Method of treating atopic dermatitis

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely allergology, and may be used for treating atopic dermatitis. That is ensured by the introduction of a preparation of a complex of cause significant allergens is combined with using antiallergic antimediators and topic steroids. The procedures of allergovaccination are conducted once a day in dose 0.1 ml to be increased by 0.1 ml daily to 0.9 ml in the 10-6 potency of cause significant allergens to 1 ml of the undiluted complex of allergens introduced once every 2 weeks for 3 years. The allergovaccination by cause significant allergens is performed with underlying pharmacological remission (control) of atopic dermatitis by external steroids and systemic therapeutic antimediators.

EFFECT: method provides higher clinical effectiveness in atopic dermatitis ensured by improved pharmacological control of the disease during the staged allergen-specific immune therapy, as well as enables effective arrest of the manifestations of atopic dermatitis with multiple sensibilisation.

1 ex

 

The invention relates to medicine, namely to Allergology, and can be used in the treatment of atopic dermatitis combined polyvalent etiology, persistent currents.

Currently, there is no doubt that the position that the most effective method of treatment of allergic diseases with uncontrolled and/or partially controlled sensitization is allergen-specific immunotherapy cause significant allergens, leading to the reduction of state-specific hypersensitivity and the formation of immune tolerance.

There is a method of treatment of persisting and seasonal atopic dermatitis household and pollen etiology by allergen-specific immunotherapy, consisting of subcutaneous injection cause significant allergens (allergen) in gradually increasing doses. Household and pollen sensitization is diagnosed when the results are at least 3 stages of the four support points diagnose allergies: allergic history, skin testing, provocative tests, and laboratory studies of specific antibodies of immunoglobulin E.

The disadvantage of this method is its low efficiency and the technical difficulties associated with the high cost of the time of the doctor-allergist is, and the patient, and the possibility of complications such as anaphylaxis [Bousquet j, Lockey R, Malling H.J., Alvarez-Cuesta E., et al. Allergen immunotherapy: therapeutic vaccines for allergic diseases. Wold Healtg Organization. American academy of Allergy, Asthma and Immunology // Ann. Allergy Astgma Immunol. - 1998. - Vol.81. - P.401-405 (ID: 9860031)].

Closest to the claimed invention, the achieved result is a method for the treatment of atopic dermatitis household and pollen etiology, consisting of sublingual application cause significant domestic and pollen allergens: house dust, microclima, allergens library dust, trees, shrubs, grass and weeds [Bussmann, S., Bockenhoff A., H. Henke Et al. Does allergen-specific immunotherapy represent a therapeutic option for patients with atopic dermatitis? // J. Allergy Clin. Immunol. - 2006. - Vol.118. - P.1292-1298].

The disadvantage of this method is its low efficiency because of the broader spectrum of sensitization to allergens of other groups in this disease and constantly-recurrent nature of the disease, limiting the application of this method in the period of clinical manifestations.

The authors proposed a method for the treatment of atopic dermatitis with multiple sensitization: food, household, epidermal and pollen etiology that do not require a visit to the doctor-allergist and eliminating the risk of anaphylaxis to effectively stop the allergic process in the dermal tissue is x integument and conductive to long-term and sustained remission of the disease.

The technical result of the proposed method is to increase the effectiveness of treatment of atopic dermatitis by improving the pharmacological control of the disease during a phased allergen-specific immunotherapy according to the method proposed by the authors.

The technical result is achieved by the fact that in the proposed method, including sublingual application of allergen-specific immunotherapy simultaneously with the introduction of the drug complex cause-significant allergens, use intimidatory, anti-Allergy medications and topical steroids, and the procedure of allergological carried out 1 time per day from 0.1 ml increase in volume of 0.1 ml daily to 0.9 ml of 10-6the dilution of the complex cause-significant allergens to 1 ml not divorced complex allergens, input 1 every 2 weeks for 3 years, allowing you to effectively arrest the symptoms of atopic dermatitis with multiple (food, household, epidermal and pollen) sensitization.

The method is as follows.

Established complex causal important food allergens, domestic, epidermal or pollen etiology sublingual applied against the backdrop of pharmacological remission persistent atopic dermatitis, achieved by the system assignment of the complex anti-Christ. editornew funds and external therapy topical steroids, which leads to the penetration and "present" allergen load in the peripheral lymphoid education and a more rapid and reliable relief of atopic dermatitis, without the risk of systemic allergic reactions, with a subsequent gradual decrease in pharmacological load on the background of the effect of allergological.

The method is as follows.

Patients with atopic dermatitis sublingual impose a complex set of cause-significant allergens: food, household, epidermal or pollen etiology 1 times a day, starting with the 0.1 ml increase in volume of 0.1 ml daily to 0.9 ml of 10-6the dilution of the complex cause-significant allergens, then 10-5and 10-4in the same sequence dose 1 time per day, and 10-3in the same sequence and time doses the treatment was carried out every other day, 10-2in the same sequence of doses 2 times a week, 10-1in the same sequence doses of allergens to enter 1 time per week and then brought to 1 ml of the complex is not diluted allergens, which then assign 1 to every 2 weeks for 3 years.

Simultaneously with the sublingual application of the allergen on the skin as an anti-relapse therapy applied topical steroids, such as mometasone fuerat, 1 time per day, duration, and frequency is Yesenia which depends on the severity of skin allergic process, and inside designate intimidatory drugs such as cetirizine, 10 mg 1 time per day.

Clinical example

Catherine J., 25 years.

Clinical diagnosis: Atopic dermatitis, disseminated form adults, persisting for domestic (house dust 90S, dermatophagoides), pollen (birch, fire, sagebrush), food (whole egg and its components) sensitization.

Complained of symmetrically located itchy skin lesions with indistinct borders, growing in the room, in the afternoon and at night and decreasing on the street. In addition, notes increased rash and pruritus in the spring and summer, with the deterioration in the street and out of town, especially on a hot Sunny windy weather. Got sick at the age of about 3 years. From 10 to 18 years were noted improvement in reducing the amount of skin rashes and reduce the intensity of itching. With 18 years the disease has taken the nature of the flow described above. Treatment used antihistamines and topical steroid ointments, when you try lifting the rash recurred and/or amplified within 3-7 days.

The General condition is satisfactory, health does not suffer. On the skin symmetrically located erythematous-papular-squamous lesions on lichenoides background with enhanced natural when the tab with numerous excoriation. Palpable submandibular, axillary and inguinal lymph nodes.

During remission, due to cancellation of antihistamines for 5 days, with skin-scratch test defined a positive test with allergens: house dust to 90 ° C (++), microclean (Dermatophagoides) (+++), birch (+++), fire (++), wormwood (++), whole chicken egg (+) and its components: protein (+) and yolk (+). Provocative nasal tests with the same allergens were also positive.

Treatment by the present method.

The patient through daily use of antihistamines cetirizine (Zyrtec) in the morning and hydroxyzine (Atarax) in the evening, and montelukast (Singulair) during the day and topical steroid mometasone fourat (Elokim ointment) in the form of a dermatological compress at night after 3 weeks was achieved pharmacological remission (control of atopic dermatitis), while continuing in full-relapse treatment had been initiated sublingual allergen-specific immunotherapy (ASIT) complex allergens: house dust 90S, microclima (Dermatophagoides), birch, fire, sage, whole egg and its components with a dose of 0.1 ml of 10-6the dilution of 1 times a day and within 6 months was brought to 1 ml not divorced preparation of the complex of allergens that enter the th 1 time in 2 weeks. When the volume ASIT 0.5 ml of 10-3the dilution cancelled montelukast and hydroxyzine. With the continued control of atopic dermatitis at a dose of 0.5 ml of 10-1the dilution of the complex allergens cancelled cetirizine, and when the volume ASIT 1 ml not divorced complex allergens outdoor therapy in mode 2 times a week topical steroid mometazon replaced with cosmeceuticals.

After 6 months of therapy after cancelled pharmacological relapse support clinical manifestations of atopic dermatitis in the patient presents with xerodermia and light manifestations of pruritus in water hygiene procedures. By the present method ASIT was carried out for 3 years and was accompanied by sustained clinical remission of the disease.

Authors ' treatment of atopic dermatitis makes it possible to arrest the clinical manifestations of this disease. The advantage of the proposed method over the known is that the inventive method allows in a short time effectively arrest the symptoms of atopic dermatitis without the risk of systemic allergic reactions, with minimal supervision by a physician, allergist, and provides quality of life is restored in a short time from the start of treatment.

The method of treatment atopy the definition of dermatitis, including sublingual application of allergen-specific immunotherapy, characterized in that simultaneously with the introduction of the drug complex cause-significant allergens used intimidatory anti-Allergy medications and topical steroids, and procedures allergological carried out 1 time per day from 0.1 ml, with an increase in volume of 0.1 ml daily to 0.9 ml of 10-6the dilution cause significant allergens to 1 ml of undiluted complex allergens, input 1 every 2 weeks for 3 years, and the vaccination for Allergy cause significant allergens carried out on the background of pharmacological remission (control) atopic dermatitis outer steroid and systemic intimidatory drugs.



 

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2 tbl

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14 cl, 5 dwg

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EFFECT: improved preparing method, improved method for diagnosis.

1 tbl, 3 ex

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