The method of treatment of microsporum scalp and smooth skin with a concomitant intestinal giardiasis

 

(57) Abstract:

The invention relates to medicine, namely to dermatology, and for the treatment of Microsporum scalp and smooth skin with a concomitant lambliosis of bowels. The background to the use of external antifungal agents use the system introduction grizeofulvina according to the following scheme: 10 days, 22 mg/kg of body weight per day, on the 11th day appointed Ornidazole 40 mg/kg body weight, once at night for 2 days, from the 13th day resume reception grizeofulvina in the same daily dose of conventional scheme. The method allows to avoid the prescription of high doses grizeofulvina and reduce the time of treatment of patients through rehabilitation of giardiasis in the treatment of microspores.

The invention relates to medicine, namely to dermatology, section of Mycology, and relates to a method of treatment of Microsporum scalp and smooth skin with a concomitant lambliosis of bowels.

Currently, for the treatment of Microsporum scalp and smooth skin use etiotropic drugs for systemic effects - griseofulvin, ketoconazole, terbinafine, Itraconazole; external use of iodine, aniline dyes, mikoseptin, Cecil), vitamins, physiotherapeutic methods of forcing (CRF) (Rukavishnikova C. M., Samsonov Century A. Treatment of dermatophytosis with a primary lesion of hair. //The journal of dermatology and venereology. 1996. - 3. -S. 17-20; Rukavishnikova C. M., Fedorov, S. M. On therapeutic efficacy lamizila in patients with dermatophytosis and some determinovanii mycosis. //The journal of dermatology and venereology. - 2. -1997. -S. 19-23; Mohammad Y. Clinical and epidemiological features of microspores in modern conditions and the development of new treatment medication: author. dis. Kida. the honey. Sciences. Moscow, 1996.; Queen L. P. Orungal Treatment of children with microsporia. // The journal of dermatology and venereology. - 1997. - 4.- S. 69-71).

However, when using the above means and methods of treatment the duration of treatment of patients microsporia, especially when the lesions of the scalp remains long and is 39,7 56 days, and in some cases it reaches 100 days, which leads to the development of iatrogenic disease (Umakhanov D. H. Clinical course and efficacy of a specific therapy of dermatophytosis hair of the head in children with concomitant parasitic infection. Abstract. dis. Kida. the honey. Sciences. - M., 1985).

Secretaria as the main infection among mycoses in children and antibiotic therapy. Abstract. dis. Kida. the honey. Sciences. - Leningrad, 1974.- 16 C.). The presence of worms requires increasing daily and dose rate grizeofulvina. Preliminary degelmintizatsija can significantly reduce the time of the patient on the bed and avoid the side effects of large doses grizeofulvina (Kozlenko centuries, Fedotov, B. N., karakowsky Century A. features of the epidemiology and clinical manifestations of Microsporum, caused by M. canis.// Journal of dermatology and venereology. 1988 at M.V.Lomonosov. - 2. -S. 26-29).

The problem is preliminary remediation of giardiasis, because the treatment of protozoal infestations longer than helminthiases (24 days). Given this fact. treatment of giardiasis intestinal conducted after receiving systemic antimycotics, which significantly increased the duration of treatment of Microsporum.

Duration of therapy microspores of the scalp in combination with giardiasis intestinal until the first negative studies may take up to 45 days or more, with possible side effects. Rehabilitation of giardiasis in the treatment of Microsporum scalp and smooth skin allows you to avoid the prescription of high doses grizeofulvina, thereby reducing the frequency of iatrogenic disease and significantly socialnih microsporia scalp with associated lambliosis of bowels and reduce side effects from receiving systemic antimycotics.

A method of treatment of Microsporum scalp and smooth skin with a concomitant giardiasis intestinal, namely, that on the background of traditional external therapy (iodine-ointment) and receiving systemic antimycotics grizeofulvina produce a reorganization of giardiasis with Ornidazole, the Swiss drug company Hoffman-Leros LTD. Ornidazole (Tiberal) - antimicrobial and Antiprotozoal drug, manufactured in tablets of 500 mg (GOS. registration 007209/05.06.96). Tiberal used in the treatment of giardiasis scheme:

adults and children weighing more than 35 kg: 3 tablets in the evening;

children weighing less than 35 kg: 40 mg/kg once a day.

The treatment duration 1-2 days.

The method is as follows. The patient is prescribed griseofulvin tablets 125 mg based 22 mg/kg of body weight per day in three doses. From the fourth day connect hepatoprotectors (cars, lipoic acid). On the 11th day griseofulvin cancel appointed Ornidazole overnight for two days. From the second day of taking Ornidazole appoint cholagogue (allohol, choleretic herbs or teas), and 13-14 days (depending on the child) resume reception of griseofulvin is nnow iodine-ointment therapy and weekly shaving of the hair in the lesions.

The advantage of this method is the rehabilitation of giardiasis, which allows prompt treatment of Microsporum, because after a 10-day reception grizeofulvina therapeutic concentration in the blood is stored for 3 days.

Example 1.

Patient K. , aged 10 years. Diagnosis: Multifocal microsporia scalp and smooth skin. Sick for 2 weeks, not treated.

Upon admission to the clinic fungal process is represented by six lesions on the scalp and over fifty lesions on smooth skin, round shape, with a diameter of 1.5 cm, with abundant desquamation and bummer hair at a height of 3-4 mm in lesions on the scalp. Identified the luminescent glow of the affected hair. When conducting a mycological study of pathological material from lesions detected pathogen microsporia - M. canis.

An objective examination of the internal organs revealed no pathology. The results of laboratory tests (urinalysis, biochemical and immunological study of blood) abnormalities not detected. In OAK was marked eosinophilia - 20%. When parasitological examination of feces revealed cysts tablets per day in 3 divided doses.

2. IDNO-ointment therapy: lubrication foci of 2% iodine solution and cream "Mikoseptin".

3. Tiberal 3 pills at night - 2 days.

4. Lipoic kituta 1 table. x 3 times a day.

5. Allohol 1 table. x 3 times a day.

6. Daily washing of the lesions.

7. Weekly shaving of the lesions.

When clinical and mycological monitoring found that negative pathogen fungal infection of the lesions, defined microscopic and bacteriological methods has occurred on the 23rd day of therapy. Clinical recovery occurred at 28 days. Re mycological research carried out three times with an interval of 5-6 days, showed the absence of the pathogen on the ground leading to lesions. Subjective discomfort, intolerance, allergic reactions during therapy is not marked.

Further clinical supervision within 3 months confirmed the patient's full recovery. In the control feces analysis, carried out after 1 month, Giardia cysts were not found.

Example 2.

Patient M., aged 2 years. Diagnosis: Multifocal microsporia scalp: Ill for three months, Lachlan multiple small diameter up to 0.5 cm centers throughout the scalp with minor peeling, hyperemia and bummer hair at a height of 3-4 mm Revealed a bright fluorescent glow of the affected hair.

When conducting mycological examination of pathological material from lesions detected pathogen microsporia - M. canis.

An objective examination of the skin pale, dry. From internal organs revealed no pathology. In urinalysis, biochemical analysis of blood abnormalities not detected. In OAK eosinophilia was observed in 13%. In the study of fecal worm-protozoal invasion detected Giardia cysts.

The following treatment was performed.

1. Griseofulvin is based 22 mg/kg of body weight - 2 table. a day in three doses.

2. IDNO-topical therapy.

3. Tiberal 1 table. on night 2 days.

4. Lipoic acid 1/3 x 3 times a day.

5. Choleretic herbs for 30 minutes before meals three times a day.

6. Daily washing of the lesions.

7. Weekly shaving of the lesions.

When clinical and mycological monitoring found that negative pathogen fungal infection of the lesions, defined microscopic and bacteriological methods has occurred on the 26th day of therapy, knee three times with an interval of 5-6 days, showed the absence of the pathogen on the ground leading to lesions. Subjective discomfort, intolerance, allergic reactions during treatment are not marked. Further clinical supervision within 3 months confirmed the patient's full recovery. In the control feces analysis, carried out after 1 month, Giardia cysts were not found.

In this way received treatment for children aged 2 to 10 years with microsporia scalp and smooth skin on the background associated giardiasis intestinal (18 people) with disease duration from a week to 3 months.

The duration of treatment until the first negative studies on fungi of the lesions 250,92 days. The effectiveness of the method is to reduce the duration of treatment of patients microsporia scalp and smooth skin in the redevelopment of giardiasis intestinal 10-11 days.

The tolerability of the drugs was good, allergic reactions, side effects are not marked.

Recurrence of fungal diseases in the observation is not revealed.

Giardia cysts during the control study was detected in one patient (6.25 per cent).

The way lacantina grizeofulvina and external antifungal agents, characterized in that griseofulvin is used for 10 days at 22 mg/kg of body weight per day, on the 11th day appointed Ornidazole 40 mg/kg body weight, once at night for 2 days, from the 13th day resume reception grizeofulvina in the same daily dose of conventional scheme.

 

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