Saratov JOURNAL of Medical and Scientific Research

psoriasis

Photodynamic therapy of psoriasis

Year: 2017, volume 13 Issue: №3 Pages: 678-681
Heading: Dermatovenerology Article type: Review
Authors: Utz S.R., Dobdina A.Ju., Talnikova Е.Е., Utz I.A.
Organization: Saratov State Medical University
Summary:

The review presents literature data on the use of photodynamic therapy in the treatment of psoriasis. In addition, the article discloses aspects of the mechanism of action, indications and contraindications, as well as the development of possible side effects when using this phototherapeutic technique.

AttachmentSize
2017_03-1_678-681.pdf392.64 KB

Assessment of the efficiency of cyclosporine use in psoriasis

Year: 2017, volume 13 Issue: №3 Pages: 673-678
Heading: Dermatovenerology Article type: Review
Authors: Kruglova L.S., Ponich E.S., Osina A.V., Gryazeva N.V.
Organization: Central State Medical Academy of the ADP of the Russian Federation
Summary:

The article presents a review of randomized studies involving patients with severe psoriasis, which showed that after 10-12 weeks of monotherapy with cyclosporine there was a decline of the Index of prevalence and severity of psoriasis (PASI). After achieving clinical remission must be decided on a gradual reduction of the dose of cyclosporine to the lowest effective dose, or the complete abolition of the medication. Simultaneous use of cyclosporine and UVB at the moment is not widely studied. Combined use of methotrexate and cyclosporine has been used successfully in the treatment of rheumatoid and psoriatic arthritis. The combined intake of cyclosporine and systemic biological agents should be used in exceptional cases of severe forms of psoriasis, not amenable to other treatments, and only for a limited period of time.

AttachmentSize
2017_03-1_673-678.pdf306.37 KB

Analysis of the various schemes efficiency of methotrexate use in psoriasis treatment

Summary:

Currently, there has been a steady increase in the incidence of psoriasis, including severe forms. It is extremely important for psoriasis to administrate medicines in time. Methotrexate inhibits the increased proliferation of keratinocytes, inhibits the production of such inflammatory mediators as leukotrienes, TNF-a, collagenase, IL-1, IL-6, but at the same time it increases production of anti-inflammatory IL-10. Objective: to analyze the efficacy of methotrexate in various forms of psoriasis. Material and Methods. Under observation in the period from 2011 to 2016 were 516 patients, including those treated with methotrexate. Methotrexate was assigned according to the scheme: 1st injection 10mg/week, with no adverse effects 20-25 mg/week. All patients received folic acid at a dose of 20-40 mg/day for 5 days starting 3 days after the injection of methotrexate. Evaluation of efficiency was carried out using indices of dermatological status and quality of life. Results. Achievement of clinical remission was observed in 257 (49.7%) in patients; achieving a significant improvement was noted in 32 (6.2%) patients; achieving improvements in 126 (24.4%) patients; no effect 33 (6.4%) patients, and deterioration (further progression of skin lesions) were observed in 68 (13.2%) patients. Conclusion. Methotrexate has a high efficacy in such clinical forms of psoriasis as vulgar (64.9%), inverse (63.9%), exudative (44.7%), and pustular palmar-plantar psoriasis 12.9%.

AttachmentSize
2017_03-1_662-668.pdf413.39 KB

Study results of DNA damage dynamics in mononuclear cells in patients with psoriasis under phototherapy impact

Year: 2017, volume 13 Issue: №3 Pages: 622-628
Heading: Dermatovenerology Article type: Original article
Authors: Okhlopkov V.A., Gudinova Zh.V., Poleschuk E.l., Zhernakova G.N., Repina T.V.
Organization: Omsk State Medical Academy
Summary:

Objective: to investigate the effect of phototherapy on the level of DNA damage in mononuclear blood cells in patients with psoriasis using DNA Comet Assay. Material and Methods. 87 patients with psoriasis were included into the group treated by photochemotherapy; and 58 patients composed the group receiving 311 nm narrow-band phototherapy. Results. The median mean values for the median of DNA damage in the mononuclear cells under phototherapy exposure do not exceed the standard reference range. While performing a visual study of the dynamics of DNA damage level in the nucleated cells, the patients with the parameters exceeded the initial values and upper level of the reference range have been identified. UV-induced increase of DNA damage level in the mononuclear blood cells may indicate the slowing down the activity of DNA repair system processes. A predictive model for DNA damage final level from the initial values under phototherapy has been obtained, allowing identifying the patients with increased sensitivity to ultraviolet irradiation and slowing down the processes of DNA excision nucleotide repair. Conclusion. Biomonitoring of DNA damage level in the nucleated blood cells under photochemotherapy exposure and UVB-311nm demonstrates the efficacy of nucleotide excision repair processes in the studied groups of patients with psoriasis and the safety of phototherapy in compliance with medical technology.

AttachmentSize
2017_03-1_622-628.pdf1.7 MB

Nail psoriasis: the first experience of photodynamic curcumin therapy.

Year: 2017, volume 13 Issue: №3 Pages: 600-604
Heading: Dermatovenerology Article type: Original article
Authors: Utz S.R., Tal'nikova Е.Е., Sultanakhmedov E.S., Myasnikova T.D., Safonov V.A., Popovicheva O.A.
Organization: Saratov state university, Saratov State Medical University
Summary:

Aim: to determine the effectiveness of the photosensitizer "Curcumin" in various concentrations (0.15%, 1%, 1.5%) in combination with visible spectrum radiation in the treatment of nail psoriasis. Material and Methods. 6 patients (4 women and 2 men) of different age groups (from 20 to 50 years) with the established diagnosis of "Psoriasis" were observed. The study was carried out using the "Curcumin" photosensitizer solution, the broadband spectrometer "Ocean Optics USB4F01891", the LS-55 spectrometer, the PhotoDyn-750 and the THORLABS PM100D. To assess the dynamics of the pathological process, the N-NAIL Index was used. Results. The most pronounced and clinically significant changes were detected when using a 1.5% solution of the "Curcumin" photosensitizer. Conclusion. The photosensitive agent "Curcumin" is effective in photodynamic therapy of psoriasis of the nails.

AttachmentSize
2017_03-1_600-604.pdf1.02 MB

Evaluation of expenses for treatment of patients with different forms of psoriasis in the conditions of round-the-clock hospital

Year: 2017, volume 13 Issue: №3 Pages: 595-599
Heading: Dermatovenerology Article type: Original article
Authors: Nelyubova O.I., Sazanova G.Yu., Utz S/R.
Organization: Siberian State Medical University
Summary:

 Objective: to evaluate the structure and volume of expenditures on treatment of patients with different clinical forms of psoriasis using the method of analysis of "cost of illness". Material and Methods. The study was conducted on the basis of the Clinic for Skin and Venereal Diseases Medical University of the Saratov State Medical University n.a. V. I. Razumovsky. To determine the costs of treating patients with different clinical forms of psoriasis, 702 medical records of a stationary patient have been analyzed. To assess and analyze the costs of treating patients with psoriasis, one of the methods of clinical and economic analysis was used-the "cost of illness". In the analysis of costs, the costs of inpatient treatment were included, which included direct medical costs, including the payment of medical personnel, the costs of diagnostic, medical manipulation, medicines, the use of medical equipment, inventory, etc.; indirect costs, including the costs of ensuring the activities of the medical institution. The comparative characteristic of the evaluation of the cost of treatment of patients with different forms of psoriasis in accordance with the program of state guarantees and the actual costs of the clinic. Results. It was revealed that the actual cost of the treatment for the completed case of patients with severe forms of psoriasis is 3 times higher than the cost of the treatment under the state guarantees program. The study of the structure of expenditures showed that the main costs are for the purchase of medicines and supplies in severe forms of psoriasis. Conclusion. The difference between the cost of treatment for patients with different forms of psoriasis according to the territorial program of state guarantees of the Saratov region and the actual costs is explained, because the state guarantees program does not take into account comorbid pathology and concomitant diseases, patient's age, which requires additional diagnostic and treatment methods. Analysis of the structure of actual expenditures showed that the maximum share of costs is accounted for by medicines and supplies in severe forms of psoriasis.

AttachmentSize
2017_03-1_595-599.pdf441.85 KB

Analysis of a real practice in hospital pharmacotherapy psoriatic arthritis

Year: 2016, volume 12 Issue: №3 Pages: 498-500
Heading: Dermatovenerology Article type:
Authors: Levitan A.l., Reshet'ko O.V.
Organization: Saratov State Medical University
Summary:

The Aim of the study: to define the characteristics of the current treatment of psoriatic arthritis in the settings of specialized medical care in a hospital, based on pharmacoepidemiological study, to optimize the treatment of such patients. Material and Methods. A retrospective pharmacoepidemiological study is based on an analysis of medical records of hospitalized patients rheumatology department requesting assistance in the period from January 2016 to April 2016. Result. As a part of basic anti-inflammatory therapy of psoriatic arthritis, methotrexate was used in 67% patients, sulfasalazine in 25% patients, and cyclosporine and D-penicillamine in 4% patients. Genetically engineered biologic drugs (GEBD) were not used. The anti-inflammatory therapy in hospital was carried out with glucocorticosteroids in 33% patients, with non-steroidal anti-inflammatory drugs (NSAIDs) in 20% cases and in 47% cases a combination of both was used. Gastroprotective therapy was given to all patients receiving corticosteroids and NSAIDs. Conclusion. The study shows that, the treatment of psoriatic arthritis meets the current recommendations, although there are problems associated with excessive use of corticosteroids and the lack of GEBD.

AttachmentSize
2016_03-1_498-500.pdf234.54 KB

Psoriasis, cardiovascular syndrome and methotrexate

Year: 2016, volume 12 Issue: №3 Pages: 490-492
Heading: Dermatovenerology Article type: Author's opinion
Authors: Utz S.R., Juke A.N.
Organization: Saratov State Medical University
Summary:

Often while treating psoriasis, clinicians face great difficulty in choosing the best treatment for patient and often face the question such as: what preparation is more suitable in a concrete case? Especially in psoriasis associated with comorbid diseases. In this article the data from Russian and foreign literature is collected about the effectiveness of methotrexate (in small and medium doses) in treating not only psoriasis but also other comorbid diseases. The positive effects of this medication from cytostatic group having not only anti-tumor activity but also immunosuppressive effect are evident not only on underlying disease, but also on the associated disease that has similar pathogenesis.

AttachmentSize
2016_03-1_490-492.pdf233.39 KB

Curcumin usage in dermatology

Year: 2016, volume 12 Issue: №3 Pages: 484-487
Heading: Dermatovenerology Article type: Review
Authors: Utz S.R., Talnikova Е.Е.
Organization: Saratov State Medical University
Summary:

This review summarizes the literature, reflecting the use of curcumin in historic aspect, its physical and chemical properties, and also results of different researches to demonstrate the effectiveness of diferoylmethane in treatment of various diseases, particularly in treatment of skin diseases.

AttachmentSize
2016_03-1_484-487.pdf260.75 KB

Nosometamorphosis of psoriasis in the Saratov region

Year: 2016, volume 12 Issue: №3 Pages: 467-475
Heading: Dermatovenerology Article type: Original article
Authors: Nelyubova O.I., Utz S.R.
Organization: Saratov State Medical University
Summary:

Aim: to study the clinical polymorphism of psoriasis widely in Saratov region for the last 30 years period. Materials and methods. A retrospective analysis of medical records of 2083 patients with various forms of psoriasis, which were hospitalized at the Clinic of Skin and Venereal Diseases of Saratov Medical Institute in the period from 1984 to 1988 and data for statistical comparison from register of 1450 medical records of patients with various forms of psoriasis, also hospitalized at the Clinic of Skin and Venereal Diseases of Saratov State Medical University in the period of 2009-2013. Results. An increase in the incidence of severe and atypical forms of dermatosis is noted. Exudative and pustular forms of psoriasis are found more commonly. Psoriatic arthritis is noted to be slightly more associated with exudative form. Conclusion. The risk of psoriasis developing is noted in the age group of 10-30 years. In psoriatic arthritis an increase in morbidity is noted in the period of 30-60 years.

AttachmentSize
2016_03-1_467-475.pdf1.6 MB