Array
(
)
Уровень 1
Уровень 2
Уровень 3
Уровень 4
Уровень 5
Уровень 6
Уровень 7
Уровень 9
Уровень 10
Уровень 11
Уровень 12
Уровень 13
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Уровень 12: Акнеформные дерматозы

Представляет



    

Раводин Роман Анатольевич
Дерматовенеролог, дерматоонколог, дерматокосметолог
Доктор медицинских наук, доцент
Категория: первая
Консультирует взрослых и детей
Город: Санкт-Петербург
Подробнее о враче Отзывы5



Стаж: 15 лет
Базовое образование:
Военно-медицинская академия им. С.М. Кирова с золотой медалью, 1999
Дополнительное образование:
Адъюнктура при кафедре кожных и венерических болезней Военно-медицинской академии (2002-2005)
Основное место работы:
ООО "НПЦ ЛОГОДЕРМ", Северо-Западный государственный медицинский университет им. И.И. Мечникова,кафедра дерматовенерологии
Должность:
Доцент
Профессиональный опыт:
Занимается лечением и диагностикой всего спектра дерматовенерологических заболеваний, уделяя особое внимание редким и атипичным формам. При необходимости самостоятельно берёт соскобы и мазки, микроскопирует их и выдаёт заключение. Выполняет лазерное удаление невусов (родинок) и опухолей кожи. Является автором и соавтором более 70 научных работ по дерматовенерологии, включая два изобретения.



[~PREVIEW_TEXT] =>

Уровень 12: Акнеформные дерматозы

Представляет



    

Раводин Роман Анатольевич
Дерматовенеролог, дерматоонколог, дерматокосметолог
Доктор медицинских наук, доцент
Категория: первая
Консультирует взрослых и детей
Город: Санкт-Петербург
Подробнее о враче Отзывы5



Стаж: 15 лет
Базовое образование:
Военно-медицинская академия им. С.М. Кирова с золотой медалью, 1999
Дополнительное образование:
Адъюнктура при кафедре кожных и венерических болезней Военно-медицинской академии (2002-2005)
Основное место работы:
ООО "НПЦ ЛОГОДЕРМ", Северо-Западный государственный медицинский университет им. И.И. Мечникова,кафедра дерматовенерологии
Должность:
Доцент
Профессиональный опыт:
Занимается лечением и диагностикой всего спектра дерматовенерологических заболеваний, уделяя особое внимание редким и атипичным формам. При необходимости самостоятельно берёт соскобы и мазки, микроскопирует их и выдаёт заключение. Выполняет лазерное удаление невусов (родинок) и опухолей кожи. Является автором и соавтором более 70 научных работ по дерматовенерологии, включая два изобретения.



[PREVIEW_TEXT_TYPE] => html [~PREVIEW_TEXT_TYPE] => html [DETAIL_TEXT] =>

Уровень 13: Поражения ногтей

Представляет

Раводин Роман Анатольевич
Дерматовенеролог, дерматоонколог, дерматокосметолог
Доктор медицинских наук, доцент
Категория: первая
Консультирует взрослых и детей
Город: Санкт-Петербург
Стаж: 15 лет
Базовое образование:
Военно-медицинская академия им. С.М. Кирова с золотой медалью, 1999
Дополнительное образование:
Адъюнктура при кафедре кожных и венерических болезней Военно-медицинской академии (2002-2005)
Основное место работы:
ООО "НПЦ ЛОГОДЕРМ", Северо-Западный государственный медицинский университет им. И.И. Мечникова,кафедра дерматовенерологии
Должность:
Доцент
Профессиональный опыт:
Занимается лечением и диагностикой всего спектра дерматовенерологических заболеваний, уделяя особое внимание редким и атипичным формам. При необходимости самостоятельно берёт соскобы и мазки, микроскопирует их и выдаёт заключение. Выполняет лазерное удаление невусов (родинок) и опухолей кожи. Является автором и соавтором более 70 научных работ по дерматовенерологии, включая два изобретения.


[~DETAIL_TEXT] =>

Уровень 13: Поражения ногтей

Представляет

Раводин Роман Анатольевич
Дерматовенеролог, дерматоонколог, дерматокосметолог
Доктор медицинских наук, доцент
Категория: первая
Консультирует взрослых и детей
Город: Санкт-Петербург
Стаж: 15 лет
Базовое образование:
Военно-медицинская академия им. С.М. Кирова с золотой медалью, 1999
Дополнительное образование:
Адъюнктура при кафедре кожных и венерических болезней Военно-медицинской академии (2002-2005)
Основное место работы:
ООО "НПЦ ЛОГОДЕРМ", Северо-Западный государственный медицинский университет им. И.И. Мечникова,кафедра дерматовенерологии
Должность:
Доцент
Профессиональный опыт:
Занимается лечением и диагностикой всего спектра дерматовенерологических заболеваний, уделяя особое внимание редким и атипичным формам. При необходимости самостоятельно берёт соскобы и мазки, микроскопирует их и выдаёт заключение. Выполняет лазерное удаление невусов (родинок) и опухолей кожи. Является автором и соавтором более 70 научных работ по дерматовенерологии, включая два изобретения.


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Ногти: исторический и культурологический аспекты

Ногти – производные кожи в виде плотных роговых пластинок, покрывающих дорсальную поверхность дистальных (ногтевых) фаланг пальцев верхних и нижних конечностей, которые растут в течение всей жизни человека. Ногти для человека играют важную роль в его социо-культурном восприятии. Так при раскопках Древнего Вавилона археологи обнаружили мумии с окрашенными ногтями, чаще у мужчин: представители высших сословий окрашивали ногти в чёрный цвет, а низших – в зелёный. В Древнем Вавилоне был также изобретён нейл-арт – украшение ногтей кусочками золота и драгоценными камнями. Длинные ногти имели иногда и чисто прикладной характер, так в Междуречье, Риме и Египте полководцы использовали длинный ноготь одного из пальцев в качестве писчего инструмента и указки при планировании сражений.

В древнем Китае длинные и ухоженные ногти олицетворяли мудрость своего хозяина. А мудрым, по представлениям того времени, имел право быть только правитель, за его ногтями очень бережно ухаживали многочисленные слуги. Уход за ногтями императора Китая был важным ритуалом не только для самого императора, но и для всей страны – в ту пору считалось, что это укрепляет благополучие всех жителей Поднебесной. Ногти покрывали особым составом из воска, яичных желтков, гуммиарабика с добавлением сока фруктов (в качестве красителя). Ежедневным ритуалом было погружение ногтей в теплое молоко (источник кальция для укрепления ногтевых пластин). Чтобы отросшие ногти не ломались, китайцы придумали специальные защитные напальчники из золота и серебра.

В Европе уходовые процедуры за ногтями (маникюр) ассоциируются с годами правления Екатерины Медичи (Франция). Тогда запрещалось носить длинные ногти, при этом их полировали дощечками, обтянутыми замшей. Современный маникюр, каким мы привыкли его видеть, зародился во времена правления Луи Филиппа Орлеанского. Однажды он вызвал врача, чтобы тот удалил ему заусенец. Доктор оказался грамотным и сообразительным – так появился первый примитивный маникюрный набор, который включал в себя замшевую пилку, апельсиновую палочку, пудру и мазь. Впоследствии производиться такие наборы стали в промышленных масштабах. До 1920-х годов придавать ногтевой пластине цвет могли только представительницы древнейшей профессии. Целомудренные и семейные женщины лишь содержали руки в чистоте и изредка полировали ногтевые пластины кусочками замши. Впоследствии стали изготавливаться специальные инструменты для полировки ногтей на основе замши или кожи.

В США необходимость найти любой способ, чтобы ногти выглядели ухоженными, возникла с появлением цветного кинематографа. Многие актеры не могли похвастаться красивыми и длинными ногтями, поэтому для ухода и полировки ногтей использовалось абсолютно все: от молока и морской воды до чайных пакетиков и бумаги. Проблема разрешилась благодаря любознательному стоматологу, который при смазывании ногтя раствором для пломб обнаружил, что он создаёт покрытие, практически не отличающееся от естественного. Так впервые появилось акриловое наращивание ногтей.

Здоровый ноготь выполняет защитную функцию, повышая чувствительность кончиков пальцев. Часто человек использует ногти в качестве рабочего инструмента и орудия самообороны.

Не стоит также забывать, что ногти могут отражать и патологические изменения в организме. На состояние ногтей обращают внимание уже при рождении (длина ногтевой пластины служит одним из критериев доношенности)

У человека ногти начинают развиваться на 10-11-й неделе внутриутробного развития. Первый признак – появление плоской поверхности (ногтевого ложа) на тыльной поверхности дистальных (концевых) фаланг пальцев рук и ног. На 14-ой неделе запускается процесс ороговения (кератинизации). Собственно ноготь развивается из эпителия, находящегося в проксимальной части ногтевого ложа, ограниченного ногтевыми валиками. Этот эпителий играет роль ногтевого матрикса (зоны роста). Вначале развивающиеся ногтевые пластинки полностью покрыты тонким кератинизированным слоем эпителия, который называется эпонихием и сохраняется в течение всей последующей жизни.

Вследствие медленного роста во внутриутробном периоде ногти достигают концов пальцев только к моменту рождения, оставаясь в своих передних частях очень тонкими и мягкими. После рождения происходит усиление процесса ороговения: ногтевые пластинки превращаются в плотные роговые образования.


Строение ногтя

Ноготь состоит из ногтевой пластины, лежащей на ногтевом ложе, которое ограничивают кожные валики (боковые и проксимальный (задний)). Между боковыми валиками и ногтевой пластиной находятся боковые каналы (синусы). Между проксимальным ногтевым валиком и ногтем располагается эпонихиум – тонкая кожная складка, плотно охватывающая ногтевую пластину. Эпонихий выполняет защитную функцию, предохраняя корень ногтя от проникновения инфекции. Ноготь представляет собой слегка выпуклую, гладкую, бесцветную, почти прозрачную компактную роговую пластинку, которая кажется розовой из-за просвечивающих через неё кровеносных сосудов ногтевого ложа.

Ногтевая пластина условно делится на корень, тело и свободный край. Корень ногтя расположен под проксимальным валиком. С противоположного конца ноготь заканчивается свободным краем, который несколько выступает за край ногтевого ложа. Между свободным краем и ногтевым ложем находится гипонихиум, предохраняющий от проникновения инфекции и инородных тел. При некоторых заболеваниях гипонихиум является источником подногтевого гиперкератоза. Ногтевое ложе состоит из дермы, прикрепленной связочным аппаратом к кости, и эпидермиса.

Рост ногтя осуществляется за счет матрикса – «зародышевой матрицы». Зона матрикса начинается вблизи сустава ногтевой фаланги и представлена базальным клеточным слоем и несколькими рядами (2-3) круглых и овальных клеток – онихобластов. Дистальная часть матрикса образует более глубокие слои ногтевой пластины, тогда как проксимальная часть – поверхностные. Поэтому поражение проксимальной части матрикса сопровождается изменениями на поверхности ногтевой пластины (точечные углубления), тогда как при поражении дистальной части матрикса наблюдаются более глубокие изменения (возникают поперечные или продольные борозды, изменяется форма ногтевой пластинки, её толщина). Ширина и толщина ногтевой пластины определяется размерами матрикса. Чем он длиннее, тем толще и плотнее ногтевая пластина. Видимая часть матрикса представлена лунулой – серповидным белым основанием у ногтя.

У млекопитающих скорость роста ногтей связана с длиной ногтевых фаланг. У человека ногти указательных и больших пальцев растут быстрее, чем остальные. На руках ногти растут приблизительно в 3 раза быстрее, чем на ногах. Полное обновление ногтевых пластин на руках происходит за 6-8 месяцев, на ногах – за 12-15 месяцев. Темпы роста ногтей зависят от возраста, пола, времени года, особенностей питания и наследственных факторов.

По своему составу ногти схожи с копытами и рогами у животных. Основное вещество ногтя – кератин. Он обеспечивает плотность ногтевой пластины, а межклеточная жидкость придает ногтю упругость. Сочетание прочности и упругости создает картину идеальной ногтевой пластины. К нарушению равновесия могут привести длительное воздействие воды, растворителей (жидкость для снятия лака), ношение гель-лака и т.д.

Химический состав ногтей:

62% – кератин

15-16% – вода

15-16% – жиры

5-6% – сера

Остальное – микроэлементы (кальций, азот, фосфор, кремний, магний, железо, барий, марганец, цинк).


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