Download Summary of the candidate thesis “Clinical and Pathogenic

Summary
of the candidate thesis “Clinical and Pathogenic Peculiarities of the Acne Associated
with Lambliosis and Optimisation of the Treatment”
Acne is one of the most spread skin diseases (e.g. functional disturbances in
the sebaceous glands of the hair follicles). 80-85 per cent of the population of the
puberty reproductive age suffers from the disease. Complicated anamnesis and
hereditary factors are often found. Skin rash mostly progress till 20 years but
sometimes disease may be lingering. Clinical manifestations of acne are found
approximately in 5 per cent of women and 3 per cent of men within 40-49 years age
group. Acne in the open body areas causes serious psychological aggravations.
Acne ranks first in the list of the worst human characteristics among the
teenagers. Rash in the open areas causes dysmorphophobia. The presence of pustules,
stains, and cicatricles, as well as unpleasant greasy skin aggravates communication
and causes reduced self-evaluation often resulting in complete isolation.
Psychological disturbances due to marked cosmetic defects gradually have an impact
on the reproductive system.
For the recent decades acne is cured with systemic and local anti-acne
medications that are aimed at breaking the major chains of acne pathogenesis,
particularly abnormal keratinisation, keratocytes differentiation in the ducts of the
sebaceous glands and an increased microflora activity in the sebaceous glands.
Systemic therapy in the treatment of acne suggests the use antibiotics.
Administration of 5-10 days antibiotic course in severe acne is doubtful since
it can not effectively fight P. acnes in sebaceous glands because of excessive
cutaneous fatty secretion.
According to some data, low sufficiency of antimicrobial therapy in acne is
caused by series of factors, in particular lower potency of the antibiotic if compared
to the severity of the disease; short course of treatment; high rate of cutaneous fatty
excretion that hampers proper accumulation of the drug in the sebaceous and hairy
follicle; folliculitis at the background of antibiotic administration due to saprophyte
grows (gram-negative bacteria, staphylococci, Candida fungi); growing P. acnes
resistance to antibiotics.
The objective of the investigation is to find out peculiarities of both clinical
course and pathogenesis of acne and concomitant lambliosis and to use it as a basis
for the improvement of the complex treatment.
The tasks of the investigation are:
1.
to study clinical course and pathogenic peculiarities of the combination of acne
and concomitant lambliosis using common clinical, laboratory including
parasitological and instrumental methods of investigation;
2.
to investigate the possible role of endogenous intoxication (medium molecules
and erythrocytes’ sorption capacity);
3.
to find out the change of values in both cellular and humoral immunity in
different severity stages of acne associated with lambliosis;
4.
to study both specific and quantitative microbiocinosis content of an injured skin
area in patients with acne associated with lambliosis;
5.
to elaborate complex treatment of patients with acne associated with lambliosis.
Phenomena under investigation are acne and lambliasis.
The objects of the investigation are the patients with acne both associated
and not associated with concomitant lambliosis.
The methods of the investigation are as follows:
 clinical – diagnosis of acne, finding out the severity of the course, and control
of the therapy efficiency;
 biochemical – determination of bilirubin and its fractions, general protein,
alkaline phosphatase and cryoglobulin concentrations in blood;
 immunological – investigation of humoral and cellular immunity value,
endogenous systemic intoxication, finding antibodies to lamblia
 parasitological – analysis of faeces for the presence of lamblia;
 bacteriological – the study of both specific and quantitative microbiocinosis
content of an injured skin area;
 instrumental – ultrasound investigation of the liver.
The novelty of the investigation. The clinical course of acne associated with
lambliosis is to be studied for the first time. The possible role of endogenous
intoxication (medium molecules and erythrocytes’ sorption capacity) in acne
pathogenesis including parasitic invasion is to be investigated. The type of changes in
the cellular and humoral immunity values in different severity stages of acne
associated with lambliosis will be studied. Both specific and quantitative
microbiocinosis content of an injured skin area in patients with acne associated with
lambliosis will be studied. Complex treatment of patients with acne associated with
lambliosis is to be worked out.
The expected results and their possible use. Peculiarities of the acne
clinical picture will be determined including that at the background of lambliosis. The
type of changes of endogenous intoxication values, humoran and cellular immunitya
and cryoglobulins in patients with the given pathology will be studied. In addition,
microbioconosis of an injured skin area will be investigated and complex treatment of
patients with acne associated with lambliosis will be worked out. The results of the
thesis are expected to find application in the clinical practice of dermatologists,
infectious diseases specialists, parasitologists and family doctors.