasonova Research Institute of Rheumatology, who underwent DECT for diagnostic purposes. 13 patients with undifferentiated arthritis underwent DECT of peripheral joints to diagnose gout; 7 patients with an established diagnosis of gout (based on the 2015 ACR/EULAR classification criteria for gout) – to clarify the genesis of lesions to the axial joints and spine. The study was performed on a Siemens SOMATOM Definition Flash computed tomograph.Results. Using DECT in patients with undifferentiated arthritis, deposits of monosodium urate crystals (MSUc) were detected in 7 out of 13 (54 %), which made it possible to verify the diagnosis of gout. In the second sample, 6 out of 7 patients (85 %) showed signs of MSUc deposition on DECT, which explained the genesis of the existing complaints. Among these 6 patients, in 1 person, DECT revealed the presence of MSUc and calcium pyrophosphate crystals in the shoulder joint, which made it possible to make two diagnoses at once – gout and calcium pyrophosphate deposition disease.Conclusion. DECT in patients with undifferentiated arthritis makes it possible to verify the diagnosis of gout in more than half of the cases (54 %). In 85 % of patients with gout and pain in the back and axial joints of unknown origin, urate deposits are detected according to DECT. This method may be a useful tool for identifying microcrystalline arthritis of the axial joints, but further research is needed to implement the method in routine practice.
双能计算机断层扫描(DECT)是一种放射诊断方法,在风湿病学中用于验证微晶关节炎,但在俄罗斯,这种方法鲜为人知,使用经验也相当匮乏。分析在临床实践中对未分化关节炎和轴骼病变患者使用 DECT 的经验。这项回顾性研究包括在 V. A. Nasonova 风湿病学研究所接受 DECT 诊断的 20 名患者(14 名男性和 6 名女性)。13名未分化关节炎患者接受了外周关节DECT检查,以诊断痛风;7名痛风确诊患者(根据2015年ACR/EULAR痛风分类标准)接受了DECT检查,以明确轴关节和脊柱病变的成因。研究在西门子SOMATOM Definition Flash计算机断层扫描机上进行。在未分化关节炎患者中使用 DECT,13 人中有 7 人(54%)检测到了单钠尿酸盐结晶(MSUc)沉积,因此可以确诊为痛风。在第二个样本中,7 名患者中有 6 名(85%)在 DECT 上显示出 MSUc 沉积的迹象,这解释了现有主诉的起因。在这 6 名患者中,有 1 人的 DECT 显示肩关节中存在 MSUc 和焦磷酸钙晶体,因此可以同时做出两种诊断--痛风和焦磷酸钙沉积症。对未分化关节炎患者进行 DECT 检查后,超过一半的病例(54%)可以确诊为痛风。85%的痛风患者背部和轴关节疼痛原因不明,DECT可检测到尿酸盐沉积。该方法可能是鉴别轴关节微晶关节炎的有用工具,但要在常规实践中应用该方法,还需要进一步研究。
{"title":"Analysis of experience in the clinical use of dual-energy computed tomography in patients with undifferentiated arthritis","authors":"M. S. Eliseev, Y. I. Kuzmina","doi":"10.33667/2078-5631-2024-10-19-24","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-10-19-24","url":null,"abstract":"Dual-energy computed tomography (DECT) is a radiation diagnostic method that is used in rheumatology to verify microcrystalline arthritis, but in Russia this method is little known and the experience of its use is rather scarce.Objective of the research. To analyze the experience of using DECT in patients with undifferentiated arthritis and lesions of the axial skeleton in clinical practice.Material and Methods. The retrospective study included 20 patients (14 men and 6 women) observed at the V. A. Nasonova Research Institute of Rheumatology, who underwent DECT for diagnostic purposes. 13 patients with undifferentiated arthritis underwent DECT of peripheral joints to diagnose gout; 7 patients with an established diagnosis of gout (based on the 2015 ACR/EULAR classification criteria for gout) – to clarify the genesis of lesions to the axial joints and spine. The study was performed on a Siemens SOMATOM Definition Flash computed tomograph.Results. Using DECT in patients with undifferentiated arthritis, deposits of monosodium urate crystals (MSUc) were detected in 7 out of 13 (54 %), which made it possible to verify the diagnosis of gout. In the second sample, 6 out of 7 patients (85 %) showed signs of MSUc deposition on DECT, which explained the genesis of the existing complaints. Among these 6 patients, in 1 person, DECT revealed the presence of MSUc and calcium pyrophosphate crystals in the shoulder joint, which made it possible to make two diagnoses at once – gout and calcium pyrophosphate deposition disease.Conclusion. DECT in patients with undifferentiated arthritis makes it possible to verify the diagnosis of gout in more than half of the cases (54 %). In 85 % of patients with gout and pain in the back and axial joints of unknown origin, urate deposits are detected according to DECT. This method may be a useful tool for identifying microcrystalline arthritis of the axial joints, but further research is needed to implement the method in routine practice.","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141818770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Laser technologies in the treatment of patients with a combination of rosacea subtypes: comparative data 激光技术在红斑痤疮综合亚型患者治疗中的应用:比较数据
Pub Date : 2024-07-21 DOI: 10.33667/2078-5631-2024-9-80-82
A. L. Rodina, Yu. I. Matushevskaya, G. V. Sofinskaya
Phototechnologies occupy a leading position in the treatment of patients with rosacea. The most effective technologies are laser: pulsed dye laser (585nm, 595nm) and neodymium laser (1064nm), however, issues of comparative analysis, including in patients with a combination of rosacea subtypes, require further study.Material and methods. We observed 64 patients with diagnosed rosacea with a combination of subtypes: erythematotelangiectatic and papulopustular. Among them, 48 (75%) were female and 16 (25%) were male. The age of the patients varied widely: from 31 to 57 years, the average age was 39.2±4.6 years. The average duration of the disease was 5.1±2.3 years. Depending on the therapy, patients were divided into 2 groups: group 1 received treatment with a neodymium laser, group 2 – treatment with a pulsed dye laser.Research results. A cumulative assessment taking into account clinical research methods with a sufficient degree of reliability revealed the advantages of a neodymium laser over a pulsed dye laser, regardless of the clinical picture of rosacea, which was confirmed by the dynamics of the IGA/PGA indices: reduction in group 1 was 79.5%/66.7%, in group 2–63.2%/51.3%, respectively. These data were confirmed by the dynamics of the DIQI index – 81.7% and 61.6%, respectively.
光电技术在酒糟鼻患者的治疗中占据主导地位。最有效的技术是激光:脉冲染料激光(585nm、595nm)和钕激光(1064nm),然而,需要进一步研究比较分析的问题,包括酒糟鼻亚型组合患者的比较分析。我们观察了 64 名确诊为酒渣鼻的患者,他们都有不同的亚型:红斑扩张型和丘疹脓疱型。其中,女性 48 人(占 75%),男性 16 人(占 25%)。患者的年龄差异很大:从 31 岁到 57 岁不等,平均年龄为(39.2±4.6)岁。平均病程为 5.1±2.3 年。根据治疗方法的不同,患者被分为两组:第一组接受钕激光治疗,第二组接受脉冲染料激光治疗。根据具有足够可靠性的临床研究方法进行的累积评估显示,无论红斑痤疮的临床表现如何,钕激光都比脉冲染料激光更有优势,这一点在 IGA/PGA 指数的动态变化中得到了证实:第一组的减少率分别为 79.5%/66.7%,第二组为 63.2%/51.3%。DIQI 指数的动态变化也证实了这些数据--分别为 81.7% 和 61.6%。
{"title":"Laser technologies in the treatment of patients with a combination of rosacea subtypes: comparative data","authors":"A. L. Rodina, Yu. I. Matushevskaya, G. V. Sofinskaya","doi":"10.33667/2078-5631-2024-9-80-82","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-9-80-82","url":null,"abstract":"Phototechnologies occupy a leading position in the treatment of patients with rosacea. The most effective technologies are laser: pulsed dye laser (585nm, 595nm) and neodymium laser (1064nm), however, issues of comparative analysis, including in patients with a combination of rosacea subtypes, require further study.Material and methods. We observed 64 patients with diagnosed rosacea with a combination of subtypes: erythematotelangiectatic and papulopustular. Among them, 48 (75%) were female and 16 (25%) were male. The age of the patients varied widely: from 31 to 57 years, the average age was 39.2±4.6 years. The average duration of the disease was 5.1±2.3 years. Depending on the therapy, patients were divided into 2 groups: group 1 received treatment with a neodymium laser, group 2 – treatment with a pulsed dye laser.Research results. A cumulative assessment taking into account clinical research methods with a sufficient degree of reliability revealed the advantages of a neodymium laser over a pulsed dye laser, regardless of the clinical picture of rosacea, which was confirmed by the dynamics of the IGA/PGA indices: reduction in group 1 was 79.5%/66.7%, in group 2–63.2%/51.3%, respectively. These data were confirmed by the dynamics of the DIQI index – 81.7% and 61.6%, respectively.","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141818035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Aspects of the use of modern injection disease-modifying therapy in real clinical practice in patients with osteoarthritis and (or) back pain 在骨关节炎和(或)背痛患者的实际临床实践中使用现代注射改变病情疗法的各个方面
Pub Date : 2024-07-21 DOI: 10.33667/2078-5631-2024-10-25-30
A. R. Baitimerov, D. R. Gilyazova
The results of a study on the effectiveness of the injectable chondroprotector Ambene® Bio in the treatment of patients with degenerative-dystrophic diseases of the spine and pain in the lower back are presented. The program involved 30 patients diagnosed with osteoarthritis and/ or spondyloarthritis, facet syndrome, osteochondrosis in the acute stage (severe symptoms: pain according to VAS 40–90 mm). All patients were prescribed the chondroprotector Ambene® Bio in the regimen of 2 ml every other day No. 10.Results. During treatment with the injectable chondroprotector Ambene® Bio for 20 days, it was possible to significantly reduce the manifestations of the target nosologies, restore the ability to move and self-care, improve the psycho-emotional state of patients, while reducing the need for NSAIDs.Conclusions. A short course of therapy with Ambene® Bio contributed to the effective treatment of study participants due to the synergism of the unique composition of biologically active substances. The study demonstrated a high safety profile and good tolerability of the therapy.
本报告介绍了一项关于注射用软骨保护剂 Ambene® Bio 在治疗脊柱退行性萎缩性疾病和下背部疼痛患者中的有效性的研究结果。该项目涉及 30 名被诊断为骨关节炎和/或脊柱关节炎、面神经综合征、骨软骨病急性期(症状严重:根据 VAS 40-90 mm 疼痛)的患者。所有患者都被处方注射软骨保护剂 Ambene® Bio,剂量为每隔一天 2 毫升。在使用注射用软骨保护剂 Ambene® Bio 20 天的治疗过程中,患者的症状表现明显减轻,恢复了活动能力和自理能力,改善了心理情绪,同时减少了对非甾体抗炎药的需求。由于其独特的生物活性物质成分具有协同作用,使用 Ambene® Bio 进行短期治疗有助于对研究参与者进行有效治疗。研究表明,该疗法安全性高,耐受性好。
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引用次数: 0
Assessment of the mental status of patients with rosacea 评估红斑痤疮患者的精神状态
Pub Date : 2024-07-21 DOI: 10.33667/2078-5631-2024-9-69-72
A. V. Sokolova, G. R. Fimochkina
Rosacea is a common chronic skin disease that significantly impairs patients’ quality of life. Various phenotypic characteristics and the localization on the face can have a negative impact on mental health and socialization, causing anxiety and depression in patients with rosacea. The aim of the study was to determine baseline levels of anxiety and depression in patients with erythematotelangiectatic telangiectatic and papulopustular rosacea and their combination and to compare the effect of combination therapy on patients’ psychoemotional state. We observed 45 patients with a diagnosis of erythematous telangiectatic rosacea and papulo-pustular subtypes of mild and moderate severity and their combination. Patients were divided into three groups according to the choice of combination of treatment methods. In group No. 1: 15 patients received botulinum toxin therapy with topical azelaic acid plus ivermectin. In group No. 2: 15 patients received PDL 595 nm procedure in combination with the topical therapy azelaic acid plus ivermectin. In group No. 3: 15 patients received botulinum toxin therapy with incobotulotoxin in combination with ILC 595 nm and topical azelaic acid therapy in combination with ivermectin. 26.7 % of the patients included in the study showed a deterioration in skin appearance due to emotional strain and stress. All patients showed subclinical manifestations of anxiety and depression according to the Hospital anxiety and depression scale (HADS). In addition, the mental state and anxiety of patients with rosacea can be significantly improved after treatment. Combination therapy with ivermectin, azelaic acid, LC 595 nm and botulinum therapy brings maximum results in normalizing the psychoemotional state. Alleviating the clinical manifestations of rosacea helps to reduce the level of anxiety and depression in patients with rosacea.
酒糟鼻是一种常见的慢性皮肤病,严重影响患者的生活质量。酒糟鼻的各种表型特征和面部定位会对患者的心理健康和社交产生负面影响,导致患者焦虑和抑郁。本研究旨在确定红斑扩张毛细血管扩张型和丘疹脓疱型酒渣鼻患者及其联合患者的焦虑和抑郁基线水平,并比较联合疗法对患者心理情绪的影响。我们观察了 45 名被诊断为轻度和中度红斑毛细血管扩张型酒渣鼻和丘疹脓疱型酒渣鼻亚型及其合并症的患者。根据治疗方法组合的选择,将患者分为三组。第一组:15 名患者接受肉毒杆菌毒素治疗,外用杜鹃花酸加伊维菌素。第 2 组:15 名患者在接受 PDL 595 nm 治疗的同时,还接受壬二酸加伊维菌素的局部治疗。第 3 组:15 名患者在接受 ILC 595 纳米疗法的同时,还接受了肉毒杆菌毒素疗法和壬苯醇酸外用疗法以及伊维菌素疗法。26.7%的患者因情绪紧张和压力过大而导致皮肤外观恶化。根据医院焦虑抑郁量表(HADS),所有患者都表现出焦虑和抑郁的亚临床表现。此外,红斑痤疮患者的精神状态和焦虑在治疗后可得到明显改善。伊维菌素、杜鹃花酸、LC 595 nm 和肉毒杆菌疗法的联合治疗可在最大程度上改善患者的心理情绪。缓解酒糟鼻的临床表现有助于降低酒糟鼻患者的焦虑和抑郁程度。
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引用次数: 0
Trifarotene, a retinoid of the fourth generation, in the treatment of acne: the first experience of use in a real clinical practice 治疗痤疮的第四代视黄醇-- Trifarotene:首次临床使用经验
Pub Date : 2024-07-21 DOI: 10.33667/2078-5631-2024-9-73-79
L. S. Kruglova, S. R. Mayransaeva, N. Gryazeva
The article presents data on the local retinoid of the fourth generation trifarotene. The results of three large trials have been presented, which have proven good efficacy and long-term safety of monotherapy of the drug trifarotene in patients with moderate acne and in patients with severe acne for combination therapy. It has been shown that trifarotene demonstrates high selectivity to retinoic acid receptors RAR-γ, which are predominant in the skin, which provides clinical efficacy in low concentration and good tolerability.
文章介绍了有关第四代局部维甲酸药物三伐罗汀的数据。三项大型试验的结果表明,对中度痤疮患者进行单药治疗和对重度痤疮患者进行联合治疗,三伐他汀具有良好的疗效和长期安全性。结果表明,曲瓦芦汀对皮肤中占主导地位的视黄酸受体 RAR-γ 具有高选择性,在低浓度时具有临床疗效,且耐受性良好。
{"title":"Trifarotene, a retinoid of the fourth generation, in the treatment of acne: the first experience of use in a real clinical practice","authors":"L. S. Kruglova, S. R. Mayransaeva, N. Gryazeva","doi":"10.33667/2078-5631-2024-9-73-79","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-9-73-79","url":null,"abstract":"The article presents data on the local retinoid of the fourth generation trifarotene. The results of three large trials have been presented, which have proven good efficacy and long-term safety of monotherapy of the drug trifarotene in patients with moderate acne and in patients with severe acne for combination therapy. It has been shown that trifarotene demonstrates high selectivity to retinoic acid receptors RAR-γ, which are predominant in the skin, which provides clinical efficacy in low concentration and good tolerability.","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141818285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Change of epidermal barrier parameters and biomechanical parameters of the skin in children with atopic dermatitis during the use of a lipid-restoring cream containing biotic complex 特应性皮炎患儿在使用含生物复合物的脂质修复霜期间表皮屏障参数和皮肤生物力学参数的变化
Pub Date : 2024-07-20 DOI: 10.33667/2078-5631-2024-9-102-108
D. Zaslavsky, A. V. Taganov, A. V. Molochkov, E. D. Zaslavskaya, Ju. B. Belenkova, K. A. Klimova, D. Kozlova
Emollients are an integral part of the therapy for patients with atopic dermatitis. The most effective will be the new generation of emollients – emollients plus, which normalize the skin microbiome. Their effectiveness can be assessed by determining the parameters of the epidermal barrier (hydratation, sebum level, pH) and skin elasticity.Objectives. To evaluate the effectiveness and safety of a lipid-restoring cream containing a biotic complex LE SANTI in children with atopic dermatitis.Material and methods. From August to December, 25 children (9 girls, 36 % and 16 boys, 64 %) aged from 3 to 17 years (average age 9.2 years) with atopic dermatitis participated in an observational program to evaluate the effectiveness and safety of a lipid-restoring cream LE SANTI. For 21 days, patients applied the cream twice a day, they had 6 visits, during which was collected their medical history, adverse events, physical examination, determined indicators of the epidermal barrier (hydratation, sebum content, pH), biomechanical characteristics (skin elasticity), and also severity of disease (SCORAD) and quality of life (CDLQI). At visit 6, patients were assessed for satisfaction with the use of the cream.Results. All participants of the observation program completed their participation on time. As part of the observational program, there was an increase in skin hydration and sebum level by 3 and 3.5 times, respectively, pH level turned to the acidic values by 18%, an increase in elasticity by 30%, a decrease in SCORAD and CDLQI indices by 1.9 times or more 3 times respectively. The patients did not experience any adverse events; the satisfaction rating from the use of the cream was 4.78/5.Conclusions. Lipid-restoring cream LE SANTI can be recommended for inclusion in the treatment regimen for atopic dermatitis as a basic external agent that meets all the requirements for effectiveness and safety for children with atopic dermatitis, as well as basic care during remission.
润肤剂是特应性皮炎患者治疗中不可或缺的一部分。最有效的将是新一代润肤剂--"润肤剂+",它能使皮肤微生物群正常化。可以通过确定表皮屏障参数(水合作用、皮脂水平、pH 值)和皮肤弹性来评估其有效性。评估含有生物复合物 LE SANTI 的脂质修复霜对特应性皮炎患儿的有效性和安全性。从 8 月到 12 月,25 名 3 至 17 岁(平均年龄 9.2 岁)的特应性皮炎患儿(9 名女孩,占 36%;16 名男孩,占 64%)参加了一项观察项目,以评估脂质修复霜 LE SANTI 的有效性和安全性。在 21 天的时间里,患者每天涂抹两次药膏,共就诊 6 次,期间收集了病史、不良反应、体格检查、表皮屏障指标测定(水化、皮脂含量、pH 值)、生物力学特征(皮肤弹性)、疾病严重程度(SCORAD)和生活质量(CDLQI)。在第 6 次就诊时,对患者使用药膏的满意度进行评估。所有参加观察项目的人员都按时完成了任务。作为观察计划的一部分,皮肤水分和皮脂含量分别增加了 3 倍和 3.5 倍,pH 值转为酸性增加了 18%,弹性增加了 30%,SCORAD 指数和 CDLQI 指数分别下降了 1.9 倍和 3 倍以上。患者未出现任何不良反应;使用满意度为 4.78/5.结论。脂质恢复乳膏LE SANTI可作为一种基本外用药物,满足特应性皮炎患儿对有效性和安全性的所有要求,也可作为缓解期的基本护理药物,推荐纳入特应性皮炎的治疗方案。
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