16 research outputs found

    Π‘ΠΈΠ½Π΄Ρ€ΠΎΠΌ Роуэлла Π² дСрматологичСской ΠΏΡ€Π°ΠΊΡ‚ΠΈΠΊΠ΅ (клиничСскоС наблюдСниС)

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    Rowell syndrome is a rare cluster of symptoms characterized by clinical manifestation of lupus erythematosus and erythema multiforme (EM). About 100 cases of the syndrome have been reported in medical publications during the last 100 years. This may be related to misinterpretation of the symptoms and subsequent incorrect diagnosis due to its EM-like manifestations. Important clues for the diagnosis of Rowell syndrome are findings of positive rheumatoid factor, anti-nuclear antibodies and other erythematoid markers, as well as additional investigations, in particular, direct immunofluorescence technique. The paper describes a clinical case of Rowell syndrome in a 16-year old male patient. The diagnosis was challenging due to EM-like skin manifestations and required additional laboratory work-up, as well as the patient's follow-up. The diagnosis of Rowell syndrome was based on the clinical manifestations and on such diagnostic criteria as positive rheumatoid factor and anti-nuclear antibodies, as well as histological and laboratory abnormalities characteristic of the erythematosis. The patient was hospitalized and received the following treatment: prednisolone infusion (2.5 mg/kg/daily for 7 days), chloropyramine (1 mL i.m. twice daily for 5 days), hydroxychloroquine (6.5 mg/kg daily for 5 days), magnesium asparaginate/potassium asparaginate (one tablet (166.3 mg/175 mg) 3 times daily for 7 days), topical methylprednisolone aceponate cream 1% (once daily for 7 days). The treatment resulted in positive changes in the skin lesion and improvement of his general state. This clinical observation gives an example of classic Rowell syndrome proven both by lab and clinical signs, taking into account skin symptoms of lupus erythematosus and EM-like rash.Π‘ΠΈΠ½Π΄Ρ€ΠΎΠΌ Роуэлла - Ρ€Π΅Π΄ΠΊΠΎ Π²ΡΡ‚Ρ€Π΅Ρ‡Π°ΡŽΡ‰ΠΈΠΉΡΡ симптомокомплСкс, для ΠΊΠΎΡ‚ΠΎΡ€ΠΎΠ³ΠΎ Ρ…Π°Ρ€Π°ΠΊΡ‚Π΅Ρ€Π½Ρ‹ клиничСскиС проявлСния красной Π²ΠΎΠ»Ρ‡Π°Π½ΠΊΠΈ ΠΈ ΠΌΠ½ΠΎΠ³ΠΎΡ„ΠΎΡ€ΠΌΠ½ΠΎΠΉ экссудативной эритСмы (МЭЭ). Π—Π° послСдниС 100 Π»Π΅Ρ‚ Π² Π½Π°ΡƒΡ‡Π½ΠΎΠΉ Π»ΠΈΡ‚Π΅Ρ€Π°Ρ‚ΡƒΡ€Π΅ описано ΠΎΠΊΠΎΠ»ΠΎ 100 случаСв Π΄Π°Π½Π½ΠΎΠ³ΠΎ синдрома, Ρ‡Ρ‚ΠΎ ΠΌΠΎΠΆΠ΅Ρ‚ Π±Ρ‹Ρ‚ΡŒ связано с ΠΎΡˆΠΈΠ±ΠΎΡ‡Π½ΠΎΠΉ ΠΈΠ½Ρ‚Π΅Ρ€ΠΏΡ€Π΅Ρ‚Π°Ρ†ΠΈΠ΅ΠΉ симптомов ΠΈ, ΠΊΠ°ΠΊ слСдствиС, Π½Π΅Ρ‚ΠΎΡ‡Π½ΠΎΠΉ диагностикой ΠΏΠΎ ΠΏΡ€ΠΈΡ‡ΠΈΠ½Π΅ Π΅Π³ΠΎ манифСстации высыпаниями ΠΏΠΎ Ρ‚ΠΈΠΏΡƒ МЭЭ. Π’Π°ΠΆΠ½ΠΎΠ΅ Π·Π½Π°Ρ‡Π΅Π½ΠΈΠ΅ Π² диагностикС синдрома Роуэлла ΠΈΠΌΠ΅Π΅Ρ‚ выявлСниС ΠΏΠΎΠ»ΠΎΠΆΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠ³ΠΎ Ρ€Π΅Π²ΠΌΠ°Ρ‚ΠΎΠΈΠ΄Π½ΠΎΠ³ΠΎ Ρ„Π°ΠΊΡ‚ΠΎΡ€Π°, антиядСрных Π°Π½Ρ‚ΠΈΡ‚Π΅Π» ΠΈ Π΄Ρ€ΡƒΠ³ΠΈΡ… ΠΌΠ°Ρ€ΠΊΠ΅Ρ€ΠΎΠ² эритСматоза, Π° Ρ‚Π°ΠΊΠΆΠ΅ Π΄ΠΎΠΏΠΎΠ»Π½ΠΈΡ‚Π΅Π»ΡŒΠ½Ρ‹Π΅ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹ исслСдования, Π² частности прямая ΠΈΠΌΠΌΡƒΠ½ΠΎΡ„Π»ΡŽΠΎΡ€Π΅ΡΡ†Π΅Π½Ρ†ΠΈΡ. Π’ ΡΡ‚Π°Ρ‚ΡŒΠ΅ Π΄Π°Π½ΠΎ описаниС клиничСского наблюдСния синдрома Роуэлла Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π° 16 Π»Π΅Ρ‚. УстановлСниС Π΄ΠΈΠ°Π³Π½ΠΎΠ·Π° Π²Ρ‹Π·Π²Π°Π»ΠΎ затруднСния ΠΏΠΎ ΠΏΡ€ΠΈΡ‡ΠΈΠ½Π΅ манифСстации ΠΊΠΎΠΆΠ½Ρ‹Ρ… проявлСний ΠΏΠΎ Ρ‚ΠΈΠΏΡƒ МЭЭ ΠΈ ΠΏΠΎΡ‚Ρ€Π΅Π±ΠΎΠ²Π°Π»ΠΎ Π΄ΠΎΠΏΠΎΠ»Π½ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠΉ Π»Π°Π±ΠΎΡ€Π°Ρ‚ΠΎΡ€Π½ΠΎΠΉ диагностики, Π° Ρ‚Π°ΠΊΠΆΠ΅ динамичСского наблюдСния. ΠŸΡ€ΠΈ постановкС Π΄ΠΈΠ°Π³Π½ΠΎΠ·Π° синдрома Роуэлла ΠΎΠΏΠΈΡ€Π°Π»ΠΈΡΡŒ Π½Π° клиничСскиС проявлСния, Π° Ρ‚Π°ΠΊΠΆΠ΅ Π½Π° Ρ‚Π°ΠΊΠΈΠ΅ диагностичСскиС ΠΊΡ€ΠΈΡ‚Π΅Ρ€ΠΈΠΈ, ΠΊΠ°ΠΊ ΠΏΠΎΠ»ΠΎΠΆΠΈΡ‚Π΅Π»ΡŒΠ½Ρ‹Π΅ ΠΏΡ€ΠΎΠ±Ρ‹ Π½Π° Ρ€Π΅Π²ΠΌΠ°Ρ‚ΠΎΠΈΠ΄Π½Ρ‹ΠΉ Ρ„Π°ΠΊΡ‚ΠΎΡ€ ΠΈ антиядСрныС Π°Π½Ρ‚ΠΈΡ‚Π΅Π»Π°, гистологичСскиС ΠΈ Π»Π°Π±ΠΎΡ€Π°Ρ‚ΠΎΡ€Π½Ρ‹Π΅ измСнСния, присущиС эритСматозу. ΠŸΠ°Ρ†ΠΈΠ΅Π½Ρ‚ находился Π² стационарС ΠΈ ΠΏΠΎΠ»ΡƒΡ‡Π°Π» ΡΠ»Π΅Π΄ΡƒΡŽΡ‰Π΅Π΅ Π»Π΅Ρ‡Π΅Π½ΠΈΠ΅: инфузионная тСрапия (ΠΏΡ€Π΅Π΄Π½ΠΈΠ·ΠΎΠ»ΠΎΠ½ 2,5 ΠΌΠ³/ΠΊΠ³/сут Π² Ρ‚Π΅Ρ‡Π΅Π½ΠΈΠ΅ 7 Π΄Π½Π΅ΠΉ), Ρ…Π»ΠΎΡ€ΠΎΠΏΠΈΡ€Π°ΠΌΠΈΠ½ (1 ΠΌΠ» 2 Ρ€Π°Π·Π° Π² дСнь Π²Π½ΡƒΡ‚Ρ€ΠΈΠΌΡ‹ΡˆΠ΅Ρ‡Π½ΠΎ Π² Ρ‚Π΅Ρ‡Π΅Π½ΠΈΠ΅ 5 Π΄Π½Π΅ΠΉ), гидроксихлорохин (суточная Π΄ΠΎΠ·Π° 6,5 ΠΌΠ³/ΠΊΠ³, Π΄Π»ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΡΡ‚ΡŒ - 5 Π΄Π½Π΅ΠΉ), магния аспарагинат / калия аспарагинат (1 Ρ‚Π°Π±. (166,3 ΠΌΠ³/ 175 ΠΌΠ³) 3 Ρ€Π°Π·Π° Π² дСнь Π² Ρ‚Π΅Ρ‡Π΅Π½ΠΈΠ΅ 7 Π΄Π½Π΅ΠΉ), Π½Π°Ρ€ΡƒΠΆΠ½ΠΎ ΠΊΡ€Π΅ΠΌ ΠΌΠ΅Ρ‚ΠΈΠ»ΠΏΡ€Π΅Π΄Π½ΠΈΠ·ΠΎΠ»ΠΎΠ½Π° Π°Ρ†Π΅ΠΏΠΎΠ½Π°Ρ‚ 1% (1 Ρ€Π°Π· Π² дСнь Π² Ρ‚Π΅Ρ‡Π΅Π½ΠΈΠ΅ 7 Π΄Π½Π΅ΠΉ). Π’ Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Π΅ ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½Π½ΠΎΠ³ΠΎ лСчСния Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π° ΠΎΡ‚ΠΌΠ΅Ρ‡Π΅Π½Π° ΠΏΠΎΠ»ΠΎΠΆΠΈΡ‚Π΅Π»ΡŒΠ½Π°Ρ Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΠ° Π² Ρ‚Π΅Ρ‡Π΅Π½ΠΈΠΈ ΠΊΠΎΠΆΠ½ΠΎΠ³ΠΎ процСсса ΠΈ ΡƒΠ»ΡƒΡ‡ΡˆΠ΅Π½ΠΈΠ΅ ΠΎΠ±Ρ‰Π΅Π³ΠΎ состояния. На ΠΏΡ€ΠΈΠΌΠ΅Ρ€Π΅ настоящСго клиничСского наблюдСния ΠΏΠΎΠΊΠ°Π·Π°Π½ΠΎ классичСскоС проявлСниС синдрома Роуэлла, ΠΈΠΌΠ΅ΡŽΡ‰Π΅Π΅ ΠΊΠ°ΠΊ Π»Π°Π±ΠΎΡ€Π°Ρ‚ΠΎΡ€Π½ΠΎΠ΅, Ρ‚Π°ΠΊ ΠΈ клиничСскоС обоснованиС, учитывая Π½Π°Π»ΠΈΡ‡ΠΈΠ΅ ΠΊΠΎΠΆΠ½Ρ‹Ρ… проявлСний красной Π²ΠΎΠ»Ρ‡Π°Π½ΠΊΠΈ ΠΈ высыпаний ΠΏΠΎ Ρ‚ΠΈΠΏΡƒ МЭЭ

    Age evolutionary dynamics of atopic dermatitis

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    The article describes evolutionary dynamics of atopic dermatitis (AD) course and clinical features of the disease in different age periods. It analyzes in detail the impact of genetically determined pathogenetic factors and external environment triggers for the development of AD considering patients age. Authors substantiate approach to external therapy, efficacy and safety of methylprednisolone aceponate in AD treatment. Β© 2016, Pediatria Ltd. All rights reserved

    The use of recombinant interferon-alpha preparations for the combined treatment of genital papillomaviris infection

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    [No abstract available

    Modern aspects of treatment of purulent wounds with combined drugs

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    The relevance of patients’ management with long-term healing wounds and ulcers is beyond doubt. Poor nutrition, a sedentary lifestyle, a de-teriorating environment, an increasing life expectancy of the population cause the development of a large number of somatic diseases (onco-logical and neurodegenerative diseases, diabetes mellitus, obesity, etc.), resulting that infectious skin diseases becomes chronic and often non-responsive to ongoing therapy. An ulcer is a defect in the skin or mucous membrane, which is characterized by a chronic course without a tendency to spontaneous healing, or periodic recurrence of the disease. An integrated approach to managing patients with chronic wounds and ulcers has been successfully applied in clinical practice. The wound process is a complex of local and general biological reac-tions of tissues and body systems, aimed at delimiting and rejecting necrotic masses, fighting infection, restoring and replacing damaged struc-tures. The infectious process is the process of the introduction and development of microorganisms in habitats unusual for them (tissues, in-ternal cavities and organs) with the subsequent development of complex interactions between macro-and microorganisms. Β© 2020, Media Sphera Publishing Group. All rights reserved

    Age evolutionary dynamics of atopic dermatitis

    No full text
    The article describes evolutionary dynamics of atopic dermatitis (AD) course and clinical features of the disease in different age periods. It analyzes in detail the impact of genetically determined pathogenetic factors and external environment triggers for the development of AD considering patients age. Authors substantiate approach to external therapy, efficacy and safety of methylprednisolone aceponate in AD treatment. Β© 2016, Pediatria Ltd. All rights reserved

    Immunomodulatory therapy of papillomavirus infections

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    [No abstract available

    Π­Ρ„Ρ„Π΅ΠΊΡ‚ΠΈΠ²Π½ΠΎΡΡ‚ΡŒ узкополосной Ρ„ΠΎΡ‚ΠΎΡ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Π² Π»Π΅Ρ‡Π΅Π½ΠΈΠΈ Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹Ρ… Ρ„ΠΎΡ€ΠΌ псориаза с прСимущСствСнным ΠΏΠΎΡ€Π°ΠΆΠ΅Π½ΠΈΠ΅ΠΌ Π»Π°Π΄ΠΎΠ½Π΅ΠΉ ΠΈ подошв

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    Background: Palmar-plantar psoriasis is characterized by a torpid course and resistance to conventional systemic treatments. Phototherapy is usually considered as an adjuvant treatment of a patient with psoriasis. The potential use of phototherapy as a basic treatment strategy in limited psoriasis, including its plantar-palmar localization, could be of interest. Aim: To study the efficacy, safety and tolerability of the narrowband phototherapy (UVB 311 nm) in the treatment of different forms of psoriasis with predominant palmar-plantar involvement. Materials and methods: We retrospectively analyzed the results of treatment of 77 in-patients admitted to the Department of Dermatology for treatment of various types of psoriasis with prevailing palmar and plantar lesions. The main group consisted of 42 patients who were administered combination therapy including topical corticosteroids, hepatic protectors, antihistaminic agents and, in addition, the narrowband phototherapy with a phototherapy device Dermalight 500-1 (Dr. Hnle Medizintechnik GmbH, Germany). The initial radiation doses were set without the determination of the minimal erythema dose, depending on the patient's skin type, in accordance with the guidelines from the manufacturer. At each consecutive session, the dose was increased by 0.060.3 J/cm. The sessions were conducted 5 times a week with a total of 1421 sessions. The mean cumulative dose was 22.8 J/cm. The control group included 35 age-, gender- and psoriasis severity-matched patients who received the same treatments, except the narrowband phototherapy. The treatment efficacy was assessed by changes in the Palmoplantar Pustulosis Area and Severity Index (PPPASI). Clinical results of treatment were evaluated at day 10 after the treatment course had been completed. Results: No serious adverse events were registered during the treatment. In the patients with psoriasis vulgaris and predominant palmoplantar lesions, receiving the narrowband phototherapy, the PPPASI reduction was higher than in the patients who received only conventional treatment (U-test, p = 0.015). A PPPASI decrease of 50% was observed in 83.3% (25/30) and 60% (15/25) of the patients, respectively. Clinical efficacy criteria were achieved in 66.6% (8/12) of the patients with palmoplantar pustular psoriasis receiving the combination treatment with phototherapy and in 40% (4/10) of the conventionally treated patients in the control group; however, the difference in the distribution of remission achievement was non-significant (U-test, p = 0.123). Conclusion: The study has demonstrated the efficacy of UVB 311 nm narrowband phototherapy in the treatment of patients with psoriasis with predominant palmoplantar lesions. The results obtained make it possible to recommend the inclusion of the narrowband phototherapy UVB 311 nm at mean cumulative dose of 22.8 J/cm into the standardized set of treatments of patients with psoriasis vulgaris with predominant palmoplantar lesions, not only as an adjuvant technique, but also as the main therapeutic strategy. The role of the narrowband phototherapy UVB 311 nm in the treatment of palmoplantar pustular psoriasis, as well as the dosing regimens of the radiation and determination of the necessary follow-up duration should be the subject of further studies.ΠΠΊΡ‚ΡƒΠ°Π»ΡŒΠ½ΠΎΡΡ‚ΡŒ. Π›Π°Π΄ΠΎΠ½Π½ΠΎ-ΠΏΠΎΠ΄ΠΎΡˆΠ²Π΅Π½Π½Ρ‹Π΅ Ρ„ΠΎΡ€ΠΌΡ‹ псориаза ΠΎΡ‚Π»ΠΈΡ‡Π°ΡŽΡ‚ΡΡ Ρ‚ΠΎΡ€ΠΏΠΈΠ΄Π½Ρ‹ΠΌ Ρ‚Π΅Ρ‡Π΅Π½ΠΈΠ΅ΠΌ ΠΈ ΡƒΡΡ‚ΠΎΠΉΡ‡ΠΈΠ²ΠΎΡΡ‚ΡŒΡŽ ΠΊ Ρ‚Ρ€Π°Π΄ΠΈΡ†ΠΈΠΎΠ½Π½ΠΎ ΠΏΡ€ΠΈΠΌΠ΅Π½ΡΡŽΡ‰ΠΈΠΌΡΡ ΠΌΠ΅Ρ‚ΠΎΠ΄Π°ΠΌ систСмной Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ. ΠŸΡ€ΠΈ Π»Π΅Ρ‡Π΅Π½ΠΈΠΈ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с Π΄ΠΈΠ°Π³Π½ΠΎΠ·ΠΎΠΌ псориаза Π² комплСксС тСрапСвтичСских мСроприятий принято Ρ€Π°ΡΡΠΌΠ°Ρ‚Ρ€ΠΈΠ²Π°Ρ‚ΡŒ Ρ„ΠΈΠ·ΠΈΠΎΡ‚Π΅Ρ€Π°ΠΏΠΈΡŽ Π² Ρ†Π΅Π»ΠΎΠΌ ΠΈ Ρ„ΠΎΡ‚ΠΎΡ‚Π΅Ρ€Π°ΠΏΠΈΡŽ Π² частности ΠΊΠ°ΠΊ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹ Π°Π΄ΡŠΡŽΠ²Π°Π½Ρ‚Π½ΠΎΠ³ΠΎ лСчСния. Π˜Π½Ρ‚Π΅Ρ€Π΅Ρ прСдставляСт Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡ‚ΡŒ примСнСния Ρ„ΠΎΡ‚ΠΎΡ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Π² качСствС основной тСрапСвтичСской стратСгии ΠΏΡ€ΠΈ ΠΎΠ³Ρ€Π°Π½ΠΈΡ‡Π΅Π½Π½Ρ‹Ρ… Ρ„ΠΎΡ€ΠΌΠ°Ρ… псориаза, Π² Ρ‚ΠΎΠΌ числС ΠΏΡ€ΠΈ Π΅Π³ΠΎ Π»Π°Π΄ΠΎΠ½Π½ΠΎ-подошвСнной Π»ΠΎΠΊΠ°Π»ΠΈΠ·Π°Ρ†ΠΈΠΈ. ЦСль ΠΎΡ†Π΅Π½ΠΈΡ‚ΡŒ ΡΡ„Ρ„Π΅ΠΊΡ‚ΠΈΠ²Π½ΠΎΡΡ‚ΡŒ, Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡ‚ΡŒ ΠΈ ΠΏΠ΅Ρ€Π΅Π½ΠΎΡΠΈΠΌΠΎΡΡ‚ΡŒ узкополосной Ρ„ΠΎΡ‚ΠΎΡ‚Π΅Ρ€Π°ΠΏΠΈΠΈ (UVB 311 Π½ΠΌ) Π² комплСксном Π»Π΅Ρ‡Π΅Π½ΠΈΠΈ Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹Ρ… Ρ„ΠΎΡ€ΠΌ псориаза с прСимущСствСнным ΠΏΠΎΡ€Π°ΠΆΠ΅Π½ΠΈΠ΅ΠΌ Π»Π°Π΄ΠΎΠ½Π΅ΠΉ ΠΈ подошв Π² сравнСнии с Ρ‚Ρ€Π°Π΄ΠΈΡ†ΠΈΠΎΠ½Π½ΠΎ ΠΏΡ€ΠΈΠΌΠ΅Π½ΡΡŽΡ‰Π΅ΠΉΡΡ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠ΅ΠΉ. ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π» ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹. ΠŸΡ€ΠΎΠ²Π΅Π΄Π΅Π½ рСтроспСктивный Π°Π½Π°Π»ΠΈΠ· Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚ΠΎΠ² лСчСния 77 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ², госпитализированных Π² дСрматологичСский стационар для лСчСния Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹Ρ… Ρ„ΠΎΡ€ΠΌ псориаза с прСимущСствСнным ΠΏΠΎΡ€Π°ΠΆΠ΅Π½ΠΈΠ΅ΠΌ Π»Π°Π΄ΠΎΠ½Π΅ΠΉ ΠΈ подошв. ΠžΡΠ½ΠΎΠ²Π½ΡƒΡŽ Π³Ρ€ΡƒΠΏΠΏΡƒ составили 42 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π°, ΠΏΠΎΠ»ΡƒΡ‡Π°Π²ΡˆΠΈΡ… ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ½ΡƒΡŽ Ρ‚Π΅Ρ€Π°ΠΏΠΈΡŽ, Π² состав ΠΊΠΎΡ‚ΠΎΡ€ΠΎΠΉ ΠΏΠΎΠΌΠΈΠΌΠΎ топичСских кортикостСроидов, Π³Π΅ΠΏΠ°Ρ‚ΠΎΠΏΡ€ΠΎΡ‚Π΅ΠΊΡ‚ΠΎΡ€ΠΎΠ² ΠΈ антигистаминных срСдств Π±Ρ‹Π»Π° Π²ΠΊΠ»ΡŽΡ‡Π΅Π½Π° узкополосная фототСрапия с использованиСм фототСрапСвтичСского оборудования Dermalight 500-1 (Dr. Hnle Medizintechnik GmbH, ГСрмания). ΠΠ°Ρ‡Π°Π»ΡŒΠ½Ρ‹Π΅ Π΄ΠΎΠ·Ρ‹ облучСния устанавливали Π±Π΅Π· опрСдСлСния минимальной эритСмной Π΄ΠΎΠ·Ρ‹, Π² зависимости ΠΎΡ‚ Ρ„ΠΎΡ‚ΠΎΡ‚ΠΈΠΏΠ° ΠΊΠΎΠΆΠΈ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π°, Π² соотвСтствии с рСкомСндациями изготовитСля мСдоборудования. Π£Π²Π΅Π»ΠΈΡ‡Π΅Π½ΠΈΠ΅ Π΄ΠΎΠ·Ρ‹ ΠΏΡ€ΠΈ ΠΊΠ°ΠΆΠ΄ΠΎΠΌ ΠΏΠΎΡΠ»Π΅Π΄ΡƒΡŽΡ‰Π΅ΠΌ сСансС соотвСтствовало 0,060,3 Π”ΠΆ/см. БСансы ΠΏΡ€ΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΈ 5 Ρ€Π°Π· Π² нСдСлю, Π½Π° курс 1421 сСанс. ΠšΡƒΠΌΡƒΠ»ΡΡ‚ΠΈΠ²Π½Π°Ρ Π΄ΠΎΠ·Π° Π² срСднСм составляла 22,8 Π”ΠΆ/см. Π’ Π³Ρ€ΡƒΠΏΠΏΡƒ сравнСния вошли 35 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ², сопоставимых ΠΏΠΎ ΠΏΠΎΠ»Ρƒ, возрасту ΠΈ тяТСсти псориаза, ΠΏΠΎΠ»ΡƒΡ‡Π°Π²ΡˆΠΈΡ… Π°Π½Π°Π»ΠΎΠ³ΠΈΡ‡Π½ΡƒΡŽ Ρ‚Π΅Ρ€Π°ΠΏΠΈΡŽ, Π½ΠΎ Π±Π΅Π· назначСния узкополосной Ρ„ΠΎΡ‚ΠΎΡ‚Π΅Ρ€Π°ΠΏΠΈΠΈ. Π­Ρ„Ρ„Π΅ΠΊΡ‚ΠΈΠ²Π½ΠΎΡΡ‚ΡŒ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ ΠΎΡ†Π΅Π½ΠΈΠ²Π°Π»ΠΈ ΠΏΠΎ измСнСнию индСкса тяТСсти Π»Π°Π΄ΠΎΠ½Π½ΠΎ-подошвСнного псориаза PPPASI. ΠšΠ»ΠΈΠ½ΠΈΡ‡Π΅ΡΠΊΠΈΠ΅ Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹ лСчСния ΠΎΡ†Π΅Π½ΠΈΠ²Π°Π»ΠΈ Π½Π° 10-ΠΉ дСнь послС окончания ΠΏΠΎΠ»Π½ΠΎΠ³ΠΎ курса Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ. Π Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹. Π’ Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Π΅ ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½Π½ΠΎΠΉ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ ΡΠ΅Ρ€ΡŒΠ΅Π·Π½Ρ‹Ρ… ΠΏΠΎΠ±ΠΎΡ‡Π½Ρ‹Ρ… эффСктов выявлСно Π½Π΅ Π±Ρ‹Π»ΠΎ. Π’ Π³Ρ€ΡƒΠΏΠΏΠ΅ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с Π΄ΠΈΠ°Π³Π½ΠΎΠ·ΠΎΠΌ Π²ΡƒΠ»ΡŒΠ³Π°Ρ€Π½ΠΎΠ³ΠΎ псориаза с прСимущСствСнным ΠΏΠΎΡ€Π°ΠΆΠ΅Π½ΠΈΠ΅ΠΌ Π»Π°Π΄ΠΎΠ½Π΅ΠΉ ΠΈ подошв, ΠΏΠΎΠ»ΡƒΡ‡Π°Π²ΡˆΠΈΡ… ΡƒΠ·ΠΊΠΎΠΏΠΎΠ»ΠΎΡΠ½ΡƒΡŽ Ρ„ΠΎΡ‚ΠΎΡ‚Π΅Ρ€Π°ΠΏΠΈΡŽ, сниТСниС PPPASI Π±Ρ‹Π»ΠΎ Π±ΠΎΠ»Π΅Π΅ Π²Ρ‹Ρ€Π°ΠΆΠ΅Π½Π½Ρ‹ΠΌ, Ρ‡Π΅ΠΌ Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ², Π»Π΅Ρ‡ΠΈΠ²ΡˆΠΈΡ…ΡΡ Ρ‚ΠΎΠ»ΡŒΠΊΠΎ стандартными ΠΌΠ΅Ρ‚ΠΎΠ΄Π°ΠΌΠΈ (U-test, p = 0,015): сниТСниС индСкса PPPASI Π½Π° 50% ΠΈ Π±ΠΎΠ»Π΅Π΅ ΠΎΡ‚ΠΌΠ΅Ρ‡Π΅Π½ΠΎ Ρƒ 83,3% (25/30) ΠΈ Ρƒ 60% (15/25) соотвСтствСнно. Π‘Ρ€Π΅Π΄ΠΈ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с Π»Π°Π΄ΠΎΠ½Π½ΠΎ-ΠΏΠΎΠ΄ΠΎΡˆΠ²Π΅Π½Π½Ρ‹ΠΌ пустулСзным псориазом Π΄ΠΎΡΡ‚ΠΈΠ³Π½ΡƒΡ‚ΡŒ ΠΊΡ€ΠΈΡ‚Π΅Ρ€ΠΈΠ΅Π² клиничСской эффСктивности ΡƒΠ΄Π°Π»ΠΎΡΡŒ Ρƒ 66,6% (8/12) Π² Π³Ρ€ΡƒΠΏΠΏΠ΅ ΠΏΠΎΠ»ΡƒΡ‡Π°Π²ΡˆΠΈΡ… комплСксноС Π»Π΅Ρ‡Π΅Π½ΠΈΠ΅ с Ρ„ΠΎΡ‚ΠΎΡ‚Π΅Ρ€Π°ΠΏΠΈΠ΅ΠΉ ΠΈ Ρƒ 40% (4/10) ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² Π² Π³Ρ€ΡƒΠΏΠΏΠ΅ контроля. Различия Π² распрСдСлСнии этих ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² ΠΏΠΎ уровням достиТСния рСмиссии Π² зависимости ΠΎΡ‚ лСчСния Π½Π΅ Π±Ρ‹Π»ΠΈ статистичСски Π·Π½Π°Ρ‡ΠΈΠΌΡ‹ΠΌΠΈ (U-test, p = 0,123). Π—Π°ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠ΅. Показана ΡΡ„Ρ„Π΅ΠΊΡ‚ΠΈΠ²Π½ΠΎΡΡ‚ΡŒ узкополосной Ρ„ΠΎΡ‚ΠΎΡ‚Π΅Ρ€Π°ΠΏΠΈΠΈ UVB 311 Π½ΠΌ Π² Π»Π΅Ρ‡Π΅Π½ΠΈΠΈ Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… псориазом с прСимущСствСнным ΠΏΠΎΡ€Π°ΠΆΠ΅Π½ΠΈΠ΅ΠΌ Π»Π°Π΄ΠΎΠ½Π΅ΠΉ ΠΈ подошв. ΠŸΠΎΠ»ΡƒΡ‡Π΅Π½Π½Ρ‹Π΅ Π΄Π°Π½Π½Ρ‹Π΅ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΡŽΡ‚ Ρ€Π΅ΠΊΠΎΠΌΠ΅Π½Π΄ΠΎΠ²Π°Ρ‚ΡŒ Π²ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠ΅ узкополосной Ρ„ΠΎΡ‚ΠΎΡ‚Π΅Ρ€Π°ΠΏΠΈΠΈ UVB 311 Π½ΠΌ с достиТСниСм срСднСй кумулятивной Π΄ΠΎΠ·Ρ‹ 22,8 Π”ΠΆ/см Π² стандартный комплСкс Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с Π΄ΠΈΠ°Π³Π½ΠΎΠ·ΠΎΠΌ Π²ΡƒΠ»ΡŒΠ³Π°Ρ€Π½ΠΎΠ³ΠΎ псориаза с прСимущСствСнным ΠΏΠΎΡ€Π°ΠΆΠ΅Π½ΠΈΠ΅ΠΌ Π»Π°Π΄ΠΎΠ½Π΅ΠΉ ΠΈ подошв Π² качСствС Π½Π΅ Ρ‚ΠΎΠ»ΡŒΠΊΠΎ Π°Π΄ΡŠΡŽΠ²Π°Π½Ρ‚Π½ΠΎΠΉ ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΈΠΊΠΈ, Π½ΠΎ ΠΈ основной тСрапСвтичСской стратСгии. ΠœΠ΅ΡΡ‚ΠΎ узкополосной Ρ„ΠΎΡ‚ΠΎΡ‚Π΅Ρ€Π°ΠΏΠΈΠΈ UVB 311 Π½ΠΌ Π² Π»Π΅Ρ‡Π΅Π½ΠΈΠΈ Π»Π°Π΄ΠΎΠ½Π½ΠΎ-подошвСнного пустулСзного псориаза, ΠΊΠ°ΠΊ ΠΈ Ρ€Π΅ΠΆΠΈΠΌΡ‹ дозирования облучСния, Π° Ρ‚Π°ΠΊΠΆΠ΅ ΠΎΠΏΡ€Π΅Π΄Π΅Π»Π΅Π½ΠΈΠ΅ Π½Π΅ΠΎΠ±Ρ…ΠΎΠ΄ΠΈΠΌΡ‹Ρ… сроков динамичСского наблюдСния ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² ΠΏΡ€Π΅Π΄ΠΌΠ΅Ρ‚ Π΄Π°Π»ΡŒΠ½Π΅ΠΉΡˆΠΈΡ… исслСдований
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