Course Of Dermatosis Research Articles

Потенциальные фармакологические эффекты продуктов фотоокисления псоралена и их циклоаддуктов с аминотиолами: хемоинформационный анализ

Psoralens are medicinal photosensitizing furocoumarins which are used in photochemotherapy and photoimmunotherapy of dermatoses. Psoralen photooxidation products may be involved in therapeutic effects, but the possible mechanisms of their action remain unclear. The study was aimed to assess the prospective pharmacological effects and mechanisms of activity for six previously identified ortho–hydroxyformyl-containing psoralen photooxidation products and their cycloadducts with aminothiols, as well as for structurally similar compounds (furocoumaric acid and tucaresol). Chemoinformatic analysis of the prospective pharmacological effects and mechanisms of action of these compounds was performed using the PASS and PharmaExpert software. The predicted pharmacological effects partially confirmed by previous studies highlight the possible involvement of psoralen photooxidation products in the effects of PUVA therapy or photopheresis during the course of dermatoses and proliferative disorders treatment. A broad spectrum of pharmacological effects found for furocoumaric acid and cycloadducts of coumarinic and benzofuranic photoproducts of psoralen with cysteine and homocysteine appoints new directions of research relating to therapeutic use of psoralens.

Optimization of modern complex treatment of microsporia in athletes taking into account the clinical course of dermatosis

Objective — to optimize the modern complex treatment of patients with microsporia with regard to the clinical course of dermatosis by the use of systemic antifungals of griseofulvin in combination with the drug Antral and terbinafine depending on the localization of the pathological process, antifungal agent 2 % sertaconazole nitrate cream Zalain, probiotic-vitamin-mineral complexes Bion 3 Kid and Bion 3. Materials and methods. There were 55 patients under observation: 22 — with microsporia of the scalp, 14 — with microsporia of the scalp and smooth skin, 19 — with microsporia of the smooth skin. All patients were divided into two groups. Patients of group 1 were given griseofulvin in tablets in combination with Antral. Patients of group 2 were prescribed terbinafine depending on body weight. Systemic therapy was combined with external treatment with 2 % sertaconazole nitrate cream Zalain. Duration of treatment ranged from 1 to 5 weeks. 25 patients were prescribed the original probiotic-vitamin-mineral complexes Bion 3 Kid and Bion 3 depending on age. Duration of treatment ranged from 1 to 3 weeks.Results and discussion. As a result of treatment, clinical and etiological recovery was achieved in all 55 patients with microsporia. Duration of treatment ranged from 1 to 5 weeks. Introduction of the original probiotic-vitamin-mineral complexes Bion 3 Kid and Bion 3 to the complex treatment of microspore made it possible to increase the effectiveness and improve the results of treatment, reduce its duration by 1—2 weeks, prevent relapse of the disease and development of concomitant colds during and after treatment. Тhere was good tolerability of drugs without changes in indicators of general and biochemical blood and urine tests.Conclusions. Complex treatment with systemic antifungal drug griseofulvin in combination with Antral and 2 % sertaconazole nitrate cream Zalain is effective and safe in treating microsporia of the scalp and smooth skin. Complex treatment with systemic antifungal drug terbinafine and 2 % sertaconazole nitrate cream Zalain is effective and safe in children and adults with microsporia of smooth skin. The inclusion of probiotic-vitamin-mineral complexes Bion 3 Kid and Bion 3 in combination with systemic antimycotic agents griseofulvin and terbinafine as also antifungal agent 2 % cream sertaconazole nitrate Zalain in the complex of treatment of patients with microspore contributed to an increase in the effectiveness of treatment, acceleration of clinical and mycological recovery, prevention of recurrence of the disease and prophylaxis of acute respiratory viral infections.

Porokeratosis: clinical manifestations and treatment options

Porokeratosis is a rare disease with an autosomal dominant type of inheritance. It is customary to distinguish classic Mibelli porokeratosis, as well as disseminated and localized variations of the course of dermatosis, which differ in genetic predisposition, trigger factors, and treatment approaches. The article describes the variants of the disease – eruptive itchy papular malformation that occurs on the extremities against the background of microcirculation disorders and giant, developed on the skin of the trunk. The main methods of treatment of porokeratosis are also described.

Atopic dermatitis: evaluation of the influence of physiotherapy on the barrier function of the skin and the severity of the course of dermatosis in children

The article presents data on the dynamics of indicators reflecting the barrier function of the skin: pH-metry, TEWA-metry and corneometry, under the infl uence of physiological factors. It was shown that under the influence of polarized light, laser radiation and hydrotherapy, in combination with drug treatment, the maximum decrease in the Scorad index is determined by 4,5 times. Moreover, each of the applied factors had a positive effect.

FEATURES OF THE CLINICAL COURSE OF PSORIASIS IN PATIENTS WITH OBESITY

Psoriasis is the most common chronic, genetically determined autoimmune polyetiological inflammatory disease with impaired epidermal proliferation, provoked by exogenous and endogenous factors, and manifested by erythematous and scaly elements, papules and plaques. According to the results of clinical and epidemiological studies, psoriasis affects about 3-4% of the population of our planet, regardless of gender, age, and ethnic group, and the specific gravity of this pathology in the general structure of skin diseases reaches, from the data of different authors, from 1% to 40 %. However, despite the significant incidence of psoriasis and a large amount of research on this problem, there is still no single view of the pathogenesis of this dermatosis. For an objective understanding of the pathogenesis of psoriasis, it is necessary to take into account the insufficiently studied comorbidity of this pathology. Therefore, in the studies of the pathogenesis of psoriasis in recent years, more attention is paid to the impairment of metabolic processes. Recently, an indisputable link between psoriasis and obesity has been proven. Obesity has been found to increase the risk of many diseases, including psoriasis. The literature has broadly highlighted the question of the pathogenetic mechanisms of inflammatory processes in psoriasis and obesity that form a vicious circle at the level of the immune system, which must be broken for the successful treatment of these diseases. In this research, we studied the clinical presentation of the disease, measured anthropometric parameters, determined the grade of obesity by BMI, analyzed the history of life and disease, and conducted clinical and biochemical blood tests. The results of the study revealed that alimentary obesity in patients with psoriasis leads to metabolic disorders, complicating the course of dermatosis, which leads to a worsening of the DLQI of patients, the inefficiency of standard methods of therapy and frequent exacerbations of psoriatic disease. Therefore, the prospect for further research is a more in-depth study of the comorbidity of psoriatic disease, which will identify new targets for the treatment of this dermatosis to prevent complications and more effective treatment of this pathology.

Синдромологічні аспекти розацеа

The objective: to clarify the clinical syndromological manifestations of the skin and other body systems in women of reproductive age, patients with rosacea. Materials and methods: clinical and laboratory examination of 52 women of reproductive age (from 18 to 35 years old), patients with rosacea. All patients consulted with a gynecologist, endocrinologist, neuropathologist. Results and its discussion. A clear connection was found between the exacerbation of the course of dermatosis and disorders of the hypothalamic-pituitary-gonadal system in 59.6% of the examined women with rosacea, in particular, with menstrual irregularities in 15 of them (40.4%). These changes were mainly of a syndromic nature, and on the skin manifested mainly in the form of hirsutism, hyperpigmentation, atrophic striae, follicular hyperkeratosis, male alopecia. Separate skin manifestations typical of rosacea have a need to differentiate also with more than 20 other syndromes, in which there is a rash or cosmetic changes on the skin, dysendocrinia or vegetative-vascular disorders. Both for rosacea and for syndromes with rosacea-like changes, peptide signaling molecules of various classes (neuropeptides, prostaglandins, kinins, etc.) play an important role in pathogenesis, and the identification of changes in the content of these biologically active compounds in patients requires an adjustment to the complex therapy of patients. Conclusions. In women with rosacea, the current features of the course of the disease are its appearance at an earlier age and the combination of dermatosis with certain syndromes (mainly associated with disorders of the hypothalamic-pituitary-gonadal system), which requires further study of the role of peptide signaling compounds in the pathogenesis of dermatosis as modulators of it regulatory activities and factors that may determine the clinical signs of the disease and rosacea-like manifestations in various syndromes.

Comprehensive treatment of rosacea patients taking into account the indicators of inflammatory mediators and the state of prooxidant-antioxidant homeostasis

Objective - increasing the effectiveness of treatment of patients with rosacea, taking into account changes in the indicators of inflammatory mediators, the state of proox­idant-antioxidant homeostasis and the clinical course of dermatosis by developing complex differentiated therapy using anti-inflammatory and antioxidant drugs.
 Material and methods. Under the supervision were 112 patients with rosacea (73 women, 39 men) aged 26 to 67 years. In patients with rosacea, the parameters of prooxidant­antioxidant homeostasis and inflammatory mediators (individual cytokines) were determined before and after standard treatment (comparative group) and the developed complex treatment using anti-inflammatory and antioxidant drugs (main group) according to known methods.
 Results. A significant increase in the activity of the processes of free radical oxidation of lipid and protein structures with the formation of oxidative stress and the state of endogenous intoxication was established in patients with rosacea, and their connection with the clinical course of dermatosis was proved. Significant growth in the serum of proinflammatory cytokines (interleukins - 8, 17A and 18) was investigated in patients with rosacea and their relationship with the clinical form of dermatosis was determined.The correlation between indicators of oxidative stress and the level of proinflammatory cytokines in patients with rosacea was found. An improved method of complex treatment of rosacea patients with combined and differentiated use of anti-inflammatory and antioxidant drugs has been developed.
 Conclusions. The developed complex treatment of rosacea patients with combined and differentiated use against the background of standard therapy of antihistamines with anti-inflammatory activity of fast (containing bilastine) and prolonged action (ketotifen fumarate) and antioxidant drug ethylmethylhydroxypyridine succinate significantly improves both the immediate and long-term clinical results of treatment of such patients.

The state of prooxidant-antioxidant homeostasis and immune status in patients with lichen planus and its correction

Objective - increasihg the effectiveness of treatment for patients with lichen planus by developing an improved tactic of complex differential therapy, taking into account changes in the parameters of prooxidant-antioxidant homeostasis, immune status of the organism and clinical manifestations of dermatosis.
 Material and methods. Under the supervision were 124 patients with lichen planus (85 women, 39 men) aged 24 to 67 years. In patients with lichen planus, the parameters of prooxidant-antioxidant homeostasis and immune status were determined before and after standard treatment (I comparative group - 42 patients), standard treatment with the inclusion of quercetin preparation (II comparative group - 41 patients) and the developed complex treatment using quercetin, polyenzyme preparation and low-intensity laser therapy with antioxidant and anti-inflammatory effects (III - main group - 41 patients) by known methods.
 Results. The modern tendencies of morbidity and clinical features of the course of lichen ruber planus have been investigated. A significant increase in patients with lichen ruber planus activity of the processes of free radical oxidation of lipid and protein structures with the formation of oxidative stress and the state of endogenous intoxication were established. Changes in phagocytosis, increase in serum levels of circulating immune complexes and certain proinflammatory cytokines were defined in patients with lichen ruber planus, their dependence on the nature of the clinical course of dermatosis was determined. An improved method of complex treatment of lichen ruber planus with the use of quercetin, a polyenzyme medication and low-intensity laser therapy with antioxidant and anti­inflammatory action has been developed.
 Conclusions. The developed advanced complex treatment of lichen planus patients with combined and differentiated use and the background of standard therapy for quercetin, a polyenzyme preparation, and low-intensity laser therapy with antioxidant and anti-inflammatory effects contributes to the normalization of prooxidant-antioxidant homeostasis, phagocytosis, circulating immune complexes of cytosets and studied pro-inflammatory direction, and also likely to improve short- and long-term clinical outcomes of therapy for such patients.

Comprehensive treatment of acne patients with gastroduodenal pathology and manifest herpesvirus infection

Objective -increasing the efficiency of treatment of acne patients by using anti-Helicobacter, antiviral and immunotropic drugs in their complex therapy, taking into account the clinical features of dermatosis, identifying concomitant H. pylori diseases and associated mani­festations of herpes simplex type I and II and individual indicators of systemic immunity. Material and methods. 134 acne patients aged 18 to 30 years, among which 74 women and 60 men, were under the supervision. In patients with acne, the presence of concomitant H. pylori and manifest herpes virus infection, as well as individual immunological parameters by known methods, were in­vestigated. Results. We have established the incidence of concomitant H. pylori and herpes manifest infection, their effect on the clinical course of dermatosis, quality of life and immune status of patients and, based on this, we worked out measures to improve their comprehen­sive treatment by means of anti-Helicobacter (amoxi­cillin, clarithromycin), antivirus (inosine pranobex) and immunotropic (thymalin) drugs that improve significantly immediate and long-term results of acne treatment in these patients. Conclusions. The developed improved methods for the treatment of acne patients, taking into account the presence of concomitant H. pylori - associ­ated diseases and manifest forms of herpes virus infec­tion, changes in systemic immunity and the clinical fea­tures of dermatosis, can improve both the immediate and long-term results of acne treatment, which is confirmed by the reliable positive dynamics of the studied clinical and laboratory indicators.

State of pituitary­thyroid system in patients with acne from iodine deficiency region

Objective — to determine and analyze the state of pituitary-thyroid system in patients with acne disease (AD) who live in the region with natural iodine deficiency.Materials and methods. We have examined 114 patients with acne (66 males and 48 females) aged from 19 to 25 years — residents of Chernivtsi region which is a biogeochemical region with natural iodine deficiency. 28 (24.5 %) of them had a mild course of acne disease, 67 (58.8 %) — acne disease of moderate severity and 19 (16.7 %) — severe clinical course of dermatosis. To assess the state of pituitary-thyroid system using enzyme immunoassay, patients underwent an ultrasound examination of the thyroid gland and had the levels of thyroid-stimulating hormone (TSH) and free thyroxine and triiodothyronine fractions in the blood serum assessed.Results and discussion. In 76 (66.7 %) of the 114 examined patients, permanently residing in the region with natural iodine deficiency, disorders of the pituitary-thyroid system were revealed, which are manifested by changes in the echo structure of the thyroid gland (symptoms of diffuse goiter I and II degree — in 30.7 %, thyroiditis — in 7.9 %, nodular goiter — in 6.1 %, thyroid hypoplasia — in 5.3 %) and/or multidirectional changes in the content of thyroid hormones and TSH in the serum with signs of euthyroidism (in 60.5 %), hyperthyroidism of glands (23.7 %) and hypothyroidism (15.8 %) with predominantly latent or subclinical course of thyroid disease. Changes in the pituitary-thyroid system are significantly more often recorded in patients with moderate and severe clinical course of AD. They are accompanied by more frequent exacerbations of dermatosis. The results of the research prove the feasibility of a comprehensive examination with the use of an ultrasound study of the thyroid gland and determination of serum thyroid hormones and TSH in order to detect thyroid pathology and make differentiated prescription within the complex therapy aimed at normalization of the state of pituitary-thyroid system of patients with AD who live in iodine-deficient regions.Conclusions. The majority (66.7 %) of patients with AD who live in natural iodine deficiency environment revealed violations of the pituitary-thyroid system, manifested by changes in the echo structure of the thyroid gland and the content of thyroid hormones and TSH in blood serum, which are more often recorded in patients with moderate and severe clinical course. If patients live in the region with natural iodine deficiency it is expedient to examine their state of the pituitary-thyroid system and include the means for differentiated correction of the identified thyroid pathology in their complex therapy.

CLINICAL AND METABOLIC ANALYSIS OF DISORDERS IN PSORIATIC PATIENTS

Introduction: Elucidation of the primary nature of biochemical shifts in psoriatic disease and prediction of interconnected subsequent changes in metabolic and inflammatory processes are important in foreseeing the dynamic development of pathological process and the choice of individual treatment. The aim of the research was to assess the disorders and correlations between main indicators of protein, fat, hydrocarbon and pigment metabolism and specifics of inflammatory processes in psoriatic patients against the clinical course of dermatosis. Materials and methods: We analysed the results of clinical and laboratory examinations conducted in 62 psoriatic patients. All these patients have been analysed as per their age,sex, prevalence and the type of skin rash as well as per the clinical disease form. Biochemical examinations were conducted using appropriate sets of reagents. To establish the possible correlation between the indicators of biochemical blood analysis, we calculated the correlation coefficient, which determines the nature of correlation between the studied variables. Results: The analysis of results received upon examining psoriatic patients indicated that microbial-viral associations, stress factors and genetic predisposition were the most frequent trigger factors of psoriatic disease, which corresponds to the data from literary sources. We detected that the duration of psoriaric disease up to 5 years was the most common, and relapses were manifested in its limited form against the background of the disease advanced stage; the prevalent psoriasis was more common at the hospital stage. Our study justifies that metabolic changes occurred in the overwhelming majority of examined patients of different age groups. At that, abnormalities of a number of indicators of protein, lipid, hydrocarbon and enzyme metabolism have been established. In addition, the expressiveness of corresponding changes correlated with the prevalence of skin psoriatic process and the duration of dermatosis course as well as the presence of pathology of a number of internal organs, in particular of gastrointestinal tract, hepatobiliary and cardiovascular systems, that suggest the presence of systemic disorders at psoriasis. Conclusions: The identification of independent mechanisms existing between some changes in metabolic process parameters in psoriasis has a theoretical and practical significance in dermatology, which involves the use of medications to regulate the detected disorders, the possibility to restore correlations, and it will inevitably contribute to the achievement of clinical and preventive effect.

Modern view on treatment of microsporia of children, taking into account the etiology, pathogenesis and features of clinical course of dermatosis

Objective — to analyze publications and summarize literature data on the optimization of the treatment of microsporia of children, taking into account the etiology, pathogenesis and features of the clinical course of dermatosis. Materials and methods. Based on a retrospective analysis of scientific sources and the results of our own research, information on the treatment of microsporia in children is systematized, taking into account the etiology, pathogenesis and features of the clinical course of dermatosis. Results and discussion. Mycotic skin lesions occupy one of the leading places in the structure of dermatovenerological diseases. The high prevalence of fungal infections shows that 20—25 % of the world’s population has skin mycoses, making them one of the most common forms of infection. An important role in the pathogenesis of microsporia is played by various changes in the immune status, the expression of which determine the clinical course of mycosis, its prediction and the choice of rational therapy. Conclusions. At present, complex treatment with the use of systemic antimycotic terbinafine and 2 % sertaconazole nitrate cream is considered effective and safe for microsporia of smooth skin with predominant lesion of vellus hair. Systemic antimycotic grisofulvin combined with the original drug antral proved to be effective and safe in the treatment of microsporia of the scalp in children and adults. Introduction of the probiotic-vitamin-mineral complex Bion 3 Kid in combination with systemic antimycotics griseofulvin, terbinafine and 2 % sertaconazole nitrate cream into the complex of treatment of microsporia contributed to increasing effectiveness of treatment, accelerating clinical and mycological recovery, preventing recurrence of the disease and the occurrence of concurrent cold-related diseases.

Quality of life in acne patients with Demodex folliculorum and Demodex brevis mites in areas of affected skin

Objective — to compare the quality of life in acne patients with and without detected Demodex folliculorum and Demodex brevis in affected skin. Materials and methods. We studied 105 patients with acne for the presence of demodex mites. All of them were examined for the presence of Demodex folliculorum and Demodex brevis . In addition, all patients completed «Dermatology Life Quality Index» and «Cardiff Acne Disability Index» questionnaires. Results and discussion. In 19 (18.10 %) of 105 patients with acne, Demodex folliculorum and Demodex brevis mites were found in the affected areas of the facial skin. At the time of filling out the questionnaire, they characterized their skin as itchy, sensitive, painful or stinging compared to patients in whom demodex mites were not detected. 7 (6.67 %) patients had demodex mites in the past. All of them were treated with various systemic and local acaricidal drugs. This indicates the advisability of examining acne patients with pronounced subjective complaints for the presence of Demodex folliculorum and Demodex brevis mites at the sites of rash, as well as conducting individualized acaricidal treatment. Conclusions. The presence of Demodex folliculorum and Demodex brevis in patients with acne in affected areas of the facial skin influences the severity of the clinical course of dermatosis, in particular, reinforces subjective complaints, which has a negative impact on the quality of life of patients.

Comparative analysis of prooxidant and antioxidant homeostasis rates in patients suffering from rosacea with different clinical course of dermatosis

Objective is to determine and analyse prooxidant and antioxidant homeostasis rates in patients suffering from rosacea with different clinical course of dermatosis. Material and methods. The study involved 67 patients with rosacea (51 women and 16 men) aged 27 to 64 years of whom 24 individuals were diagnosed with erythematous-telangiectastic and 43 patients with papulo-pustular stage (form) of rosacea. In 21 patients dermatosis lasted up to 6 months, in 23 individuals – from 6 to 12 months and in 22 of them – for more than a year. The condition of the prooxidant blood system was evaluated by the content of malonic aldehyde (MA) in plasma and in red blood cells and of medium mass molecules (МMМ Е254 and МMМ Е280) – in the serum, while that of the antioxidant system- by the reduced glutathione (RG) rate and by the catalase activity (CA) in blood hemolysate and of ceruloplasmin (CP) in the serum according to the known methods. Results. The patients with rosacea had a reliable increase in MA content in the plasm and in red cells (by 53,3 % and 23,9 % respectively, p 0,05) as well as a decrease in the RG content in red cells (by 20,9 %, p<0,001). The patients with papulo-pustular stage (form) of dermatosis experienced more significant changes in these rates compared to those with erythematous-telangiectastic stage (form) of rosacea as well as in case when dermatosis lasts for more than half a year. Conclusion. The patients with rosacea experienced reliable changes in the rates of prooxidant and antioxidant homeostasis, which is indicative of an increase in the intensity of processes of free radical oxidation of lipid structures and development of the state of endogenous intoxication against the background of an intensity and a decrease in the activity of antioxidant protection factors, which are more significant in patients with papulo-pustular stage (form) of dermatosis and a duration of the disease for more than half a year, which substantiates the differentiated administration of ntioxidants in the comprehensive therapy of such patients.

THE SIGNIFICANCE OF LIPID METABOLISM DISORDERS IN THE BLOOD AND SKIN OF PATIENTS WITH PSORIASIS IN THE PATHOGENESIS OF DERMATOSIS

Summary. The etiology of psoriasis continues to remain unsettled, and issues of the pathogenesis of this dermatosis are also not fully resolved. The analysis of lipid metabolism disorders in the blood and skin of patients with psoriasis, established at the present stage, indicates their importance in the pathogenesis of this dermatosis. At the same time, taking into account the wave-like recurrent course of psoriasis and the existence of autumn-winter, spring-summer and offseason (mixed) types of dermatosis, there remain unsolved questions of the influence of the features of lipid spectrum indexes in the body of psoriasis patients in the development of clinical exacerbations of dermatosis in different seasons of the year. Uncertainty is also the possibility of a correlation relationship between the degree and nature of imbalance in the level of the lipid spectrum in the blood and skin of patients with psoriasis with the severity of the clinical course of dermatosis. Further in-depth study of lipid metabolism in the body of patients with psoriasis involving new immunopathohistochemical techniques will contribute to the development of an improved complex individualized therapy and broadening the understanding of the pathogenesis of this dermatosis.

EXPERIENCE OF THE LONG-TERM USE OF ANTICYTOKINE THERAPY IN PSORIASIS

Increasing the effectiveness of treatment and restoring the quality of life in patients with moderate to severe and severe forms of psoriasis is one of the most important trends in modern dermatology. The appearance of biological products in the late XXth century opened new opportunities in the treatment and control of the course of the disease in patients suffering from moderate and severe forms of psoriasis. Conducting maintenance system treatment with biological products reduces the severity of course of dermatosis, and in some cases prevents the occurrence of disease relapses. Despite the increasing popularity of anti-cytokine drugs, there are difficulties in the treatment of choice of the therapy in some cases. Among the main reasons for the lack of response to ongoing biological therapy are the genetic characteristics of the patient and the immunogenicity of the drugs. Failures in the use of biological therapy can also result a low concentration of the drug before the next administered dose. It has been proven that the combined use of methotrexate and infliximab inhibits the development of anti-drug antibodies that are associated with the development of a low therapeutic response. The article describes the clinical observation of a patient suffering for 20 years from a severe form of psoriasis and psoriatic arthritis. The experience of long-term (about 10 years) prescription of the biological preparation infliximab with sufficient clinical response without additional use of methotrexate is shown. The results of successful combined therapy of psoriatic erythroderma and psoriatic arthritis with infliximab and acitretin in order to reduce the immunogenicity of the tumor necrosis factor α blocker and avoid the ”escape” effect are described. The data of restoration of a good therapeutic response to systemic biological therapy with infliximab after administration of acitretin are presented.

858 Analysis of the Incidence of Giardiasis in Children with Atopic Dermatitis

Atopic dermatitis holds the first place among children’s allergic diseases. One of its proven ethiopathogenetic factors is parasitosis, affecting the course of dermatoses and leading to frequent recurrences and chronization...

Role of the Helicobacter pylori as a trigger factor in the development of rosacea and effect of its eradication on the course of dermatosis

The authors conducted an analysis of diseases of the gastrointestinal tract, a study of morphology and functional activity of the mucous coat of different stomach sections, determination of H. pylori, determination of the cytokine profile (anti-inflammatory cytokines) in 55 patients with different forms of rosacea vs. 20 healthy volunteers and 55 patients from the risk group consulted or treated by a gastroenterologist because of gastrointestinal disorders but without any manifestations of dermatosis. Moreover, the authors evaluated the effect of the eradication of H. pylori on the course of the disease and cytokine profile of the immune response in patients suffering from rosacea. It was shown that the group of patients with rosacea have much fewer cases of stomach diseases (gastritis, gastroduodenitis, ulcer) than the group of patients with an increased risk of the development of these diseases. On the contrary, patients with rosacea have more cases of H. pylori (83%) than the group of healthy volunteers (20%) and group of patients with stomach diseases (47%) though the bacterial load is lower (I—II vs. III—IV in the risk group). Indices of the cytokine profile demonstrate that patients with rosacea form an immune response based on the mixed Th1/Th2 response type. This results in the microbial persistence, chronic inflammation and possible autoimmune reactions lasting even after the eradication of H. pylori and improvement of the clinical picture of the disease, which possibly explains the chronic course of the disease and development of recurrences.

Role of correction of metabolic disorders in the complex therapy of acne in women

The prevalence and genetic origin of acne explain the urgency of searching for new dermatosis treatment methods. The occurrence of acne in women is stipulated by hyperandrogynous conditions and is often accompanied with insulin resistance. The administration of Metformin in the complex therapy of acne in women with insulin resistance contributes to considerable improvement of the clinical course of dermatosis and achievement of remission for a greater number of patients.

Effects of Various Modes of Administration of Pyribenzamine on the Histamine Wheal and Epidermal Sensitivity Reactions

An extensive literature has developed relating the effects of the various antihistamine drugs on the course of dermatoses thought to be based on the mechanism of allergy. Their oral, as well as parenteral administration, has had definite therapeutic effects on those skin eruptions which, like urticaria, have an element of whealing in their pathology (1—7). In dermatoses with mainly epidermal pathology, both allergic and non-allergic in nature, the effects of the antihistamine drugs have varied with the mode of administration. The pruritic element seems to be the factor chiefly affected where beneficial therapeutic results were obtained (8—10). With the introduction of ointments containing histamine antagonists, further evaluation of their therapeutic action has been made in many dermatoses (11—15). The pharmacology of the antipruritic effect of the antihistamine drugs is as yet little understood. There is the possibility, however, that in these topical applications the ointments act only partly in a manner similar to a local anesthetic. That is well demonstrated in the experiments of Mayer (15) and Aaron, Peck and Abramson (16). The therapeutic results with topical application of antihistamine drugs in the form of ointments have varied widely not only in skin eruptions of differing pathology, but in different patients with the same skin disease or even in the same patient at different stages of the eruption. Naturally, the question of absorption of the antihistaminic substance through the skin comes into the foreground in such instances. In this study, we have attempted to evaluate the effects on histamine whealing and allergic epidermal reactions of the administration of Pyribenzamine by oral and parenteral administration, as well as by iontophoresis and the application of Pyribenzamine ointment. Quantitative excretion studies of Pyribenzamine after topical application were made in an attempt to correlate the clinical action of this drug administered in this way with the question of absorption through the skin. The results of these experiments also explain the variability in antipruritic as well as other effects with ointments containing Pyribenzamine.