RU2210374C1 - Method for treatment of allergodermia - Google Patents

Abstract

FIELD: medicine, dermatology. SUBSTANCE: method involves the topical treatment with medicinal ointments used usually in allergodermia on the background of the general therapy. Ointments contain diatomite (tripoli) taken in the amount 0.5-1.5% of ointment weight. Treatment of damaged skin site is carried out 1-2 times per 24 h being treatment with ointments is alternated for each 2-3 days up to the attainment of stable remission. EFFECT: enhanced effectiveness of treatment. 4 ex

Description

 The invention relates to medicine and can be used to treat allergic dermatoses.

 A known method of treating allergic dermatoses, which consists in applying to the lesion site 1-2 times a day a cream containing a mineral mixture of natural halite and natural carnallite, lanolin, vegetable oil and water (Application 98103699, class A 61 K 9/06, 35 / 02, publ. 10.01.2000).

 However, natural clays are used as a mineral mixture, in which the process of absorbing moist secretions of the skin is quite low, which slows down the process of treating dermatoses.

 A known method of treating dermatoses, including drug therapy and external therapy, which involves treating the surface of the lesion with an ointment dosage form (Yu.K. Skripkin. "Skin and sexually transmitted diseases." Publishing House "Medicine", Moscow, 1980, pp. 85-102, 105 )

 However, the available experience of local treatment of allergic dermatoses indicates that the use of ointment forms greatly weakens the skin perspiration, which is already impaired by dermatosis, which reduces the therapeutic effect of the use of ointments.

 The objective of the invention is to provide a method for the treatment of allergic dermatoses, which will provide anti-inflammatory, analgesic, decongestant effect.

 The technical result is the expansion of the arsenal of methods for the treatment of allergic dermatoses.

 To achieve the named technical result in the proposed method for the treatment of allergic dermatoses, including drug therapy and external therapy, comprising treating the surface of the affected area of the skin 1-2 times a day with ointment dosage forms traditionally used to treat allergic dermatoses, according to the invention, ointment dosage forms additionally contain tripoli in an amount of 0.5-1.5% of the weight of the ointment, and the dosage form of the ointment is changed every 2-3 days to a state of persistent remission and.

 The difference of the proposed solution is the use of tripoli in the composition of ointments used to treat dermatoses, in an amount of 0.5-1.5% by weight of the ointment.

 Tripoli is a natural formation containing biologically active biogenic silicon.

 A very important indicator that determines many useful properties of biogenic silicas is a fairly developed cellular structure of the surface, due to which there is good adsorption of skin metabolite products. In this case, ointments containing tripoli relieve itching, pain, swelling, hyperemia, resolve primary morphological elements, as a result of which there is an improvement in skin perspiration, the water-lipid mantle is restored, the emotional sphere is improved, which in itself already contributes to recovery.

 Under the influence of alternating various ointments with tripoli, the vessels dilate in the lesion foci, the medicinal substances are absorbed, the epithelization of the surfaces occurs, the skin softens and acquires a normal pattern after the natural exfoliation of the upper part of the stratum corneum.

 At the same time, ointments used in dermatology are used as ointment dosage forms: sulfuric, tar, salicylic, milk, naphthalan, ASD, ichthyol and others.

 To obtain the dosage form of tripoli ointment, tripoli was used in the Pervomaisky deposit of the Alatyr district of the Chuvash Republic, containing,%: silicon oxides 60.3-72.5; iron 2.8-4.2; aluminum 8.4-10.1; calcium 2.6-12.3; magnesium 0.9-1.3; sodium 0.18-0.29; potassium 1.4-1.5.

 Tripoli of the Shadrinsk deposit of the Kurgan region, containing,%: silicon oxides 57.3-68.9; iron 4.4-8.4; aluminum 11.2-20.8; calcium 0.1-2.3; magnesium 1.6-3.0.

 Of trace elements in tripoli contain: copper, molybdenum, fluorine, manganese, phosphorus. Heavy metals (arsenic, cadmium, mercury) are not contained. Used tripoli finely ground with a particle size of 0.03-0.04 mm.

 The invention is illustrated by the following examples.

 Example 1. Patient G., 42 years old, went to the clinic on 02/18/99, in the direction of a rheumatologist with a diagnosis of Periarteritis nodosa. Sick two weeks ago, when there were symmetrical rashes on the lower extremities in the form of spots of red color of a ring-shaped form. The treatment prescribed by the rheumatologist was ineffective. The number of rashes began to increase. Suffers from rheumatic heart disease. Until 1983, she regularly received anti-relapse treatment.

 Objectively: proper physique, moderate nutrition. The pharynx is clean. Peripheral lymph nodes are not enlarged. Heart sounds are muffled, no noise. In the lungs, vesicular breathing. The liver and spleen are not enlarged. HELL 115/75 mm Hg The pathological process is localized on the lower extremities. The first elements appeared on the anteroposterior surface of both feet in the form of grouped spots saturated with red color ranging from millet grain to a pea. The rash was in the form of rings of irregular shape with a diameter of 1.5 to 3.5 cm. Its elements were mainly located around the hair follicles. The appearance of the first rashes was preceded by pain in the joints of the lower extremities. At the time of the rash, subfebrile temperature was noted. The patient complained of tingling in the areas of the rash of elements. On the 2nd and 3rd days, the rash spread to the ankles, the middle and upper third of both legs, and a few days later hemorrhages appeared on these places.

Complete blood count: er. 4.2 • 10 ^{12 / l} , Нb 118 g / l, col. indicator 0.9, l. 7.1 • 10 ^{9 / l} , e. 1%, p. 2%, s. 57%, lymph. 37% mon 3%; ESR 9 mm per hour. DAC for syphilis is negative. Urine analysis without features. On the ECG, moderate diffuse changes in the myocardium. Chest x-ray: heart and lungs within the radiological norm. The patient was diagnosed with Ring-shaped telangiectatic purpura Mayokki.

The following treatment:
externally: an ointment containing tripoli in the amount of 1% of the weight of the ointment is applied in a thin layer on the affected areas of the skin in the morning and evening. Every two days, alternating ointments are carried out - sulfuric 10%; tarry 10%; salicylic 2%; milk 6%; naphthalan 5%; ASD 2%; ichthyol.

General treatment - prednisone 25 mg / day; potassium chloride 10% and calcium chloride 10% inside. Vitamin therapy - intramuscular injections of vitamins B ₆ , B ₁₂ ; Ascorutinum - inside: sedatives (Elenium, Rafkin's medicine). After the prescribed treatment during the 1st week, the appearance of new elements was not observed. From the second week, the process began to regress. By the end of the 4th week, secondary pigmentation with minor atrophy of the skin remained at the rash sites.

 Example 2. Patient A., 52 years old, was admitted to the hospital 09.11.1999, with complaints of heavy rashes on the trunk and limbs, accompanied by severe itching. Considers himself ill from 10/16/1999, when the rash on the trunk and limbs first appeared. According to the patient, from 02.10 to 11.10.1999 he took analgin for toothache, an average of 10 tablets (5 g) per day. A few days after the appearance of the rash, severe itching arose.

 Grew up and developed normally, proper physique, moderate nutrition. The musculoskeletal system is unchanged. Axillary, inguinal lymph nodes are enlarged to the size of a cherry, not soldered to the skin, and painless.

 The boundaries of the lungs are normal. Percussion-pulmonary sound. With auscultation, vesicular respiration over the entire surface of the lungs. The borders of the heart are not enlarged. Heart tones are clear, rhythmic. Pulse 80 per minute. HELL 120/80 mm Hg

 The tongue is coated with a white coating, wet. The abdomen on palpation is painless in all departments. The liver is not enlarged, painless. Ortner's symptom is negative. The spleen is not palpable.

Upon admission to the hospital, the skin of the trunk, upper and lower extremities had a multiple monomorphic papular rash. Papules the size of lentils, flat, polygonal in shape with a waxy gloss, umbilical indentation in the center and Wickham mesh, had a bluish-pink color with a purple hue. The largest number of papules was localized in the forearm region. On the mucous membrane of the cheeks, the lateral surfaces of the tongue, there were multiple point grayish-white papular elements, merging in the form of a mesh, lace. Blood tests: er. 4 • 10 ^{12 / l} , Нb 125 g / l, 7 • 10 ^{9 / l} , e. 2%, p. 2%, s. 68%, lymph. 18% mon 10%; ESR 5 mm per hour. Urine without pathology. Prothrombin blood 89%. Blood sugar 4.5 ml mol / L.

 Neurologist examination: the patient is excitable, reactive, asthenoneurotic reactions. Optometrist's conclusion: beginning cataract of the left eye, retinal angiopathy of the right eye.

 Diagnosis: Toxicoderma, as an acute widespread lichen planus with lesions of the oral mucosa.

 He received 10 intravenous infusions of 30% sodium thiosulfate in 10 ml, tazepam, valerian root extract, penicillin intramuscularly, 300,000 units 4 times a day, a total of 8,000,000 units, locally hormonal ointments (without tripoli).

 After 7 days, due to treatment failure, dexamethasone was prescribed at 3 mg per day.

The following treatment:
externally: ointment containing tripoli in the amount of 1% by weight of the ointment is applied in a thin layer on the affected areas of the skin in the morning and evening. Every two days, alternating ointments are carried out - sulfuric 10%; tarry 10%; salicylic 2%; milk 6%; naphthalan 5%; ASD 2%; ichthyol. After 4 days, a decrease in itching, blanching and flattening of all skin rashes were noted. On December 4, 1999, a decrease in the dose of corticosteroids by 0.25 mg in 3-4 days was started. Over the next 2 weeks, all elements resolved, leaving brown pigmentation in its place. The patient was discharged on December 22, 1999 for outpatient treatment. Having received the appointment of 1.5 mg of dexamethasone per day with the recommendation of a further slow dose reduction, ointments with tripoli are applied to the lesions externally. After 1.5 months, clinical recovery was noted.

 Example 3. Patient V., 26 years old, was admitted on September 8, 1999 with atonic neurodermatitis. The disease began in infancy. Repeatedly treated in hospitals in Moscow and in resorts (Sochi-Matsesta, Anapa). For a long time I received glucocorticoid hormones inside, vitamins, antihistamines, autohemotherapy, intravenous infusions of hemedes, UV radiation. Ointments and creams with ASD, naphthalan oil, corticosteroid hormones, Unna cream, homeopathic ointments (calendula, linin) were applied externally. The improvement was usually short-lived in the summer. A longer remission (28 days) was noted at the beginning of pregnancy. Then a relapse occurred, especially acute after childbirth, about which the patient was hospitalized.

Upon admission, the skin process was universal, as an erythroderma, with diffuse pronounced swelling, congestive erythema, profuse peeling and weeping on the skin of the face, around the mouth, lateral surface of the neck. On the chest, flexion surfaces of the upper and lower extremities, lichenization was observed with multiple excoriations and follicular pustules. The process was accompanied by intense itching, insomnia, expressed neurotic reactions. Heredity is burdened. Notes intolerance to many drugs (sulfonamides, penicillin, glucose) and food. When examined from pustules, Staphil epiderm was seeded. Blood test: er. 3.7 • 10 ^{12 / l} , Нb 120 g / l, tr. 200 • 10 ⁹ , l. 14.6 • 10 ^{9 / l} , e. 16%, p.%, S. 64%, lymph. 14% mon 5%; ESR 17 mm per hour. The study of protein fractions revealed dysproteinemia: albumin 45.0, globulins 55.0: λ1-9.4; λ2-15.6; β-14.3, γ-15.7.

The patient received:
externally - an ointment containing tripoli in the amount of 1% of the weight of the ointment was applied in a thin layer on the affected areas of the skin in the morning and evening. Every two days, alternations of ointments were performed - sulfuric 10%; tarry 10%; salicylic 2%; milk 6%; naphthalan 5%; ASD 2%; ichthyol.

 General treatment: 20 mg of prednisone, 200 ml hemodesis infusion, calcium gluconate, potassium orotate, aevit in usual dosages.

 Despite the ongoing therapy and the disappearance of pustular elements, weeping foci with infiltration, swelling and peeling persisted. A week after admission, she underwent hemosorption on two columns with a volume of 400 ml with adsorbents of the IGI brand. Blood perfusion rate was 60 ml / min; total perfusion volume was 9000 ml. Introduced heparin 20,000 IU of prednisolone 30 mg, 2% solution of promedol - 1 ml. The condition during the procedure is satisfactory. There were no complaints. An improvement in the dynamics of the skin process was noted on the next day and continued in the following days. Within 2-3 days, weeping stopped, swelling disappeared, erythema sharply paled, lichenization decreased. The daily dose of prednisone on the first day after sorption was reduced to 1/2 tablet (7.5 mg). The patient continued to receive general strengthening therapy: injections of calcium gluconate, potassium orotate, aevit and externally the treatment of affected skin in the morning and evening with a thin layer of ointment containing tripoli in the amount of 1% of the weight of the ointment. Every two days, alternations of ointments were carried out - sulfuric 10%; tarry 10%; salicylic 2%; milk 6%; naphthalan 5%; ASD 2%; ichthyol.

The condition improved: erosion was epithelized, lichenization sites resolved, and skin elasticity and splint were restored. After 2 weeks, the patient's condition was characterized as clinical remission with normalization of blood morphology: Нb 120 g / l, color index 0.9, platelets 280 • 10 ⁹ / l, 5.4 • 10 ⁹ /, e. 4%, p. 3%, s. 57%, lymph. 30% mon 3%; ESR 10 mm per hour. Clinical observation continued for a year without a rash, and the patient removed mild skin itching with ointments with tripoli.

 Example 4. Patient C., 27 years old, was admitted 12.05.1999. Diagnosis: True eczema. Sick since 8 months. The disease steadily recurred, despite repeated hospitalization and spa treatment. The last relapse began in March 1999. Upon admission, pronounced lichenization was determined with significant erythema, peeling and excoriation throughout the skin, with more intense compaction, dry skin and follicular hyperkeratosis, with brown pigmentation on the side surfaces of the neck, in the area of the flexor surface shoulders, forearms, inner thighs and popliteal folds. Subjectively notes intense itching, irritability, irritability. An allergic history is characterized by intolerance to certain foods (strawberries, citrus fruits, chocolate, eggs).

 The examination revealed a decrease in the absorption-excretory function of the liver. Blood tests determined moderate eosinophilia (9%) and lymphocytosis (38%), ESR 16 mm per hour. Prothrombin 82%, fibrinogen 377, fibrinolysis 4 hours. Urine tests without pathology. No other studies were performed.

 Prior to hemosorption, the patient received compliant 0.15 g 3 times a day, diazolin 0.1 g 2 times a day and Aevit 0.2 times a day, externally - Unna cream. Inflammation persisted, lichenization and erythema with follicular hyperkeratosis and dry skin remained. Taking into account the prevalence of the process, the severity of infiltration, the duration of the disease, 2 hemosorption sessions were performed. There were no complications or side effects. After the 2nd sorption, a decrease in erythema, swelling, lichenization and skin tension occurred. The intensity of itching decreased. In order to eliminate the foci of residual infiltration, lichenoid elements, the patient is topically treated with the surface of the lesion with an ointment dosage form once a day every two days by alternating ointments: sulfuric 10%; tarry 10%; salicylic 2%; milk 6%; naphthalan 5%; ASD 2%; ichthyol mixed with tripoli in the amount of 1% by weight of the ointment. Discharged in a state of clinical remission lasting for 6 months.

 Thus, the proposed method for the treatment of allergic dermatoses will expand the range of methods for this purpose.

Claims (1)

 A method of treating allergic dermatoses, including drug therapy and external therapy, comprising treating the surface of the affected area of the skin 1-2 times a day with medicinal ointments traditionally used to treat allergic dermatoses, characterized in that the medicinal ointments additionally contain tripoli in an amount of 0.5-1.5 % of the weight of the ointment, and surface treatment is carried out by alternating ointments every 2-3 days, to a state of stable remission.