urmjУральский медицинский журналUral Medical Journal2949-4389Ural State Medical University10.52420/2071-5943-2023-22-2-102-108urmj-1233Research ArticleОригинальные статьи | Original articlesOriginal articlesМорфологические особенности изменений кожи при неопределенной клинической картине псориаза и атопического дерматита у детейMorphological features of skin changes in the undetermined clinical picture of psoriasis and atopic dermatitis in childrenhttps://orcid.org/0000-0002-6907-8629ЮринаН. В.YurinaN. V.

Наталья Владимировна Юрина – аспирант

Новосибирск

Natalya V. Yurina – Postgraduate student

Novosibirsk 

yurina_nat@mail.ruhttps://orcid.org/0000-0001-7933-8394АгееваТ. А.AgeevaТ. A.

Татьяна Агустовна Агеева – доктор медицинских наук

Новосибирск

Tatyana A. Ageeva – Doctor of Science (Medicine)

Novosibirsk 

ageta@mail.ruhttps://orcid.org/0000-0003-2287-7172МакеенкоО. А.MakeenkoO. A.

Оксана Алексеевна Макеенко − ассистент кафедры

Новосибирск

Oksana A. Makeenko – Department assistant

Novosibirsk 

oksana@makeenko.infoЕремеевИ. Р.EremeevI. R.

Илья Русланович Еремеев – студент

Новосибирск

Ilya R. Eremeev – Student

Novosibirsk 

i.eremeev@g.nsu.ruhttps://orcid.org/0000-0003-1748-8957СергееваИ. Г.SergeevaI. G.

Ирина Геннадьевна Сергеева – доктор медицинских наук

Новосибирск

Irina G. Sergeeva – Doctor of Science (Medicine)

Novosibirsk 

i_g_sergeeva@mail.ruНовосибирский государственный медицинский университетРоссияNovosibirsk State Medical UniversityRussian FederationНовосибирский национальный исследовательский государственный университетРоссияNovosibirsk National Research State UniversityRussian Federation202330042023222102108Copyright © Юрина Н.В., Агеева Т.А., Макеенко О.А., Еремеев И.Р., Сергеева И.Г., 20232023Юрина Н.В., Агеева Т.А., Макеенко О.А., Еремеев И.Р., Сергеева И.Г.Yurina N.V., Ageeva Т.A., Makeenko O.A., Eremeev I.R., Sergeeva I.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.umjusmu.ru/jour/article/view/1233Введение

Введение. Все чаще в литературе описываются нетипичные клинические формы псориаза и атопического дерматита у детей, сочетающие в себе черты обоих заболеваний. В таких случаях дерматологи в комплексной диагностике прибегают к биопсии бляшечных элементов кожи. Однако гистологическая картина в этих биоптатах неопределенная и не позволяет однозначно судить о соответствии изменений тому или иному заболеванию.

Цель работы – сравнить патоморфологические изменения в биоптатах бляшечных элементов кожи при неопределенной клинической картине заболевания у детей с изменениями при типичных формах псориаза и атопического дерматита.

Материалы и методы

Материалы и методы. Было проведено морфометрическое исследование 10 биоптатов бляшечных элементов кожи детей (средний возраст 9,2±1,11 года) с неопределенной клинической картиной заболевания. Полученные данные сравнивались с двумя контрольными группами взрослых пациентов с типичными клиническими картинами псориаза (n=20; средний возраст 34,35±3,58 года) и атопического дерматита (n=10, средний возраст 41,33±7,35 года).

Результаты

Результаты. Сравнительный морфометрический анализ биоптатов кожи выявил наименьшее количество различий анализируемых параметров плоского эпителия пациентов исследуемой группы и группы с псориазом. Во всех трех группах основной массив воспалительного инфильтрата в дерме составили лимфоциты и макрофаги, численная плотность которых различалась при псориазе и атопическом дерматите на разных уровнях дермы, а в исследуемой группе имело промежуточные значения. Количество нейтрофилов и эозинофилов в исследуемой группе имели минимальные значения. Обсуждение. Морфологические изменения в эпидермисе исследуемой группы были наиболее близки к изменениям при псориазе, а клеточный состав воспалительного инфильтрата дермы не соответствовал ни одной из контрольных групп и имел либо промежуточные значения (по показателям лимфоцитов и макрофагов), либо минимальные значения (по показателям эозинофилов и нейтрофилов).

Заключение

Заключение. Анализ морфологических изменений кожи в группе пациентов с неопределенной клинической картиной заболевания выявил наличие морфологических критериев как псориаза (в большей степени), так и атопического дерматита, а так же промежуточные значения показателей в части критериев. Такая разнородность морфологических изменений согласуется с неоднородностью клиники и требует дальнейшего изучения. 

Absrtact

Introduction The literature describes atypical clinical forms of psoriasis and atopic dermatitis in children that combine features of both diseases. In such cases, dermatologists resort to biopsy of plaque skin elements in the complex diagnosis. However, the histological picture in these biopsy specimens is uncertain and does not allow to make an unequivocal judgment about the correspondence of changes to one or another disease.

The purpose of work was to compare pathomorphological changes in biopsy specimens of plaque skin elements in children with undetermined clinical picture of the disease with changes in typical forms of psoriasis and atopic dermatitis.

Materials and methods A morphometric study of 10 plaque skin biopsy specimens from children (mean age 9.2±1.11 years) with an indeterminate clinical picture of the disease was performed. The obtained data were compared with two control groups of adult patients with typical clinical pictures of psoriasis (n=20; mean age 34.35±3.58 years) and atopic dermatitis (n=10; mean age 41.33±7.35 years).

Results A comparative morphometric analysis of skin biopsy specimens revealed the fewest differences between the analyzed parameters of the squamous epithelium of the patients in the study group and the group with psoriasis. In all three groups, the main mass of the inflammatory infiltrate in the dermis was composed of lymphocytes and macrophages whose numerical density differed in psoriasis and atopic dermatitis at different levels of the dermis, while in the study group it had intermediate values. The number of neutrophils and eosinophils in the study group had minimal values.

Discussion Morphological changes in the epidermis of the study group were closest to those in psoriasis, while the cellular composition of the inflammatory infiltrate of the dermis did not correspond to any of the control groups and had either intermediate values (in terms of lymphocytes and macrophages) or minimal values (in terms of eosinophils and neutrophils).

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The authors declare that there are no conflicts of interest present.