RU2566201C1 - Method of treating vitiligo - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: affected areas are exposed to narrow-band medium-wave ultraviolet light at wave length 311 nm. That is combined with applications of VITISKIN gel applied on depigmentations 1 hour before the exposure. The therapeutic course makes 10-12 procedures.

EFFECT: higher therapeutic effectiveness, reduced length of treatment and side effects.

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Description

The invention relates to medicine, namely to dermatology, and can be used to treat patients with vitiligo and other diseases with depigmentation.

Currently, researchers are considering vitiligo as a chronic disease with the phenomenon of depigmentation, with a definitively unspecified pathogenesis. Several hypotheses are considered as the cause of vitiligo: deficiency of melanocytes, immune disorders leading to depigmentation; stress caused by overoxidation of the upper layers of the epidermis and melanocytes (Blumina V.A., Khairova O.A. Modern ideas about the role of oxidative stress in the process of melanogenesis and the possibility of restoring the antioxidant balance using superoxide dismutase preparations using the example of Dismutin (DISMUTIN-J PP) | / / Effective pharmacotherapy. - 25/2013. - p. 37-38).

A known method of treating patients with vitiligo by applying photochemotherapy (PCT). The method is based on the use of photosensitizers and ultraviolet rays of spectrum A (320-400 nm) (Skripkin Yu.K. “Skin and sexually transmitted diseases.” 1980, p. 410; “Rational pharmacotherapy of skin diseases and sexually transmitted infections” / Under Edited by A.A. Kubanova, V.I. Kisina. 2005, p. 274). The experience of using photochemotherapy (PCT) allowed us to note the possibility of developing a number of side effects and complications caused by both the action of the photosensitizer and the total dose of ultraviolet radiation of the long wavelength range (UVA), namely, increasing the contrast of normally pigmented skin and vitiligo, phototoxic reactions, pruritus, xerosis (“Rational pharmacotherapy of skin diseases and sexually transmitted infections” / Edited by A. A. Kubanova, V. I. Kisina. 2005, p. 275).

Closest to the proposed method of treatment is a method of treating vitiligo, which involves irradiating lesions (foci of depigmentation) with medium-wave ultraviolet radiation (UV) with a wavelength of 280-320 nm, starting with a dose of 0.01-0.025 J / cm ² and increasing subsequent single doses every 2-4 procedures at 0.01-0.03 J / cm ² to a maximum value of 0.1-0.55 J / cm ² . The first 8-12 procedures are performed 4 times a week, then 2-3 times a week, at the end of the course - once a week for 1-2 months, for a total of 60-100 procedures. The effectiveness of this therapy increases with its combination with the drug "Melagenin Plus." It is used in the form of external applications once a day (RU, patent No. 2209098 C1, IPC A61N 5/067, publ. 07.27.2003).

Despite the improvement of repigmentation, the disadvantages of this treatment method are the low treatment efficiency (lack of repigmentation effect of approximately 48% of the lesion area), the long duration of therapy (the number of procedures per course ranges from 60 to 100), the presence of side effects such as toxic-allergic reactions , erythema, burning, hyperpigmentation, itching and dryness of the skin, a feeling of heat and dizziness.

The objective of the invention is to improve the treatment of patients with vitiligo.

The technical result that will be achieved by using the invention is to increase therapeutic efficacy, reduce treatment time and reduce side effects.

The technical result is achieved by the fact that in the method of treating vitiligo, which includes irradiating lesions with narrow-band medium-wave ultraviolet radiation with a wavelength of 311 nm using external applications on depigmented spots of a drug, VITISKIN gel applied on depigmented spots for 1 is used as a drug hour before exposure. The course of treatment is 10-12 procedures.

The invention consists in a combination of external therapy and phototherapy (UV).

The combination of the narrow-band (311 nm) method of medium-wave ultraviolet radiation (UV) with other medications allows you to simultaneously affect various pathogenetically significant pathological processes.

The use of VITISKIN gel before ultraviolet irradiation provides the correction of lipid peroxidation, which has a therapeutic effect on a number of significant components of the pathogenesis of vitiligo.

VITISKIN gel contains a complex of components - superoxide dismutase, reductase, catalase (SOD), vitamin B12, calcium pantothenate (a precursor to melanin), zinc, and copper acetate. The drug has a detoxifying, anti-inflammatory effect, protects the skin from oxidative damage, promotes the synthesis of new melanin.

External administration of VITISKIN gel 1 hour before the narrow-band medium-wave ultraviolet irradiation with a wavelength of 311 nm in a course of 10-12 procedures due to their complex effect on the main mechanisms of the pathogenesis of the disease can significantly reduce side effects, complications, and to achieve high skin repigmentation in a shorter time reducing the number of procedures and reducing the dose of medium-wave ultraviolet radiation.

From an analysis of the scientific, technical and patent literature of the claimed combination of properties, leading to a significant increase in therapeutic efficacy and the prevention of side effects while shortening the treatment time, we can conclude that the claimed technical solution meets the criteria of "novelty" and "inventive level".

The method is as follows.

Patients with vitiligo are consulted by an ophthalmologist, endocrinologist, gynecologist to identify diseases in which the use of narrow-band medium-wave ultraviolet radiation is contraindicated.

VITISKIN gel is prescribed for vitiligo foci 1 hour before the procedure of narrow-band (311 nm) medium-wave ultraviolet radiation. A narrow-band medium-wave ultraviolet ultraviolet with a wavelength of 311 nm is carried out 3 times a week (course - 10-12 procedures). Irradiation with ultraviolet radiation is carried out in the ultraviolet cabins “Waldmann UV-7002K” (Herbert Waldmann GmbH and K °, Germany) or other physiotherapeutic equipment with similar radiation parameters that are approved for use in medical practice. Irradiation begins with a dose of 0.35-0.4 J / cm ² , subsequent single doses increase each procedure or through the procedure by 0.05 J / cm ² until severe erythema appears, bringing the maximum value to 0.85-0.95 J / cm ² .

The proposed method of therapy is easily reproducible, accessible and feasible in medical institutions.

Example 1

Patient N., 31 years old, turned to the clinical diagnostic department of the UrNIIDViI with complaints of widespread rashes of white color in the area of the trunk, armpits and face with a tendency to spread. Anamnesis: first fell ill 2 years ago, when she began to notice rashes in the periorbital region, after 3-4 months the process began to progress, foci appeared on the trunk. I went to the doctor for the first time. I was not treated on my own. Conducted a traditional laboratory examination and consultation: therapist, gynecologist, ophthalmologist.

The treatment was prescribed according to the developed scheme: VITISKIN gel was applied to depigmented spots 2 times a day in combination with a narrow-band medium-wave ultraviolet UV with a wavelength of 311 nm. Narrow-band medium-wave ultraviolet ultraviolet with a wavelength of 311 nm was carried out 3 times a week No. 12. VITISKIN gel was prescribed 1 hour before the procedure on days of phototherapy. Irradiation was carried out with an initial dose of 0.40 J / cm ² , a single dose was increased by 0.05 J / cm ² for each procedure, and the total dose was 0.95 J / cm ² . Against the background of the treatment, good tolerance of the proposed method and a significant improvement in the clinical picture in the form of the absence of new rashes and repigmentation of 96% of the lesion area were noted.

Example 2

Patient P., 8 years old, turned to the clinical diagnostic department of the UrNIIDViI with complaints of white foci in the trunk and thighs. Anamnesis: first fell ill 7 months ago, when he began to notice a discoloration of the skin in the form of white spots on the hips, after 5 months, spots appeared on the body. Associates his disease with excessive insolation in the summer. I was not treated on my own. Conducted a traditional laboratory examination and consultation: therapist, ophthalmologist.

The treatment was prescribed according to the developed scheme: VITISKIN gel was applied to depigmented spots 2 times a day in combination with a narrow-band medium-wave ultraviolet UV with a wavelength of 311 nm. Narrow-band medium-wave ultraviolet ultraviolet with a wavelength of 311 nm was carried out 3 times a week No. 10. VITISKIN gel was prescribed 1 hour before the procedure on days of phototherapy. Irradiation was carried out with an initial dose of 0.40 J / cm ² , a single dose was increased each procedure by 0.05 J / cm ² , the total dose was 0.85 J / cm ² . Against the background of the treatment, good tolerance of the proposed method and a significant improvement in the clinical picture in the form of the absence of new rashes and repigmentation of 96% of the lesion area were noted. The contrast between repigmented and healthy skin was almost invisible.

Tolerance to the drug was satisfactory, no side effects were observed.

The indicated scheme was applied in the treatment of 25 vitiligo patients. The comparison group consisted of 23 patients who received a narrow-band medium-wave ultraviolet ultraviolet with a wavelength of 311 nm 3 times a week. Additionally, Melagenin Plus was used daily, once in the form of external applications and moisturizers.

Comparative data of the methods according to the invention and the prototype are shown in table 1.

As can be seen from the table, the proposed method of treatment reduces the course of therapy by 6-8.3 times, eliminates completely toxic-allergic reactions, burning and hyperpigmentation of the skin, a feeling of heat and dizziness, reduces transient erythema by 30.7%, and itching and dryness reduce skin by 13.7% compared with the prototype. In addition, the proposed method of treatment allows the treatment of patients, both adults and children, with good tolerance and relative safety with a clear clinical effect.

Claims (1)

A method of treating vitiligo, including irradiating lesions with narrow-band medium-wave ultraviolet radiation with a wavelength of 311 nm using external applications for depigmented spots of a drug, characterized in that VITISKIN gel is applied as a drug, applied to depigmented spots 1 hour before irradiation , the course of treatment is 10-12 procedures.