EP3484422A1

EP3484422A1 - Device for hyperthermia treatment of pruritus

Info

Publication number: EP3484422A1
Application number: EP17735608.6A
Authority: EP
Inventors: Jörg Zippenfennig
Original assignee: Dermapharm AG
Current assignee: Dermapharm AG
Priority date: 2016-07-12
Filing date: 2017-07-12
Publication date: 2019-05-22
Also published as: BR112019000498A2; JP2019521825A; WO2018011262A1; TW201815364A; PL3484423T3; US20190290477A1; TWI744353B; SG11201900258XA; CN109475426A; CA3030224A1; MX2019000408A; EP3484423B1; US11759348B2; KR20190029650A; AU2017295000B2; CN109475427B; KR20190053175A; JP7129407B2; KR102485936B1; SG11201900257UA

Abstract

The invention relates to a device for hyperthermia treatment of itching by applying a treatment surface having a size of between 1 cm² and 18 cm², said treatment surface being maintained at a temperature between 40°C and 65°C for 2 s to 12 s, preferably 4 s to 6 s, during the treatment phase. The device according to the invention allows considerably relieve itching over large areas of the skin and permits an effective treatment of pruritus, chronic pruritus, dermatitis, allergies or envenomation by cnidarians.

Description

DEVICE FOR THE HYPERTHERMIC TREATMENT OF PRURITUS

DESCRIPTION

The invention relates to a device for hyperthermic treatment of pruritus by applying a treatment surface having a size between 1 cm ² and 18 cm ² , wherein the treatment surface during the treatment phase at a temperature between 40 ° C and 65 ° C for 2 s to 12 s, preferably 4 s to 6 s is maintained. The device of the invention allows a strong alleviation of itching over large areas of the skin and effective treatment of pruritus, chronic pruritus, dermatitis, allergies or poisoning by cnidarians.

Background and state of the art

Itching (pruritus) is a subjectively unpleasant, on the skin or mucosa related sensory perception. It may be local or affect the whole body.

Frequently, itching is accompanied by a burning, stinging or tingling sensation, which the affected person often tries to relieve by scratching, rubbing, rubbing, pressing, kneading or rubbing. Therefore it comes heaped with itching to further pathological appearance of the skin such as scratch marks, open wounds, crusting and skin infections. Experts believe that itching is mediated through the skin's pain receptors and transmitted to the brain via the autonomic nervous system. The causes of itching can be very diverse. In addition to dry skin, lack of moisture or allergies, itching can also be caused by external influences and skin irritations, such as stitches of mosquitoes or after contact with cnidarians. Itching can be a reaction to chemical, mechanical or thermal stimuli. It may be as a result of external irritation, such as by the action of chemical substances, eg histamine (mosquito bite), apamine (bee sting), by allergic immune reaction, by pressure or friction or by heat or sunlight, wheals, urticaria and other skin reactions associated with itching be caused. From a medical point of view, the causes or underlying diseases that cause itching spread a wide range of dermatological and medical disorders. These include skin diseases such as eczema, atopic dermatitis, urticaria, skin infections (eg candidosis), xeroderma, parasites (eg scabies), insect bites or allergies, metabolic diseases such as iron deficiency anemia or diabetes mellitus, infectious diseases especially AIDS, varicella, measles or herpes zoster, proctological diseases such as Hemorrhoids or analgesics, renal diseases such as uremia, liver disease and liver failure or neoplasia, in particular mycosis fungoides or Hodgkin's disease. Also, hormonal causes such as menopause or side effects from taking medicines, especially carbamazepine, antibiotics, opiates (morphine), hydroxyethyl starch, captopril and miconazole can trigger and promote pruritus. Furthermore, senile pruritus is mentioned, which leads to unpleasant skin irritation in old age.

Chronic pruritus (constant itching) is a particularly severe itching, which is extremely difficult to treat symptom especially o.g. Basic diseases occur (Rothmann et al., 1941). Pruritus is considered chronic if it persists for more than six weeks. The point prevalence of chronic pruritus is up to 13.5% in the general population (Ständer et al., 2007) and up to 16.8% in the working population (Ständer et al., 2010). There is also an increased occurrence of new cases. The incidence of pruritus is 7% in one year (Vogelgesang et al., 2012).

In addition to the physical and psychological burden on those affected, the medical costs and work interruptions, in particular chronic pruritus, represent a significant socio-economic burden on society. The further development of therapies is therefore highly relevant.

Basically, a treatment of the underlying disease is the essential pillar for a sustainable therapy of pruritus. If the cause is known, for example, a specific treatment of the dermatosis, a avoidance of the identified contact allergen, the discontinuation of a drug or a specific internistic, neurological, psychiatric or even operative (eg in the case of a tumor) treatment. The improvement chances of the pruritus are to be evaluated with an effective treatment of the basic illness as positive. Often, however, the cause of pruritus is unknown or hardly treatable. The diversity and complexity of the possible causes continue to complicate a causally-adapted therapy. For the treatment of the symptoms of itching, a number of medicines or cosmetic products are known. Thus, essential oils, in particular comprising menthol, thymol or camphor, are used to generate cooling in the short term. Even skin care products such as creams or lotion can exert an analgesic effect by increasing the moisture content of the skin. In addition, antihistamines are helpful treatment options, which include, for example, the administration of Dimetindenmaleat or mepyramine. Other medications include topical glucocorticoids, anesthetics, zinc ointments, calcineurin inhibitors or capsaicin.

In the treatment of pruritus, however, it should be noted that these can lead to side effects, especially in combination with drugs for the treatment of the underlying disease. Furthermore, in pruritus, the wide range of patients, ranging from children to pregnant women to multimorbid patients, represents a therapeutic challenge. Drug treatment for pruritus often does not lead to the desired success or is accompanied by side effects. For this reason, the development of alternative therapies for the treatment of pruritus is required, which are not based on the administration of medication.

It is known from the prior art to reduce the triggering of itching by introducing a quantity of heat into the puncture of insects. A device for a local, thermal treatment especially of mosquito bites is described in EP 1231875 B1. The device has a hot plate with a size of about 0.2 cm ² , which is brought to a temperature between 50 ° C and 65 ° C, while the hot plate contacts the insect bite. While the device is well-suited for relieving itching in smaller insect bites, it can not be used for extensive skin irritation in case of chronic pruritus or contact with cnidarians. For these diseases, the prior art makes use of conventional medical treatments with the above-mentioned disadvantages.

US Pat. No. 6,245,093 B1 discloses a device for the hyperthermic treatment of skin diseases and itching on affected skin areas, which in one embodiment discloses a treatment area of metal with a size of approximately 5 cm ² . This is heated homogeneously to a monitored by a controller and a temperature sensor and generated by a flat heating element temperature of 46 ° C-69 ° C for a treatment period of 0 s - 3 s. However, it will not be particularly for the treatment of itching preferred treatment duration of 4 s - 6s described. Due to the treatment area, which is smaller than 7 cm ² , special nerve cells responsible for the regulation of the itching can not be specifically addressed. By using only one hot plate despite the larger area, certain temperature distributions of the treatment area advantageous for the treatment of pruritus can not be generated. The use of mercury to protect against overheating of the treatment area, which may have too slow a reaction time to effectively protect against burns, and the absence of an additional fuse does not provide a safety mechanism against overheating that meets high standards. Likewise, there are no indications of particularly preferred metals as the treatment surface. Within the materials in question, there are great differences in the important parameters of thermal conductivity and skin tolerance. Particularly suitable, selected ceramics are not used. Likewise, there is no explicit warning signal in the form of an acoustic warning tone and / or an illuminated optical signal generator, which can warn the user when triggering quickly, clearly and reliably against especially high temperatures of the treatment area.

EP 2 206 483 A1 describes a device for the application of heat and cold for cosmetic purposes. The heat can be transferred via one or more partly gold plated surfaces. The treatment area is a maximum of about 2 cm ² and is formed by several balls of minerals. This device can also be used to cool skin areas. The device, which was not designed for the treatment of itching, is unsuitable for the hyperthermal treatment of pruritus, in particular due to the long application times of the generated heat of at least 30 s. The balls of minerals can be heated and release the heat to the skin. For this purpose, separate heating elements are used, which rest against the balls and / or directly to the skin. However, these can not be controlled individually in order to achieve a particularly advantageous temperature distribution. Another disadvantage for the treatment success and the functionality is the low thermal conductivity of the minerals.

WO 2006/063202 A2 discloses a device for the hyperthermic treatment of a large number of skin disorders, including suffering after contact with jellyfish or itching. The device is heated by at least one electric heating element and uses a sensor and an electrical control. The use of heat pulses of up to 3s at a temperature of 70 ° C - 400 ° C is described. The treatment area is about 1 cm ² small. However, the high treatment temperatures are for the specific treatment of Itching by regulation of the immune system and by activation of nerve cells and receptors unsuitable. The heat pulses of typically less than 1 second are also not suitable for effective pruritus treatment. The small treatment area is not suitable for treating large-scale skin conditions. The passive safety mechanism used is an adapted dimensioning of a capacitor responsible for the power supply of the heating element, which limits the heat energy delivered per discharge cycle. However, rapidly passing cycles over a longer period of time could still deliver dangerously high heat energies across the treatment area. A fuse is not available, anyway, a dangerous continuous reheating, which could occur due to the special design caused by such a difficult backup. A treatment area of particularly advantageous with respect to the thermal conductivity and skin compatibility ceramics is not provided.

Object of the invention

The object of the invention was to provide a device which overcomes the disadvantages of the prior art. In particular, a device should be provided which is suitable for the treatment of extensive, even chronic pruritus and has a higher effectiveness and safety over known devices and methods.

Summary of the invention

The object of the invention is achieved by a device according to the independent claim. The dependent claims concerning preferred embodiments of the invention.

In a preferred embodiment, the invention relates to a device for hyperthermic treatment of itching comprising a) a treatment surface

and

b) a control device for regulating the temperature of the treatment surface

the size of the treatment area is between 1 cm ² and 18 cm ² and the control device can regulate the treatment area in a heating phase to a treatment temperature between 40 ° C and 65 ° C and the treatment temperature in a treatment phase for a period of 4 s to 6 s can be held. To alleviate the itching, the device according to the invention is preferably applied to the skin areas of the patient to be treated. As soon as the device with the treatment surface contacts the relevant skin areas, it is possible with the aid of the control device to regulate the temperature of the treatment area. For this purpose, the treatment surface is first led to a treatment temperature between 40 ° C and 65 ° C in a heating phase. It is preferred that the heating phase be kept short. Preferably, the heating phase should not be more than 10 s, more preferably not more than 2 s. After completion of the heating phase, the temperature of the treatment surface is preferably maintained at the predetermined treatment temperature. The treatment temperature preferably corresponds to a constant temperature, which lies in the stated range between 40 ° C and 65 ° C. This treatment temperature is preferably kept constant during the treatment phase. However, it may also be preferred that the treatment temperature is not kept constant. For example, the treatment surface can also be led in a temperature ramp to a maximum temperature in the range of the treatment temperature between 40 ° C and 65 ° C. Following this, it may be preferred that the temperature is lowered again to a temperature below the range of the treatment temperature in order to subsequently rise again. The treatment phase preferably designates the period during which the temperature is in the range of the treatment temperature from 40 ° C to 65 ° C. The treatment phase preferably lasts between 2 s and 12 s, particularly preferably between 4 s and 12 s, very particularly preferably 4 s-6 s. It is particularly preferred that the treatment phase denotes a continuous period of time. But it may also be that the treatment phase is interrupted by passing the temperature in a ramp briefly. The preferred variants, which relate to a non-constant treatment temperature, have surprisingly proved to be advantageous in relation to maintaining a constant treatment temperature in some itching skin diseases. The skin diseases may preferably be diseases caused by allergies, atopic dermatitis, psoriasis, eczema and hives, candidosis, xeroderma, parasites, environmental factors, autoimmune diseases, senile itching (pruritus senilis) and winter itching (pruritus hiemalis), aquagenic pruritus or dry skin be called forth. Further preferred skin diseases are diseases that go back in particular to kidney diseases, liver diseases, diseases of the blood or the lymphatic system, or to Hodgkin's disease, polycythemia vera, iron deficiency, tumors, metabolic disorders or hormonal diseases, thyroid diseases, hormone fluctuations, diabetes mellitus, anemia. rexia nervosa, gluten intolerance or malnutrition, HIV infection, neurological diseases or infectious diseases. Of course, it is also possible that the skin diseases are caused by antibiotics, opiates, anti-inflammatories, antimalarials, psychoparhamaka, hormones, diuretics, cytostatics, antihypertensive agents, gold, anticoagulants or retinoids. For example, it may be advantageous in the case of the abovementioned disorders to reach the maximum temperature only for a very short time via an increasing temperature and then to cool it down again on a ramp. As a result, tailor-made heat impulses can be delivered to the skin via the treatment surface. By regulating the treatment surface at a temperature between 40 ° C and 65 ° C for a treatment phase between 2 s and 12 s, preferably between 4 s and 12 s, more preferably between 4 s - 6 s, a heat pulse is generated, which allows it To bring a well-defined amount of heat to the skin site in a controlled manner. The heat transfer surprisingly leads to a superposition of the itching due to other temperature-dependent skin sensations. In contrast to conventional methods for the treatment of pruritus, which target the itching sensation via regulation of the pain receptors, the free nerve endings of the C fibers are activated by the heat treatment according to the invention. In particular, the C fibers designate the slow-conducting nerve fibers of the somatosensitive system and are responsible for pain perception. In this case, in particular the free ends of the C-fibers, which are also referred to as Nozizrezeptoren, an important role. The nerve endings of the fibers are activated by tissue hormones (eg, histamine, serotonin, substance P). Also, mast cells near the nerve endings could be involved in the process by releasing the mediator tryptase.

According to the invention, the knowledge about the mechanism of action in pruritus is exploited in order to regulate by a heat treatment in a surprising manner, the sensory perception, which are triggered by the fibers. Although smaller heating plates for the treatment of insect bites are known in the prior art. However, a person skilled in the art could not assume that a heat treatment would be advantageous even in the case of large areas of affected skin, as in the case of chronic pruritus, allergies or jellyfish stings. The experts believe that the hyperthermic treatment of mosquito bites is based on an inhibition of the insect venom, which relieves the itching. However, the finding according to the invention of the above-described mode of action, however, allows for further application even to extensive skin irritation. Here, pruritus of very different causes can be effectively alleviated. Furthermore, the concept of a larger treatment area represents a drastic departure from the state of the art for the hyperthermic treatment of itching. Thus, the experts assumed that a large-scale treatment of affected skin areas a positive relief of itching are superimposed by strong negative side effects such as skin burning or hyperthermic pain sensation. It has been found that with a larger treatment area of about 1 cm ² to 18 cm ² , preferably at least 2 cm ² , at least 3 cm ² , at least 4 cm ² , more preferably between 6 cm ² to 9 cm ^2, and most preferably between 7 cm ² and 9 cm ² in a surprising manner even large areas of the skin, which are affected by pruritus, can be treated. Thus, it is for example possible in the case of skin rashes by convenient and easy placement of the treatment area on the corresponding skin, to transfer the itching sensation by the heat transfer in a bearable pain sensation. Secondary damage to the skin, such as wound formation due to severe scratching, can be effectively avoided. With devices of the known state of the art a repeated application to different positions would be necessary for a treatment of large areas of skin. Due to the time offset, however, this does not mean that the same effect can be achieved.

It may also be preferred that a treatment area of at least 7 cm ² size be used. External stimuli of a chemical, mechanical or physical nature that can trigger feelings of itching are perceived by three different receptor cells (sensory cells). These sensory cells are so-called open nerve endings, whose stimulus-absorbing structures are located in the epidermis and the underlying dermis, and whose axons transmit the signals to the spinal cord via perceived stimuli. In these sensory cells, the unmyelated C-fibers are of particular importance. Their receptive structures are sometimes up to 0.1 mm below the skin surface. The C-fibers are distinguished from polymodal, mechanically and heat-sensitive fibers and mechanically insensitive C-fibers, which can also be stimulated by heat. C-fibers not only take pruritogenic stimuli, but also serve as nociceptors (pain receptors). It has been shown in the literature that heat stimuli can suppress the sense of itching as a counter-irritant. The individual C-fibers perceive stimuli of a certain area of the skin, whereby a defined skin area is innervated by a sensory cell. This region is called a receptive field. The receptive fields of C-fibers may be partially overlapping. By investigations on humans Surprisingly, it was discovered by micromapping that the mechanically insensitive C-fibers have receptive fields of up to 5 cm ^{2 in} size; those of mechanically sensitive C-fibers are slightly smaller and up to 2 cm ^{2 in} size. Surprisingly, it has been found that from a preferred size of the treatment area of about 7 cm ² can be achieved, the receptive fields of both types of C fibers particularly well to address. With the preferred treatment size between 7 cm ² and 18 cm ² , the receptive fields of the different types of C fibers are thus surprisingly well covered and, moreover, the effect of the horizontal outflowing heat is compensated. Thus, an itching, even of affected skin smaller than the size of the treatment area, surprisingly be treated very effectively.

It may also be preferred to use a treatment area of preferably 6 to 11 cm ² , more preferably 7 to 10 cm ² , most preferably 8 to 9 cm ² , in particular 8.4 cm ² . Such a treatment area may ideally utilize the effects described above to relieve itching. Surprisingly, it has been found that such a treatment surface is very well suited to treat a wide variety of large-area skin disorders by applying it only once.

For the purposes of the invention, the "treatment area" refers to that area of the device which is heated to the treatment temperature during the treatment and in direct thermal contact with the skin area The size of the treatment area refers in each case to the entire contact area In the case of a treatment area which consists of several partial areas, the size of the treatment area does not correspond to the outline area which encloses the partial areas, but rather to the sum The outline area preferably corresponds to the convex hull of the subareas according to the mathematical definition In the case of a contiguous treatment area, the size of the treatment area is equal to the area of the outline Given the sizes and geometries of the treatment area, a treatment optimally adapted to the cause can be carried out, which optimizes efficiency and well-being and thus contributes to a more sustainable treatment success.

Preferably, the treatment surface is brought to the treatment temperature with the aid of at least one heating plate. For this purpose, the treatment surface is preferably in contact with the at least one heating plate whose temperature is set by the control device can be, wherein an adjustment of the treatment temperature takes place at the treatment surface by heating the heating plate. As a result, the treatment surface can be heated in a particularly efficient manner. The treatment temperature preferably always indicates the temperature which is present on the skin area of the patient. For the purposes of the invention, the control device is preferably a processor or a processor chip which is configured to regulate the temperature of the heating plates according to predetermined values. The at least one heating plate is preferably a component, as is well known from the prior art. It is preferable that the heating plate can be guided by applying a voltage to a desired temperature, but other means for heat supply may be provided. Preferably, the component referred to below the heating plate, which can be heated by the control device, inter alia by applying an electric current. However, it is preferred that the heating plate does not come into direct contact with the skin to be treated. This results in a higher safety, on the other hand, an optimized heat dissipation, which is achieved by the nature and geometry of the treatment surface, the result. For this purpose, the heating plate is preferably located above the treatment surface and is in direct or indirect thermal contact with the treatment surface. Above is preferably referred to the inward positioning of the heating plate, which is coated on the outside of a treatment surface located below the heating plate. The direct thermal contact preferably designates an immediate contact and the indirect thermal contact a contact which is realized via a heat-conducting layer. It may be preferred that the device has a single heating plate. However, it may also be preferred that the device comprises a plurality of heating plates.

In a particularly preferred embodiment of the invention, the size of the treatment surface is at least 6 cm ² and the treatment temperature is between 42 ° C and 53 ° C, more preferably between 50 ° C and 53 ° C.

It has surprisingly been found that with the aforementioned parameters an itching can be particularly greatly reduced, especially on large areas of the skin. A combination of a treatment area of at least 6 cm ² with a treatment temperature of 42 ° C and 53 ° C and in particular with the preferred treatment temperature between 50 ° C and 53 ° C allows an action on the skin areas, which relieve the itch quickly and effectively. It has been recognized that it is possible to achieve a particularly pronounced superimposition of the itching sensation if the thermal and capsaicin receptors TRPV1 and TRPV2 are activated locally at the same time in the relevant skin areas. The TRPV1 is involved in acute heat-induced pain in healthy skin and regulates, for example, the hot sensation at temperatures around 45 ° to 50 ° C. In addition, the TRPV2 is activated in the case of particularly severe, painful heat stimuli, which start at temperatures above 52 ° C. The activation threshold of TRPV1 is between 40 ° C and 45 ° C, whereas that of TRPV2 is between 50 ° C and 53 ° (Yao et al 201 1, So- mogyi et al., 2015, Cohen et al., 2014, Mergler et al 2014).

While current research results in the literature provide a first understanding of the mode of action of the TRPV1 and TRPV2 receptors as temperature sensors, their role in the sensation of itching is unknown. A person skilled in the art would therefore, even with the knowledge of the literature, not assume that it would be the activation of these receptors which makes possible a particularly effective superimposition of the itch sensation. This is a surprising finding, which was obtained according to the invention. The preferred embodiment, which provides for a temperature control of the treatment area in a narrow range between 50 ° C and 53 ° C, allows in a surprisingly effective manner a simultaneous activation of the receptors, without causing unpleasant strong pain sensations in the treated persons. By experimental experiments, the range of the activation threshold of the TRPV2 could be determined as a particularly optimized effective range. This is likely to lead to a feedback mechanism between the receptors, which superimposes the itching particularly effective, without causing side effects. For a treatment area which is larger than 6 cm ² , a specialist could not expect this. Rather, a person skilled in the art would have assumed that at a treatment temperature of 50 ° C.-53 ° C. over a period of 2 seconds to 12 seconds and even more over the particularly preferred period of 4 seconds to 6 seconds severe skin irritation or pain comes to light burns. Instead, the preferred treatment of the skin area leads to an alleviation of itching, which surprisingly persists for hours after treatment. The sustained action of the preferred embodiment is due, at least in part, to immune regulation by heat transfer. Thus, not only the sensation of pain is superimposed, but by regulating the immune system, the local irritation of the skin is actively suppressed. Advantageously, therefore, a single treatment can already lead to a lasting decrease in itching sensation. However, it may also be preferable to carry out a treatment several times in chronological order. The interval-like Transfer of heat with a treatment phase of 2 s - 12 s or more preferably 4 s to 6 s achieves an optimal effect on the signaling pathways of pruritus without causing unwanted side effects.

It has surprisingly been found particularly for the preferred treatment time of 4s - 6s and the intended treatment temperature, in particular for the particularly preferred treatment temperature of 50 ° C - 53 ° C, that an exceptionally effective activation of TRPV1 and in particular the TRPV2 receptors takes place. It was completely surprising that this specific selection of treatment temperature and duration of treatment contributes particularly effectively to a reduction in itching. Also, the C-fibers, especially their free ends, are ideally addressed by this preferred choice. It has surprisingly been found that even for small treatment areas from 1 cm ² treatment area by the heat flux taking place in the preferred area and large receptive fields of C-fibers can be effectively addressed. It has surprisingly been found that the treatment success is not approximately linearly related to the duration of treatment, but is particularly high especially for the preferred duration of treatment. Likewise, a particularly effective immune regulation takes place in the combination of treatment duration and treatment temperature mentioned above. Surprisingly, a treatment duration of 4 s-6 s and the intended treatment temperature, in particular for a treatment temperature of 50 ° C.-53 ° C., result in a synergistic effect which results from an interaction of a particularly effective activation of TRPV1 and TRPV2 for this selection Receptors can be explained by an ideal response of the C-fibers and by a particularly strong immune regulation. Surprisingly, it has been found that an unpleasant sensation on the skin as well as burns of the skin can be avoided for this selection, even with large treatment areas, so that a sustainable treatment success can be achieved.

An apparatus for hyperthermic treatment of pruritus comprising a control device for regulating the temperature of the treatment surface and a size of the treatment surface between 1 cm ² and 18 cm ² , wherein the control device, the treatment surface in a heating phase to a treatment temperature between 40 ° C and 65 ° C, preferably 50 ° C - 53 ° C, can regulate and the treatment temperature in a treatment phase for a period of 4 sec to 6 sec can be maintained, has been found to be surprisingly advantageous for the treatment of itching especially after the action mechanisms presented here. It may also be preferred that a treatment temperature between 40 ° C and 65 ° C, preferably 50 ° C to 53 ° C, for a treatment time of 4 sec to 12 sec is maintained. This preferred treatment time leads to a heat conduction into the skin, by means of which an ideal temperature level for the treatment of pruritus with the aid of the above-described mechanisms of action can be achieved in the individual skin layers. As a result of this preferred duration of treatment, isotherms are formed in the various layers of the skin, which in a completely surprising manner have proven to be ideal for the success of the treatment.

In a preferred embodiment of the invention, the device is characterized in that the device comprises at least two heating plates, preferably at least four heating plates and most preferably at least six heating plates, which are in contact with the treatment surface and whose temperature can be adjusted by the control device by heating the heating plates, an adjustment of the treatment temperature takes place at the treatment area. Due to the presence of two heating plates whose positioning is freely selectable, a particularly advantageous temperature distribution on the skin of the patient can be achieved. Thus, it may be preferred that the treatment surface is a contiguous surface over which the at least two, preferably at least four, more preferably at least six heating plates are present attached. This makes it possible to achieve an optimized temperature distribution.

It is preferred that the preferably at least two heating plates can be controlled separately. This means preferably that each heating plate can be controlled individually by the control device and can be brought to individually adjustable heating temperatures. In this way, it is possible to set a temperature distribution at the treatment surface which is optimized for the success of the treatment. Surprisingly, as a result, the treatment temperature is perceived as particularly pleasant, so that the treatment is not interrupted. It may be advantageous to achieve a particularly homogeneous temperature distribution by the separately controlled heating plates, for example by slightly different heating temperatures of the heating plates outer inhomogeneities, which, for example, by the geometry of the treatment surface or by the different heat flow at different points of the treated Skin area, be balanced. However, it may also be desired that a slightly inhomogeneous temperature distribution is generated in a targeted manner on the treatment surface. Likewise, depending on the size of the area of the skin to be treated, it is conceivable that only a corresponding part of the treatment area is heated that an efficient and for the patient as pleasant as possible treatment can be made.

For this purpose, the distances of the heating plates can be adjusted. For example, it may be preferred that the heating plates are arranged in a grid shape, wherein there is a distance between the heating plates which is between 0.2 mm and 10 mm, preferably between 0.5 mm and 3 mm. For this purpose, a particularly effective temperature distribution can be generated. Thus, the temperature distribution is not exactly homogeneous, but slightly at the positioning of the heating plates, i. preferably by less than 2 ° C, increased. The temperature difference is preferably given as compared to a low temperature of the treatment area between the heating plates. Surprisingly, such a locally minor heterogeneity with a temperature difference between 0.1 ° C to 2 ° C based on the average treatment temperature leads to a particularly pronounced alleviation of itching. The expansion preferably designates a characteristic length of the cross section of the heating plates. In the case of circular heating plates, the expansion preferably corresponds to the diameter. In the case of square-shaped heating plates, the expansion is preferably to be understood as meaning the lateral length of the square. It may be preferred that in order to reduce the driving effort, the device has not more than 15, preferably not more than 12 heating plates.

In particular, it is preferred to use at least two separately controllable heating plates in conjunction with a treatment area of at least 6 cm ² , preferably at least 7 cm ² . In this way, an optimized and rapid heating of the treatment surface and thus preferably a good reduction of the itching can be effected.

However, it may also be preferred that the preferably at least two heating plates are driven together. By this preferred variant, a particularly simple, inexpensive and robust control can be realized.

It is preferred that at least about 0.84 hot plates are used per cm ^{2 of} treatment area. For a treatment area of 6 to 11 cm ^2, at least are preferred

5 heating plates, more preferably for a treatment area of 7 to 10 cm ² at least

6 hotplates, most preferably used for a treatment area of 8 to 9 cm ² , in particular 8.4 cm ² at least 7 hot plates. Particularly for a preferred embodiment, for which the size of the heating plates is between 0.05 cm ² and 2 cm ² , preferably between 0.1 cm ² and 0.5 cm ² , it has been shown that this results in both an optimum Temperature distribution during the treatment phase and an effective heating can be achieved. It has been found that this preferred minimum number of heating plates per cm ^{2 is} necessary in order to realize a heating phase of 10 s, preferably 2 s.

It has also been shown that a particularly homogeneous temperature distribution can be achieved during the treatment phase. This leads to a particularly good treatment result.

In particular for a preferred treatment area of at least 6 cm ² , the preferred treatment temperature of 50 ° C-53 ° C and the preferred treatment time of 4s-6s, a minimum of two heating plates, more preferably at least 5 heating plates, has been found to be ideal to realize a heating phase of 10 s, preferably 2 s. Likewise, this allows a particularly homogeneous temperature distribution during the treatment phase can be achieved.

It is preferred to use at least 6 hotplates for a preferred treatment area of at least 7 cm ² . For a preferred treatment area of about 8.4 cm ² , it is preferred to use at least 7 heating plates. Surprisingly, it has been found that very good treatment results can be achieved hereby.

It may also be preferred that at least two heating plates are realized without spacing from one another in a connected component. This has the advantage that a large-area component is produced, which heats over its entire, formed by the contiguous surfaces of the at least two heating plates surface. At the same time, the individual heating plates can be controlled individually, so that a customized temperature distribution can be generated.

However, it may also be preferred that the treatment surface consists of several partial surfaces, which are preferably congruent to the heating plates. Kongruent prefers a congruence of the partial surfaces of the treatment surface and the heating plates located above it, so that the shape and size of the partial surfaces corresponds to the shape and size of the heating plates. For this purpose, for example, the heating plates can be coated or coated with the materials preferably used for the treatment surface. However, it may also be preferred that the partial surfaces project beyond the heating plates, wherein it is preferred that the partial surfaces of the treatment surface do not touch one another in the contact plane.

It is preferred that the treatment surface consists of several partial surfaces, if, for example, particularly large areas of skin are to be treated. To this end For example, the patches may be arranged so that they are far apart to cover a large outline area. For example, it may be preferable for the partial surfaces to be distributed in a lattice-like manner, with a spacing between the partial surfaces which is between 0.2 mm and 10 mm, preferably between 0.5 mm and 3 mm. When placing the treatment area on the skin areas a more heterogeneous temperature distribution is achieved in comparison to a contiguous treatment area, which can be advantageous for certain pruritus diseases. Furthermore, the total amount of heat transferred is advantageously reduced by a punctiform Hitzeabgabge within the outline area.

It is particularly preferred that the heating plates are adjusted by the control device to a temperature which leads to the treatment surface at the desired treatment temperature. Thus, it may be preferred that the heating plates are controlled to a slightly elevated temperature compared to the targeted treatment temperature. The difference in temperatures reflects the expected temperature gradient between the heating plate and the outside of the treatment area.

In a preferred embodiment of the invention, the device is characterized in that the control device can regulate the heating plates in the heating phase to a heating temperature between 43 ° C and 54 ° C and the heating temperature in the treatment phase for a period of 2 s to 12 s, preferably between 4 sec and 6 s can be maintained. The heating temperature thus preferably corresponds to that temperature at which the heating plates are preferably kept constant during the treatment phase. By means of such a regulation of the heating plates, the temperature of the treatment surface can be guided particularly precisely in a range from 42 ° C. to 53 ° C., with a corresponding period of the treatment phase between 2 s to 12 s, preferably between 4 s and 6 s. It may be preferred that the heating plates are set to a slightly elevated temperature, as the desired treatment temperature to compensate for any heat loss and a temperature gradient. Furthermore, it may be preferred that the heating plates are constantly set to the same heating temperature. But it may also be preferred that the heating plates are set to different temperatures. It is therefore preferred that the heating plates can be controlled and heated separately via the control device. In particular for embodiments having at least 6 or preferably at least 8 heating plates, it has been found that a surprisingly homogeneous temperature distribution can be achieved on the treatment surface when they are at the edge heating plates are heated to a slightly elevated temperature than medium heating plates. It is also conceivable to heat the outer heating plates before the middle heating plates are heated. The positioning of edge and center will be apparent to those skilled in the art in a plan view of the arrangement of the heating plates. The middle heating plates are preferably those heating plate, which are bordered by outer heating plates. The heating plates located at the edge do not have a border of other outer heating plates. A slightly elevated temperature preferably means a temperature difference between 0.1 ° C and 2 ° C, more preferably between 0.1 ° C and 0.5 ° C. If all the heating plates are switched on and off at the same time, it could happen that reaching the

Effective temperature of the entire treatment area takes place too late or the user in the middle already feels a strong heat peak, although the treatment temperature has not yet been reached over the entire treatment area.

In a further preferred embodiment of the invention, the device is characterized in that the treatment surface has a thickness between 0.2 mm and 5 mm, preferably between 0.5 mm and 2 mm, particularly preferably between 1 mm and 1, 5 mm and out a material which has a thermal conductivity at 50 ° C between 20 W / mK and 400 W / mK, preferably between 100 W / mK and 350 W / mK. The thermal conductivity (also referred to as thermal conductivity) preferably characterizes the thermal properties of the material from which the treatment surface is made. The thermal conductivity indicates how high the amount of heat is, which is passed through the treatment surface when a temperature gradient is applied to this. In addition to the thermal conductivity, the heat transfer depends on the thickness of the treatment surface, the size of the treatment surface and the temperature difference between the inside of the treatment surface (contact with the heating plates) and the outer side of the treatment surface (contact with the skin). The thermal conductivity is preferably given as the ratio of the transported heat output Watt (W) per temperature difference in Kelvin (K) and per meter (m). The thermal conductivity can also be preferred as the ratio of the transported heat output Watt (W) per temperature difference in millikelvin (mK) can be specified. Since the thermal conductivity can also change slightly depending on the temperature, in the present case the reference temperature is given as 50 ° C. The thickness of the treatment surface further preferably designates the extent of the treatment surface between the outermost surface which contacts the skin and the innermost surface against which the heating plates abut. With a treatment surface area of between 0.2 mm and 5 mm, preferably between 0.5 mm and 2 mm and particularly preferably between 1 mm and 1.5 mm, in combination with the preferred thermal conductivity between 100 and 350 W / mK a therapeutically particularly effective heat transfer to the skin. In experimental experiments, the preferred mentioned parameters have proved to be surprisingly advantageous. Thus, a treatment area designed in this way avoids too rapid a release of the heat to the affected areas of the skin, as a result of which an uncomfortably piercing pain could be triggered. Nevertheless, the heat is released in a period of time which is sufficiently impulsive to effectively excite the receptors and superimpose an itch. The mentioned parameters therefore represent an optimized selection which would not be obvious to a person skilled in the art.

In a preferred embodiment, the treatment area comprises ceramic or gold. It is particularly preferred that the treatment surface consists of gold or ceramic. The materials ceramic and gold fall on the one hand in the experimentally determined, preferred range of thermal conductivity. In addition, both ceramic and gold are surprisingly characterized for the treatment of dermatological itching. In particular, the materials develop in chronic pruritus, allergies or after contact with venomous cnidarians in the patients an increased perceived pain overlay. This is surprising in that the effect can go beyond the pure temperature effect of thermally comparable materials. Furthermore, the materials are characterized by a surprisingly antimicrobial function at the treatment temperature in question. This feature is of particular importance in pruritus. In particular, in chronic pruritus or large areas affected skin, patients tend to scrape rubbing or scrubbing a short-term, seek subjective alleviation. Through psychological reinforcement, this can grow into a compulsive behavior. As a side effect of pruritus therefore microscopic wounds, scratch marks, skin lesions or even open wounds occur frequently. The antimicrobial function of gold and ceramics at the treatment temperature therefore shows in addition to the relief of itching long-term positive effects for the recovery of the skin. In addition, gold and ceramics are characterized by a surprisingly high biological compatibility, which, in combination with a particularly low degree of allergies to these materials, particularly characterizes the use in a device for the treatment of predominantly dermatological disorders. A particularly preferred ceramic is aluminum nitride. This is particularly notable for exceptional biocompatibility, surprising antimicrobial function at the treatment temperature and excellent thermal properties. In addition, a treatment surface made of aluminum nitride is particularly highly electrically insulating, so that increased safety in the application can be ensured.

In a further preferred embodiment of the invention, the device is characterized in that the device between 4 and 18 preferably comprises between 8 and 14 heating plates and the size of the heating plates between 0.05 cm ² and 2 cm ² , preferably between 0.1 cm ² and 0.5 cm ² . It is particularly preferred that the heating plates are circular, preferably with a diameter between 3 and 10 mm. But also quadrangular heating plates may be preferred. Furthermore, it is particularly preferred that the heating plates are arranged in a grid, wherein a preferred distance between the heating plates between 0.2 mm and 10 mm, preferably between 0.5 mm and 3 mm. The arrangement of the heating plates leads to a surprisingly strong alleviation of itching, which in particular a treatment of chronic pruritus, areal allergies or jellyfish stings is particularly effective possible. Furthermore, it comes in the preferred dimensioning of the heating plates to a synergistic, positive effect when they heat a treatment surface, which is configured contiguous, has a thickness between 0.5 mm and 2 mm and consists of a material having a thermal conductivity at 50 ° C. between 20 and 400 W / mK, preferably between 100 and 350 W / mK. For this very particularly preferred embodiment results in optimum heat transfer. The thermal conductivity in connection with the thickness not only determines the heat transfer between the heating plates and the outer surface of the treatment surface, but also the temperature distribution within the plane of the treatment surface. The parameters mentioned here are characterized by a particularly effective temperature distribution, which is sufficiently homogeneous to achieve a uniform effect on the skin, but nevertheless achieves a slightly heterogeneous, selective heat release. Here, at the position of the treatment surface directly below the respective heating plates, a slightly elevated temperature, which is preferably higher by 0.1 ° C. to 2 ° C. than the average of the treatment temperature. This distribution is surprisingly effective in reducing itching.

It may also be preferred that the device comprises only a single, flat heating plate. In a preferred embodiment, this may be a hotplate which has a large surface area. That is, it is preferable that the heating plate cover an area of at least 50% of the treatment area. It may also be preferred that the heating plate is substantially congruent with the treatment surface. Essentially, here means that the areas are approximately equal. Information such as approximate, approximate, nearly or synonymous terms preferably denotes a tolerance range of less than ± 10%, preferably less than ± 5%, more preferably less than ± 1%. It may be preferred that the one heating plate is in the form of a heating spiral. A heating coil preferably designates a heating plate whose web-shaped heating surface moves away from or approaches a central point in a plane above the treatment surface on a spiral path. However, it may also be meant a web-shaped heating plate, which is arranged in a meandering manner in a plane above the treatment surface. By web-shaped is preferably meant an elongated surface whose length is more than twice as large as its width. By using a single heating plate, a particularly simple construction of the device can be realized.

In a preferred embodiment of the invention, the device comprises at least one temperature sensor for measuring the temperature of the treatment surface and / or at least one heating plate, wherein the control device sets the temperature of the at least one heating plate based on measurement data of the temperature sensors. A temperature sensor preferably designates an electrical or electronic component which sends an electrical signal to the control device by measuring the temperature.

In the prior art, a variety of temperature sensors are known, such as, for example, semiconductor temperature sensors, resistance temperature sensors, pyroelectric materials, thermocouples or quartz crystals. The control device is furthermore preferably configured such that it can receive and evaluate the measured values of the temperature sensors in order to effect a regulation of the heating plates. The regulation of the heating plates can preferably take place by means of the application of an electrical current or a voltage. It is particularly preferred that the temperature sensor measures the temperature of the treatment surface directly, ie that the temperature sensor is in contact with the treatment surface, wherein the temperature sensor may be located both on the inner side of the treatment surface and on the outer side of the treatment surface. In the case of a contiguous treatment surface, it may be preferable for a plurality of temperature sensors to be present at different positions of the treatment surface in order to allow a particularly precise readout of the location-dependent temperature distribution. However, it may also be preferred that the temperature sensor does not cover the treatment area, but the heating plates contacted and monitored. On the basis of the knowledge of the material properties of the treatment surface, it is also advantageously possible to deduce the temperature distribution of the treatment surface from the measured data on the heating plates. An evaluation of the temperature of the heating plates and the temperature of the treatment surface allows a particularly precise regulation of the heating plates in order to ensure the optimum temperature distribution and heat transfer. For this purpose, it may be preferable to drive individual heating plates separately, for example to compensate for a temperature gradient. However, it may also be preferred that the heating plates are controlled together, so that a temperature regulation is uniform for all heating plates. In particular, with regard to the many possible applications of the device for the treatment of various pruritus diseases, a temperature-based feedback regulation is suitable to meet the different safety requirements. In the case of skin lesions with lesions or in children, it is particularly important to set an exact treatment temperature and not to exceed a maximum value. In addition, feedback control based on temperature measurements can effectively prevent operator error. The use of at least one temperature sensor thus not only increases the effectiveness, but also the safety and reliability of the device.

In a preferred embodiment of the invention, the device has a software and / or hardware-based safety shutdown when a maximum temperature is exceeded. This preferred embodiment allows a special safe operation of the device. Due to the treatment area, which is much larger than that of the prior art, a safety shutdown is particularly advantageous. Otherwise, systemic defects can lead to skin damage, especially when treating large areas of the skin. Furthermore, the broad applicability of the device is to be considered, which includes not only different sensitive areas of skin but also a wide variety of patient groups from children to seniors to pregnant women. A software and / or hardware implemented locking of the device by a safety circuit from a maximum temperature can meet the highest safety requirements. It is particularly preferred that the safety shutdown hardware is implemented, for example, by fuses or bimetallic strip, so that without an active intervention of the control device, the exceeding of a maximum temperature is avoided. In addition, it may be preferred that, in addition, a software-based shutdown takes place. This one will preferably implemented by the control device, which evaluates the temperature data of the heating plates and / or the treatment surface and compares with a maximum value.

It may also be preferred that the device comprises a hardware-implemented temperature monitor limiting the maximum temperature of the treatment area to a predetermined maximum value. "Hardware-implemented temperature monitor" preferably designates a temperature control system for the treatment surface, which hardware-based can shut off power to the treatment area heater plates In particular, the "hardware-implemented temperature monitor" preferably allows the power supply of the heating plates to be switched off when the maximum temperature is exceeded, independently of the regulation of the heating plates by the control device, eg a microprocessor. If, for example, a firmware has been installed for the regulation of the heating plates on the control device, it is preferred that the hardware-implemented temperature monitor reliably limits the maximum temperature of the treatment surface even in the event of failure or faulty execution of the firmware. Advantageously, the hardware-implemented temperature monitor is set so that it must not come to a permanent shutdown of the power supply of the device. Rather, the hardware-implemented temperature monitor is designed so that when the temperature of the treatment surface exceeds a maximum temperature, during the period of exceeding the power supply of the heating plates is interrupted. The power interruption by the hardware-implemented temperature monitor is thus advantageously reversible, ie as soon as the temperature of the treatment surface falls below the maximum temperature, the heating plates can heat again. Such a hardware-implemented temperature monitor could for example be implemented by a bimetallic strip. However, it may also be preferred that such a hardware-implemented temperature monitor comprises at least one temperature sensor independent of the control loop for measuring the temperature of the treatment surface and a comparator, the comparator comparing the temperature of the treatment surface with the maximum temperature and the current supply when the maximum temperature is exceeded the at least one hot plate prevents. A comparator preferably designates an electronic circuit for comparing two voltages, the output indicating in a binary manner which of the two voltages is higher. Sufficiently different comparators are known in the prior art which are suitable for outputting a binary output signal from two analog voltages, which indicates which of the input voltages is higher. As an example of a comparator Circuit is called the Schmitt trigger. It is preferred that a reference value for a voltage is applied to an input of the comparator with the aid of a voltage distributor. This reference value preferably corresponds to the voltage value which the second temperature sensor would have if the temperature of the treatment surface is equal to the maximum temperature. At the second input of the comparator is preferably the output voltage of the temperature sensor, which depends on the temperature of the treatment surface. A particularly preferred temperature sensor for this purpose comprises an NTC thermistor, ie a thermistor. This has a negative temperature coefficient, so that with an increase in temperature, the resistance drops and a higher current flows. But it can also PTC thermistors are used, which have a positive temperature coefficient, so that with an increase in the temperature, the resistance increases and a lower current flows. By this realization of a hardware-implemented temperature monitor, a surprising device with little susceptibility to interference can be provided.

If the temperature of the treatment surface increases, the voltage value controlled by the second temperature sensor at the comparator moves to the reference value of the voltage which corresponds to the maximum temperature. As soon as the temperature exceeds the maximum temperature, the output signal at the comparator changes to binary. The comparator is preferably integrated in the power supply of the heating plates. That is, before the temperature of the treatment surface reaches the maximum temperature, the comparator preferably releases the supply voltage of the heating plates. However, as soon as the temperature is higher than the maximum temperature, the output of the comparator switches off and interrupts the supply voltage of the heating plates. If the temperature of the treatment surface falls again, the supply voltage is advantageously released again by the comparator. As a result, a reversible switching on and off of the heating plates only for the period, while the temperature of the treatment surface exceeds the maximum temperature. Furthermore, it may be preferred that the comparator is enabled by the control device when starting the device. If the device is not properly started, the comparator in the default setting is configured so that the voltage supply to the heating plates is interrupted. It was surprising that a particularly simple, robust and less susceptible to interference from overheating could be realized by this advantageous mechanism. The described preferred embodiment of the hardware-implemented temperature monitor has proven to be particularly robust and reliable in tests. Due to the reversibility of the safety shutdown and simple design, the preferred embodiment is further characterized by low manufacturing and maintenance costs.

Likewise, a hardware-implemented temperature monitor in the form described by taking advantage of a comparator is particularly fast, since comparators identify next to their reliability by their surprisingly fast switching capability. For example, there are comparators with switching times of ns and below. It has surprisingly been found that the use of comparators in the circuit due to their speed, a particularly effective protection mechanism against overheating of the treatment surface could be built.

In a further preferred embodiment of the invention, the device comprises a fuse, which shuts off the device in case of short circuit or unregulated Durchheizen. A fuse is preferably a device for the protection of an overcurrent, which is interrupted by the melting of a fuse conductor of the circuit. Thus, a predetermined by the fuse conductor current can not be exceeded. A fuse effectively prevents a short circuit and can also prevent unregulated heating of the device. An unregulated heating of the device preferably designates a heating of the heating plates beyond the maximum temperature due to software or hardware errors. Such uncontrolled heating can occur, for example, if the temperature sensors are defective or a safety shutdown does not intervene properly. The fuse allows an additional hardware-based fuse to be achieved. By means of a fuse thus another technical feature can be provided, which increases the safety of the device, in particular with regard to the requirements of the diverse medical use.

The preferred combination of the security features of a hardware-implemented temperature monitor with a fuse allow a surprisingly reliable control of the temperature with the most economical means possible staggered security barriers, the hardware-implemented temperature monitor is reversible as the first level of security, and only the second level of security through the fuse irreversible, permanent Uncoupling the supply voltage from the device has the consequence. In a further embodiment of the invention, the device is characterized in that the treatment temperature during the treatment phase in a range of ± 10%, preferably ± 5% and most preferably ± 3% can be maintained. By keeping the treatment temperature preferably constant in the aforementioned ranges, a particularly precise and constant heat transfer can be ensured, so that an optimized heat transfer to the relevant skin areas is ensured. In order to comply with the mentioned parameters, preferably measurement data from the temperature sensors can be used and evaluated.

In a further preferred embodiment of the invention, the device is characterized in that the device comprises a visual display and / or a sounder, which the start of the heating phase, reaching the treatment temperature, the duration of the treatment phase and / or the end of the treatment phase by a indicates acoustic and / or optical signal. The optical display can preferably be effected by light emitting diodes (LED), incandescent lamps, liquid crystal (LCD) displays or other known optical displays. Preferably, a color code comes into play, which is adapted to the function. For example, the heating phase can be indicated by an orange signal, the treatment phase by a red signal and the end of the treatment phase by a green signal. The acoustic signaling is preferably carried out by a speaker, which emits particularly preferred short or longer beeps. Through the optical and / or acoustic signaling, the user experiences the state of the device at any time during the preparation or treatment phase. Surprisingly, this results in an additional psychological effect, which leads to an even greater reduction of itching by a concentration on the signaling. Furthermore, the preferred embodiment greatly enhances ease-of-use, safety and patient compliance. In addition, the optical and / or acoustic signaling allows to introduce further security mechanisms. Thus, the exceeding of a maximum temperature can be displayed to the user quickly and clearly. By "clearly indicated" is meant that when a maximum temperature is exceeded, an optical signal is illuminated and / or an audible signal is sounded, thereby allowing the user to remove the treatment area from the skin area before skin damage may occur It is much slower to respond to a visual and / or audible warning signal due to pain sensations for self-protection, as well as warning signals that are more effective and faster Protection, as this is possible by a safety shutdown of the heating plates. It is particularly preferred that a failure to reach a predetermined treatment temperature and / or deviations of the treatment temperature during the treatment phase, which are greater than preferably ± 5% and more preferably ± 3%, is indicated by an audible and / or audible warning.

In a preferred embodiment of the invention, the device is characterized in that the treatment surface is bordered by a marking which lights up as a function of the treatment cycle. As a marking, it may be preferable, for example, to surround the treatment surface with a light guide. This can be brought to light, for example during the heating or during the treatment phase. It has been shown that by an explicit luminous indication of the position of the treatment surface, the success of the hyperthermic treatment can be increased. The visual marking promotes a centered placement on the affected areas of the skin so that the heat impulse can be applied to these areas of the skin in a targeted manner. Due to the illuminated marking, use in the dark, for example in a tent outdoors at night, can be made without problems.

In a further preferred embodiment, the device comprises a watertight housing. The housing preferably represents an outer casing of the device, so that it encloses in particular the control device and other electronic components. It is preferred that the housing has a housing head and a housing handle, wherein the treatment surface is preferably present at a lower portion of the housing head. For controlling and tempering the treatment surface, the housing preferably has a breakthrough at the corresponding position. In the preferred embodiment, the housing is designed such that all breakthroughs, ie, for example, possibly also existing battery compartments, are waterproof. For example, sealing rings or suitable seals, for example made of elastomers, can be used for this purpose. However, the person skilled in the art knows many other technical possibilities for constructing a housing watertight. The waterproof design of the housing is an additional security element, as this damage to the control device or other electronic components due to incoming fluids can be effectively avoided. Also, the watertight housing leads to the prevention of corrosion and thus to a prolonged life of the device. In particular, the invention in this preferred embodiment, in combination with the illuminated marking for use under special conditions, for example, in expeditions in civilization remote areas, in some humid climates, suitable.

In a further preferred embodiment of the invention, the device is characterized in that the device comprises a power supply unit and a voltage monitor, which monitors the voltage of the power supply unit. For the purposes of the invention, the power supply unit preferably provides the electrical energy for operating the device. Preferred power supply units are batteries or rechargeable batteries. These provide the electrical energy usually by providing a DC voltage available. In the preferred embodiment, the voltage provided by the power supply unit is monitored by means of a voltage monitor. For the purposes of the invention, a voltage monitor preferably designates an electrical circuit which can measure the voltage of the power supply unit and triggers an action if it falls below a predetermined limit value. A variety of voltage monitor variants are known in the art, with those skilled in the art knowing which voltage monitors for which types of power supply units, i. especially batteries or rechargeable batteries. It is preferred that if the voltage monitor detects a drop in the voltage of the power supply unit below a certain value, it sends an interrupt request (IRQ) to the control device, which is preferably a microprocessor. If, during this, a treatment cycle, i. a warm-up or a treatment phase, the interrupt request leads to a termination of the treatment cycle. This constitutes another safety mechanism. It has thus been found that an undervoltage on the power supply unit results in failure of the control device, e.g. of the microprocessor can lead. In that case, it may happen that the temperature regulation of the treatment temperature by means of the control device is carried out incorrectly and there is an uncontrolled heating of the treatment surface. The voltage monitor can thus additionally contribute to increasing the safety of the device and to avoid a health hazard in the case of, for example, a faulty battery.

In a preferred embodiment, the device is characterized in that the control device comprises a microprocessor. For the purposes of the invention, a microprocessor is preferably a data processing device, ie a processor. which is characterized by small dimensions in the range of a few mm and preferably all the components of the processor on a microchip or integrated circuit (IC). The microprocessor may preferably also be a microcontroller which, in addition to the processor, integrates further peripheral elements on the microchip and, for example, also has a data memory. It is further preferred that the microprocessor is installed on a printed circuit board (PCB). Apart from the microprocessor, the heating plates and the temperature sensors are preferably also installed on the PCB. This preferred embodiment allows an extremely compact and equally robust construction of the device and a particularly intelligent temperature regulation by means of the microprocessor. Thus, the microprocessor is not only able to evaluate the measured temperature data and translate in a control of the heating plates, but can also quickly and reliably take into account other parameters such as error messages and user input.

In a preferred embodiment of the invention, the device is characterized in that the microprocessor, the at least one heating plate and the at least one temperature sensor are installed on a printed circuit board (PCB), wherein at least the at least one heating plate and the temperature sensor coated by means of a protective lacquer are. For the purposes of the invention, the protective lacquer is preferably understood to mean a lacquer or a paint which is intended to protect components of the PCB from environmental influences. The protective lacquer preferably has an electrically insulating effect for this purpose and is water-resistant. The property of the electrical insulation can preferably be quantified on the basis of the surface resistance or SIR. The SIR can preferably be measured, for example, by leakage currents between the components of the printed circuit board. A high resistance corresponds to a good electrical insulation. Water resistant preferably means that even with a high humidity or the penetration of water the painted electronic components remain intact and there is no short circuit. For example, the water resistance can also be tested by measuring the SIR under high humidity conditions. In the prior art, a variety of protective coatings are known, which can preferably be used. Exemplary protective coatings are called on acrylic, silicone or polyurethane-based. By applying the protective varnish in the area of the heating plates and temperature sensors, they are effectively protected against deposits, so that incorrect measurements of the temperature sensors are avoided can be. On the one hand, this increases the accuracy with which the treatment temperature can be set and, on the other hand, avoids that due to an erroneous measurement of the temperature, the treatment surface overheats.

The coating of said components allows in a surprising way a reliable, additional thermal protection of the device with particularly simple and inexpensive technical means. Surprisingly, an installation of the components on a PCB has proven particularly advantageous for the coating of the components.

In a preferred embodiment of the invention, the device is characterized in that the device comprises a data memory for storing the system data and / or error messages. Preferred system data include a treatment cycle counter, which preferably separately counts the use of different types of treatment cycles. For example, if a short or long treatment cycle can be selected, it will be counted separately. Furthermore, the system data preferably include a boot counter, that is, a counter for how often the device was started and an indication of the error messages with the current error status.

The following error messages may preferably be stored: A "reset" indicates that the voltage monitor has triggered a reset A "watchdog" indicates that a watchdog reset has occurred in the firmware, i. a system restart due to a software error. Preferably, it can be determined for the error message in which program mode the device was when the error occurred. A "temperature too high" may indicate that the temperature measured at the temperature sensor is too high, or that the temperature sensor is faulty, a "temperature too low" may indicate that the temperature measured at the temperature sensor is too low or the temperature sensor is defective is. A "treatment temperature reached" may indicate whether the desired treatment temperature has been reached or an error has occurred during the preheat phase.

Advantageously, the stored system data and error messages may be used for the diagnosis and troubleshooting of the device. For example, this data can be read when a customer sends in a defective device. On the basis of the data, it is possible to correlate the error that has occurred, eg "temperature too high", with further system data on the number of treatment cycles or watchdog resets.Thus, using this data, the safety features of the device can be continuously monitored both during the development phase and thereafter be optimized. Thus, the device includes storage of system data and error messages, thus allowing the continuous improvement of the hardware and software components of the device based on meaningful data.

In a further preferred embodiment, the device is characterized in that there is a firmware installed on the control device which controls at least the temperature regulation of the treatment surface, the firmware comprising a watchdog counter (WDC) which monitors whether the firmware is being executed. For the purposes of the invention, software, i. E. understood the instructions for a computer-implemented method, which is present in the control device preferably embedded in the microprocessor. That the firmware preferably includes the software associated with the hardware of the device, i. in particular is functionally connected to the heating plates and temperature sensors. Preferably, the firmware is executed with the start of the device and takes over the control and control function of these hardware components of the device. Thus, the control device preferably evaluates based on the firmware e.g. the temperature sensor readings and user inputs to control the power supply to the hotplates during the treatment cycle. For the purposes of the invention, hardware-implemented components preferably denote components whose function is ensured independently of a correct execution of the firmware. As described above, the preferred temperature monitor is hardware implemented so that its function, i. a limitation of the maximum temperature, regardless of a correct execution of the firmware can be done on the control device. Even with a crash of the firmware, the hardware-implemented temperature monitor can therefore quickly and correctly limit the maximum temperature of the treatment area.

In the particularly preferred embodiment, the firmware of the control device is monitored by means of a hardware-implemented watchdog counter. Particularly preferably, this is a time-out watchdog. The time-out watchdog is preferably activated by the firmware before the start of the treatment phase. During the treatment phase, the firmware sends a signal to the time-out watchdog within a predetermined time interval to reset it. If the time-out watchdog is not reset, this preferably leads to a restart of the firmware. The time interval is preferably based on the time which is provided to carry out a temperature measurement and regulation of the heating plates by the firmware and can be, for example, between 2 ms and 10 ms. Such a time-out watchdog can advantageously It must be ensured that the firmware functions correctly at least during the treatment phase of the device and that the temperature of the treatment surface is monitored. By a hardware-implemented watchdog for monitoring the firmware, preferably for example by means of a time-out watchdog, it can thus be ensured that if the firmware does not work properly and the predetermined time interval is not met, the treatment phase is aborted. Thus, another preferred security feature of the device is in addition to the already mentioned preferred features, which, in particular in conjunction with the preferred hardware-implemented temperature monitor, ensures that overheating of the treatment surface is precluded even if the firmware is not functioning properly. As a last, additional security level, the fuse is preferably additionally available. This staggering of security mechanisms results in the device being surprisingly durable and secure.

In a further preferred embodiment, the invention relates to a use of the device for the treatment of chronic pruritus, for the reduction of itching in dermatitis or after contact with venomous cnidarians or plants, preferably after contact with jellyfish. Moreover, the device can be used for the treatment of pruritus as a side effect of skin diseases such as eczema, atopic dermatitis, urticaria, skin infections, xerodermia, parasites (eg scabies), metabolic diseases or infectious diseases. Even with allergies to foods or medicines, the device can effectively reduce the itching. According to the invention, it has been recognized that hyperthermic treatment with the preferred parameters mentioned for the treatment temperature and dimensioning of the treatment area in the mentioned fields of application leads to a surprisingly positive effect. For example, in comparison to conventional ointments or creams, the device can significantly and effectively prevent itching after contact with venomous cnidarians. When using the device, this is preferably placed on the skin. Subsequently, preferably after an input by the user, the regulation of the temperature of the treatment surface automatically takes place with the aid of the control device. Advantageously, this must be no doctor present, but the person can independently use the device. Because of the ease of use and the almost immediately noticeable relief of itching compliance is unusually high. Due to the pronounced adherence to therapy, even serious pruritus diseases can be treated sustainably. Furthermore, the compact size allows flexible use. The device can be transported easily and therefore also be taken as a preventative when traveling, where there is an increased risk of allergies or jellyfish stings. The immediate start of treatment after the onset of the first symptoms of pruritus has a positive effect on the success of the treatment.

In the following, the invention will be explained in more detail with reference to examples, without being limited to these.

Brief description of the figures

Fig. 1 Schematic side view of a preferred embodiment of the device

Fig. 2 Schematic plan view of a preferred treatment surface and arrangement of the heating plates

Detailed description of the pictures

FIG. 1 shows a schematic side view of a preferred embodiment of the device. The housing (3) of the device is preferably designed in such a way that it fits snugly in the hand in order to ensure easy and convenient handling. The preferred embodiment of the housing (3) comprising a handle is particularly suitable for reaching various parts of the body without trouble with the treatment surface (1). The treatment surface (1) is for this purpose embedded on the underside of the housing in a front region.

FIG. 2 shows a schematic view of a preferred treatment surface (1) and arrangement of the heating plates (5). For better visibility, the treatment surface (1) is represented only by its border, so that the arrangement of the heating plates (5) located in the device becomes visible. In the particularly preferred embodiment, the device comprises 1 1 heating plates (5) with a diameter of about 6 mm. The treatment surface (1) is heated by the contacting heating plates (5) to the treatment temperature and, in this particularly preferred embodiment, consists of the aluminum nitride ceramic with a thickness of 1.3 mm. With this particularly preferred embodiment of the device, itching can be reduced particularly effectively in the case of a large number of diseases.

It should be understood that various alternatives to the described embodiments of the invention may be utilized to practice and to the invention to get to the solution of the invention. The device according to the invention and its use are therefore not limited in their embodiments to the above preferred embodiments. Rather, a variety of design variants is conceivable, which may differ from the illustrated solution. The aim of the claims is to define the scope of the invention. The scope of the claims is directed to cover the device of the invention and preferred uses, as well as equivalent embodiments thereof.

LIST OF REFERENCE NUMBERS

1 treatment area 3 housing

5 heating plate

REFERENCES

Cohen MR, Moiseenkova Bell VY. Structure of thermally activated TRP channels. Curr Top Membr. 2014; 74: 181 -21 1.

Mergler S et al. Temperature-sensitive transient receptor potential channels in corneal tissue layers and cells. Ophthalmic Res. 2014; 52 (3): 151 -9.

Matterne U, Apfelbacher CJ, Loerbroks A, Schwarzer T, Büttner M, Ofenloch R, Diepgen TL, Weisshaar E: Prevalence, Correlates and Characteristics of Chronic Pruritus: A Population-Based Cross-sectional Study. Acta Derm Venereol 201 1; 91: 674-679

Rothmann S. Physiology of itching. Physiol Rev 1941; 21: 357-381

Stand S, Weisshaar E, Mettang T, Szepietowski JC, Carstens E, Ikoma A, Bergasa N, Gieler U, Misery L, Wallengren J, Darsow U, Streit M, Metze D, Luger TA, Greaves MW, Schmelz M, Yosipovitch G , Bernhard J. Clinical Classification of itch: a position paper of the International Forum for the Study of Itch. Acta Dermatol Venerol 2007, 87: 291-294

Stands S, Schäfer I, Phan NQ, Blome C, Herberger K, Heigel H, Augustin M.: Prevalence of chronic pruritus in Germany: Results of a cross-sectional study in a sample working population of 1 1, 730. Dermatology 2010; 221: 229-35

Somogyi CS et al. Polymodal Transient Receptor Potential Vanilloid (TRPV) Ion Channels in Chondrogenic Cells. Int J Mol Be. 2015; 16 (8): 18412-38.

Vogelgsang L, Loerbroeks A, Apfelbacher CJ, et al. Incidence of chronic pruritus and its determinants: results from a population-based study. Exp Dermatol 2012; 21: e1 -e48

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Claims

1. Apparatus for hyperthermic treatment of itching comprising

a) a treatment area (1)

and

b) a control device for regulating the temperature of the treatment surface (1) characterized in that

the size of the treatment area (1) is between 1 cm ² and 18 cm ² and the control device can regulate the treatment area (1) in a heating phase to a treatment temperature between 40 ° C and 65 ° C and the treatment temperature in a treatment phase for a period of 4 sec to 6 sec can be held.

2. Device according to the previous claim

characterized in that

the size of the treatment area (1) is at least 6 cm ² , preferably at least 7 cm ² , and the treatment temperature is between 42 ° C and 53 ° C, more preferably between 50 ° C and 53 ° C.

3. Device according to one of the preceding claims

characterized in that

the device comprises at least two heating plates (5), preferably at least four heating plates (5) and very particularly preferably at least six heating plates (5) which are in contact with the treatment surface (1) and whose temperature can be adjusted by the control device, wherein a heating of the heating plates (5) takes place an adjustment of the treatment temperature at the treatment surface (1).

4. Device according to one of the preceding claims

characterized in that

the at least two heating plates (5), preferably at least four heating plates (5) and very particularly preferably at least six heating plates (5) can be controlled and heated separately via the control device.

5. Device according to one of the preceding claims

characterized in that the treatment surface (1) is a continuous surface and / or the treatment surface (1) consists of a plurality of partial surfaces, which are preferably congruent with the heating plates (5).

6. Device according to the previous claim

characterized in that

the control device can regulate the heating plates (5) in the heating phase to a heating temperature between 43 ° C and 54 ° C and the heating temperature in the treatment phase for a period between 4 sec and 6 sec can be maintained.

7. Device according to one of the preceding claims

characterized in that

the treatment surface (1) has a thickness between 0.2 mm and 5 mm, preferably between 0.5 mm and 2 mm and particularly preferably between 1 mm and 1, 5 mm and consists of a material having a thermal conductivity at 50 ° C. between 20 and 400 W / mK, preferably between 100 and 350 W / mK.

8. Device according to one of the preceding claims

characterized in that

the treatment surface (1) comprises ceramic and / or gold.

9. Device according to one of the preceding claims

characterized in that

the device between 4 and 18 preferably comprises between 8 and 14 heating plates (5) and the size of the heating plates (5) is between 0.05 cm ² and 2 cm ² , preferably between 0.1 cm ² and 0.5 cm ² ,

10. Device according to one of the preceding claims

characterized in that

the device comprises at least one temperature sensor for measuring the temperature of the treatment surface (1) and / or at least one heating plate (5) and the control device sets the temperature of the at least one heating plate (5) based on measurement data of the temperature sensor.

11. Device according to one of the preceding claims

characterized in that the device has a software and / or hardware-based safety shutdown when a maximum temperature is exceeded.

12. Device according to one of the preceding claims

characterized in that

the device comprises a fuse which shuts off the device in case of short circuit or unregulated heating.

13. Device according to one of the preceding claims

characterized in that

the treatment temperature during the treatment phase can be maintained in a range of ± 10%, preferably ± 5% and most preferably ± 3%.

14. Device according to one of the preceding claims

characterized in that

the device comprises an optical display and / or a sounder which indicates the start of the heating phase, the reaching of the treatment temperature, the duration of the treatment phase and / or the end of the treatment phase by an acoustic and / or optical signal.

15. Device according to one of the preceding claims

characterized in that

the device comprises an optical display and / or a sounder, which by failing to reach a predetermined treatment temperature and / or deviations of the treatment temperature during the treatment phase, which are greater than preferably ± 5% and more preferably ± 3%, by an optical and / or acoustic Warning signal indicates.

16. Use of a device according to one of the preceding claims for the treatment of chronic pruritus, for the reduction of itching in dermatitis or after contact with venomous cnidarians or plants, preferably after contact with jellyfish.