[Ultrastructure of epidermocytes in true pemphigus acantholysis]

OBJECTIVE

To investigate the ultrastructure of epidermocytes in skin biopsy specimens, by taking into account an update on the pathomorphogenesis of true pemphigus acantholysis.

MATERIAL AND METHODS

Affected skin biopsy specimens from 4 patients with Pemphigus vulgaris (a mixed mucosal-epidermal variant) and from 1 patient with P. foliaceus at the onset of the disease in the absence of therapy were examined by light microscopy of semifine sections and by transmission electron microscopy.

RESULTS

Skin biopsy specimens from pemphigus patients from the foci with a positive Nikolsky's sign were characterized by acantholysis and dilated intercellular spaces in the basal and spinous layers of the epidermis in combination with desmosomal hypoplasia and destruction. The reduction in the organelles of mitochondrial protein synthesis, which causes a decrease in the cytoplasm of the perikaryon and especially in the processes of a number of tonofilaments involved in the formation of desmosomes engaged our attention when studying the ultrastructure of epidermocytes.

CONCLUSION

A marked reduction in the number and size of desmosomes in P. vulgaris and P. foliaceus starts in the basal layer of the epidermis; however, acanthosis occurs in the suprabasal and spinous layers, respectively. The universal manifestations of pathology of cytoskeletal elements involved in the formation of desmosomes, as well as their underproduction must be considered in the concept of the pathogenesis of true pemphigus acantholysis.

[Inherited epidermolysis bullosa]

OBJECTIVE

To summarize an update on epidermolysis bullosa as a polymorphic group of inherited diseases with a failure of epidermal-dermal integrity. Emphasis is placed on the role of transmission electron microscopy in diagnosis and search directions for new types of the abnormality and its molecular markers. Despite numerous mutations in the genes encoding the components of desmosomes and epithelial basement membrane, the stereotyped manifestations of pathological processes in the group of epidermolysis bullosa have been identified. The paper gives a positive result of cell and gene therapies used by European scientists in the treatment of a 7-year-old child with borderline epidermolysis bullosa, which opens up new prospects for patients with butterfly disease that has long been considered fatal.

Clinical features of «metabolism» diseases of the skin in patients with chronic diffuse liver diseases

Aim. To determine the clinical features of skin diseases developing in the presence of metabolic disturbances in patients with chronic diffuse liver diseases. Subjects and methods. A total of 368 patients with different clinical forms of hepatopathy were comprehensively examined. Results. 817 cases of seborrhea, skin itch, xerodermia, xanthomatosis, and dyschromia were detected in 318 (86.4%) patients. Conclusion. The prevalence and intensity of cutaneous manifestations depended on the nature of the pathological liver process and indirectly testified to its severity and activity. The symptoms of skin diseases were most pronounced in patients with autoimmune liver lesions, chronic toxic hepatitis, and cirrhosis.

[The clinical effectiveness of the application of interferential currents for the combined treatment of onychopathies associated with psoriasis and eczema]

The frequency of the development of clinically significant changes in the nail plates was estimated in the present study that included 454 patients presenting with psoriasis and 140 patients with eczema characterized by the localization of the pathological process on the skin of the wrists and/or feet. The changes in the nail plates were shown to occur in 56,2% of the patients with psoriasis and in 90,7% of those suffering from eczema. The capillaroscopy of the microvessels feeding the affected nails was carried out to determine the type of the capillaroscopic picture. The patients with onychopathies were largely characterized by the spastic-atonic type of the changes in the microcirculatory bed. The changes of this type were documented in 86,5% of the patients with psoriatic onychopathy and in 83,9% of those presenting with onychodystrophy associated with eczema. The effectiveness of the combined treatment including the application of interferential currents was estimated in comparison with that of standard therapy. It was shown that the use of interferential currents for the treatment of the patients with psoriasis results in a decrease of the severity index of nail damage by 47,8% in comparison with 18,1% in the case of standard medicamentous therapy. Similarly, a 77,2 and 51,3% decrease of the index of severity was documented in the patients with eczema after their treatment with the use of interferential currents and standard medicamentous therapy, respectively.

DIAGNOSTIC SIGNIFICANCE OF SKIN "SIGNS" IN CHRONIC DIFFUSE LIVER DISFASES

AIM

Frequency Estimation of registration of various skin changes in patients with chronic diffuse liver diseases (CDDL).

SUBJECTS AND METHODS

A cross-sectional observational study in patients with CDDL and dermatological changes. The basis of this study - the results of clinical and laboratory findings 468 patients with various liver diseases (viral, toxic, parasitic).

RESULTS

A detailed analysis of dermatological manifestations of"dermal signs" in the studied group has allowed both to expand their roster, and refine clinical description of some of them. Specifically, that patients can simultaneously generate multiple dermatological stigmata.

CONCLUSION

The results suggest that skin extrahepatic "marks" is very variable. Their various combinations available to patients is a high screening signs of liver disease. The data can be used by physicians gastroenterologists and dermatologists.