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Research of efficiency of microsporia diagnostics methods 小孢子虫诊断方法的有效性研究
Pub Date : 2021-10-01 DOI: 10.30978/ujdvk2021-3-21
S. Lavrushko, V. Stepanenko
Objective — to investigate the effectiveness of different methods of microsporia diagnostics in children. Materials and methods. 50 children aged 2 to 16 (24 boys and 26 girls) were under survey. Depending on the clinical course, diagnosis and research results, all patients were divided into two groups: the 1st group included 40 children with microsporia (19 — with smooth skin microsporia, 13 — with scalp microsporia, 8 — with scalp and smooth skin microsporia); and the 2nd group consisted of 10 children in whom microsporia was not detected. The clinical diagnosis of all patients of the 1st group was confirmed by the results of PCR, microscopic, cultural and luminescent studies. The material for the study was scales from the smooth skin and scalp, as well as hair from the scalp of patients. 10 patients of the 2nd group did not have any clinical manifestations of microsporia and the results of the studies were negative. Results and discussion. The study with PCR in children with microsporia had 100 % positive result. Microsporum canis DNA was detected in all 40 patients. The microscopic method of the study was positive in 95 %. Bacteriological research revealed Microsporum canis in 85 %, while in 15 % the result was negative. Luminescent glow of hair in the rays of the Wood lamp in our study was observed in 87.5 % patients, while in 12.5 % it was absent. Conclusions. The study found that the most effective and accurate method is PCR. This is a method of modern accurate specific diagnostics of microsporia which allows the identification of the pathogen of Micro­sporum canis at the DNA level. Microscopic, cultural and luminescent research methods can also be used to diagnose this disease.
目的:探讨儿童小孢子虫不同诊断方法的有效性。材料和方法。50名2至16岁的儿童(24名男孩和26名女孩)接受了调查。根据临床病程、诊断和研究结果将所有患者分为两组:第一组40例小孢子虫患儿(皮肤光滑小孢子虫19例,头皮小孢子虫13例,头皮和皮肤光滑小孢子虫8例);第二组10例患儿未检出小孢子虫。第一组所有患者的临床诊断均通过PCR、显微镜、培养和发光研究结果得到证实。这项研究的材料是来自光滑皮肤和头皮的鳞片,以及患者头皮上的头发。第二组10例患者无任何小孢子虫临床表现,研究结果均为阴性。结果和讨论。PCR检测儿童小孢子虫的阳性率为100%。40例患者均检测到犬小孢子菌DNA。本研究的镜检阳性率为95%。细菌学研究显示犬小孢子菌85%阳性,15%阴性。在我们的研究中,87.5%的患者在Wood灯的光线下观察到头发的发光,而12.5%的患者没有。结论。研究发现,PCR是最有效、最准确的方法。这是一种在DNA水平上对犬小孢子虫病原进行准确特异诊断的现代方法。显微、培养和发光研究方法也可用于诊断本病。
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引用次数: 0
Ways to increase the effectiveness of treatment of psoriasis patients with dystrophic lesions of the nail plates 提高银屑病患者甲板营养不良病变治疗效果的方法
Pub Date : 2021-10-01 DOI: 10.30978/ujdvk2021-3-48
T. Lytynska, L. Naumova
Objective — to increase the effectiveness of treatment of psoriasis patients with degenerative changes in the nails, by including in the complex therapy of the topical drug Onychocid® Emtrix, aimed at restoring the integrity of the nail plates. Materials and methods. 38 patients with psoriasis and various forms of onychodystrophy (OD) were examined and treated. The effectiveness of therapy was evaluated based on the results of treatment of patients who were divided into two clinical groups — the main and the comparison ones. Patients in both groups received basic therapy. In addition, patients of the main group were prescribed a combined drug Onychocid® Emtrix, which was applied on the nail plates and under the tips of damaged nails once a day for 3 – 6 months. Results and discussion. Patients with psoriasis are diagnosed with dystrophic changes of nail plates of varying severity. OD of the fingers only was detected in 14 (36.8 %) patients; toes — in 5 (13.2 %); fingers and toes at the same time — in 19 (50.0 %) patients. As a result of complex treatment, in patients of the main group there was an early (already on the 2—4th week of use of the drug Onychocid® Emtrix) improvement of the appearance of deformed nails. After the course of treatment, these patients showed a positive clinical effect, i. e. decrease in thickness, normalization of density, color and structure of nail plates. At the same time, «significant improvement» and «improvement» were noted in 34 (89.5 %), «slight improvement» — in 3 (7.9 %), «no improvement» — in 1 (2.6 %) patients. Conclusions. Treatment of psoriasis patients with dystrophic nail lesions should be complex and focused, including the restoration of the integrity of the nail plates. The inclusion in the complex therapy of patients with psoriatic OD of the combined drug Onychocid® Emtrix increases the effectiveness of treatment, in particular, helps to restore the structure, shape, integrity, thickness and color of the nail plates.
目的:通过外用药物Onychocid®Emtrix的复合治疗,提高银屑病患者指甲退行性改变的治疗效果,旨在恢复甲板的完整性。材料和方法。本文对38例银屑病伴不同形式甲关节营养不良(OD)的患者进行了检查和治疗。根据治疗结果评价治疗效果,将患者分为两组:主要组和对照组。两组患者均接受基础治疗。另外,主组患者给予Onychocid®Emtrix联合用药,每日1次涂抹于甲板及受损指甲尖下,疗程3 - 6个月。结果和讨论。牛皮癣患者被诊断为不同程度的甲板营养不良变化。14例(36.8%)患者仅检出手指外径;脚趾- 5例(13.2%);手指和脚趾同时发生- 19例(50.0%)患者。由于复杂的治疗,在主组患者中,早期(已经在使用药物Onychocid®Emtrix的2 - 4周)畸形指甲的外观得到改善。经过疗程治疗后,这些患者均表现出良好的临床效果。钉板厚度减少,密度、颜色和结构不规整。同时,34例(89.5%)患者出现“显著改善”和“改善”,3例(7.9%)患者出现“轻微改善”,1例(2.6%)患者出现“无改善”。结论。银屑病患者的营养不良指甲病变的治疗应复杂和重点,包括恢复指甲板的完整性。在银屑病OD患者的复杂治疗中加入联合药物Onychocid®Emtrix可提高治疗效果,特别是有助于恢复甲板的结构、形状、完整性、厚度和颜色。
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引用次数: 0
Monitoring quality of life in the first half­year period of coronaviral infodemy in Ukraine 监测乌克兰冠状病毒疫情前半年的生活质量
Pub Date : 2021-10-01 DOI: 10.30978/ujdvk2021-3-4
O. Fedorenko, K.V. Koladenko, L. Sologub
The COVID-19 pandemic, political and economic factors, the latest technological advances, environmental changes in the world — all this significantly influenced the awareness of the quality of life by most of the population. For us, as clinicians and lecturers of the Department of Dermatology and Venereology with a course of cosmetology at Bogomolets National Medical University, this became obvious after the forced abandonment of the usual «live» teaching and the transition to distance learning at Zoom in March 2020, and at the same time the re-profiling of the clinical base of the department for inpatient treatment of only COVID-19 patients with the simultaneous discharge of specialized dermatological patients.During the pandemic, we were in fact deprived of the possibility of further professional contact with specialized patients with dermatological diseases. We only had the technical ability to contact the 4th year students of NMU online. It was decided to take advantage of this opportunity not only for their distance teaching of the basics of dermatovenerology, but also for determining (clarifying) their psychostatus with the help of appropriate tests. Objective — to conduct a remote monitoring study of the quality of life (QOL) indicators in young medical workers (students) against the background of the negative informative influence of the media due to the forced long-term stay in a stressful situation of lockdown and strict multi-week quarantine caused by the COVID19 pandemic. Materials and methods. QOL was assessed using the Health Status Survey (SF36) which is one of general (non-specialized) questionnaires. Results and discussion. During the period from March to June, there were noticeable changes in the self-esteem of somatically quite healthy fourth-year medical students of their own QOL, both on several SF-36 scales and in general. This was despite the fact that none of them and their family members were infected with COVID-19 or had any clinical manifestations of this disease for all 3 months. In general, during this time, the existing changes were negative, albeit to varying degrees, according to individual scales. In conditions of remote contact, it became technically possible and scientifically justified to use questionnaires to determine QOL in statistically significant samples of voluntary respondents. Conclusions. We find it hypothetically possible to consider changes in QOL self-esteem in general and according to individual SF-36 scales as a kind of unconventional but quite objective and visual diagnostic test for preclinical (early) determination of the threat of formation and development of psychosomatic disorders in any adult patient who saw a family doctor.
2019冠状病毒病大流行、政治和经济因素、最新技术进步、世界环境变化——所有这些都极大地影响了大多数人对生活质量的认识。对于我们来说,作为Bogomolets国立医科大学皮肤科和性病科美容课程的临床医生和讲师,在2020年3月Zoom被迫放弃通常的“现场”教学并过渡到远程学习之后,这一点变得明显,同时重新分析了该部门的临床基础,仅住院治疗COVID-19患者,同时出院专科皮肤科患者。在大流行期间,我们实际上被剥夺了与皮肤病专科患者进一步专业接触的可能性。我们只有技术上的能力可以在线联系到北大的四年级学生。我们决定利用这个机会,不仅对他们进行皮肤性病学基础知识的远程教学,而且通过适当的测试来确定(澄清)他们的精神状态。目的:针对新冠肺炎大流行导致青年医务工作者(学生)被迫长期停留在封锁和严格隔离的紧张局面下,媒体带来的负面信息影响,对青年医务工作者(学生)的生活质量指标进行远程监测研究。材料和方法。使用健康状况调查(SF36)评估生活质量,这是一般(非专业)问卷之一。结果和讨论。在3月至6月期间,身体相当健康的四年级医学生的自尊在自己的生活质量方面都有明显的变化,无论是在几个SF-36量表上还是在总体上。尽管他们及其家人在所有3个月内都没有感染COVID-19或出现任何该疾病的临床表现。总的来说,在这段时间内,现有的变化是消极的,尽管根据个人尺度程度不同。在远程接触的情况下,在统计上显著的自愿受访者样本中,使用问卷来确定生活质量在技术上是可能的,在科学上也是合理的。结论。我们发现,假设有可能考虑总体生活质量自尊的变化,并根据个人SF-36量表作为一种非常规但相当客观和直观的诊断测试,用于临床前(早期)确定任何看过家庭医生的成年患者心身疾病形成和发展的威胁。
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引用次数: 0
Skin disorders in patients with diabetes mellitus: a review 糖尿病患者的皮肤病:综述
Pub Date : 2021-10-01 DOI: 10.30978/ujdvk2021-3-54
C. Diehl
Diabetes mellitus (DM) is a frequent metabolic disease whose prevalence is estimated to be around 9.3 % in the world population in the age group 20—79, corresponding to 463 million affected subjects. Moreover, this prevalence will probably increase in the course of the next years. It accounts for more than 90% of the diabetic patients. Besides systemic complications, those ay also be observed in dermatology. According to the region, the prevalence of skin disorders in patients suffering DM is ranging from 35.4 to 98.8 %. This makes these symptoms a frequent cause of consultation in dermatological practice. The most occurring disorders are skin infections, but yellow nails, candidiasis, acrochordons, limited joint mobility and idiopathic guttate hypomelanosis may also be frequently observed. Diabetic dermopathy and diabetic foot syndrome are also common, such as pigmentation disorders such as acanthosis nigricans and vitiligo. Differences between patterns of lesions remain unclear among types of DM (type 1 or type 2). Overall, cutaneous infection and xerosis showed to be highly prevalent and important skin disorders in several studies, regardless DM type. Among cutaneous infections, fungal aetiology appears to be the most common and those with bacterial origin are the less frequent.DM affects the skin through several mechanisms — High levels of glycaemia strongly affect skin homeostasis by impairing the normal functioning of keratinocytes in vitro, decreasing their proliferation and differentiation. They also lead to advanced glycation end products (AGEs) formation. The latter are formed from glycation of proteins, lipids and nucleic acids. They have various deleterious effects at skin levels: inducing reactive oxygen species (ROS) formation, impairing ROS clearance, as well as intra and extracellular proteins function, and inducing pro inflammatory cytokine through nuclear factor κβ (NF-κβ) pathway. AGE alters collagen properties, decreasing flexibility and solubility and increasing its rigidity, thickening dermal collagen, with increased cross linking from non-enzymatic glycosylation, participating in the development of fibrosis. In diabetic patients, the vascular changes found in the skin are similar to those caused by UV-exposure, i. e. thickening of the vessels walls, increasing from thigh to foot and most marked in the capillaries and leading to failure of vascular responsivenessThis paper is aimed to summarize all these pathologies, reporting their prevalence, giving a brief description of the symptoms, of their pathogenesis and guidelines for their management. Dermatologists have a key role in their treatment, but also in detecting new cases of DM when taking in charge these pathologies. They must also promote glycaemic control by these patients.
糖尿病(DM)是一种常见的代谢性疾病,其患病率估计在世界20-79岁年龄组人口中约为9.3%,相当于4.63亿受影响者。此外,这种流行率在今后几年可能还会增加。占糖尿病患者的90%以上。除全身并发症外,皮肤病学也可观察到这些并发症。根据该地区的情况,糖尿病患者中皮肤病的患病率从35.4%到98.8%不等。这使得这些症状成为皮肤科就诊的常见原因。最常见的疾病是皮肤感染,但黄指甲、念珠菌病、肢索、关节活动受限和特发性低黑素症也可能经常被观察到。糖尿病性皮肤病和糖尿病足综合征也很常见,如黑棘皮病和白癜风等色素沉着障碍。在不同类型的糖尿病(1型或2型)中,病变模式之间的差异尚不清楚。总体而言,在几项研究中,皮肤感染和干燥症显示出高度普遍和重要的皮肤病,与糖尿病类型无关。在皮肤感染中,真菌病因似乎是最常见的,而那些细菌来源是不太常见的。糖尿病通过几种机制影响皮肤-高水平的血糖通过损害体外角质形成细胞的正常功能,减少其增殖和分化,强烈影响皮肤稳态。它们也会导致晚期糖基化终产物(AGEs)的形成。后者是由蛋白质、脂质和核酸的糖基化形成的。它们在皮肤水平上具有多种有害作用:诱导活性氧(ROS)的形成,损害ROS的清除以及细胞内和细胞外蛋白的功能,并通过核因子κβ (NF-κβ)途径诱导促炎细胞因子。AGE改变胶原质的性质,降低其柔韧性和溶解度,增加其刚性,增厚真皮胶原,增加非酶糖基化的交联,参与纤维化的发展。糖尿病患者的皮肤血管变化与紫外线照射引起的血管变化相似。血管壁增厚,从大腿到足部增加,最明显的是毛细血管,导致血管反应性失败。本文旨在总结所有这些病理,报告其患病率,简要描述症状,发病机制和治疗指南。皮肤科医生在他们的治疗中起着关键作用,但在处理这些病理时,也能发现新的糖尿病病例。他们还必须促进这些患者的血糖控制。
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引用次数: 0
Analysis of molecular mechanisms of development of actinic keratosis: a review 光化性角化病发生的分子机制分析
Pub Date : 2021-10-01 DOI: 10.30978/ujdvk2021-3-66
Yu.V. Tepliuk
Objective — to study the molecular mechanisms of the development of actinic keratosis (AK) and compare them with Bowen’s disease. Materials and methods. A literature review, analysis of national and international protocols for the diagnosis of AK are presented, which meet the selection criteria. We reviewed works with at least one recommendation for AK diagnostic scenario published after 2015. The systematic literature review is based on modern studies containing descriptions of molecular diagnostics of certain proto-oncogenes to establish the final diagnosis. Interdisciplinary guidelines were also reviewed to further explore all possible diagnostic criteria. Results and discussion. Until now, the molecular mechanisms of AK development have not been fully studied and grouped into a single review. In most of the sources, only p53 protein was mentioned as the main transcription factor regulating apoptosis. However, recent studies prove a sufficient influence of CD95, which, like p53, induces apoptosis and plays a leading role in the development of AK. All precancerous and malignant neoplasms of the skin arise due to mutations in cells, which cause a violation of apoptosis, but there are still no recommendations and a clear diagnostic algorithm that will allow to quickly establish the final diagnosis and make a choice in favor of this or another method of treatment. Conclusions. AK and Bowen’s disease are different stages in the development of the same malignant process, differing in the proliferative activity of cells and the expression of proto-oncogenes CD95, bcl-2, and p16 which can be used as differential diagnostic markers. Thanks to early diagnosis, it is possible to choose the most suitable treatment option, with consideration for modern protocols.
目的探讨光化性角化病(AK)发生的分子机制,并与Bowen病进行比较。材料和方法。文献回顾,分析国家和国际协议诊断AK提出,符合选择标准。我们回顾了2015年以后发表的至少有一项推荐AK诊断方案的作品。系统的文献综述是基于包含某些原癌基因的分子诊断描述的现代研究,以建立最终诊断。还审查了跨学科指南,以进一步探索所有可能的诊断标准。结果和讨论。到目前为止,还没有对AK发育的分子机制进行充分的研究和归纳。在大多数文献中,只有p53蛋白被认为是调控细胞凋亡的主要转录因子。然而,最近的研究证明CD95的影响是充分的,它与p53一样,诱导细胞凋亡,在AK的发生发展中起主导作用。所有的皮肤癌前肿瘤和恶性肿瘤都是由于细胞突变引起的,细胞突变会导致细胞凋亡的破坏,但目前还没有建议和明确的诊断算法,可以快速建立最终诊断并选择这种或另一种治疗方法。结论。AK和Bowen病是同一恶性过程发展的不同阶段,细胞的增殖活性和原癌基因CD95、bcl-2和p16的表达不同,可作为鉴别诊断标志物。由于早期诊断,有可能选择最合适的治疗方案,并考虑到现代协议。
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引用次数: 0
Seborrheic dermatitis: the choice of topical treatment tactics, taking into account the characteristics of the skin microbiome 脂溢性皮炎:局部治疗策略的选择,考虑到皮肤微生物组的特点
Pub Date : 2021-10-01 DOI: 10.30978/ujdvk2021-3-39
N. Reznichenko, Y. Reznichenko, O. Veretelnyk
Objective — to study the clinical efficacy and safety of Betasalic, Triacutan and Psoricap drugs in the treatment of patients with seborrheic dermatitis. Materials and methods. The study included 75 patients with seborrheic dermatitis (main group). The control group consisted of 56 healthy individuals of the same age. The severity of seborrheic dermatitis in patients was assessed on a point scale, which included the assessment of the intensity of erythema, edema, oozing lesions, excoriation, scaling, skin oiliness. The study of skin microbiocenosis was carried out by the method of its direct qualitative and quantitative assessment. The level of anxiety was assessed using the Spielberger—Khanin self-assessment scale. Depending on the proposed treatment, patients with seborrheic dermatitis were divided into 2 groups: Group I (experimental group) — 43 patients who received Betasalic for 5 days, Triacutan — for 5 days, Psoricap — for 18 days starting from the 11th day of therapy; Group II (comparison group) — 32 patients who received topical corticosteroids. Results and discussion. The course of seborrheic dermatitis is accompanied by disorders of the skin microbiocenosis with an increase in the number of fungi of Malassezia and Candida genus in the affected areas, which requires appropriate treatment. Patients with seborrheic dermatitis are characterized by the presence of high personal and situational anxiety. The inclusion of Betasalic and Triacutan in the standard therapy of seborrheic dermatitis contributed to the recovery of the majority of patients and a significant improvement in different localizations of the pathological process. In contrast to the experimental subgroup, in the subgroup with standard treatment, these rates were significantly lower. Additional inclusion of Psoricap in the treatment regimen of patients with seborrheic dermatitis led to the recovery of 100 % of patients with the localization of the pathological process on the scalp and face. Conclusions. Complex therapy of seborrheic dermatitis with the use of Betasalic ointment, Triacutan cream or ointment and Psoricap cream is pathogenetically proved, since it provides a quick clinical effect, normalization of skin microbiocenosis.
目的:探讨倍他理、曲库坦和Psoricap治疗脂溢性皮炎的临床疗效和安全性。材料和方法。研究纳入75例脂溢性皮炎患者(主要组)。对照组由56名同年龄的健康个体组成。脂溢性皮炎患者的严重程度采用点量表进行评估,包括红斑、水肿、渗出病变、擦伤、脱屑、皮肤油腻程度的评估。采用直接定性和定量评价的方法对皮肤微生物病进行研究。焦虑水平采用斯皮尔伯格-哈宁自评量表进行评估。根据建议的治疗方法,将脂溢性皮炎患者分为两组:第一组(实验组)- 43例患者接受倍他利康治疗5天,曲acutan治疗5天,Psoricap治疗18天,从治疗第11天开始;第二组(对照组)- 32例接受局部皮质类固醇治疗的患者。结果和讨论。脂溢性皮炎病程伴有皮肤微生物病,受影响地区马拉色菌属和念珠菌属真菌数量增加,需要适当治疗。脂溢性皮炎患者的特点是存在高度的个人和情境焦虑。在脂溢性皮炎的标准治疗中纳入倍他力和曲acutan有助于大多数患者的康复,并在不同部位的病理过程中有显着改善。与实验亚组相比,在标准治疗的亚组中,这些比率明显较低。在脂溢性皮炎患者的治疗方案中额外加入Psoricap,导致头皮和面部病理过程定位的患者100%恢复。结论。使用Betasalic软膏、Triacutan软膏或软膏和Psoricap软膏对脂溢性皮炎的综合治疗在病理学上得到了证明,因为它提供了快速的临床效果,使皮肤微生物病正常化。
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引用次数: 0
Relationships between psoriasis severity indices and dermatological life quality index in children with psoriasis 银屑病患儿严重程度指数与皮肤生活质量指数的关系
Pub Date : 2021-10-01 DOI: 10.30978/ujdvk2021-3-11
Е.О. Murzina, Yu.А. Rokhletsova
Objective — to аssess the impact of dermatosis on the quality of life of children with psoriasis. Materials and methods. Psoriasis severity indices (BSA, PASI, PGA) and dermatological life quality indices (DLQI, CDLQI) in children with psoriasis aged 4 to 17 years depending on the clinical and epidemiological features of dermatosis were determined. A correlation analysis of the presence of a relationship between the obtained indicators was carried out. Results and discussion. In 73.81 % of children, the BSA index was higher than 10, which provided an average BSA of 25.85 (8.78—38.38). The calculated PASI index at the beginning of treatment averaged 9.3 (3.6—18.9). 53.06 % of children had PASI < 10. The PASI index at the first diagnosis was almost 1.5 times lower than in relapses (p = 0.043). The average PGA index was 3 (2—3), namely, 32.99 % of children had PGA 1—2, 43.20 % had PGA 3 and 23.81 % of children had PGA 4. In the group of children aged 4—7 years, there was the smallest number of participants with the PGA index 4 (7.69 %), while in the group aged 16/17—17 years, this number was the largest (41.49 %) (p = 0.039). The calculated DLQI in children with psoriasis was 5 [3—9]. The average DLQI indicator in the group of girls was statistically higher than in the group of boys (p = 0.016). Statistically significant differences were identified between DLQI in the age groups, where the highest impact on quality of life was found for the children aged 16—17 years (p < 0.001) and depended on the clinical form of psoriasis: in scalp psoriasis, the impact on quality of life was moderate, and in inverse psoriasis, it was insignificant (p = 0.021). It was found that in moderate­severe/severe psoriasis, the impact on the quality of life in children increased and was assessed as moderate, while in mild psoriasis, the impact was assessed as minor (p < 0.05). Conclusions. The course of psoriasis in children can be assessed as moderate and severe, but in the first episodes of psoriasis in droplet and inverse forms, the course is mostly mild. The intensity of skin manifestations increases with age, especially in case of the disease recurrences in the plaque form. On the whole in children, psoriasis has an ambiguous impact on the quality of life: in boys, the impact of the disease is minor; in girls, it is moderate. Damage to the visible skin areas caused by psoriasis, an increase in the area affected by the pathological process and an increase in the intensity of skin manifestations with age leads to a more negative impact on the quality of life of a child.
目的:评估皮肤病对牛皮癣患儿生活质量的影响。材料和方法。根据皮肤病的临床和流行病学特征,测定4 ~ 17岁银屑病患儿的银屑病严重程度指数(BSA、PASI、PGA)和皮肤生活质量指数(DLQI、CDLQI)。对所获得的指标之间存在的关系进行了相关分析。结果和讨论。73.81%的儿童BSA指数大于10,平均BSA为25.85(8.78 ~ 38.38)。治疗开始时计算的PASI指数平均为9.3(3.6 ~ 18.9)。53.06%患儿PASI < 10。首次诊断时PASI指数比复发时低近1.5倍(p = 0.043)。平均PGA指数为3(2-3),即PGA 1-2患儿占32.99%,PGA 3患儿占43.20%,PGA 4患儿占23.81%。4 ~ 7岁儿童中PGA指数为4的人数最少(7.69%),16/17 ~ 17岁儿童中PGA指数为4的人数最多(41.49%)(p = 0.039)。银屑病患儿DLQI计算值为5[3-9]。女生组平均DLQI指标高于男生组,差异有统计学意义(p = 0.016)。DLQI在不同年龄组间的差异有统计学意义,其中16-17岁的儿童对生活质量的影响最大(p < 0.001),并取决于牛皮癣的临床形式:头皮牛皮癣对生活质量的影响中等,而逆型牛皮癣对生活质量的影响不显著(p = 0.021)。结果发现,中重度/重度牛皮癣对患儿生活质量的影响增加,评价为中度,轻度牛皮癣对患儿生活质量的影响评价为轻微(p < 0.05)。结论。儿童牛皮癣的病程可分为中度和重度,但在牛皮癣滴状和逆状的首发发作中,病程多为轻度。皮肤表现的强度随着年龄的增长而增加,特别是在斑块形式的疾病复发的情况下。总的来说,在儿童中,牛皮癣对生活质量有模糊的影响:在男孩中,疾病的影响较小;在女孩中,它是适度的。银屑病引起的可见皮肤区域的损伤,受病理过程影响的区域的增加以及皮肤表现强度随着年龄的增长而增加,导致对儿童生活质量的更负面影响。
{"title":"Relationships between psoriasis severity indices and dermatological life quality index in children with psoriasis","authors":"Е.О. Murzina, Yu.А. Rokhletsova","doi":"10.30978/ujdvk2021-3-11","DOIUrl":"https://doi.org/10.30978/ujdvk2021-3-11","url":null,"abstract":"Objective — to аssess the impact of dermatosis on the quality of life of children with psoriasis. \u0000Materials and methods. Psoriasis severity indices (BSA, PASI, PGA) and dermatological life quality indices (DLQI, CDLQI) in children with psoriasis aged 4 to 17 years depending on the clinical and epidemiological features of dermatosis were determined. A correlation analysis of the presence of a relationship between the obtained indicators was carried out. \u0000Results and discussion. In 73.81 % of children, the BSA index was higher than 10, which provided an average BSA of 25.85 (8.78—38.38). The calculated PASI index at the beginning of treatment averaged 9.3 (3.6—18.9). 53.06 % of children had PASI < 10. The PASI index at the first diagnosis was almost 1.5 times lower than in relapses (p = 0.043). The average PGA index was 3 (2—3), namely, 32.99 % of children had PGA 1—2, 43.20 % had PGA 3 and 23.81 % of children had PGA 4. In the group of children aged 4—7 years, there was the smallest number of participants with the PGA index 4 (7.69 %), while in the group aged 16/17—17 years, this number was the largest (41.49 %) (p = 0.039). The calculated DLQI in children with psoriasis was 5 [3—9]. The average DLQI indicator in the group of girls was statistically higher than in the group of boys (p = 0.016). Statistically significant differences were identified between DLQI in the age groups, where the highest impact on quality of life was found for the children aged 16—17 years (p < 0.001) and depended on the clinical form of psoriasis: in scalp psoriasis, the impact on quality of life was moderate, and in inverse psoriasis, it was insignificant (p = 0.021). It was found that in moderate­severe/severe psoriasis, the impact on the quality of life in children increased and was assessed as moderate, while in mild psoriasis, the impact was assessed as minor (p < 0.05). \u0000Conclusions. The course of psoriasis in children can be assessed as moderate and severe, but in the first episodes of psoriasis in droplet and inverse forms, the course is mostly mild. The intensity of skin manifestations increases with age, especially in case of the disease recurrences in the plaque form. On the whole in children, psoriasis has an ambiguous impact on the quality of life: in boys, the impact of the disease is minor; in girls, it is moderate. Damage to the visible skin areas caused by psoriasis, an increase in the area affected by the pathological process and an increase in the intensity of skin manifestations with age leads to a more negative impact on the quality of life of a child.","PeriodicalId":23420,"journal":{"name":"Ukrainian Journal of Dermatology, Venerology, Cosmetology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89517154","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
A саsе of effective treatment of acne in patient with secondary immune deficiency of the first degree 一种治疗原发性继发性免疫缺陷患者痤疮的有效方法
Pub Date : 2021-09-22 DOI: 10.30978/ujdvk2021-3-27
P. Fedorych, A.Ye. Alatorskykh, L. Hrechanska, S. V. Ivanov
Acne is an urgent problem in modern dermatology. The management of this disease is a complex, lengthy and multi-step process that requires a combination of different treatment methods and an individualized approach. Objeсtive —  to demonstrate a clinical case of effective treatment of acne in a patient with secondary immune deficiency of the first degree. Materials and methods. A clinical case is presented of treatment of a 23-­year­-old man suffering from papulopustular form of moderate acne developed on the background of secondary immune deficiency of the first degree. The disease had a chronic course and resistance to the therapy used. The retinoid drug isotretinoin was used for treatment with a gradual increase and then decrease in its daily dose; antibiotic therapy; the drug Propes as an immunomodulator; as well as a set of cosmetic measures — chemical peelings and laser skin resurfacing. After the onset of dryness of certain areas of the skin, as a side effect of isotretinoin, emollients were locally intended. Results and discussion. At the end of the seventh month of treatment, the inflammatory rash on the skin completely stopped. The phenomenon of postacne was eliminated. During the control immunogram 2 months after the start of complex therapy, there was complete normalization of its parameters. In addition, during the first month of taking the drug isotretinoin , the patient did not have the exacerbation of the inflammatory process on the skin which was usual for this stage of treatment. Conclusions. The success in the treatment of the patient with acne who had secondary immune deficiency of the first degree as concomitant pathology, in our opinion, is due to a well­chosen comprehensive treatment which included antibacterial therapy, systemic retinoid isotretinoin in an appropriate for this clinical stage dose, Propes medication of the defensins group as an immunomodulatory agent, as well as the use of a complex of cosmetic measures.
痤疮是现代皮肤科亟待解决的问题。这种疾病的管理是一个复杂、漫长和多步骤的过程,需要结合不同的治疗方法和个性化的方法。目的-展示一个临床病例有效治疗痤疮患者继发性免疫缺陷的一级。材料和方法。一个临床病例是提出了治疗的23岁男子患丘疹样中度痤疮发展的背景下继发性免疫缺陷的一级。这种疾病病程较长,对所使用的治疗方法有耐药性。采用类维甲酸类药物异维甲酸治疗,日剂量先逐渐增加后减少;抗生素治疗;药物作为免疫调节剂的特性;还有一系列美容措施——化学换肤和激光换肤。在皮肤某些部位出现干燥后,作为异维甲酸的副作用,润肤剂是局部使用的。结果和讨论。在治疗的第七个月结束时,皮肤上的炎症性皮疹完全停止。痘痘后现象消除。在综合治疗开始2个月后的对照免疫图中,其参数完全正常化。此外,在服用异维甲酸药物的第一个月期间,患者没有皮肤炎症过程的加剧,这是该治疗阶段通常出现的情况。结论。我们认为,在治疗伴有第一级继发性免疫缺陷的痤疮患者的成功,是由于精心选择的综合治疗,包括抗菌治疗,适合该临床阶段剂量的全身类维甲酸异维甲酸,作为免疫调节剂的防御素组药物,以及使用复杂的美容措施。
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引用次数: 0
Clinical case of pyodermia ulcerosa serpiginosa(pyoderma gangrenosum)
Pub Date : 2021-09-22 DOI: 10.30978/ujdvk2021-3-32
L. Verbytska, D. A. Kinash
Objective — to highlight the issue of difficulties in the diagnosis and treatment of patients with pyoderma gangrenosum (PG).Materials and methods. A literature review and analysis of the results of the clinical examination of patients with PG was performed. Pyoderma gangrenosum is most commonly observed in young and middle-aged people, more frequently in women. The pathogenesis of PG has not been fully studied. It is believed to be related to genetic mutations, neutrophil dysfunction and impaired immunity/inflammation regulation. Maverakis and others developed diagnostic criteria for PG. First-line treatment is aimed at optimizing the local wound care. For more severe diseases, systemic therapy is required. Oral corticosteroids (0.5—1 mg/kg/day) are the basis of treatment and used for control of PG. Cyclosporine can be used either alone or in combination with corticosteroids. At present, there is an increasing evidence of effectiveness of biological therapy as treatment method for a number of cytokines. Results and discussion. This article presents a clinical case of a patient diagnosed with PG. Based on recent guidelines, systemic corticosteroid therapy (Medrol starting at 48 mg/d), systemic anti-inflammatory and vascular drugs, topical therapy and treatment results were presented.Conclusions. Without treatment, the disease lasts for months and years. Ulcers sometimes grow very fast, reaching huge sizes in a matter of days. After the healing of some ulcers new ones often emerge. Pain syndrome, the addition of a secondary infection and the continuous progression of the pathological process lead to a decrease in the patient’s quality of life, as well as to a deterioration in his social adaptation. Therefore, timely adequate diagnosis, treatment and full compliance of the patient are the key to success.
目的:强调坏疽性脓皮病(PG)的诊断和治疗困难的问题。材料和方法。对PG患者的临床检查结果进行文献回顾和分析。坏疽性脓皮病最常见于青年和中年人,多见于妇女。PG的发病机制尚未得到充分的研究。它被认为与基因突变、中性粒细胞功能障碍和免疫/炎症调节受损有关。Maverakis等人制定了PG的诊断标准。一线治疗旨在优化局部伤口护理。对于更严重的疾病,需要全身治疗。口服皮质类固醇(0.5-1 mg/kg/天)是治疗的基础,用于控制PG。环孢素可单独使用,也可与皮质类固醇合用。目前,越来越多的证据表明生物疗法作为治疗多种细胞因子的有效方法。结果和讨论。本文报告1例确诊为PG的患者,根据最新的指南,对全身性皮质类固醇治疗(Medrol起始剂量为48mg /d)、全身性抗炎和血管药物、局部治疗和治疗结果进行了报告。如果不进行治疗,这种疾病会持续数月甚至数年。溃疡有时生长得非常快,在几天内就会长得很大。一些溃疡愈合后,经常会出现新的溃疡。疼痛综合征,继发感染的增加和病理过程的持续进展导致患者生活质量下降,社会适应能力恶化。因此,及时充分的诊断、治疗和患者的完全依从性是成功的关键。
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引用次数: 0
Stretch marks: a review 妊娠纹:回顾
Pub Date : 2021-06-29 DOI: 10.30978/ujdvk2021-2-68
C. Diehl
Stretch marks (SM) feature visible linear scars developing on the body in the areas of excessive stretching of the skin. This is a benign skin condition, but because of their aesthetic implications, they can cause distress among their sufferers. SM show high prevalence, probably more than 50 % among pregnant women, and 50 to 90 % in the general population. SM affect more likely certain ethnic groups, especially dark-skinned patients. During pregnancy, risk factors include family history, but also important weight gain whilst more generally elevated body mass index also constitutes a risk factor. Clinically, the initial erythematous and violaceous lesions referred to as striae rubrae fade into wrinkled, hypo-pigmented, atrophic scar-like marks named striae albae. Four main theories support SM formation: 1) mechanical stretching of the skin; 2) hormonal changes; 3) an innate structural disturbance of the integument; 4) genetic predispo­sitions. Histologically various abnormalities of collagen and elastic fibres are described at dermal level. The treatment of SM is always deceptive. Topical treatments are the commonest, among them Centella asiatica or hyaluronic acid creams, almond oil, topical retinoids, cocoa butter or olive oil are the most popular. Chemical peels may also be used with limited success. Various office procedures may also be performed, such as microdermabrasion, radiofrequency, laser/light therapy, platelet-rich plasma and others, but the results are often limited and deceptive for both the patient and the dermatologist. More remains to be done about the study of this frequent dermatological disorder.
妊娠纹(SM)是指在身体过度拉伸的皮肤上形成的可见的线性疤痕。这是一种良性的皮肤状况,但由于它们的美学含义,它们会给患者带来痛苦。SM的流行率很高,在孕妇中可能超过50%,在一般人群中为50%至90%。SM更有可能影响某些种族,尤其是深色皮肤的患者。在怀孕期间,风险因素包括家族史,但也包括体重增加,而更普遍的身体质量指数升高也构成风险因素。临床上,最初的红斑和紫色病变(称为红纹)逐渐变成皱纹,色素沉着,萎缩性疤痕样标记(称为白纹)。支持SM形成的主要理论有四种:1)皮肤的机械拉伸;2)激素变化;3)被皮固有的结构紊乱;4)遗传倾向。组织学上胶原蛋白和弹性纤维的各种异常在真皮水平被描述。对SM的治疗总是具有欺骗性。局部治疗是最常见的,其中积雪草或透明质酸面霜,杏仁油,局部类维生素a,可可脂或橄榄油是最受欢迎的。化学换肤也可能使用,但效果有限。各种办公室程序也可以执行,如微磨皮,射频,激光/光疗,富血小板血浆和其他,但结果往往是有限的和欺骗患者和皮肤科医生。关于这种常见的皮肤病的研究还有很多工作要做。
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引用次数: 0
期刊
Ukrainian Journal of Dermatology, Venerology, Cosmetology
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