Представлено клиническое наблюдение субкорнеального пустулезного дерматоза у женщины 27 лет. Дана историческая справка, освещены современные представления об этиологии, патогенезе, клинической картине, лечении, а также о дифференциальной диагностике редкого дерматоза-болезни Снеддона-Уилкинсона. Представлены результаты гистологического исследования биоптата, выявившие образование субкорнеальных пустул, содержащих нейтрофилы, лимфоциты и фибрин. Дно пустул образовано зернистым слоем. В верхних отделах дермыотек, периваскулярная инфильтрация, представленная лимфоцитами, гистиоцитами, небольшим количеством нейтрофилов, проникающих в эпидермис. Иммунофлюоресцентное исследование не выявило антитела класса IgA против клеток эпидермиса. Показано, что комплексное лечение заболевания препаратами диаминодифенилсульфонового ряда и топическими кортикостероидными препаратами привело к регрессу процесса на коже. Ключевую роль в постановке правильного диагноза играет современное гистопатологическое и иммунофлюоресцентное исследование (прямой и непрямой метод) с целью обнаружения антител класса IgA, направленных против клеток эпидермиса. Ключевые слова: субкорнеальный пустулезный дерматоз, препараты диаминодифенилсульфонового ряда, болезнь Снеддона-Уилкинсона, патоморфология, иммунофлюоресцентное исследование, лечение.

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Introduction. Improving organizational approaches to the provision of specialized, including high-tech medical care to patients with psoriasis remains one of the main problems of dermatology. Purpose of research. To research the trends in the dynamics of general and primary incidence of psoriasis and to assess the need of the adult population of St. Petersburg in specialized, including high-tech, medical care. Material and methods. The indicators of primary and total morbidity of diseases of the skin and subcutaneous tissue of children and adults in St. Petersburg for 5 years (2013-2017) were researched. The analysis of statistical indicators of the activity of the dermatological department of the Kashkin Research Institute of Medical Mycology (2013-2017) was carried. Results. Over the past 5 years, the total morbility level of diseases of the skin and subcutaneous tissue has increased by 15.1%, and the primary morbility level - by 13.5%. Herewith the total morbility level of psoriasis increased by 9.4%, and that of primary level increased by 31.6%. The highest growth rates of total (by 12.7%) and primary incidence (by 35.5%) were observed in the group of persons over 18 years of age. In the structure of hospitalization in the dermatology department Kashkin Research Institute of Medical Mycology, the proportion of patients with psoriasis was 55.4%. Of these, 35.1% received high-tech medical care. The majority of patients who received high-tech medical care were residents of St. Petersburg (77.0%). Discussion. Indicators of General and primary incidence of psoriasis for 2013-2017 show an unfavorable forecast towards its growth in St. Petersburg over the next years. In the structure of hospitalizations in the dermatological Department, the proportion of patients with psoriasis was 55.4%. Of all those hospitalized for psoriasis, 35.1% received high-tech medical care. They were mostly residents of St. Petersburg (77.0%). Conclusion. The study revealed unfavorable trends in the dynamics of the general and primary incidence of psoriasis in the adult population of St. Petersburg.

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