Makhabbat G. Lecaillon, Konstantin M. Lomonosov, Elizaveta A. Krotkova
BACKGROUND: Treatment of vitiligo is one of the most difficult problems in dermatology. Despite the availability of various safe and effective methods of treatment, there are problems with combining and correctly applying techniques for the most effective result. Vitiligo has an impact on the psycho-social aspects of patients' daily life. This makes it necessary to use additional techniques, such as cosmetic camouflage to improve the quality of life of patients with vitiligo.
AIM: to assess the effectiveness of microneedling and cosmetic camouflage for the treatment of vitiligo.
MATERIALS AND METHODS: The study included 78 people with vitiligo aged 2846 years. At the first stage of the study, 49 patients underwent microneedling in combination with ultraviolet B therapy and local tacrolimus. The subjects of the control group (n=29) were affected only by ultraviolet B therapy and tacrolimus. Phototherapy with ultraviolet B rays of 311 nm was carried out according to the method of 3-fold irradiation per week (Monday, Wednesday, Friday) with an initial dose of 0.05 J/cm2. 0.1% tacrolimus ointment was applied twice a day during the course of therapy. The treatment lasted for 25 months; 2 courses of 2 months were carried out with a break of 3 months (in total 5 months). On average, for therapeutic effect (complete or partial repigmentation), patients received 6064 sessions. Patients of the studied groups underwent a comparative analysis of repigmentation 2 and 5 months after treatment. At the second stage of the study, patients after microneedling were divided into the main group (n=33) and the comparison group (n=16). The subjects of the comparison group underwent cosmetic camouflage of vitiligo sites. Before and after treatment, the dermatological index of quality of life was determined for patients.
RESULTS: After 1 month from the start of treatment, 67.4% of patients after microneedling and 6.1% of patients in the control group showed moderate improvement (2650% repigmentation). There was a good improvement with 5175% repigmentation in 26.5% of patients after microneedling. After 5 months from the start of treatment, 67.4% of the subjects after microneedling showed an improvement in repigmentation of more than 51%. It was found that the average indicators of the dermatological quality of life index after treatment in patients of the main group (9.60.3 points) and the comparison group (7.00.3 points) corresponded to the values of "moderate effect of the disease on quality of life" and were significantly (p=0.018) lower than the baseline level (20.80.2 points and 19.91.1 points). This was not determined in the control group (18.20.4 points and 22.40.1 points). In the comparison group, this indicator was significantly (p=0.001) lower in comparison with the scores of other study groups.
CONCLUSION: The combination of microneedling, ultraviolet B therapy and tacrolimus is an effective method of treating patients with vitiligo. It
{"title":"The effectiveness of microneedling and cosmetic camouflage in the treatment of vitiligo","authors":"Makhabbat G. Lecaillon, Konstantin M. Lomonosov, Elizaveta A. Krotkova","doi":"10.17816/dv442826","DOIUrl":"https://doi.org/10.17816/dv442826","url":null,"abstract":"BACKGROUND: Treatment of vitiligo is one of the most difficult problems in dermatology. Despite the availability of various safe and effective methods of treatment, there are problems with combining and correctly applying techniques for the most effective result. Vitiligo has an impact on the psycho-social aspects of patients' daily life. This makes it necessary to use additional techniques, such as cosmetic camouflage to improve the quality of life of patients with vitiligo.
 AIM: to assess the effectiveness of microneedling and cosmetic camouflage for the treatment of vitiligo.
 MATERIALS AND METHODS: The study included 78 people with vitiligo aged 2846 years. At the first stage of the study, 49 patients underwent microneedling in combination with ultraviolet B therapy and local tacrolimus. The subjects of the control group (n=29) were affected only by ultraviolet B therapy and tacrolimus. Phototherapy with ultraviolet B rays of 311 nm was carried out according to the method of 3-fold irradiation per week (Monday, Wednesday, Friday) with an initial dose of 0.05 J/cm2. 0.1% tacrolimus ointment was applied twice a day during the course of therapy. The treatment lasted for 25 months; 2 courses of 2 months were carried out with a break of 3 months (in total 5 months). On average, for therapeutic effect (complete or partial repigmentation), patients received 6064 sessions. Patients of the studied groups underwent a comparative analysis of repigmentation 2 and 5 months after treatment. At the second stage of the study, patients after microneedling were divided into the main group (n=33) and the comparison group (n=16). The subjects of the comparison group underwent cosmetic camouflage of vitiligo sites. Before and after treatment, the dermatological index of quality of life was determined for patients.
 RESULTS: After 1 month from the start of treatment, 67.4% of patients after microneedling and 6.1% of patients in the control group showed moderate improvement (2650% repigmentation). There was a good improvement with 5175% repigmentation in 26.5% of patients after microneedling. After 5 months from the start of treatment, 67.4% of the subjects after microneedling showed an improvement in repigmentation of more than 51%. It was found that the average indicators of the dermatological quality of life index after treatment in patients of the main group (9.60.3 points) and the comparison group (7.00.3 points) corresponded to the values of \"moderate effect of the disease on quality of life\" and were significantly (p=0.018) lower than the baseline level (20.80.2 points and 19.91.1 points). This was not determined in the control group (18.20.4 points and 22.40.1 points). In the comparison group, this indicator was significantly (p=0.001) lower in comparison with the scores of other study groups.
 CONCLUSION: The combination of microneedling, ultraviolet B therapy and tacrolimus is an effective method of treating patients with vitiligo. It","PeriodicalId":487039,"journal":{"name":"Rossiiskii Zhurnal Kozhnykh i Venericheskikh Boleznei","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136363651","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}
Olga A. Aleksandrova, Valeriy V. Dubenskiy, Ekaterina S. Muraveva, Maksim A. Tenyaev
Rosacea is a multifactorial dermatological disease that is widespread throughout the world, initially manifested as a cosmetic defect, and in the absence of systemic and topical therapy leads to a change in the structure and functions of the facial skin.
Patients with rosacea often seek medical attention, as these aesthetic problems impair their quality of life and contribute to the development of social and psychological problems. Chronic stress is often the cause of the development of social maladaptation, which occurs because of a constant feeling of self-doubt, own inferiority, and anxiety. Anxiety and chronic depression can cause even minor manifestations of rosacea, as it is localized on the skin of the face. Dermatosis often manifests itself in women older than 30 years, under the influence of multiple trigger factors, has a chronic relapsing course.
Understanding the pathophysiology and the use of combined therapies can improve the effectiveness of therapy in patients with rosacea, achieve and prolong clinical remission, identify trigger factors and possible prevention. This explains the need to study rosacea not as an independent dermatosis, but as a sign of more significant disorders that can lead not only to social and aesthetic problems, but also affect the general health of the patient.
{"title":"Modern view on rosacea: Topical issues of epidemiology, pathogenesis and therapy. Literature review","authors":"Olga A. Aleksandrova, Valeriy V. Dubenskiy, Ekaterina S. Muraveva, Maksim A. Tenyaev","doi":"10.17816/dv375277","DOIUrl":"https://doi.org/10.17816/dv375277","url":null,"abstract":"Rosacea is a multifactorial dermatological disease that is widespread throughout the world, initially manifested as a cosmetic defect, and in the absence of systemic and topical therapy leads to a change in the structure and functions of the facial skin.
 Patients with rosacea often seek medical attention, as these aesthetic problems impair their quality of life and contribute to the development of social and psychological problems. Chronic stress is often the cause of the development of social maladaptation, which occurs because of a constant feeling of self-doubt, own inferiority, and anxiety. Anxiety and chronic depression can cause even minor manifestations of rosacea, as it is localized on the skin of the face. Dermatosis often manifests itself in women older than 30 years, under the influence of multiple trigger factors, has a chronic relapsing course.
 Understanding the pathophysiology and the use of combined therapies can improve the effectiveness of therapy in patients with rosacea, achieve and prolong clinical remission, identify trigger factors and possible prevention. This explains the need to study rosacea not as an independent dermatosis, but as a sign of more significant disorders that can lead not only to social and aesthetic problems, but also affect the general health of the patient.","PeriodicalId":487039,"journal":{"name":"Rossiiskii Zhurnal Kozhnykh i Venericheskikh Boleznei","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136363519","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}
Natalya P. Teplyuk, Olga V. Grabovskaya, Varvara A. Rogozina
Necrobiosis lipoidica is a chronic granulomatous skin disease of a vascular-exchange nature from the group of localized skin lipoidosis, accompanied by the development of degenerative changes in the connective tissue.
The reason for the development of necrobiosis lipoidica is unknown, but the most common theory remains the theory of vascular disorders, including the deposition of immune complexes (IgM, complement component C3), microangiopathic changes (deposition of a glycoprotein in the walls of blood vessels), as well as other combinations of inflammatory and structural changes leading to collagen degeneration and decreased perfusion and oxygenation of the skin. Necrobiosis lipoidica occurs in association with systemic diseases (sarcoidosis, autoimmune thyroiditis, inflammatory bowel disease, such as ulcerative colitis, and rheumatoid arthritis) and can also occur in otherwise healthy individuals. Necrobiosis lipoidica is closely associated with diabetes mellitus.
The predominant localization of necrobiosis lipoidica is tibial surface of the legs. Atypical localization is: skin of the scalp and face.
Clinical polymorphism of necrobiosis lipoidica, possibility of transition from one form to another, its combination with other dermatoses can pose difficult diagnostic questions for the doctor.
The article describes our own clinical observation of a patient with complaints of rashes on the skin of the legs and scarring alopecia in the scalp. The focus on the scalp had a tendency to grow and signs of development of scarring alopecia. According to the results of a biopsy performed at the Rakhmanov Department of Skin and Veneral Diseases, I.M. Sechenov First Moscow State Medical University, was diagnosed with "Necrobiosis Lipoidica". The case was interesting due to the extreme rarity of rashes on the skin of the scalp and the absence of dermatoscopic features of lesions in this area. Due to ongoing therapy for a month, there was a positive effect in the form of a lack of growth of existing plaques and the appearance of new ones, a decrease in the brightness of the color of the rash, a partial regression with an outcome in residual hyperpigmentation.
Thus, despite the absence of a gold standard in the treatment of necrobiosis lipoidica, the most well-studied group of drugs for the treatment of the disease at the moment are glucocorticoids, which confirms our experience. Therapy of patients with necrobiosis lipoidica should be carried out by an interdisciplinary team (dermatovenereologist, endocrinologist, therapist).
{"title":"Necrobiosis lipoidica of the scalp","authors":"Natalya P. Teplyuk, Olga V. Grabovskaya, Varvara A. Rogozina","doi":"10.17816/dv450869","DOIUrl":"https://doi.org/10.17816/dv450869","url":null,"abstract":"Necrobiosis lipoidica is a chronic granulomatous skin disease of a vascular-exchange nature from the group of localized skin lipoidosis, accompanied by the development of degenerative changes in the connective tissue.
 The reason for the development of necrobiosis lipoidica is unknown, but the most common theory remains the theory of vascular disorders, including the deposition of immune complexes (IgM, complement component C3), microangiopathic changes (deposition of a glycoprotein in the walls of blood vessels), as well as other combinations of inflammatory and structural changes leading to collagen degeneration and decreased perfusion and oxygenation of the skin. Necrobiosis lipoidica occurs in association with systemic diseases (sarcoidosis, autoimmune thyroiditis, inflammatory bowel disease, such as ulcerative colitis, and rheumatoid arthritis) and can also occur in otherwise healthy individuals. Necrobiosis lipoidica is closely associated with diabetes mellitus.
 The predominant localization of necrobiosis lipoidica is tibial surface of the legs. Atypical localization is: skin of the scalp and face.
 Clinical polymorphism of necrobiosis lipoidica, possibility of transition from one form to another, its combination with other dermatoses can pose difficult diagnostic questions for the doctor.
 The article describes our own clinical observation of a patient with complaints of rashes on the skin of the legs and scarring alopecia in the scalp. The focus on the scalp had a tendency to grow and signs of development of scarring alopecia. According to the results of a biopsy performed at the Rakhmanov Department of Skin and Veneral Diseases, I.M. Sechenov First Moscow State Medical University, was diagnosed with \"Necrobiosis Lipoidica\". The case was interesting due to the extreme rarity of rashes on the skin of the scalp and the absence of dermatoscopic features of lesions in this area. Due to ongoing therapy for a month, there was a positive effect in the form of a lack of growth of existing plaques and the appearance of new ones, a decrease in the brightness of the color of the rash, a partial regression with an outcome in residual hyperpigmentation.
 Thus, despite the absence of a gold standard in the treatment of necrobiosis lipoidica, the most well-studied group of drugs for the treatment of the disease at the moment are glucocorticoids, which confirms our experience. Therapy of patients with necrobiosis lipoidica should be carried out by an interdisciplinary team (dermatovenereologist, endocrinologist, therapist).","PeriodicalId":487039,"journal":{"name":"Rossiiskii Zhurnal Kozhnykh i Venericheskikh Boleznei","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136363657","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}
Juvenile hemangiomas can occur from the first months of life, with the prevalence of superficial juvenile hemangiomas (76.1%), more often solitary (83.3%).
Female infants predominate among the patients, with a 2:1 ratio.
Localization on the skin of the face and scalp is determined in 30% of cases; the remaining juvenile hemangiomas are located on the skin of the trunk and extremities.
Hemangiomas are mostly peripheral and small in size (1020 mm), superficially and up to 5 mm deep.
The most frequent complication of juvenile hemangiomas is ulceration, both as a consequence of exophytic growth and treatment methods.
The predominance of arterial intramedullary blood flow was found at ultrasound diagnosis, however, variants of 2-phase blood flow can also occur, which requires additional ultrasound examination of all cases of juvenile hemangiomas.
We offer the publication of a photo gallery on this problem.
{"title":"Photogallery. Juvenile hemangiomas","authors":"Vladislav V. Dubensky, Valeriy V. Dubenskiy","doi":"10.17816/dv430370","DOIUrl":"https://doi.org/10.17816/dv430370","url":null,"abstract":"Juvenile hemangiomas can occur from the first months of life, with the prevalence of superficial juvenile hemangiomas (76.1%), more often solitary (83.3%).
 Female infants predominate among the patients, with a 2:1 ratio.
 Localization on the skin of the face and scalp is determined in 30% of cases; the remaining juvenile hemangiomas are located on the skin of the trunk and extremities.
 Hemangiomas are mostly peripheral and small in size (1020 mm), superficially and up to 5 mm deep.
 The most frequent complication of juvenile hemangiomas is ulceration, both as a consequence of exophytic growth and treatment methods.
 The predominance of arterial intramedullary blood flow was found at ultrasound diagnosis, however, variants of 2-phase blood flow can also occur, which requires additional ultrasound examination of all cases of juvenile hemangiomas.
 We offer the publication of a photo gallery on this problem.","PeriodicalId":487039,"journal":{"name":"Rossiiskii Zhurnal Kozhnykh i Venericheskikh Boleznei","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136363658","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}
Kseniia A. Vovdenko, Olga Yu. Olisova, Konstantin V. Smirnov, Daria A. Svistunova, Konstantin M. Lomonosov
BACKGROUND: Vitiligo refers to acquired hypomelanosis, characterized by the appearance of depigmented spots on the skin. The search for new vitiligo treatment approaches, which would simultaneously have a pathogenetic focus on the therapy of this disease and at the same time have a safe spectrum of side effects, is relevant today.
AIM: to evaluate the clinical and laboratory efficacy of azathioprine in progressive non-segmental vitiligo compared with NB-UVB monotherapy.
MATERIALS AND METHODS: 60 patients with progressive non-segmental vitiligo were divided into 2 equal groups: group 1 received azathioprine in combination with NB-UVB, group 2 received NB-UVB monotherapy. The follow-up period was 6 months. The effectiveness of therapy was evaluated based on the dynamics of the Vitiligo Area Scoring Index (VASI), dermatological quality of life index (DLQI), as well as the titers of proinflammatory cytokines IL-1, IL-2, IL-6, IL-8, IFN-, TNF- and S100 protein in serum blood.
RESULTS: In the azathioprine + NB-UVB group, compared with the control group, a statistically significant prevalence of VASI and DLQI indices reduction was observed. (Me -61.70%, Q1Q3: -75.14-47.08%, p 0.001; Me -55.83%, Q1Q3: -67.80-40.29%, p 0.001). The dependence of the quality of life of patients on the prevalence of the skin process was noted (p 0.001). There was a statistically significant relationship between the activity of the skin process and the S100 protein in the blood serum of patients with vitiligo. (p 0.05) In addition, the analysis of the dynamics of immunological parameters of the main group compared with the control group showed a more significant decrease in the level of cytokines, as well as S100 protein in blood serum (p 0.001).
CONCLUSION: The combination of azathioprine and NB-UVB is effective and safe, helps to stabilize the skin process and stimulate the repigmentation of foci, significantly improving the quality of life of patients, contributes to the normalization of immunological parameters, leading to an earlier stop of the progression of the skin process.
背景:白癜风是指获得性低黑色素沉着症，其特征是皮肤上出现色素沉着斑。寻找新的白癜风治疗方法，既要关注这种疾病的发病机制，又要保证副作用的安全范围，这在今天是有意义的。目的:比较氮唑嘌呤与NB-UVB单药治疗进行性非节段性白癜风的临床及实验室疗效;材料与方法:将60例进行性非节段性白癜风患者分为2组，1组采用硫唑嘌呤联合NB-UVB治疗，2组采用NB-UVB单药治疗。随访6个月。根据白癜风区域评分指数(VASI)、皮肤生活质量指数(DLQI)以及血清中促炎细胞因子IL-1、IL-2、IL-6、IL-8、IFN-、TNF-和S100蛋白滴度动态评估治疗效果。结果:硫唑嘌呤+ NB-UVB组与对照组相比，VASI患病率和DLQI指数降低具有统计学意义。(Me -61.70%， Q1Q3: -75.14-47.08%， p 0.001;Me -55.83%， Q1Q3: -67.80-40.29%， p 0.001)。患者的生活质量依赖于皮肤过程的流行(p 0.001)。白癜风患者的皮肤过程活性与血清中S100蛋白有统计学意义。(p 0.05)此外，与对照组相比，主组免疫参数动态分析显示，血清中细胞因子水平和S100蛋白水平下降更为显著(p 0.001)。
结论:氮唑嘌呤联合NB-UVB有效、安全，有助于稳定皮肤进程，刺激病灶重色素沉着，显著提高患者的生活质量，有助于免疫参数的正常化，使皮肤进程的进展更早停止。
{"title":"Clinical and pathogenetic justification of the use of azathioprine in the treatment of progressive non-segmental vitiligo","authors":"Kseniia A. Vovdenko, Olga Yu. Olisova, Konstantin V. Smirnov, Daria A. Svistunova, Konstantin M. Lomonosov","doi":"10.17816/dv321219","DOIUrl":"https://doi.org/10.17816/dv321219","url":null,"abstract":"BACKGROUND: Vitiligo refers to acquired hypomelanosis, characterized by the appearance of depigmented spots on the skin. The search for new vitiligo treatment approaches, which would simultaneously have a pathogenetic focus on the therapy of this disease and at the same time have a safe spectrum of side effects, is relevant today.
 AIM: to evaluate the clinical and laboratory efficacy of azathioprine in progressive non-segmental vitiligo compared with NB-UVB monotherapy.
 MATERIALS AND METHODS: 60 patients with progressive non-segmental vitiligo were divided into 2 equal groups: group 1 received azathioprine in combination with NB-UVB, group 2 received NB-UVB monotherapy. The follow-up period was 6 months. The effectiveness of therapy was evaluated based on the dynamics of the Vitiligo Area Scoring Index (VASI), dermatological quality of life index (DLQI), as well as the titers of proinflammatory cytokines IL-1, IL-2, IL-6, IL-8, IFN-, TNF- and S100 protein in serum blood.
 RESULTS: In the azathioprine + NB-UVB group, compared with the control group, a statistically significant prevalence of VASI and DLQI indices reduction was observed. (Me -61.70%, Q1Q3: -75.14-47.08%, p 0.001; Me -55.83%, Q1Q3: -67.80-40.29%, p 0.001). The dependence of the quality of life of patients on the prevalence of the skin process was noted (p 0.001). There was a statistically significant relationship between the activity of the skin process and the S100 protein in the blood serum of patients with vitiligo. (p 0.05) In addition, the analysis of the dynamics of immunological parameters of the main group compared with the control group showed a more significant decrease in the level of cytokines, as well as S100 protein in blood serum (p 0.001).
 CONCLUSION: The combination of azathioprine and NB-UVB is effective and safe, helps to stabilize the skin process and stimulate the repigmentation of foci, significantly improving the quality of life of patients, contributes to the normalization of immunological parameters, leading to an earlier stop of the progression of the skin process.","PeriodicalId":487039,"journal":{"name":"Rossiiskii Zhurnal Kozhnykh i Venericheskikh Boleznei","volume":"88 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136363522","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}
BACKGROUND: Acne is a chronic inflammatory skin disease of multifactorial nature that affects more than 80% of adolescents and is one of the top 10 most common diseases in the world. Currently, dermatologists have various techniques for the correction of postacne scars: from minimally invasive hydroxy acid peels to surgical excision of scar tissue. One of the most effective, affordable, and at the same time minimally invasive and safe treatment methods is microneedling ― micro-damage of the skin with thin needles in the lesion area, stimulating the production of collagen and elastin.
AIM: to study the efficacy and safety of transdermal redermalization with microneedling using high-molecular-weight hyaluronic acid and sodium succinate in patients with atrophic postacne scars of varying severity.
MATERIALS AND METHODS: A prospective study was carried out at the Clinic of Skin and Venereal Diseases of the Sechenov University. A. Rakhmanov, Sechenov University, with the participation of 80 patients with postacne scars of varying severity. The Hyalual Perfoskin Complex device was used for microneedling in combination with a sodium succinate preparation based on hyaluronic acid. The apparatus was used in a linear technique along the Langer tension lines and in mutually perpendicular direction, 1015 passes in each area (lower jaw, cheek-curve area, forehead area). Each subject underwent 4 treatments at 21-day intervals. Clinical assessment of the treatment dynamics before and after treatment was performed using the Miravex 3D multispectral imaging device. Before and after treatment, patients were evaluated for the severity of postacne scars according to the International Qualitative Scale for the classification of postacne scars, as well as a dermatological index of quality of life. Subjective evaluation of the effectiveness of therapy by the physician and the patient was performed using the International Global Aesthetic Improvement Scale one month after each treatment and 3 months after the last treatment.
RESULTS: Among the 80 patients, 47 women and 33 men aged 18 to 46 years had atrophic postacne scars of varying severity: I in 9, II in 26, III in 40, and IV in 5 patients; the rashes were most often localized to the cheek-cusp (55; 69%) and forehead (15; 19%) and were represented by U-shaped (35; 44%), V-shaped (17; 21%), M-shaped (19; 24%) and macular (9; 11%) patterns. The duration of the disease averaged 5.33.2 years. Improvement of the clinical picture was observed in 92.5% of cases after treatment. For example, 8 patients with I degree of scarring managed to achieve complete clearing of the skin; out of 26 patients with II degree of scarring, 15 patients achieved I degree of severity and 10 patients experienced clinical remission at the end of treatment; in the group of patients with III degree of scarring (n=40), 18 patients had I degree of severity, 20 patients had II degree of severity; in the group of patients with IV degr
{"title":"Efficacy of transdermal microneedling redermalization with high-molecular-weight hyaluronic acid and sodium succinate in the correction of postacne scars","authors":"Elena S. Snarskaya, Aleksandr S. Bykanov","doi":"10.17816/dv159401","DOIUrl":"https://doi.org/10.17816/dv159401","url":null,"abstract":"BACKGROUND: Acne is a chronic inflammatory skin disease of multifactorial nature that affects more than 80% of adolescents and is one of the top 10 most common diseases in the world. Currently, dermatologists have various techniques for the correction of postacne scars: from minimally invasive hydroxy acid peels to surgical excision of scar tissue. One of the most effective, affordable, and at the same time minimally invasive and safe treatment methods is microneedling ― micro-damage of the skin with thin needles in the lesion area, stimulating the production of collagen and elastin.
 AIM: to study the efficacy and safety of transdermal redermalization with microneedling using high-molecular-weight hyaluronic acid and sodium succinate in patients with atrophic postacne scars of varying severity.
 MATERIALS AND METHODS: A prospective study was carried out at the Clinic of Skin and Venereal Diseases of the Sechenov University. A. Rakhmanov, Sechenov University, with the participation of 80 patients with postacne scars of varying severity. The Hyalual Perfoskin Complex device was used for microneedling in combination with a sodium succinate preparation based on hyaluronic acid. The apparatus was used in a linear technique along the Langer tension lines and in mutually perpendicular direction, 1015 passes in each area (lower jaw, cheek-curve area, forehead area). Each subject underwent 4 treatments at 21-day intervals. Clinical assessment of the treatment dynamics before and after treatment was performed using the Miravex 3D multispectral imaging device. Before and after treatment, patients were evaluated for the severity of postacne scars according to the International Qualitative Scale for the classification of postacne scars, as well as a dermatological index of quality of life. Subjective evaluation of the effectiveness of therapy by the physician and the patient was performed using the International Global Aesthetic Improvement Scale one month after each treatment and 3 months after the last treatment.
 RESULTS: Among the 80 patients, 47 women and 33 men aged 18 to 46 years had atrophic postacne scars of varying severity: I in 9, II in 26, III in 40, and IV in 5 patients; the rashes were most often localized to the cheek-cusp (55; 69%) and forehead (15; 19%) and were represented by U-shaped (35; 44%), V-shaped (17; 21%), M-shaped (19; 24%) and macular (9; 11%) patterns. The duration of the disease averaged 5.33.2 years. Improvement of the clinical picture was observed in 92.5% of cases after treatment. For example, 8 patients with I degree of scarring managed to achieve complete clearing of the skin; out of 26 patients with II degree of scarring, 15 patients achieved I degree of severity and 10 patients experienced clinical remission at the end of treatment; in the group of patients with III degree of scarring (n=40), 18 patients had I degree of severity, 20 patients had II degree of severity; in the group of patients with IV degr","PeriodicalId":487039,"journal":{"name":"Rossiiskii Zhurnal Kozhnykh i Venericheskikh Boleznei","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136363523","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}
BACKGROUND: Psoriasis is a chronic inflammatory immune-mediated disease characterized by an increased rate of keratinocyte division. Modern ideas about the immunopathogenesis of psoriasis, systemic inflammation and manifestations, comorbid conditions bring to the fore the question of the rational choice of therapy in patients with moderate and severe psoriasis.
AIM: to study the effect of the combined use of PUVA therapy and methotrexate on the expression levels of receptors for the proliferation marker Ki-67 and the anti-apoptotic protein Bcl-2.
MATERIALS AND METHODS: The study included 110 patients with moderate to sеvеrе psоriаsis,divided into 2 groups: the first group received PUVA therapy in combination with methotrexate (Mt); the second group received methotrexate (Mt) monotherapy. Skin biopsies were taken from the affected areas in 10 patients from the 1st group before and after therapy for immunohistochemical study to determine the level of expression of Ki-67 and Bcl-2. Healthy skin bioptats were taken from patients operated on for appendicitis and used as the control samples.
RESULTS: An immunohistochemical study revealed a statistically significant increase in the initial indicators of the expression level of Ki-67 and Bcl-2 in all patients with psoriasis compared with the control group. As a result of the combined therapy, there was a significant decrease in the expression of Ki-67 and Bcl-2.
CONCLUSION: The combined method of treatment of patients with psoriasis has an immunosuppressive effect, as evidenced by a significant decrease in the expression of the proliferation marker Ki-67 and the apoptosis inhibitor Bcl-2.
{"title":"Impact of combination therapy on Ki-67 and Bcl-2 expression in psoriasis","authors":"Nigina I. Melikova, Umida A. Tashkenbaeva","doi":"10.17816/dv352496","DOIUrl":"https://doi.org/10.17816/dv352496","url":null,"abstract":"BACKGROUND: Psoriasis is a chronic inflammatory immune-mediated disease characterized by an increased rate of keratinocyte division. Modern ideas about the immunopathogenesis of psoriasis, systemic inflammation and manifestations, comorbid conditions bring to the fore the question of the rational choice of therapy in patients with moderate and severe psoriasis.
 AIM: to study the effect of the combined use of PUVA therapy and methotrexate on the expression levels of receptors for the proliferation marker Ki-67 and the anti-apoptotic protein Bcl-2.
 MATERIALS AND METHODS: The study included 110 patients with moderate to sеvеrе psоriаsis,divided into 2 groups: the first group received PUVA therapy in combination with methotrexate (Mt); the second group received methotrexate (Mt) monotherapy. Skin biopsies were taken from the affected areas in 10 patients from the 1st group before and after therapy for immunohistochemical study to determine the level of expression of Ki-67 and Bcl-2. Healthy skin bioptats were taken from patients operated on for appendicitis and used as the control samples.
 RESULTS: An immunohistochemical study revealed a statistically significant increase in the initial indicators of the expression level of Ki-67 and Bcl-2 in all patients with psoriasis compared with the control group. As a result of the combined therapy, there was a significant decrease in the expression of Ki-67 and Bcl-2.
 CONCLUSION: The combined method of treatment of patients with psoriasis has an immunosuppressive effect, as evidenced by a significant decrease in the expression of the proliferation marker Ki-67 and the apoptosis inhibitor Bcl-2.","PeriodicalId":487039,"journal":{"name":"Rossiiskii Zhurnal Kozhnykh i Venericheskikh Boleznei","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136363652","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}
On April 18, 2023, the 1152nd meeting of the Moscow Society of Dermatologists and Cosmetologists named after A.I. Pospelov took place. The meeting was held in a face-to-face format. There were 115 participants in total. Ac-cepted as a member of the MSDC 1 person.
Two reports are presented in the clinical part of the meeting: clinical variations of the course of skin sarcoidosis: the mini-lecture describes 8 clinical cases of cutaneous sarcoidosis; Kaposi's sarcoma in a 24-year-old patient with positive antibodies to cytomegaly and EpsteinBarr viruses.
Three reports were presented in the scientific part of the meeting: The possibilities of im-proving the effectiveness of onychomycosis therapy (speaker I.S. Maximov, Sechenov University); The use of botulinum toxin type A for the correction of erythematous-telangiectatic subtype of rosacea (speaker A.O. Yakovleva, State Scientific Center of Dermatovenerology and Cosmetology); A post-graduate student of the Department of Dermatovenereology of the Peoples' Friendship University of Russia Aun Rami Yusefovi made a report on targeted therapy of children with moderate and severe forms of atopic dermatitis (co-speakers ― Prof. E.A. Batkaev, Prof. V.Yu. Ujuhu).
{"title":"Chronicles of A.I. Pospelov Moscow Society of Dermatovenerologists and Cosmetologists (MSDC was founded on October 4, 1891) Bulletin of the MSDC meeting N 1152","authors":"Alexey B. Yakovlev, Ivan S. Maximov","doi":"10.17816/dv462797","DOIUrl":"https://doi.org/10.17816/dv462797","url":null,"abstract":"On April 18, 2023, the 1152nd meeting of the Moscow Society of Dermatologists and Cosmetologists named after A.I. Pospelov took place. The meeting was held in a face-to-face format. There were 115 participants in total. Ac-cepted as a member of the MSDC 1 person.
 Two reports are presented in the clinical part of the meeting: clinical variations of the course of skin sarcoidosis: the mini-lecture describes 8 clinical cases of cutaneous sarcoidosis; Kaposi's sarcoma in a 24-year-old patient with positive antibodies to cytomegaly and EpsteinBarr viruses.
 Three reports were presented in the scientific part of the meeting: The possibilities of im-proving the effectiveness of onychomycosis therapy (speaker I.S. Maximov, Sechenov University); The use of botulinum toxin type A for the correction of erythematous-telangiectatic subtype of rosacea (speaker A.O. Yakovleva, State Scientific Center of Dermatovenerology and Cosmetology); A post-graduate student of the Department of Dermatovenereology of the Peoples' Friendship University of Russia Aun Rami Yusefovi made a report on targeted therapy of children with moderate and severe forms of atopic dermatitis (co-speakers ― Prof. E.A. Batkaev, Prof. V.Yu. Ujuhu).","PeriodicalId":487039,"journal":{"name":"Rossiiskii Zhurnal Kozhnykh i Venericheskikh Boleznei","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136363518","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}
Olga Yu. Olisova, Ekaterina V. Grekova, Konstantin V. Smirnov, Olga S. Yazkova, Danila A. Koriakin, Nigina I. Melikova
BACKGROUND: Phototherapy using different wavelengths of the ultraviolet (UV) spectrum has been successfully used to treat a variety of dermatoses. Along with the positive effects of this intervention, there are both acute and long-term side effects that should be taken into account by the clinicians.
AIM: to study the tolerability and safety of phototherapy (PUVA and UVB-311 nm) in patients with moderate to severe psoriasis.
MATERIALS AND METHODS: There were 920 patients with psoriasis under our supervision from 2005 to 2021, of which 756 (82%) patients suffered from psoriasis vulgaris, 36 (4%) ― guttate psoriasis, 73 (8%) ― exudative psoriasis, 55 (6%) ― inverse psoriasis. 249/920 (27%) were diagnosed with psoriatic arthritis. Patients with moderate psoriasis received 311 nm UVB therapy (n=473), with severe psoriasis ― PUVA therapy (n=447).
RESULTS: Out of 920 patients with psoriasis during the entire follow-up period, 385 (41.8%) noted one or more early side effects, which were short-lived and disappeared after the end of the PUVA course if the recommendations were followed. Among the early side effects that occurred during the procedures from taking a photosensitizer, the most common were transient nausea, vomiting, dizziness, headache, transient increase in hepatic transaminases. Side effects from the action of ultraviolet rays were reduced to the manifestation of itching, photodermatitis in the form of erythema, photodermatitis in the form of blisters, photoallergic reaction in the form of papular rash, dry skin, photoconjunctivitis, herpes simplex and even photoonycholysis. Patients treated with UVB-311 nm phototherapy complained on xerosis of the skin, itching, photodermatitis in the form of erythema, burning of the skin as early side effects. Long-term side effects in patients treated with PUVA therapy included lentigo (persistent mottled pigmentation), growth of melanocytic neoplasms, PUVA keratosis. In 11 (2.3%) patients with psoriasis who received UVB-311 nm therapy, new nevi appeared. In 42 (9.6%) patients treated with PUVA therapy and in 17 (3.8%) patients treated with UVB-311 nm, signs of photoaging were detected as well. In our study, only 1 (0.2%) patient was diagnosed with facial skin basal cell carcinoma, who received 5 courses of PUVA (119 procedures).
CONCLUSION: Our study showed that side effects, especially long-term ones, were fewer and significantly less pronounced in patients treated with UVB-311 nm therapy. Comparing the benefits and risks of phototherapy sessions, we can conclude in favor of the effectiveness, good tolerability and safety of PUVA and UVB-311 nm therapy for the treatment of patients with moderate to severe psoriasis. A dose-dependent effect of photoaging was established: the more phototherapy courses were received, the more pronounced the signs of photoaging were, especially after PUVA therapy.
{"title":"On the issue of tolerability and safety of phototherapy in patients with psoriasis","authors":"Olga Yu. Olisova, Ekaterina V. Grekova, Konstantin V. Smirnov, Olga S. Yazkova, Danila A. Koriakin, Nigina I. Melikova","doi":"10.17816/dv375363","DOIUrl":"https://doi.org/10.17816/dv375363","url":null,"abstract":"BACKGROUND: Phototherapy using different wavelengths of the ultraviolet (UV) spectrum has been successfully used to treat a variety of dermatoses. Along with the positive effects of this intervention, there are both acute and long-term side effects that should be taken into account by the clinicians.
 AIM: to study the tolerability and safety of phototherapy (PUVA and UVB-311 nm) in patients with moderate to severe psoriasis.
 MATERIALS AND METHODS: There were 920 patients with psoriasis under our supervision from 2005 to 2021, of which 756 (82%) patients suffered from psoriasis vulgaris, 36 (4%) ― guttate psoriasis, 73 (8%) ― exudative psoriasis, 55 (6%) ― inverse psoriasis. 249/920 (27%) were diagnosed with psoriatic arthritis. Patients with moderate psoriasis received 311 nm UVB therapy (n=473), with severe psoriasis ― PUVA therapy (n=447).
 RESULTS: Out of 920 patients with psoriasis during the entire follow-up period, 385 (41.8%) noted one or more early side effects, which were short-lived and disappeared after the end of the PUVA course if the recommendations were followed. Among the early side effects that occurred during the procedures from taking a photosensitizer, the most common were transient nausea, vomiting, dizziness, headache, transient increase in hepatic transaminases. Side effects from the action of ultraviolet rays were reduced to the manifestation of itching, photodermatitis in the form of erythema, photodermatitis in the form of blisters, photoallergic reaction in the form of papular rash, dry skin, photoconjunctivitis, herpes simplex and even photoonycholysis. Patients treated with UVB-311 nm phototherapy complained on xerosis of the skin, itching, photodermatitis in the form of erythema, burning of the skin as early side effects. Long-term side effects in patients treated with PUVA therapy included lentigo (persistent mottled pigmentation), growth of melanocytic neoplasms, PUVA keratosis. In 11 (2.3%) patients with psoriasis who received UVB-311 nm therapy, new nevi appeared. In 42 (9.6%) patients treated with PUVA therapy and in 17 (3.8%) patients treated with UVB-311 nm, signs of photoaging were detected as well. In our study, only 1 (0.2%) patient was diagnosed with facial skin basal cell carcinoma, who received 5 courses of PUVA (119 procedures).
 CONCLUSION: Our study showed that side effects, especially long-term ones, were fewer and significantly less pronounced in patients treated with UVB-311 nm therapy. Comparing the benefits and risks of phototherapy sessions, we can conclude in favor of the effectiveness, good tolerability and safety of PUVA and UVB-311 nm therapy for the treatment of patients with moderate to severe psoriasis. A dose-dependent effect of photoaging was established: the more phototherapy courses were received, the more pronounced the signs of photoaging were, especially after PUVA therapy.","PeriodicalId":487039,"journal":{"name":"Rossiiskii Zhurnal Kozhnykh i Venericheskikh Boleznei","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136363521","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}
Anna V. Michenko, Larisa S. Kruglova, Evgeniya A. Shatokhina, Andrey N. Lvov, Ekaterina M. Simenskaya, Dmitry V. Romanov, Inessa B. Kononenko, Anton V. Snegovoy
Uremic pruritus is a common symptom in chronic kidney disease and end-stage renal failure. In addition to physical discomfort uremic pruritus disrupts sleep, negatively affects the psycho-emotional state and quality of life. In this group of patients, the association of uremic pruritus with an increase in mortality due to any causes was demonstrated. At the same time, there are no standardized approaches to the treatment of uremic itching. There is also a special category of patients receiving antitumor therapy and developing dermatological adverse events, also potentially accompanied by itching.
This article presents a case of uremic pruritus in a patient with papulo-pustular cutaneous reaction (grade II on a Scale Common Terminology Criteria for Adverse Events, CTCAE v 5.0) to the epidermal growth factor (EGFR) inhibitor cetuximab in combination with leucovorin and 5-fluorouracil for rectal cancer. Treatment of uremic pruritus with small doses of gebapentin (300 mg/day) led to complete regression of pruritus. Papulo-pustular rashes completely regressed after recommended systemic and topical therapy according to the severity of rush (doxycycline 100 mg 2 times a day for 5 days, cream with neomycin, natamycin and hydrocortisone 3 times a day for 7 days). Pruritus was absent during the next 6 months of follow-up. Antitumor therapy was not interrupted due to acneiform rush, and following supportive topical therapy allowed to control severity of exacerbations which did not exceed III grade according to CTCAE v 5.0 and did not require the addition of systemic therapy.
Thus, therapy of uremic pruritus with gabapentin has shown was effective also in a patient with severe comorbid pathology. Supportive topical therapy consistent with the severity of papulo-pustular rash reduced the severity of exacerbations during following EGFR inhibitor therapy.
尿毒症瘙痒是慢性肾脏疾病和终末期肾功能衰竭的常见症状。除身体不适外，尿毒症瘙痒会扰乱睡眠，对心理情绪状态和生活质量产生负面影响。在这组患者中，尿毒症瘙痒与任何原因引起的死亡率增加的关联得到了证实。同时，治疗尿毒症瘙痒没有标准化的方法。还有一类特殊的患者接受抗肿瘤治疗并出现皮肤不良事件，也可能伴有瘙痒。
本文报道一例尿毒症性瘙痒，患者对表皮生长因子(EGFR)抑制剂西妥昔单抗联合亚叶酸钙和5-氟尿嘧啶治疗直肠癌有丘疹-脓疱性皮肤反应(二级不良事件通用术语标准，CTCAE v 5.0)。小剂量(300mg /天)治疗尿毒症性瘙痒可使瘙痒完全消退。根据皮疹的严重程度，推荐全身和局部治疗丘疹-脓疱性皮疹后完全消退(强力霉素100 mg每天2次，持续5天，新霉素、纳他霉素和氢化可的松乳膏每天3次，持续7天)。在接下来的6个月的随访中没有瘙痒。抗肿瘤治疗没有因痤疮发作而中断，并且根据CTCAE v 5.0，支持局部治疗可以控制恶化的严重程度，不超过III级，不需要增加全身治疗。
因此，加巴喷丁治疗尿毒症性瘙痒对有严重合并症的患者也有效。支持局部治疗与丘疹-脓疱疹的严重程度一致，降低了EGFR抑制剂治疗后恶化的严重程度。
{"title":"A case of uremic pruritus and papulo-pustular rash associated with anti-EGFR therapy in a patient with rectal cancer and chronic kidney disease","authors":"Anna V. Michenko, Larisa S. Kruglova, Evgeniya A. Shatokhina, Andrey N. Lvov, Ekaterina M. Simenskaya, Dmitry V. Romanov, Inessa B. Kononenko, Anton V. Snegovoy","doi":"10.17816/dv340919","DOIUrl":"https://doi.org/10.17816/dv340919","url":null,"abstract":"Uremic pruritus is a common symptom in chronic kidney disease and end-stage renal failure. In addition to physical discomfort uremic pruritus disrupts sleep, negatively affects the psycho-emotional state and quality of life. In this group of patients, the association of uremic pruritus with an increase in mortality due to any causes was demonstrated. At the same time, there are no standardized approaches to the treatment of uremic itching. There is also a special category of patients receiving antitumor therapy and developing dermatological adverse events, also potentially accompanied by itching.
 This article presents a case of uremic pruritus in a patient with papulo-pustular cutaneous reaction (grade II on a Scale Common Terminology Criteria for Adverse Events, CTCAE v 5.0) to the epidermal growth factor (EGFR) inhibitor cetuximab in combination with leucovorin and 5-fluorouracil for rectal cancer. Treatment of uremic pruritus with small doses of gebapentin (300 mg/day) led to complete regression of pruritus. Papulo-pustular rashes completely regressed after recommended systemic and topical therapy according to the severity of rush (doxycycline 100 mg 2 times a day for 5 days, cream with neomycin, natamycin and hydrocortisone 3 times a day for 7 days). Pruritus was absent during the next 6 months of follow-up. Antitumor therapy was not interrupted due to acneiform rush, and following supportive topical therapy allowed to control severity of exacerbations which did not exceed III grade according to CTCAE v 5.0 and did not require the addition of systemic therapy.
 Thus, therapy of uremic pruritus with gabapentin has shown was effective also in a patient with severe comorbid pathology. Supportive topical therapy consistent with the severity of papulo-pustular rash reduced the severity of exacerbations during following EGFR inhibitor therapy.","PeriodicalId":487039,"journal":{"name":"Rossiiskii Zhurnal Kozhnykh i Venericheskikh Boleznei","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136363524","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}
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