Mukabel O. Optimization of treatment in cutaneus lupus erythematosus patients in view of development factors of photosensitivity and data of immunohistochemical skin studies

The object of study - chronic lupus erythematosus. The purpose of the study - to improve the effectiveness of treatment of patients with chronic lupus erythematosus using a method of complex metabolic therapy by pathogenesis based treatment based on the results of the morphological and histochemical study of the skin, the study of blood biochemical parameters and characteristics of nutraceutical regime. Methods: clinical, biochemical, morphological, morphometric and statistical. The dissertation deals with solving of a scientific problem - the study of pathogenesis of diagnostic quality improvement and efficiency of treatment in cutaneus lupus erythematosus (CLE) patients. Under supervision there were 105 CLE patients. The current clinical features of disease - morphology and topography of a rash, a degree of expressiveness of clinical displays of illness, duration of remission, frequency of disease relapses were considered, biochemical parameters of oxidative stress - system of lipid peroxidation and parameters of antioxidative protection were investigated. The degree of skin photoprotective function and value of photosensitivity factors development in CLE patients is estimated. The nutrition mode of CLE patients is studied - a contents of products with antioxidative and photoprotective activity in a diet of CLE patients. The expression of proliferative cell nuclear antigen (PCNA) is studied in cells of epidermis, dermis and hair follicles, distribution of immune complexes in the skin of CLE patients is estimated. Clinical, laboratory, morphological, immunohistochemical studies have shown the great number of tissue metabolism disturbances, the great role of photosensitivity in CLE development and course. Photosensitivity develops in patients with disturbances in nutrition, less vitamins and microelements - antioxidants and photoprotective factors in diet of CLE patients, especially in the base of chronic gastrointestinal diseases. Lipid peroxidation processes disturbances, depressed activity of antioxidant protection, vitamin balance shown in CLE. Morphologic and immunohistochemical investigations of skin was shown expression of proliferative cells nuclei antigen in inflammative infiltrate cells and immune complexes deposites in injured skin of CLE patients. Results have been implemented in the practice of the Donetsk regional clinical dermato-venerological dispensary, Donetsk municipal clinical dermato-venerological dispensary No. 1, Makiivka municipal dermato-venerological dispensary, as well as in the educational process of Donetsk National Medical University named by M. Gorky. Use area - dermatovenerology.