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.
The lipidotransport system at conglobate acne as more severe form that characterized by pronounced hyperplasic and hypertrophic processes in sebaceous gland was studied. The study was based on the presence of relative hyperandrogenism in the pathogenesis of acne, due to the active synthesis of 5.alpha.-dihydrotestosterone sebocytes of sebaceous hair follicles of type III, and the fact that the predecessor of 5a-dihydrotestosterone is cholesterol. The study included 130 persons (60 women, 70 men) at the age of 17-36 years with acute stage of conglobate acne and disease duration from 3 months to 18 years. In addition 55 persons with papulopustule acne (23 women, 32 men) in similar age as control group were studied. A total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides were determined by semi-automatic biochemical analyzer BTS-350 using the kits of the company Deacon (Moscow). An abdominal organs and retroperitoneal space (liver, gall bladder, and pancreas) were examined by ultrasound diagnostic. Lipid metabolism changes were revealed in patients with conglobate acne, and was not found in patients with papulopustule acne. This lipid changes were associated with a tendency to increase in triglycerides, total cholesterol, lowering LDL cholesterol in HDL cholesterol content. It’s noted that in papulopustule form were not registered a higher LDL cholesterol levels but in conglobate form this parameter were 7.69% patient. With increasing duration of the disease the concentration of triglycerides, total cholesterol, LDL cholesterol is rising, while lowering levels of HDL cholesterol at the development of chronic pancreatitis.
The article presents the results of a study of efficacy of using Aicida, a cosmetic drug with such an active substance as ASD (Dorogovs
antiseptic stimulator) in a liposomal form providing for the target delivery of the drug to deep skin tissues, for treatment of
patients with atopic dermatitis.
It also demonstrates high efficacy and good tolerance of the cosmetic product in patients with medium to severe forms of atopic
dermatitis.
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