OPTIMIZATION OF THERAPEUTIC MEASURES IN PATIENTS WITH NUMMULAR ECZEMA


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Abstract

Constant cellular and humoral immunity disorders promote the development of nummular eczema. Severe refractory cases of eczema represent a complex therapeutic problem. Increasingly eczema resistance to standard methods of therapy forces specialists to use systemic drugs with immunosuppressive action and a high risk of serious complications. Material and methods. The therapeutic possibilities and safety of the new domestic immunoactive agent L-isoleucyl-L-glutamyl-L-tryptophan sodium salt in patients with nummular eczema and its effect on the immune homeostasis were analyzed. The drug was included in complex treatment in 34 patients with nummular eczema. The comparison group composed 20 patients who received standard therapy. The highly sensitive methods for assessing the immune status: the cytokine system, the relative affinity of antibodies and the expression of Toll-like receptors (TLRs) are used. Results. 24 (70.6%) patients had a clinical cure and 9 (26.5%) patients had a significant improvement after L-isoleucyl-L-glutamyl-L-tryptophan sodium salt treatment. Only 1 (2.9%) patient had no effect from the therapy. There were no any side effects and complications in the course of the therapy. In the comparison group, clinical cure was achieved in 11 (55%) patients, the effect of the therapy was not observed in 2 (10%) patients. Conclusion. After the termination of the course of therapy, 15 (44.1%) patients had a clear tendency to normalize the affinity of immunoglobulins, The intensity of TLR4 expression was significantly reduced and did not differ from those in healthy donors. The use of this drug quickly allowed to stop the clinical manifestations of nummular eczema with the preservation of long-term remission, to normalize the processes of interleukin-dependent regulation of the immune response and nonspecific resistance. The advantage of the proposed method of treatment is the possibility of using in outpatient settings.

About the authors

Vladislav Yu. Udzhukhu

Department of dermatovenereology of pediatric faculty N.I. Pirogov Russian National Research Medical University

Email: sovet140011@mail.ru
MD, PhD, DSc., professor of N.I. Pirogov Russian National Research Medical University, Moscow, 117997, Russian Federation Moscow, 117997, Russian Federation

N. G Korotkiy

Department of dermatovenereology of pediatric faculty N.I. Pirogov Russian National Research Medical University

Moscow, 117997, Russian Federation

E. V Davtyan

Department of dermatovenereology of pediatric faculty N.I. Pirogov Russian National Research Medical University

Moscow, 117997, Russian Federation

A. A Kubylinskiy

Department of dermatovenereology of pediatric faculty N.I. Pirogov Russian National Research Medical University

Moscow, 117997, Russian Federation

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