RU2104001C1 - Agent for treatment of scabies patient - Google Patents

Abstract

FIELD: medicine, dermatology. SUBSTANCE: agent has the following components, wt. -%: benzylbenzoate, 20; potassium soap, 2; chlorohexidine bigluconate, 0.25-0.5; and distilled water, 77.75-77.5. EFFECT: enhanced effectiveness of agent. 1 tbl

Description

 The invention relates to medicine and can be used to treat scabies.

 To date, the treatment of scabies presents certain difficulties. However, in recent years there has been an increase in patients with scabies, characterized by a torpid course and resistance to existing methods of therapy. The latter is due to a decrease in immunity, an increase in the aggressiveness of the itch mite due to its genetic changes and the emergence of new, more pathogenic forms of the pathogen [8].

 The drugs used to treat scabies are sulfur and tar (in the form of an ointment), sodium thiosulfate (solution N 1) and hydrochloric acid (solution N 2), benzyl benzoate (in the form of an emulsion or ointment), etc. [2, 3, 7 ].

 Closest to the proposed composition is benzyl benzoate [5].

 However, the lack of benzyl benzoate is the lack of activity against pustular microorganisms, which does not eliminate the clinical signs of secondary pyoderma and does not prevent its development. This leads to very long periods of therapy - 7-10 days or more, and sometimes requires the appointment of antibiotics, sulfonamides, immunomodulators in a hospital [1]. In addition, in 10-20% of cases, the therapeutic effect is absent or relapses of scabies occur [6].

 It is proposed that the composition for the treatment of scabies containing benzyl benzoate, potassium soap and distilled water additionally introduce chlorhexidine bigluconate as an activating substance in the following ratio, wt.%: Benzyl benzoate 20.0; potash soap 2.0; chlorgesidine bigluconate 0.25-0.5; distilled water 77.75-77.5.

 Chlorhexidine bigluconate is known as an antiseptic that has a quick and strong bactericidal effect on gram-positive and gram-negative bacteria [4]. There is no information on the acaricidal effect of chlorhexidine bigluconate in relation to the human scabies pathogen.

 In the proposed composition, the concentration of chlorhexidine bigluconate 0.25-0.5 wt.% Is the most optimal. The increase in the concentration of the drug is more than 0.5 wt. % does not lead to a further reduction in the treatment of the disease. The decrease in the concentration of less than 0.25 wt.% Does not improve with confidence the treatment indicators in comparison with the prototype.

 The tool was prepared according to the technology conventional for the preparation of the suspension.

 Under observation were 12 patients with scabies aged 20 to 36 years, the duration of the disease from 14 days to 2.5 months.

 The proposed composition was rubbed into the entire skin (except for the head) for 10 minutes twice with an interval of 10 minutes. Processing of the skin was carried out twice with an interval of 3 days.

 In the lesions on the skin, paired and scattered small papulovesicles, dashed dotted lines of a grayish color (scabies), excoriation, pustules and conflicts, erosion, serous-hemorrhagic and purulent crusts, accompanied by severe itching, were determined. The diagnosis of scabies in all cases was confirmed by microscopic examination with the detection of a tick in scraping or serous contents of the bladder.

 As a result of the treatment with the proposed composition, a distinct therapeutic effect was noted in all patients. In addition, the treatment time was reduced compared to the prototype (see table).

 On average, on the 4th day from the start of therapy, papular vesicular elements and scabies were resolved, on the 4th-5th day pustules and conflicts were dried up, epithelization of erosion and excoriation occurred on the 5-6th day, crust rejection on the 6-7th day, full clinical recovery - on the 6-7th day. There were no local or general complications in the treatment of the proposed composition. Deviations in laboratory indicators were not noted. Relapses of the disease (when monitoring patients for 3 months) were not detected.

 When using a 20% water-soap emulsion of benzyl benzoate in a similar way (the control group of patients with scabies - 20 people), the clinical signs of the disease disappeared at a later date, amounting to 5-6, respectively; 7-8; 8-9; 9-10; 10-11 days.

 Example 1. Patient K., 22 years old. The duration of the disease is 1 month. Objectively: in the interdigital folds of the hands, on the flexion surface of the wrist joints, the anterolateral surfaces of the trunk, mammary glands, paired and scattered small papulovesicles, scabies, excoriation, pustules and conflicts, erosion, serous-hemorrhagic and purulent crusts are determined. Concerned about severe itching, worse at night. Microscopy of scrapings from the foci revealed an itch mite. Diagnosis: scabies.

 Treatment with the proposed composition was prescribed (benzyl benzoate 20.0 wt.%; Potassium soap 2.0 wt.%; Chlorhexidine bigluconate 0.5 wt.%; Distilled water 77.5 wt.%). Already on the 5th day of treatment, papulovicule elements and scabies were resolved. On the 6th day, pustules and conflicts were dried up. On the 7th day, epithelization of erosion and excoriation occurred. On the 8th day, peels were torn away. Clinical recovery occurred after 8 days. The treatment was well tolerated. Side effects were not noted. When examining the scraping of the epidermis, the scabies mite was not found.

 Example 2. Patient E., 29 years old. The duration of the disease is 3 weeks. Objectively: on the skin of the interdigital folds of the hands, abdomen, inner thighs, buttocks, genitals - paired papular vesicles, scabies, excoriation, sometimes pustules and conflicts, erosion, serous-purulent crusts. Concerned about intense itching of the skin, mainly in the evening and night. Microscopy of a cut of the scabies revealed a tick. The diagnosis is scabies.

 He was prescribed treatment with the proposed composition with a lower concentration of the component (benzyl benzoate 20.0 wt.%; Potassium soap 2.0 wt.%; Chlorhexadine bigluconate 0.25 wt.%; Distilled water 77.75 wt.%). On the 3rd day from the start of treatment, papulovicule elements and scabies were allowed, on the 4th day pustules and conflicts were dried up, on the 5th day erosion and excoriation were epithelized, and peels were torn off on the 6th day. Clinical recovery occurred on the 6th day. The treatment was well tolerated. Side effects were not noted. After the treatment, the scabies mite was not found in the scraping of the epidermis.

 Example 3. Patient A., 32 years old. The duration of the disease is 1.5 months. Objectively: on the anterolateral surfaces of the trunk, abdomen, inner thighs, buttocks, a large number of paired and scattered papular vesicular elements, scabies, pustules, erosion and excoriation, serous-hemorrhagic and purulent crusts. In the region of the extensor surface of the elbow joints - conflicts, dry crusts. Microscopy of the serous contents of the vesicles revealed an itch mite. Diagnosis: scabies.

 Treatment was prescribed with an average value of the proposed component (benzyl benzoate 20.0 wt.%; Potassium soap 2.0 wt.%; Chlorhexidine bigluconate 0.4 wt.%; Distilled water 77.6 wt.%). The evolution of elements occurred in the following terms: the disappearance of papulovesicles and scabies in 4 days, drying of pustules and conflict after 5 days, epithelization of erosion and excoriation after 6 days, rejection of crusts after 7 days. Clinical recovery after 7 days. The treatment was well tolerated. Side effects were not noted. After the treatment, the scabies mite was not found in the scrapings of the epidermis.

 Examples from clinical practice indicate a high activity in the local treatment of scabies of the proposed composition when the content of chlorhexidine bigluconate in it is at least 0.25 wt.%. A concentration of chlorhexidine bigluconate of more than 0.5 wt.% Is not advisable, since it does not lead to a reduction in treatment time.

 The use of a water-soap emulsion of benzyl benzoate in combination with chlorhexidine bigluconate provides the drug with a new (synergistic) property and, as a result, shortens the treatment time for scabies.

 Thus, the proposed composition reduces the treatment time by 3-4 days, increases the effectiveness of treatment, does not cause side effects.

Sources of information:
1. Anthonyev A.A., Arbatskaya Yu.D., Shevarova V.N. Examination of disability in skin diseases. M .: 1982, p. 88-90.

 2. Kulaga V.V., Romanenko I.M. Treatment of skin diseases. Kiev. Health, 1988, p. 247-249.

 3. Mashkillayson A. L. Treatment of skin diseases (a Guide for doctors). M .: 1990, p. 238-240.

 4. Mashkovsky M.D. Medicines M., 1993, part 2, p. 450-451.

 5. Mashkovsky M.D. Medicines M., 1993, part 2, p. 456-457.

 6. Seiketova O.Zh., Nugmanova M.L., Zimina L.P. Incidence of scabies and measures to combat it. Sexually transmitted and skin diseases. Alma-Ata, 1981, p. 168-174.

 7. Sokolova T.V., Fedorkovskaya R.F., Lange A.B. Scabies. M., 1989.

 8. Colombo E., Jriffanti P. Epidemiologia della entomodermatos; Chson desm. 1983. Vol 14, N 2, p. 171-178.

Claims (1)

 An agent for treating patients with scabies containing benzyl benzoate, potassium soap and distilled water, characterized in that it additionally contains chlorhexidine bigluconate in a ratio of components, wt. Benzyl benzoate 20.0
Potash soap 2.0
Chlorhexidine bigluconate 0.25 0.5
Distilled water 77.5 77.75i

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