ABSTRACT
The article presents a description of a clinical case of necrobiosis lipoidica complicated by ulcera-tion in a 55-year-old woman and a brief review of the literature on the topic of modern ideas about necrobiosis lipoidica. The disease manifested itself in 2005 after traumatization of the upper third of both shins as a result of a fall. The patient did visit a dermatologist office for medical help, there was a slow progression of the disease. In 2017, as a result of visiting a dermatologist office at her place of residence, she was diagnosed with necrobiosis lipoidica. The ongoing therapy with vasodi-lators and topical steroids did not lead to significant improvement. In 2021, against the background of vaccination against COVID-19 (22.07.20201 and 12.08.2021 Gam-COVID-Vac- Sputnik V) the patient notes a sharp deterioration of the process after the injection of the second component of the vaccine there were an increased in the area of lesion, ulceration. No data for diabetes mellitus were obtained during the examination. There is a history of a multi-nodular non-toxic goiter, for which a complete resection of the left lobe of the thyroid gland was performed in 1995 and a partial resection of the right lobe of the thyroid gland in 2003. The patient has been receiving L-Thyroxine replacement therapy since 2003. A biopsy of the affected skin was per-formed. The final diagnosis: necrobiosis lipoidica erythematous-ulcerative variant was established according to the pathoanatom-ic examination of the biopsy and atypical clinical picture. As a result of the therapy, the patient was discharged from the clinic with improvement. © 2023 Authors. All rights reserved.
ABSTRACT
Background. Patients with hand eczema account for 30–40% of dermatological patients. With the pandemic of new coronavirus infection COVID-19 and the need for frequent antiseptics use, there has been a steady increase in hand eczema incidence. The dominant symptoms in exacerbating eczema are skin inflammation and itching, which requires effective and safe skincare that is effective and safe. Objective. To evaluate the efficacy of the therapy with synthetic tannin and polidocanol-based agents and modern emollients, the time of resolution and degree of severity of clinical symptoms of eczema in patients, as well as the time and duration of remission, safety and compliance with sodium hypochlorite hand antiseptic spray. Materials and methods. Thirty-four patients with exacerbation of hand eczema were examined. The study was conducted in two stages. At the stage 1, before the remission, the patients received synthetic tannin and polidocanol-based agents and modern emollients;at the stage 2, monotherapy with modern emollients was used. Patients used sodium hypochlorite spray as a hand sanitizer throughout the study period. Results. The NESCI score became zero in 33 (96%) patients after the complex treatment of hand eczema. The Dermatology Life Quality Index by the end of stage 2 decreased 6-fold compared to the beginning of the study. No exacerbation of the dermatosis was observed in any of the patients included in the study during the use of sodium hypochlorite hand spray. Conclusion. The complex therapy with synthetic tannin, polidocanol-based agents, and modern emollients in hand eczema helps to achieve stable medical remission, decreases the itching intensity, and improves the patients’ quality of life. The use of new hand sanitizers during the pandemic in patients with hand eczema did not result in dermatosis exacerbations.