Analysis of clinical and diagnostic features and criteria for the effectiveness of treatment of autoimmune bullous dermatoses pemphigus group

2021 ◽  
pp. 51-57
Author(s):  
М.Е. Zapolsky ◽  
М.М. Lebediuk ◽  
N.B. Prokofyeva ◽  
V.V. Goncharenko ◽  
S.V. Nerubashchenko
Keyword(s):  
Immunofluorescence Microscopy ◽  
Clinical Manifestations ◽  
Diagnostic Algorithm ◽  
Pemphigus Vulgaris ◽  
Diagnostic Features ◽  
Iga Pemphigus ◽  
Modern Classification ◽  
Pemphigus Erythematosus ◽  
Pemphigus Vegetans

The modern classification of autoimmune bullous dermatoses is represented by three groups of diseases that have not only clinical, but also histomorphological, histochemical and immunogenetic similarities. Autoimmune bullous dermatoses are a group of heterogeneous diseases accompanied by the formation of blisters and erosions on the skin and/or mucous membranes under the influence of specific autoimmune complexes. The main clinical manifestations and diagnostic markers of autoimmune bullous dermatoses (ABD) belonging to the pemphigus group are considered.Objective — to analyze the prevalence of clinical forms of pemphigus in the southern region of Ukraine for the period from 2010 to 2020.Materials and methods. The observation group consisted of 88 patients aged 21 to 75 years. The features of clinical manifestations of typical and atypical forms of pemphigus have been studied, a diagnostic algorithm and criteria for the effectiveness of treatment in the early stages of the disease have been developed.Results and discussion. Pemphigus vulgaris was found in 61 (69.3 %), pemphigus vegetans — in 7 (7.9 %), pemphigus erythematosus — in 6 (6.8 %), herpetiform pemphigus — in 4 (4.5 %), IgA pemphigus — in 3 (3.4 %), paraneoplastic pemphigus — in 3 (3.4 %) patients.Conclusions. Modern clinical diagnostic features of ABD (pemphigus group) require the inclusion of immunofluorescence microscopy, direct and indirect enzyme immunoassay in laboratory screening. Not only positive clinical dynamics, but also the rate of disappearance of autoantibodies that induce the diseases (desmoglein, desmoplakin, periplakin, etc.) should be considered the criteria of the effectiveness of treatment of patients with ABD. At the same time, knowledge of the clinical features of ABD and the diseases that mimic them remains an important aspect.

scholarly journals IgG/IgA-pemphigus — extremely rare blistering autoimmune diseases

2020 ◽  
Vol 96 (1) ◽  
pp. 45-51
Author(s):  
Arfenya E. Karamova ◽  
Lyudmila F. Znamenskaya ◽  
Vadim V. Chikin ◽  
Viktoria A. Mihina ◽  
Maria A. Nefedova
Keyword(s):  
Skin Biopsy ◽  
Clinical Manifestations ◽  
Pemphigus Vulgaris ◽  
Biopsy Sample ◽  
Cytological Examination ◽  
Iga Pemphigus ◽  
Laboratory Examinations ◽  
Skin Biopsy Sample ◽  
Unaffected Skin ◽  
Effective Medication

Purpose. To present a clinical case of IgG/IgA pemphigus in a 32-year-old woman. Material and methods. Clinical and laboratory examinations were performed to diagnose the disease: cytological examination of an impression smear from the bottom of the erosion, histological examination of a skin biopsy sample from the lesion, immunofluorescent examination of a biopsy sample of visually accessible unaffected skin. Results. Clinical manifestations of the disease were similar to Duhring's dermatitis herpetiformis, morphological ones to pemphigus vulgaris, but immunofluorescent examination of the skin biopsy sample in equal measure revealed deposits of both IgG and IgA in the epidermis, which allowed to determine a diagnosis of IgG/IgA pemphigus. Dapsone therapy at a dose of 100 mg per day led to a significant improvement in the patient's condition. Conclusion. Diagnosis of bullous dermatoses requires immunofluorescent examination of a biopsy sample of visually accessible unaffected skin. Dapsone was an effective medication for the patient with IgG/IgA pemphigus.

Differential Diagnosis of Retinoblastoma and Conditions Simulating Retinoblastoma (Pseudoretinoblastoma)

2020 ◽  
pp. 51-58
Author(s):  
D.P. Volodin ◽  
◽  
A.V. Kotelnikova ◽  
E.S. Kotova ◽  
A.A. Yarovoy ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Key Words ◽  
Review Article ◽  
Diagnostic Features ◽  
Modern Classification ◽  
History Of

The review article provides literature data related to the history of differential diagnosis of retinoblastoma and lesions simulating retinoblastoma (pseudoretinoblastomas), provides a modern classification of pseudoretinoblastomas, describes clinical and diagnostic features that allow to differentiate these conditions. The analysis of Russian and foreign publications on main pseudoretinoblastomas requiring differential diagnosis with retinoblastoma in pediatric ophthalmological practice was carried out. Key words: ophthalmology, retinoblastoma, lesions simulating retinoblastoma, pseudoretinoblastomas, differential diagnosis.

scholarly journals Chronic tonsillitis in the practice of ENT and cardiology

2014 ◽  
Vol 5 (3-4) ◽  
pp. 60-65
Author(s):  
D. L Yalymova ◽  
V. N Kostyuk ◽  
V. V Vishnyakov ◽  
A. A Yalymov ◽  
G. G Shehyan ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Chronic Tonsillitis ◽  
Associated Diseases ◽  
Modern Classification

The problem of chronic tonsillitis (CT), its complications and associated diseases with positions of ENT doctor and cardiologist. The etiology and pathogenesis are also presented, as well as chemotherapy and clinical manifestations of conjugate pathology. A modern classification of CT is also presented. We consider the diagnosis of CT and related diseases.

scholarly journals Echinococcosis and Other Parasitic Liver Diseases

2020 ◽  
Vol 16 (30) ◽  
pp. 88-91
Author(s):  
V.V. Skvortsov ◽  
◽  
B.N. Levitan ◽  
A.N. Gorbac ◽  
Keyword(s):  
Liver Diseases ◽  
Clinical Manifestations ◽  
Parasitic Diseases ◽  
Modern Classification ◽  
Basic Approaches

This article provides information on the epidemiology and etiopathogenesis of echinococcosis and other parasitic diseases affecting the liver. The modern classification of liver echinococcosis, clinical manifestations of this disease, as well as methods of laboratory and instrumental diagnostics, basic approaches to therapy are presented

scholarly journals Revisiting the question of pemphigus classification

2021 ◽  
Vol 97 (2) ◽  
pp. 9-15
Author(s):  
Alexey V. Samtsov ◽  
Evgeny V. Sokolovskiy ◽  
Natalia P. Teplyuk ◽  
Irena E. Belousova ◽  
Muza M. Kokhan ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Guidelines ◽  
Pemphigus Vulgaris ◽  
Neutrophilic Dermatosis ◽  
Pemphigus Foliaceus ◽  
Paraneoplastic Pemphigus ◽  
Iga Pemphigus ◽  
Subcorneal Pustular Dermatosis ◽  
Pemphigus Erythematosus

Analysis of various classifications of pemphigus shows that there are no fundamental differences between them. The main distinctions consist in use of diverse terms in naming of some forms of pemphigus and in inclusion or exclusion of certain subtypes from the classifications. Authors propose to use the following classification in the dermatological clinical practice, for educational and scientific purposes and for clinical guidelines: 1) pemphigus vulgaris (1.1. Pemphigu s vegetans); 2) pemphigus foliaceus (2.1. Pemphigus endemic (Fogo selvagem), 2.2. Pemphigus erythematosus (Senear Usher)); 3) herpetiform pemphigus; 4) paraneoplastic pemphigus; 5) IgA pemphigus (5.1. Subcorneal pustular dermatosis, 5.2. Intraepidermal neutrophilic dermatosis).

scholarly journals CLINICAL MANIFESTATIONS OF ORAL MUCOSAL LESIONS IN VERIOUS DERMATOSIS

2020 ◽  
Vol 16 (1) ◽  
pp. 5-13
Author(s):  
Olga Guryevskaya ◽  
Irina Usmanova ◽  
Zuhra Hismatullina ◽  
Al'bina Bulgakova ◽  
Yigal Granot ◽  
...  
Keyword(s):  
Oral Mucosa ◽  
Clinical Manifestations ◽  
Pemphigus Vulgaris ◽  
Complex Treatment ◽  
Significant Progress ◽  
Systematic Analysis ◽  
Oral Mucosal Lesions ◽  
Modern Classification ◽  
Mucosal Lesions ◽  
Modern Technologies

Subject. This review presents a modern literature review on the clinical manifestations of severe autoimmune disease — pemphigus vulgaris, chronic genetic determinate dermatosis — by the example of epidermolysis bullosa, dermatosis — lichen planus, acute immuno-mediated disease — multiforme exudative erythema. The goal is to conduct a systematic analysis of modern domestic and foreign literature to determine some features of the clinical manifestations of chronic dermatoses with lesions of the oral mucosa. Methodology. A review of the studies allows us to consider the etiology and pathogenesis of the development of these nosologies, approaches to modern classification, as well as an analysis of their clinical features with an emphasis on differential diagnosis. Results. It was noted that with combined damage to the skin and oral mucosa, the diagnosis of these dermatoses in patients does not present any particular difficulties. However, the significance of determining pathognomonic signs of damage to the oral mucosa with a particular dermatosis increases significantly with an isolated lesion of the oral mucosa, and when it is the primary and only manifestation of skin disease. Conclusions. Undoubtedly, the principle of continuity of the interested specialties among which are undoubted - dermatovenerologists, dentists, gastroenterologists, gynecologists, neuropsychiatrists, has great prospects in both diagnosis and complex treatment. Nevertheless, for their widespread use, the local and general treatment of these patients needs to be verified, solving urgent problems of introducing and adapting modern technologies for rapid prototyping them into practical healthcare, which together will allow significant progress in their diagnosis and prevention.

scholarly journals Simultaneous Oral and Umbilical Locations as a First Sign of Pemphigus Vulgaris

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Eya Moussaoui ◽  
Yassine Oueslati ◽  
Lamia Oualha ◽  
Mohamed Denguezli ◽  
Badreddine Sriha ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Early Treatment ◽  
Clinical Manifestations ◽  
Pemphigus Vulgaris ◽  
Skin Lesions ◽  
Oral Lesions ◽  
Cutaneous Lesions ◽  
Autoimmune Bullous Diseases ◽  
Bullous Diseases ◽  
Pemphigus Vegetans

The place of pemphigus vulgaris (PV) among autoimmune bullous diseases (AIBD) is well established. It is an acquired chronic, autoimmune, vesiculobullous disease in which IgG antibodies target desmosomal proteins to produce intraepithelial mucocutaneous blistering. The diagnosis is often challenging for the clinicians. It requires a combination of three major features: clinical, histopathological, and immunological. Clinically, oral lesions are the first manifestations of the disease in 50-90% of the patients with widespread blisters affecting the oral mucosa. On the skin, lesions are characterized by flaccid blisters that rapidly progress into erosions and crust formation. Umbilical lesions as a clinical manifestation of PV are peculiar and have rarely been reported, and they are not yet completely elucidated. Umbilical region involvement in patients with pemphigus was assessed in a limited study totalling just 10 patients. This localisation may be a valuable hint easing the diagnosis at the clinical level for patients with oral mucosal blisters. Dentists must be familiar with the clinical manifestations of PV to make an early diagnosis and start an early treatment which determines the prognosis of the disease. To the best of the authors’ knowledge, the coexistence of these lesions with the oral lesions as a first sign of PV in the absence of skin involvement was reported in only one case of pemphigus vegetans (PVe). In this paper, we describe an observation of a female patient that was diagnosed with PV that begun with simultaneous oral and umbilical locations which coexisted for a period of 4 months before the appearance of other cutaneous lesions. We highlight the role of dentists, by being familiar with the clinical manifestations of PV, to make an early diagnosis to start an early treatment which determines the prognosis of the disease and to follow closely the evolution of lesions to change treatment if required. We also discuss the clinical, histological, and immunological features of the disease that enabled the differential diagnosis as well as the appropriate therapeutic management.

scholarly journals Diabetic neuropathy

2018 ◽  
pp. 68-75
Author(s):  
N. V. Pizova
Keyword(s):  
Diabetic Neuropathy ◽  
Genetic Factors ◽  
Clinical Manifestations ◽  
Nerve Fibers ◽  
Emergency Situations ◽  
Wide Range ◽  
The World ◽  
Modern Classification

Diabetes mellitus is one of the emergency situations worldwide. DM is the most common cause of neuropathy throughout the world that create a wide range of conditions associated with the damage of various nerves and various pathological mechanisms. The article considers the main pathogenetic mechanisms of neuropathy - the role of metabolic, vascular and genetic factors. It presents the main clinical manifestations, depending on what type of nerve fibers are affected. A modern classification of diabetic neuropathy is provided. The most common form - diabetic distal symmetric polyneuropathy is considered in detail. The authors describe the main drugs used for the treatment of diabetic neuropathy, which were proposed by the International Diabetic Federation (2017) in 2017. Lipoic acid supplements are examined in more details.

Use of photodynamic therapy for photodamage skin (review of literature)

2019 ◽  
Vol 1 (7) ◽  
pp. 19-23
Author(s):  
S. I. Surkichin ◽  
N. V. Gryazeva ◽  
L. S. Kholupova ◽  
N. V. Bochkova
Keyword(s):  
Photodynamic Therapy ◽  
Comparative Evaluation ◽  
Clinical Manifestations ◽  
Light Sources ◽  
Review Of Literature ◽  
Photosensitizing Agents ◽  
Selection Of

The article provides an overview of the use of photodynamic therapy for photodamage of the skin. The causes, pathogenesis and clinical manifestations of skin photodamage are considered. The definition, principle of action of photodynamic therapy, including the sources of light used, the classification of photosensitizers and their main characteristics are given. Analyzed studies that show the effectiveness and comparative evaluation in the selection of various light sources and photosensitizing agents for photodynamic therapy in patients with clinical manifestations of photodamage.

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