Publications by authors named "Svitlana Vozianova"

3 Publications

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Practical algorithm to inform clinical decision-making in the topical treatment of atopic dermatitis.

J Dermatol 2021 May 7. Epub 2021 May 7.

Department of Dermatology and Venereology, Peking University First Hospital, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, National Clinical Research Center for Skin and Immune Diseases, Beijing, China.

Atopic dermatitis is a chronic relapsing, inflammatory skin disorder associated with skin barrier dysfunction, the prevalence of which has increased dramatically in developing countries. In this article, we propose a treatment algorithm for patients with mild-to-moderate and severe atopic dermatitis flares in daily clinical practice. An international panel of 15 dermatology and allergy experts from eight countries was formed to develop a practical algorithm for the treatment of patients with atopic dermatitis, with a particular focus on topical therapies. In cases of mild-to-moderate atopic dermatitis involving sensitive skin areas, the topical calcineurin inhibitor pimecrolimus should be applied twice daily at the first signs of atopic dermatitis. For other body locations, patients should apply a topical calcineurin inhibitor, either pimecrolimus or tacrolimus, twice daily at the first signs of atopic dermatitis, such as pruritus, or twice weekly in previously affected skin areas. Emollients should be used regularly. Patients experiencing acute atopic dermatitis flares in sensitive skin areas should apply a topical corticosteroid twice daily or alternate once-daily topical corticosteroid/topical calcineurin inhibitor until symptoms improve. Following improvement, topical corticosteroid therapy should be discontinued and patients switched to a topical calcineurin inhibitor. Maintenance therapy should include the use of pimecrolimus once daily for sensitive areas and tacrolimus for other body locations. This treatment algorithm can help guide clinical decision-making in the treatment of atopic dermatitis.
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http://dx.doi.org/10.1111/1346-8138.15921DOI Listing
May 2021

morphological and immunohistochemical features of tissue homeostasis in patients with alopecia areata in the chronic stage associated with metabolic syndrome and the non-burdened course of the disease.

Wiad Lek 2019 ;72(7):1236-1242

Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine.

Objective: Introduction: Alopecia areata (AA) is a tissue-specific disease of the hair follicles, manifested by foci of baldness on the head and other areas of the skin. The aim of the study was to identify the tissue homeostasis state on the basis of pathomorphological and immunohistochemical changes taking into account the features of Ki67, bcl-2, caspase-3, and CD31 expression in patients with AA in the chronic stage associated with metabolic syndrome and the non-burdened course of the disease.

Patients And Methods: Materials and methods: Pathomorphological and immunohistochemical studies of Ki67, bcl-2, caspase-3, and CD31 expression in biopsies specimens from skin lesions in the chronic stage of the disease were performed in 11 patients with AA associated with metabolic syndrome and the non-burdened course of the disease.

Results: Results: The results of complex morphological study showed that in skin biopsies of patients with AA with metabolic disorders pathomorphological changes were more affected both in the epidermis and skin appendages - degenerative changes in the epithelium, in the dermis, manifestations of appendage atrophy and stromal fibrosis. In patients with AA without metabolic disorders the proliferative potential of epithelial cells (Ki67 proliferation index) was 20-25%, in cases of AA with metabolic syndrome - 5-10%, indicating a decrease in regenerative capacity of the tissue. The state of the microcirculatory bed (CD31) in cases of AA without metabolic disorders is more favorable for the trophic tissue function and decreases in the group of AA with metabolic disorders. It was found that activation of pathological cell apoptosis was observed in cases of AA with metabolic disorders and lower level of bcl-2 expression. In our observations, the level of expression of caspase-3 was at a relatively high level, indicating the activation of pathological apoptosis in the tissues of the affected areas.

Conclusion: Conclusions: Our pathomorphological, immunohistochemical data allows us to assert that it is advisable to carry out a biopsy of the affected areas with the establishment of levels of proliferative activity of epithelial and stroma cells, the state of the microcirculatory vessels, the possibilities of repair of the affected areas, assessment of the level of apoptosis in order to predict the course of the disease and usage of the personified approach to treatment.
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August 2019

[Genetic-morphological peculiarities of response to standard therapy in patients with dyshidrotic eczema of palms and soles].

Wiad Lek 2018;71(9):1707-1713

Department of Pathological and Topographic Anatomy of Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine.

Objective: Introduction: Dyshidrotic eczema of palms and soles (DEPS) is an inflammatory skin disorder that has a multifactorial nature and is characterized by the development of vesical elements with the histological picture of spongiosis and development of intraepidermal vesicles. The aim: Establishment of the features of pathomorphological changes of the epidermis and dermis in patients with manifestations of dyshidrotic lesions of palms and soles with different genotypic variants of the C646G of the NR3C1 gene before treatment based on the study of skin biopsies taking into account the response to standard therapy.

Patients And Methods: Materials and methods: In 57 patients with dyshidrotic lesions, a pathomorphological and immunohistochemical examination of biopsy specimens from a lesion focus of the skin were carried out and a genetic examination was carried out to determine the polymorphic variant C646G of the NR3C1 gene.

Results: Results: The results of this study in patients with DEPS showed that in patients with genotype 646 CC, which are torpid to treatment, there is a complex of immune defense with the activation of complement system with activation of C3 and C4d. The activity of expression of CD4 + cells indicating the intensity of the inflammatory response compared with patients with the 646 CC genotype, which were sensitive to treatment. In cases of 646 CG genotypes which were sensitive to topical treatment with steroid, there was a slight decrease in C3 and a decrease in C4d. There was no change in the activation of CD4 + lymphocytes compared with insensitive patients with genotype 646 CG. Moreover, in determining the prognosis and choosing treatment tactics, of great practical value is the presence of immunological parameters that were revealed by the immunohistochemical examinations and were determined by the genotypic peculiarities in patients with DEPS.

Conclusion: Conclusions: Integral evaluation of the pathomorphological study of biopsy dyshidrotic lesions of sensitive and insensitive patients with different genotypic variants of the C646G of the NR3C1 gene before treatment allows obtaining objective information on the direct effect of glucocorticosteroid therapy. According to the results of our study, the association between NR3C1 gene variants, the pathomorphological features and degree of healing of dyshidrotic lesions of palms and soles was established: the polymorphic version of 646 CC in insensitive patients was associated with additional complement activation of the complement of fractions of C3 and C4d in comparison with sensitive patients of this genotype; рolymorphic variants of 646 CG in sensitive patients - with a slight decrease in the deposition of complement fractions of C3 and C4d іn comparison with insensitive patients of the corresponding genotype.
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June 2019