(Indian Medical Gazette (1984): (CXVII), 152-154)

P.K. Saraswat, M.D., D.V.D.,
Lecturer in Skin and V.D.
and
R. Gangil, M.B.,B.S.,
Post-graduate Student, Department of Medicine (Skin and V.D. Section),
G.R. Medical College, Gwalior, India.

Chronic relapsing conditions are the most frustrating problems in day-to-day practice. In dermatological practice there are many such types of conditions which are resistant to routine therapeutic measures. Sometimes these measures may give rise to short-term remission but relapses are quite frequent. Quite often modern drugs and antibiotics have a deleterious effect on the skin. Hence it was planned to use an indigenous Ayurvedic medicine, Septilin of The Himalaya Drug Co., for its clinical assessment in cases of recalcitrant dermatoses.

Septilin has marked anti-inflammatory and anti exudative properties (Behl and Pradhan, 1978), as demonstrated by the granuloma pouch method. Behl and Pradhan (1978), have conducted a clinical and experimental study on "Septilin in dermatology". They have estimated the phagocytic co-efficient to find out the real efficacy of this drug as a herbal "antibiotic". they found that Septilin gave a high rise in the phagocytic co-efficient, which correlated with the clinical improvement in chronic infections that were resistant to commonly used broad spectrum antibiotics. Whereas the phagocytic co-efficient values of Septilin were very significant, those in respect of chloramphenicol, prednisolone and multivitamins were not so.

Mohanty (1982) also found excellent results with Septilin in a few intractable dermatological disorders. Bhat (1983) studied 10 cases of chronic dermatoses and the phagocytic co-efficient of Septilin in those cases. He was also of the opinion that Septilin is useful in these dermatological disorders.

Ashok Puri (1981) treated a 3 year old child with atopic dermatitis with Septilin, that was resistant to conventional chemotherapeutic agents.

Punshi (1980) found excellent results in all the cases of seborrhoea and acne vulgaris he studied.

Besides dermatological disorders Septilin has been found effective in chronic stubborn infections of the upper respiratory tract (Das 1980, Garg 1980 and Vishwakarma 1979) and also in rheumatic fever (Eranna 1978).

Ross (1984) studied the anti-infective and antibacterial efficacy of Septilin in various infective and allergic disorders. In his study he found excellent and good results with this drug.

Agarwal et al. (1980) have conducted a clinical trial with Septilin in resistant cases of chronic suppurative otitis media and have found good to excellent results with this drug in the majority of cases.

Taking into account the impressive clinical reports and record of Septilin, a trial with Septilin was conducted in the Skin and V.D. Section (Dept. of Medicine), G.R. Medical College, Gwalior to study and record its clinical effects in various infective and allergic dermatoses resistant to conventional therapy.

Each tablet of Septilin contains :

The present study comprises those dermatological disorders which had either not responded or only partially to routine chemotherapeutic agents. In other words we have taken those skin conditions which were previously treated with commonly known therapeutic drugs for several weeks before Septilin therapy. All such treatment was withdrawn before beginning Septilin therapy

Two hundred cases diagnosed clinically formed the subject material for the present study
(See Table I).

These cases belonged to both sexes and different age groups.

Septilin, 2 tablets t.i.d. was given for a 4-6 week period. Each case was reviewed at the end of one week or, in a few cases, at the end of 2 weeks. During this period no other drug was given except an emollient cream just to impart a soothing effect or for psychological satisfaction in the patient.

All the cases were carefully observed for disappearance of signs of inflammation, side-effects and response to treatment. The results were recorded as excellent where response was immediate, good when signs of inflammation and itching were relieved (fairly quick response), fair when signs of inflammation were reduced by more than 60% and poor when the improvement was less than 50%.

Out of the 200 cases, 148 were males and 52 females, the ratio being 3:1 approximately. Recurrent furunculosis was seen in 70 males and 26 females. Sycosis barbae was seen in 20 males. Bockhart's impetigo affected 18 males and 20 females and endogenous eczemas, 40 males and 20 females. So it was obvious that in the present study males outnumbered females (Table-II).

From Table III it is evident that the maximum number of cases were seen in the age group of 1-10 years followed by the 21-30 years group. Recurrent furunculosis was the commonest clinical type in the 1-10 years group. It was surprising that the least number of cases were encountered in the age group of 51 and above. Bockhart's impetigo was seen only in young adults.

Out of the 200 cases, excellent response was seen in 94 cases, good results in 46 and fair response in 30. In the remaining 30 cases the response was poor or improvement was less than 50% (See Table IV).

Boils and carbuncles are caused mostly by Staphylococcus aureus and Streptococci. The lesions are deep-seated affections of the hair follicle in which the hair root is completely destroyed. They are commonly seen during the hot and humid weather. Low socio-economic status, poor personal hygiene and low host resistance are predisposing factors for recurrent furunculosis.

Out of 96 cases, 62 showed excellent response, 10 good response, 8 fair response and in the remaining 16 the response was poor.

The offending organisms are Staphylococci. It is characterised by small pus discharging follicular pustules which dry to form crusts. It is a very chronic disorder. Trauma favours spread of the disease. Relapses and remission are very common.

Out of 20 cases, 9 showed excellent results, 4 good results, 3 fair results and in the remaining 4, the response was less than 50%.

It is a type of recurrent foliculitis involving mostly the extensor aspects of the limbs, caused by Staphylococcus aureus or albus. The follicles and perifollicular area are affected by the formation of follicular pustules covered by tiny yellowish crusts. The infection spreads from one hair follicle to another producing multiple but discrete lesions.

Out of 24 cases, 15 showed good results and 9 fair response. It was the only clinical condition in which no poor response was seen.

Eczemas are allergic manifestations of the skin. Cases of discoid, seborrhoeic and infective eczematoid dermatitis were included in this group. No specific cause of eczema could be found in these cases. There are chances for eczema to undergo phases of relapses and remission. Various chemotherapeutic agents, including the steroids, give temporary relief.

Out of the 60 cases, 23 showed excellent response, 17 good response, 10 fair response and in the remaining 10, the response was less than 50%.

No side effect was observed during the course of therapy.

From the above results it is clear that Septilin is a useful therapeutic agent in resistant infection and allergic disorders of the skin. Septilin contains herbal polysaccharides which may activate the properdin system and increase the chemotaxis of polymorphs. This leads to greater accumulation of polymorphs at the site of infection, phagocytosis and subsequent destruction of microorganisms.

All the patients in this study had taken other chemotherapeutic agents with temporary relief. There were frequent relapses probably due to diminished phagocytic activity. Septilin prevented recurrences through increased phagocytic activity concurrent with therapy.

SUMMARY

We wish to acknowledge our thanks to The Himalaya Drug Co. for the liberal supply of Septilin.