Treatment of skin diseases should be comprehensive, using etiological, pathogenetic and symptomatic agents, as well as combined: general and local. General treatment should be dictated by expediency: for example, for the treatment of superficial pyoderma, external treatment is sufficient. Etiological and pathogenetic therapy is carried out if the etiology and mechanisms of development of dermatosis are known. Etiological therapy is mainly carried out for the treatment of infectious diseases of the skin and skin appendages. Pathogenetic therapy includes hyposensitizing drugs, glucocorticosteroids, antihistamines, detoxifiers, immunomodulators, vitamins and microelements, etc. Symptomatic treatment includes painkillers, antipruritics, and anti-inflammatory drugs.
External agents according to the nature of their action are divided into indifferent (zinc oxide, talc, white clay), anti-inflammatory and astringent (boric acid, zinc sulfate, silver nitrate, tannin, glucocorticosteroids, etc.), keratoplastic (ichthyol, tar, naphthalan), keratolytic ( salicylic acid, benzoic acid), antipruritic substances (menthol, corticosteroids, anesthesin, antihistamines), absorbable drugs (sulfur, ichthyol, birch tar, resorcinol), cauterizing and destructive (salicylic acid and resorcinol in concentrations of 10%, silver nitrate 2- 10%, podophyllin 5-10%, lactic acid 5-10%.
Dosage forms may vary. Powders, solutions, shaken suspensions, and aerosols act most superficially; creams, ointments, pastes and patches penetrate deeper. In the treatment of dermatological patients, in addition to medications, physiotherapeutic methods of influence are widely used: thermal procedures, cryotherapy, light therapy, electrotherapy, ultrasound therapy. Sanatorium-resort treatment for many chronic dermatoses helps to prolong remission and reduce the number of relapses.
Topic No. 1: Pyoderma.
The goal is to consolidate theoretical knowledge on the etiology, pathogenesis, clinical picture, diagnosis and treatment of pyoderma.
Information material.
Pyoderma(pustular skin diseases) are the most common infectious skin lesions in children and adults. They can occur primarily or secondarily as complications of other, more often itchy, dermatoses.
Etiology. The causative agents of pyoderma are mainly staphylococci and streptococci. Purulent inflammation of the skin can also be caused by Pseudomonas aeruginosa, Proteus vulgaris, pneumococci and many other microorganisms.
Pathogenesis. For the occurrence of pyoderma, not only the pathogenicity and virulence of the coccus strain are important, but also various endogenous and exogenous factors that change the protective functions of the skin. Of the most common exogenous factors It should be noted superficial skin injuries (cuts, abrasions, scratches, insect bites, injections, maceration, etc.), skin contamination (as a result of insufficient skin hygiene, occupational contamination with lubricating oils, coal, cement, lime, gasoline, kerosene), hypothermia and overheating of the body.
TO endogenous factors include disorders of carbohydrate metabolism (hyperglycemia), endocrine pathology (insufficiency of the pituitary-adrenal system, thyroid gland), functional disorders of the nervous system (autonomic neuroses), nutritional disorders (deficiency of proteins, vitamins), acute and chronic debilitating diseases, gastrointestinal diseases (intestinal intoxications ), hereditary factor, local circulatory and lymph circulation disorders, weakening of immune defense mechanisms.
Classification. Depending on the etiological factor, all pyoderma is divided into staphylococcal, streptococcal and mixed. According to the depth of location - superficial and deep, according to the nature of the course - acute and chronic.
Staphyloderma. Staphylococci primarily affect skin appendages - hair follicles, sebaceous and sweat glands, causing purulent-exudative or purulent-necrotic inflammation, and less often - inflammation not associated with adnexal formations. Staphyloderma is more often deep than streptoderma.
Staphyloderma associated with hair follicle .
Ostiofolliculitis- a follicular pustule (abscess) the size of a millet grain, located in the center of the hair follicle and surrounded by a narrow, acutely inflammatory hyperemic corolla. The mouth of the hair follicle is affected. Within a few days, the pustule becomes covered with a yellow crust, which falls off without leaving a trace.
Folliculitis – next stage development of ostiofolliculitis, is an inflammation of the entire follicle. Painful red nodules form on the skin, turning into a pustule riddled with hair. After a few days, the secretion of the pustule shrinks into a crust, which is rejected after 5-6 days, leaving a small dotted scar. The most common localization of folliculitis and ostiofolliculitis is the back of the hands, the skin of the face, neck, legs, thighs, and scalp.
Vulgar sycosis occurs against the background of chronic foci of infection, skin sensitization to staphylococci, pathology of internal organs, and the nervous system. Men get sick more often. The predominant localization is the area of the beard and mustache, sometimes - the skin in the area of the eyebrows, scalp, pubis, and armpits. The disease begins with the development of ostiofolliculitis and folliculitis, the number of which gradually increases. They merge with each other, forming infiltrated foci of bright red color, dotted with pustules, dirty yellow crusts, and erosions. When removing hair from the affected area, you can see a gelatin-like muff - an epithelial sheath of hair, saturated with pus. Vulgar sycosis usually exists for a long time, periodically worsens, depressing the patient’s psyche, and is accompanied by a feeling of itching, burning, and pain.
Keloid acne(sclerosing folliculitis of the back of the head) is represented by inflammation of the hair follicles and sebaceous glands on the back of the skin of the neck and back of the head. Men get sick more often. A papulopustular rash appears, resolving with the formation of keloid scars and cicatricial alopecia (baldness).
Furuncle– is a further development of folliculitis. It is expressed in purulent-necrotic inflammation of the hair follicle and surrounding tissue. The formed boil is a painful inflammatory node measuring from 1 to 3 cm (the stage of infiltration development, which takes 3-4 days). Then a purulent-necrotic core with a pustule on the surface is formed in the center (stage of suppuration and necrosis). During this period, the pain becomes sharp, the temperature may rise, and symptoms of general intoxication appear. Next, the cover of the boil is opened, purulent or bloody-purulent contents are released from the boil, and then a yellow-green “plug” (necrotic core). After this, swelling, infiltration and pain disappear and the ulcer scars within 2-3 days (healing stage). Typically, the development cycle of a boil is 8-10 days. Furunculosis is said to occur when boils recur. Furunculosis usually develops against the background of diabetes mellitus, immunodeficiency, chronic debilitating diseases, anemia, etc. It should be remembered that boils of the upper lip are especially dangerous due to the possibility of thrombosis of the lymphatic and venous tracts with the formation of septic phlebitis of cerebral vessels.
Carbuncle is a diffuse purulent-necrotic inflammation of the deep layers of the dermis and hypodermis as a result of simultaneous damage to several hair follicles (a conglomerate of boils). A deep, dense infiltrate up to 10 cm in size is formed. The skin over it is bluish-red and swollen. After 5-10 days, the infiltrate softens and purulent-necrotic masses are rejected, as a result of which holes resembling a sieve appear on the surface of the carbuncle. Due to the enlargement of the follicular openings, an ulcer is formed, which is gradually performed by granulation and heals with a retracted scar. The carbuncle is accompanied by a disturbance in the general condition of the patient and an increase in temperature.
Hidradenitis– purulent inflammation of the apocrine sweat gland. Women get sick more often. Hidradenitis does not occur in children before puberty or in the elderly because their apocrine glands do not function. Hidradenitis is localized mainly in the armpits, less often around the anus, on the labia majora, and scrotum. In the depths of the subcutaneous base, single or gradually increasing in size, multiple painful nodes appear. The skin over them becomes bluish-red. Then the nodes soften, fluctuation appears and they open with the release of creamy pus, sometimes mixed with blood. Eventually a scar will form. The average duration of hidradenitis is 10-15 days.
Streptoderma . Streptococci directly affect smooth skin: the epidermis, less often the dermis and hypodermis, causing serous-exudative inflammation. Primary element – flaccid bladder (phlytena), having a transparent secretion and a tendency to grow peripherally.
Impetigo streptococcal. Children get sick more often. The disease is contagious and is transmitted through direct contact with a patient and through infected objects. Localized mainly on the face. But it can be located on any part of the skin. It begins with a small hyperemic spot on which a phlyctena forms. The serous contents of the phlyctena shrink into brown crusts, which, when removed, reveal erosion. The conflicts can merge with each other, forming extensive erosions. After peeling off the crust, a bluish-pink spot remains, which resolves without a trace.
Types of streptococcal impetigo.
Bubble impetigo- conflicts form in the form of a bubble.
Ring-shaped impetigo characterized by peripheral growth of phlyctena. Its center dries out, and the peripheral part remains in the form of a ring-shaped rim filled with a grayish-turbid liquid.
Streptococcal slit-like impetigo (angular stomatitis or jam) – located in the corners of the mouth. At first, phlyctena appears in this area, and then linear erosion. The skin of the corners of the mouth is swollen and hyperemic. The crust that forms on the surface of the erosion and the restoring epithelium are easily torn when the lips move. The defeat is painful.
Streptococcal paronychia– inflammation of the periungual fold. This is a phlyctena, which is located in a horseshoe shape, bending around the nail on three sides.
Intertriginous streptoderma develops in large skin folds (intergluteal, axillary, behind the ears, inguinal-femoral). It is characterized by the formation in the skin folds of a continuous erosive weeping surface of a bright pink color, sharply demarcated from the surrounding healthy skin, with a border of exfoliating epidermis.
Streptoderma diffuse chronic– superficial streptoderma, which begins as streptococcal impetigo and then becomes chronic. The skin in limited areas is bluish-red in color, swollen, eroded, weeping, and covered with crusts. The lesions have scalloped outlines and are located asymmetrically, usually on the upper or lower extremities, face, and around the mammary glands. The lesion gradually increases in size, covering large areas of the skin.
Streptoderma erythematous-squamous (simple lichen) – superficial pyoderma, affecting the trunk, limbs, face. Often observed in children. It is characterized by the appearance of rounded lesions, 1-3 cm in size. The lesions are white or pinkish in color, covered with pityriasis scales.
Ecthyma ordinary– deep streptoderma, which occurs in persons with reduced protective functions of the body, low nutrition, suffering from chronic infections, and alcoholism. Ordinary ecthyma is characterized by the presence, most often on the legs, of single, deep, painful ulcers that form from large (1-2 cm in diameter) pustules. The bottom of the ulcer is covered with a yellowish-brown crust. Ecthyma tends to grow peripherally. The ulcer heals with the formation of a scar.
Streptostaphyloderma- as a rule, pyoderma caused by mixed flora has a chronic, more severe course, sometimes with an atypical clinical picture.
Vulgar impetigo. Infection is facilitated by skin trauma, pollution, maceration of the skin with saliva and other secretions, and previous itchy dermatoses. On hyperemic and swollen skin, conflicts appear, the contents of which quickly become cloudy and become purulent. The secretion then dries out, forming thick, honey-yellow or yellow-green crusts. The most common location is around natural openings. The disease most often affects children, girls and young women. The entire development cycle of the element lasts 8-15 days, after which secondary pigmentation remains on the skin.
Chronic ulcerative And ulcerative-vegetative pyoderma refers to deep forms of pyoderma. Develops against the background of decreased reactivity of the body, with impaired immunity, carbohydrate metabolism, against the background of thrombophlebitis and varicose veins. The disease begins with the development of streptococcal ecthyma, a boil, which undergo necrosis with the formation of an ulcer. New deep pustules form along the periphery of the main lesion. In the depths of the infiltrates, deep purulent cavities communicating with each other are formed. Under the crust, the ulcers grow along the periphery, merge, acquiring different shapes. The lesion is gradually increasing. The process may involve not only the epidermis, dermis and hypodermis, but also muscles and sometimes bones. The disease ends with scarring. As a rule, the disease is accompanied by insomnia, pain, and weakness. On the surface of ulcerations or along the periphery of ulcers, warty growths - vegetations - can develop. Fistulous tracts are often formed.
Erythrasma. a disease caused by the bacterium Corinebacterium minutissimum or the association of microbes staphylo- and streptococci. Men are more often affected.
Clinic. In the folds of the skin (axillary, inguinal, under the mammary glands) spots are pink-brown or yellow-brown, pityriasis-flaky with polycyclic outlines. There are no subjective sensations.
Treatment: erythromycin ointment. 2% iodine tincture, 2% salicylic alcohol, in persistent cases - 0.2 erythromycin orally 5 times a day for 5 days.
Diagnostics pyoderma: microscopy of a Gram-stained smear (Gram-positive cocci), bacteriological culture to determine the sensitivity of the flora to antibiotics, general blood test (leukocytosis, possible increase in ESR), in rare cases - serological reactions, pathomorphology of the skin.
1. External treatment is indicated for the treatment of superficial pyoderma.
1-2% alcohol solutions of aniline dyes (gentian violet, methylene blue, brilliant green, pyoctanin, fucorcin)
Depilate hair on the affected area using manual depilation and wipe healthy skin with 1-2% camphor or salicylic alcohol
irrigation with 1% chlorophyllipt solution, microcide, ectericide solutions.
ointments with antibiotics (erythromycin, tetracycline, gentamicin), wound-healing drugs (levomekol ointment, methyluracil, pantestin), sulfonamides (5% liniment streptocide), for weeping - aerosols (lifusol, oxycyclosol, levovinisol)
for deep pyoderma at the stage of infiltrate formation, ichthyol cakes, 10% ichthyol ointment, and balsamic liniment according to Vishnevsky are used.
2. Systemic therapy is indicated for the treatment of deep and chronic pyoderma, when external therapy is ineffective.
antibiotics (penicillin, tetracycline groups, macrolides, cephalosporins, especially 1-2 generation, fluoroquinolones 2-3 generation, aminoglycosides)
sulfonamides (biseptol, bactrim)
specific and nonspecific immunotherapy
vitamins and microelements
if necessary, absorbable drugs, vascular agents, reparants
physiotherapy: UHF in the stage of infiltrate formation, irradiation with short-wave rays (SWRF) after rejection of the necrotic rod, general ultraviolet irradiation, paraffin applications and lidase phonophoresis during scar formation.
Prevention: compliance with the rules of personal hygiene, sanitation of foci of infection, in the case of ENT pathology - lubrication of the ear and nasal openings with creams and ointments with antibiotics and gargling with antiseptic solutions, diet with limited carbohydrates. Timely treatment of skin injuries and wounds. Carrying out measures to combat dust and pollution. If pyoderma occurs, frequent changes of clothing and linen, boiling of linen and daily treatment with hot steam.
Target classes: consolidate theoretical knowledge on the etiology, pathogenesis, clinical picture, diagnosis and treatment of scabies, lice and demodicosis.
Information material.
Scabies.(Scabies)
Pathogen – scabies mite. The only owner is man. People of any age and gender are affected; the disease is widespread. Males, fertilizing females, soon die. The female penetrates the stratum corneum of the epidermis, breaks through a horizontal passage in it, laying about 50 eggs over 6-8 weeks of life, from which larvae form after 4-5 days. Females dig tunnels at night (2-3 mm per day), lay eggs during the day, each with 40-50 eggs in their entire life. The larvae hatch after 72-96 hours, emerge on the surface of the skin and penetrate into the mouths of the hair follicles. The larvae form into sexually mature ticks within 15 days. Outside the skin, females die after 5-15 days. Infection occurs when the skin comes into contact with the affected surface - during sexual intercourse, children's games, or when caring for a patient. Ticks can live in clothing and bedding for more than 2 days. The main route of transmission is contact and household.
Clinic. The incubation period is 4-6 weeks. The disease is characterized intense itching that gets worse at night (typical only for scabies). The rash may be absent or very few in number (clean scabies). Typical location of the rash : rashes are localized in the interdigital spaces and on the fingers of the hands, on the flexor surfaces of the wrist joints, in the cubital fossae, on the elbows, the anterior surface of the armpits, abdomen, and thighs. In men, the rash is often localized in the penis area , in women - in the area of the mammary glands. In children The skin of the palms, soles, face, neck and even the skin of the scalp is affected and is very quickly complicated by the addition of pyoderma. Rash It consists of small bubbles and pink nodules arranged in pairs. Sometimes you can see an itch located between two elements, looking like a gray winding strip 0.3-1.0 cm long.
Diagnostics. Based on identifying symptoms typical of scabies:
itching, worse at night;
typical localization of the rash;
character skin rashes;
the appearance of yellowish-brown stripes in the form of a comma when the rash sites are lubricated with a 2-5% iodine solution (scabies tracts)
Microscopy of scabies scraping in oil or alkali
Treatment. To treat scabies, agents are used that destroy the scabies tracts and destroy the mites and their eggs located there. Apply 33% sulfur ointment (children 6-10-16%), 20% (children 10%) emulsion or ointment of benzyl benzoate, Demyanovich method (solution 3!-60% aqueous solution of sodium thiosulfate, solution No. 2 - 6% aqueous solution of hydrochloric acid acids), Spregal aerosol (piperonyl butoxide, esdepalletrin), used as a single irrigation, permethrin ointment 5% (nittifor). Disinfection of linen and clothes is mandatory: boiling in a 1-2% solution of washing powder for 10-15 minutes or soaking the linen for 1 hour in a disinfectant solution (5% DDT soap, 2% K soap emulsion, etc.), steaming. Dry clean, spray with A-PAR (esdepalletrin, piperonyl butoxide) or seal in a plastic bag for 72 hours. All those in contact with the patient and those living with him are examined by a dermatologist at least once every 10 days. Prophylactic treatment is recommended.
All this leads to the fact that the same medicinal substances for the same diseases often give different therapeutic effects.
Significant therapeutic difficulties are presented by dermatoses that are often encountered in practice with changes in the body's reactivity to exogenous and endogenous irritants - food, medication, chemical, household, occupational, etc. A large group of dermatoses (eczema, neurodermatitis, urticaria, etc.) is caused by sensitization, i.e. . increased sensitivity of the body. If
Since dermatosis is based on a known irritating factor (for example, a chemical allergen in occupational dermatosis), which has not yet led to polysensitization (hypersensitivity to several substances), its elimination relatively quickly leads to recovery. However, in practice, it is often not possible to determine the allergen that caused the dermatosis, or there is increased reactivity to many irritants due to genetically determined or acquired polyvalent sensitization. In such cases, the main importance is given to general treatment, desensitizing and symptomatic therapy, treatment of foci of chronic infection and detected diseases of internal organs, nervous system, endocrine glands that support dermatosis. It is especially difficult to treat children suffering from chronic allergic dermatoses.
Symptomatic treatment currently in dermatology it occupies a much smaller place than etiotropic and pathogenetic therapy using symptomatic agents as auxiliary ones.
The treatment plan is drawn up and adjusted in accordance with the medical history and the results of clinical and laboratory examination. Of no small importance are clinical thinking, experience, qualifications and intuition developed in the process of work, as well as the study of special periodical literature and knowledge of the achievements of related specialties, especially therapy and neurology.
Treatment should be carried out strictly individually, taking into account the patient’s gender, age, anamnestic data, results of previous treatment, tolerability medicines, form, stage and prevalence of dermatosis.
The relationship between the doctor and the patient plays an important role in the success of treating a dermatological patient. The correct individualized psychotherapeutic approach to the patient to a certain extent ensures a positive result of drug therapy for most dermatoses.
5.1. General treatment
For the general treatment of skin diseases, a large arsenal of drugs and methods is currently used. These are sedative, hyposensitizing, hormonal, immune therapy, chemotherapy, antibiotic treatment, spa treatment, etc. However, this division of general therapy is to some extent arbitrary, since the same remedy often has a multifaceted effect.
Psychopharmacotherapy. Functional disorders of the central and autonomic nervous system play a significant role in the pathogenesis of various dermatoses, especially those accompanied by itching, therefore neuropharmacological agents are important in the treatment of such diseases. In addition to medications, non-drug methods of influencing the nervous system, primarily psychotherapy and physiotherapy, are widely used in the treatment of skin diseases.
Psychotherapy is one of the components of successful treatment of patients with dermatoses. Psychotherapy primarily involves influencing the patient with words and behavior. Psychotherapy should be carried out taking into account the neuropsychological state of the patient and eliminate possible sources of iatrogenicity. Patients should be taught that their illness is curable, even in cases of severe skin disease. The doctor must patiently listen to the patient's complaints. The prescription of each drug must be accompanied by an explanation in accessible form the principle of its positive action, time and doses of its use.
To improve the activity of the nervous system in patients with dermatoses, it is necessary to normalize sleep and the rhythm of wakefulness and sleep.
Non-drug methods of influencing the central nervous system include electrosone, acupuncture and transcutaneous electrical nerve stimulation (TENS).
Electroson has a positive effect on functional disorders of the central nervous system, leading to an improvement in the general condition of patients. This method is based on the effect on the nervous system of a weak pulse current with a certain oscillation frequency. Under its influence, physiological sleep or a state close to it occurs.
Reflexology, acupuncture (acupuncture), The therapeutic effect of which is based on neuroreflex mechanisms, has a normalizing effect on the central nervous system and its autonomic component, and also reduces or even eliminates itching. In this regard, various types of acupuncture are quite widely used in the treatment of various dermatoses, primarily itching.
The leading role in the antipruritic effect of TENS is played by the opioid and serotonergic mechanisms of the endogenous antinociceptive system.
Neuropharmacological therapy. Many common dermatoses are accompanied by itching, restlessness, feelings of anxiety, fear, disturbances in the rhythm of sleep and wakefulness, and sometimes a depressive state, therefore, sedatives are used to treat such patients
facilities. Psychotropic drugs affect mental functions, emotional state and behavior. In dermatology, antipsychotic drugs, tranquilizers, sedatives, antidepressants, analeptics, stimulants, ganglion-blocking and antiadrenergic drugs are used.
Hyposensitizing therapy. Allergies play an important role in the pathogenesis of many dermatoses, so their treatment is aimed at eliminating the allergen and hyposensitization. In each case of an allergic disease, an attempt must be made to detect and eliminate the causative allergen. This is possible only with monovalent sensitization, and with polyvalent sensitization it becomes impossible. If an allergen has been identified, but polyvalent sensitization has not yet developed, then specific desensitization can be performed. For this purpose, very small amounts of allergen are injected into the patient’s skin according to a certain scheme, gradually increasing their concentration.
More often in dermatology, nonspecific hyposensitization with antihistamines, sodium hyposulfite, calcium preparations, corticosteroids, etc. is used.
Many antihistamines also have antiserotonin, sedative and anticholinergic properties. The principle of their action is based on blocking histamine receptors on cells. The most commonly used antihistamines in dermatological practice are those related to HI receptor blockers: diphenhydramine, diazolin, diprazine, tavegil, fenkarol, kestin, claritin, zyrtec, tinset.
In order to naturally produce antihistamine antibodies in the patient’s body and increase the ability of serum to inactivate free histamine, histaglobulin is used, which is injected subcutaneously.
The most commonly used calcium preparations are calcium chloride, calcium gluconate and calcium lactate. They have desensitizing, anti-inflammatory and sedative effect. However, calcium supplements should not be prescribed to patients with neurodermatitis with white dermographism. Sodium thiosulfate has strong hyposensitizing and detoxifying properties. Calcium preparations and sodium thiosulfate are either prescribed orally or administered intravenously.
Vitamin therapy. B vitamins have an anti-inflammatory effect, vitamins A and E regulate keratinization processes, have antioxidant and anti-infective properties, influencing the formation of immunity. Synthetic derivatives
vitamin A are retinoids (tigazone, neotigazone, roaccutane); they are widely used in patients with severe psoriasis, acne, etc. Patients with psoriasis, necrobiosis lipoidica, Raynaud's disease, scleroderma, and vasculitis are indicated a nicotinic acid and other vasodilating drugs that improve microcirculation (dipromonium, trental, xanthinol nicotinate, etc.).
Vitamin D 2 is used to treat ulcerative forms of tuberculosis of the skin and mucous membranes, vitamin D 3 is used to treat psoriasis.
Hormone therapy has found particularly wide application in dermatology. The introduction of glucocorticoids into dermatological practice in the 50s of the last century changed the prognosis of many diseases, primarily pemphigus and systemic lupus erythematosus. Permanent treatment with these drugs not only prevents the death of patients, but in most cases restores their ability to work. For a number of other dermatoses, corticosteroids quickly stop severe exacerbations (toxicoderma, atopic dermatitis, eczema, dermatomyositis, bullous pemphigoid, etc.).
The use of corticosteroids in the treatment of dermatoses is based on their anti-inflammatory, hyposensitizing, antiallergic, antitoxic, and immunosuppressive effects. Of the large group of corticosteroids, prednisolone, triamcinolone, and dexamethasone are mainly used in the treatment of skin diseases. For pemphigus vulgaris, acute lupus erythematosus, dermatomyositis, periarteritis nodosa, and erythroderma, the administration of corticosteroid hormones is vital even with certain relative contraindications to therapy with these hormonal drugs. The use of corticosteroid hormones in other dermatoses should be limited to cases that cannot be treated with other means. This is due to the fact that corticosteroid hormones have a morbidistic effect, causing an improvement in the process only for the period of their use, and then you have to resort to maintenance doses for a long time.
The possibility of side effects and complications, the number and severity of which increase with increasing dose and lengthening the period of use, makes one cautious about prescribing corticosteroids. Rapid withdrawal of steroid drugs can lead to severe complications (“withdrawal syndrome”). Doses are reduced gradually and over a longer period of time, the higher the dose and the longer the corticosteroid was used. When treated with corticosteroids
You should limit your intake of table salt and prescribe a diet rich in proteins and vitamins. With long-term use of steroid hormones, which contribute to excessive excretion of potassium from the body, patients are prescribed potassium preparations (potassium acetate, potassium orotate, potassium chloride, panangin) from the first day of treatment.
Long-term use of steroid hormones, especially in large daily doses, can lead to the development of severe complications and side effects. Most often there is a so-called Cushingoid syndrome (Cushingoid): Due to uneven deposition of fat, the face takes on a moon-shaped appearance, the supraclavicular fossae are filled with fat, and the stomach becomes large. The subcutaneous fatty tissue on the extremities becomes thinner, hair growth increases, acne appears, and skin atrophic stripes (striae). In addition, blood pressure may increase (steroid hypertension), to appear steroid diabetes, peptic ulcer disease worsens, sometimes with bleeding as a result of perforation of a peptic ulcer (cortisone perforation), the tuberculosis process in the lungs will worsen. Other foci of focal and general acute and chronic infection may become active due to the suppression of the immunobiological defenses of the macroorganism. Vascular thrombosis may develop due to an increase in blood prothrombin, amenorrhea may occur, mental disorders cannot be excluded (first euphoria, then depression), osteoporosis (usually the spine), etc. Due to the possibility of these complications during corticosteroid therapy, it is necessary to monitor your appetite, blood pressure, body weight of patients, diuresis, examine urine and blood for sugar, determine chlorides and urea in urine, examine potassium, calcium and sodium, blood coagulability, platelet count, prothrombin index, etc.
Anabolic hormones have a positive effect on nitrogen metabolism, delay the release of potassium, sulfur and phosphorus necessary for the synthesis of proteins, and promote the fixation of calcium in the bones. When anabolic hormones are prescribed, an increase in appetite, an improvement in the general condition of patients, and an acceleration of calcium deposition in the bones (for osteoporosis) are noted, so they are indicated for long-term use of steroid hormones. Nerobolil, retabolil, methandrostenolone and other anabolic steroids have a weak androgenic effect and are therefore not indicated for men with adenoma prostate gland, and for women - in the follicular (estrogenic) stage of the menstrual cycle.
Other hormonal drugs used according to indications include dash-one, gonadal hormones, etc.
Adrenergic blocking drugs. In patients with chronic recurrent dermatoses as a result of a pathological state of the neuroendocrine system, visceral disorders, it is necessary to briefly interrupt the flow of viscerodermal and neurodermal impulses into the skin, promoting regression of the inflammatory process. Ganglion blockers are used to treat diseases associated with impaired peripheral circulation (scleroderma, endarteritis, acrocyanosis, atrophoderma).
Antibiotic therapy. Many antibiotics are used to treat patients with infectious dermatoses. Antibiotics are prescribed for syphilis and other sexually transmitted diseases, tuberculous skin diseases, erysipelas, erysipeloid, anthrax, as well as scleroderma. Biosynthetic penicillins (benzylpenicillin, benzathine-benzylpenicillin, penicillin), semisynthetic penicillins (ampicillin, amoxicillin, augmentin) are especially widely prescribed. From the group of cephalosporins, kefzol, zinnat, rocephin, etc. are used in dermatovenerological practice. From the group of tetracyclines, doxycycline, oxycycline, metacycline, tetracycline are most often prescribed; macrolides (erythromycin, su-mamed, rovamycin, rulide). For external use, synthomycin liniment, lincomycin, heliomycin, and tetracycline are used.
For dermatomycosis Antifungal agents are widely used - lamisil, orungal, amphoglucamine, griseofulvin, nystatin. For pyodermatitis and mycoplasmosis, it is advisable to use antibiotics from the lincosamide group (lincomycin, clindamycin, etc.).
The disadvantage of all antibiotics is toxicoallergic complications and side effects - dermatitis, toxicoderma up to toxic epidermal necrolysis (Lyell's syndrome), urticaria, itching, anaphylactic reactions. In these cases, antibiotics are canceled or combined with antihistamines and vitamins (ascorbic acid, calcium pantothenate or calcium pangamate).
Synthetic antimalarial drugs, those. drugs of the quinoline series, namely quinamine (delagil, resoquine, chloroquine) and hydroxychloroquine (plaquenil), are quite widely used for various skin diseases.
Their therapeutic effect is based on the ability to reduce the sensitivity of the skin to sunlight, as well as somewhat stimulating
stimulate the production of corticosteroids by the adrenal cortex. Apparently, this is due to their anti-inflammatory and hyposensitizing effects. These drugs are prescribed to patients with lupus erythematosus, photodermatoses, arthropathic psoriasis, lichen planus, etc.
Antimycotic agents act mainly on fungi of the genus Candida(miconazole, ketoconazole, fluconazole, nystatin, levo-rin), on dermatophytes (griseofulvin, tolnaftate, tolcyclate, oxyconazole), on the structure and function of the cell wall of fungi and the synthesis of nucleic acids (amphotericin B, natamycin, terbinafine, naftifine, amorolfine ), on the processes of transmembrane exchange in fungal cells (batrafen), etc.
From biologically active drugs heparin is used in the treatment of a number of dermatoses (psoriasis, pemphigus, vasculitis); for dermatoses accompanied by an increase in hyaluronic acid in the connective tissue (scleroderma), lidase.
For dermatoses accompanied by joint damage, for example, arthropathic psoriasis, non-steroidal anti-inflammatory drugs (indomethacin, ortofen, naprosyn, mefenamic acid, rengazil, surgam, etc.) are successfully used. In order to activate phagocytosis, accelerate regenerative processes, and mobilize the body's defenses in the treatment of a number of dermatoses, the use of methyluracil and pentoxyl is indicated. According to indications for the treatment of various skin diseases, general tonic agents (iron preparations, calcium glycerophosphate, zinc preparations, fish oil, etc.) can be prescribed.
Immune therapy. An important role in the treatment of dermatoses, the pathogenesis of which involves disorders of the immune system, is played by immunocorrective therapy, including agents that both stimulate and inhibit immune processes. Along with thymus-specific drugs (thymalin, thymosin, tactivin, etc.), chemical immunomodulators (levamisole, isoprinosine) and lycopid (a structural component of bacterial cell walls) have become widespread.
For severe bacterial and viral infections with signs of humoral immune deficiency, gamma globulin preparations (native plasma, human gamma globulin, antistaphylococcal gamma globulin, etc.) are prescribed.
Lymphokines and other cytokines used as immunomodulators, which became possible with the improvement of hybridoma technology, genetic engineering and the possibility of obtaining recombinant
drugs. Interferons (α, β, γ) are cytokines that regulate cell growth and reproduction. They protect the body from infection by viruses and inhibit the growth of malignant cells. Their antiviral effect is carried out through disruption of the synthesis of viral RNA and viral proteins in the cell. Changing the properties of the cell membrane leads to the degradation of foreign genetic information, which is used to suppress the growth of bacteria and fungi. Indications for the use of recombinant interferons are AIDS, chlamydia and other sexually transmitted diseases, viral diseases, Kaposi's sarcoma, mycoses.
Recently, a promising therapeutic direction has been developing, which consists in obtaining recombinant monoclonal antibodies that act on cell adhesion molecules and pro-inflammatory cytokines (anti-cytokine therapy). As a result, the activation of T-lymphocytes in the lymph nodes, the cytotoxic activity of CD8 lymphocytes, and the migration of T-lymphocytes to foci of inflammation (in particular, psoriatic ones) are suppressed.
Immunosuppressive therapy used in the treatment of autoimmune dermatoses (lupus erythematosus, pemphigus), as well as psoriasis and a number of other dermatoses. A combination of cytostatics (methotrexate, azathioprine, mercaptopurine, cyclophosphamide) with glucocorticosteroids is rational.
An effective immunosuppressive drug that suppresses the secretion of lymphokines (including interleukin-2) is sandimmune (cyclosporine, neoral), prescribed at 1.25-2.5 mg/kg. It is used in the treatment of pemphigus, psoriasis, atopic dermatitis, etc.
Medical nutrition- an important factor influencing a wide variety of dermatoses. This is especially true for patients with allergic dermatoses, in which etiological factor may be one or another food product. In this case, its exclusion from the diet leads to recovery or at least to a weakening of the symptoms of the disease. In addition, in the diet of patients with allergic dermatoses, the amount of carbohydrates, citrus fruits, nuts, honey, concentrates, coffee, and table salt should be limited. Spicy foods and alcoholic drinks are prohibited. Patients with Dühring's dermatitis herpetiformis should not consume foods containing gluten; patients with psoriasis should not consume animal fats while limiting carbohydrate intake; patients with xanthoma should not consume animal fats, including butter, sour cream, and milk.
5.2. External therapy
Local treatment, like general therapy, always requires an individual approach. The success of external therapy depends on correct consideration of the nature of the dermatosis (acute, subacute, chronic), the stage of the process (progressive, stationary, regressive), the depth and localization of the lesions, the pharmacological properties of the prescribed medication, indications and contraindications for its use, the concentration and dosage form of the external agent . The most demonstrative example is eczema, in which external therapy depends on the form of eczema, its stage, location and other factors. Strict individualization of external treatment and constant monitoring of the patient are necessary, since it is often necessary to replace drugs (if they are intolerant or become accustomed to them) or change the dose. One of the basic rules of local treatment for a number of skin diseases is to first use a weak concentration of drugs with a gradual increase and transition to more active drugs. At the same time, there are forms and stages of skin diseases in which the use of potent local medications is indicated, for example, some infectious dermatoses (trichomycosis, scabies, etc.).
In acute and subacute forms of the inflammatory process, you should use mainly dosage forms with the surface action of the agents they contain (lotions, shaken suspensions, powders and pastes). In the case of chronic and deep processes, one should prefer dosage forms that allow the substances to act more deeply (ointments, compresses, etc.). However, there are exceptions to this rule. For example, glucocorticoid ointments can be used in the acute stage of the inflammatory process, since the effect of the steroid covers the “adverse” effect of the ointment base.
The general rule: the more acute the inflammatory process, the more superficial the dosage form and the anti-inflammatory substances included in it should act. Thus, lotions, powders, shaken mixtures act more superficially than pastes, and pastes - more superficially than ointments, compresses, etc. The concentration of the medication included in the dosage form is also important. External agents, according to the degree of their effect in depth, can be arranged in ascending order: powders, lotions, shaken mixtures, pastes, ointments, compresses, glues, patches, varnishes.
Before using any external medicine, you should clean the lesion from pus, crusts, scales, scraps of vesicles and blisters. However, it is impossible to forcibly remove scales, crusts, and ointment residues. Such areas are generously lubricated with sunflower, linseed or other vegetable oil, after 15-20 minutes the lesion is re-treated or the oil dressing is left for a longer time. Contaminated erosions and ulcers are treated with a 3% hydrogen peroxide solution. The skin around the lesions with pyoderma and other infectious dermatoses is wiped with camphor, 2% salicylic or 2% boric alcohol.
Some medicinal substances can cause allergic contact dermatitis, for example antibiotics, iodine tincture, tar, etc. In very rare cases, skin cancer develops at the site of tar preparations used for years.
5.2.1. The main methods of external use of drugs in dermatology
Powders consist of powdery substances that are applied to the affected area in an even thin layer. The powder dries and degreases (due to hygroscopicity) the skin, cools it (as a result of increased heat transfer) and helps to narrow the superficial blood vessels of the skin. This helps reduce hyperemia, swelling (especially in skin folds), sensations of heat and itching. However, when the lesions become wet, powder is not used, since together with the exudate they form crusts that intensify the inflammatory process and irritate the skin. Powders are used against excessive sweating and increased sebum secretion.
Powders consist of mineral or plant powders. The mineral substances most often found in powders include magnesium silicate - talc. (Talcum), zinc oxide (Zincum oxydatum), from vegetable - wheat starch (Amylum tritici). Starch can be fermented, so it should not be consumed if there is excessive sweating, especially in the skin folds. Some drugs in powder form are added to powders to treat erosions and ulcers.
Rp: Zinci oxydati Talci veneti - 10.0 M.D.S. Powder
Rp: Zinci oxydati Talci veneti a - a 15.0 Dermatoli Bolus albae - 10.0 M.D.S. External
Rp: Zinci oxydati Talci veneti Amyli aa 10.0 M.D.S. Powder
Lotions in the form of aqueous and alcoholic solutions in dermatology, it is often used as an anti-inflammatory, astringent or disinfectant. Moisten 4-6 gauze napkins or soft cloth with cooled medicinal solutions, wring them out and apply them to the affected wet area. The lotions are changed after 5-15 minutes (as they dry and warm up) for 1-1.5 hours; The entire procedure is repeated several times a day. Most often, 1-2% tannin solution, 0.25-0.5% silver nitrate solution (lapis), 2-3% boric acid solution, 0.25-0.3% lead water (Aqua plumbi) are used for lotions. . Lotions with a solution of boric acid are prescribed with caution due to possible toxic effects.
If there is a purulent infection in the areas of acute inflammatory lesions, then disinfectant lotions are used: 0.1% solution of ethacridine lactate (rivanol), solutions of furatsilin (1:5000), potassium permanganate (0.05%), resorcinol (1-2% ).
Wet-dry dressing. This dressing is prepared according to the same principle as the lotion, but there are more layers of gauze (8-12) and the dressing is changed much less frequently (every 1/2-1 hour or more) as it dries. The top of the wet-dry bandage is covered with a thin layer of absorbent cotton wool and bandaged. These dressings help to subside the symptoms of acute inflammation, since the slowly evaporating liquid causes cooling of the skin (however, less actively than a lotion).
Lubrication produced with aqueous or alcoholic solutions of aniline dyes (for example, brilliant green), aqueous
alcohol solutions of menthol (1-2%), silver nitrate (2-10%), fucorcin.
Agitated suspensions (chatterers) There are water and oil. These are the same powders, but suspended in water and glycerin and therefore do not fall off quickly from the surface of the skin. After the water evaporates, the powders (they make up 30-45% of the mass of the mash) are deposited on the skin in a thin, uniform layer and are retained on it for a long time thanks to glycerin. Thus, talkers, like lotions, have an anti-inflammatory and drying effect.
The most commonly used powdered substances are zinc oxide, talc, white clay, and starch. Aqueous shaken mixtures act in the same way as powders: anti-inflammatory, soothing itching and burning.
Rp: Zinci oxydati Talci veneti Glycerini
Aq. destillatae a - a 25.0
M.D.S. Shake before use
Water-alcohol shaken mixtures contain 96% ethyl alcohol.
Rp: Zinci oxydati Talci veneti Amyli tritici a - a 30.0 Glycerini
Sp. Vini rectif. 96% aa 25.0
Aq. destill. ad 220.0
M.D.S. External (water talker)
Oil mash consists of powdery substances and a liquid fat base (sunflower, peach or vaseline oil). An oil shaken mixture called "zinc oil" is often used, which contains 30% zinc oxide and 70% vegetable oil. Oil mixtures soften the skin, reduce the feeling of tension, tightness and help remove scales and crusts.
Rp: Zinci oxydati 30.0 Ol. Helyanthi 70.0
M.D.S. External (oil chatter)
You can add sulfur preparations, ichthyol, tar, menthol, etc. to chatterboxes.
Water and oil suspensions are shaken and applied with a piece of cotton wool to the affected area (with swelling and acute inflammatory erythema), where they quickly dry. They are not applied to the scalp.
Shaked suspensions are used for acute, subacute and aggravated inflammation of the skin (dermatitis, eczema, etc.), the absence of weeping and excessive dryness of the affected areas of the skin. The advantage of shaken suspensions is the possibility of their use without applying bandages.
Pastes They are a mixture of equal mass parts of indifferent powders (zinc oxide, talc, starch, etc.) and a fat base (lanolin, petroleum jelly, etc.). The official zinc paste has the following formula:
Rp: Zinci oxydati Amyli tritici a - a 10.0
Vaselini 20.0
M.D.S. External
Rp: Zinci oxydati Talci pulverati Lanolini Vaselini a - a 10.0 M.D.S. External
Pastes act more deeply than shaken mixtures, but are less active than ointments; they have an anti-inflammatory and drying effect. The viscous consistency of the pastes allows you to apply them without a bandage. Do not use them on the scalp when it gets wet. The paste is applied to the skin 1-2 times a day; Once every 3 days, it is removed with a swab moistened with vegetable oil.
By reducing the amount of powdery substances, soft pastes can be prepared. According to indications, naphthalan, ichthyol, sulfur preparations, tar, etc. are added to the paste.
Compresses have a warming effect and are designed to absorb skin infiltrates, reduce inflammation, and protect affected areas from external influences. For compresses, alcohol, drilling fluid, and lead water are mainly used.
Oils in its pure form (peach, flaxseed, sunflower, olive, etc.) are used to cleanse affected areas of the skin from secondary pathological deposits and remove remnants of used medicinal substances.
Ointment contains one or more medicinal substances evenly mixed with a fatty ointment base (vaseline, lanolin, lard, naphthalan, etc.), which must be chemically neutral (so as not to cause skin irritation) and have a soft, elastic consistency that does not change under the influence of body temperature.
Ointment bases made from synthetic substances are increasingly used: polymers of ethylene oxides, cellulose derivatives, esters of sorbitan and higher fatty acids, etc. Ointments on such a basis penetrate the skin better and are more easily released from the drugs included in them, do not oxidize or decompose, and are good transferred by skin.
Ointments have a deep effect, so they are prescribed for chronic and subacute diseases, for inflammatory infiltrate in the skin (absorbable or keratoplasty ointments). Keratoplasty substances include naphthalan, tar, and ichthyol. Detachment of the stratum corneum (keratolytic effect) is caused by salicylic acid (in ointment at a concentration of 5%) and lactic acid. For more information about keratolytic ointments, see the section “Treatment of ringworm.”
They use 2-10% sulfur ointment, 2-3% tar, 1-3% white mercury, 2% salicylic, 2-5% ichthyol, 2-3% naphthalan ointment, etc. They use ointments with antibiotics (2.5-5 % erythromycin, tetracycline, lincomycin, etc.). During treatment vesicular lichen for herpes zoster, interferon, oxolinic ointment, acyclovir, etc. are used.
Cream used for dry skin, decreased elasticity and minor inflammatory phenomena. Lanolin (animal fat) included in the cream makes the skin softer and more elastic. The water in the cream cools the skin and has an anti-inflammatory effect. The cream is well tolerated by the skin, but for children, Vaseline, which irritates the skin, is replaced with castor or sunflower oil. Unna's cream is widely used, as well as “Children's”, “Spermaceti”, “Delight” and others produced by the perfume industry. In Unna's cream, instead of Vaseline, it is more advisable to use vegetable oil (olive, peach, sunflower, castor): Lanolini, Ol. Helyanthi, Aq. destill. a-a.
Ointments, creams and aerosols containing corticosteroids and having an anti-inflammatory and hyposensitizing effect are widely used in medical practice. In case of severe inflammation or weeping, it is more advisable to use aerosols.
Numerous steroid ointments and creams are produced: betnovate, dermovate, fluorocort, elocom, cutivate, laticort, triacort, locacor-ten, celestoderm, sinaflan. New synthetic non-halogenated corticosteroids have been created - Advantan, Apulein, Lokoid, Dermatop, Elokom. For the treatment of dermatoses complicated by bacterial infection, triderm, belogent, diprogent, celestoderm B, sina-lar N, flucinar N, polcortolone TS, cortimycetin are used; drugs with anti-inflammatory, antimicrobial and antifungal action are triderm, sinalar K, sikorten plus, lotriderm, travocort, sangviritrin.
In recent years, ointments and gels have been used, prepared on the basis of liposomal emulsions, which include biologically active substances from medicinal plant extracts and cytokines. Glycyrrhizin and keratin were used as thickeners. Liposomes are a model of a living membrane and consist of natural lecithin, which is part of biological membranes. These artificial membranes interact more effectively with cell membranes (fusion, passage through the lipid layer, etc.). They can include hydrophilic, hydrophobic and amphiphilic substances and carry a very wide range of drugs.
Varnish - a liquid that quickly dries on the surface of the skin to form a thin film. Most often, the varnish consists of a collodion into which various medicinal substances are introduced (Ac. salicylicum, resorcinum, gryseofulvinum, etc.). Typically, varnish is used when you want to have a deep effect on the tissue (for example, on the nail plate) and in a limited area.
Rp: Ac. lactic
Ac. Salicylici
Resorcini a - a 10.0
Ol. Ricini 3.0
Collodii ad 100.0
M.D.S. Varnish for lubricating vulgar plantar warts, calluses, as well as nail plates affected by fungus.
Varnishes like Loceryl and Batrafen are widely used for the treatment of onychomycosis.
Based on the nature of their action, all external agents are divided into several groups. Thus, there are anti-inflammatory, antipruritic, disinfectant, keratolytic and keratoplasty, cauterizing, fungicidal and other agents. This division of external means is convenient
Anti-inflammatory drugs are used for lotions, powders, shaken mixtures, pastes, as well as corticosteroid ointments and creams.
Keratoplasty, or reducing agents in low concentrations also have an anti-inflammatory effect. These are ichthyol, preparations of sulfur, tar, naftalan oil and naftalan, the drug ASD (3rd fraction), etc., used mainly in the form of ointments and pastes for chronic non-acute inflammatory skin lesions.
TO keratolytic The products mainly include various acids (salicylic acid, as well as lactic and benzoic acid are especially widely used) and alkalis of 3-15% concentration, used to exfoliate the superficial parts of the stratum corneum.
Antipruritic substances can be divided into two groups. The first consists of agents (in solution, ointment, cream) with only antipruritic action: menthol, anesthesin, vinegar solutions, thymol, chloral hydrate, etc. The second group includes agents that act anti-inflammatory or keratoplastically and at the same time reduce itching: tar and sulfur preparations, salicylic acid , corticosteroids in ointments and creams.
Cauterizing and destructive agents include salicylic acid and resorcinol (in high concentrations), silver nitrate, lactic acid, podophyllin solution, pyrogallol, acetic and trichloroacetic acids, caustic alkalis, etc.
Patients with fungal diseases are prescribed fungicidal agents, which include iodine (2-5% alcohol solutions), aniline dyes, undecylenic acid preparations, as well as sulfur and tar in the form of ointments.
Quinine, salol, tannin, and para-aminobenzoic acid have photoprotective properties.
The publisher is not responsible for possible consequences arising from the use of information and recommendations of this publication. Any information presented in the book does not replace specialist advice.
Introduction
According to the World Health Organization, more than 20% of the world's population suffers from skin diseases. At the same time, the number of patients increases every year. The most common ailments are dermatitis of various origins, eczema, acne (acne) and psoriasis. Many of them are chronic, relapsing and difficult to treat. Despite the development in dermatology of quite effective methods of traditional therapy for diseases such as rosacea, demodicosis, psoriasis, none of them leads to a complete cure, but only temporarily keeps the disease under control. In addition, in some cases, the effectiveness of using the same method decreases over time, and the doctor has to look for a new method each time.
Like most sciences, medicine throughout its existence has developed in two ways: from the whole to the particular and from the particular to the whole. The first path involves an in-depth and detailed study, diagnosis and treatment of diseases of individual organs, while the increasingly narrow specialization of doctors often leads to a loss of skills in working with the body as a whole. The second way, based on ideas about the integrity of the body, is aimed at searching for the root causes of diseases and eliminating the internal causes of their development. Our official medicine often fights not with the disease itself, but with its manifestations and symptoms, trying to suppress them. So the queues for cosmetologists for patients with rosacea and demodicosis are growing, who were sent there by dermatologists who forgot that the human body is a single whole and there is an inextricable connection between its parts. In addition, psoriasis, eczema, rosacea and demodicosis are diseases of unknown origin, i.e. the causes of their occurrence may be problems with hormones, the nervous system, the gastrointestinal tract, and the immune system - and doctors Often there is only one answer to all this: such and such an ointment and such and such tablets. It is possible to cure these ailments, from which many have suffered for years and decades, only by approaching therapy comprehensively - this means that treatment should not only be systemic and local, but also include many methods of physiotherapy and oriental medicine, and even psychotherapy - yes, yes, it gives very good results for rosacea, psoriasis and eczema good effect.
This book presents 28 ways to cure skin diseases - both traditional and alternative. All methods are supported by information about clinical studies conducted at various institutes, all recipes are tested on themselves and are based on real stories of people who were cured of them. Yes, some are helped by mud therapy, others by mesotherapy, and others by simple fasting or a raw food diet. Yes, the cure will not come right away, with a snap of your fingers, but it is definitely waiting for you ahead. Try to go from simple to complex - start with yoga, homeopathy, Sytin's moods, juice therapy, Edward Bach's flower essences. It is important to try everything in the fight against the disease, clearly move towards your goal, without retreating a step, and believe in success. And you must agree that 28 methods are much more than they can offer you at the district clinic. Praemonitus praemunitus - as they say, forewarned is forearmed. So, let's go.
Part 1
Causes of skin diseases
Rosacea, demodicosis, psoriasis and eczema are diseases whose genesis is not clearly defined. All of these ailments can occur for many different reasons.
1. Hormonal disorders
Hormones are substances that are produced in the body by specialized cells or organs and affect the activity of other organs and tissues. Hormones are involved in the regulation of all vital processes - growth, development, reproduction, metabolism. When shifts occur in the hormonal system, this negatively affects many systems of the body, including the excretory system.
As is known, rosacea mainly affects women in premenopausal and menopause. The results of a survey conducted at the St. Petersburg Medical Academy of Postgraduate Education and the Department of Dermatovenereology of St. Petersburg (Mozharova M.V., Raznatovsky K.I.) showed that the majority of patients had reduced hormonal function of the ovaries - in particular, a decrease in estradiol levels was observed in blood. In addition, the gonadotropic function of the pituitary gland was manifested in a sharp increase in FSH and LH, and the level of cortisol was also increased. Also in the pathogenesis of rosacea, the involvement of changes in the metabolism of sex steroid hormones (H. Aizawa and M. Niimura) and adrenal insufficiency (H. Ritter and J. Wadel) was found.
When examining patients with demodicosis, 67% indicated the presence of hormonal dysfunctions.
One of the causes of psoriasis may also be problems in the functional state of the gonads - an exacerbation of the disease has been noted during menstruation and during breastfeeding.
Hormonal imbalances in the body can trigger the appearance of eczema.
2. Reduced immunity
Antibodies or immunoglobulins are special proteins that are found in human blood and are used by the immune system to identify and neutralize foreign objects - such as bacteria and viruses. When the level of antibodies for some reason increases or decreases, a person has problems with immunity, which means the risk of getting sick increases. Allergies occur as a common reaction to problems with the immune system.
There is evidence that immune system disorders may be a cause of rosacea. Thus, patients showed a significant increase in the level of immunoglobulins of all three classes: A, M, G - regardless of the duration and stage of the disease. Deposits of immunoglobulins and an increase in the absolute number of “total” and “active” rosette-forming cells and a decrease in the number of T-suppressors were also detected. In addition, in patients with rosacea, single antinuclear antibodies and antibodies to collagen IV extracted from lymphocytes were detected, which is regarded as immune disorders that developed due to chronic damage to connective tissue by solar radiation.
One of the theories for the occurrence of psoriasis is the immune theory. It has long been noted that the disease often occurs when the body is exposed to provoking factors, for example, foci of infection (chronic tonsillitis and others), which contributes to a serious disruption of immune processes. Psoriasis is defined as a systemic disease, manifested in the form of immune-dependent dermatosis (Yu.K. Skripkin, 1993; A.M. Shutina, 1995).
Allergy is interpreted as a pathological immune reaction, which is accompanied by damage and inflammation of body tissues, therefore, in the pathogenesis of eczema, the main importance is given to immune changes. For example, in patients with eczema, dysgammaglobulinemia is noted - the level of IgG, IgE is increased and IgM is decreased, the number of functionally active T-lymphocytes is reduced, the total number of T-cells is insufficient, the ratio of helper and suppressor subpopulations is changed, which is why the level of B-lymphocytes is increased .
3. Slag-laden body, polluted liver and blood
In the modern world, it is difficult to find time for proper nutrition - we often snack on the go, without even thinking about the usefulness of the food entering the body. Is our poor nutrition with a large amount of sugar and fat causes metabolic disorders, which, in turn, leads to the appearance of pimples, blackheads, boils and various skin diseases. In addition, the body is polluted due to poor performance gastrointestinal tract, as well as the quality of food taken - additives, artificial colors and flavors, GMOs - all this contributes to the development of putrefactive and fermentative processes in the body. The body, in particular the liver, ceases to cope with the flow of toxins, and self-poisoning occurs. Various skin formations appear - warts, moles, eczema, psoriasis, rosacea. The body signals us about internal dirt.
Numerous studies have revealed a correlation between rosacea and hepatopathy or cholecystopathy - for example, F. Auer found metabolic disorders in the liver and plasma protein composition in most patients with rosacea.
One of the theories of the occurrence of psoriasis (J.O.A. Pagano, 2001) is an autoimmune disorder associated with intestinal diseases. Due to disruption of the intestines, toxins immediately enter the bloodstream, and the liver ceases to cope with the cleansing function, resulting in psoriasis as an external manifestation of the body’s attempt to get rid of internal toxins.
4. Stress
We all know how destructive stress is to the body. Our body reacts so sensitively to negative emotions that we can already forget about some experience or suffering, and the body responds to us with rashes, itching and skin diseases.
Previously, mental factors were considered one of the main causes of rosacea. Many patients experience a high degree of neurasthenia and depression, emotional disturbances, vegetative neurosis, excessive emotionality, vulnerability.
According to one theory, psoriasis also appears as a result functional disorders nervous system - thus, it has been noted that the disease occurs or recurs after mental and physical injuries, concussions, burns. This theory is indirectly confirmed by the fact that after the use of medications aimed at normalizing the functions of the central and autonomic nervous system, patients with psoriasis experienced an improvement in their condition.
It is also believed that one of the possible causes of eczema is disorders of the nervous system. Animal studies have shown that after severe mental trauma there is a possibility of functional changes skin. In addition, the role of the nervous system in the pathogenesis of eczema is indicated by the possibility of its occurrence after damage to peripheral nerves. Indirect evidence can also be the beneficial effect that is observed when using hypnotherapy, sedatives and electrosleep.
Since the metabolic products produced by worms are foreign to the human body, i.e. allergens, the likelihood of eczema occurring is high.
6. Tick
Demodex folliculorum is a small mite with an elongated worm-like body, 0.15–0.4 mm long. First discovered in 1841 by Berger in earwax human ear canal. They live on the skin of the face (nasolabial fold, cheeks, nose, chin), eyelashes, ears, scalp, neck, meibomian glands, skin follicles.
7. Hypovitaminosis
The word “vitamins” itself comes from the Latin vita - “life”. Without vitamins, normal functioning of the body is impossible.
Hypovitaminosis or vitamin deficiency leads to various painful conditions. Thus, in patients with rosacea and demodicosis, a deficiency of vitamin B is often found. The connection of rosacea-keratitis with hypovitaminosis B 6 and B 12 has also been reliably proven. Vitamin K and C are prescribed to strengthen capillaries and blood vessels.
With psoriasis, vitamin metabolism is also impaired. In patients, the content of vitamin C is reduced. Vitamins A, B 6, B 12 are also insufficient in the blood. There are similar shifts between the contents of copper, zinc and iron.
There are cases of eczema arising from poor nutrition, deficiency of proteins and B vitamins. In addition, many patients have vitamin A hypovitaminosis.
8. Problems with blood vessels
Another theory for the occurrence of rosacea is vascular pathology. Rashes with this disease are localized mainly over the inactive muscles of the face. Under a microscope, abnormalities of the capillary endothelium are detected in these places on the skin. It is assumed that blood and lymphatic vessels are not initially involved in the inflammatory process. Meanwhile, research shows that dysregulation of the brain's influence on the blood vessels of the facial skin plays a significant role in the pathogenesis of rosacea. Due to these disturbances, the redistribution of blood flow slows down and venous stasis (blood stagnation) occurs in the area where rashes most often appear. The area where the facial vein drains also includes the conjunctiva, which explains the frequent involvement of the eyes (rosacea keratitis) in this disease.
Helicobacter pylori (Helicobacter pylori) is a gram-negative bacterium that infects various areas of the stomach and duodenum, in particular, is the cause of chronic active gastritis type B.
There are conflicting data regarding the correlation of detection of the bacterium in patients with rosacea. For example, in 1992, Schneider M. A. et al. detected antibodies to H. pylori in only 49% of patients. In 2000 (A. E. Rebora et al.) of 31 patients with rosacea, H. pylori was found in 84% of cases. In 2001 V.P. Adaskevich et al identified Helicobacter in 18 of 20 patients with rosacea. Research (Arifov S.S., Babajanov O.A.), conducted on the basis of the Tashkent Institute for Advanced Training of Physicians of the Ministry of Health of the Republic of Uzbekistan, showed that out of 28 patients with rosacea, Helicobacter pylori infection, determined by specific immunoglobulins to the Helicobacter pylori antigen using the ELISA method, was found in 15 patients. It is worth noting that of these 15 patients, 7 suffered from diseases of the gastrointestinal tract, and 8 did not. In addition, in the control group, which included patients with other dermatoses, Helicobacter was found in only 3 out of 14 patients.
Part 2
28 New Treatments for Skin Diseases
Chapter 1
Traditional medicine
Dermatology as a branch of traditional medicine involves an integrated approach to the treatment of diseases such as demodicosis, rosacea, psoriasis and eczema. As a rule, the general treatment regimen for all these ailments looks like this: local treatment - creams, ointments, gels, systemic treatment - antibiotics, antihistamines, physiotherapy, vitamin therapy and immunotherapy, as well as appropriate therapy when various concomitant diseases are identified. However, local doctors often do not approach the treatment of these ailments seriously and comprehensively enough, and people are forced to suffer from illnesses for years.
Pyrethorin is contained in 4% permethrin cream from LMP.
In addition to physical therapy for demodicosis, consultations are prescribed for the examination and treatment of concomitant gastrointestinal diseases, it is recommended to take vitamins and correct immunological and neurological disorders - with the use of appropriate medications.
At the initial stage of the disease, it is advisable to use lotions from a 1-2% solution of boric acid, 1-2% solution of resorcinol, adrenaline, as well as lotions from various herbs (chamomile, linden blossom, yarrow, celandine, horsetail, sage, rose petals, string , St. John's wort, marshmallow root) and tea. In the absence of papules and pustules, it is recommended to massage the face to enhance lymphatic drainage and relieve swelling. Local treatment also includes ointments with ichthyol, naphthalan or metronidazole, the drug Skinoren or other drugs based on azelaic acid.
As systemic therapy, tetracycline antibiotics and macrolides - erythromycin, oleandomycin - are indicated. The starting dose of tetracycline and oxytetracycline is about 1000-1500 mg per day 3-4 times a day. Then the dose is reduced to maintenance - 250–500 mg per day. The initial dose of doxycycline is 200 mg/day, maintenance dose is 100 mg, minocycline is 100 and 50 mg, respectively. Treatment with tetracyclines usually lasts for 10–12 weeks. Therefore, it is advisable to prescribe maintenance therapy in the form of antihistamines, probiotic and prebiotic medications. Erythromycin is prescribed 500–1500 mg per day, roxithromycin - 150 mg twice a day, clarithromycin - 150 mg twice a day. The mechanism of action of antibiotics for rosacea is not completely clear. Studies back in 1958 (R. Aron-Brunnetiere et al.) showed that when treated with chloromycetin and aureomycin, regression was observed in 90% of cases.
Metronidazole preparations, such as Rosamet, are widely used in external therapy for rosacea. Treatment with Rosamet lasts from 2 to 4 weeks. It is also common to prescribe synthetic retinoids - isotretinoin or roaccutane, but the drug has too many side effects.
Good clinical results have been shown by therapy with the drug "Eglonil", which is prescribed for asthenic and asthenodepressive conditions, as well as somatic disorders of a neurogenic nature. (M.V. Cherkasova and Yu.V. Sergeev). This is explained by the fact that the early stages of rosacea are often associated with psycho-emotional factors.
An essential part of the complex treatment of rosacea and demodicosis is vitamin therapy - it is recommended to take ascorutin for 2-3 months, repeating the course after 2-3 weeks.
Also, taking into account neurogenic factors, it is advisable to take B vitamins - B 1 and folic acid, multivitamins. In addition, immunomodulatory drugs are prescribed - interferon preparations, Likopid, Kemantan, Glyciram, sodium nucleinate, Polyoxidonium and others.
Psoriasis is treated in combination with systemic and external therapy, physiotherapy, vitamin therapy and immunotherapy.
Local preparations include ointments and creams with salicylic acid, sulfur, urea, dithranol and glucocorticoid creams and ointments - they are prescribed, as a rule, in the progressive stage. When an exacerbation occurs repeatedly, it is advisable to use fluoridated drugs - Betamethasone, Vipsoral - or non-halogenated glucocorticoid ointments. Recently, the prescription of “Calcipotriol”, a synthetic analogue of the most active metabolite of vitamin D3, which has anti-inflammatory and immunocorrective properties, has become widespread. It is worth remembering that ointments become addictive, so they must be alternated regularly.
Systemic therapy for psoriasis consists of taking aromatic retinoids - “Etretinate”, “Acitretin”. It is also recommended to take Cyclosporin A, a cyclic polypeptide with an immunosuppressive effect. The drug is usually prescribed to patients with severe forms of psoriasis, when conventional therapy does not have the desired effect or there are contraindications to other treatment methods.
Vitamin therapy is indicated in the form of taking vitamins A, B and C, as well as polyunsaturated fatty acids.
Therapy for eczema also includes systemic therapy, external therapy, physiotherapy and vitamin therapy.
External therapy is prescribed depending on the clinical picture of eczema: if there are weeping rashes, lotions from a solution of silver nitrate, tannin, as well as gels - “Dimetindene” and “Fenistil”, solutions of “Furacilin”, “Dioxidine”, methylene blue, potassium permanganate are indicated , chlorhexidine, 0.5% resorcinol, 2% boric acid. The crusts are coated with aniline dyes - “Fukortsin”, brilliant green.
For the exudative form, aerosols of Polcortolone, Oxycort, Oxycyclosol, Panthenol, Aekol, and Levovinizol are used. In addition, the following ointments are prescribed: boron-tar, boron-naphthalan, 5% ASD, zinc, ichthyol, sulfur, salicylic. Steroid ointments are used: Belosalik, Beloderm, Celestoderm-B, Lokasalen, Diprosalik and others.
Systemic therapy involves taking calcium preparations - calcium chloride and calcium gluconate, sodium thiosulfate solution intravenously, hemodez solution 200–400 ml drip. Antihistamines are also prescribed - parenteral administration of clemastine, diphenhydramine, chloropyramine in combination with oral H1-histamine receptor blockers. In severe cases, it is advisable to take corticosteroids - a solution of betamethasone (Diprospan), Prednisolone.
If eczema occurs with the involvement of a purulent process, it is necessary to take antibiotics - enhanced and antistaphylococcal penicillins, cephalosporins of the first and second generations, aminoglycosides, macrolides, fluoroquinolones. In addition, non-steroidal anti-inflammatory drugs (ibuprofen, indomethacin, diclofenac) and angioprotectors - xanthinol nicotinate, pentoxifylline, dipyridamole are prescribed.
Immunocorrective agents are also prescribed - interferons, solutions of Splenin, Humisol, Plazmol, Imunofan, immunoglobulin, Myelopid, Lykopid, Kemantan, Glyciram, sodium nucleinate, Diucifon, Dimocyphon, Avlosulfone, dapsone.
Vitamin therapy consists of taking vitamins B 1, B 6, B 12, B 15, A, E, C, calcium pantothenate, and folic acid. It is recommended to prescribe gastrointestinal enzymes and biostimulating drugs - tincture of Eleutherococcus, aloe, ginseng, aralia, pantocrine.
Chapter 2
Psychotherapy
There is an opinion that all diseases arise due to psychological inconsistencies and disorders in the soul, subconscious and thoughts of a person. Also in Ancient Greece The idea of the influence of the soul and spirit on the body was widespread. One of the first to use the term “psychosomatic” was the doctor Johann Christian Heinroth in 1818.
Psychosomatics considers diseases such as atopic dermatitis, psoriasis, rosacea and eczema as psychosomatic. The first attempt to explain skin diseases as having a psychogenic nature was made in 1681 by T. Siedenchen, who described angioedema as a manifestation of hysteria. D. Turner linked rosacea and severe stress- The patient was in shock after the death of her husband. Nowadays, research results show that 25–50% of patients with rosacea experience mental trauma that preceded the development of the disease (M.V. Cherkasova, 1997; A.M. Lalaeva et al., 2003). V.P. Adaskevich (2000) reports a connection between stress and exacerbation of rosacea in 67% of cases. 25–60% of patients with psoriasis experience psychogenic effects of varying severity before exacerbation or manifestation of the disease (M. Gupta, A. Gupta, 1998). In 76% of people suffering from dyshidrotic eczema of the hands and 70% of patients with atopic dermatitis, the primary role of stress in the manifestation or exacerbation of the disease was noted (R. Griesemer 1979).
German doctor and psychotherapist Rudiger Dahlke believes that all skin diseases arise from a person’s desire to isolate himself from the world and limit his contacts. For example, a skin rash indicates that some emotions or desires are trying to get out - in adolescence growing sexuality is suppressed by a person as something new, unknown and frightening. With psoriasis, the protective function of the skin is transformed into a shell, with the help of which a person separates himself from the world, fences himself off on all sides and does not want to let anyone in or out. This suggests that the person is afraid of damage, afraid of being offended. Itchy skin indicates that something is irritating a person, that the problem was not addressed properly and now it “itches.” Itching is something that cannot leave a person indifferent, some kind of strong emotion.
To understand the cause of the disease, ask yourself the following questions:
1. Do you limit yourself too much from the world around you?
2. How are things going with your contacts?
3. Is there a suppressed desire for intimacy hidden behind your rejected action?
4. What exists inside of you that wants to break through the border to be noticed?
5. What really prevents you from living in peace?
6. Are you dooming yourself to isolation?
Dahlke argues that once you realize that a skin problem is the result of your fear or repressed emotions, it is absolutely wrong to try to get rid of it as quickly as possible. Try to enjoy the fact that you feel fear or a desire to hide, since your aggression or fear of intimacy and contacts will not disappear if you look in their direction for a long time with a dissatisfied look.
Dahlke advises accepting yourself as you are. He claims that there are no dangerous phenomena and character traits: any phenomenon is neutralized by the opposite, and in isolated form any manifestation will be dangerous. Thus, peace exists only when there is a balance of forces. Harmony and balance are the key to solving problems and achieving happiness. A disturbing symptom disappears only when the patient becomes indifferent to it. Indifference shows that a person has realized and accepted the phenomenon or feeling. If we cannot understand something, we just need to accept it and love it, because it is something that realizes what is missing in us. Treatment has nothing to do with “recovery” at all, since recovery occurs only in our head and our consciousness. As one of the methods of healing and achieving harmony, Dalke recommends a system of guided meditation, which promotes deep emotional and physical relaxation, a state of absolute calm, and the disappearance of psychological barriers and anxiety. These meditations are effective in treating many physical ailments, including skin ones.
Psychologist Irina Malkina-Pykh also believes that our thinking affects how we experience stress and determines behavior related to maintaining health. Numerous studies and observations confirm that thoughts have a physical effect on all major organs through the autonomic nervous system, as well as the endocrine and immune systems.
One of the causes of skin diseases can be considered internal conflict, difficulties in establishing contact and communication. Thus, acne in adolescence indicates an unconscious fear of communicating with the opposite sex - that is, when an internal conflict arises, consciousness “runs away” into illness.
An important aspect is the effect of suggestion. It is noted that people suffering from skin ailments, from childhood, are strongly attached to external beauty and cleanliness, which is instilled in them by their parents. Often parents set the condition that if the child is dirty, then they will not love him. As a result, the principle of holistic psychology is triggered: a person is deprived of what he is too attached to - i.e. beauty.
Another reason may be “elements of organic speech,” when the disease is the physical embodiment of the phrase. Thus, the expression “I’m allergic to it” or “I can’t digest it” can turn into real symptoms.
In addition, Malkina-Pykh identifies as a reason - an attempt to be like someone - while a person demarcates himself from his body and does not accept it. Self-punishment can also become a “trigger” when a person behaves differently from how he was raised and begins to experience a feeling of guilt for which he seeks punishment.
The most serious source of illness is, as a rule, traumas in the past - long-forgotten childhood traumas, repressed, but still affecting a person. Such injuries can resurface at any time and with many years of remission.
Another important reason may be alexithymia - a person’s inability to express their emotions. Such people usually suffered in childhood from the suppression of emotions by their parents for educational purposes: for example, “men don’t cry,” “only ill-mannered children laugh,” “girls don’t behave like that.” As a result, the person becomes unable to perceive and verbally express his feelings.
It is well known that stress can both cause and aggravate diseases such as eczema, psoriasis, and rosacea. The body, which is in a state of stress, releases histamines into the blood, which causes a rash or small pimples and itching.
Malkina-Pykh notes that most people suffering from skin diseases are characterized by problems in their relationship with their mother. Because babies initially perceive the world around them through tactile sensations, through the skin. Thus, the child could suffer from an infantile mother who shows hostility towards him, a mother who is reluctant to touch him, reluctant to care for him, and constantly abstains from skin contact with him.
On the other hand, the child could, on the contrary, suffer from manifestations of exaggerated tenderness. Many patients say that it was customary in the family to hide from children both quarrels and anger, as well as joyful changes in life. The meaning of life and faith were usually not mentioned at all in such families.
One of the methods of psychotherapy that could help patients with skin diseases, Malkina-Pykh calls gestalt therapy, namely, exercises for self-awareness, for identifying the background and cause, for analysis, for remembering, for awareness of one’s body and emotions, for verbalization, self-integration, retroinflection and projection, introjection. All these exercises make a person think about the cause of his illness, promote awareness of the cause of the illness, awareness of what is happening and its acceptance.
Chapter 3
Homeopathy and homeosiniatry
Modern homeopathy was founded by the German physician Christian Friedrich Samuel Hahnemann (1755–1843), who described all the basics of homeopathy in his treatise “The Organon of the Medical Art.” The main principle of this type of therapy is that homeopathic medicines cause effects in the body that are similar to the manifestations of the diseases for which they are synthesized. “Similia similibus curantur,” which translates to “Like is cured by like.” In addition, from the point of view of homeopathy, small doses of substances that cause symptoms of the disease are much more effective than large doses, i.e., there is an accumulation effect.
To treat rosacea in homeopathy, the following substances are used: in solutions - Arnica (mountain arnica), Lachesis (poison of Lachesis mutus or surukuku, a very poisonous snake that lives in South America), Sanguinaria (canadian sanguinaria), Nux vomica (chillibuha, vomit nut); in peas - Carbo animalis (animal coal), Calcarea silicata (lime silicate) and Sulfur (sulfur).
Homeopathy treats eczema with: Alumina (calcined alumina) tablets, Arsenicum album (arsenic), Barium carbonicum (neutral barium carbonate), Calcium carbonicum (preparation from the middle layer of oyster shell), Graphites (graphite), Kalium arsenicosum (acid arsenic potassium ), Phosphorus (phosphorus), Sepia (cuttlefish), Silisea (hydrous silicic acid), Sulfur (sulfur),
Weeping rashes with serous discharge are treated by homeopathy with: Arsenicum album, Dulcamara (sweet bitter nightshade), Kreosotum, Natrium muriaticum, Rhus toxicodendron (poison ivy) or Sarsaparilla (sarsaparilla). Weeping rashes with mucopurulent secretion: Anacardium orientate, Antimonium crudum, Calcium carbonicum, Graphites, Lycopodium, Mezereum.
Homeopathy recommends treating psoriasis by starting with medications that correct existing organ failure and are excreted through the liver or kidneys. For symptoms of liver and gallbladder disorders, Berberis aquifolium (barberry) or (greater celandine) is prescribed. For symptoms of kidney damage - Berberis vulgaris (barberry) or Solidago virga aurea (golden rod, goldenrod). For severely irritated skin and acute itching, use Rhus toxicodendron (poison ivy) or Fumaria (fumaria).
Then medications are prescribed for psoriasis itself. Depending on the type of miasm (in homeopathy, when it was not yet known about infections and microorganisms, it was customary to call the hypothetical infectious agent that caused the disease), substances, as well as symptoms of the disease, were divided into 4 types: psoric, tuberculinic, sycotic and luesinic . To find out the nature of the disease, doctors took into account the patient’s physical constitution, his activities, habits and lifestyle, age, sexual function, temperament, etc. Thus, in the treatment of psoriasis, psoric drugs will be: Calcium carbonicum, prescribed for pityriasis peeling, Graphites ( graphite) - for dense peeling, Sepia (cuttlefish) - when cracks form, Silicea - for rough, easily suppurating skin; as well as sulfur. Tuberculin drugs in the treatment of psoriasis are Phosphor (phosphorus), Tuberculinium nosodes, especially Tuberculinum Koch or Rest. Sycotic - Acidum nitricum, Lycopodium, Natrium sulfuricum, Thuja. Luesinic - Arsenicum album, prescribed for small-lamellar peeling; Arsenicum iodatum - with large scales; Hydrocotyle - for the formation of plaques with severe itching; Mangan (manganese acetate) when localized on the extensor surface of the joints; Petroleum - for peeling, mainly in winter.
Also in the treatment of psoriasis, atopic dermatitis and eczema, “Psoriaten” ointment, containing a matrix tincture of the Mahonia aquifolium plant (Magonia subfolia) and “Iricar” ointment, which is based on a matrix tincture of the plant Cardiospermum halicacabum (cardiospermum halicacabum - a tropical liana from the family) can have a good effect. sapindaceae).
Tests conducted at the St. Petersburg State Medical Academy named after. Academician I.I. Mechnikova (Lalaeva A.M., Piryatinskaya A.B., Guseva S.N., Danilov S.S.), showed that out of 42 patients with eczema, psoriasis and atopic dermatitis who received external ointments, remission was observed in 82% of cases - with complete disappearance of rashes. Improvement was noted in 16% of patients.
The concept of homotoxicology - a synthesis of homeopathy, naturopathy and official medicine - was developed by the German doctor Hans-Heinrich Reckeweg. He founded the Heel company in 1936 (HEEL, from the first letters of the expression Herba est ex luce, which is translated from Latin as “Plants came from the light”). Homeopathic medicines developed by Reckeweg based on extracts and extracts from plants, animal organs, and sterilized microorganisms are used in homeosiniatry.
Homeosynia is a method of injecting homeopathic remedies into acupuncture points using a medical syringe, which were known in ancient China. This method enhances the effect of treatment from homeopathic remedies.
Thus, when treating rosacea in homesiology, it is recommended to use the following drugs: Cutis compositum (Cutis compositum) and Traumeel S (Traumeel C) at points V13, V40, GI4, GI11, Hepar compositum (Hepar compositum) at points F13, F14, V18. To get rid of keloid scars - Coenzyme compositum (Coenzyme compositum) at points VB34, GI11, RP4, RP6, RP10. Psoriasis in homeosiniatry is treated with Cutis compositum, Traumeel S (Traumeel C) at points V40, R24, GI4, GI11, Coenzyme compositum (Coenzyme compositum) at points IG4, VG13, F5, Psorinohel N at points TR5, VG41. Eczema - Cutis compositum at points GI4, GI11, V13, V40, Coenzyme compositum at points P7, R7, Lymphomyosot at points E36, GI4, GI11, Solidago compositum C at points V23, R2, R7 and Hepar compositum at points V18, F2, F13, F14, RP9, RP10.
Chapter 4
Blood purification
The human body contains 5–6 liters of blood, which performs the most important function of all liquids - it transports substances to carry out metabolic processes in cells, tissues and the body. When the blood is contaminated with various toxins and wastes, metabolic processes and cell cleansing are disrupted. Problems with metabolism manifest themselves, among other things, in the form of skin rashes, so for diseases such as psoriasis, rosacea, eczema, etc., it is important that the blood is clean.
Medical methods of blood purification include autohemotherapy, plasmapheresis and ultraviolet irradiation of blood, which we will consider in a separate chapter, as well as hemosorption and intravenous laser blood purification (ILBI). In addition, there are many folk remedies for blood cleansing.
Autohemotherapy consists of administering intramuscularly or subcutaneously a small amount of the patient’s own venous blood. The blood protein products released during the breakdown process are irritants to the systems of the diseased body, as a result of which it begins to produce antibodies. Thus, autohemotherapy dramatically increases immunity, therefore in dermatology it is used as one of the components of complex treatment of rosacea, psoriasis, demodicosis and other dermatoses.
So, T.E. Filichev noted the high effectiveness of the combination of intravenous administration calcium chloride with autohemotherapy in the treatment of patients with acne, rosacea, toxicoderma, sycosis. Patients were injected intravenously with 8–10 ml of a 10% calcium chloride solution, and then, without removing the needle, 10 ml of blood was drawn and injected into the buttock. The course of treatment consisted of 8–12 procedures performed at intervals of one day. Also, in the group of patients with rosacea (Fedotov V.P., Dzhibril V.A., 2004), who received treatment in the form of autohemotherapy 2-4-6-8-10 ml every other day, a significant prolongation of the duration of remission and a decrease in the number of complications were noted and improving the quality of treatment compared to traditional therapy of this disease.
In the treatment of psoriasis (A.I. Abramovich, 1984), treatment was carried out in the form of intravenous administration of the drug Essentiale, 5 ml in 5 ml of autologous blood. The course of treatment was 20 days. Of the 40 patients who underwent this treatment, in 31 the progression of the process stopped, infiltration, redness and peeling disappeared. In all patients, the period of remission extended to 10–12 months.
A contraindication to autohemotherapy is nephritis.
Also, in some cases, patients with rosacea, psoriasis, demodicosis and acne are prescribed hemosorption. This method involves passing the blood through a filter, which collects toxin molecules, and then returning the blood through an IV back into the patient's blood. This method purifies the blood without removing plasma or introducing auxiliary fluids. It is recommended to repeat the procedure at least three times.
Over the past 20 years, the method of intravenous laser blood irradiation (ILBI) has found widespread use in dermatology. The average course of ILBI ranges from 10 to 15 procedures. The method involves irradiating blood directly into the vascular bed through an optical waveguide with waves of 450 nm (blue laser) and 630 nm (red laser). As a result, photoreceptors on the surface of the blood are excited, which sets in motion a number of biochemical reactions. The effect of laser irradiation of blood has no analogues with traditional drug treatment. ILBI has analgesic, antiviral, antibacterial, antiallergic, anti-inflammatory, detoxification and immunostimulating effects.
Studies conducted among 56 patients with rosacea (D.I. Mavrova, Dobrinka Mavrova Clinic Kharkov, 2009), who received irradiation with a semiconductor laser with a wavelength of 0.63 microns every other day for 2 weeks, showed that after the first procedures, redness and infiltration decreased significantly, cyanosis, telangiectasia, and swelling disappeared. The general condition of the patients also improved significantly. After the first ILBI procedure in patients with the erythematous form of rosacea, the effectiveness of treatment was observed in 80% of cases, in the papular form - in 50% of cases, in the pustular form - in 30% and in patients with the infiltrative-productive form - in 10% of cases. Complete clinical recovery was achieved in 85.4% of patients, and improvement occurred in 14.6%.
In patients with true and microbial eczema, the use of ILBI shortened the treatment period by a week and doubled the duration of remission.
Therapy of patients with eczema and atopic dermatitis using this method (S.A. Isakov) showed clinical remission in 62.5% of cases and significant improvement in 34.4% of patients.
This method is also used in the treatment of psoriasis. So, E.P. Burova and co-authors irradiated blood with a defocused GNL beam, observing positive effect in 12 of 14 patients. Simultaneous with ILBI intramuscular injections 1 ml of Aevit (D.A. Shakhmatov, A.P. Rakcheev) for 20–25 days showed significant improvement in 60% of patients - the number of rashes decreased, pain decreased and joint function was restored.
A promising direction is also a non-invasive version of laser irradiation of blood - percutaneous laser irradiation (PLI). Thanks to this method, the likelihood of contracting HIV, hepatitis and other infections is completely eliminated. PCI imparts energy to the blood equivalent to that of 1–2 mW ILBI. This type of low-intensity laser irradiation has found application, in particular, in the complex therapy of psoriasis. It has a sedative, detoxifying and anti-inflammatory effect. Thus, when treated with PCLO, clinical remission was observed in 45.8%, and significant improvement in 25%; improvement occurred in 29.2% of cases.
At home, blood can be purified using enterosorbents. These drugs do not affect the composition of the blood in any way, but absorb toxins from the gastrointestinal tract, removing them from the body naturally. Enterosorbents help remove bacteria, pathogenic flora, dead cells, waste, and toxins. The course of cleansing is usually 7–10 days. This procedure will improve the body’s condition and metabolism, and increase immunity. The most famous and easily accessible sorbent is activated carbon.
Alcohol tincture of garlic is also used to cleanse the blood. It is believed that in this way you can clear blood vessels from cholesterol plaques. To prepare the tincture, take 350 g of chopped garlic and 200 ml medical alcohol. The garlic must be squeezed out and the resulting juice mixed with alcohol and left in a dark place for 10 days. Strain and leave for another 3 days. The tincture should be taken three times a day 30 minutes before meals, dissolved in milk. Start the intake with 1 drop and increase the number of drops with each dose to 15. Then with each dose you need to reduce the number of drops to 1. From the 11th day, take 25 drops of the tincture until it runs out. Here are a few more recipes from traditional medicine that cleanse the blood:
1) take a nettle decoction for 2 weeks - pour 2 tbsp. spoons of dry herbs with 2 liters of boiling water; Drink between 3 and 5 p.m.
2) Joy Gardner advises cleansing the blood with red foods: beets, grapes, red cabbage, blackberries, cranberries, cherries.
3) in the summer it’s good to make a dandelion tincture: mince the roots, leaves or flowers, squeeze, mix the resulting juice at the rate of 1 liter of juice per 1 glass of vodka. Consume with honey and lemon juice.
4) take yarrow decoction three times a day - 3 tbsp. l. dry herbs, pour a liter of boiling water, leave in a thermos and drink half a glass before meals.
5) take 1 tbsp three times a day. l. infusion of dill seeds (1 tbsp), dry ground valerian root (2 tbsp) and 2 cups of honey. Pour the mixture with 2 liters of boiling water, leave for a day and drink 30 minutes before meals.
6) take 1 glass of beet juice, left in the refrigerator, along with carrot juice, the amount of which should be gradually reduced. Course - 1 month.
7) dry ginger root - 1.5 g - pour 1.5 liters of boiling water, simmer for 20 minutes over low heat and add a pinch of ground black pepper. Then cool and add 3 tbsp. l. honey Take 1/3 cup with honey and warm water 30 minutes before meals, three times a day.
Chapter 5
Liver cleansing
The liver, as you know, is the largest gland in our body and a kind of filter. All blood entering the liver is purified from toxic substances that are formed in the body during metabolism or enter it from the outside. When a large amount of harmful substances accumulates in the liver, its main functions are disrupted, as a result, metabolism suffers, and stones appear in the liver. gallbladder, various diseases arise, including dermatological ones. Even if it has not yet reached the point of formation of stones in the liver, it still needs to be cleaned periodically, since for skin diseases the most important aspect of therapy is to strengthen the detoxification function of the liver. The essence of the cleansing process is the choleretic effect of the agents used, which allows you to get rid of stones.
In folk medicine, there are a large number of different recipes for enhancing the separation of bile and dissolving stones. Remember that any independent actions carried out without the supervision of a doctor can lead to an unfavorable outcome.
Most widely known method Cleansing the liver using olive oil. To prepare properly, a few days before, eat only fruits and vegetables, drink juices, apple and beet juice will be especially useful. Also, the night before cleansing, go to bed with a heating pad on your right side so that the bile becomes more viscous and the stones pass painlessly. In the morning, on an empty stomach, drink 100-200 ml of olive oil heated to 3740 degrees, washed down with a small amount of juice or any other drink. To enhance the choleretic effect, you can add lemon juice to the oil. After taking the oil, lie down for a while without removing the heating pad. When all the stones are out of the body, it is better to limit yourself to drinking juices that day, excluding food intake.
Traditional medicine claims that this method of cleansing is dangerous, since large stones can block the bile duct, leading to rupture of the gallbladder and peritonitis. Doctors advise cleansing the liver with hepatoprotectors, which enhance the activity of liver cells and protect it from toxins. The most famous plant-based hepatoprotectors are allochol and karsil from milk thistle, and synthetic ones - essential.
Also popularly, the liver is cleansed with sorbitol. The technique consists of taking a glass of water before bed, in which a spoonful of sorbitol has previously been dissolved. Then you can go to bed with a heating pad on the liver area. The procedure is repeated for a week, and then carried out once every three days. Another way to cleanse the liver is with the help of choleretic herbs. On an empty stomach in the morning, drink half a glass of warm decoction of herbs that enhance the secretion of bile - this corn silk, immortelle, dandelion, lemon balm, calamus, oregano, chamomile, calendula, lingonberry, strawberry and blueberry leaves - and after half an hour another half a glass of decoction, to which you need to add a spoonful of honey. Then lie on your right side with a heating pad for an hour and a half. Complete the procedure with deep breaths, do a few squats, and you can start breakfast.
Another way is to cleanse the liver using black radish. The juice is squeezed out of it and taken before meals, starting with a teaspoon and increasing the dose to half a glass. During the cleansing period, a vegetarian diet is assumed. You can also cleanse your liver with melon diet. To do this, two weeks before the start of cleansing, exclude meat, fish, milk, sour cream, and flour products from the diet. Then, for two weeks, from 7 a.m. to 10 p.m., you can only eat melon and drink only green tea. It is forbidden to take melon and tea after ten in the evening. Then you should slowly and gradually return to your normal diet.
When cleaning with rosehip decoction, take three tablespoons brewed in half a glass of water orally. dried berries. In the morning on an empty stomach, drink half of the decoction, adding sorbitol to it, then after half an hour, finish the rest of the decoction. Then you can have breakfast. The procedure is carried out once every three days, then weekly.
Ignatenko’s method involves cleansing the liver using calendula. To do this, you need to brew 4 tablespoons of calendula flowers with a liter of boiling water, leave for 20 minutes and drink this portion three times before meals for two weeks. Then begin taking a chilled mixture of olive oil and lemon juice - 100 g of each product. On the first day of cleansing, a light lunch is allowed, but dinner is prohibited. In the morning you need to do an enema, and then drink only water with lemon juice and honey. The next day, do the enema again, after which you are allowed to eat dried fruits and steamed vegetables. It is recommended to repeat the procedure after 2 weeks.
Chapter 6
Bioresonance therapy
The first bioresonance therapy device was invented in 1977 by physician Franz Morel and engineer Erich Rasche. The principle of operation of this therapy is based on the fact that electromagnetic oscillations emanate from any organic tissue. When disturbances occur in the human body and he begins to get sick, then as a result of the action of infectious agents, new sources of vibrations arise, which are called pathological. If the body is able to independently cope and correct these pathological fluctuations, then the person recovers. When negative vibrations begin to predominate in the body, the person becomes ill.
Bioresonance therapy involves exposing a person to electromagnetic vibrations that resonate with the body. With optimal selection of the frequency and method of exposure, pathological fluctuations can be weakened and the disease can be eliminated. Therapy is carried out in two ways: endogenous and exogenous. In the first method of treatment, the characteristics of the patient’s body vibrations are read by a special device that processes them and separates pathological signals from physiological ones. Then, with the help of the device, vibrations are sent back to the body, while the device weakens pathological signals, and, on the contrary, strengthens physiological ones. When using the second method, electric or magnetic field generators affect the body with oscillations of a certain frequency, causing a strong response from the body and forcing it to work in the correct mode. In addition, physiological fluctuations can be recorded healthy body onto various media (for example, water) and also use them for treatment between sessions.
Bioresonance therapy is used in dermatology to treat diseases such as rosacea, demodicosis and psoriasis. Thus, according to research results, 18 patients with rosacea who underwent a complex course of treatment, including BRT for 1–2 hours 1–4 times a day, daily, showed positive dynamics. Clinical cure occurred in 14 patients.
Also, studies based on the Research Institute of Traditional Treatment Methods (SRI TML) of the Ministry of Health of the Russian Federation and the Scientific and Practical Center of Traditional Medicine and Homeopathy (SPC TMG), conducted between 1997 and 2000, showed that out of 503 patients with various pathologies, including including eczema, rosacea and psoriasis, a positive effect was obtained in 95.2% of cases - the general condition of the patients improved, it became possible to reduce the doses of drugs in drug therapy, as well as completely or partially cancel other types of treatment, but with the need for long-term maintenance BRT .
Chapter 7
Ultraviolet irradiation of blood and plasmapheresis
The first scientific works on plasmapheresis appeared in 1915, and in 1928, the method of extracorporeal ultraviolet irradiation of blood was first applied to a woman in labor dying of sepsis), after which she recovered. In 1979 in Leningrad at the State Optical Institute named after. S.I. Vavilova Popov Yu.V. and Kukuy L.M. developed a device for ultraviolet radiation, which is used by doctors to this day.
The mechanism of action of irradiated blood on humans is complex and diverse, and there is still no single theory about the effect of this method on the human body. However, it is known that ultraviolet radiation in the blood kills microorganisms, increases immunity, and activates metabolism and oxidative processes. Cells begin to renew themselves faster, the activity of T- and B-leukocytes, complement and lysozyme increases, and the supply of oxygen to tissues and cells improves. The method also reduces blood viscosity and the formation of blood clots. Swelling is reduced and wound healing is accelerated. Purulent-inflammatory diseases of the skin and internal organs are indications for irradiation.
With UVB, a needle with a diameter of 0.8–1.2 mm is inserted into a peripheral vein. The blood enters the system with a transparent cuvette, and then into the apparatus, where it is irradiated with ultraviolet rays, and is reinjected. The course of treatment is 5–10 sessions lasting 40–60 minutes. Some dermatocosmetologists note a clinical effect in the treatment of demodicosis and rosacea after 2-3 procedures.
Plasmapheresis is used for dermatological diseases as a pathogenetic treatment mechanism, since it helps eliminate toxic products accumulated in the blood from the body. It significantly improves fluidity in the bloodstream and restores previously impaired microcirculation, improving metabolism.
As Professor N.N. Potekaev writes in his dissertation “Plasmapheresis in the treatment of severe forms of rosacea,” plasmapheresis is indicated for torpid forms of rosacea that are resistant to traditional methods of treatment. Two catheters are inserted into a peripheral vein: through the first, blood is taken and cleaned, and through the second, it is returned back. The procedure is carried out once every 2 days with a single removal of 600–700 ml of plasma. Plasma is replaced with 0.9% sodium chloride solution. The course consists of 7–10 procedures. After therapy, there was a significant reduction in rashes, skin cleansing and a prolonged remission phase.
Psoriasis is also an indication for plasmapheresis. In 1991 Potekaev N.N. used plasmapheresis in the treatment of refractory forms of psoriasis. The results showed that out of 18 patients, remission occurred in 10 patients, significant improvement occurred in 5 patients, and improvement occurred in 3 patients.
Contraindications for ultraviolet irradiation of blood are: oncological diseases, including blood diseases, mental illness, active tuberculosis, syphilis, AIDS (HIV), epilepsy, ongoing bleeding, hemophilia, intolerance sunlight, UV radiation, taking medications that increase photosensitivity. Plasmapheresis cannot be performed in case of multiple sclerosis, myasthenia gravis and hepatic rib dystrophy, severe anemia, hypoprotennemia.
Chapter 8
Ayurveda
Ayurveda (translated from Sanskrit as “knowledge of life” or “science of life”) is traditional system Indian Vedic medicine, formed as a result of the fusion of Aryan and Dravidian cultures.
Ayurveda classifies all skin diseases according to three doshas - Vata, Kapha and Pitta. Thus, any disease can be correlated with one of the doshas. In Ayurveda, depending on heredity and lifestyle, one or two doshas predominate, the qualities of which are reflected in the skin. If your dosha is Vata, then the skin may be dry, sensitive and cool, while a person with Pitta dosha will have reddish, warm and slightly oily skin. Kapha dosha predominates - the skin will be tight, oily and cool. Special questionnaires have been developed to determine your dosha.
The general recommendations of doctors of this teaching for inflammatory skin diseases and rashes are to rub in ghee, aloz juice, and cilantro juice. Ghee must be placed in a copper vessel, diluted with water in a ratio of 2:1 and kept for a month, stirring periodically with a copper spoon. An analogue is the drug “Shatodhara Grita”. Also, a study conducted in 1994 confirmed the effectiveness of a mixture of seven herbs in the treatment of various skin rashes, which is taken both internally and externally - these are aloe, margosa, turmeric, hemidesmus, haritaki, arjuna and ash waganda. In addition, “sunder vati” tablets are recommended, which contain Indian gooseberry, Embelia currant, Cholarena fluffy and ginger. To get rid of acne, guggul extract is indicated, which in its actions is equivalent to the antibiotic tetracycline.
For rosacea, Ayurveda advises reducing the manifestations of the Pitta dosha, which predominates in this disease, and toning the Kapha dosha. Grenim, mumiyo, milk thistle, lecithin and Liuweidihuan wan are recommended as preparations. Patients are shown drinking plenty of fluids and cleansing by washing - “Shankprakshalana”.
Ayurveda states that psoriasis is the result of an unequal balance between Vata and Kapha. Externally applied “Mahamarichyadi taila” (contains sesame oil and black pepper), “Raktavardhak” (mumiyo, sulfur, copper, tin, iron, “Triphala”), “Raktapo shak bati”, “Chandrakala” (syt, mica, sulfur , copper, sandalwood, withania soporific, cardamom) or “Arogyavardhini bati” (mumiyo, mica, iron, copper, “Triphala”).
Indian teaching refers to eczema as a disease caused by an excess of Kapha. For healing, the following drugs are recommended: Chyawanprash, Triphala (three myrobalans), Lecithin and the spice turmeric.
One of the main conditions for healing in Ayurveda is the balancing of the doshas, which is achieved, among other things, by diet and lifestyle changes. Thus, patients with Pitta dosha and Pitta-type diseases need a diet that reduces the manifestation of Pitta dosha. It is recommended to exclude allergenic foods from the diet - tomatoes, peaches, strawberries, and dairy products. You should avoid exposure to the sun and heat, hot water, and baths. For external use, it is good to use coconut milk, cilantro and aloe juice. Herbs that improve metabolism, such as burdock or clover, are effective. Bitter herbs with a laxative effect, rhubarb or aloe, are also useful. Ayurveda advises drinking a herbal “antipyretic composition”, which must be taken with aloe juice or dandelion tea. To prepare it for 1 serving, take 1/4 teaspoon of anise, 1/3 teaspoon of cinnamon, 1/2 teaspoon of chamomile and 1 glass of water. Add herbs and spices to boiling water and cook for 1-2 minutes over low heat. Then leave the broth for 10 minutes, strain and add brown sugar or honey.
For Vata-type constitutions and Vata-type diseases, a Vata-reducing diet is used. Salty foods best reduce Vata dosha. Dried fruits, raw and frozen vegetables, dry baked goods (crackers, crackers), corn flakes, chips, yeast bread, fried meat, low-fat dairy products, cold drinks, refined sugar, as well as hot, astringent spices and seasonings are excluded. It is recommended to apply oil to the skin that has a soothing effect, such as sesame oil. Laxatives and enemas are also used. Among the medications, you need to take Triphala (5-10 g before bedtime), as well as Triphala guggul and myrrh tincture.
With a Kapha constitution, the diet is aimed at reducing Kapha. Spicy tastes are best for reducing Kapha dosha. It is forbidden to eat heavy, fatty and oily foods; it is undesirable to drink milk and eat cheese. In addition, it is necessary to exclude from the diet all types of processed fruits with sugar - preserves, jams, marmalade, soft yeast bread, fried meat and nuts. Oils are not used either internally or externally. It is recommended to use plantain, burdock and wintergreen seeds internally. Among the drugs used are “Gokshuradi guggul” and “Triphala guggul”, as well as a herbal “antipyretic composition”, which is consumed with warm water or ginger tea.
Chapter 9
Tibetan medicine and moxotherapy
Tibetan medicine, which appeared and spread in Tibet in the 5th–7th centuries, just like Ayurveda, regards skin diseases as part of a systemic lesion of the body, the cause of which is a violation of the constitutions of Bile, Mucus and Wind. Buddhist healers believe that the skin reflects the functioning of internal organs, therefore all rashes - ulcers, pimples, rashes, discoloration - are indicators of disturbances in the functioning of the body. Tibetan healers cure skin diseases using an integrated approach: they prescribe a diet, herbal medicines, and moxotherapy is used as an external influence. Not only the visible symptoms of the disease are eliminated, but, first of all, the root cause of the disease is eliminated, and the constitution of Bile, Mucus and Wind is brought into harmony.
In accordance with the ideas of Buddhist medicine, when the Bile constitution is overstimulated, the work of the liver increases, due to which bile penetrates the skin through the general bloodstream, causing the appearance of pimples, blackheads, moles, and papillomas. It is the predominance of Bile that causes diseases such as psoriasis, eczema, neurodermatitis, dermatosis, and atopic dermatitis.
Disturbance of the constitution Mucus leads to the appearance skin itching, acne, abscesses and long-healing wounds. Violation of the constitution Wind causes peeling of the skin and the development of seborrheic dermatitis and dermatitis of nervous origin.
Tibetan doctors treat skin diseases with the help of mumiyo, known for its healing properties for about 3 thousand years. So, for eczema, it is recommended to steam the limbs in a 5-6% mummy solution in a water bath. It is also necessary to take mumiyo internally. The dose is 0.2 g and the frequency of administration is twice a day. It is better to do this with sea buckthorn or currant juice. The course of treatment is 25 days, repeated after 10 days.
For acne, pimples and ulcers from lichen, Tibetan healers suggest rubbing a mixture of salt powder, white mustard, dry leaves of Japanese mulberry on cow urine and calamus. For skin diseases based on scabies, you can rub in a mixture of milkweed and clematis on yogurt, as well as soot, sorrel, salt, roots of Saussurea burdock, ash from the roots of Steller dwarf and wine starter in rancid oil.
In addition, Tibetan doctors also cure chronic dermatoses with moxotherapy - heating and cauterization of reflexogenic zones and biologically active points of a person with wormwood cigars. There are two methods of moxotherapy - contact and non-contact. The first time, the cigar is placed on a ginger, garlic or foil plate. In the second case - 1.5–2 cm from the skin. After the treatment session, the skin remains red for one to two days. The points that Tibetan medicine doctors cauterize are divided into two types: those that are detected by palpation - when pressure is applied, pain occurs or, conversely, pleasant sensations, as well as “vein beating.” Points of the second type are known only to specialists in Tibetan medicine.
Psoriasis, for example, is treated by heating the affected area with a wormwood cigarette using an iron with a gradual transition to the affected area. The procedure is carried out every day after 2-3 days. The course consists of 10–12 sessions.
Chapter 10
ASD faction
The miracle drug “Antiseptic Dorogov Stimulant” (ASD) was first obtained by heating river frogs in a vessel to very high temperatures. Back in 1941, Academician of the Academy of Sciences of the Ukrainian SSR V.P. Filatov created the doctrine of biogenic stimulants formed in every cell of the body under unfavorable conditions. In the fight for survival, the cell releases biogenic stimulants, which, when taken orally, increase human immunity. Currently, ASD is produced by distilling meat and bone meal.
In general, the history of the creation of ASD is quite mysterious. It is known that in 1943, at the request of the Soviet leadership, scientists began searching for a means to protect people and animals from radiation. The secret work was supervised by L.P. Beria himself. Candidate of Medical Sciences, veterinarian A.V. Dorogov, having conducted experiments on frogs, presented the results of his work, and already in 1948 the drug ASD was officially approved for use in veterinary medicine, and in 1951 ASD was approved by the USSR Pharmaceutical Committee for the treatment of skin diseases in humans and testing for other diseases. Despite the fact that there were many attacks on Dorogov, he was even accused of alchemy, there is information that the miraculous elixir was used by members of the Politburo and their families.
It is known that thanks to this drug she was cured of uterine cancer last stage with metastases to the lungs and liver, Beria’s mother herself. However, in 1953, after the death of Stalin, Dorogov and his ASD began to be attacked by official medicine, which saw the elixir as a threat to the domestic pharmaceutical industry. In addition, Dorogov insisted on registering the drug under his own name, which was an unheard of display of arrogance and vanity. It is said that this is the reason why it was never registered for humans. In 1955, Dorogov was accused of bribery, and in 1957 he was found dead - according to various versions, he died from carbon monoxide asphyxiation in a car or from a fatal head wound near his home. In any case, his death still remains a mystery.
As for the action of ASD, the drug stimulates gastrointestinal motility, improves digestion and absorption, improves tissue trophism, normalizes metabolism, and is low-toxic. On the Internet you can find dozens and hundreds of testimonies of patients who were cured with the help of the elixir from a wide variety of diseases; the fraction is especially effective, as can be concluded from the reviews, in the treatment of demodicosis, rosacea and psoriasis. However, the drug is currently approved by official medicine for use exclusively in veterinary medicine. Having decided to start self-treatment using ASD, remember that there are no data on contraindications or side effects of this medicine, since it has not undergone clinical trials and is not registered as a treatment for humans.
During therapy with ASD, the intake of products containing alcohol is strictly prohibited. ASD-2 is taken orally, diluted with boiled chilled water in a ratio of 1:20. ASD-3 is used externally only. It is especially noted that the bottle should not be opened, since upon contact with air it loses its properties. It is recommended to remove the circle from the aluminum cap and then use a disposable syringe to draw the required dose.
If you experience nausea or discomfort in the stomach while taking the drug, you should slowly drink 1 glass of kefir 10–15 minutes after taking ASD. Also, in some cases, after using the fraction, an increase in body temperature above 38 degrees may be observed, in this case it is recommended to stop taking the drug for 1-2 days and then continue by reducing the dose. Another side effect of using ASD can be pain in the kidneys, so in between courses you need to drink kidney tea. Please note that when treating ASD, it is necessary to carry out control blood and urine tests 1-2 times.
To treat skin diseases such as psoriasis, eczema, rosacea and demodicosis, ASD-2 should be taken according to the following scheme: dilute 1–2 ml of the drug in 0.5 cups of boiled water, drink for 5 days in a row, then do it for 2– 3 days break. Take only on an empty stomach, at the same time use ASD-3 as a compress. Compresses from ASD-3 diluted in a ratio of 1:20 in vegetable oil are applied until the symptoms of the disease disappear. If redness is observed during use of the drug, treatment is stopped for 3 days. It is especially worth noting that in the treatment of chronic skin diseases, exacerbations often occur, in which therapy is repeated. If you want to carry out treatment under the supervision of a specialist, you should contact Olga Dorogova, this is the daughter of the inventor of the drug, she conducts consultations in one of the Moscow clinics.
Even doctors from the Institute of Dermatology talk about the miraculous properties of this drug, but they do not officially prescribe it...
Chapter 11
Hirudotherapy
Humanity has been using leeches for healing for about 3 thousand years. The discoverer of this method is considered to be the Greek Nikander from Colophon, who lived in 200130. BC e. However, paintings on the walls of the tombs of Egyptian pharaohs testify to the use of hirudotherapy earlier. Leeches were used by Hippocrates, Galen and Avicenna.
At one time, these useful animals were on the verge of extinction due to their popularity - and now they simply do not exist in nature, they are listed in the Red Book. But they have learned to breed them in captivity, which is successfully done in hirudological factories. The effect of hirudotherapy is complex, consisting of several factors: reflex, mechanical and biological. So it is great for healing skin diseases.
How are these unsightly looking worms treated? The fact is that when a leech bites, negative pressure arises at the site of the bite, due to which blood flows to the damaged tissues. Prolonged bleeding after a bite helps reduce local inflammatory swelling and venous congestion. In addition, the secretion of the salivary glands of the leech has anti-inflammatory, analgesic, defibrosing and bacteriostatic effects.
Thus, when bitten, over 100 different biologically active compounds penetrate into the human blood. Known leech secretion proteins are hyaluronidase, collagenase, bdellin, eglin, apyrase, kininase, cholinesterase, hirudin and others. Hirudin, for example, reduces blood viscosity, improving blood microcirculation and reducing facial swelling. Hyaluronidase breaks down hyaluronic acid molecules, destroying intercellular cement, and collagenase actively breaks down pathological collagen, which causes scars to form, which helps smooth them out, and fibrotic connective tissue softens.
Thus, leech bites restore microcirculation in the skin and activate lymphatic drainage and regeneration, as a result of which the skin turns pink, becomes soft, elastic, firm and smooth, and facial scars smooth out and gradually disappear.
3-8 leeches are placed in the area of inflammation. The first sessions are carried out daily, then every other day. The duration of the course is determined by the prevalence and severity of the process. It is noted that hirudotherapy can be used at any stage of the disease. For example, leeches were administered to patients with rosacea in the acute and subacute stages, as well as during the rehabilitation period. Sessions were carried out weekly, in a course of 5–10 procedures. Already after the first procedure, there was a noticeable reduction in redness on the face, in addition, health and sleep improved. Doctors noted the maximum clinical effect after 6–7 procedures.
For psoriasis, methods of placing leeches with and without bloodletting are used. One course, conducted twice a year, requires 100–150 leeches. Clinical observations (S.E. Musina and V.F. Korsun, 1998) on the use of hirudotherapy in 26 patients with psoriasis showed that this method of treatment can be used along with other traditional methods and means of therapy, especially in the torpid course of the disease. Positive results were observed in almost all patients.
The therapy has a number of contraindications: pregnancy, increased bleeding - hemophilia and hemorrhagic diathesis, severe anemia, cachexia, allergy to leeches, mental disorders and physical exhaustion.
Chapter 12
ethnoscience
Until the end of the 18th century, folk medicine was not separated from traditional medical medicine, based on old postulates passed down from generation to generation. Now that evidence-based medicine is dominant, “traditional medicine” is considered a teaching based on witchcraft and is regarded as something dangerous and outdated. Meanwhile, in folk medicine there are many recipes, truly proven over centuries, that can help, including people who have been trying to get rid of dermatological diseases for many years.
Thus, various anti-inflammatory lotions, lotions and masks are used to treat rosacea. When swelling and redness appear, cold lotions of yarrow infusion (1:10), string (1:30), chamomile flowers (1:15) and parsley (1:10) are recommended.
It’s good to wipe your face with 5% propolis tincture every day for a month at night. In the morning, the resulting film is removed with a cotton swab soaked in vodka. Then the course is repeated, but using a 10% tincture.
Masks are also effective for treating rosacea. For example, with aloe juice - the plant juice is diluted with warm water (1:1), gauze wipes are soaked in it and applied to the face for 20 minutes. This procedure must be carried out at intervals every other day. In total you need to make 20 masks. Aloe juice can be replaced with cabbage juice. Masks with infusion (1:20) of rose hips are also effective. To do this, napkins are soaked in warm infusion and changed 6-7 times within 20 minutes. The course consists of 20 masks at intervals every other day.
In addition, herbal decoctions are very helpful when taken orally. For example, 2 tbsp. l. a collection of nettle leaves, horsetail grass and young burdock stems, taken in equal quantities, pour 0.5 liters of water and cook over low heat for 5 minutes. Take half a glass of decoction 4 times a day. Also effective is taking burdock root tincture - 20 drops three times a day or garlic tincture - 15-20 drops three times a day.
Demodectic mange in folk medicine is well treated with a decoction of black currant berries. For this, 2 tbsp. l. dried berries, pour 0.5 cups of water, bring to a boil and cook over very low heat for 10 minutes. Then leave the broth for 10–15 minutes, soak gauze pads in it and apply to the affected areas for 15–20 minutes. You can also use fresh currant puree.
A clay mask also works great for demodicosis. Dilute the clay with water to the consistency of thick sour cream and add a few drops of iodine. Apply to affected areas and let dry. The procedure must be done regularly.
In folk medicine, kerosene is also successfully used to treat skin ailments. So, for purulent, long-term non-healing wounds, it is recommended to mix 1 liter of sunflower oil, 30 ml of freshly squeezed celandine juice and 100 ml of purified kerosene and leave for 7 days. The resulting mixture, which must be thoroughly shaken before each use, is soaked in a gauze pad and applied to the affected areas twice a day for 2 weeks.
One of the patients, a patient with demodicosis, shared the following recipe: she lubricated her face with purified kerosene for two weeks, while simultaneously taking a decoction of birch leaves for giardiasis. Decoction of 1 tbsp. l. crushed birch leaves, picked on July 7, brewed with a glass of boiling water and infused for 20 minutes, take 1 tbsp. l. 3 times a day half an hour before meals. Using this method, she achieved complete recovery.
Kerosene also helps with psoriasis - a mash of nut-kerosene extract, birch tar and fish oil (1:3:2) is applied to the affected areas daily for 2 weeks.
Garlic compresses also work well for demodicosis: peel 5-6 cloves of garlic, chop into a paste, add 1/2 tsp. sunflower oil, mix and apply the mixture onto a sterile bandage folded in half, apply to the affected skin, cover with a bag or film, and secure. After 30 minutes, remove the compress, rinse the skin with boiled water and tar soap and dry gently with a well-ironed towel. One of the women suffering from demodicosis offers the following recipe: lubricate the skin with garlic pulp 4 times a day for a week. She warns that this procedure is accompanied by skin burns, so it can only be recommended as a last resort.
Here is another popular way to get rid of demodicosis: put a village chicken egg with its shell in a jar and pour vinegar essence so that it completely covers it, close the lid and leave in a dark place for 9 days. Drain the vinegar and crush the egg in the same jar. Apply the resulting ointment to the mite-affected hairy parts of the body.
Daily lotions twice a day have an effective effect on demodicosis. Before the procedure, the skin must be disinfected with tincture of calendula or eucalyptus. 1 tbsp. l. pour a glass of boiling water over crushed juniper berries and leave for 6 hours, strain and use for lotions. An infusion of buckthorn bark is also suitable: 1 tbsp. l. pour a glass of boiling water over the bark, simmer covered for 5 minutes, leave for 4 hours, strain. You can also use wormwood infusion: 2 tbsp. l. dry herbs, pour a glass of boiling water, leave for 5 hours, strain. In addition, an infusion of elecampane roots cleanses the skin well: 1 tbsp. l. pour dry roots into a glass, simmer over low heat for 7 minutes, leave for 4 hours and strain. For demodicosis, it is good to wash your face with a decoction of chamomile and mint, taken in equal quantities, poured into 1 liter of boiling water and infused for 15 minutes.
For the treatment of psoriasis, traditional medicine offers the following recipes: Golyuk solidol ointment and hellebore-solidol ointment.
The ointment of the traditional healer Golyuk is prepared from: egg white 5.0–6.0, flower honey 3.0–3.2, baby cream 0.8–1.0, medical grease - the rest (90–91). After the plaques disappear, an ointment of the following composition is used: egg white 5.0–5.5, honey 2.0–2.5, baby cream 1.5–2.0, crushed celandine 1.0–1.3, medical grease - the rest (89–90.5). At the same time, 2–4 ml of Aralia and Eleutherococcus tinctures are taken orally.
Treatment lasts 2–3 months and is not prescribed during an exacerbation period.
Hellebore ointment is prepared as follows: put 250 g of fat grease in a wide bowl, pour 2-3 tsp into the hole in the middle. hellebore water (Lobel tincture), mix and store in the refrigerator, keep away from children, since hellebore water is poisonous.
Another ointment recipe: 1 liter of sour cream, 300 g of beeswax, 300 g of sulfur, 300 g of horse sorrel root, 150 g of oleoresin, 50 g of vitriol, 2 tbsp. l. burdock ash, 200 g of oregano, 50 g of celandine, 150 g of honey, 100 g of black buckthorn bark, beef fat. Boil the mixture to 1/3 of the original volume, strain, and cool. Lubricate the affected areas, do not wash off for 2 days, and on the third day wash with laundry soap. Repeat the procedure 5-6 times, then take a break for 10 days. If necessary, repeat the course.
Also, for psoriasis and eczema, it is good to drink a decoction of the following herbs: 1 tbsp. l. lingonberry leaves, 1 tbsp. l. nettle leaves, 1 tsp. swamp valerian root - all in a glass of boiling water. Boil the root for 10 minutes over low heat, add the rest of the herbs and leave for 10 minutes. Strain and drink 1 tbsp. l. twice a day on an empty stomach half an hour before meals. The course of treatment is 15–20 days.
Chapter 13
Cryotherapy
The beneficial effect of cold on the body has been known to mankind since ancient times. Abu Ali Ibn Sina in his “Canon of Medical Science” described that swimming in cold water strengthens the body. About a hundred years ago, the German doctor Sebastian Kneipp, suffering from pneumonia, took a swim as a last resort in the icy Danube and recovered. After an incident that happened to him, he introduced the concept of “cryotherapy” or cold treatment into official medicine. However, cryotherapy in its modern form appeared in the 70s of the last century, when the Japanese scientist Toshima Yamauchi first used a mixture of liquid nitrogen vapor and air to treat rheumatism, thanks to which about 80% of patients recovered.
Cryotherapy is most often done using liquid nitrogen, the temperature of which in the liquid state is minus 196 degrees. When it comes into contact with air, it immediately turns into a gaseous state, heating up to minus 70–50 degrees. Cryotherapy is carried out using various methods, depending on which it causes different effects in the skin: either freezing, destruction and death of tissue, or a sharp narrowing of blood vessels. When the cold stops affecting the skin, the blood vessels immediately dilate, which causes significant blood flow, and as a result, an improvement in the supply of oxygen and other nutrients to the skin. In addition, nitrogen has a powerful bactericidal effect, and as a result of its action, bacteria and viruses die.
With cryomassage in the skin, there is an improvement in lymphatic drainage, cellular metabolism and regenerative processes are activated. In addition, due to short-term exposure to low-temperature gas on the skin, the immune system is mobilized and the production of endorphins is restored.
For demodicosis, the course of cryotherapy procedures is about 15–20. Liquid nitrogen is used in the form of extinguishing and deep freezing of areas of inflammation. The applicator is moved over the affected skin surface 2-3 times for 5-10 minutes, treating each area for 3-5 seconds until the skin whitens slightly. After the end of the session, persistent redness appears.
Treatment with nitrogen deeply freezes the areas affected by demodicosis, the skin on which then exfoliates naturally, promoting the formation of new, clean and healthy skin. In addition, mites cannot tolerate cold, so cryomass soot has a detrimental effect on them, without affecting the hair follicles and surrounding tissues. Treatment usually lasts up to 1.5 months. Many cosmetologists advise carrying out procedures daily.
When treating rosacea, cryotherapy is indicated regardless of the stage of the disease, and the intensity depends on the form of rosacea and skin type. The most gentle method would be shading, as in the case of demodicosis. Nodular and pustular elements are frozen separately. After the procedure, pronounced redness is observed, which can last from several hours to a day, which ends on the 3rd day with lamellar peeling.
According to the observations of specialist L.A. Palchikova from the Vitalong Medical Center in Togliatti, when treating patients with psoriasis using cryotherapy, patients with a mild form of the disease underwent a course of general cryotherapy, consisting of 10 procedures daily. Patients with severe diseases and moderate severity- 14–20 procedures. 60% patients with mild form of psoriasis, cure occurred within a month, and 62% of patients with moderate and severe forms of psoriasis achieved complete remission in 1–3 months.
Contraindications to cryotherapy are: thin transparent skin with manifestations of rosacea, allergies to cold, elevated body temperature, heart failure, hypertension, previous stroke or myocardial infarction and severe liver and kidney diseases.
Chapter 14
Electrotherapy
Electrotherapy is the use of electricity with therapeutic purpose. Even in ancient times, people treated paralysis and rheumatism with the help of the electrical action of amber and discharges of electric fish. In dermatology, electrotherapy is used in the form of electrocoagulation, microcurrent therapy, darsonvalization, ultratonotherapy, interference currents, and electrophoresis.
For rosacea, electrocoagulation is used to destroy telangiectasia, as well as papular and papulopustular elements. Depending on the severity of the disease, from 20 to 100 procedures are required. Patients with erythematous and limited papular stages of rosacea achieve complete clinical cure with this method.
Microcurrent therapy is also used in the treatment of rosacea, which activates metabolic processes inside cells, accelerates the regeneration of damaged tissues and improves microcirculation. E.S. Pankina (2008), having conducted research, recommends using microcurrent therapy in lymphatic drainage mode for the treatment of erythematous and papular stages of the disease. A 20-minute session is prescribed as a course 2-3 times a week. Total - 8–10 procedures. The successful use of microcurrents in the treatment of rosacea was reported by Fedotova M.A., Gorbunov Yu.G. (Military Medical Academy, St. Petersburg), performing 10 procedures three times a week on 14 people. Experts noted that improvement occurred after the first or second procedure; after 4–5, redness and swelling decreased, and after 5–6, papules disappeared.
Suvorov A.P., Grashkina I.G., Myasnikova T.D. (1991) recommend the use of endonasal zinc electrophoresis for monotherapy of rosacea. In addition, electrophoresis in the treatment of this disease is used with 1–2% ichthyol or 1% copper sulfate solution. The drugs are administered over 20 minutes, at intervals every other day. The course consists of 15–20 procedures.
Electrophoresis is also used in the treatment of demodicosis. Demodicosis of the eyelids Rozko T.E. (2003), having conducted research at the Department of Eye Diseases of the Kemerovo State Medical Academy and at the Kemerovo Regional Clinical Ophthalmological Hospital, recommends treatment with electrophoresis of a 0.5% metrogil solution using a specially invented device containing positive and negative electrodes, which are connected to DC source. 171 people were treated with the new device, while the complete disappearance of clinical signs of demodicosis was noted within 24 hours, and clinical recovery occurred in 96% of cases.
Interference currents are effective in the treatment of psoriasis. Results of the study (2009) at the department of the State Educational Institution of Higher Professional Education MMA named after. THEM. Sechenov under the guidance of Professor Potekaev N.N. showed that current therapy leads to clinical remission in 75.5% of cases, and the condition of 15.1% of patients significantly improved. Thus, a positive clinical effect was observed in 90.6% of patients. It is recommended to carry out treatment twice a day, every day, with intervals between treatments of at least 8 hours. The course lasts for 3–8 weeks, and in torpid cases its duration increases to 12 weeks.
Psoriasis and eczema are also treated using the Ultraton-amp-2int device, designed to apply supratonal frequency currents. For eczema, the procedure is carried out during the period of subsidence of acute inflammatory manifestations and the absence of weeping and fresh rashes with a mushroom-shaped electrode without pressure on the underlying tissue at a power that is defined by the patient as a feeling of pleasant warmth. The duration of the procedure is 10–20 minutes, sessions are repeated daily or every other day. The course of 10–15 procedures is recommended to be repeated after a month. For psoriasis, the procedure is recommended daily for 3-5 minutes on the affected area. The impact is carried out using a labile technique. The course of treatment is 10–20 procedures. As a result of therapy, the progression of the disease stops, inflammation in the inflammation site decreases, itching, pain, and skin tightness decrease.
Chapter 15
Phototherapy
Phototherapy involves exposure to bright light at specific wavelengths for a specific time. Infrared light in short pulsed waves enters the middle layers of the skin, where vascular disorders develop, and eliminates them. Clinical trials confirm the high effectiveness of phototherapy in the treatment of rosacea and other dermatological diseases, in particular demodicosis. A correctly conducted course of phototherapy allows you to get rid of increased activity tick.
The method is based on the principle of exposure to intense pulsed light, which, when it hits the skin, heats the vessels to high temperatures, as a result of which they stick together. At the same time, the surrounding tissues are not damaged, and the skin becomes lighter. In addition, phototherapy helps reduce the work of the sebaceous glands, and accordingly the number of rashes also decreases. Some patients note a decrease in itching after the first procedure. Pulsed light stimulates the production of one’s own collagen, so patients’ skin redness not only disappears, but its texture is evened out and scars are smoothed out. The skin becomes smooth, firm and elastic.
It is recommended to carry out a course of 3–5 procedures lasting 20–25 minutes once or twice a month. After sessions, side effects may occur: peeling, post-inflammatory hyperpigmentation, hematomas, but all of them are reversible.
Thus, according to a clinical study conducted by dermatocosmetologist O.N. Safina of the Evalar Center in Biysk in 2008, 14 patients received from 4 to 6 phototherapy sessions. 90% of patients reported a 90% reduction in hot flashes and improvement in skin texture, 95% had a decrease in redness, and 68% had a decrease in the number of rashes.
O.Yu. Olisova, I.Ya. Pinson from MMA named after. THEM. Sechenov conducted research on the use of phototherapy for psoriasis. It turned out that the progressive stage of vulgar and exudative psoriasis is not a contraindication for this treatment method. Patients received selective phototherapy 5 times a week and the dose was increased if there was no redness. The course of treatment consisted of 20–30 procedures, and therapeutic effectiveness reached 85–90%.
It also reported the treatment of 236 patients with psoriasis using a two- and three-times-a-week irradiation technique after determining the minimum photoerythemal dose (MED) in the back area outside the lesions. The research results showed that 28 patients with palmoplantar psoriasis were cured, 7 had a significant improvement, 3 patients with psoriatic erythroderma had a significant improvement, and one patient had an improvement. Clinical cure was observed in the vast majority of patients - 92%.
The British Journal of Dermatology published the results of a 2010 study conducted by University of Amsterdam dermatologist Ellan Brenninkmeijer. He used an excimer laser with ultraviolet radiation with a wavelength of 308 nm to treat patients with eczema. The results of the experiment showed that laser therapy reduces the symptoms of eczema and can be considered a suitable option for treating this disease.
Chapter 16
Mesotherapy
The mesotherapy method was first described by the French doctor Michel Pistor (1924–2003), who gave an anesthetic injection to a deaf man suffering from bronchospasms near the ear, after which he began to hear.
Mesotherapy is carried out by introducing medications into the skin with syringes, as well as special devices - mesoinjectors. Mesotherapy is widely used in a variety of fields of medicine; in dermatology it is recommended for the treatment of acne, atopic dermatitis, eczema, pustular diseases, scars, and demodicosis.
The principle of mesotherapy is that mini-stresses and microdamages are the main factor in stimulating the body's repair systems. Tissue damage causes fibroblasts to intensively produce and secrete growth factors and glycosaminoglycans, resulting in the formation of new vessels, thickening of the dermis, improving its blood supply and hydration.
Michel Bicheron's theory of microcirculation explains the effect of mesotherapy by improving local blood circulation. As is known, in the focus of inflammation, impaired microcirculation is accompanied by impaired tissue trophism, which manifests itself in the form of a pain symptom, which in turn worsens microcirculation. A painful stimulus during mesotherapy leads to the release of endogenous analgesic substances and “cuts” the knot of local pathological reactions. This treatment method relaxes the smooth muscle walls of blood vessels, stimulating blood flow.
When treating rosacea, mesotherapy is carried out taking into account the visceral cutaneous zones of the reflex projection, since in acute and subacute conditions injections into the facial skin are too aggressive. The emphasis is on drugs that strengthen the vascular wall and improve microcirculation and lymphatic drainage. Anti-inflammatory and antioxidant drugs are also included. All areas are injected using the classical technique, individual papules and pustules, biologically active points, as well as the cervical and upper thoracic regions.
Head of the Department of Skin and Venereal Diseases of the Yaroslavl State Medical Academy Zavadsky N.N. spent clinical researches in the treatment of patients with psoriasis using mesotherapy. The experiment involved 97 people who were administered vero-methotrexate 10 mg (1 ml), diluted with saline to 3–5 ml; 1 time per week, 4 procedures; diprospan 1 ml (betamethasone 7 mg with extended action), diluted with saline to 3–5 ml, once; repeated administration of diprospan (if necessary) - no earlier than after 1 month. If the face was affected, injections were made behind the ear on the scalp. The results showed that almost all patients had a decrease in rashes, and after 1-2 courses, a fairly stable result was achieved in most patients. The period of remissions also lengthened.
Chapter 17
Ozone therapy
Ozone was discovered in 1840 by the Swiss chemist Christian Friedrich Schönbein. In 1857, Werner von Siemens created the “perfect magnetic induction tube,” with which the first technical ozone installation was constructed, and a century later, physicist, chemist and mathematician Joachim Hanzler came up with a medical ozone generator that allows precise dosing of the ozone-oxygen mixture. Ozone itself is toxic, but medical ozone does not contain toxic nitrogen oxides. For treatment, a gas mixture consisting of 5% pure ozone and 95% oxygen is used.
Ozone therapy improves blood circulation in tissues, improves blood flow and microcirculation, as well as the supply of oxygen to cells. The gas mixture has an anti-inflammatory and hemostatic effect, promotes rapid healing of wounds. In addition, it has an antibacterial effect, destroying viruses, bacteria and fungi. Also, the oxygen-ozone mixture stimulates redox processes, the immune system and quadruples its phagocytic protective function.
Ozone therapy has proven itself in the treatment of demodicosis and rosacea. Ozone, being a strong oxidizing agent, effectively destroys pathogenic microorganisms, while they do not develop resistance to the substance, as is the case with antibiotic therapy. Ozone has a beneficial effect on humoral and cellular immunity, providing an anti-inflammatory effect, which makes it possible to reduce the treatment time for patients with demodicosis and rosacea several times.
Thus, it was noted that patients underwent a course of 10 BAGOT procedures (twice a week), and at home they used specially prepared ozonated oil, applying it at night. The gas mixture was used in increasing concentrations, starting from 10 mg/l to 40 mg/l. The oil was produced by bubbling purified refined olive oil with an ozone concentration of 60 mg/l in an ozone-oxygen mixture. Already after 3–4 procedures, all patients showed a marked improvement in skin condition, and after 1.5 months clinical recovery occurred, confirmed by the absence of mites in control scrapings.
Also, in addition to puncturing foci of inflammation, local application of gauze lotions with ozonized water with an OM concentration of 10–15 mg/l is carried out.
To treat rosacea, an oxygen-ozone mixture is administered subcutaneously from 2–3 weeks of treatment after an exacerbation of inflammatory phenomena. The course is 3–10 procedures 1–2 times a week. In patients with rosacea, after ozone therapy, swelling of the face, congestive hyperemia, as well as small telangiectasias disappeared, and papules resolved faster. In addition, the likelihood of relapse was reduced. To remove stagnant spots and restore skin color, maintenance oxygen-ozone therapy is performed 2-3 times a month, followed by lymphatic drainage massage.
Conducted by specialists of the Vitebsk Regional Clinical Dermatovenerological Dispensary V.E. Spiridonov, Yu.A. Lovchinovskaya, V.V. Salarev. Observations of 112 patients with psoriasis and eczema showed that ozone therapy in complex treatment stopped the inflammatory reaction and reduced peeling and infiltration. Cure or “significant improvement” occurred in all patients with exudative erythema and pyoderma, in 69.2% of patients with psoriasis, in 78.2% with atopic dermatitis and in 88.4% of patients with chronic eczema.
Contraindications to ozone therapy are: early period after various, including internal bleeding, hemorrhagic stroke, hyperthyroidism, tendency to convulsions, acute alcohol intoxication, thrombocytopenia, decreased blood clotting and allergy to ozone. Women interrupt treatment during menstruation.
Chapter 18
Yoga
Traditional yoga speaks of the existence of seven main energy centers - chakras, corresponding to the seven nerve plexuses. The channels of the human subtle energy system correspond to the peripheral autonomic nervous system - sympathetic and parasympathetic. The left channel or ida carries the energy of our desire. He is responsible for the past. The unconscious draws information and images from this channel, where everything that happens in the process of evolution is stored, as well as everything that comes out of the unconscious mind of people. The right channel or pingala carries the energy of action and is responsible for the future. The collective superconsciousness receives everything that is dead, that has happened due to overly ambitious, future-oriented individuals, aggressive animals or plants. It is believed that excessive “departure” to the right or left channel leads to negative psychological and physical consequences, in particular, to skin diseases. Skin rashes occur, from a yoga point of view, due to problems with excretory system- when it stops outputting what it should.
Asanas and pranayama affect the endocrine system, increasing blood supply to tissues and organs, which leads to their full functioning. Also, performing exercises gives the effect of “internal hydraulic massage” - yoga represents the human body as an interconnected system of cavities filled with various liquids and gases; in the process of performing asanas, the volume of these body cavities and the pressure in them changes, blood flow changes and metabolism is corrected.
Among the asanas affecting the endocrine system are: Setu Bandhasana - bridge pose, Eka Pada Rajakapotasana I - pigeon pose, Valakhiliasana, Bhujangasana I, Bhujangasana II - snake pose, Shirshasana, Chaturanga Dandasana staff pose, Nakra sana - crocodile pose, Adho Mukha Svanasana - one of the dog poses, Lolasana - earring pose, Tolasana - scales pose, Simhasana - lion pose, Maha mudra, Yoganidrasana, Pash chimottanasana. Remember that all exercises are performed only on an empty stomach, and the effect does not come from regular exercise for a long time - about 3 months or more. You shouldn’t wait to get rid of skin problems after the first sessions.
The “agni-sara-dhauti-kriya” or “cleansing by internal fire” exercise also perfectly increases vitality and is indispensable in the treatment of any ailments. It consists of three parts.
Part 1. Starting position: stand on slightly bent legs, tilt your torso slightly forward to relax your abdominal muscles. Place your palms on your stomach. The index fingers are placed horizontally on the navel line, the middle fingers are almost touching on the vertical center line of the body. Exhale deeply, then press with all fingers, except the thumbs, on the middle part of the abdomen, pressing it inward. Do up to 18 presses, then inhale and sit quietly. You need to do 6 such approaches. Holding your breath should be comfortable - even if you don’t manage to do all 18 presses the first time.
Part 2. Starting position: stand up, straighten up, put your hands on your belt, lower them under your chin and press them to your chest. Inhale, at the same time strongly drawing your stomach in, lifting the diaphragm, and contracting the muscles of the perineum and anus, pulling them into yourself. Stay in this state for a few seconds and then completely relax all your muscles, exhaling calmly. Keep your chin pressed to your chest at all times. Do 5–10 approaches.
Part 3. Starting position: the same as in part 2, inhale, then exhale deeply. Bend forward, parallel to the floor, place your hands on your knees. At the same time, press your chin to your chest and contract the muscles of the perineum and anus. Fix the position for 3-5 seconds, then, without straightening, relax your stomach and, sharply lowering the diaphragm, push your stomach forward, then pull it back just as sharply. Do quick retractions and protrusions of the abdomen. The total number of such cycles in one approach should be brought to 18, approaches - 6. Do the second approach in the same way as the first, but without pressing the chin to the chest. The third and fourth - like the first and second, respectively, only tilt your torso at an angle of 45 degrees to the floor. The fifth and sixth are like the first and second, only keep your torso vertical.
Chapter 19
Acupuncture
The Chinese art of acupuncture or acupuncture has been around for about 2,000 years. In accordance with the ideas of this teaching, the vital energy “qi” flows in the human body along 14 channels - meridians. In acupuncture, 360 points are stimulated along these channels.
Acupuncture provides reflex correction of functional systems at almost all levels of the central nervous system and affects the activity of the neurohumoral regulation system. Thus, acupuncture has an anti-inflammatory and anti-allergic effect, therefore it is widely used in the treatment of chronic dermatoses - demodicosis, rosacea, psoriasis and others.
Acupuncture is carried out using special needles made of medical steel - they are longer than ordinary sewing needles and very thin, so inserting them into the skin is almost painless. The needles are used only once, screwing them into the skin, sometimes to a depth of 8 cm.
As noted in the work of Olisova O.Yu., Bondareva G.I., Dodina M.I. from the Department of Skin and Venereal Diseases of the 1st Moscow State Medical University named after I.M. Sechenov, when treating the erythematous stage of rosacea, patients were prescribed 2 courses of acupuncture of 10 sessions with an interval of 2 weeks. The patients were treated with the 2nd version of the inhibitory method of corporal points, local and general (for example, G21, 20, 15, 12; T12, 14, 11, 20; F1, 23; VB41; TR5, 14; R6, 15, 16, 17, etc.) and auricular (adrenal point, Shen Men, endocrine gland point, etc.), corresponding to areas of the pathological process. In all patients, reflexology therapy contributed to a more rapid relief of the “exacerbation reaction.”
According to research by Dr. Florian Pfaeb, an employee of the Technical University of Munich, acupuncture relieves itching in patients with atopic eczema. It was found that a reflexology session performed a few minutes after the patient’s skin was exposed to an allergen (pollen or saprophyte) relieved itching. In addition, when patients were repeatedly exposed to the allergen, the immune response from the skin was calmer after acupuncture, i.e. acupuncture also has a preventive effect.
When treating generalized eczema using reflexology, the same points are indicated as for itching. Thus, when eczema is localized on the scalp, the following points are stimulated: shuai-gu (56 Gv), tai-yang (61 Gv), qiang-jian (7 Gv), cheng-ling (18 G2). When the process is localized on the legs, the following are affected: yang-lingquan (300 Np1), feng shi (303 Np1), tzu-san-li (314 Np2), yin-ling-quan (328 Np3), san-yin-jiao ( 333 Nb4), wei-zhong (356 Np6), kun-lun (367 Np6), xue-hai (329 Np3). When eczema is localized on the ears: ting-gong (35 Gu), jiao-sun (40 Gu), i-feng (43 Gu). If the back is affected: da-zhu (109 C1), da-chang-shu (123 C1), jian-liao (86 C), shen-zhu (97 C), ming-men (105 C), chang-qiang ( 108 Ss). When localizing the process on the hands, the following points are stimulated: qu-tze (253 P3), da-ling (249 P3), he-gu (258 P4), shou-san-li (264 P4), nei-guan (250 P3), (250 Р3), (265 Р4), le-que (232 Р1), wai-guan (281 Р5). When localized on the chest: xuan-ji (148 Gy), tan-zhong (152 Gy), zhong-fu (167 Gy3). If the abdomen is affected: guan-yuan (188 Zhs), yin-jiao (185 Zhs), sy-man (199 Zh1), cheng-man (204 Zh2). When eczema is localized on the face: i-feng (43 Gu), yang-bai (28 Gg), sy-bai (32 Gg), da-ying (65 Gg), ting-gong (35 Gu). If the neck is affected: tian-tu (66 Shs), da-zhui (95 Ss), tian-ding (71 Shs).
In one session, acupuncture is performed at 5–6 points, which are selected depending on the location of the disease. In addition, points are taken according to the affected segments. In the acute stage, the first version of the excitatory method is used, in case of a chronic disease, the first version of the inhibitory method is used. Every day it is recommended to make superficial injections at the site of the lesion with strong irritation. In total, 3–4 courses of treatment are required, lasting 2 weeks. The break between courses should be 10–12 days.
For the treatment of patients with psoriasis (E. D. Tykochinskaya, 1979), points on the midline of the head and back, as well as segmental ones in the limbs and local ones in the affected area - He-gu (258 Rnt; 1.5) are predominantly stimulated by the first or second version of the inhibitory method ), Qu-chi (265 Rnt), Zusan-li (314 Nsp), Wei-chung (356 Nsp). Using the second version of the exciting method, the points Zhi-bian (147 C2b), Xue-hai (329 Nvp), Ge-shu (115 C1b), Pi-shu (118 C1b), Yin-ling- quan (328 Nvp), San-yin-jiao (333 Nvs), Shou-san-li (264 Rnt).
Contraindications to acupuncture are: tumors, fever, chronic infections (tuberculosis, brucellosis) in the acute stage, organic diseases heart, kidneys, severe exhaustion, drug addiction, age under 3 years and over 75 years, second half of pregnancy, acute infectious diseases, decompensation of breathing, blood circulation, acute mental agitation, intoxication, acute pain syndromes.
Chapter 20
Metal therapy
One of the oldest methods of medicine is metal treatment, which was subsequently used quite limitedly, since the physical nature of the therapeutic effect was not clear. Aristotle and Galen knew about metal therapy. Bürg was the first to make a scientific attempt to apply this type of therapy. He treated patients with hysterical attacks by applying brass. He also used metals to save people from anesthesia, paralysis, spasms, vomiting, neuralgia and other diseases. Bürg noticed that patients with the same disease were affected by different metals, deciding that patients had their own idiosyncrasy for metal. He believed that to get rid of the disease, metal must coincide with idiosyncrasy. Thus, in 1856 he was awarded a silver medal of the Hygienic Society for the treatment of cholera convulsions with metals.
Galvanic effects in metal therapy were studied by the French physiologist P. Regnard. He established that different metals have different conductivities, causing different deflections of the needle on the instrument, and selected currents from a chemical current source that gave the same deflection of the needle. It turned out that the effect of external current on patients was similar to the effect of metal plates.
Research by Safonova N.M. at the Institute of Balneology in Sochi they showed that when copper, gold, zinc and lead come into contact with human skin, the current flows from the metal to the skin, and when silver and tin come into contact, on the contrary, from the skin to the metal. She started using it when skin diseases copper disks. In the process of studying the method, it turned out that the body attracts metal in a sore spot, and when it is not needed, it rejects it.
In metal treatment, the metal is first applied for one to two days to test for allergies and the patient's reaction. It is also important to establish the root cause of the disease, otherwise the application of metal to the secondary focus - the one that is bothering you at the moment - may not have an effect or the disease will worsen. The metal is applied to patients of any age for several days, followed by a break of up to 5 weeks, and then treatment continues. It is necessary to apply plates or coins to active points of the skin where pain is most felt.
Tin and also lead are suitable for the treatment of skin diseases. The antiseptic and cleansing properties of silver are well known - it also has a beneficial effect on the skin. In addition to decorations, silver plates are used externally, which are attached to problem areas bandage or adhesive tape. Remember that before use, any metal must be cleaned - for this, in accordance with Ayurveda, it must be heated and treated with oil, milk or grain gruel. Then you need to feel the metal, interact with it and turn to it for help.
You can also use water with silver ions for treatment, which you can buy or you can make yourself. To do this, silver items are placed in a vessel with water, left for 10–12 hours, then the jewelry is removed, and water is taken three times a day, 2 teaspoons. This water destroys all pathogenic organisms and improves immunity. Doctors recommend bathing infants in it to prevent dermatitis and eczema. It should be noted that sometimes with an increased content of silver in water, argerosis can occur - a disease in which silver is deposited in tissues and organs. Symptoms of the disease are a grayish-green or bluish tint to the skin and mucous membranes.
In the reflexology room in clinic No. 2 in Kaliningrad near Moscow, this method was successfully used for 17 years. The principle of metal therapy is that with any impact on the skin - pressure, injection, current - there is an effect on sympathetic system, the magnitude of which depends on the metal, its area, place of application and session time. Doctors have found that the therapeutic effect is achieved when the effect corresponds to the minimum wave of excitation, which is individual for each patient and for each disease. The minimum is found using the galvanic skin reflex (GSR) method according to the Ferri method. Specialists from a Kaliningrad hospital reported successful treatment in children with neurodermatitis and eczema using metal therapy. On average, the course of treatment is 9–10 procedures.
Chapter 21
Hydrotherapy
Hydrotherapy or hydrotherapy was first mentioned in the ancient Indian Vedas in 1500 BC. Hydrotherapy refers to the use of water for therapeutic and preventive purposes - this includes irrigation (irrigation), baths, showers, treatment with thermal waters (balneotherapy), and enemas. It is known that water has a higher heat capacity than therapeutic mud compared to other thermal therapeutic agents: 1.0 at a temperature of 16 °C. Water absorbs 2 times more heat than therapeutic mud and has good thermal conductivity (for example, the thermal conductivity of water is 28–30 times higher than that of air). Hydrotherapy, or hydrotherapy, is the external use of water at various temperatures for therapeutic and prophylactic purposes.
Procedures for hydrotherapy can be: cold - then the temperature of the water used is below 20 degrees, cool with a temperature of 20–33 degrees, lukewarm - 37 degrees, warm - 38–39 degrees, hot - 40 degrees and above and the so-called indifferent - 34 -36 degrees.
The greater the difference between the water temperature and body temperature, the greater the effect of baths. Patients with rosacea do not want to take very cold or very hot baths, so dermatologists recommend that they use thermal water sprays to reduce inflammation and reduce the risk of pathological scarring. Many patients note that their condition improved significantly after using sprays from well-known cosmetic companies specializing in the production of products based on thermal waters.
For other diseases in dermatology, sulfide or hydrogen sulfide, radon, as well as carbon dioxide mineral waters and siliceous thermal baths are most often used. Treatment with thermal waters reduces the number of relapses in patients with chronic dermatoses by two to three times. In addition, it is possible to achieve a high degree of rehabilitation.
When treating patients with non-acute inflammatory dermatoses (for example, torpid psoriasis, neurodermatitis, chronic eczema), carbon dioxide baths are used. Contraindications to them are: previous myocardial infarction, as well as nephritis and nephrosis.
For the treatment of chronic dermatoses in a stationary or regressive stage - such as eczema, psoriasis, neurodermatosis, scleroderma, red lichen planus, urticaria, ichthyosis - patients are prescribed hydrogen sulfide baths with a concentration of free hydrogen sulfide from 30–40 to 100–150 mg/l. The procedures last 5–10 minutes. The course is 10–15 baths, with an interval of 1–2 days. Contraindications are tuberculosis, liver and kidney diseases and thyrotoxicosis.
For eczema, urticaria, progressive psoriasis, neurodermatitis, pruritus, it is recommended to take radon baths, which well reduce the acute inflammatory course of the disease due to a decrease in the permeability of skin vessels and a vasoconstrictor effect. The duration of the procedure is 5–15 minutes. Contraindications to such baths are cardiovascular diseases, neoplasms and erythroderma.
Chapter 22
Therapeutic fasting
Periodic abstinence from food to get rid of an illness or for moral reasons has a long history. The beneficial effects of fasting on the body were known to doctors and philosophers of Ancient Greece, India, and Tibet.
Our body experiences a state without water and food as stress, which, according to F.Z. Meerson (1981), is the initial stage of the body’s adaptation to extreme conditions. Many diseases modern man arise precisely due to a violation of the body’s adaptation to external and internal environmental conditions, so fasting can be regarded as a preventative measure for improving adaptive capabilities.
Therapeutic effect fasting is to stimulate reparative processes, death of “sick” cells, and removal of toxins. Indications for fasting are numerous diseases, including skin allergies, which include neurodermatitis, psoriasis, eczema, etc.
In domestic medicine, therapeutic fasting in hospitals is called fasting-dietary therapy (RDT - the term of Yu.S. Nikolaev). RDT is divided into three main periods: preparatory, loading and recovery. In the preparatory period, a comprehensive examination of patients is carried out, the necessary consultations with specialists are prescribed, and foci of chronic infection are sanitized. The fasting and recovery periods vary depending on the type of therapeutic fasting, which can be complete, absolute, combined, or stepped.
Complete therapeutic fasting is fasting without restricting water intake. In the preparatory period, bowel cleansing is also carried out, the patient goes to bed without eating dinner. In the morning he is prescribed a saline laxative - 40–50 g of magnesium sulfate dissolved in 200 ml of warm boiled water. After this, food intake stops. The fasting period is calculated individually, depending on the age, condition of the patient, and well-being. It is recommended to achieve a “ketoacidotic crisis”, which in most patients is observed on days 7–9. On average, fasting lasts 12–14 days, but in the presence of psoriasis, for example, it is advisable to increase the period of abstinence to 18–21 days. A longer restriction is impractical due to the fact that it is poorly tolerated by patients. During the fasting period, patients take at least 1–1.6 liters of boiled water or weakly brewed tea, not sweet, preferably green, daily. You can also drink a decoction of mint or rose hips.
During this time, smoking, drinking coffee and alcohol are strictly prohibited. Most medications are discontinued from the first days of fasting. Every day, patients are prescribed enemas with 1–1.5 liters of water at room temperature, a circular shower, and a Charcot shower. Patients are recommended to have an active daily routine, preferably spending a lot of time outdoors. Night sleep should last at least 8–9 hours, sleep in a well-ventilated area. Signs of the end of the fasting period are: the appearance of a feeling of hunger and dreams about food, complete cleansing of the tongue from plaque, the absence of feces in the washing water after the enema, the persistent disappearance of symptoms of the disease. During the recovery period of RDT, a gentle, hypoallergenic diet, split meals, and a gradual expansion of the diet with the exclusion of table salt are recommended for persons with skin allergies.
With absolute or “dry” fasting, food and water are completely excluded. From a physiological point of view, the body is in the process of complete fasting does not experience a fluid deficiency, since for every kilogram of fat that is broken down, up to 1 liter of endogenous water is released every day, and losses due to the evaporation of moisture from the skin and diuration are insignificant. So, the water deficit in a fasting body does not exceed 0.5–1 liters per day. Typically, patients are prescribed short-term absolute fasting, lasting from 1 to 3 days. Laxatives and cleansing enemas are usually not prescribed before and during absolute fasting. This type of fasting is also successfully used for those suffering from skin allergies. It is also worth noting that the effectiveness of absolute fasting is higher than complete fasting (V.A. Zakirov, 1989). It is believed that 3 days of absolute fasting correspond to 7–9 days of complete fasting. It is important to remember that “dry” fasting for more than 3 days is undesirable.
Chapter 23
Juice therapy and raw food diet
For the first time, the German scientist Eugen Heun proposed treating diseases with juices in 1951. The theory was founded by the Englishman Norman Walker, who lived for almost 100 years on vegetable and fruit juices and nuts. Juice therapy gained popularity after the publication of books by the Austrian healer Rudolf Breuss, who created a new method of treating cancer based on fasting and drinking juices. According to Breus, he managed to cure 40 thousand cancer patients with this method.
We all know that freshly squeezed juices are healthy, but their biggest advantage is their rapid absorption by the body. Juice, unlike fruits and vegetables containing fiber, is absorbed in just 10–15 minutes, thereby relieving the digestive system of unnecessary work. Juice therapy perfectly cleanses the body of toxins, saturates it with vitamins and nutrients, and activates metabolism.
The juice treatment method involves taking 1–1.5 liters of fruit and vegetable juices per day. The course can vary from 7 to 70 days, depending on the improvement of symptoms and the person’s well-being. Juices should be freshly squeezed and it is better to drink them within the first five minutes after preparation. At the beginning of juice therapy, it is recommended to take unmixed juices. You can add lemon or rhubarb juice to berry juices, but it is better not to mix juices from stone fruits (cherries, cherries, plums, cherry plums) with other juices. In addition, when preparing a mixture of juices, you should observe their certain compatibility: for example, pears and radishes, apples and carrots, apples and tomatoes, pineapple and celery, orange and radish.
After starting juice therapy, toxins begin to be eliminated from the body, therefore, to help it cope with this flow of harmful substances, it is necessary to regularly cleanse the intestines and liver.
Juice therapy is usually well tolerated by the body. But there are a number of contraindications for this treatment method. So, if you are allergic to pollen, you should not drink juice from green wheat shoots. During exacerbation of peptic ulcer disease and enteritis, you should not drink carrot juice. You should also be careful with tomato and citrus juices - in addition to allergies, they can disrupt the acid-base balance in the body.
Another way to cleanse the body and normalize metabolism can be a raw food diet. When eating a raw food diet, the consumption of food that has undergone heat treatment (cooking, stewing, frying, etc.) is completely excluded; in addition to raw vegetables and fruits, it is allowed to eat dried fruits and cold-pressed vegetable oils. You can also eat raw sprouted cereals, which are prepared by soaking the seeds in water for a day and keeping them in a humid air environment for several days.
Proponents of a raw food diet, as arguments in favor of this approach to nutrition, note that heat treatment of food at a temperature of 40–45 degrees destroys enzymes, as a result of which the natural digestion process slows down, and also destroys a number of vitamins and microelements, which makes their absorption difficult. In addition, as a result of thermal processing, new chemical compounds arise that are not found in living nature and often negatively affect humans - carcinogens, trans fats, etc. It is also worth noting that thermally cooked food is not completely digested in the stomach, and part of it remains to rot in the digestive system, which promotes the proliferation of pathogenic microflora.
A raw food diet is useful for various diseases, as it perfectly cleanses the body. Treatment with such a diet gives good results for skin diseases, in particular eczema, rosacea and psoriasis. On the Internet you can find many reviews of patients with these ailments, who, after switching to a raw food diet, were almost completely cured - for example, they reported that after 2-3 weeks the redness went away, pimples and plaques disappeared.
However, when switching to a raw food diet, it is worth remembering that if you have a duodenal ulcer, consuming most raw vegetables is contraindicated, especially zucchini, carrots, cabbage, beets, cucumbers and turnips, as well as green salad. In addition, zucchini should not be eaten if you have kidney disease. In case of ischemia, hypertension and tachycardia, it is undesirable to use large quantity bell pepper. Beets, potatoes and turnips should not be eaten if you have diabetes and obesity, and if you have urolithiasis, gout and exacerbation chronic colitis spinach and green salad are excluded.
Chapter 24
Apitherapy
Apitherapy is a method of treating various diseases using live bees, as well as their metabolic products: honey, pollen, propolis, royal jelly, bee bread, wax and poison. Apitherapy was known in Ancient Egypt, Greece and China. Mention of healing after consuming honey and other bee products is found in the Vedas, the Bible and the Koran. In Rus', bee stinging has been used since ancient times and was considered a traditional method of treating many diseases. However, the first scientific basis apitherapy in medicine occurred in 1894 - it was then that Professor Lukomsky of the St. Petersburg Academy of Forestry proposed treating rheumatism and gout with bee venom.
Bee venom is produced by special glands, which are modified glands of worker bees and queens. When a bee stings, it injects 0.2 to 0.8 mg of venom containing pheromones, toxins, enzymes and biologically active amines. In small doses, the poison causes various physiological reactions that normalize disturbed homeostasis. In addition, bee venom has anti-inflammatory, bactericidal, immunostimulating, antiallergic, absorbable, decongestant and protective effects.
Propolis, which bees collect from various parts of plants, has powerful bactericidal properties. It destroys fungi, bacteria, viruses, protozoa, improves immunity, relieves pain and has anti-inflammatory and antioxidant effects.
There is evidence of a cure for demodicosis by bee stings. The poison can be administered either by live bees or by syringe. First, a sting tolerance test is carried out by placing the bee on the lower third of the forearm, after which the sting is removed after 10 seconds. The patient then takes blood and urine tests and blood glucose tests the next day. After receiving the results, another sting is done, but the sting is removed after a minute and repeated tests are carried out. After the bite, redness, swelling and itching appear - this reaction can last for several days. If the tests are normal and there are no side effects from the treatment - nausea, headache, deterioration in health, then after 5-7 days you need to do the tests again and begin treatment, which should only be carried out by a qualified apitherapist. Every day the number of bees for perching increases to 18–20, and the number of procedures ranges from 9 to 21. Sessions lasting 10–15 minutes are done every other day, three times a week.
It is also known that propolis is a good remedy for treating rosacea. Its 5–10% alcohol tincture is prescribed after severe inflammatory phenomena have subsided. Treatment begins with weaker concentrations, since some patients develop intolerance to the drug in the form of itching and exacerbation of inflammation. In this case, treatment must be stopped immediately. Propolis is applied daily to the affected areas of the skin without rinsing. A film forms on the face, which is washed off in the morning with a cotton swab dipped in vodka. The first month of the procedure is done every day, and during the second month - every other day.
In the book “Apitherapy” G.S. Kozhukharya (1981) describes a method of treating bee stings for patients with psoriasis. Over the course of 10 days, stings are made from 1 to 10 per session, and the sting is removed after 5–10 minutes. Then a break is taken for 3–4 days and then the course is repeated again, but with the number of bees increased by 3 times. In just two courses, 180–200 stings are carried out. Good treatment results are reported.
K. Braileanu treated chronic eczema, epidermophytosis, hyperkeratotic fungal eczema, chemical fungal dermatitis and neurodermatitis with 10 and 20% propolis ointments. As a result, itching in patients decreased and the skin process improved.
In 1985, Fang Chu successfully treated psoriasis with propolis by giving patients tablets containing 0.3 propolis for 2–3 months. Complete cure was observed in 37 out of 160 patients, and relapse in those who recovered occurred in 16 cases.
Contraindications to such therapy are: type 1 diabetes mellitus, pregnancy, breastfeeding, children under five years of age, various neoplasms, Addisson's disease, hepatitis and tuberculosis, acute and chronic infectious diseases, intolerance to bee venom, vaccination (not earlier than a month after vaccination), failure of internal organs (cardiac, vascular, respiratory, renal and liver).
Chapter 25
Mud therapy (peloidotherapy)
Pelotherapy or mud therapy has been known to mankind for at least 5 thousand years. Treatment with silt from floods of the Nile River in Egypt was reported by Claudius Galen in the 2nd century BC.
Mud liquor or solution has a complex chemical composition and contains minerals, salts and mineral substances. The solution also contains various peptides, low molecular weight proteases, gammalinolenic acid, nucleic acids, compounds of humic acids with iron, phenols, hydrocarbons, cellulose, enzymes, lignins, antibiotic analogues, phytohormones and vitamins.
There are several types of mud depending on its composition. Their application affects the receptors of the skin and mucous membranes, reflexively affects the nervous, endocrine and vascular systems, due to which a functional, microcirculatory and metabolic shift occurs in skin cells, tissues and organs, which, first of all, is manifested by an improvement in cellular nutrition. The trophic effect helps resolve the inflammatory process - accelerates the resorption of decay products, reduces adhesions and scars.
Therapeutic mud also affects the immune system, increasing it as a result of stimulating the function of the adrenal cortex and increasing the synthesis of catecholamines. Also, the warmth of the mud has an analgesic, antiseptic and anti-inflammatory effect.
Applying mud enhances peripheral circulation, blood supply, relieves swelling, and enhances lymphatic drainage. Mud liquor penetrates deeply into the skin, nourishing it, as a result of which it becomes more elastic and elastic, wrinkles are smoothed out, scars are softened and smoothed out. All these properties of mud are widely used in the treatment of psoriasis, eczema, urticaria, acne, rosacea and demodicosis.
Thus, when treating rosacea with peloid therapy, the symptoms of peeling, redness and infiltration completely disappeared in 92.5% of patients, and hyperpigmentation disappeared in 96.3% of cases. (candidate of medical sciences Tarkina T.V., Alma-Ata). In addition, all patients experienced stable remission.
Mud therapy using silt sulfide and hill mud, peat, sapropels has a good therapeutic effect on reducing the symptoms of psoriasis. Liquor acts on psoriatic lesions as an anti-inflammatory, absorbable and analgesic. It is recommended to apply mud at a temperature of up to 40 degrees for 10–30 minutes every day or every other day for a month. Many patients report stable remission after treatment.
In Russia, mud therapy is practiced in the sanatoriums and boarding houses of Staraya Russa in the Novgorod region, Yarovoe in the Altai region, Karachi in the Novosibirsk region, Uchum in the Krasnoyarsk region, Anapa in the Krasnodar region, Sadgorod in Vladivostok and others. Patients also reported good results after staying at the Sergievsky mineral waters in the Samara region, Saki in the Crimea and at the Dead Sea in Jordan or Israel.
Contraindications to peloidotherapy are: acute inflammatory diseases, malignant tumors, myomas and fibroids, ovarian cysts, blood diseases, bleeding, tuberculosis, hypertension, ischemia, varicose veins, endocrine diseases, atherosclerosis, epilepsy, infectious diseases and pregnancy.
Chapter 26
Magnetotherapy
Magnetotherapy is one of the areas of physiotherapy, based on the impact on the human body of variable magnetic field low frequency. Russian specialists have developed a number of devices for magnetic therapy, which is indicated for rosacea, psoriasis, eczema and other dermatoses.
It is known that this method of treatment has an analgesic effect, relieves spasms, promotes the activation of repair and regeneration processes, and also has a strong anti-inflammatory effect, eliminates swelling, improves microcirculation, peripheral circulation and lymph flow, improves the functioning of the autonomic nervous system, endocrine system and restores immunity. Magnetotherapy increases the diameter of capillaries, due to which the speed of blood flow in them increases, which, in turn, leads to improved metabolism and nutrition of tissues, and restores impaired functions.
Doctors of the central Cheboksary hospital (K.M. Volkova, M.P. Vinokurova, L.V. Semenova) observed 21 patients with stage 2 rosacea in 2009. Patients were offered to undergo treatment using the AMT-02 Magniter device. The impact was carried out contactally on the forehead area with an alternating and pulsating magnetic field, and the induction value was 10–30 mT. The procedure was applied for 10 minutes and for 5 minutes on the cheek area. Improvement in clinical signs of the disease was noted in 16% of patients.
Magnetic therapy is also used in the treatment of the progressive stage of psoriasis. Its action (Zuev A.V., Moscow, 2003) accelerates the transition to the stationary and regressive stages without further prescription of medications. In patients psoriatic arthritis who received magnetic field treatment in combination with drug therapy, improvements occurred in 91.5% of cases. In addition, studies conducted in the clinic of skin and venereal diseases of the Siberian State Medical University on the effects of a traveling magnetic field using the domestic device “AMO-ATOS” and the attachment “HEAD” on 55 patients with psoriasis showed that average duration The hospital stay of patients was 7.3 days less than that of patients who underwent traditional drug treatment.
According to the same clinic of skin and venereal diseases of the Siberian State Medical University, magnetic therapy was also used in the treatment of atopic dermatitis. 60 patients under observation reported a significant reduction or complete disappearance of itching by the end of the first week of therapy.
One of the developments of our scientists in the field of magnetic therapy was the Reich chamber - a special chamber within which a special electromagnetic environment is formed. The chamber in which a person is placed, dressed in cotton clothes, consists of several alternating layers of metal and dielectric. The duration of the procedure ranges from 25 to 35 minutes. Treatment is carried out daily for 10–15 days. As studies have shown at the Department of Dermatovenereology and Dermato-Oncology together with the Department of Hyperbaric Oxygenation of the M.F. MONIKI. Vladimirsky (Tretyakova E.I., Sukhova T.E., Groznova A.A., Kiselev S.O., Osenovskaya E.N.), after a course of treatment in the Reich chamber, the average duration of which was 9 sessions, out of 62 patients atopic dermatitis, neurodermatitis, eczema and urticaria, 4 patients with lichen planus, 7 patients with psoriasis, 13 with scleroderma and 6 with other dermatological diseases (cutaneous lymphoma, Raynaud's disease, Kaposi's sarcoma, erythema multiforme exudative, prurigo, pruritus nodosum ) a positive effect was observed in 99.6% of cases.
Contraindications to magnetic therapy are: thrombophlebitis, vasculitis and increased bleeding, pregnancy, the presence of a pacemaker, circulatory insufficiency, hypotension, ischemia, systemic blood diseases, metal parts in the affected area (pins, plates, prostheses, etc.), as well as chronic dermatoses in the acute stage.
Chapter 27
Sytin's healing moods
The SOEVUS method (verbal-figurative, emotional-volitional control of the human condition), invented by Doctor of Sciences, Academician of the International Academy G. N. Sytin, can also be successfully used for healing from various skin diseases. Our thoughts are material, therefore self-persuasion according to Sytin’s method is an excellent example of how a person’s mental and somatic state is regulated by speech. SOEVUS consists of listening or reading special moods, which in their form are similar to the conspiracies of our great-grandmothers. Thus, in Sytin’s method, two techniques are used at once, which increase the degree of suggestion and which are characteristic of ancient conspiracies: tautological repetitions of certain words and rhythmic repetition of sounds and their combinations. Research by psycholinguists has shown that one of the important parameters of suggestion is the sound organization of texts, since sound affects the analyzers of our feelings. Suggestibility increases with repeated repetition of the same idea, text, thought. Also, suggestibility is increased by the rhythm of the text.
The SOEVUS method is not limited only to the treatment of diseases; it can be used to heal and rejuvenate the body. If drug therapy is carried out in parallel, then the use of moods can strengthen the nervous system, increasing the effectiveness of treatment. Among the numerous moods there are texts that specifically influence individual organs and systems. In addition, SOEVUS will help people in difficult, crisis situations, since it is programmed with general attitudes: for luck and stability in business and life.
Sytin's moods are texts with positive statements that create cheerful images of health and youth in a person. The formula also contains phrases that stimulate the will and suppress doubts, which contributes to better assimilation of attitudes. Texts help with bright images manage well-being and performance. In addition to the direct healing effect, SOEVUS develops will and self-education, awakens internal strength, and forms an active life position.
Under the influence of specially composed texts that carry a charge of energy and vigor, a person’s idea of himself and his health gradually changes, as a result of which corresponding changes occur in the body. Carefully selected words in Sytin’s mood contribute to the emergence of positive emotions after reading the text, which are maintained even after the end of classes. Even one lesson has an effect that is recorded by devices for a whole month.
In the first days of reading the moods, classes should begin with a special introductory text. You can either listen to the recordings or read them out loud or to yourself. Sytin advises walking actively when listening to the mood, and also making an effort to memorize the text. In addition, it is useful to read or listen to those passages of moods that a person most likes several times. For healing from skin diseases, the academician published a separate book, “Skin Health.” It contains such ideas as rejuvenation of the skin and subcutaneous tissues, improvement of men’s skin, health female skin, healing from psoriasis, allergies, eczema, general attitude towards skin health and others. Classes last about 25-40 minutes 1-2 times a day for two weeks. Then there is a break, after which classes resume.
The texts of the sentiments can be found on the official website of the academician, as well as on other Internet sites.
Chapter 28
Bach Flower Essences
No matter what disease the patient has, we can overcome them main reason“if we can identify and overcome a mental disorder,” this is what is believed among adherents of Dr. Bach’s treatment method. Flower essence therapy is named after its founder, the English physician Edward Bach, who studied homeopathy and herbal medicine for many years. According to Bach, flower essences cause changes at the energetic level in the body's chakras and subtle bodies, and some of them directly affect the physical body. Essences, due to their subtle vibrational qualities, transport energy quanta with a specific frequency, which interact with the molecular structure of the body.
Bach created 38 flower essences - burdock, aspen, beech, cornflower, cornflower, cherry plum, chestnut bud, chicory, clematis, wild apple, elm, gentian, gorse, heather, holly, honeysuckle, hornbeam, balsam, larch, mimosa, mustard, oak, olive, pine, red chestnut, rock rose, mountain water, diwala, star of Bethlehem, sweet chestnut, verbena, vine, walnut, violet, white chestnut, wild oats, wild Rose and willow.
12 flower essences are called “doctors” and are used for 12 mental states of a person, which, according to the supporters of this therapy, have the most negative impact on health: cowardice, phobias, self-doubt, indecisiveness, timidity, living in a world of illusions, complacency, inner restlessness, exaggerated concern for others, overwork, impatience and exaltation. The remaining 26 essences are called "helpers".
Raw materials for essences are collected in certain places and the forests of Wales, which Bach indicated. The flowers are placed in a glass vessel with spring water and kept in the sun for three hours. The water is then diluted with alcohol to make it last longer. Apply essences internally drop by drop or externally.
In order to choose the appropriate essence for healing, it is necessary to formulate the psychological problem that needs to be solved. Then fill out the “Situation Questionnaire”, which reflects the negative feelings experienced by the person at the moment. After this, fill out the “Character Questionnaire”, which reflects the negative aspects that interfere with life. And then fill out the “Checklist”, answering the question what causes the greatest concern. After summing up the results, you need to carefully re-read the description of the colors chosen in the test and choose an essence, carefully considering your choice.
Bach stated that the 38 flower essences he created are a holistic system that corrects absolutely all negative emotional states existing in the world, which is aimed not at suppressing, but at neutralizing any negative feelings that, as we discussed above, can become triggers, triggering many diseases, including skin diseases. Many followers of this teaching around the world say that this system really works. Here is a list of Dr. Bach's 38 essences and their main properties:
This system is complemented by the rescue elixir RescueRemedy. 3-4 drops of this magical remedy help to quickly cope with nervous shock or anxiety and quickly relieve emotional stress in any stressful situation. And most importantly, RescueRemedi prevents the occurrence and eliminates the consequences of stress.
Conclusion
This concludes our review of the latest methods of treating skin diseases. Once again I would like to emphasize that rosacea, demodicosis, psoriasis, eczema and other skin diseases are not a sentence with which you are forced to live for many years, but a diagnosis that can be cured, as evidenced by numerous stories of people’s healing.
Don’t let the disease take over you, learn to tame it, become its master, not its slave. And be sure to look at life with a positive attitude and good mood- this is the main condition for getting rid of the disease. Yes, and illness is not a reason to give up cosmetics, which, of course, will not cure, but will significantly improve the condition of your skin and slightly increase your self-esteem. Many cosmetic companies have special means, for example, for those suffering from rosacea, these are Rosaliac from La Roche-Posay, Roseliane from Uriage, Avene products, Apaisance from Lierac, Sensibio from Bioderma. All these products are well suited for skin affected by demodicosis.
And, of course, do not forget about precautions: if you have rosacea and demodicosis, it is not recommended to drink alcohol, in particular, red wine is absolutely contraindicated. In addition, you should refrain from hot drinks and liquids and, conversely, drink ice-cold drinks, which have a cooling and vasoconstrictor effect on the blood vessels. You cannot take hot baths, showers, steam your feet, or wash your face with hot water. You should avoid rich, hot, spicy foods, as well as tomatoes, spinach, eggplant, yeast, liver and some types of cheese, especially Parmesan. Tanning is also contraindicated, and daily year-round use of sunscreen with a high protection factor - UPF 25 or higher - is mandatory. It is also not recommended to take vasodilator drugs such as nicotinic acid and its derivatives, amyl nitrite, mithramycin and nifedipine.
We hope that the recommendations in this book will help you recover from skin diseases. You can write about treatment results and methods that are not included in the book at
As already indicated, in most cases the doctor has to deal with a general disease in which the skin is predominantly affected. In this regard, as a rule, general therapy comes to the fore. However, properly prescribed external treatment can significantly help the patient, and in some cases lead to a cure.
Most often, external therapy is symptomatic, less often pathogenetic and etiotropic. Depending on the severity of the inflammatory process, its localization, prevalence and individual characteristics of the patient’s skin, different dosage forms are used. The therapeutic effect is achieved not only due to active medicinal substances, but also due to the physical properties of these forms. On the other hand, the wrong choice of dosage form can significantly aggravate the patient’s condition.
External dosage forms
The most commonly used forms include solution, powder, shake, gel, paste, aerosol, cream, ointment, varnish and patch.
Solutions
Aqueous solutions are usually used to prepare lotions, wet-dry dressings and, less commonly, compresses. Alcohol solutions are used for lubrication.
The lotion is used for acute inflammation, especially accompanied by swelling and weeping. Gauze (4-6 layers) is moistened with cold water (an aqueous solution of the medicinal substance) and, after squeezing, applied to the inflamed area of the skin. After 5-10 minutes, as the gauze warms and dries, the latter becomes moisturized again. The procedure should take 60-90 minutes, after which a break of at least 1 hour is necessary. With proper use of the lotion, the heat transfer of this area of the skin should increase sharply, which will lead to a narrowing of blood vessels, a decrease in their permeability and, as a result, to the subsidence of acute inflammatory phenomena.
A wet-dry dressing has a similar, but weaker effect. In this case, 6-8 layers of gauze soaked in cold water (an aqueous solution of the medicinal substance) are applied to the lesion for 3-4 hours, after which the bandage is renewed.
Warming compresses are used only for chronic inflammation, as they have the ability to enhance the inflammatory response and promote the resorption of infiltrates. For compresses, both aqueous and alcohol solutions can be used.
Powder (medicated powder)
Indifferent powders of mineral (zinc oxide, talc) and vegetable (starches) origin are used as a base. Powders of mineral origin degrease the skin to a greater extent, while powders of vegetable origin dry out the skin, which is why mixtures of them are more often used. Under the influence of powders, heat transfer from the skin increases (the area of heat transfer increases and evaporation increases). The indication for prescribing powders is acute inflammation, but not accompanied by weeping (when wet, lumps form that irritate the erosive surface). When using powder in skin folds, starch is not introduced into it, since at high humidity it undergoes fermentation and forms a paste-like mass.
Shaked suspensions (“chatter”) consist of water with glycerin or vegetable oil (for dry skin) and powders insoluble in them. They are used for acute and subacute inflammatory processes that are not accompanied by weeping.
Gel
Gel (jelly) does not have a strong anti-inflammatory effect. Used as a form of reporting active substance to the surface of the skin.
Aerosol
Aerosol consists of gas and solid or liquid substances, which are suspended in it. Just like a gel, it is a form of delivering the active substance to the surface of the skin. Aerosols are convenient to use, especially for large affected areas.
Paste
Paste consists of indifferent powders and fat in a 1:1 ratio. Due to the fact that the volume of powders exceeds the volume of fats, the paste has anti-inflammatory and drying effects, promoting the evaporation of exudate and cooling the skin. The presence of fats in the paste allows you to increase the permeability of the skin to active medicinal substances introduced into its composition. Pastes are indicated for subacute inflammatory processes that are not accompanied by weeping. The paste is removed from the skin using a cotton swab soaked in sterilized vegetable oil (preferably olive oil).
Cream
Cream is an emulsion form of the “fat in water” or “water in fat” type. Emulsions of the first type cool the skin more strongly and have a stronger, but not very long-lasting anti-inflammatory effect. Artificial cooling creams (cold cream) soften inflamed skin, preventing it from drying out. Creams are used for subacute inflammation. It should be noted that some modern cream bases (for example, some topical steroids) are hydrophilic, which allows them to be applied to moderately damp surfaces.
Ointment
Ointment has a fatty base (vaseline, lanolin, animal fats, various oils, etc.). When applying the ointment to the skin, the latter's contact with the environment is disrupted and heat transfer is reduced. As a result, inflammation intensifies. Therefore, ointments are used only for chronic inflammation of the skin. At the same time, the use of an ointment form promotes the deepest penetration of active medicinal substances into the skin.
Varnish
Varnish- a solution of film-forming substances in organic solvents. Once applied to the skin, it dries quickly, leaving a thin film that seals the surface of the skin. In this regard, contact of the skin with the active pharmacological substances introduced into the varnish remains for quite a long time. It is often used when it is necessary to create a high concentration of a medicinal substance in a limited area of skin.
Patch
Patch- a viscous mass containing waxes, rosin, resins, lanolin and other substances.
External pharmacological agents are introduced into dosage forms to enhance their inherent anti-inflammatory effect or give one form or another a new effect. The same substances in different concentrations can have opposite effects (for example, astringent and cauterizing).
Anti-inflammatory drugs
Anti-inflammatory drugs include astringents, naftalan, calcineurin inhibitors and corticosteroids.
Astringents(1-2% solutions of tannin and resorcinol, 0.25% solution of silver nitrate, 0.1% solution of copper sulfate, etc.) are used in the form of aqueous solutions for preparing lotions and wet-dry dressings.
Glucocorticosteroids (GC)
Glucocorticosteroids (GC) when applied directly to the skin, they make it possible to create a particularly high concentration of the active substance in the pathological focus and at the same time reduce the risk of side effects. The latter, however, is not completely eliminated, since at least partial absorption always exists.
Drugs created specifically for local therapy have the advantage that they have only a moderately pronounced systemic effect, the severity of which depends on the type of steroid, its activity, the excipient used and the concentration of the active substance in it, the dosage form, the characteristics and size of the surface area exposed to the drug, duration of treatment. The likelihood of a systemic effect increases significantly when using an occlusive dressing or after preliminary removal of the stratum corneum.
At the same time, local steroid therapy has its own side effects, which include the following manifestations:
- skin atrophy;
- activation of viral, bacterial and fungal infections (especially during occlusive treatment).
Steroid dermatitis (telangiectasia, erythema, increased sensitivity to UV rays, atrophy of the epidermis and dermis) is identified as an independent disease caused by the use of topical GCs, primarily on the skin of the face. Today there are modern non-fluorinated drugs, the use of which is relatively safe. Therefore, they are the drugs of choice for chronic skin diseases.
Among the drugs containing only GCs as an active principle, the most commonly used GCs are those that have a strong effect: betamethasone (celestoderm-U), clobetasol (Dermovate), flumethasone (locacorten), flucortalone (Ultralan), fluocinolone (sinaflane, sinalar, flucinar), etc. In addition, drugs that have moderate and weak effects are used.
A number of drugs used in dermatology are combined and contain, in addition to HA, other active principles. Most often, combinations of HA with substances that have antimicrobial, antimycotic and keratoplasty effects are needed. In the manufacture of such drugs from potent GCs, betamethasone (celestoderm-U with garamicin, diprogent, diprosalik, triderm), flumethasone (lorindene A, lorindene C), fluocinolone (sinalar K, sinalar N, flucinar N) are used.
With such a wide choice, it is necessary to place the highest possible demands on the prescribed drug. In addition to price, criteria such as the activity of the drug, the severity of the resorptive effect and local side effects must be used. A dermatologist must be able to predict the speed of relief of an exacerbation, the duration of use, and the possibility of the formation of local steroid dependence.
When choosing a base (carrier) of a glucocorticosteroid, the condition of the skin (seborrhea, sebostasis), the severity of dermatosis, as well as permeability due to the localization and nature of the pathological process are taken into account. HA preparations can be applied to the skin in the form of a cream, ointment or lotion, or injected internally into the skin. The basis of modern topical steroids produced by the world's leading companies is characterized by an acidic pH level, which has a beneficial effect on the condition of the skin and prevents the activation of pathological bacterial flora.
To reduce the likelihood of undesirable effects of local GC therapy, a number of measures are recommended:
- make GC applications with a minimum frequency - do not prescribe the drug in doses exceeding 30 g per week for strong drugs, 50 g per week for medium drugs and 200 g per week for weak drugs with a total duration of treatment of more than a month;
- If possible, avoid applying products with HA to the skin of the face, palms and soles;
- alternate areas of exposure when using highly active HA preparations;
- do not use HA preparations externally for herpetic skin lesions;
- if it is necessary to use HA in the treatment of mycotic or pyococcal skin lesions (with a pronounced exudative reaction), it is necessary to use combination drugs containing antifungal and antimicrobial components.
Survey:
Treatment of skin diseases in humans - principles of external therapy
MINISTRY OF HEALTH OF UKRAINE
LUBENSKY MEDICAL SCHOOL
GRADUATE WORK
IN DERMATOVENEROLOGY
ON THE TOPIC OF:
Completed: student of group F-31
Nochovny Alexey
Principles of treatment of skin diseases
General drug therapy
Antimicrobial agents
Antiproliferative agents
Psychotropic drugs
Psychotherapy
Surgery
Spa therapy
References
Principles of treatment of skin diseases
Effective treatment of skin diseases is undoubtedly the pinnacle of professional skill of a dermatologist. Due to the large number and variety of dermatoses, the inherent uncertainty of their etiology and pathogenesis, and their tendency to have a protracted course, this task is often difficult to accomplish and requires from a specialist not only a broad general medical outlook, but also a great personal experience and a high level of clinical reasoning. What is of particular value here is clinical reasoning- the doctor’s ability to individualize this observation as much as possible and select a strictly individual treatment that is adequate to the form and stage of the disease, gender and age of the patient, concomitant pathology, household and professional characteristics of the case. Only like this adequate therapy promises the greatest success.
Ancient doctors left us in lapidary form a set of requirements that can be considered as criteria for optimal treatment: cito, tuto, jucunde (“quickly, efficiently, pleasantly”). Dermatological science and practice in their development have always strived to fulfill these calls and have achieved considerable success in this direction.
The most successful, naturally, is treatment aimed at eliminating the cause of the disease - it is called etiological. This, for example, is the use of acaricidal drugs for scabies (killing the causative agent of the disease - the scabies mite). However, etiological treatment, unfortunately, is possible only for a limited range of dermatoses that have a clearly established etiology, while in many skin diseases the true cause of the disease is still unclear. However, for most dermatoses, sufficient information has been accumulated about the mechanisms of their development, which makes it justified to carry out pathogenetic treatment, aimed at correcting certain aspects of the pathological process (for example, the use of antihistamines for urticaria caused by excess histamine in the skin). And finally, it is often necessary to resort to symptomatic therapy, aimed at suppressing individual symptoms of the disease when its etiology and pathogenesis are unclear (for example, the use of cooling lotions in the presence of swelling and weeping in the lesions). Complex therapy often combines etiological, pathogenetic and symptomatic treatment methods.
In the treatment of skin diseases, almost all modern therapeutic methods are used, which can be classified as follows:
3. Drug therapy (general and local)
4. Physiotherapy
5. Psychotherapy
6. Surgical treatment
7. Spa therapy
Treatment of dermatoses, as a rule, is complex, including the inclusion of an appropriate set of therapeutic measures, depending on the characteristics of the disease.
Mode
In the concept of a therapeutic and preventive regimen, dermatologists include caring for diseased skin, protecting it from the damaging effects of various adverse environmental factors.
For purely hygienic reasons, first of all it is necessary to resolve the issue of washing the skin. Here it is necessary to take into account the nature of the disease and the stage of the skin process. In case of acute purulent skin lesions (impetigo, boils, hidradenitis), as well as in the most contagious fungal diseases (microsporia), general washing (in the shower, in the bath) is prohibited in order to avoid dissemination of the infection. It is replaced by alcohol rubdowns (70% ethyl, 1% salicylic or 3% boric alcohol), which should be carried out at least 2 times a day, observing the rule “from the periphery to the center.”
Hygienic washing with water and neutral disinfecting soap is allowed in certain areas away from the main sources.
In case of acute allergic inflammatory dermatoses (for example, with dermatitis or eczema in the weeping stage), general washing is also prohibited, and skin cleansing in areas around them is carried out with disinfectant lotions or swabs with vegetable oils.
For “dry” dermatoses in progressive stage(psoriasis, lichen planus, atopic dermatitis) general washing in the shower or bath should be gentle - without a washcloth or soap. In these cases, it is recommended to use a cotton mitten or gauze, use shower gels instead of soap, and dry with a soft towel using blotting movements.
In case of severe disseminated dermatoses, especially those occurring with general symptoms (chilling, fever, general weakness), hospitalization in the skin department and sometimes strict bed rest are often required.
In concept treatment regimen in case of chronic dermatoses, regulation of sleep and bowel movements, and exposure to fresh air are also included. For photodermatoses, lupus erythematosus, aggravated by sun rays, you should avoid sun exposure, use an umbrella or a wide-brimmed hat. The concept of a regimen for a skin patient with allergic inflammatory and especially itchy rashes includes the correct selection of clothing and, first of all, underwear. It is prohibited to use underwear made of synthetic, wool and silk fabrics, which, due to their physical and chemical properties, can cause or intensify itching and inflammation. The patient should wear underwear only made from cotton fabrics, and it is recommended to wash it with soap, and not with powders, which often contain sensitizing components. It is also necessary to take into account the properties of other clothing parts. Tights, socks, trousers, gloves, scarves, hats, if they contain irritating fabrics, should not come into contact with the skin of not only the affected, but also healthy areas. In these cases, appropriate cotton “understudies” or linings should be used.
Diet
The most important, and sometimes decisive, importance for many dermatoses is compliance a certain regime nutrition.
This primarily applies to allergic and itchy skin diseases, some of which may even have a food etiology (for example, separate forms urticaria and skin itching). In these cases, it is necessary to confirm the presence of hypersensitivity to certain food products and completely exclude them from the patient’s diet, which is called specific elimination diet. The range of food allergens is extremely wide, and the most unexpected findings are possible here (for example, toxidermia only from green apples, urticaria only from a certain type of table wine, cheese, etc.).
There is also a concept nonspecific elimination diet, prescribed in almost all cases of itchy and inflammatory dermatoses during the period of exacerbation: spicy, smoked, salted, fried, canned and extractive foods (for example, pepper, horseradish, mustard, smoked sausage, spicy cheeses, marinades, strong tea, coffee, honey, jam, chocolate, citrus fruits), sweets. In childhood, as a rule, exclusion of milk and eggs is required. Naturally, in all cases it is prohibited to use alcoholic drinks(including beer). Fasting days, short-term therapeutic fasting, and drinking plenty of fluids are indicated.
Often, a chronic recurrent skin disease can be caused by a disorder of general metabolism, diseases of the gastrointestinal tract or hepatobiliary system. This pathology is called background and pathogenetically requires mandatory (primarily dietary) correction, usually with the involvement of specialists of the appropriate profile (gastroenterologist, hepatologist, nutritionist). Regulating bowel movements and combating constipation and flatulence play a big role here.
General drug therapy
In most cases, a skin patient, in addition to local (external) treatment, also requires general (systemic) drug therapy in accordance with the etiological, pathogenetic and symptomatic aspects of the disease. It must be strictly individual and justified.
Due to the extreme diversity of etiological and pathogenetic factors in skin diseases, systemic drug therapy for dermatoses includes almost all the main methods and means available in the arsenal of modern clinical medicine: antimicrobial, desensitizing, psychotropic and hormonal drugs, vitamins, anabolic steroids, immunocorrectors, biogenic stimulants and enterosorbents, cytostatics and nonspecific anti-inflammatory drugs, enzymes, quinolines and etc.
Let us dwell on the main modern means of general drug therapy.
Antimicrobial agents
Antibiotics- the most important group of antimicrobial etiological therapy agents - they are used primarily for pustular diseases skin (pyodermatitis) caused by staphylococci and streptococci. They are prescribed in the presence of general symptoms (fever, chills, headache), dissemination of a pustular rash, the appearance of regional lymphadenitis, as well as in the localization of deep pyoderma in the head and neck area. Antibiotics of all groups can be used (penicillins, tetracyclines, macrolides, cephalosporins), but before treatment, the sensitivity of the flora to antibiotics should be established and, first of all, use the antibiotic to which the pathogens are most sensitive. If it is impossible to obtain an antibiogram, broad-spectrum antibiotics are used or two antibiotics are used in parallel. Single, daily and course doses of antibiotics depend on the severity of the patient’s condition and are usually within average parameters. In addition to pyoderma, antibiotics are also used for other skin infections - tuberculosis, leprosy, leishmaniasis (usually rifampicin).
Have not lost their importance in infectious and inflammatory dermatoses sulfonamides, especially with a prolonged effect (Biseptol, Bactrim, Septrin).
Sulfones(diaminodiphenylsulfone - DDS, dapsone, avlosulfone, dimocyfon) are the main therapeutic agents for leprosy.
Fluoroquinolones(ciprofloxacin, tsifran, tsiprobay, tarivid, maxaquin, etc.), which have a wide spectrum of action, are of particular therapeutic value among the newest antimicrobial drugs.
When prescribing all antimicrobial agents, contraindications to their use, as well as their compatibility with other medications, should be taken into account.
Antimycotics- a group of drugs of various origins that have an antifungal (fungicidal or fungistatic) effect. They are used both for external (local) and general (systemic) therapy. By interfering with the formation of the fungal cell membrane, they lead to the death of the pathogen or, at least, to the cessation of its reproduction. The list of main antimycotics is given in the table in the “Mycoses” section.
Systemic antimycotics (Lamisil, Orungal, Griseofulvin, etc.) are usually used for lesions of nails, hair, disseminated and deep forms of dermatomycosis. To select a particular drug, you need to know the spectrum of its action and conduct a cultural study to determine the causative agent of mycosis. Griseofulvin has a narrow spectrum of antifungal activity and is currently used only in some cases of microsporia. Nystatin is effective only for candidiasis, lamisil - mainly for dermatophytosis (rubromycosis, epidermophytosis, microsporia). Diflucan is especially active against yeast infections of the skin and mucous membranes. Nizoral is used for all forms of fungal infections of the skin and its appendages. But with long-term use, nizoral produces a number of serious side effects, which limits its use. Among systemic antimycotics, orungal (sporanox) has the widest spectrum of action, effective against all fungal diseases (keratomycosis, dermatophytosis, candidiasis, deep mycoses). The method of pulse therapy with orungal for onychomycosis - nail lesions (2 capsules 2 times a day for a week, then a break of 3 weeks, a course of 2-3 cycles) is especially effective.
Thanks to modern antimycotics of general and local action, the treatment of fungal infections of smooth skin does not pose a serious problem - usually 2-3 weeks are enough for a complete cure. However, nail treatment is still a difficult and time-consuming task.
Antiviral drugs have both systemic and external dosage forms, which are often advisable to use in parallel. Indications for their use are various viral dermatoses (herpes simplex and herpes zoster, molluscum contagiosum, papillomavirus infection of the skin). Basic antivirals are presented in the table in the section "Viral dermatoses". Most effective when herpetic infection drugs of the latest generation (acyclovir, Valtrex, Famvir).
Anti-inflammatory drugs
Glucocorticosteroids (GCS) have the most pronounced anti-inflammatory effect and, therefore, are used for most skin diseases, which are based on acute or chronic inflammation. GCS also have antiallergic, antipruritic, antiproliferative and immunosuppressive effects, and therefore they are used not only for allergic dermatoses (eczema, allergic dermatitis, toxidermia, urticaria, atopic dermatitis, angiitis), but also for psoriasis, lichen planus, and lymphomas. The main systemic corticosteroids used for skin lesions are presented in the table in the “Allergodermatoses” section. Doses of drugs vary greatly depending on the form and stage of the process (from 2-3 tablets per day for dermatitis to 20-25 for pemphigus). Recently, diprospan, containing fast- and slow-acting components, is often used, usually administered intramuscularly once every 2-3 weeks. Among tablet forms, prednisolone and metipred remain the leaders. When using large doses of GCS, it is necessary to prescribe in parallel the so-called corrective therapy, which prevents or mitigates the side effects of GCS. You should always remember the need to gradually reduce the daily dose of GCS in order to avoid the so-called withdrawal syndrome in the form of a sharp exacerbation of the underlying disease, since GCS in most dermatoses with an unclear etiology have only a morbistatic effect.
Quinolines(Delagil, Plaquennl), among their many properties, have a pronounced anti-inflammatory effect and are especially convenient for use in chronic inflammatory dermatoses (lupus erythematosus, rosacea, sarcoidosis, angiitis, etc.). They are usually prescribed as basic therapy for a long period (six months, a year) in moderate doses (Delagil 1 tablet, Plaquenil 2 tablets per day).
NSAIDs- nonsteroidal anti-inflammatory drugs (aspirin, brufen, indomethane, voltaren, piroxicam, etc.) - used in medium therapeutic doses mainly for acute and subacute inflammatory lesions of subcutaneous fat (erythema nodosum, panniculitis), as well as for joint damage accompanying the skin process (for arthropathic psoriasis, lupus erythematosus).
Antihistamines used in dermatology, the main goal is to block H1 receptors, which relieves pathological reactions caused by histamine in the skin (redness, swelling, itching). Their action is predominantly symptomatic or pathogenetic. They are indicated for many allergic and itchy dermatoses (urticaria, eczema, allergic dermatitis, toxicerma, neurodermatitis, etc.). The antihistamines presented in the table in the section “Allergodermatoses” differ in the duration of action and the corresponding rhythm of administration: suprastin, fenkarol, diazolin are prescribed 3 times a day, tavegil 2 times, and the latest generation drugs claritin, zyrtec, kestin 1 time a day. Most antihistamines have a sedative effect. Although this reaction is very individual, nevertheless they should not be prescribed before work, especially to persons who are involved in driving vehicles.
Nonspecific hyposensitizers along with antihistamines, they also have a moderate anti-inflammatory and antiallergic effect, and therefore are used for allergic dermatoses in the period of exacerbation. This group includes calcium preparations (calcium gluconate, calcium chloride), prescribed both orally and parenterally, as well as sodium thiosulfate, which is mainly administered intravenously in the form of a 30% solution.
Antiproliferative agents
Cytostatics and immunosuppressants(presented in the table in the section “Lymphoproliferative diseases”), their main indications for use are proliferative, including tumor, skin diseases (lymphomas and other hemoblastoses, psoriasis), as well as dermatoses associated with pathology of the immune system (angiitis, lupus erythematosus and etc.).
Psychotropic drugs
The majority of skin patients, especially chronic patients, experience certain neuropsychic disorders, and there is a clearly visible connection between the onset and exacerbations of the disease with stressful situations. This primarily applies to patients with itchy skin lesions (neurodermatitis, eczema, prurigo, urticaria). Symptomatic and pathogenetic therapy with psychotropic drugs is indicated for patients with symptoms of irritability, fear, depression, insomnia, and this often happens necessary consultation psychoneurologist. Psychotropic drugs include tranquilizers, antipsychotics and antidepressants, which are indicated in small and medium doses for the corresponding disorders. Some skin diseases cannot be corrected without the involvement of a psychiatrist (pathomimia, trichotillomania, neurotic excoriations).
Vitamins, microelements, anabolic steroids
The role of vitamins in skin pathology cannot be overestimated. Almost all vitamin deficiencies are accompanied by certain changes in the skin and its appendages. Vitamins for skin diseases are used not only in physiological (small, medium) doses, but often in high (mega-doses). Both mono‑ and multivitamin therapy are carried out. recently with the inclusion of microelements and anabolic drugs in vitamin complexes
Vitamin A(retinol) and its derivatives (retinoids) are indicated primarily for disorders of horn formation in the epidermis (the so-called keratoses and dyskeratoses - ichthyosis, keratoderma, Darier's disease). Here it is used for a long time in high daily doses. Retinol is used for general and local therapy in all cases of dry skin (xeroderma), thinning and thinning of hair (hypotrichosis), brittle nails (onychodystrophy). Retinoids tigazon and neotigazon are very effective for psoriasis, as they have an antiproliferative effect. The retinoid roaccutane is used for severe forms of acne, as it has a sebostatic effect (inhibition of the secretion of the sebaceous glands). A list of the main forms of retinol and retinoids is presented in the table in the “Psoriasis” section.
B vitamins(thiamine, riboflavin, pyridoxine, cyanocobalamin, nicotinic acid, pangamate and calcium pantothenate) are used orally and parenterally, isolated and in complex preparations for chronic dermatoses of a neurogenic, vascular and metabolic nature, especially in cases where there are clear signs of corresponding hypovitaminosis.
Vitamin C(ascorbic acid) is an active detoxifying and desensitizing agent, indicated in large doses (up to 1-3 g per day) for acute toxicoderma, allergic dermatitis, and eczema. In medium therapeutic doses, it is used for hemorrhagic angiitis of the skin (often in combination with rutin) to reduce increased vascular permeability. Due to the depigmenting effect ascorbic acid used for skin hyperpigmentation.
Vitamin D preparations(often in combination with calcium salts) are indicated in the complex therapy of cutaneous tuberculosis.
Vitamin E(tocopherol) is a strong antioxidant and is used more often for metabolic and vascular dermatoses, connective tissue diseases. It is most effective in combination with retinol (the drug Aevit).
Zinc preparations(zincteral, zinc oxide) is used for diseases with a deficiency of this element in the body (enteropathic acrodermatitis, hypotrichosis, alopecia).
In weakened patients it is necessary to use anabolic steroids, increasing protein synthesis in tissues, having general strengthening effect(nerobol, retabolil, methyluracil, methionine). They are indicated for patients with chronic pyoderma and ulcerative dermatoses. They are used as corrective agents for long-term and massive glucocorticoid therapy.
Complex complexes are very effective for chronic dermatoses. multivitamin preparations with macro- and microelements and anabolic steroids (vitrum, centrum, oligovit, etc.).
Local (external) drug therapy
Nowhere in clinical medicine is local therapy used as widely as in dermatology. It can be (like general therapy) etiological, pathogenetic and symptomatic. For example, rubbing benzyl benzoate emulsion into the skin for scabies, killing the pathogen, eliminates the cause of the disease; the use of corticosteroid ointments for eczema as an inflammatory-allergic disease has a pronounced pathogenetic effect; The use of rubbing with menovazine for itching of any kind is a purely symptomatic measure.
Selection and implementation of local therapy require great medical skill. First you need to decide the issue of selection local dosage form, and then the question of inclusion in it specific active ingredient. Dermatological local dosage forms are very diverse and themselves also have a therapeutic effect. Since the vast majority of skin diseases are of an inflammatory nature, it is the assessment of the severity and nature of inflammation that should be used when choosing a local dosage form. The location of the lesion is also taken into account. Correct selection of the dosage form is crucial in achieving a therapeutic effect.
Lotions They are aqueous solutions of various (disinfecting, anti-inflammatory) substances. Boiled water or saline solution can be considered as the simplest lotions - it’s all about the method of application: take 8-16 layers of rags or 16-32 layers of gauze, which should correspond in size to the source of weeping, moisten in the appropriate cold solution, wring out and apply to the sore skin . The lotion is changed as it warms up (in a few minutes). The lotion can sometimes be replaced with a wet-dry bandage, which is changed as it dries after 2 hours, during which it is fixed with one or two rounds of bandage. The lotions have an anti-inflammatory (vasoconstrictor) effect, reduce swelling, soothe burning and itching, and most importantly, absorb exudate oozing from erosions. Only the lotion has an adsorbing effect, so it is indispensable in case of weeping. The simplest disinfectant lotion is boric :
Rр.: Ac. borici 4.0
Aq. distillate 200.0
M. D. S. Lotion
Convenient to use when hairy areas get wet aerosols with strong anti-inflammatory substances such as glucocorticosteroids.
Pastes They are a 1:1 mixture of fatty substances (ointments) with powders, due to which they have a superficial, drying effect, they are used for subacute inflammatory rashes, after the oozing is completed, they are applied in a thin layer 1-2 times a day. The classic base for pastes is zinc paste:
Rр.: Zinci oxidi
Amyli tritici aa 10.0
D.S. Lubricate the area 2 times a day.
Powders consist of plant or mineral powders (talc, zinc oxide, starch). The simplest indifferent powder consists of a mixture of talc and zinc oxide in equal parts:
Rр.: Zinci oxidi
D.S. Powder.
Due to their hygroscopicity, powders have a drying, anti-inflammatory, and degreasing effect. They are most conveniently used for the treatment of subacute inflammatory lesions on the scalp and skin folds. The powder should not be rubbed into the skin, but should be applied with a cotton swab using patting movements.
Agitated suspensions (chatterers) consist of a mixture of powders and aqueous (water-alcohol) solutions or vegetable oils. In the first case we talk about water (alcohol) chatterboxes, in the second - about oil :
Rр.: Zinci oxidi
Amyli tritici aa 30.0
Aq. destill. ad 250.0
M. D. S. Shake and powder the skin (water mixture).
Rр.: Zinci oxidi 10.0
Ol. Persicorum ad 100.0
M. D. S. Shake and powder the skin (oil mash).
The action of shaken suspensions is similar to that of pastes, but due to the evaporation of water they have a stronger cooling and antipruritic effect.
Ointments are mixtures of fatty or fat-like substances. The simplest recipe is a mixture of anhydrous lanolin and petroleum jelly in equal parts:
Rр.: Lanolini anhydrici
Vaselini aa 15.0
D.S. Lubricate the skin.
Ointments have a warming, softening and nourishing effect, and therefore they are indicated for chronic inflammatory lesions with severe infiltration. The ointments are lightly rubbed into the skin of the lesions several times a day. In cases where the infiltration of rash elements is particularly pronounced, it is recommended to apply ointments under an occlusive dressing, which enhances the warming of the skin and, therefore, accelerates the resorption of rashes. For occlusive dressings, compress paper or thin (food grade) polyethylene film is used. The bandage is fixed with a bandage and can remain on the skin from 2-3 to 12 hours.
Creams They are an ointment base to which water is added, which, when evaporated, gives a cooling, anti-inflammatory effect within 2 hours. After the water evaporates, the cream begins to act like an ointment. Classic recipe - Unna cream :
Aq. destill. aa 10.0
D.S. Lubricate the skin.
Creams are used for chronic inflammation in the transition period from subacute. They act more gently than ointments, without causing aggravation.
Plasters, which are a thick mass of a mixture of resins, wax, lead oxide and other substances, provide the strongest warming and absorbable effect, and therefore are used on limited areas of chronic inflammation or thickening of the skin.
Lucky, consisting mainly of collodion, are used mainly for the treatment of nail diseases, as they are held on the surface without a bandage.
Selection of active substance, which will be included in one or another local dosage form described above, is dictated by information about the etiology, pathogenesis or symptoms of a particular nosology, adjusted for the characteristics of the case. Many of the active ingredients are described in the section on general (systemic) therapy of dermatoses: most of them are also used in local (external) therapy (for example, antibiotics, glucocorticosteroids, antimycotics, etc.).
Anti-inflammatory local agents are used for various inflammatory dermatoses in appropriate dosage forms (from lotions to ointments). Classic preparations include astringent lotions (lead, Burov's liquid, silver nitrate solution, infusions and decoctions of medicinal herbs - chamomile, sage, string, etc.). Among modern local anti-inflammatory drugs, the leaders are glucocorticosteroids in the form of creams, ointments, gels and solutions (lotions) of varying strengths.
Antimicrobial drugs include both classical disinfecting agents (solutions of iodine, aniline dyes, furatsilin, ethacridine lactate, silver nitrate, boric acid) and modern ones (ointments and emulsions with antibiotics and sulfonamides). Modern local antiviral drugs are listed in the section "Viral dermatoses". Modern local antifungal agents (antimycotics) are listed in the “Mycoses” section.
Reducing agents have the main goal of resolving skin infiltration in chronic inflammatory dermatoses. They are included in creams and ointments and used in occlusive dressings. In order of increasing reducing effect, they can be arranged in the following order (at the same concentration in dosage forms): naphthalan, ichthyol, sulfur, tar. Typically, treatment begins with weak drugs of low concentration - 2%, then the percentage of the active substance is gradually increased and switched to more active ingredients, and then occlusive dressings are added. Treatment is carried out until the infiltration completely disappears.
Keratolytic agents provide softening and subsequent rejection of excessively keratinized skin and are used mainly for so-called keratoses. Salicylic and lactic acids and resorcinol in high concentrations (ointments 10-20-30%) have a keratolytic effect. For limited keratoses (for example, calluses), onychomycosis, it is convenient to use keratolytic varnishes and plasters.
Antipruritics have a symptomatic effect, reducing the sensation of itching in the skin. These include menthol, anesthesin, diphenhydramine, carbolic, citric and acetic acids. They are used in alcohol solutions, shaken suspensions, creams, and ointments. There are ready-made complex preparations (menovazin). Glucocorticosteroids have a strong antipruritic effect.
Complex preparations of combined action (anti-inflammatory, antimicrobial, keratolytic, fungicidal) deserve special attention, as they are highly effective, easy to use, and give the least number of adverse reactions. These are creams, ointments, aerosols and solutions of glucocorticosteroids mixed with other agents. Some of these drugs can be considered almost universal (for example, Triderm cream has strong anti-inflammatory, antimicrobial and fungicidal effects). Glucocorticosteroids with antibiotics are used for allergic dermatoses complicated by pyococcal infection; corticosteroids with salicylic acid are especially effective for psoriasis and neurodermatitis. Glucocorticosteroids with antimycotic agents are necessary for itchy and exudative forms of fungal skin diseases.
Physiotherapeutic treatments
In dermatological practice, all classical and modern methods of physiotherapeutic effects on the affected skin and the body as a whole are actually used. Physiotherapy is in most cases a necessary component in the treatment of skin patients. Physiotherapeutic methods include treatment with heat, cold, electric current, rays, magnets, oxygen, ozone, a combination of physical and chemical influences (photochemotherapy).
When carrying out treatment, naturally, one should take into account existing contraindications to one or another physiotherapy procedure.
Psychotherapy
The onset and exacerbation of many skin diseases are provoked by various mental influences; a significant part of dermatoses leads to secondary neuroses and even psychoses, and sometimes to suicide attempts. Therefore, psychotherapy is a necessary component in complex treatment almost all skin patients.
Most often, one has to resort to suggestive therapy - suggestion both while the patient is awake and when he is immersed in a hypnotic sleep. First of all, the patient must be reassured, dispelling with an authoritative medical word the fear of danger, incurability or contagiousness of the disease (naturally, if there are grounds for this). In all cases, the doctor should try to give the most optimistic prognosis for both life and cure. For a number of diseases (warts, neurodermatoses, psoriasis, eczema), hypnosis can be useful, which should be carried out by an appropriate specialist.
If the patient's sleep is disturbed, all measures should be taken to normalize it, in particular, use electrosleep procedures. For neurodermatoses, usually accompanied by painful itching, acupuncture is effective.
Nessesary to use large arsenal psychopharmacological medicinal drugs- antidepressants, tranquilizers, antipsychotics. Here, consultation with a neuropsychiatrist is often useful. Recently, a new section of our specialty has begun to develop - psychodermatology.
Surgery
Surgical methods associated with complete excision of affected areas of skin (excision) have not lost their importance to this day. They are used in cases of lack of effect from conservative treatment methods (warty tuberculosis, flat tuberculous lupus, neoplasms, chronic pyoderma). It is often necessary to resort to surgical opening (incision) of lesions deep pyoderma(hidradenitis, abscess boils, conglobate acne). For long-term non-healing ulcerative skin lesions, the only effective remedy may be plastic surgery (autoplasty) of the defects.
Spa therapy
At chronic diseases skin of a neurogenic, allergic or metabolic nature, the inclusion of various spa factors in the therapeutic cycle is extremely useful. This is usually done after the relapse of the disease has stopped (during the rehabilitation period) in the complete or almost complete absence of eruptive elements. Possible indications and contraindications for concomitant diseases should always be taken into account.
Resort factors include climatotherapy, balneotherapy, heliotherapy, thalassotherapy, pelloid therapy .
The influence of climate on the course of individual dermatoses can be radical. For example, complete cure atopic dermatitis without subsequent relapses, as a rule, is only possible with long-term climatotherapy (stay-free living in a warm, dry climate for at least 3 years). Some forms of psoriasis and eczema go away completely with permanent residence in a suitable climatic zone, which can be selected purely empirically. Short-term climatotherapy (1-2 months) usually only prolongs remissions.
Balneotherapy is very effective for many skin diseases (eczema, neurodermatitis, psoriasis, scleroderma, prurigo) - treatment with mineral baths: sulfide (Sochi-Matsesta), radon (Pyatigorsk). Heliotherapy in the form of dosed air baths is indicated for the above dermatoses in the resorts of the middle and southern zone. It goes well with thalassotherapy (sea bathing).
For persistent inflammatory dermatoses with sudden infiltration of the skin in the affected areas (chronic eczema, neurodermatitis, psoriasis) excellent results They give applications of therapeutic mud (pelloidotherapy) at resorts such as Anapa.
The integrated use of various spa factors significantly increases the overall therapeutic effect.
References
1. O.L. Ivanov. Skin and venereal diseases: Chicot; Moscow; 2006