RU2804182C1 - Method for preventing retinoid dermatitis in patients with acne - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention is related to dermatovenereology and cosmetology, and can be used for prevention of retinoid dermatitis in patients with acne. Systemic isotretinoin is taken at a dose of 0.5 mg/kg until a course dose of 120 mg/kg body weight is reached, facial skin is cleansed with Vichy Purete Thermale foam in the morning and evening, after cleansing, Vichy Mineral 89 Probiotic Fractions restorative serum concentrate is applied and express mask Vichy Mineral 89 is used once every 10 days.

EFFECT: method allows for prevention and relief of retinoid dermatitis and side effects such as dryness and irritation of the facial skin, by expanding the arsenal of products for external use for dry and stressed skin in patients with acne receiving a course of systemic isotretinoin.

1 cl, 1 ex

Description

The invention relates to medicine, namely to dermatovenereology and cosmetology, and can be recommended as home care to prevent symptoms of retinoid dermatitis when treating patients with acne with systemic isotretinoin.

Acne is defined as a complex, chronic, genetically determined dermatosis that affects the pilosebaceous follicle. Acne occurs with the formation of open and closed comedones, as well as inflammatory elements in the form of papules, pustules and nodes [1]. This disease is widespread in the world, and, according to the authors, acne affects up to 94% of men and women aged 12 to 30 years [2]. Acne treatment depends on the severity. Severe forms of acne and acne that do not respond to other types of therapy are an indication for the administration of systemic isotretinoin. One of the side effects of this therapy is the development of retinoid dermatitis: itching, burning, peeling and redness of the skin.

To reduce these side effects, patients receiving systemic isotretinoin therapy should be prescribed dermatocosmetics, which are aimed at eliminating dryness, flaking and itching. Today, certain difficulties arise in choosing the most effective professional and therapeutic facial skin care products due to their wide variety.

Thus, the problem of preventing the development of retinoid dermatitis is relevant.

There is a known method for treating various forms of acne with systemic isotretinoin [3]. The disadvantage of this method is the frequent occurrence of adverse reactions and the lack of treatment results within a year after treatment. Another method of treating patients with acne is known: systemic isotretinoin and skin care products [4]. The disadvantage of this known method is the exacerbation of the skin process and the manifestation of severe dry skin.

The closest to the proposed method is a method of combined treatment of severe acne and consists of taking systemic isotretinoins and using skin care products, which consists in reducing the number of complications in the form of exacerbation of the skin process and dry skin with high efficiency of therapy by expanding the arsenal of skin care products skin that is dry during treatment, and deeper introduction of a moisturizer using phonophoresis [5].

A new technological result is the prevention and relief of retinoid dermatitis and side effects such as dryness and irritation of the facial skin, by expanding the arsenal of topical products for dry and stressed skin in patients with acne receiving a course of systemic isotretinoin.

To achieve a new technical result in the method of treating acne using systemic retinoids and facial skin care products, use: systemic isotretinoin 0.5 mg/kg to achieve a cumulative dose of 120 mg per kilogram of body weight, Vichy Purete Thermale facial skin cleansing foam in the morning and evening , restoring serum-concentrate Vichy Mineral 89 Probiotic Fractions, which is applied to clean and dry facial skin and the Vichy Mineral 89 express mask 1 time every 10 days.

Before starting therapy with systemic isotretinoin, patients undergo a complete clinical and laboratory examination, which includes a general blood test, a biochemical blood test, and a pregnancy test for females.

Systemic isotretinoin is prescribed to patients at a dosage of 0.5 mg per kg of body weight, followed by increasing the dose until a cumulative dose of 120 mg/kg is reached.

To cleanse the skin of the face, use a light foaming cleanser Vichy Purete Thermale, after washing in the morning and in the evening, apply the Vichy Mineral 89 Probiotic Fractions restoring serum concentrate and use the Vichy Mineral 89 express mask once every 10 days.

Vichy Purete Thermale cleansing foam contains the following components: glycerin provides skin hydration, eliminates signs of dryness, restores the hydrolipid film on the skin surface; Shea butter (karite) has a soothing effect and supports intensive skin nutrition; Vichy SPA thermal water soothes, strengthens and restores facial skin. Soft foaming components ensure gentle cleansing of the skin. Purete Thermale foam is designed for daily cleansing of all skin types, including dry, normal, oily, combination and problematic.

Vichy Mineral 89 Probiotic Fractions restorative serum concentrate is designed to restore irritated and dehydrated facial skin under stress and exposure factors. The composition includes: probiotic fraction - strengthens the skin's protective barrier and improves its protective properties; hyaluronic acid - smoothes the skin, provides effective hydration; Volcanic water enriched with 15 minerals protects and strengthens the skin barrier; Vitamin E is an antioxidant that fights the effects of oxidation that occur due to exposure to internal and external environmental factors. The product is suitable for any skin type and can be used on any area of the face. Serum concentrate is designed specifically for intensive care of irritated, dry facial skin. Strengthens the skin barrier and restores the protective function of facial skin, reduces skin irritation during the treatment of various dermatoses. Vichy Mineral 89 Probiotic Fractions instantly reduces irritation and itching, eliminates signs of severe skin dehydration. Recommendations for use: apply twice a day to previously cleansed facial skin. The light texture spreads comfortably over the skin without leaving a greasy or sticky feeling.

Express mask Vichy Mineral 89 is a fabric mask made from microalgae, contains thermal water and hyaluronic acid. The mask is designed specifically for skin with a damaged hydrolipid mantle and protective barrier. Express mask relieves symptoms of dryness, flaking, feeling of tight skin and discomfort, enhances the natural protective properties of facial skin, intensively moisturizes and strengthens the skin barrier.

Throughout therapy with systemic isotretinoin, use Vichy Purete Thermale facial cleansing foam in the morning and evening, Vichy Mineral 89 Probiotic Fractions restoring serum concentrate after cleansing the face morning and evening, and Vichy Mineral 89 express mask once every 10 days.

Clinical example

Patient P., 26 years old, complains of rashes in the face, chest and back in the form of pustular elements, subcutaneous painful rashes, atrophic scars and stagnant red-burgundy spots after rashes. From the anamnesis it is known that these symptoms have been bothering me since adolescence, from the age of 12. I consulted a dermatologist and several years ago underwent treatment in the form of local medications and systemic antibacterial drugs. The therapy brought a temporary effect. Over the past few months, there has been an exacerbation of the skin process.

Status localis at the time of treatment: facial skin type - oily, in the area of the face, back and chest there are many papulopustular elements of red color with purulent contents, subcutaneous elements in the amount of 5 pieces on the chin, cheeks and back are bluish in color, soft-elastic on palpation consistency, soreness, enlarged pores, many blackheads and closed comedones.

Diagnosis: acne, severe severity of the skin process.

Due to the severe severity of acne and the ineffectiveness of previous treatment, the patient was recommended therapy with systemic isotretinoin. Before treatment, the patient underwent a clinical and laboratory examination and was consulted by related specialists: gynecologist-endocrinologist, gastroenterologist. The indicators of the general blood test and biochemical blood test were within the reference values. The pregnancy test was negative.

The patient was treated according to the following regimen:

1. Systemic isotretinoin preparation “Sotret” at a dose of 0.5 mg/kg with an increase in dosage to 1 mg/kg by the end of the first month until the course dose of 120 mg/kg body weight is reached.

The patient's body weight is 50 kg. The daily dosage of the drug was 50 mg per day (30 mg in the morning and 20 mg in the evening). The course of therapy was 120 days (4 months).

The pregnancy test before and during treatment was negative. A biochemical blood test was repeated after 1 month of therapy, then every three months. No deviations from the norm were identified.

2. To reduce the side effects of systemic isotretinoin in the form of dryness, redness and flaking of the skin, facial skin care was prescribed in the form of Vichy Purete Thermale facial skin cleansing foam in the morning and evening, after cleansing - Vichy Mineral 89 Probiotic Fractions restorative serum concentrate and express - Vichy Mineral 89 mask 1 time every 10 days.

The patient tolerated drug therapy quite well. In the second month, there was an exacerbation of the skin process, which decreased by the 4th month, and a stable remission was noted in the 6th month.

Before therapy, during and after therapy, patients were assessed by the dermatological quality of life index (DIQL), the Cardiff Acne Disability Index (CADI).

Each question in the questionnaire for determining the DIQL requires one of four answer options: “no”, “a little”, “moderately”, “very much”, assessed in points: 0, 1, 2, 3, respectively. The maximum score (30) corresponds to the most severe impairment of quality of life. The questionnaire assesses the quality of life of patients according to six main parameters: symptoms/well-being, daily activity, leisure, work/study, personal relationships, treatment.

The Cardiff Acne Disability Index (CADI), associated with acne, is a simplified questionnaire with 5 main items. CADI shows how much acne interferes with a person's ability to experience positive emotions in life. For each answer option, a certain score is assigned from 0 to 3. The CADI index is calculated by summing the scores; the higher the score, the lower the quality of life.

The patient's DIQL before treatment was 19 points, during treatment (at 3 months) it decreased to 2 points, and after completion of the course to 0 points, which indicates that the disease after therapy did not reduce the patient's quality of life.

A similar picture is observed in the dynamics of the CADI index: before therapy 15 points, during therapy 4 points, after completion of therapy 1 point. We can conclude that after acne therapy, this disease does not interfere with receiving positive emotions from life.

30 patients with moderate to severe acne were observed. While taking Sotret, no side effects such as dryness, peeling or redness were noted due to the use of the facial skin care described above. All patients experienced stable remission after the course of therapy.

This method of preventing retinoid dermatitis in patients with acne during isotretinoin therapy expands the arsenal of skin care products and is highly effective. The proposed facial skin care while taking systemic isotretinoin helps to avoid the negative consequences of retinoid dermatitis such as dryness, itching, peeling and redness.

Information sources

1. Kubanova A.A. Clinical recommendations / Russian Society of Dermatovenerologists / Acne M.: DEX-Press, 2010. - 28 p.; ISBN 978-5-9517-0049-0.

2. Skripkin Yu.K., Butov Yu.S. & Ivanov O.L. Dermatovenerology. National leadership. M.: GEOTAR-Media, 2013, 613-623.

3. Kruglova L.S., Talybova A.M., Gluzmina M.M. The effectiveness of various regimens of isotretinoin in the treatment of acne patients. Clinical dermatology and venereology. 2018. T. 17. No. 1. P. 64-71.

4. Aripova M.L., Khardikova S.A. Psycho-emotional state of patients with severe acne during isotretinoin therapy. Bulletin of dermatovenereology and cosmetology. - 2015. - No. 5. - pp. 122-127.

5. RU 2713938 “Method of combined treatment of severe acne.”

Claims (1)

A method for the prevention of retinoid dermatitis in patients with acne, including taking systemic isotretinoin at a dose of 0.5 mg/kg until a course dose of 120 mg/kg body weight is achieved and the use of skin care products, characterized in that facial skin is cleansed using Vichy foam Purete Thermale morning and evening, after cleansing, apply the Vichy Mineral 89 Probiotic Fractions restorative serum concentrate and use the Vichy Mineral 89 express mask once every 10 days.