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INVENTION
Patent of the Russian Federation RU2036667
METHOD OF TREATMENT OF DISSEMINATED PSORIASIS
The name of the inventor: Mashkov Oleg Alekseevich; Mashkov Sergey Olegovich; Vasileysky Sergey Serafimovich; Vorontsova Elena Mikhailovna; Loginova Tatiana Konstantinovna
The name of the patent holder: Mashkov Oleg Alekseevich; Mashkov Sergey Olegovich; Vasileysky Sergey Serafimovich; Vorontsova Elena Mikhailovna; Loginova Tatiana Konstantinovna
Address for correspondence:
Date of commencement of the patent: 1994.01.24
Use: in dermatology in the treatment of disseminated psoriasis. The essence of the method: first cryoprotection of hair follicles is carried out, then cryodestruction is sector-wise, and hemosorption is performed between cryodestruction sessions, which allows to reduce complications in the form of focal alopecia, reduce intoxication due to absorption of epidural cell destruction products and shorten the duration of treatment.
DESCRIPTION OF THE INVENTION
The invention relates to medicine, in particular dermatology, and is intended for the treatment of psoriasis.
Treatment of psoriasis includes a large arsenal of means and methods of therapeutic, physiotherapeutic, physical effects, based on the effect on the pathogenetic links of this pathology, and those that have a symptomatic character.
One of the ways to treat psoriasis in a complex treatment is hemosorption in various variants (biogemosorption by perfusion of the patient's blood through xeno-spleen, hemosorption in combination with hemodilution, ultrafiltration and oxygenation). However, with sufficient complexity and technical difficulty, it is not always possible to obtain a stable therapeutic effect.
A method of treating psoriasis is known in which cryodestruction of psoriatic eruptions is performed by cryoapplication with liquid nitrogen at a temperature below -100 ° C and exposure of 5-30 s. Using this method, which is the closest analogue, under conditions of disseminated psoriasis, a long treatment period is required, which is from 2 to 4.5 months (in all, about 20 procedures with a frequency of 3-5-7 days). This is due to the fact that in the process of cryodestruction the epidermal cells disintegrate and the treatment of large areas of skin leads to the threat of intoxication development, therefore, the sectoral treatment is carried out with breaks of 3-7 days, which, with the vastness of the lesion, significantly prolongs the period of treatment.
At the same time, clinical observations showed that during cryodestruction of the epidermis in the field of psoriatic plaques, hair growth is subsequently impaired after healing. In the guinea pig experiment, selective high sensitivity of hair follicles to liquid nitrogen exposure and irreversible damage was shown. This was the basis for pre-treatment of the skin by cryoprotectants before cryoviding with liquid nitrogen. The rates of diffusion of cryoprotectants into different cells vary greatly. In the epidermis, a much lower concentration is achieved than in the follicles. With such a gradient, it becomes possible, on the one hand, to protect the hair follicles, on the other hand, to provide a fairly rigid cryoversion to the epidermis. Various substances can be used as cryoprotectants, in particular 70-80% glycerol solution or a solution containing glycopeptides from fish serum. As the experience of their application has shown, cryoprotection should be started 30-60-120 minutes before cryoexposure.
Cryodestruction of large areas is accompanied by considerable intoxication, which forces to prolong the period of treatment due to interruptions in treatment. This was a prerequisite for using the method of hemosorption for the purpose of detoxifying the body, and due to this shortening of the treatment period. Thus, the resulting technical result is due to a combination of three methods of cryoprotection, cryodestruction and hemosorption. For cryoprotection, any means that possess such properties can be used; Cryo-exposure is carried out in regimes that ensure the destruction of the epidermis in the field of psoriatic plaques; Hemosorption alternates with cryodestruction in modes sufficient for detoxification, depending on the area of the skin being treated, the sorbent and the individual characteristics of the patient's condition.
The method is carried out as follows. Before the cryo-exposure, the skin is processed in the area of those psoriatic foci that will be exposed to this session. Apply a solution of one of the protectors in as many minutes as required for this cryoprotectant. After this, a cryodestruction of a known method with liquid nitrogen is carried out for 5-7 seconds at each point of the selected sector. Sessions are repeated a few more days, depending on the treated area and the patient's condition, on average, for three days. After this, hemosorption is carried out in an amount of 2-2.5 volumes of circulating blood, using a column volume of 400 cm 3 as a sorbent, for example a sorbent of the "FAS" type. Then within a few days, an average of about 10, the patient does not receive treatment, after a break, the treatment resumes with the same methods, but for other body sectors.
Outpatient treatment was conducted in 50 patients with disseminated psoriasis. The entire period of treatment and subsequently the patients were under observation. The longest observation period is up to 1.5 years. The available clinical data confirm the high efficacy of the proposed method, sufficient simplicity and absence of complications. The method is of particular value for patients who do not show any therapeutic or other methods of treatment of psoriasis.
Example 1 . Patient B. is 31 years old. She is ill with psoriasis for 17 years. The process was widespread with predominant localization in the trunk and head region. The patient was repeatedly treated out-patient with the use of local drugs, vitamin therapy. Physiotherapeutic treatment is not indicated because of the contraindication in the form of uterine fibroids. The effect of the treatment is insignificant. The proposed method was treated in this mode. It took only 18 days to implement the method. Drug therapy was completely ruled out. As a result of the treatment, psoriatic rashes on the skin of the head and trunk completely disappeared. Follow-up observations for 1.5 years showed no exacerbations.
Example 2 . Patient T. 34 years. She is sick with psoriasis for 22 years, was treated repeatedly, concomitant diseases chronic tonzilit, mastopathy. Physiotherapeutic methods of treatment are contraindicated. The treatment included vitamin therapy, hemosorption. The effectiveness of treatment was insignificant. Psoriasis is disseminated, plaques have a size of 0.5-1.5 cm in diameter. The patient was treated only with the use of cryotherapy. Due to the threat of intoxication sessions were held intermittently (the first 2 weeks 3 times a week, then 2 times a week and 1 time a week). Total treatment took 2 months, while a complete remission was achieved. However, in the field of ex-psoriatic plaques, there are foci of alopecia.
Thus, the available clinical experience shows the high effectiveness of the proposed method of treatment of psoriasis with a reduction in the number of complications and shortening of the treatment period.
CLAIM
1. METHOD OF TREATMENT OF DISSEMINATED PSORIASIS, including a sectoral cryodestruction of the foci of skin lesions, characterized by the fact that cryopreservation is performed with a cryoprotectant, and cryoexposure alternates with hemosorption.
2. A method according to claim 1, characterized in that for cryoprotection, 70
80% aqueous solution of glycerin and applied to the skin for 30-60 minutes before cryoexposure.
3. A method according to claim 1, characterized in that for cryoprotection a solution containing glycopeptides from fish serum is used and applied to the skin 30-40 minutes prior to cryogenic exposure.
4. The method according to claim 1, characterized in that the sorbent FAS is used for hemosorption and hemosorption is carried out every three cryodestruction sessions.
print version
Date of publication 01.04.2007гг
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