RU2540493C1 - Method for local treatment of oral lichen planus of typical shape - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method for the local treatment of oral lichen planus of typical shape consists in coating a lesion twice a day with two uniform layers no more than 0.01 mm thick of a therapeutic composition of tysol and lydase in ratio: tysol 10g, lydase 128 international units for 15 minutes. The therapeutic course makes 14 days.

EFFECT: using the method provides the optimum concentration of the therapeutic composition in the lesion for ensuring the high therapeutic effect with the preparations of tysol and lydase potentiating each other that enables preventing the advance or terminating the hyperkeratosis manifestations.

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Description

The invention relates to medicine, specifically to clinical dentistry, can be used to treat diseases of the oral mucosa, namely, lichen planus of the oral mucosa of a typical form.

Lichen planus - a chronic polyetiological disease with rashes of papules on the mucous membranes and skin, is found in all age groups, but women from 30 to 60 years old are more likely to get sick. The clinical picture and the course of lichen planus on the oral mucosa significantly differ from its manifestations on the skin, which is due to structural features of the oral mucosa, as well as the specificity of biological and physicochemical processes in the oral cavity associated with the presence of focal infection foci, fillings and prostheses from various metals, the composition and properties of saliva, the processes of initial cleavage of food products [1].

According to the classification proposed by A. Mashkillayson. and Borovsky E.V. (1984), the following clinical forms of lichen planus of the oral mucosa were identified: typical, exudative-hyperemic, erosive-ulcerative, bullous, hyperkeratotic, atypical [2]. In the oral cavity, the favorite place for localization is the mucous membrane of the cheeks, lateral and dorsal surfaces of the tongue, less often the mucous membrane of transitional folds, lips and the bottom of the oral cavity.

To date, the problem of treatment of lichen planus (CPL) is one of the important and unresolved tasks of clinical dentistry [3, 4, 5].

The most significant of the primary stages of complex therapy for CPL, in addition to etiotropic and pathogenetic therapy, is local conservative treatment.

The arsenal of drugs used in local therapy for CPL has expanded significantly in recent years - these are antiseptic solutions, enzymes, hydrocortisone ointment, 0.5% prednisone ointment, various combined biomaterials containing solcoseryl, proteolytic enzymes, emoxipin, parmidine, dalargin , tocopherol and retinol acetate based on collagen [6, 7, 8, 9].

However, these drugs have a number of drawbacks: poor adhesion to the affected area, high solubility in the oral fluid, and are inconvenient to use (liquid forms in the form of applications on gauze napkins).

Traditionally used drugs and methods of their administration have significant disadvantages. During irrigation, instillation, drugs are quickly washed out with oral fluid, reducing the necessary therapeutic concentration.

The main problem of local application of medicinal compositions is the problem of creating an effective concentration in the focus of inflammation and maintaining such a concentration for the period necessary for treatment.

The well-known and most common method of local treatment of a typical form of CPL MOP adopted as a prototype is the application of a 3.4% oil solution of vitamin A. At the same time, the regeneration of epithelial cells is stimulated, and the progression of hyperkeratosis is prevented.

When applying, the drug is applied to a gauze bandage, the dimensions of which correspond to the place of the procedure. An impregnated gauze strip is placed on the mucous membrane for 15 minutes.

However, this method of local treatment has a number of disadvantages: low adhesion to the affected area, high solubility in oral fluid, inconvenience in use. In addition, there is an excess consumption of the drug. An insufficient concentration of the drug in the lesion is created and, as a result, a limited therapeutic effect.

The problem to which this invention is directed is to enhance the therapeutic effect in the pathological focus of the mucous membrane by creating the necessary constant therapeutic concentrations of drugs.

To solve the problem in a method of local treatment of a typical form of CPL MOP, including applying to the lesion site the medicinal composition Tolis with lidase. At first, the place of application must be drained with a gauze swab, then with a soft toothbrush twice applied with a thin layer on the lesion site the drug composition of thysol with lidase in the composition: lidase 128 UE, tizol 10 g. The layers are applied in 15 seconds. The layer thickness is not more than 0.01 mm. The course of treatment is 2 times a day for 14 days.

Tizol (titanium glycerol solvate aquacomplex) has anti-inflammatory, antiseptic, dehydrating, local analgesic effects. The high ability of Toliz to transcutaneous diffusion allows deep penetration and delivery of the drug - lidase - necessary for adhesiolysis into the tissues of the pathological focus. Lidase (hyaluronidase) causes the breakdown of hyaluronic acid, which has a high viscosity and is a “cementing substance of connective tissue”, increases the permeability of tissues, facilitates the movement of fluids in interstitial spaces.

In the gel composition of thysol with lidase, these drugs potentiate the effect of each other, and prevent the progression or cessation of hyperkeratosis. The composition of tizol with lidase allows you to save the original active properties of the enzyme lidase (hyaluronidase).

Hydrophilic gel Tizol with lidase when applied to the lesion focus on the oral mucosa quickly and completely penetrates intra- and transcutaneously.

The layering of the application of the drug composition Tolis with lidase provides the optimal concentration to create a high therapeutic effect due to the gradual penetration of the drug composition into the mucous membrane. A permanent depot of the drug composition is created in the lesion focus, providing a prolonged effect of the enzyme lidase (hyaluronidase) on hyaluronic acid, which prevents the occurrence of hyperkeratosis. Applying a soft toothbrush to the lesion ensures even distribution of a thin layer on the mucous membrane.

The method is as follows:

The place of application must first be drained with a gauze swab, then with a soft toothbrush a thin layer is twice applied to the lesion site with the drug composition of thysol with lidase (composition: lidase 128 UE, tizol 10 g). The application of the layers is carried out after 15 seconds. The layer thickness is not more than 0.01 mm. To improve the therapeutic effect, it is recommended not to eat food for one hour. The drug composition is used twice a day, the course of treatment is 14 days. The drug composition Tolis is prepared by mechanical stirring Tolis 10 g with lidase 128 UE.

The advantages of the proposed method of treatment are as follows:

1. Due to the high adhesion of the drug to the oral mucosa and layer-by-layer application, the therapeutic concentration of the drug in the lesion (inflammation) increases.

2. Accelerated treatment time

3. The drug consumption is reduced several times and its dosage is achieved.

4. There are no systemic side effects.

5. Convenient and easy to use.

6. There are no negative reactions in patients.

The claimed method of local treatment was used to treat 30 patients with lichen planus of the oral mucosa with a typical form. The effectiveness of treatment was evaluated in dynamics according to subjective signs and the clinical picture.

Clinical examples:

Example No. 1. Patient O. went to the therapeutic dentistry clinic of the Ural State Medical University with complaints of discomfort and pain in the oral cavity, especially when taking fresh vegetables and fruits.

Objectively: on the mucous membrane of the cheeks, multiple papular elements, grayish-white in color, merge to form a mesh pattern, the mucous membrane is not changed, painless on palpation.

Diagnosis: lichen planus, typical form.

In terms of local treatment, the patient was prescribed Tizol with lidase by the claimed method 2 times a day for 14 days.

On day 10, single papules without signs of inflammation, flattened, were observed. By the end of treatment, nodular elements disappeared. After treatment, the patient has no complaints, the mucous membrane of the oral cavity is pale pink without elements of damage.

Example No. 2. Patient I. turned to the therapeutic dentistry clinic of the Ural State Medical University with complaints of a feeling of tightness of the oral mucosa, whitish formations on the mucous membrane of the cheeks.

Objectively: on the mucous membrane of the cheeks, grayish-white papules merge into a fancy lace-like pattern, the mucous membrane of the cheeks is pale pink, painless on palpation.

Diagnosis: lichen planus - a typical form (Figure 1).

Together with general treatment, Tizol with lidase by the claimed method 2 times a day for 14 days was prescribed as a local treatment.

On day 9, papules without signs of inflammation, flattened, were observed. After treatment, the patient does not complain, the mucous membrane of the oral cavity is pale pink with single flattened papules. (Figure 2).

Example No. 3. Patient M. turned to the clinic of therapeutic dentistry of the Ural State Medical University with complaints of a feeling of roughness of the mucous membrane of the lips and cheeks.

Objectively: the mucous membrane of the lips and cheeks is pale pink in color, on which typical papules are located, the mucous membrane is painless on palpation.

Diagnosis: lichen planus is a typical form (Figure 3).

In terms of local treatment, the patient was prescribed Tizol with lidase by the claimed method 2 times a day for 14 days.

On day 9, single papules without signs of inflammation, flattened, were observed. After treatment, the patient has no complaints, the mucous membrane of the oral cavity is pale pink without elements of damage (Figure 4).

Bibliography:

1. Dovzhansky, S.I. Clinic, immunopathogenesis and therapy of lichen planus / S.I. Dovzhansky, N.A. Slesarenko // Ross. honey. Journal. - 1998. - No. 6. - S. 348-352.

2. Mashkillayson A.L. Lichen planus. In the book: Diseases of the mucous membrane of the mouth and lips. - M., - 1984. - S.190-204.

3. Litvinov S.L. Local treatment of lichen planus of the oral mucosa // Russian Journal of Skin and Sexually Transmitted Diseases. - 2003. - No. 3. - S. 4444.

4. Petrova L.V., Kushlinsky N.E., Makarov Ya.L. Treatment of patients with leukoplakia of the oral mucosa with spironolactone // News. dermatology and venereology. - 2004. - No. 4. - S.68-69.

5. Rabinovich O. F., Grigoryan A. S., Epeldimova E. L. The use of the drug "Emparkol" in the treatment of erosive and ulcerative forms of lichen planus of the oral mucosa // Institute of Dentistry. - 2003. - No. 4. - S. 39.

6. Lukinykh L.M., Tiunova N.V. Optimization of treatment of lichen planus of the oral mucosa // Dentistry Maestro. - 2009. - No. 4. - S. 79-81.

7. Samoilova O.P., Molokov V.D., Noskov S.I. et al. Evaluation of the effectiveness of local treatment of sick women with erosive and ulcerative form of lichen planus associated with iodine deficiency // Sib. honey. journal (Irkutsk). - 2007. - No. 5. - S. 44-46.

8. Epeldimova E.L., Rabinovich O.F. Methods of diagnosis and local treatment of diseases of the oral mucosa (lichen planus, recurrent aphthous stomatitis, decubital ulcers) // Dentistry. - 2005. - No. 3. - S. 58-63.

9. Papageorgiou V.P., Assimopoulou A.N., Ballis A.S. Alkannins and shikonins: a new class of wound healing agents // Current Medicinal Chemistry. - 2008 .-- Vol.15. - P.3248-3267.

Claims (1)

A method of local treatment of lichen planus of the oral mucosa of a typical form, comprising applying a medicinal composition, characterized in that two layers with a thickness of not more than 0.01 mm of the medicinal composition thysol with lidase are uniformly applied to the lesion site with an exposure of 15 seconds in the ratio: tizol 10 g, lidase 128 UE, the course of treatment is 2 times a day for 14 days.

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