Emollient composition

Drug – bio-affecting and body treating compositions – Topical sun or radiation screening – or tanning preparations

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514863, 514873, A61K 742

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active

055018491

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BRIEF SUMMARY
DESCRIPTION

This application is a 371 of PCT/GB 92/00556 Mar. 26, 1992.
This invention relates to an emollient for use in a method of treating psoriasis in which the abnormal skin is exposed to Ultraviolet light (UV), preferably to UVA.
Psoriasis has been treated successfully by irradiating effected areas of skin with ultraviolet light, since this method was first proposed by Goeckerman (North West Med, 24: 229-231, 1925). The original Goeckerman regime requires the effected area to be topically treated with crude coal tar, the subsequent removal of the crude coal tar with olive oil, followed by irradiation of the area with ultraviolet light from a medium pressure mercury discharge lamp. In a modern development of this original therapy, known as PUVA treatment, a psoralen, such as trimethylpsoralen, or 8-methoxypsoralen is administered, either systemically or topically to the effected area and the effected area is subsequently irradiated with UVA radiation. The PUVA treatment appears to be a most effective treatment for psoriasis and has been in use since first being described in 1974 (Parrish et.al. New England Journal of Medicine, Vol. 29, No.23, 1974). Also some good results have been achieved by irradiating psoriatic plaques, coated with an emollient, with UVB (See Fischer, Acta Dermatovener (Stockh)56; 473-479, 1976).
In both PUVA and other similar treatments, it has been a common practice to coat the skin with an emollient prior to treatment, in order to ensure that diseased areas of skin receive a sufficient dose of radiation, while preventing the skin from flaking and suffering localised burning. There are numerous air spaces between the abnormal corneocytes in dry psoriatic plaques and, accordingly, if no emollient is used, incident ultraviolet radiation must pass through many air/skin boundries, before impinging upon the epidermis below, where it may have a therapeutic effect. At each air/skin boundry a certain amount of light is reflected and, thus, the many such boundries present in dry psoriatic skin can reflect a significant amount of radiation. The effect of an emollient is to fill these air spaces and to render the scales of skin translucent by decreasing the reflection of incident ultraviolet light. It has been shown that the transmission of ultraviolet light through psoriatic plaques can be increased between 2 and 3 times by the use of an emollient (see Leroy et.al. Photo dermatol 3, 1986, 51-52; J. A. Parrish Phototherapy of Skin diseases and; R. R. Anderson and J. A. Parrish, the Optics of Human Skin, J. Invest. Dermatol. 1981; 77: 13-19.).
In this way, the transmission properties of psoriatic plaques can be rendered similar to that of a normal stratum corneum and the therapeutically effective dose of radiation can be reduced to a level less likely to be harmful (by way of causing painful erythema or burning) to normal skin, which it is often impossible to avoid irradiating when carring out PUVA or like treatments. Thus, an emollient can prevent damage to normal skin, while allowing a therapeutically effective dose of radiation to be given to adjacent diseased areas.
The emollients employed up to date in PUVA therapy and phototherapy using UVB, all absorb a certain amount of ultraviolet light and, thus, reduce the amount of such radiation that reaches the epidermis (this effect is usually outweighed by the previously discussed enhancement of transmission through scaly skin.). In order to overcome this difficulty, patients can be exposed to radiation for longer periods, or to higher intensities of radiation, in order to provide a therapeutic dose of radiation. In theory, this practice should not increase the amount of radiation penetrating skin coated with an emollient.
Where the effected areas of skin are extensive, it is common practice for a sufferer's entire body to be irradiated, in a light cabinet, after an appropriate emollient has been applied to all exposed areas of skin.
A well documented harmful side effect of exposure to ultraviolet light is that, after significant periods o

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patent: 4994263 (1991-02-01), Lang et al.
Cosmetics & Toiletries, vol. 104, May 1989, Raab, The Use of Tanning Accelerators: "Sense, Nonsense or Danger" 1989.

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