[About experiment on decrease of dermatovenerological disease incidence among servicemen of Northern Caucasian Military District].
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Biomedical subjects
Publications and source records attributed to A V Samtsov.
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We report a patient with specific cutaneous involvement by B-cell chronic lymphocytic leukemia, who demonstrated unusual clinical features during the course of the disease, namely several spontaneous regressions of skin lesions with the formation of scars. In addition, histologically proven keratoacanthoma was found. During the follow-up period of approximately 1.5 years, the patient experienced several recurrences of skin lesions and their partial spontaneous regression. The scars persisted and remained unchanged. We hypothesize that vascular injury combined with edema could have accounted for dermal ischemia and the subsequent development of the scarring lesions.
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At 51 men at the age from 20 till 30, sick with pyodermatitis, the clinical-immunological aspects and efficiency of-actoprotector, capable to support motor activity and human performance in the extreme environments. Bemitil has appeared more effective in comparison with conventional therapy: by general and combined application the parameters of immunity have been normalized statistically authentically, and at outside application-the places of damage were cleared faster, disappeared painfulness, hyperemia, edema, terms of staying in the hospital were reduced. The clinical recovery was in 86.3 +/- 4.8% of the patients, while effectiveness from conventional means was 62.1 +/- 6.8%.
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Twenty patients with cutaneous sarcoidosis and 21 patients carrying isolated skin sarcoids were studied. (We use the term 'sarcoid' to emphasize that exclusively skin was altered.) Both groups were compared by clinical and histological patterns and certain data concerning the state of the mononuclear phagocyte system (MPS). It was found that skin lesions in sarcoids and sarcoidosis do not differ regarding either in clinical or histological manifestations. The changes in the functional activity of monocytes and macrophages were the same. The data obtained allow us to suggest that sarcoids should be regarded as a systemic disease connected with changes in the MPS reaction.
Electron microscopic examination of epithelioid-cell granulomas of two patients with total sarcoidosis and of three ones with isolated sarcoidosis of the skin (sarcoid reactions) has revealed a morphologic polarization of epithelioid cells, manifesting as 4 zones: (1) crimped [correction of chimp] edge zone, (2) zone of vesicles and vacuoles, (3) basal zone, (4) osmiophilic granules zone. The structure of epithelioid cells in sarcoidosis and in sarcoid reactions was found similar, evidencing a high biosynthetic function of the cells.
A female patient suffering from the ulcerative form of skin sarcoidosis is described and the literature dealing with this problem is reviewed. Peculiar features of this case are described: ulceration of the nodes, which is an extremely rare phenomenon; no involvement of other organs, lungs included, was detectable, which is not typical of ulcerative sarcoidosis; small-nodular elements are parallelled by nodes (Boeck's small-nodular sarcoid and Darier-Roussy's subcutaneous sarcoids) in this patient, this evidencing an uniform pathologic process in the skin and subcutaneous fat. Ulceration in this patient is explained by the development of allergic vasculitis of the immediate hypersensitivity type (leukocytoclastic vasculitis and manifest increase of the level of circulating immune complexes). Prednisolone therapy has resulted in an excellent clinical effect.
Histologic and electron microscopic study of the epidermis in, respectively, 30 and 4 patients with skin sarcoidosis has revealed that atrophy of the epidermis is the most incident condition, whose severity depends on microcirculation disorders that are explained by the location of the epithelioid-cell granulomas relative to skin microcirculatory bed. Moderate atrophy involves the following ultrastructural changes in the keratinocytes: increased count of ribosomes and mitochondria, tonofibril condensation, perinuclear vacuolization, separation of individual cellular contact sites. If atrophy is well manifest, basal keratinocytes grow in size and the nuclei in them are positioned apically. These data suggest that drugs improving the microcirculation be prescribed to such patients in order to obliterate possible cosmetic defects.
The findings of immunologic examinations of patients with sarcoidosis and sarcoids of the skin are reviewed. Immune disorders in these conditions are identical. Lowered cellular immunity activity and elevated humoral immunity activity have been revealed. Increased level of circulating immune complexes evidences the process activity in both sarcoidosis and sarcoids of the skin. The intensity of immune disorders does not depend on the disease duration, form, and dissemination.
Twenty-eight patients with skin sarcoidosis were treated with thymalin, thymogen, levamisole, dimocifon, with due consideration for their immune status. Immunostimulating therapy has failed. Plaquenil, phthivazide and duplex therapy did not result in noticeable improvement either. An individual pattern of mononuclear phagocyte response to various immunoregulators was revealed. The highest sensitivity to human interferon, hydrocortisone, and prospidine was determined in vitro. The highest effect was achieved by a combination of corticosteroids with prospidine, though in 20 percent of cases the disease recurred within 2 years. Since these drugs are not harmless for the body, the major indications for their prescription to patients with skin sarcoidosis (provided there are no direct indications because of other conditions) are the process activity and dissemination, cosmetic defects because of the disease. In case of a local involvement and uneventful course of the process a follow-up is advisable.
A female patient is described, suffering from a lingering superficial form of Wegener's granulomatosis. The disease has been diagnosed on the basis of its prolonged (7 yrs) relatively benign course, isolated involvements presenting as skin and nasal mucosa ulcers, hard palate and nasal septum defect, and histologic shifts (necrotizing paling granulomas, combined with vasculitis). Low prednisolone doses have been quite effective in therapy of this condition.
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