Federal agency of health care and social development
Volgograd State Medical University
Department of dermatology and venerology
Principles of topic therapy of skin diseases
Volgograd 2007
The topic treatment may be carried out in the majority of skin diseases.
In many cases it may be sufficient without systemic treatment (parasitaria
diseases, some pyodermias, mild variants of chronic dermatoses, etc.).But
usually the topic treatment is administered simultaneously with systemis
treatment and such as systemic one it may be etiologic (mycoses of the skin,
parasitaria diseases), pathogenetic (psoriasis, eczema, atopic dermatitis) and
symptomatic (ichthyosis, itching diseases, etc.).
The topic treatment acts on ill skin by a) effective agent (substance); b)
drug base, that is form of topic treatment.
As a rule, the base has more intensive effect than agent (substance). Non
adequate base could not only decrease the action of agent-substance, but
very often causes worsening of skin disease. For example, steroid ointment
may cause exacerbation of exudative inflammation in the patients with
eczema; the pastes aren’t indicated for rash on the scalp.
The substances for topic treatment may be classified accordingly to their
therapeutic action.
Tabl.№ 1
The most common substances for topic treatment
Antibacterial
Antiinflammatory
Antiitching
Reparative
Antiparasitaria
Antifungal
Antibiotics, antiseptics (hydrogenium peroxide,
potassium permanganate, boric acid, argentum
nitratum, jodine, anyline dyes, etc.)
Corticosteroids, nonsteroid antiinflammatory drugs,
ichthyolum, tar, salicylic acid, tanninum, salts of
bismutum, argentum, some plants etc.
Mentholum,
anaesthesinum,
carbolic
acid,
dimedrolum, acetic acid, novocainum, etc.
Methyluracilium, tar, balsamic vegetable oils,
«Actoveginum», «Solcoseryl», «Vulnusan», etc.
Sulfur, tar, benzyl-benzoatis, salts of hydrargyrum,
«Spregal», «Nitifor», «Para-plus».
Jodine, tar, sulfur, boric acid, antifungal antibiotics,
derivates of chinolinum, imidazolum («Canesten»),
terbinafinum(«Fungoterbinum», «Lamizilum») etc.
Keratoplastic
(peeling)
Keratolytic
Antivirus
Antiseborrhoic
Salicylic acid, resorcum, tar, sulfur, etc.(low
concentrations).
Salicylc acid, latic acid, benzoic acid, resorcinum
(more then 3%), argentum nitratum, etc.
Anyline dyes, aethacridinum lactatum (rivanolum),
chinolinum («Dermosolon»), thebrophenum,
«Bonaphton», «Gossipolum», «Florenalum»,etc.
Sulfur, tar, selenum, vit.A, etc.
In any cases, some another substances may be used, for example,
antitumoral, cytostatics, antisclerotic (resolvent), irritant, sunprotective, photosensibilized, special antiseptics for acne (benzoilperoxyde and another), substances for the treatment of psoriasis.
Sometimes one substance have various treatment actions (sulfur, tar,
salicylic acid).
The bases (forms) for the topic treatment aren`t so multiple. The
common classic bases are formed by one or two such components as
liquid (water, spiritus, another in rare cases), oil (vaselinum, lanolinum,
another in rare cases), powder (zincum oxydum, talcum, amylum,
another in rare cases). These components have concrete intensive
actions: water evaporates and cools the skin, causes vasoconstriction,
diminishes manifestations of acute inflammation; oil softens and warms
the skin, causes vasodilatation, resolves infiltration; powder drys,
absorbs, diminishes the exudative inflammation. Another bases and
components are less common- varnish (collodium), jelly, soap, wax,
balsams, etc.
Tabl.№ 2
Wet
bandage
Water
t C=12-16
Like previous, but less
manifested.
Suspension
Powder +
water (in any
cases +
spiritus +
glycerinum)
Subacute inflammation
(urticas, erythema,
microvesicles without
hyperexudation,
especially abundant
rash.)
Paste
Powder + oil
in the equal
quantitis
Subacute inflamation or
mixed- subacute and
chronic.
Not generalized rash.
Cream
(emulsion,
liniment,
liquid
ointment,
lotion )
Oily
ointment
Oil + water
(glycerinum,
emulgators
may be also
used ).
Subacute inflammation ,
especially in ambulance
practice. Defects of the
skin (ulcers, wounds,
erosions, fissures ),
dryness of the skin.
Chronic inflammation
Cold
poultice
Components
Water
t C=12-16
Indications
Notes
Acute
exudative
inflammation, intensive
oedema, microvesicles
with hyperexudation
The
most
common
substances- boric acid,
argentum
nitratum,
rivanolum,
tanninum,
ichthyolum, plants, etc.
4-6 layers of gauze are
used.
Prolongation is 1,5-2
Various substances may
be used, usually not more
that 5-10 %.
Tabl.№ 3
Another bases (forms) for topic treatment
(they haven`t intensive action)
The most common bases (forms) for topic treatment
Form
Oil
hours with wetting every
in5-20 min.
In contrary to cold
poultice gauze is used as
bandage for 4-5 hours.
The most common
substances and
components-mentholum,
anaesthesinum, zincum,
talcum, amylum. For
antiseborrhoic actionresorcinum, sulfur, etc.
The most common is zincpaste without any
substances. Salicylic acid
may be addes ( Lassar
paste), sometimes another
substances ( ichthyolum,
etc.)
Various substances may
be used accordingly to
concrete disease. For
healing action the bandage
is common.
Powder
Powder
Subacute inflammation or
absence of inflammation
Water
solution
Spirituose
solution
Water
For toilet, rinsing,
instillation, treating, etc.
Subacute inflammation in
the cases of pyodermias,
virus and another
intections.
Spiritus
In dermatology it
usually is used like
prophylactic remedy.
Usually antiseptics are
used.
Usually antibacterial,
antifungal, antivirus
substances are used.
Aerosolum
Water and
another
(oil, etc.)
Superficial defects
usually.
Antiseptics and heeling
substances are usually
used.
These are examples of prescriptions of some topic forms:
Rp.: Sol. Methyleni coerulei 1%-20 ml
D.S.: Water solution of methylen blue.
Rp.: Viridis nitentis spirituosae 2%-10 ml
D.S.: Spirituosae solution of brilliant green.
Rp.: Sol. Acidi borici 2%-300 ml
D.S.: For cold poultice.
Rp.: Zinci oxydi
Talci
Vaselini
Lanolini aa 5.0
M.f. pasta
D.S.: Zinc-paste.
Rp.:Mentholi 1.0
Anaesthesini 10.0
Zinci oxydi
Amyli tritci aa 20.0
Glycerini 40.0
Spiritus aethylici 96 50 ml
Aquae destillatae 300.0
M.D.S. Suspension (to shake before usage).
Rp.:Sulfuris p.p.
Olci Rusci aa 5.0
Vaselini aa 50.0
M.f. ung.
D.S. 10.0% sulfur-tar ointment.