RU2200594C2 - Method for treating atypical form of psoriasis - Google Patents

Abstract

FIELD: medicine, dermatology. SUBSTANCE: one should carry out intramuscular injections of epithalamine per 1 ml daily for 10-15 d. During next 10 procedures epithalamine should be injected due to binasal electrophoresis per 10 mg from positive electrode. The second electrode is placed onto occipital area. One should locally apply bandages with nitrogen-silicon mineral water onto psoriatic plaques for 1-2 h once or twice daily for 20-25 d. EFFECT: higher efficiency of therapy. 1 cl, 2 ex

Description

 The invention relates to medicine, in particular to dermatology.

 In recent years, atypical forms of psoriasis have begun to be recorded more often, including with exudative manifestations such as eczema-psoriasis, which occur as an allergic skin process. In patients with psoriasis, changes have been revealed in the coagulating and immune systems, lipid and cholesterol metabolism, psychoemotional and other areas, therefore exacerbations in this course of dermatosis can occur from various causes (mental and physical overstrain, trauma, exacerbation of chronic diseases, etc.) without seasonal effects factor and characteristic relapses of psoriasis mainly in the winter - in 60-75% of cases. Atypical forms of psoriasis require a non-standard approach to their treatment, as conventional methods in such cases are not very effective, since they have a one-sided effect on any one broken link in the pathogenesis of psoriasis.

 The hypothalamic system of the brain is the main regulatory system in the body through which the effects of external environmental factors affect the internal organs and systems. Stressful situations that reduce adaptive capabilities in patients, especially with a hereditary predisposition to dermatosis, lead to a violation of the regulatory effect of the central nervous system (CNS).

 The objective of the invention: to restore the consistency of the functional systems of the body between themselves and with external environmental factors in patients with an atypical form of psoriasis.

 The closest analogue - protopip - is the treatment of atypical forms of psoriasis using PUVA therapy, hemosorption, and cytostomy. (Skripkin Yu.K. Skin and sexually transmitted diseases. M: Triad-X, 2000, p. 369-373).

 But the disadvantages of these methods are the possible occurrence of serious complications (skin cancer, impaired hematopoiesis), the need for special expensive and complex equipment that is available only in special institutions of a dermatological profile.

 The proposed present method provides for the treatment of an atypical form of psoriasis - with exudative manifestations, reminiscent of the course of psoriasis with the presence of eczematization, i.e. with island-inflammatory phenomena, erosive-weeping areas (especially in natural large folds) and the presence of scaly-crust plaques on the surface, which is not typical of typical psoriasis.

 The purpose of the invention is to increase the therapeutic efficacy of treating patients with an atypical form of psoriasis, reduce the number of complications, and simplify the method.

 The goal is achieved by first administering epithalamine intramuscularly in a dose of 1 ml daily, for 10-15 days, to the island-inflammatory progressive stage, and then to a stationary-regressive stage of 10 ml in electrophoresis binasally from the positive pole (the second electrode is placed on the occipital region or cervicothoracic spine) in the amount of 10-15 procedures. At the same time, out-of-resort treatment is performed externally with nitrogen-siliceous mineral water in the form of dressings for 1-1.5 hours 2 times a day (in the island-inflammatory, progressive stage) and 1.5-2 hours 1 time per day on the following days of treatment with permission exudative inflammatory phenomena. The general course lasts for 20-25 days. The appointment of epithalamin binasally in electrophoresis was carried out with the aim of direct injection of the drug into the nerve structures of the regulatory hypothalamic part of the brain of patients, in addition, the non-injury of the drug was taken into account, because in patients with psoriasis, Kebner's symptom is expressed (when new psoriatic elements appear at the site of damage from injections or skin irritation).

 The mechanism of action of nitrogen-silicon mineral water is its anti-inflammatory, vasoconstrictive effect (therefore, this mineral water is most effective for exudative-inflammatory skin processes), hormone-like, desensitizing, nitrogen-adsorbing immune complexes with their removal from the lesion sites, "substitution" action with a lack of silicon in pathological foci, which strengthens the walls of blood vessels of the skin due to silicon and, thus, reduces the permeability of blood vessels for exudate, yhodyaschego from the bloodstream into the tissues.

 30 patients with exudative form of psoriasis at the age of 20 to 56 years and disease duration from 10 to 25 years were treated according to the proposed method. The introduction of epithalamin was binasal possible only after the abatement of island-inflammatory phenomena and the resolution of psoriatic elements in the occipital region or cervicothoracic spine (since it is impossible to place the electrode on wet erosive surfaces). External treatment with wet-drying dressings (in the form of lotions) with nitrogen-siliceous mineral water was carried out by the patient in the morning (9-10 hours) and evening (20-21 hours) times for 1-1.5 hours daily until the exudative-inflammatory process subsided , then once in the morning for 1.5-2 hours. Treatment of patients with an atypical form of psoriasis took 18-25 days, on average 20-22 days instead of 30-35 days with conventional methods of treatment.

The advantage of the proposed method is:
- the possibility of treating atypical exudative forms of psoriasis;
- restoration of mitotic (proliferative) activity of the epidermis;
- removal of "fixed" immune complexes from the surface of lesions;
- removal of the "allergic background" due to hormone-correcting, desensitizing and anti-inflammatory effects of silicon.

 Example 1. Patient G. 50 years. Sick psoriasis for 20 years. In the first years after the onset of dermatosis, exacerbations were seasonal in winter, with typical clinical manifestations on the skin of the trunk, upper and lower extremities. The patient was repeatedly treated in inpatient and outpatient settings, received spa treatment. After active therapy conducted by the patient for several years, every year (PUVA therapy, the next year - hemosorption, cytostatics in case of erythroderma, hormone therapy), this patient developed an atypical course of dermatosis with exudative manifestations and extra-seasonal exacerbations arising from various stress factors .

 At the next exacerbation of the skin process, the patient was treated for 10 days with 1 ml intramuscular injections of epithalamine.

 At the same time, dressings with nitrogen-siliceous mineral water were applied externally for 1-1.5 hours daily, 2 times a day. After the subsidence of island-inflammatory exudative phenomena subsided, treatment was started with the administration of 10 mg epithalamine binasally using electrophoresis from the positive pole and the application of a second electrode to the occipital region in the amount of 15 procedures. Local: continued the use of dressings with mineral water for 1.5 hours 1 time per day. The skin process was completely resolved within 25 days. Observation of the patient after treatment by this method was carried out for a year - off-season exacerbation was not observed.

 Example 2. Patient C. 40 years. Has psoriasis since the age of 16. She notes the occurrence of an exacerbation of the skin process annually, in spring and autumn, in connection with which she has repeatedly received treatment in inpatient and outpatient settings. Since 1994, plasmapheresis has been treated, after which hemosorption exacerbation arose after a neuropsychic trauma. Extensive lesions of bright red color with the presence of scaly crusts appeared on the skin of the trunk and limbs, after removal of which weeping erosive lesions were revealed. There was also a deterioration in general condition, the presence of subfebrile temperature. Diagnosed with common exudative psoriasis, lenticular-plaque form, indefinite type.

 1 ml epithalamin therapy was started intramuscularly, daily with simultaneous external anti-inflammatory treatment with nitrogen-siliceous mineral water in the form of lotions (under a bandage) for 1-1.5 hours 2 times a day - in the morning and in the evening. After 14 days, the island-inflammatory phenomena resolved, the general condition of the patient returned to normal. Active resolution of psoriatic elements has occurred. The treatment was continued with the introduction of epithalamin binasally at 10 mg from the positive pole and the application of a second electrode to the occipital region for 10 days. Outwardly, non-ointment treatment continued with 1.5-hour nitrogen-siliceous water dressings, also for 10 days. The total course of treatment was 24 days. Elements of the rash were completely flattened, turned pale and the patient was discharged with clinical recovery.

Claims (2)

 1. A method of treating an atypical form of psoriasis, characterized in that first, intramuscular injections of epithalamin are given in 1 ml daily, for 10-15 days, in the next 10 daily procedures, epithalamine is administered by 10 mg binasal electrophoresis from a positive electrode, the second electrode is placed on occipital region.  2. The method according to p. 1, characterized in that topically on psoriatic plaques apply dressings with nitrogen-siliceous mineral water for 1-2 hours 1-2 times a day, daily, for 20-25 days.