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INVENTION
Patent of the Russian Federation RU2192250
METHOD OF TREATMENT OF PATIENTS WITH RED FLAT DEPRIVES
The name of the inventor: Glavinskaya TA; Kurnikov G.Yu .; Ivlieva T.I.
The name of the patent holder: Nizhny Novgorod Research Institute of Dermatology and Venereology
Address for correspondence: 603600, Nizhny Novgorod, ul. Kovalikhinskaya, 49, NNIKVI
Date of commencement of the patent: 2000.07.11
The invention relates to medicine, namely, to dermatology, and can be used to treat patients with red planus. To do this, administer acyclovir to 0.2 g five times a day for 7-10 days and additionally, from the first day of treatment, neovir is administered 2 ml intramuscularly every other day, for a course of 5-10 injections. The method provides relief of clinical manifestations of the disease.
DESCRIPTION OF THE INVENTION
The invention relates to medicine, viz., Dermatovenereology, and can be used to treat patients with red planus (CRP).
CPL is an increasingly frequent multifactorial disease with unidentified etiology and pathogenesis, which is hardly inferior to the treatment. The most significant in recent years are the virus and immunoallergic concepts of the disease, which causes an increased interest in the use of antiviral and anti-inflammatory drugs. More commonly used griseofulvin, which has anti-inflammatory, antiviral and antitumor effect, and aminoquinoline derivatives (delagil, plakvenil). Long-term multi-course treatment, often accompanied by toxic effects on the liver, gastrointestinal tract, allergic reactions, causes the need to improve the therapy of patients with CPL.
As a prototype, we chose to use the antiviral drug metisazone at a daily dose of 20 mg per kg of weight for 6 days (Sergeev S.Ya., Pesterev PN, Labzovskaya NP et al., Vestn. Dermatol 1986. 3. p. 63-64). However, the therapeutic effectiveness of this method is insufficient. The pronounced clinical effect (disappearance of manifestations and significant improvement) was noted by authors in 27.5% (in 8 out of 29 patients observed).
The aim of the invention is to increase the effectiveness of treatment of patients with CPL.
The stated task is solved by the fact that as antiviral agents acyclovir is prescribed for 0.2 g five times a day for 7-10 days and additionally from the 1st day neovir possesses and immunostimulating action, 2 ml intramuscularly every other day, per course 5-10 injections (RLS-ENCYCLOPEDIA OF MEDICINES: The seventh edition, revised and enlarged / Editor-in-Chief Yu.F. Krylov. -M .: RLS-2000, 2000. pp. 116-117 and p. 629.)
The method was carried out as follows.
After a clinical and laboratory examination, a patient with CPL was prescribed monotherapy with acyclovir and neovir. Acyclovir was prescribed to 0.2 g five times (every 4 hours during the day) for 7-10 days; Neovir 2 ml (250 mg) intramuscularly every other day, for a course of 5-10 injections.
After the end of monotherapy, a repeated laboratory examination was performed.
Drug tolerance was good, no side effects were reported.
9 patients with CPL were treated, including 2 men and 7 women, the average age was 48.7 years (from 26 to 70), the average duration of the disease was 5.15 years (from 1 month to 33 years). Only two patients with CPL did not have concomitant diseases, the majority registered the pathology of the gastrointestinal tract, liver, cardiovascular, nervous systems, diabetes mellitus. Prior therapy included antihistamine, efferent, aminoquinoline, vitamin preparations and external agents.
In all patients skin manifestations were common, half of them (4 people) except skin had a mucous membrane of the oral cavity, and 2 of them and genitals.
As a result of treatment, 1 person lost clinical manifestations, 4 had a significant improvement, 4 had an improvement.
Example 1 . Patient R., 70 years old, ist. Bol. 1256. Diagnosis: CPL, bullous form (diagnosis confirmed histologically). Duration of the disease is 1 month. Concomitant disease: hypertensive disease 2 tbsp. B.
Clinical manifestations are abundant, located on the skin of the trunk, upper and lower extremities in the form of numerous small flat papules of rich red color, with waxy luster and formed on the surface of some of them with vesicles. In some places, papules merge into plaques with a pronounced Wickham retina. The itch is strong. The acceleration of ESR (26), an increase in IgG (13.89 g / l) and U- globulin (18.2%) was detected.
The patient received acyclovir for 0.2 g 5 times a day for 10 days, neovir intramuscularly 2.0 ml every other day, 5. It was prescribed with an improvement in the clinical picture. 3d decreased. Outpatient was not treated. After 3 months came to the control, complete disappearance of papular eruptions, intense hyperpigmentation in place of the former elements was established.
Example 2 . Patient X., 62 years old, ist. Bol. 2474. Diagnosis: CPL. Duration of the disease is 5 months. Concomitant diseases: latent diabetes mellitus, essential hypertension of the 1st degree of alimentary-constitutional genesis, rubyphytia of the feet with onychomycosis. Outpatient treatment without effect.
The manifestations of CPL are widespread, localized on the skin mainly by the flexural surfaces of the upper and lower extremities, the trunk, especially at the waist, where individual papular elements merge into large plaques. Papules are flattened, cyanotic red, with waxy luster, often with hemorrhagic crusts on the surface. The fingernails are shiny, "polished". Severe itching.
Treatment with acyclovir (0.2-5 times a day) for 7 days, neovir 2 ml intramuscularly 10, gave a positive dynamics. Normalization of B-lymphocytes (from 10 to 20%), IgG (from 13.1 to 11.87 g / l) and IgM (from 1.32 to 1.12 g / l), immunoregulatory index T x : T S (IRI) (from 1.26 to 2.14). The patient is discharged after 10 days with significant improvement: the rash on the trunk regressed completely, on the limbs acquired a brownish hue, the itching is weak.
Example 3 . Patient S., 49 years old, ist. Bol. 2101. Diathesis: CPL. The duration of the disease is 3 years. Concomitant disease: bronchial asthma of infectious-allergic and atopic origin on the background of diffuse catarrhal bronchitis.
Clinical manifestations are extremely common, capture the skin of the trunk, in the folds under the mammary glands forming garlands, upper limbs, thighs, and the mucous membrane of the oral cavity and genitals. Papules on the skin have a typical stagnant red color, waxy luster, their diameter is 2-5 mm, sometimes merge into plaques. In the oral cavity small whitish papules are located on the mucous cheeks, mainly at the level of the closing of the teeth, in the form of "fern leaves". On the mucosa of small and large labia papules larger, hypertrophic, merged mainly into powerful conglomerates, cause painful itching.
Treatment with acyclovir (0.2 g 5 times a day) for 10 days, neovir 2 ml intramuscularly 9 with a positive result, normalization of ESR (from 20 to 13 mm / h), B-lymphocyte content (from 32 to 22% ), IRI (from 1.3 to 2.5).
The patient is discharged with significant improvement: the rashes on the skin and the oral mucosa regressed completely, on the genitals markedly flattened. It is recommended to continue treatment with external means.
Thus, the proposed method has a positive effect on clinical manifestations and immune status in patients with CPL. The treatment is well tolerated and is indicated for use in complex CPL therapy. The pronounced clinical effect (disappearance of manifestations and significant improvement) was obtained in 55.5% of cases, which is 2 times higher when compared with the prototype (27.5%).
CLAIM
A method for treating patients with red planus, including the administration of antiviral agents, characterized in that as antiviral agents, 0.2 g of acyclovir is administered five times a day for 7-10 days and additionally, from the first day, neovir possessing and immunostimulating action , 2 ml intramuscularly every other day, for a course of treatment 5-10 injections.
print version
Date of publication 01.04.2007гг
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