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Pruritus is one of the subjective sensations that significantly reduces the quality of life of patients. In patients with malignancies, itch can be caused by different universal or specific pathophysiological factors. This article discusses disorders that cause pruritus in cancer patients: the tumor growth on its own; pathophysiological changes associated with a number of malignancies, paraneoplastic itch, anticancer therapy, concomitant dermatoses, systemic diseases, psychosomatic disorders. Known or proposed mechanisms of the development of pruritus are presented for each of the mentioned provoking factors, and methods of treatment are described, according to the etiological factor. At the end of the article, universal methods for the correction of itching are presented, applicable in cancer patients, regardless of the pruritogenic factor. Special attention is paid to the correction of xerosis as a universal cause of itching in oncological patients.

Therapy of moderate-to-severe atopic dermatitis (AD) is associated with a number of diffculties due to the propensity of the disease to a chronic relapsing course, the tendency to develop in childhood and young age. However, a new selective JAK1 inhibitor, which suppresses cytokineinduced inflammation in the skin, has been added to the arsenal of AD systemic therapy.Objective. To evaluate the effcacy, antipruritic activity, impact on quality of life, levels of anxiety and depression, and safety of upadacitinib treatment of moderate-to-severe AD in adult patients.Material and methods. The inclusion criteria were the presence of moderate-to-severe AD, age over 18 years, signed informed consent of the patient to participate in the study. Effcacy was assessed based on clinical indices. All patients received upadacitinib (RANVEK) 15 mg once daily with or without food, topical corticosteroids (if needed), and emollients.Results. The number of patients with an IGA score of 0 or 1 was 50%. The dynamics of the maximum intensity of pruritus according to NRS during 16 weeks of therapy was 56.4%. The proportion of patients with an improvement in the assessment of the maximum severity of itching according to NRS ≥3 points at week 16 relative to the baseline was 77.8%. The dynamics of the EASI index in percent was 65.3%, and the number of patients who achieved an EASI-50 response at week 16 was 83.3%, EASI-75 was 61.1%. The dynamics of the overall SCORAD index as a percentage of the initial value for 16 weeks was 76.9%. The DLQI decreased by 68.9%. The number of patients with HADS less than 7 points on a scale of both anxiety and depression was 88.9%.Conclusions. Thus, upadacitinib demonstrates high effcacy in terms of the effect on rashes and pruritus, favorably affects the quality of life and psychosomatic characteristics of patients, and has a favorable safety profle in the treatment of moderate and severe AD in adults.

Basal cell skin cancer most often requires differential diagnosis in patients with neoplastic skin lesions, both pigmented and non-pigmented. The cytological examination is simple to perform and is widely used for the initial examination of patients with skin tumors, both non-pigmented and pigmented. This article discusses in detail the history of the use of cytological examination, technique, diagnostic criteria for basal cell skin cancer. Particular attention is paid to the objective diffculties in the application of the method, the rather high specifcity of cytological examination in the diagnosis of basal cell skin cancer is illustrated.

According to the current concepts, pathogenesis of acne includes signifcant morphological and functional changes and hypercolonization of C. acnes of the sebaceous hair follicle. But most important input into pathogenesis of acne gives permanent inflammation, previously considered as a secondary pathophysiological reaction. Recently, much attention has been given to pruritus associated with acne lesions. This literature review analyzes the data concerning the pathogenetic role of neurogenic inflammation in acne; the clinical importance of itch in the overall presentation of the disease is underlined, and its influence on psychosomatic correlations is presented.

Introduction: Mesenchymal stromal cells (MSCs) administration is an effective option for the treatment of diabetic foot ulcers (DFUs). However, to date, studies assessing long-term outcomes and evaluating skin parameters after cell-based therapy are lacking. We presented the clinical outcomes of 3 patients, treated for DFUs with the bone marrow MSCs 3 years earlier. Methods: Ultrasound examination was used to compare collagen density and epidermal thickness in areas of healed ulcers in comparison with non-affected skin used as a control. Ultrasound and dermatoscopy were used to exclude neoplasm formation, to assess scar contracture and wound recurrence. Results: In all patients, no ulcer recurrence was detected, which was lower than the expected 60% rate of re-ulceration in diabetic patients in a 3-year period (OD [odds ratio] = 0.095, P = 0.12). No neoplasm formation, no contracture of hypertrophic scar, and adjacent tissue were registered. Collagen ultrasound density was decreased by 57% (P = 0.053) and epidermal thickness was increased by 72% (P = 0.01) in the area of healed ulcers in all patients. Conclusion: MSCs therapy alone did not result in the complete restoration of the skin parameters within a 3-year period. MSCs may represent important adjuvant to the therapy, however, other novel approaches are required to achieve better results.

The consensus on the prevention and correction of rash in patients with HR+ HER2- metastatic breast cancer treated with alpelisib was developed by the experts of the Russian Society of Clinical Oncology and dermatovenerologists. PIK3CA mutation is a poor prognostic factor for HR+ HER2- metastatic breast cancer. Alpelisib demonstrates efficacy in patients with PIK3CA mutation, but treatment might be associated with adverse events that include rash. All-grade rash was reported in 35.6% patients in SOLAR-1 trial (n=284). According to the published real-world data, for Russian population (n=19) all-grade rash was reported for 37% patients. The consensus contains practical recommendation on management of patients with rash of different grade.

Pigmented neoplasms of the skin and mucous membranes are a heterogeneous group of benign and malignant neoplasms, some of which are extremely rare in the practice of pediatric oncologist. Orolabial melanosis refers to a benign pigmented pathology of the skin and mucous membranes, requires differential diagnosis with ephelids, melanoma, and when localized on the tongue – with pigmented fungiform papillae of the tongue.This article presents a clinical case of orolabial melanosis with localization on the tongue in a 9-year-old child that was not previously described in the domestic literature. The clinical, dermatoscopic, immuno-morphological and differential diagnostic features of this pathology are described in detail.

Early diagnosis of skin melanoma is one of the most reliable ways to improve the prognosis for the life of patients with this tumor. Organization of medical care for patients with a high risk of developing melanoma, together with the use of non-invasive diagnostic methods and teaching the patient the principles of prevention and early diagnosis of skin malignancies should improve the survival rates of patients with melanoma. The article discusses the experience of implementing the Organizational model of medical care for patients with skin neoplasms in Moscow, as well as the key rules for managing patients at risk of developing skin melanoma with special emphasis on recommendations to patients for regular self-examination of the skin, lifestyle correction and the use of photoprotective agents.

Therapy with epidermal growth factor receptor (EGFR) inhibitors is inevitably accompanied by the phenomena of dermatological toxicity. Being, on the one hand, a favorable prognostic factor for the effectiveness of anticancer therapy, these adverse events are one of the most frequent indications for treatment withdrawal. This article presents the clinical characteristics of a wide spectrum of dermatological adverse events, as well as the pathogenetic rationale for their correction. Algorithms for prescribing of external and systemic therapy based on the assessment of severity of skin lesions and skin appendages involvement are presented.

Gardner-Diamond syndrome is an extremely rare autoimmune disorder characterized by sensitization to phosphatidylserine of erythrocyte stroma leading to ecchymoses triggered by stressful events. Diagnostic criteria include typical history, typical skin lesions, normal parameters of blood count and blood coagulation and a positive test with intracutaneous injections of 1 ml of autoerythrocytes. Most patients with Gardner-Diamond syndrome have co-morbid mental disorders. Psychotherapy and psychopharmacotherapy (selective serotonin reuptake inhibitors, tricyclic antidepressants) seem to be most pathogenetically supported treatment modalities.

Trichotillomania (TTM) or hair pulling disorder (HPD) is defined as a recurrent pulling of one’s own hair leading to significant hair loss, i.e. self-inflicted alopecia, traction alopecia or mechanical alopecia, accompanied by repeated unsuccessful attempts to decrease or stop the behaviour. TTM often onsets following a stressful event or when one is in persistent distress. It is important to identify an acute stress (death of a partner/significant other, parental divorce, employment termination, etc.) or chronic stress (ongoing domestic violence, poor scholarly or job performance, long-lasting overwork, etc.). It is essential to overlook the general situation of an individual’s life circumstances, as there could be important signs of positive or negative reinforcement for hair pulling. Optimal or gold standard treatment is still lacking. Psychiatric referral is recommended, however, there could be other organisation forms like multidisciplinary psychodermatological clinics or consultation-liaison services. There is evidence for pharmacological treatment, as for psychotherapy. A combination of both may be more effective than either approach independently. In this chapter, the evidence for psychodermatopharmacology, psychotherapy and other therapies will be discussed.

The magnetoresonance properties of a composite film system based on alsifer nanoparticles in a polymer matrix are studied. It is shown that the system has uniaxial anisotropy of magnetic properties in a sample’s plane. The magnitude and orientation of the field of anisotropy upon varying the alsifer concentration do not change appreciably.

To study clinical characteristics of burning mouth syndrome or glossalgia is a functional disorder with painful sensations in the oral cavity with verification of the psychopathological structure, typology and nosology of the syndrome within the continuum of neurotic/psychotic disorders and dermatological pathology, i.e. lichen planus (LP).The study sample (The psychopathological picture of glossalgia syndrome has a binary structure. Basic coenesthesiopathies, ranging in severity from homonomous sensations (isteralgias) to heteronomic sensopathies (senestopathies, senesthesia), are associated with secondary hypochondriacal phenomena: from health anxiety and monopatophobia to mastery of ideas and somatopsychic confusion, respectively. According to the psychopathological register (neurotic/psychotic) and the fact of objective verification of a dermatological disease (hypochondria sine materia/cum materia), there are three types of glossalgic syndrome: 1) organo-neurotic; 2) somatopsychotic; 3) dermatological (stress-induced somatic reactions).BMS is a local syndrome limited to the oral cavity, however, in fact, it covers the entire clinical spectrum of psychosomatic pathology from mental diseases to psychodermatological ones.Описать клинические проявления глоссалгии (синдром «горящего рта»), расстройства, выражающегося патологическими телесными сенсациями в полости рта, с верификацией психопатологической структуры, типологии и нозологии синдрома в пределах континуума расстройств невротического/психотического регистров и дерматологической патологии (красный плоский лишай (КПЛ)).Выборку составили 30 пациентов (27 женщин, средний возраст 59,3±15,6 года), прошедших комплексное психопатологическое, психометрическое, дерматологическое, неврологическое обследования. Пациенты соответствовали диагностическим критериям глоссалгии согласно классификации IASP и МКБ-10 для глоссодинии (код К14.6). В 8 наблюдениях коморбидным заболеванием являлся КПЛ слизистой оболочки полости рта.Психопатологическая картина синдрома глоссалгии имеет бинарную структуру. Базисные коэнестезиопатии, ранжируемые по тяжести от гомономных сенсаций (истералгий) до гетерономных сенстопатий (сенестопатии, сенестезии), ассоциированы с вторичными ипохондрическими феноменами: от тревоги о здоровье и монопатофобий до овладевающих представлений и соматопсихической растерянности соответственно. Согласно психопатологическому регистру (невротический/психотический) и факту объективной верификации дерматологического заболевания (ипохондрия sine materia/cum materia), выделено три типа глоссалгического синдрома: 1) органоневротический; 2) соматопсихотический; 3) дерматологический (стресс-индуцированные соматические реакции).Глоссалгия — локальный, ограниченный полостью рта синдром, фактически охватывающий все условное клиническое пространство психосоматической патологии, на одном из полюсов которого доминируют психические заболевания, а на другом — дерматологические.

The authors present a review of up-to-date non-invasive visualization methods used in diagnostics of diseases of skin and its appendages. They describe physical principles forming the basis for non-invasive visualization methods such as dermatoscopy, confocal laser scanning microscopy, optical video monitoring, optical topometry, optical coherent tomography, ultrasound scanning, 3D-modeling. They also describe the potential of practical application of these diagnostics methods at the current stage of their development. The authors have demonstrated that it is possible to reduce the clinicians need in biopsy diagnostics due to the high information value of non-invasive visual diagnostics methods.

The authors disclosed the participation of apoptosis proteins in the development of acantholysis in patients with pemphigus. In this connection, studies of the PERP protein passing apoptosis signals and regulating desmosomal functions in keratinocytes are of interest. There is no information about any studies aimed at the PERP protein expression in patients with pemphigus in available literature. Goal. To assess the PERP protein expression in the skin of patients with pemphigus. Materials and methods. There was a study of 22 patients with pemphigus, a patient with bullous pemphigoid and ten healthy people. The PERP protein expression was studied in the biopsy materials obtained from lesion foci and apparently healthy skin of the patients as well as healthy people using the indirect immunofluorescence method. Results. The PERP protein expression was revealed in patients with pemphigus on areas of apparently intact skin, in lesion foci in the patient with bullous pemphigoid and skin of healthy volunteers in the membrane of keratinocytes from all epidermal layers.The PERP protein expression in the blister operculum in lesion foci in patients with pemphigus was absent. Conclusion. Substantial differences in the PERP protein expression in the blister operculum and apparently intact skin of patients with pemphigus were revealed.

Goal. To determine the nucleotide protein-coding PERP gene sequence and assess the relation between the revealed mutations/polymorphisms and development of true acantholytic pemphigus as well as particular features of its course. Materials and methods. The protein-coding PERP gene DNA sequence was studied by the sequence analysis method in 18 patients with true acantholytic pemphigus. Results. Two polymorphisms were discovered in patients with true acantholytic pemphigus in Exon 3 of the PERP gene for the first time: rs648802 (non-synonymous) and rs648396 (synonymous). The incidence of wild type genotypes in the revealed polymorphisms (С/С genotype rs648802 and Т/Т genotype rs648396) in healthy volunteers reliably exceeded that in patients (p = 0.049). Patients with true acantholytic pemphigus are characterized by a higher incidence rate of mutant heterozygous genotypes С/G rs648802 and Т/C rs648396 (p = 0.09). Mutant heterozygous genotypes of the polymorphisms (G/G genotype rs648802 and С/С genotype rs648396) were revealed in patients with the earlier onset of the disease (41-60 years) (p = 0.025) more often while heterozygous genotypes (С/G genotype rs648802 and T/С genotype rs648396) were revealed when the disease developed at the age of 61 or older more often (p = 0.01). Conclusion. Identification of the polymorphous genotype by the sequence method or other molecular methods (e.g. PCR) can be used to forecast the terms when true acantholytic pemphigus can emerge in genetically inclined patients. However, it should be noted that it is necessary to specify the preliminary results obtained based on a greater sample of patients with true acantholytic pemphigus.

The authors present a review of current approaches to studying the pathogenesis of true acantholytic pemphigus that may reveal new targets for therapeutic treatment. They discuss methods used for the first time to study this lethal dermatosis, and the development of previously used methods that are still important for studying true acantholytic pemphigus.

The rare dermatosis erythema ab igne was examined. The rarity of the observation is also determined by the factor, favoring the skin disease development, — the use of notebook, which infrared irradiation caused the illness development. Were described such items as reasons of erythema ab igne development, the clinical picture, peculiarities of diagnostics and treatment. Disease outcomes have been considered. Mechanisms of infrared irradiation, as well as its biologic effects have been represented.

Provides the survey of most prospective trends of research of the pathogenesis of the true acantholytic pemphigus. Cites key results of studies of factors of genetic predisposition to the development of this bullous dermatosis. Highlights problems of studies of the role of antiself antibodies and self-antigens in pemphigus pathogenesis. Represents the apoptolyse theory, explaining mechanisms of the loss of link between keratinocytes. Discusses issues of the cellular regulation of autoimmune reactions at acantholytic pemphigus.

Many findings confirm the influence of neuropsychic factors on the manifestation and exacerbation of the atopic dermatitis and psoriasis. Nowadays it is assumed that by means of neurotransmitters’ secretion the nervous system can influence different processes, including the immune mediated inflammation, which has the key role in the pathogenesis of such dermatosis. The article hereunder contains comprehensive data on prospective trends of following studies of the nervous regulation participation in the pathogenesis of such dermatosis.

A review of the literature concerning psychogenic purpura is presented. The diagnosis is usually based on typical anamnestic data, clinical presentation (painful inflammatory skin lesions, which progressed to ecchymoses during the next 24 h) and positive diagnostic tests with intracutaneous injections of 80% solution of washed autologous erythrocytes. No pathological findings of blood coagulation parameters are usually detected. Histopathological evaluations of lesional biopsies revealed non-specific changes. Taking into account the high frequency of psychic disorders and stress dependence of skin symptoms, therapy with psychotropic drugs (according to indications) and psychotherapy are pathogenetically grounded methods of treatment in psychogenic purpura, and should be provided together with symptomatic therapy.

The characteristics of a cylindrical magnetron, such as the dependences of the discharge voltage, chamber pressure, and plasma radiation intensity on the reactive gas flow rate and discharge current, are studied. In this magnetron, titanium nitride (TiN) and titanium dioxide (TiO2) films are obtained by reactive magnetron sputtering. The transmission and reflection spectra of the films in the visual range are taken. From the transmission data for the TiO2 films, their refractive index and absorption factor in the wavelength range 350–800 nm, as well as the porosity, are found by the Valeev method. The variation of the fundamental absorption edge with film thickness is determined with the Urbach formula.

Detected are several differences in biochemical properties of V. cholerae 569 B Inaba and V. cholerae M41 Ogawa productive strains. The differences are in the protein content in culture liquid, in the dynamics of enzyme activity in the process of reactor strain growth, and in the protease, phospholipase A2 and C activity. Demonstrated is the diverse resistance of enzymes of both of the strains to formaldehyde detoxification effect. Identified is the difference in enzyme activity of fractions, which are obtained by means of isoelectric precipitation of culture liquid proteins within the limits of pH 3,5-4,4.

Free radicals are molecules that have an unpaired electron and are usually unstable species with short lifetimes; however, radicals stabilized by resonance and steric protection can have long lifetimes. These stable radicals are utilized as polarizing agents for dynamic nuclear polarization (DNP), an NMR spectroscopic technique which provides tremendous improvements in signal-to-noise ratios. DNP is also used for in vivo cancer detection by Magnetic Resonance Spectroscopic Imaging (MRSI). This technique is often done by monitoring the metabolism of hyper-polarized 13C1-pyruvate. Novel radical polarizing agents with improved properties are needed to optimize DNP methods. Tetrabenzofluorenyl (Tbf) radicals have been designed for this purpose.The synthesis of stable Tbf radicals is discussed. The synthesis involved five steps from 9-bromophenthrene. Novel steps from known tetrabenzofluorene were bromination (88%), Friedel-Crafts alkylation (42%), and oxidation (87%) to the trimethoxy alcohol precursor in 19% overall yield for five steps. Attempts to prepare the radical from the hydrocarbon and alcohol precursors and characterization of synthetic intermediates by NMR, IR, and mass spectral analysis are described. Future work will include testing the EPR and DNP properties of the Tbf radicals by collaborators at MIT / DyNuPol.

Research suggests that fecal management systems (FMS) offer advantages, including potential cost savings, over traditional methods of caring for patients with little or no bowel control and liquid or semi-liquid stool. A budget impact model accounting for material costs of managing fecal incontinence was developed, and 1 year of experiential data from two hospitals' ICUs were applied to it. Material costs were estimated for traditional methods (ie, use of absorbent briefs/pads, skin cleansers, moisturizers) and compared with material costs of using a modern FMS for both average (normal-range weight) and complex (bariatric with wounds) ICU patients at hospital 1 and any ICU patient at hospital 2. Reductions in daily material costs per ICU patient using FMS versus traditional methods were reported by hospital 1 ($93.74 versus $143.89, average patient; $150.55 versus $476.41, complex patient) and by hospital 2 ($61.15 versus $104.85 per patient). When extrapolated to the total number of patients expected to use FMS at each institution, substantial annual cost savings were projected (hospital 1: $57,216; hospital 2: $627,095). In addition, total nursing time per day for managing fecal incontinence (ie, changing, cleaning, repositioning patients, changing pads, linens, and the like) was estimated at hospital 1, showing substantial reductions with FMS (120 minutes versus 348 minutes for average patients; 240 minutes versus 760 minutes for complex). Nursing time was not included in cost calculations to keep the analysis conservative. Results of this study suggest the materials cost of using the FMS in ICU patients was substantially lower than the cost of traditional fecal incontinence management protocols of care in both hospitals. Comparative studies using patient level data, materials, and nursing time costs, as well as complication rates, are warranted.

Long, cylindrical cathodic arc evaporators (500 and 1550 mm long) with an external side-wall working surface are considered. The evaporators run in pulsed or continuous mode and allow deposition of functional coatings of pure metals, multi- component alloys, and refractory compounds on long and large items in order to increase their wear-, corrosion- or erosion-resistance. The surface microstructure and microhardness of corrosion-resistant FeCrA1 coatings on high-temperature strengthened steel substrates, heat-resistant NiCrA1Y coatings on high-temperature strengthened ЖC6Y nickel alloy, copper coatings for brazing on 65Г steel, and erosion-resistant TiN coatings on B-95 aluminum alloy and BT6 titanium alloy are described and discussed. It is shown that vacuum-arc deposition of functional coatings using long evaporators provides the possibility of increasing significantly the working characteristics of critical machinery parts in modern engineering industry.

Rationale In mouse models for atopic dermatitis (AD) hypothalamus pituitary adrenal axis (HPA) dysfunction and neuropeptide-dependent neurogenic inflammation explain stress-aggravated flares to some extent. Lately, cholinergic signaling has emerged as a link between innate and adaptive immunity as well as stress responses in chronic inflammatory diseases. Here we aim to determine in humans the impact of acute stress on neuro-immune interaction as well as on the non-neuronal cholinergic system (NNCS). Methods Skin biopsies were obtained from 22 individuals (AD patients and matched healthy control subjects) before and after the Trier social stress test (TSST). To assess neuro-immune interaction, nerve fiber (NF)-density, NF-mast cell contacts and mast cell activation were determined by immunohistomorphometry. To evaluate NNCS effects, expression of secreted mammal Ly-6/urokinase-type plasminogen activator receptor-related protein (SLURP) 1 and 2 (endogenous nicotinic acetylcholine receptor ligands) and their main corresponding receptors were assessed by quantitative RT-PCR. Results With respect to neuro-immune interaction we found higher numbers of NGF+ dermal NF in lesional compared to non-lesional AD but lower numbers of Gap43+ growing NF at baseline. Mast cell-NF contacts correlated with SCORAD and itch in lesional skin. With respect to the NNCS, nicotinic acetylcholine receptor α7 (α7nAChR) mRNA was significantly lower in lesional AD skin at baseline. After TSST, PGP 9.5+ NF numbers dropped in lesional AD as did their contacts with mast cells. NGF+ NF now correlated with SCORAD and mast cell-NF contacts with itch in non-lesional skin. At the same time, SLURP-2 levels increased in lesional AD skin. Conclusions In humans chronic inflammatory and highly acute psycho-emotional stress interact to modulate cutaneous neuro-immune communication and NNCS marker expression. These findings may have consequences for understanding and treatment of chronic inflammatory diseases in the future.

The cholinergic system enables adaptation to environmental and endogenous stressors via neuroimmune responses. Self-environment borders such as skin are in great need of effective adaptation. We here compared skin if mice exposed to noise stress with unstressed and mice and humans with allergic/atopic dermatitis (AlD/AD) exposed to noise or Trier Social Stress Test (TSST). Microarray analysis revealed specific regulation of cytokines depending on muscarinergic and nicotinergic acetylcholine receptor (m- and n-AChR) activation. Downregulation of TNF α receptor 1 (TNFR1) and upregulation of TNFR5 in stressed mouse skin hints at downregulation of TH1 and upregulation of TH2 immune responses. Immunohistomorphometry revealed that mast cells in AlD downregulate the acetylcholine synthesizing enzyme ChAT while upregulating α 7nAChR and TNF α , which was reversed after AlD-worsening additional noise stress. In AD patients SP-cleaving tryptase + mast cells were lowest in lesional skin while epidermal thickness was highest. TSST increased mast cell numbers in healthy and decreased them in lesional skin, while epidermal thickness was increased in nonlesional skin. qRT-PCR showed lowest α 7nAchR levels in AD skin and after TSST slightly increased levels solely in lesional AD skin. SLURP1 (endogenous α 7nAchR ligand) was lowest in non-lesional AD skin and TSST decreased it in healthy skin. We conclude that stress affects cutaneous NNCS both in mice and humans facilitating AlD/AD. Further studies are needed to elucidate the underlying molecular mechanisms and functional relevance.