RU2180224C2 - Method of chronic dermatosis treatment - Google Patents

Abstract

FIELD: medicine, dermatology. SUBSTANCE: invention proposes to use melaxen as a synthetic analog of pineal gland hormone in the dose 0.5-1.5 mg before night sleep by oral route for 7-20 days. Method can be used for treatment of patients with eczema and psoriasis. EFFECT: simplified treatment schedule, decreased relapse period treatment, prolonged remission periods. 2 tbl, 1 dwg, 2 ex _

Description

 The invention relates to medicine, namely to dermatology, and can be used in the treatment of eczema and psoriasis.

 Difficulties in the treatment of these diseases, accompanied by a persistent chronic course and a tendency to relapse, are caused by their etiopathogenesis.

 Recent works have determined the importance and place of neuroallergic immunological, metabolic changes in the body of patients with eczema (A. Kubanova et al. Vestnik dermatologii. 1985. - 8. P. 16-19; Smolyagin et al. Materials for the study of pathogenesis and therapy of patients eczema and neurodermatitis. Regional scientific-practical conference of dermatovenerologists. Thesis doc. Orenburg, 1994. S. 10 .; Lobanovsky GN, Kravchenko LA Journal of Dermatology, Cosmetology and Sexopathology. 1998. - 1. - C. 107-110).

 Attention is drawn to the importance of neuropsychiatric disorders in the development of dermatosis, in particular the predominance of inhibitory processes in the cerebral cortex, in connection with which, apparently, eczema occupies a central place in the structure of skin diseases in elderly people (Belousova T. L. Materials 4th All-Russian Congress of Dermatovenerologists, Krasnodar 1976. - P. 128-129, N. Kochergin, et al. Pathological Genetic Mechanisms of Atopic Dermatitis, Medical Ref.J. - 1987. - 8. - P. 6-10 .; Anthonyov D.A., Prokhorenkov V.V. Bulletin of Dermatology. 1995. - 2. - P. 20-22).

 The attention of researchers is also attracted by the state of the immune system in the pathogenesis of eczema. In the examined patients, an immunodeficiency state was detected, proceeding with hyperreactivity of both the T-system and the B-system of immunity. A significant decrease in the number of helpers subpopulations has been established, while suppressor production remains at a normal level. This is especially evident in elderly patients (Abidov M.M. et al. Vestnik dermatologii. 1982. - 2. - P. 33-36; Danilova A.A. et al. Abstracts report. - Dnepropetrovsk, 1991. - C 63; Novikov G.M., Ivashkevich G.L. Thes. Dokl., Ekaterinburg, 1994.S. 68-69).

 Recently, methods of treating chronic dermatoses are actively being developed taking into account their etiopathogenesis: the use of antihistamines, non-steroidal anti-inflammatory drugs, vasoactive drugs, corticotropin in combination with external therapy (Anthonyev A.A. et al. Vestnik dermatologii. - 1982. - 5. - P. 12-14; Shakhtmeister I.Ya., Shimanov N.A. Bulletin of Dermatology. - 1998. - 2. - S. 27-31; Samsonov V.A. et al. Bulletin of Dermatology. - 1998. - 4. - S. 48-50).

 There is a method of treating atopic dermatitis, including a study of the patient’s immune status, and with a decrease in the relative number of T-lymphocytes, an increase in IgG and IgM, a decrease in IgA, the administration of ascorbic acid and levamisole, alternating the medications for 3 weeks (RF Patent 1638852, A 61 K 39/00, 09/27/95, BI 27).

 The method allows to reduce the treatment time for children with atopic dermatitis, prolongs the remission of the disease, reduces the number of complications and relapses. The disadvantage of this method is its duration and complexity.

 There is a method of treating psoriasis, which involves examining a patient’s immune status and in case of violation of the content of T-suppressors in T-helpers, delargin is administered intramuscularly 2 times a day for 5-10 days and, with insufficient normalization of the immune status, repeat the course (A. with USSR 1821217, A 61 K 37/02, 06/15/93, BI 22).

 However, the known methods of treatment are not effective enough, difficult to implement, long-lasting, do not reduce the tendency to relapse, due to the lack of a complex effect on the body of the drugs used (central, immune, endocrine systems). In addition, many drugs are called side effects.

 The objective of the invention is the search for a therapeutic agent that simultaneously corrects the endocrine, immune and other systems.

 The technical result in the implementation of the invention is manifested in the simplification of treatment and shortening of its terms, lengthening the inter-relapse period, which has an economic effect.

 The specified technical result is achieved by the fact that as a therapeutic agent they use a synthetic analogue of the hormone of the pineal gland, synthesized from amino acids of plant origin, in a dose of 0.5-1.5 mg, before bedtime, orally, for 7-20 days.

 Known commercial drug, which is a synthetic analogue of the hormone of the pineal gland - melaxen, melatonin (manufacturer Melanin, USA) (Radar - Doctor M., 1999, S. 600-601).

 The pharmaceutical effect of the drug is adaptogenic, it helps to organize the biological rhythm of the body and normalize night sleep. Stimulates cellular and humoral immunity, regulates neuroendocrine functions.

 Melatonin has an antistress effect, which is due to its effect on the neurotransmitter systems, the effect on the synchronization of circadian rhythms. Melatonin interferes with the activity of opioid mechanisms (Kumar MS, Chen C.Z., Sharp D. C. et al. Diurnal Huctuation in melatonin enkephalin levels in the hypothalamus and preoptic areas of die male rat: Effects of pinealectomy // Neuroendocrinology. - 1982 . - Vol. 35. - P. - 28-32).

 By acting simultaneously on the neuroendocrine and immune systems, melatonin optimizes homeostasis and protects against stress (Maestroni J. Melatonin and the immune system // Melatonin and the Pincal Gland. - Paris, 1992. - P. 59).

 The drawing shows the place of opioid peptides (light arrows) in the relationship between the pineal gland (black arrows - the effect of melatonin), the central nervous, endocrine and immune systems in the process of forming a reaction to stress (Clinical Medicine, 12, 1998, p. 49).

 Indications for use are sleep disturbances, adaptation of the body when external factors change.

 Studies on the use of melatonin made it possible to establish its beneficial effect on the normalization of the state of T cells and the thymus gland (Walter Pierpaoli, William Reolson. The Miracle of Melatonin. M., Binom, 1997, p. 111).

 At the same time, the recommended dosage of melatonin increases depending on the age from 0.5-1 mg at the age of 40-44 years to 3.5-5 mg from 75 years of age and older.

 The claimed combination of features provides a technical result, which is due to the listed properties of melatonin.

 Oral administration of the drug before bedtime optimizes its effect by taking into account biological rhythms in the body, since it is known that melatonin is produced in the pineal gland at night. The dose of 0.5-1.5 mg taken for 7-20 days is regulated not depending on age, but on the severity of the disease, it is necessary and sufficient to achieve a technical result with the exception of side effects.

 The possibility of practical implementation of the proposed method is illustrated by examples of its specific use in patients.

 Example 1. Patient M., 70 years old, was admitted to the hospital with a diagnosis of microbial eczema of the right lower limb, complicated by allergens, lymphadenitis.

 Sick for 3 years. The process is difficult, exacerbating 3-5 times a year, the usual duration of remissions is 2-3 months. Exacerbations of the skin process are always common, differing in torpidity to the therapy. Concomitant pathology: chronic gastritis, colitis. Hypertension 2 stages.

 Regarding the previous exacerbation, she was treated in a hospital and outpatient in the community by traditional means without effect, and therefore she was hospitalized in the regional clinical skin and venereologic dispensary.

 At admission, the pathological process was widespread with damage to the skin of the trunk and limbs. The main focus was localized on the right foot and lower leg, the skin was sharply swollen, infiltrated and hyperemic, against this background, large-plate peeling, exudative scales were noted. The boundaries of the lesion are clear, along the periphery the expression of screenings of papular and erosive rashes. A similar rash is absent-mindedly located on the skin of the upper limbs and trunk, more on the back.

 General biochemical parameters of blood were without deviations from the norm.

 The patient was prescribed treatment with melatonin at 0.5 mg at night for 10 days. Outwardly, the Unna cream is on the lesions.

 As a result of undergoing treatment on day 3, the itching stopped, rashes on the trunk and upper limbs disappeared. By day 5, the main focus on the left foot and lower leg decreased. Peeling of the foci stopped by the 9th day of treatment, completely the foci of lesion regressed by the 11th day.

 Clinical remission lasted 11 months and increased by 3 times compared with the usual terms.

 Example 2. Patient K., 41, was admitted to the hospital with a diagnosis of widespread large-pathopathy psoriasis in the stationary stage.

 Sick for 12 years. The process is difficult, exacerbating up to 5 times a year, the usual duration of remissions is 2-3 months. Exacerbations of the skin process are always common, differing in torpidity to the therapy. Concomitant pathology: hypertension of the 2nd degree, cholecystitis.

 Regarding the previous exacerbation, she was treated in a hospital and on an outpatient basis with traditional means, the effect is insignificant, and therefore she was re-hospitalized in the clinic.

 At admission, the pathological process was widespread. On the scalp, trunk, extremities, many large papular elements of bright pink color were localized. There was a continuous lesion on the body, covering the skin of the back, lower back, chest and abdomen. Over the entire surface of the foci, gray-white peeling was significantly expressed.

 The patient was prescribed treatment with 0.5 mg melatonin at night for 10 days against the background of external treatment with Unna cream.

 As a result of the treatment, the foci turned pale on day 3, by day 5 the infiltration decreased, on day 7, areas of healthy skin appeared on the body in the area of the continuous lesion. Peeling of the foci ceased by the 10th day of treatment. Foci of lesion completely regressed by day 13.

 Clinical remission lasted 9 months and increased by 3 times compared with the usual terms.

 In the conditions of the Stavropol Regional Dermatovenerologic Dispensary, the claimed method was used in the treatment of 45 patients with eczema and 15 patients with psoriasis of varying severity and diseases aged 36 to 82 years. Comparative data on the results of the treatment of the claimed and traditional methods are shown in tables 1, 2.

 Comparative treatment data by the traditional method and melatonin are presented in table 1 for eczema, in table 2 for psoriasis.

 Thus, the use of the claimed method provides a significant increase in the effectiveness of curing chronic dermatoses, reducing material costs by lengthening the period of remission and reducing the time spent by patients in the hospital and can be recommended in clinical practice.

Claims (1)

 A method of treating eczema or psoriasis, characterized in that the synthetic analogue of melatonin is administered orally - melaxen in a dose of 0.5-1.5 mg before bedtime for 7-20 days.

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