National guide to dermatology. Dermatovenereology

Dermoscopy of skin neoplasms / A.D. Hetman: Educational publication for residents, interns and doctors undergoing advanced training in the specialties "Oncology", "Dermatovenereology" and "Cosmetology". - Yekaterinburg: Ural Worker, 2015. - 160 p.: ill.

This illustrated edition is devoted to the issues of optical diagnostics of benign and malignant skin tumors (melanocytic and non-melanocytic). Aspects of the dermatoscopy method are highlighted, the principles of this study are described. Particular attention is paid to dermatoscopy terminology, which is given in accordance with the results of the Internet consensus, held in 2011-2012, under the auspices of the Russian Society for Dermatoscopy and Optical Skin Diagnostics.

Dermatovenerology, 2010 / [ed. A.A. Kubanova]. – M.: DEKS-Press, 2010. – 428 p. – (Clinical recommendations / Russian Society of Dermatovenerologists)

The fourth, revised and supplemented edition of the Clinical Guidelines was prepared by the Expert Council of the Russian Society of Dermatovenereologists, which consists of specialists from federal and territorial medical organizations of the dermatovenereological profile, departments of skin and venereal diseases, educational institutions of higher and additional professional education.

Dermatovenereology. National Guide, ed. Yu. S. Butova, Yu. K. Skripkina,O. L. Ivanova. - M. : GEOTAR-Media, 2013. - 896 p.

The publication contains up-to-date and up-to-date information on general and particular issues of skin pathology, principles of diagnosis and therapy, prevention of dermatosis, infectious diseases and sexually transmitted infections, as well as non-infectious dermatosis, including neonatal skin pathology, genodermatosis and skin tumors.

DERMATOVENEROLOGY

SHORT EDITION

Under the editorship of prof. Yu.S. Butova,

acad. RAMS Yu.K. Skripkina, prof. O.L. Ivanova

Prepared under the auspices of the Association of Medical Societies for Quality

UDC -07-085 (035.3) BBK 55.8ya81

A short edition of the national guidelines recommended by the Association of Medical Societies for Quality

D36 Dermatovenereology. National leadership. Short edition / ed. Yu. S. Butova, Yu. K. Skripkina,

O. L. Ivanova. - M. : GEOTAR-Media, 2013. - 896 p. ISBN 978-5-9704-2710-1

The publication is an abbreviated version of the book “Dermatovenereology. National Guide” and contains up-to-date information

and up-to-date information on general and particular issues of skin pathology, principles of diagnosis and therapy, prevention of dermatosis, infectious diseases and sexually transmitted infections, as well as non-infectious dermatosis, including neonatal skin pathology, genodermatosis and skin tumors.

V the revision of the manual was attended by leading experts dermatovenereologists. The relevance of the publication of this book is dictated by the limited choice in the market of medical literature of domestic compact manuals of this level for everyday use by doctors.

The manual is intended for dermatovenereologists, doctors of other specialties, graduate students, clinical residents, interns

and undergraduate medical students.

UDC -07-085(035.3)

The authors, editors and publishers of the guidelines have made every effort to ensure the accuracy of the information provided, including drug dosages. Given the constant changes taking place in medical science, we recommend that you specify the doses of medicines according to the relevant instructions. Patients cannot use this information for diagnosis and self-treatment.

The rights to this publication belong to LLC Publishing Group "GEOTAR-Media". Reproduction and distribution in any form of a part or the whole publication cannot be carried out without the written permission of GEOTAR-Media Publishing Group LLC.

Preface. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Members of the publication. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 List of abbreviations and symbols. . . . . . . . . . . . . . . . . . 15

SECTION I. ORGANIZATIONAL ISSUES

IN DERMATOVENEROLOGY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Chapter 1. Medico-legal aspects of the activity of a dermatovenereologist. A.G. Pashinyan. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Chapter 2. Compliance in medicine. A.A. Martynov, E.V. Spiridonova. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

Chapter 3. Informatization in dermatovenereology. A.A. Martynov, E.V. Pirogov. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

SECTION II. GENERAL QUESTIONS OF SKIN PATHOLOGY. . . . . . . . 35

Chapter 4. General pathology of the skin. V.V. Mordovtsev. . . . . . . . . . . . . . 36 Chapter 5. Structures and mechanisms of implementation of the immune defense of the skin in dermatoses. A.V. Rezaikina, O.R. Katunina. . . . . . . . . . . . 42 Chapter 6. Immunomorphology of the skin in normal and pathological conditions.

N.V. Makhneva, L.V. Beletskaya. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

Chapter 7 Peptide bioregulation. Yu.S. Butov, V.Yu. Vasenova, L.V. Silina, I.I. Bobyntsov . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

Chapter 8. Intestinal endotoxin and inflammation. M.Yu. Yakovlev. . . . 70

SECTION III. PRINCIPLES OF DIAGNOSIS AND THERAPY

IN DERMATOLOGY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77

Chapter 9. Diagnosis of skin diseases. K.N. Suvorov, Yu.S. Butov. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78

Chapter 10. Fundamentals of modern pharmacotherapy of skin diseases. A.A. Kubanova, V.V. Dubensky, Vl.V. Dubensky. . . . . . . . . . . . 94

SECTION IV. INFECTIOUS DISEASES OF THE SKIN

And STIs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117

Chapter 11. Mycoses of the skin and mucous membranes. Yu.V. Sergeev, A.Yu. Sergeev, Zh.V. Stepanova, V.M. Leshchenko, Yu.S. Butov,

V.Yu. Vasenova, P.G. Bogush. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118 Chapter 12. Deep mycoses. S.A. Burova. . . . . . . . . . . . . . . . . . . . . . 150 Chapter 13. Pustular skin diseases. S.A. Masyukova, V.V. Gladko. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165

Chapter 14 A.I. Novikov. . . . . . . . . . . . . . . . . 192

Chapter 15 N.S. Potekaev, L.P. Anan'eva, N.N. Potekaev, S.N. Potekaev . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 212

Chapter 16 Yu.N. Kovalev, A.Yu. Kovalev. . . . . . . 228 Chapter 17. Leprosy. E.I. Shats, V.V. Duiko. . . . . . . . . . . . . . . . . . . . . . . . 237

4 Contents

Chapter 19 A.A. Kubanova, M.R. Rakhmatulin. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 266 Chapter 20. Urogenital chlamydial infection.

V.V. Chebotarev. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 275 Chapter 21. Infections of the urogenital tract associated with mycoplasmas. E.V. Lipova. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 283 Chapter 22

and solutions. E.V. Lipova. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 301 Chapter 23. Urogenital trichomoniasis. E.A. Batkaev. . . . . . . . 308 Chapter 24. Venereal lymphogranuloma. V.V. Chebotarev. . . . . . 316 Chapter 25. Tropical treponematoses. N.G. Kochergin. . . . . . . . . . 319 Chapter 26 N.G. Kochergin. . . . . . . . . . . . . . . . . . . . . . . . . . 327 Chapter 27 N.G. Kochergin. . . . . . . . . . . . . . . . . . . . . . . 330 Chapter 28. Tropical ulcers. N.G. Kochergin. . . . . . . . . . . . . . . . . . . . 333 Chapter 29. Tropical ringworm. N.G. Kochergin. . . . . . . . . 338 Chapter 30 N.G. Kochergin. . . . . . . . . . . . . . . . . . 345

Chapter 31 V.V. Chebotarev, N.V. Frigo, Yu.K. Skripkin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 352

Chapter 32. Lesions of the skin and mucous membranes in HIV infection. N.S. Potekaev, S.N. Potekaev, N.N. Potekaev, A.V. Kravchenko. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 385

SECTION V. PRIVATE DERMATOVENEROLOGY. . . . . . . . . . . 405

Chapter 33 A.B. Smulevich, O.L. Ivanov, A.N. Lvov, I.Yu. Dorozhenok. . . . . . . . . . . . . . . . . . . . . 406

Chapter 34 Yu.K. Skripkin, S.A. Haydar. . . . . . . . . . . . . 413

Chapter 35 A.A. Kubanova, Yu.K. Skripkin, V.G. Akimov, L.F. Znamenskaya . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 424

Chapter 36 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 433 Skin itching. Yu.K. Skripkin, S.A. Haydar. . . . . . . . . . . . . . . . . . . . 433 Atopic dermatitis. Yu.V. Sergeev, A.Yu. Sergeev, A.V. Karaulov. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 436

Scabies. Yu.K. Skripkin, S.A. Haydar. . . . . . . . . . . . . . . . . . . . . . 453 Urticaria. Yu.K. Skripkin, S.A. Haydar. . . . . . . . . . . . . . . . . . . . 457

Chapter 37 Yu.S. Butov, V.Yu. Vasenova, V.A. Molochkov. . . 463 Chapter 38 Yu.S. Butov, V.V. Mordovtseva, V.Yu. Vasenova, A.S. Shmakova . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 482 Chapter 39 Skin lesions in connective tissue diseases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 497

Systemic and localized forms of lupus erythematosus.

I.V. Khamaganova, Yu.S. Butov, Yu.K. Skripkin . . . . . . . . . . . . . . . . 497 Systemic scleroderma, systemic sclerosis. Yu.S. Butov, Yu.K. Skripkin, A.S. Janitors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 505

Localized scleroderma. V.A. Volnukhin, Yu.S. Butov, A.S. Janitors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 507

Dermatomyositis. T.A. Glavinskaya, V.Yu. Vasenova. . . . . . . . . . . . . 513 Chapter 40. Bullous dermatoses. Yu.S. Butov, V.A. Samsonov. . . . 520 Chapter 41. Angiitis (vasculitis) of the skin. O.L. Ivanov, E.B. Mareeva. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 549

Chapter 42 O.L. Ivanov, O.Yu. Olisova. . . . . . . . . . 563

Chapter 43 O.L. Ivanov, V.A. Zaborova, S.A. monks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 573

Chapter 44 N.G. Kochergin, N.S. Potekaev. . . . . . . . . . . . . . 578 Chapter 45. Diseases of the mucous membrane of the oral cavity and lips.

Yu.N. Perlamutrov, I.Yu. Golousenko. . . . . . . . . . . . . . . . . . . . . . . . . . 593

Chapter 46 I.V. Polesko, Yu.S. Butov. . . . . 605

Chapter 47 Acne disease. O.S. Panova, Yu.S. Butov, S.N. Akhtyamov, O.M. Demina, G.F. Romanenko . . . . . . . . . . . . . . . . . . . 613

Chapter 48 Yu.S. Butov, O.S. Panova. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 623 Chapter 49. Clinical aspects of nail pathology.

V.Yu. Vasenova, Yu.S. Butov. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 650

Chapter 50 Yu.S. Butov, M.I. Kurdina, S.N. Akhtyamov, O.M. Demina . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 669

Chapter 51 V.A. Samsonov, Yu.S. Butov. . . 681 Chapter 52

HELL. Yutskovsky, Ya.A. Yutskovskaya, Yu.S. Butov, V.Yu. Vasenova. . . . 688

Chapter 53 V.G. Akimov. . . . . . . . . . . . . . . . . . . . . . . 703

Chapter 54 N.S. Potekaev, S.N. Potekaev, N.N. Potekaev . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 718

Chapter 55 A.V. Males. . . . . . . . . . . . . . . . . . . . . . . . . . . 727 Chapter 56 V.V. Mordovtseva, Yu.S. Butov. . . . . . . . . 732

Chapter 57 V.V. Mordovtseva, A.S. Dvornikov, Yu.S. Butov . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 744

Chapter 58 Pseudolymphomas of the skin. N.S. Potekaev, O.Yu. Olisova, Yu.V. Sergeev, N.N. Potekaev, Yu.E. Vinogradova . . . . . . . . . . . . . . . . 754 Chapter 59 V.V. Dubensky, Vl.V. Dubensky. . . . . . . 772

Chapter 60 V.V. Mordovtsev. . . . . . . . . . . . . . . . . . . . 806 Enteropathic acrodermatitis. V.Yu. Vasenova, Yu.S. Butov, L.A. Novikov. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 865

Chapter 61

K.N. Suvorov. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 870

Subject index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 886

FOREWORD

Development in recent years of fundamental research

v The field of immunology, biophysics and pharmacology has made it possible to make a breakthrough in elucidating individual links of pathogenesis, to improve the diagnosis and treatment of a number of dermatoses and sexually transmitted infections (STIs). The mechanisms of development of psoriatic arthritis and severe forms have been clarified

psoriasis, methods of diagnostics and cytokine-

rapia. The possibilities of photodynamic therapy with the use of various photosensitizers are being expanded, non-steroidal topical preparations are being used in staged treatment.

allergic dermatosis, methods of specific immuno-

nogenetic diagnosis of infectious diseases of the skin and genitourinary organs.

The skin performs many functions, has a large area

sparing, closely interacts due to neurohumoral connections with internal organs and systems of the whole organism and

is therefore a projection screen of various

clinical stigmas, which are sometimes very se-

serious diseases. This highlights the importance and significance

dermatovenereology as a medical discipline. Authors

analyzed new data in the field of dermatology,

investigative skin diseases and STIs and shared their experiences.

A concise edition of the national guideline presents

is a unique work and, in addition to the traditional sections on

specialty, includes a number of original ones: “Regulatory and legal

new regulation of the organization of the provision of dermatovenereal

logical assistance in modern conditions, ways to increase its

quality and accessibility for the population”, “Dermatological

aspects of Lyme disease”, “Tropical miases”, “Medico-legal aspects of the activities of a dermatovenereologist”, “Intestinal endotoxin and inflammation”, “Peptide bioregulation”, etc. Some chapters have been shortened due to the loss of relevance

v present, while others, on the contrary, are expanded.

Preface 7

dermatovenereologists and will help to improve

professional level of doctors and quality patient care.

Chief editors:

Honored Doctor of the Russian Federation, prof. Yu.S. Butov,

acad. RAMN, prof. Yu.K. Skripkin,

chief dermatovenereologist of the Medical Center of the Administration of the President of the Russian Federation O.L. Ivanov

PARTICIPANTS OF THE EDITION

Chief Editors

Butov Yuri Sergeevich - dr med. Sciences, Prof., Honored

doctor of the Russian Federation, prof. Department of Skin Diseases and Cosmetology

State Budgetary Educational Institution of Higher Professional Education "Russian National Research Medical University. N.I. Pirogov" of the Ministry of Health of Russia

Skripkin Yuri Konstantinovich - Dr. honey. sciences, acad. RAMS, Honored Worker of Science of the Russian Federation, Prof., Honorary Head. Department of Dermatovenereology, Faculty of Medicine, State Budgetary Educational Institution of Higher Professional Education "Russian National Research Medical

university. N.I. Pirogov" of the Ministry of Health of Russia

Ivanov Oleg Leonidovich - dr med. sciences, prof. Department of Skin and Venereal Diseases, Faculty of Medicine, SBEE HPE "First Moscow State Medical University"

university them. THEM. Sechenov" of the Ministry of Health of Russia

Responsible editor

Butov Yuri Sergeevich - dr med. Sciences, prof., Honored Doctor of the Russian Federation, prof. Department of Skin Diseases and Cosmetology

GBOU VPO "Russian National Research Me-

Dicino University. N.I. Pirogov" of the Ministry of Health of Russia

Akimov Vsevolod Georgievich - Dr. honey. sciences, prof., con-

consultant of the polyclinic at the City Clinical Hospital No. 14 named after. V.G. Korolenko of the Moscow Department of Health

Ananyeva Lidia Petrovna - dr med. sciences, prof. Institute-

Department of Rheumatology, Russian Academy of Medical Sciences, Head of the Laboratory of Microcirculation

culation and inflammation of the Department of Vascular Pathology of the Institute

rheumatology RAMS

Akhtyamov Sergey Nikolaevich - cand. honey. sciences, associate professor, con-

consultant of the polyclinic of the Federal State Unitary Enterprise SRC NIOPIK

Batkaev Edgem Abdulahatovich - Dr. honey. sciences, prof., head.

Department of Dermatovenereology and Clinical Mycology FPC

MR SBEI HPE "Peoples' Friendship University of Russia" of the Ministry of Health of Russia

Beletskaya Lyudmila Vyacheslavovna - Dr. honey. sciences, prof., head. Laboratory of Clinical Immunology, Federal Scientific Center for Transplantology and Artificial Organs named after N.N. acad. IN AND. Shumakova

Bobyntsov Igor Ivanovich - dr med. sciences, prof., head. ka-

Department of Pathophysiology of the Kursk State Medical

University

Members of the publication

Bogush Petr Grigorievich - cand. honey. Sciences, Assoc. departments

Department of Dermatovenereology, Faculty of Medicine, SBEE HPE "Russian National Research Medical University. N.I. Pirogov" of the Ministry of Health of Russia

Burova Sofia Alekseevna - Dr. honey. Sci., Prof., Director of the Center for Deep Mycoses (City Clinical Hospital No. 81)

Butov Yuri Sergeevich - dr med. sciences, prof., honored

ny doctor of the Russian Federation, prof. Department of Skin Diseases and Cosmetology

FUV SBEE HPE "Russian National Research Medical University named after N.N. N.I. Pirogov" of the Ministry of Health of Russia

Vasenova Victoria Yurievna - Dr. honey. sciences, prof. Cafe-

skin diseases and cosmetology FUV SBEI HPE "Russian National Research Medical University

tete them. N.I. Pirogov" of the Ministry of Health of Russia

Vinogradova Yulia Eikhenovna - cand. honey. Sciences, art. scientific employee of the Department of Chemotherapy of Hematological Diseases and Intensive Care of the Hematological Research Center

Volnukhin Vladimir Anatolyevich - Dr. honey. sciences, prof., head. physiotherapy department of the State Scientific Center for Dermatovenereology and Cosmetology of the Ministry of Health of Russia

Glavinskaya Tamara Alexandrovna - Dr. med. sciences, prof.

Department of Dermatovenereology, SBEE HPE "Nizhny Novgorod Medical

Qing Academy of the Russian Ministry of Health

Gladko Viktor Vladimirovich - Dr. honey. sciences, prof., di-

rector of the Moscow Institute for the Improvement of Doctors, head.

department of skin and venereal diseases with a course of cosmetology

gii of the Moscow Medical Institute for Postgraduate Medical Education at the Moscow State University of Food Production

Golousenko Igor Yurievich - cand. honey. Sciences, Assoc. departments

dermatovenereology SBEE HPE "Moscow State

University of Medicine and Dentistry" of the Ministry of Health of Russia

Dvornikov Anton Sergeevich - cand. honey. Sciences, Assoc. ka-

Department of Dermatovenereology, Faculty of Medicine, State Budgetary Educational Institution of Higher Professional Education

Russian National Research Medical University named after I.I. N.I. Pirogov" of the Ministry of Health of Russia

Demina Olga Mikhailovna - cand. honey. Sciences, Assoc. Department of Skin Diseases and Cosmetology, SBEE HPE "Russian National Research Medical University. N.I. Pirogov" of the Ministry of Health of Russia

Dorozhenok Igor Yurievich - cand. honey. Sciences, Assoc. Department of Psychiatry and Psychosomatics FPPOV SBEI HPE "Per-

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