[The prevalence of autoimmune endocrine diseases in vitiligo patients]

Vitiligo is a common polygenic autoimmune disease in which the foci of depigmentation are formed on the skin and/or mucous membranes as a result of the death of melanocytes. There are several hypotheses for the pathogenesis of the disease, the leading role among them is played the autoimmune hypothesis. This review summarizes the available literature data on the prevalence and structure of comorbid endocrine autoimmune pathology in vitiligo patients. In most studies conducted in Europe, America and Asia the prevalence of autoimmune thyroid diseases (including autoimmune thyroiditis and Graves disease), diabetes mellitus and autoimmune adrenal insufficiency was higher in vitiligo patients than in the general population. The results of some studies indicate a frequent association of vitiligo with autoimmune polyglandular syndromes. In the structure of comorbid pathology the highest prevalence was in autoimmune thyroid diseases. A number of studies have established a higher prevalence of autoimmune endocrine diseases in women, as well as in nonsegmental vitiligo patients and in cases of family history of vitiligo and/or other autoimmune diseases. In addition, it was shown that the prevalence of endocrine diseases increases with increasing area of depigmentation. The data obtained justify the advisability of conducting a timely examination of vitiligo patients with the aim of early detection of comorbid diseases and the appointment of appropriate treatment. Further studies are needed to investigate the effect of the identified associations on the course of vitiligo and comorbid endocrinopathies, as well as the effectiveness of therapy and the quality of life of patients.

Progression of itching intensity and expression of growth factor proteins in skin of people suffering from atopic dermatitis under the influence of ultraviolet phototherapy

Study of progression of itching intensity and expression of growth factor proteins in skin of people suffering from atopic dermatitis under the influence of narrowband (311Nm) phototherapy. Material and methods. 30 patients with atopic dermatitis were treated by using narrowband (311Nm) phototherapy. SCORAD index was used to assess the severity of the clinical responses. Itching intensity was assessed using visual analogue scale. Expression of growth factor of nerves, semaphorine-3A, amphiregulin, and PGP9.5, a protein marker for nerve fibers, was investigated by means of indirect immunofluorescence. Results. Increased expression level of nerves growth factor, decreased expression level of semaphorine-3A, and increase in the number, average length and luminous intensity of PGP9.5+ -nerve fibers were found in the patients’ epidermis. Course of narrowband (311 Nm) phototherapy resulted in a decrease of the severity of the disease and itching intensity, and semaphorine-3A expression increase, reduction of number and average length of nerve fibers in the epidermis. A direct correlation relationship between the itching intensity and expression level of nerve growth factor, number and average length of PGP9.5+ -nerve fibers in the epidermis as well as an inverse correlation relationship between itching intensity and expression level of semaphorine-3A in the epidermis were found. Conclusion. Treating patients suffering from atopic dermatitis with narrowband (311 Nm) phototherapy leads to a decrease of the itching intensity associated with a decreased intensity of innervation of the epidermis. This decrease in course of phototherapy is facilitated by decrease of nerve growth factor expression level and increase of semaphorine-3A expression.

Clinical manifestations of the skin photodamage as a result of a multi-course phototherapy of psoriasis patients

Goal. To study clinical manifestations and frequency of skin photodamage symptoms in psoriasis patients receiving a longterm multi-course phototherapy. Materials and methods. The study involved 106 patients suffering from psoriasis vulgaris and receiving a multi-course treatment by methods of the PUVA therapy, broadband medium-wave UV therapy and narrowband phototherapy with the wavelength of 311 nm. The average number of courses was 7 while the average number of treatment sessions was 141. Depending on the number of treatment sessions, the patients were divided into three groups: Group 1 (n = 33) - patients that received 50-100 phototherapy sessions, Group 2 (n = 58) - patients that received 101-200 treatment sessions, and Group 3 (n = 15) - patients that received over 200 treatment sessions. The control group comprised 20 psoriasis patients that did not receive any phototherapy before. Major results. The comparative analysis of the entire group of patients receiving a phototherapy revealed a statistically significant incidence of lentigo/sunspots, diffuse skin hyperpigmentation and actinic elastosis vs. the control group. The frequency of clinical manifestations characteristic of the skin photodamage grew as the number of treatment sessions increased. All of the symptoms except for guttate hypomelanosis and venous lakes demonstrated statistically significant dynamics. Conclusion. There is a dose-dependant increase in the frequency of skin photodamage symptoms in patients suffering from psoriasis vulgaris and receiving a long-term multi-course phototherapy.

Potential of regenerative medicine for treatment of vitiligo patients

The article presents a review of publishes sources on the efficacy of methods such as tissue engineering and cellular transplantation of autologous melanocytes for treatment of vitiligo patients. The article describes general principles of treatment and particular features of current melanocyte transplantation methods.

Modern treatment methods for patients with psoriasis

Modern approaches to treatment of patients with psoriasis depending on the type and stage of the disease, its localization and the severity degree of skin pathology are given. Data regarding external and systemic therapeutic agents as well as phototherapeutic methods of treatment currently used at inpatient & outpatient medical facilities are represented.

Personalized approach to the selection of therapy for patients with psoriasisbased on the results of molecular and genetic tests

The article presents the results of tests aimed at revealing biomarkers of patients clinical response to treatment with Infliximab and phototherapy with the use of molecular and genetic technologies. The authors revealed that the predictor of evident clinical response to treatment of psoriasis patients with Infliximab is the homozygous TT genotype at the 676 locus of exon 6 of the TNFR- II gene; predictors of high efficacy and safety of treatment of psoriasis patients with Infliximab with the use of ultraviolet therapy (PUVA and mid-wavelength ultraviolet therapy (311 nm)) are: heterozygous GA genotype at the 19007 locus of the ERCC gene and homozygous CC genotype at the 27945 locus of the XPF gene.

Clinical, molecular and genetic studies of efficacy and safety of using UV irradiation for psoriasis patients

The authors give the results of clinical, molecular and genetic studies of efficacy and safety of treatment of 87 patients suffering from extensive psoriasis with the use of UV irradiation of different spectral ranges. They showed that the administration of a course of treatment with the use of the PUVA therapy or narrowband medium-wave UV therapy with the wavelength of 311 nm does not result in the development of any clinically significant genetic mutations associated with the DNA excision repair system. They revealed that the GC genotype of the XPC gene in the 32828 site and CC genotype of the XPF gene in the 27945 site may be predictors of a pronounced therapeutic effect in treatment of patients with the use of phototherapy methods. The authors obtained data confirming a possible protective role of T>C polymorphism in the 27945 site of the XPF gene in the development of phototoxic reactions when psoriasis patients undergo an UV therapy.

On the role of dendritic cells in the pathogenesis of vitiligo

The authors give the results of immunohistochemistry studies of the skin of 16 healthy volunteers and 16 patients suffering from vulgar vitiligo with the determination of the contents of immature (CD1a+) and mature (CD83+) subpopulations of dendritic cells (DCs) as well as CD4+ and CD8+ lymphocytes in the epidermis and perivascular infiltrates of the derma. They revealed an increased quantity of CD1a+ and CD83+ DCs in areas of depigmented, peripheral and perifocal normally pigmented skin of vitiligo foci. DCs with the CD1a+ phenotype were revealed both in the epidermis and in the derma while DCs with the CD83+ phenotype were revealed in the derma only. A higher quantity of CD4+ and CD8+ lymphocytes than in healthy volunteers was also revealed along with the increased contents of DCs in all three areas of vitiligo foci. The authors established a strong correlation between the quantity of CD83+ DCs and CD4+ lymphocytes in the depigmentation zone (r=0.84; Р

Currentaspects of psoriasis phototherapy

The review covers current aspects of ultraviolet therapy for patients suffering from psoriasis. It describes mechanisms of action as well as early and remote side effects of the current phototherapy methods. The review also presents data from literature about the risk of their cancerogenicity. It also discusses approaches to the optimization of phototherapy in view of risks and benefits for the patient.