[Improvement of rosacea treatment based on the morphological and functional features of the skin].

Rosacea - a widespread disease sometimes aleak with severe complications, mainly affecting the skin. Irrational and inadequate treatment leads to chronicity of diseases and psychosocial disadaptation of patients. Lately, a clear upward trend in the number of patients in whom in the process of complex treatment manifestations (with the varying degrees of severity) of impaired barrier function of the skin are observed and they need the protection and restoration of the damaged stratum corneum. In patients with rosacea in order to study the function of the facial skin's horny layer we used the skin analyzer BIA (bioimpedance analysis, which in duration of 6 seconds determines the moisture content, oiliness and the softness of the skin) and significant deviations from the norm (decrease in moisture content, fatness and increased roughness) was revealed. These changes were most clearly pronounced in patients with steroid rosacea. To restore the skin barrier the drug "Episofit A" (Laboratory of Evolutionary Dermatology, France) has been used (1-2 times a day for 6 weeks). Evaluation of treatment efficacy was conducted every 2 weeks by means of a scale from 0 to 5 for parameters of dryness, erythema, peeling and expression of subjective feelings. In accordance with received results, using of Episofit A emulsion, especially on the baсkground of long-term treatment with topical steroids, had a pronounced therapeutic effect. Thus, treatment of patients with consideration of morphological and functional features of facial skin, helps to improve the results traditional therapy, and the drug is highly effective means of the new direction in skin care - corneotherapy aimed to reconstruct and protect damaged stratum corneum.

[Perifolliculitis capitis abscedens et suffodiens (case report)].

Perifolliculitis capitis abscedens et suffodiens (PCAS) is rare chronic, suppurative and inflammatory scalp disease. Its aetiology and pathogenesis is not completely understood. The treatment is usually difficult and often disappointing. We report a case of 25-year-old male who presented with tender, fluctuant nodules and abscesses, with draining pus and patchy alopecia on his scalp for 3 years. A skin biopsy from scalp lesions revealed features that are characteristic of perifolliculitis. Initially, the patient was treated with periodic incision and drainage of the scalp abscesses. The answer was very poor. When admitted to our department, isotretinoin was started at daily dose of 30 mg, because initially his cholesterol and triglyceride levels were mildly increased. When dose was reduced to 10 mg the levels of cholesterol and triglyceride remained normal. A response to treatment was excellent and rapid. The treatment of PCAS represents usually difficulties and frustration for both the patient and the physician. A long course of isotretinoin can be considered as one of the most effective treatment for PCAS.

[Assessment of psoriatic nail lesions therapy by means of nail psoriasis severity index].

The problem of psoriatic nail lesions is known for a long time. According to various authors, psoriatic onychodystrophy has been diagnosed in 15-78% of patients with psoriasis. At the same time, we know that the treatment of psoriatic nail lesions is not always successful. The aim of the study was to evaluate the therapeutic efficacy of the drug onypso in the complex treatment of patients with psoriasis by means of NAPSI index. We observed 39 patients with psoriasis (20 men and 19 women at the age of 19 to 65 years with disease duration of 1 year to 25 years). The distribution of clinical manifestations of psoriatic onychodystrophy was as follow: thimble symptom -150 plates, subungual hyperkeratosis lesion type - 90 plates, onycholysis lesion type was observed in 50 plates. As a systemic treatment we used the cytostatic agent methotrexate - parenteral administration of 25 mg (once a week). In duration of total treatment course the patient received 90 -120 mg. Local treatment was provided by means of varnish onypso (once a day for 6 months). The survey revealed that at 7 weeks of treatment there was a 25 % reduction of initial value of NAPSI index, at the end of 14 weeks of therapy the above mentioned index was reduced for 50 % and at the 24 weeks for 75% respectively. It should be noted, that resolution of the cutaneous pathology was much faster than improvement of the structure of affected nail plates. Thus, drug onypso proposed for the specific treatment of nail lesions used in the complex therapy of patients with psoriasis is simple in use, accessible, compliant and highly effective. As a conclusion, we can say that NAPSI method, used to determine the extent of lesions and the effectiveness of the therapy, can objectively evaluate the dynamics of clinical pathology of the nails and adequacy of used treatment.

[The evaluation of nitrogen metabolism and the reactivity of the organism in patients with dry skin].

It is known that in norm horny layer of the epidermis is able to retain water due to the presence of hygroscopic substances inside corneocytes in the form of so-called natural moisturizing factors (NMF), consisting of free amino acids and their derivatives, which are formed during the decay of filaggrin as well as lactic acid, urea, sugars, and intercellular lipid membranes, creating a barrier that prevents transepidermal water loss. At the same time, the results of recent studies have shown that urea--a kind of natural antioxidant that protects tissues from the accumulation of aggressive forms of oxygen. It is able to stabilize the lysosomal membranes, thus preventing autolysis of cells. The ability of urea at low concentrations to modify the reactivity of functional groups of proteins leads to conformational changes of immunoglobulin, which has an inhibitory effect on the immune system, including the diminishing impact on the development of reaginic type reactions. Urea has anti-inflammatory, hyposensitizing, and antioxidant effect. Based on the above the aim of this study was to determine the content of urea and some indicators of cellular and humoral immunity in case of chronic dermatoses, accompanied by dryness of the skin. Indicators of nitrogen metabolism of blood serum (urea. ammonia), some parameters of cellular and humoral immunity were studied in 27 patients, who according to nosological units were distributed as follows: atopic dermatitis (12), psoriasis (7), xerosis (8). In the study of the concentration of urea in the blood, and some indicators of cellular immunity, as well as the content of immunoglobulin E in the blood of our patients a decrease in the number of T--lymphocytes, mainly due to T--suppressor and raising the level of immunoglobulin E have been revealed. Specific patterns of changes in these parameters, depending on nosological unit, severity of disease and degree of dryness of the skin have also been observed.

[Cryotherapy in treatment of skin demodecosis].

Demodecosis is wide spread chronic skin disorder caused by the mite - Demodex folliculorum. It frequently involves the mid facial region: nasolabial folder, the nose, the chin and eyes. The treatment depends on the severity of the inflammatory skin disorder and includes complex of oral and topical drug treatment. The aim of the study was to determine the efficiency of criotherapy in complex treatment of demodecosis. We have observed 38 patients of both sexes aged 19-54. The patients were divided into two groups - "A" and "B". Patients with erythematosquamose form of the disease were treated with Trichopol peros and oral antibiotics in case of inflammatory lesions. For topical treatment in group "A" Rosamet cream was used. In group "B" Rosamet cream and criotherapy were used. The results of our study have demonstrated effectiveness of criotherapy in combination with Rosamet cream. A significantly faster decrease of inflammatory lesions and reduce the erythema was observed in group "B". Therefore the usage of criotherapy with Rosamet cream is recommended to get quick therapeutic effect.

[Role of morpho-functional changes of blood lymphocytes in pathogenesis of psoriasis and the possibilities for their correction].

It is well known, that the cells of T-lymphoid population including Th2 lymphocytes of the skin, as well as circulating cells has the great importance in the pathogenesis of psoriasis. The goal of given research was to define the role of morpho-functional changes in blood lymphocytes in the pathogenesis of psoriasis and the possibilities for their correction. On the background of our investigation it could be concluded that in the case of the vulgar form of psoriasis in peripheral blood lymphocytes the intensified expression of p-53 preapoptotic protein results from affecting of NO induced damage of DNA molecule, in terms of intensification of oxidative stress in organism, which contributes to the activation of apoptosis of peripheral blood lymphocytes and is presented as one of the reasons which can cause the degradation of lymphocyte-induced apoptosis of keratinocytes. After the course of balneal therapy in "Nunisi" the decrease in expression of p-53 lymphocytes has been observed, big lymphocytes are predominant ones, with indications of synthetic activity of ultrastructure. This effect is conditioned by antioxidative characteristics of waters of "Nunisi" which assists to decreasing of the oxidative stress in patient's organism and recovers redox state of nitrogen oxide; it contributes to the intensification of keratinocytes apoptosis and to the prompt clearance of psoriatic lesion foci in epidermis.

[The role of the mycocenosis due to Candida albicans and the herpes simplex virus type II in urethritis and vulvovaginitis]. / Rol' mikrotsenoza, vyzvannogo Candida albicans i virusom prostogo gerpesa II tipa, pri uretritakh i vul'vovaginitakh.

Dissemination of mycocenosis induced by C. albicans and herpes simplex (type 2) virus and the role of this condition in the development of inflammatory diseases of the genitals were under study. Development of urogenital candidiasis in the presence of recurrent vesicular lichen simplex (RVLS) enhanced the intensity of RVLS recurrences and made them more frequent, augmenting the gravity of the clinical picture. Factors contributing to mycocenosis formation were defects of the cellular and humoral immunity systems, of interferon production, and changes in eukaryotic cell adsorption characteristics and reduction of neutrophilic fungicidal activity in RVLS patients.

[The effect of nizoral and tinidazole on neutrophilic phagocytic activity in patients with rubromycosis and candidiasis]. / Vliianie nizorala i tinidazola na fagotsitarnuiu aktivnost' neitrofilov bol'nykh rubromikozom i kandidozom.

Nisoral and tinidasole effects on Trichophyton rubrum and Candida albicans ability to be destroyed by neutrophils were under study, as were the characteristics of neutrophil phagocytic activity in patients with various forms of trichophytosis and candidiasis over the course of nisoral or tinidasole therapy or combined therapy with both the drugs. Tinidasole and more so nisoral were found to enhance neutrophilic fungicidal activity towards Tr. rubrum and C. albicans. Combined therapy with nisoral and tinidasole distinctly augmented the counts of Ns-RFC and Nc-RFC and increased the values of the phagocytic index and the phagocytic number. Combined administration of the drugs was conducive to elevation of the neutrophilic ability to destroy the fundal elements.

[Electron microscopic study of the interaction of human neutrophils and mononuclear cells with Trichophyton rubrum]. / Elektronno-mikroskopicheskoe izuchenie vzaimodeistviia neitrofilov i mononuklearnykh kletok cheloveka s Trichophyton rubrum.

Effector action of the neutrophils and mononuclear cells on Tr. rubrum has been revealed by electron microscopy. Destruction of Tr. rubrum by effector cells may be both extracellular--via the formation of a cooperative phagosome and solid contacts (mostly in interactions of effector cells with hyphae) and intracellular (phagocytosis of the spores). Platelets have been found to contribute to effector cell cooperation in interaction with Tr. rubrum.

[Electron microscopic analysis of the effect of Trichophyton rubrum on the reproduction of the human immunodeficiency virus]. / Elektronno-mikroskopicheskii analiz vliianiia Trichophyton rubrum na reproduktsiiu virusa immunodefitsita cheloveka.

The authors have examined the effect of a Tr. rubrum infection on HIV reproduction in H9 cell culture. A statistically significant activation on HIV multiplication has been observed 24 hrs after cell culture infection with the fungus: the infected cells produced more viral particles than the reference cells. The number of HIV virions has been increased mainly at the sites of Tr. rubrum localization and near H9 cell sites containing phagocytized elements of the fungus. In case of a mixed infection abnormal HIV forms (minimal and giant ones) have been detected along with the common virions. The ability of HIV virions to adsorption on Tr. rubrum surface has been revealed.