RU2375054C2 - Preparation for treatment of skin affections, method for making said preparation (versions) and method of treating skin affections - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: declared invention concerns chemical-pharmaceutical industry, and covers a medicinal agent for treating benign, virus, premalignant and malignant non-metastasing skin affections, dysplastic (pretumour) and inflammatory affections of visible mucous membranes, virus, mycosis of skin and nails, as well as correction of wrinkles and senile pigment spots by lifetime devitalisation, containing alpha-haloidcarboxylic acid and its zinc salt of general formula R-(CH₂)_m-CXY-COOH and [R- (CH₂)_m-CXY-COO]₂Zn where Y = CI, Br or J, X=H or Y, m=1-10, R = H, aryl, cycloalkyl, alkyl of general formula C_nH_2n+1, n=1-5, in the ratio 500:1 to 10:1 and water in amount 1.5 to 70.0 wt %.

EFFECT: agent is characterised with high efficiency; it is not toxic in small dosage and does not have by-effects.

4 cl, 77 ex, 1 tbl

Description

The present invention relates to medicine, in particular to dermatology, oncology, genital urology, aesthetic medicine, plastic surgery and gynecology.

Skin diseases are one of the most common, related to the environment, the adverse effects of sunlight and a number of other factors. Their manifestation is extremely diverse, and prevention is limited, as a result of which the rate of spread of benign and malignant skin diseases is constantly increasing. Many methods have been proposed for the treatment of various types of benign lesions of the skin and visible mucous membranes at different times: in some cases, successful results are achieved with the use of radiation, photodynamic or chemotherapy, in others - plastic, laser or cryosurgery, in the third - pharmaceutical preparations, etc. . Sometimes you need to use a combination of these methods for a fairly long time. However, even complex therapy is not always effective: there are cases of relapse of diseases and complications. In addition, there are often limitations and contraindications to the use of a particular method or drug.

Among pharmaceutical preparations, compounds based on caustic fluids of an acidic nature have been widely used, which have long been used to cauterize affected skin areas, causing their necrosis. Of the mineral acids, nitric and hydrochloric acids or mixtures of nitric and nitrous acids have found the greatest use [1], of organic acids - acetic, salicylic, oxalic and other acids [2, 3], their esters [4] or combinations with metal salts [5] , 6]. For the treatment of warts in the USA, an over-the-counter formulation W is sold containing a mixture of acetic and salicylic acids. The drug, which includes zinc chloride and trichloroacetic acid, has been used for a short time to treat skin cancer (Mohs method), because turned out to be insufficiently effective and painful. Preparations based on 5-10% hydrochloric acid with the addition of chitosan or alcoholic extracts of some plants have been described [7, 8]. Preparations containing nitrous acid turned out to be unstable, therefore, it was proposed to introduce special additives (urea, pyruvic and lactic acids, metal salts of variable valency) to control the rate of its formation from nitric acid. However, the danger of using such drugs is often minimized or even hushed up.

It is known, in particular, that many mineral and organic carboxylic acids, especially haloacetic acids, are highly reactive and cause serious damage to the skin and visible mucous membranes, and, when ingested, disrupt the activity of important enzyme systems of the body. Monofluoroacetic acid is especially toxic, which, turning as a result of metabolism into fluorimonic acid, affects the central nervous and cardiovascular systems, inhibits or even stops the Krebs cycle, leading to massive cell death and death.

It was found that all low molecular weight monobasic carboxylic acids are strong irritants of the skin and visible mucous membranes and cause serious damage to body tissues. The higher members of the aliphatic series, dicarboxylic and unsaturated acids are less toxic. It is known that selenium-based formulations are used as antitumor drugs for the prevention or palliative treatment of tumors of internal organs [9], as well as a complex product of the interaction of selenium with haloacetic acids for the treatment of skin tumors and visible mucous membranes [10]. However, the latter does not act selectively, causing necrosis of healthy skin, and is not effective enough: the tumors are not completely destroyed, the percentage of relapses is high, and complications in the form of a secondary infection are often observed.

Due to differences in the chemical structure of acids, their toxic effects on the skin can manifest themselves in different ways, primarily in the form of an irritating effect, the strength of which partially depends on the degree of acid dissociation and its solubility in water. The effect of acid concentration and its dose on the pathological focus is complex and depends on the nature and severity of the disease. Preparations with a relatively high concentration of acid are more effective in neoplasms with a superficial spread than with a deep one. Contact with healthy skin can result in a chemical burn, the healing of which is often accompanied by the formation of scar tissue.

Over the past 15 years, the range of drugs for the treatment of skin diseases has been enriched with compounds based on various classes of organic compounds, and the number of patents on this subject amounts to many hundreds, which once again emphasizes the complexity of the problem.

The closest technical solution to the claimed in essence and the achieved solution is a product that is a solution of zinc salt and halocarboxylic acids of the general formula

(RCOO) ₂ Zn or (R ² CH ₂ CHR ¹ COO) ₂ Zn,

where R is Chal ₃ , CHhal ₂ , CH ₂ hal, R ¹ is hal, R ² is alkyl

The drug is prepared by reacting zinc oxide, hydroxide or carbonate with halocarboxylic acids in an aqueous medium and stabilized with 0.72-1.36% of succinic or citric acid salts. The final product is a brown solution with a pH of 2.2-3.0, containing from 2.5 to 25% zinc, and is used as a medicine in the form of an aqueous solution at a concentration of 5-45 wt.%. The drug is intended for the treatment of benign neoplasms of the skin and visible mucous membranes, has low toxicity (LD ₅₀ 1100 mg / kg), does not have a systemic, teratogenic, embryotoxic and carcinogenic effect, selectively dehydrates the tissue and has an intravital fixing effect on the tissue. After removal of the pathological tissue, healing and regeneration are completed in two weeks without noticeable side effects. The drug is easy to use, safe for patients and medical personnel, does not require special restrictions on the behavior [11].

The disadvantages of the prototype include the lack of information about the purity of the reagents used, especially halocarboxylic acids. It is known that when the latter are obtained by direct halogenation of the corresponding fatty acids, mixtures of mono- and polyhalo-substitution products and positional isomers are always formed, the separation of which in some cases is a rather complicated task. As applied to 2-chloropropionic acid, we have specifically demonstrated by NMR spectroscopy that a technical product of 95% purity from Akros contains impurities of acetic, mono-, di- and trichloroacetic, propionic, 2.2- and 2.3-dichloropropionic acids and water, that the content of the target product does not exceed 90%. All of these acid impurities under the reaction conditions are also able to turn into the corresponding zinc salts, the pharmacological activity of which has not been established. Removing impurities and obtaining 2-chloropropionic acid with a purity of more than 98.0 wt.% Is achieved only through highly efficient rectification.

The brown color of the solution, to which the authors of the patent pay attention, testifies precisely in favor of the fact that they actually dealt with a mixture of zinc salts of different acids, and not with individual compounds. This assumption is indirectly confirmed by the lack of data on the physicochemical properties of the obtained dry salts and the need to stabilize their aqueous solutions with succinic or citric acid additives (or their salts, as in the text).

In the examples presented, the stoichiometric ratio of the source of zinc (oxide, hydroxide or carbonate) and halocarboxylic acid (1: 2), which is necessary to obtain pure salt, is strictly observed everywhere. Meanwhile, the reaction product has a strongly acidic reaction (pH 2.2-3.0), which indicates the presence of a strong acid impurity, such as alpha-halocarboxylic acids, i.e. the reaction is not complete or the stoichiometry is not maintained.

An experimental verification confirmed that, for example, to complete the reaction of zinc oxide with 2-chloropropionic acid at room temperature, it takes much longer than the 15 minutes indicated in the examples of the prototype patent. Moreover, this reaction proceeds at a noticeable rate only with increasing temperature.

The possibility of obtaining pure zinc salts by the interaction of halocarboxylic acids with zinc hydroxide without its preliminary purification from sodium chloride is also doubtful. The solubility of the latter in water at room temperature is 36.0 g / 100 g of water [12]. Since only undissolved part of sodium chloride (precipitate) is separated by filtration, at least 20-25% of sodium chloride remains in the filtrate. When lyophilization of the solution, table salt will be an inevitable companion of the final product, the elemental composition of which cannot meet the formula of pure zinc salt, which contradicts the data given in the patent prototype.

Finally, in none of the examples presented for the use of the drug for the intended purpose does it indicate the zinc salt of which acid was used to treat patients. The authors of the prototype patent do not give preference to any particular compound, which is unacceptable for pharmaceutical preparations, since in this case it is impossible to confirm its reliability and quality. Judging by the presented examples, the effectiveness of salts is not inferior to the effectiveness of acids, which contradicts the known data. In addition, the name of the patent [prototype] declares the treatment of neoplasms of the skin and visible mucous membranes, and as an example, the treatment of ectopia of the cervix and genital warts (papillomavirus etiology) of the skin, which cannot be attributed to neoplasms of the skin and visible mucous membranes, is given as examples.

The aim of the present invention is to develop a new stable highly effective drug of established chemical composition for the treatment of viral, benign, precancerous and malignant non-metastatic skin lesions, dysplastic lesions of visible mucous membranes and other skin lesions. The problem is solved by the present invention.

The drug is for the treatment of skin lesions, in particular benign, viral, precancerous and malignant non-metastatic skin lesions, dysplastic-pre-tumor and inflammatory lesions of visible mucous membranes, including viral, fungal lesions of the skin and nails and other skin lesions, as well as for the correction of wrinkles and senile age spots by their intravital devitalization, according to the invention contains halocarboxylic acid and its zinc salt of the General formula

R-CXY- (CH ₂ ) _m -COOH and [R-CXY- (CH ₂ ) _m -COO] ₂ Zn

where R is aryl, cycloalkyl, alkyl of the general formula C _n H _{2n + 1} , n = 1-5, m = 1-10

X = H or Y, Y = F, Cl, Br or J,

in a ratio of from 500: 1 to 10: 1 and water in an amount of from 1.0 to 99.0% of the mass. of the total amount of the drug.

To mitigate the effect and increase the effectiveness, the preparation may additionally contain ethyl alcohol, dimethylformamide and other additives in an amount of 1.0 to 25.0% of the total amount of the preparation.

The drug can be made in dosage form, which is an aqueous or aqueous-alcoholic solution, gel, ointment, cream or aerosol.

The task can also be solved by another invention - the method of obtaining the drug.

In the proposed method for producing the preparation, zinc oxide is added to the halocarboxylic acid or its aqueous or alcohol-alcohol solution and stirred at a temperature of 40-215 ° C, mainly 85-95 ° C, for 1-600 minutes, mainly 10-60 minutes.

In another embodiment of the method, the preparation is prepared by mixing halocarboxylic acid and its zinc salt, the purity of which is at least 98.5 wt.%, And water.

The task can also be solved by another invention - a method of treating skin lesions.

The proposed method for the treatment of skin lesions, in particular benign, viral, precancerous and non-malignant malignant skin lesions, dysplastic-pre-tumor and inflammatory lesions of visible mucous membranes, including viral, fungal lesions of the skin and nails and other skin lesions, as well as for the correction of wrinkles and senile age spots by their intravital devitalization according to the invention includes the use of the drug according to claim 1

Thus, in the present invention, the uncertainties and errors that were made in the development of the previously proposed methods were investigated and eliminated in detail, and it is proposed to use an aqueous solution of the zinc salt of halocarboxylic acid in the original halocarboxylic acid as such a preparation.

A distinctive feature of the proposed method is that

- all starting compounds used in the synthesis of the target product are characterized

purity not less than 98.5% in order to avoid undesirable effects

impurities

- the optimal temperature-time regime of the reaction and

the concentration of the mixed reagents, which allows to obtain the target product in the form of a practically colorless solution,

- in some cases, for example when using unstable iodocarbon

acids, the preparation is obtained by mixing halocarboxylic acid with its zinc salt, previously obtained and isolated in an individual state, the purity of which has been confirmed analytically. This technique can be extended by us to all halocarboxylic acids, and not just their iodine derivatives, and is very useful and effective in the preparation of preparations with a molar ratio of acid: alcohol of 100: 1 or less,

- the ratio of salt and free acid in the preparation, as well as their concentration in

the solution is selected taking into account the nature of the disease on the basis of ideas about the comparative pharmacological activity of acid and salt,

- thanks to this approach, it was possible to significantly expand the range of skin diseases that can be successfully treated using the proposed drugs

(see examples).

The following examples reflect the results of the practical application of the claimed composition in the treatment of various skin diseases and visible mucous membranes, namely (* the names of the diseases are given in accordance with the histological classification of skin tumors (WHO, 1996)):

1. Genital warts of the skin and visible mucous membranes *.

2. Molluscum contagiosum.

3. Cervical dysplasia (mild and moderate).

4. Ectopia or pseudo-erosion of the cervix.

5. Chronic endocervicitis.

6. Nabotiev cysts of the cervix (Ovuli Nabothi).

7. Post hysterectomy granuloma of the vaginal dome.

8. Contact bleeding from the cervix.

9. Intradermal melanocytic nevus *.

10. Epidermal nevus *.

11. Seborrheic keratosis *.

12. Borderline melanocytic nevus *.

13. Mixed melanocytic nevus *.

14. Halo Nevus *.

15. Spitz Nevus *.

16. Pigmented spindle cell nevus of Reed *.

17. Cellular blue nevus *.

18. Congenital melanocytic nevus *.

19. Dysplastic melanocytic nevus *.

20. Superficially spreading melanoma *.

21. Melanoma type malignant lentigo *.

22. Nodular nodular melanoma *.

23. Lentigo simple (simplex) *.

24. Inflammatory linear warty epidermal nevus *.

25. Clear cell acanthoma *.

26. Skin horn.

27. Keratoacanthoma *.

28. Simple wart *.

29. Plantar wart *.

30. Flat wart *.

31. Radiation keratosis *.

32. Arsenic keratosis.

33. Oral leukoplakia.

34. Intraepidermal squamous cell cancer *.

35. Infiltrating squamous cell carcinoma *.

36. Modular basal cell carcinoma *.

37. Superficial basal cell carcinoma *.

38. Metatypical skin cancer *.

39. Syringoma *.

40. Adenoma of the sebaceous gland *.

41. Pigmented hair epidermal nevus.

42. Sebaceous nevus *.

43. Trichoepithelium *.

44. Trichofolliculoma *.

45. Pigmented basal cell carcinoma *.

46. Cyst of the funnel *.

47. Capillary malformation (Nevus of the Unna) *.

48. Nevus flaming *.

49. Nevus teleangiectatic.

50. Venous malformation (blue vesiculate nevus) *.

51. Angiokeratoma *.

52. Pyogenic granuloma *.

53. Capillary hemangioma *.

54. Kaposi's sarcoma *.

55. Cystic lymphangioma *.

56. Fibroma *.

57. Xanthoma *.

58. Fibrous papule *.

59. Primary cutaneous neuroendocrine carcinoma (tumor from Merkel cells) *.

60. Neurofibromatosis, skin form.

61. Fibroepithelial polyp *.

62. Warty diskeratoma *.

63. Large cell acanthoma.

64. Benign lichen-shaped keratosis *.

65. Tar keratosis.

66. Warty squamous cell carcinoma *.

67. Sebaceous carcinoma *.

68. Angiolymphoid hyperplasia with eosinophilia (epithelioid hemangioma) *.

69. Benign fibrous histiocytoma *.

70. Atypical fibroxanthoma *.

71. Hair tumor (proliferating tricholemal cyst) *.

72. Lipomatous nevus.

73. Wrinkles of the skin of the face.

74. Candidiasis of the skin.

The invention is illustrated by the following general methodology.

0.01-0,0002 g-mole of zinc oxide of grade of chemically pure grade is added to 0.1 g-mole of concentrated halocarboxylic acid of a special degree of purification, stirred at a temperature of 80-95 ° С for 30-60 minutes until the precipitate is completely dissolved then the reaction mixture is cooled to room temperature, filtered through a G4 glass filter and a clear drug solution is obtained.

Some features of the general procedure are reflected in the examples below, and the reaction conditions with other halocarboxylic acids are presented in table 1.

All the products obtained are practically colorless solutions with a slight characteristic odor that do not change their properties for a very long time when stored in a dark glass container at a temperature not exceeding 10 ° C.

Example 1

To 10.85 g (0.1 g mol) of concentrated 2-chloropropionic acid with a purity of 98.3%, 0.016 g (0.0002 g mol) of zinc oxide is added, heated for 30 min at 90 ° C with stirring, cooled to room temperature, filtered and obtained the preparation is in the form of a clear, colorless mobile fluid, which is a solution of the zinc salt of 2-chloropropionic acid in 98% 2-chloropropionic acid with an acid: salt molar ratio of about 500: 1.

Example 2

To 14.3 g (0.1 g mol) of concentrated 2.2-dichloropropionic acid with a purity of 98.6%, 0.020 g (0.00025 g mol) of zinc oxide (molar ratio acid: salt is 400: 1) are added, heated at 95 ° C with stirring within 20 min until the precipitate is completely dissolved, cooled to room temperature, filtered and the preparation is obtained in the form of a yellow transparent liquid, which is a solution of the zinc salt of 2,2-dichloropropionic acid in 98.5% 2,2-dichloropropionic acid with molar the ratio of acid: salt is approximately 400: 1.

Example 3

To 4.0 g (0.02 g mol) of concentrated 2-iodopropionic acid of special purification, 3 ml of distilled water and 0.81 g (0.01 g mol) of zinc oxide are added, heated at a temperature of 80 ° С with stirring for 40 min, after which a hot reaction mixture the mixture is quickly filtered through a glass filter. The obtained clear yellow solution containing about 0.01 g mol of the zinc salt of 2-iodopropionic acid was transferred to a desiccator and kept in vacuum over phosphorus pentoxide until the water was completely removed. The residue, which is an amorphous mass of light yellow color, is dissolved at room temperature in 20.0 g (0.1 g mol) of 98.0% 2-iodopropionic acid and the preparation is obtained in the form of a clear yellow liquid, which is a solution of zinc salt 2- iodopropionic acid in 98.0% 2-iodopropionic acid with an acid: salt molar ratio of about 100: 1.

The recommended dose is selected depending on the type and severity of the disease, taking into account the strength of the acid and the ratio of zinc salt: acid.

Alpha-halocarboxylic acids used in the synthesis, depending on the chemical structure, significantly differ from each other in the degree of electrolytic dissociation, i.e. have different activity. It is this feature that we used when choosing a specific dosage form for the treatment of a specific skin disease. It has been established, in particular, that when treating with halogen acetic acid preparations, complications often arise associated with damage to neighboring healthy skin areas, and preparations based on beta, gamma, and omega-halogen carboxylic acids are less active than their alpha-substituted analogues.

The composition has no contraindications.

The claimed tool can be used in the form of a solution for local and external use in a concentration of from 30% to 70% (acid). The recommended dose for one lesion ranging in size from 0.1 to 2.0 cm is 0.03-0.3 ml of the dosage form.

The examples below reflect experimental and clinical trials.

Epicrisis number 1

Patient R., born in 1980, turned to the clinic of aesthetic medicine in Kiron (Israel) with complaints of warts in the external genitalia and vaginal discharge. The duration of the disease was 2-3 weeks. When viewed on the inner surface of the labia minora, on the posterior wall of the vagina and on the cervix, multiple tumor-like formations, lobed with an uneven surface, like whitish cauliflower with a diameter of 7 to 1.6, were determined on narrow bases in the labia and the vagina mm, tight to the touch. When conducting DNA diagnostics of scraping from the surface of existing formations, the human papilloma virus type 11 (HPV 11) was detected. RPHA with Treponema palliduum antigen, RIF and Wasserman reaction are negative. The conclusion of the gynecologist: genital warts of the cervix, vagina and labia. A biopsy of one of the genital warts was performed. The histological conclusion: genital warts. After obtaining the consent of the patient on an outpatient basis, without anesthesia, an application of a composition containing a 30% solution of 2-chlorobutyric acid and its salt in a ratio of 10: 1, on condylomas, in a dose of 0.4 ml was performed. 12-15 minutes after the application, genital warts turned yellow, a slight swelling and hyperemia of the mucous membrane appeared around them, after 20 hours the warts were light brown in color and mummified. 11-15 days after treatment, condylomas freely separated from the mucous membrane, at their location, for 28-38 days, areas of hyperemia were observed, according to the area corresponding to the area of the base of the condyloma. Subsequent monitoring of the patient for 6 months did not reveal recurrence of genital warts.

Epicrisis №2

Patient D., born in 1978, turned to the clinic of aesthetic medicine in Kiron (Israel) with complaints of the occurrence of small nodules in the external genital area. These formations appeared about three weeks before treatment. When viewed on the labia majora, in the region of the vestibule, in the upper third of the vagina and on the cervix, more than two dozen translucent vesicles, well defined, hemispherical, with a smooth surface, with a diameter of 1.5 to 4.0 mm, with a depression were detected in the center. Gynecologist's conclusion: molluscum contagiosum molluscum contagiosum. Microscopic examination of the horn mass separated from the vesicles revealed intracellular cytoplasmic inclusions. The presence of the molluscum contagiosum virus in the vesicles was also confirmed by polymerase chain reaction. After obtaining the patient’s consent, an application was made of a composition containing a 30% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 to the lesion site of molluscum contagiosum, at a dose of 0.3 ml. 15-20 minutes after application, the surface of the nodules acquired a yellowish color. After 25-35 minutes, insignificant edema and hyperemia of the skin and mucous membrane appeared around the vesicles, and upon examination after 24 hours, their darkening and mummification were observed. After 22-30 days, the mummified scabs independently separated from the underlying tissues. In the area of their location, areas of hyperemia over the area coinciding with the area of application of the composition were observed for 25-50 days. Subsequent monitoring of the patient after treatment did not reveal any pathological changes in the mucous membrane or skin at the locations of the molluscum contagiosum.

Epicrisis number 3

A patient L., born in 1976, came to the clinic of aesthetic medicine in Kiron (Israel) 02.02.2006 with complaints of periodic vaginal discharge. These secretions appeared about 1 year ago. Previously sought medical help, anti-inflammatory treatment was carried out, with a temporary improvement. A visual examination of the vaginal mucosa is moderately swollen, the cervix is dull, uneven, with areas of hyperemia. Colposcopy and cytological examination of smears from the cervix were performed. The conclusion of the cytologist: moderate cervical dysplasia (CIN-II). The study of scraping from the cervix using a polymerase chain reaction revealed the presence of human papillomavirus type 18 (HPV 18). A biopsy of the cervix confirmed the conclusion of the cytologist. After obtaining the consent of the patient, an application was made of a composition containing a 30% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 to the cervix, at a dose of 0.2 ml. 15 minutes after the application, a moderate swelling of the cervix was noted, and its surface acquired a yellowish-gray color. After a day, there was a darkening and mummification of the cervical mucosa. No systemic toxic or side effects were recorded. After 20-26 days, the cervix cleared of mummified scabs and was moderately hyperemic for another 30-36 days. Subsequent monitoring of the patient from May 2006 to May 2007 did not reveal any pathological changes in the cervical mucosa. Control cytological studies of smears from the cervix, performed 4 months after treatment, did not reveal signs of dysplasia of its mucosa, and the polymerase chain reaction showed the presence of human papillomavirus.

Epicrisis №4

Patient P., born in 1983, turned to the clinic of aesthetic medicine in Kiron (Israel) on March 01, 2006 about infertility. The first pregnancy ended in 2000 with a medical abortion. On visual examination, the entire cervix is unevenly hyperemic, with an uneven, sometimes velvety, easily bleeding surface. Colposcopy and cytological examination of smears from the cervix, in which cells of the cylindrical epithelium were detected, were performed. Microbiological examination of the vaginal discharge from the posterior fornix revealed an opportunistic microflora. Gynecologist's conclusion: ectopia or pseudo-erosion of the cervix. After obtaining the consent of the patient, an application was made of a composition containing a 30% solution of 2-chlorobutyric acid and its salt in a ratio of 200: 1 to the cervix, at a dose of 0.4 ml. 15-20 minutes after application, a moderate swelling of the cervix was observed, and its surface acquired a yellowish-gray color. A day later, there was a darkening and mummification of the cervical mucosa. No systemic toxic or side effects were recorded. After 22-28 days, the cervix cleared of mummified scabs and was moderately hyperemic for another 30-36 days. Subsequent monitoring of the patient did not reveal any pathological changes in the cervical mucosa. Control cytological studies of smears from the cervical mucosa, performed 3 months after treatment, found only multilayer epithelial cells.

Epicrisis №5

A patient L., born in 1985, came to the clinic of aesthetic medicine in Kiron (Israel) on December 03, 2005 with complaints of vaginal discharge. The indicated discharge appeared 3 months ago. Previously treated for chlamydia and ureaplasmosis. The sexual partner had symptoms of chronic urethritis. When viewed with pressure from the canal on the cervix, there was a light yellow discharge. When staining according to Gram, separated from the cervical canal, a large number of segmented white blood cells and coccal microflora were found. Microbiological examination of the cervical discharge revealed the presence of fecal enterococcus (more than 1000 colonies). Gynecologist's conclusion: chronic endocervicitis. Two courses of general and local antibiotic therapy within 2 months reduced the amount of mucopurulent discharge from the cervix, but did not lead to the relief of the inflammatory process in the endocervical canal. After obtaining the consent of the patient, an application was made of a composition containing a 30% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 to the endocervical canal at a dose of 0.2 ml. 20 minutes after the application, moderate edema of the cervical mucosa was observed, and its surface turned yellowish. A day later, there was a darkening and mummification of the cervical mucosa. No systemic toxic or side effects were recorded. After 30 days, the endocervical canal cleared of mummified scabs and was moderately hyperemic for another 30-35 days. Subsequent monitoring of the patient did not reveal any pathological changes in the cervical mucosa and endocervical canal.

Epicrisis №6

The patient Zh., Born in 1984, turned to the clinic of aesthetic medicine in Kiron (Israel) on April 19, 2005 with complaints of infertility. A visual examination of the cervix revealed several roundish formations with a smooth surface with a diameter of 4.0 to 8.0 mm. Ultrasound transvaginal and magnetic resonance imaging revealed cystic formations in the cervix with homogeneous contents with a maximum size of up to 9.0 mm. Gynecologist's conclusion: cervical cervix (Ovuli Nabothi). After obtaining the consent of the patient, an application was made of a composition containing a 30% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 to the cervix, in a dose of 0.5 ml. 15-25 minutes after application, a moderate swelling of the cervix was observed, and its surface acquired a yellowish-gray color. A day later, there was a darkening and mummification of the cervical mucosa. No systemic toxic or side effects were recorded. After 30-34 days, the cervix cleared of mummified scabs and was moderately hyperemic for another 35-40 days. Subsequent monitoring of the patient did not reveal any pathological changes in the cervical mucosa.

Epicrisis number 7

Patient G., born in 1961, turned to the clinic of aesthetic medicine in Kiron (Israel) on March 09, 2005 with complaints of the presence of bloody discharge from the vagina. Two months before treatment, the patient underwent hysterectomy for the tumor. The immediate postoperative period was uneventful, spotting appeared about two weeks before treatment. A visual examination of the vagina in the area of its dome revealed a granulating, easily bleeding mass 1.5 × 1.5 cm in size. Microscopic examination of the vaginal smear revealed large numbers of red blood cells. Magnetic resonance imaging did not reveal any pathological lesions in the pelvic area. Gynecologist's conclusion: post hysterectomy granuloma of the vaginal dome. After obtaining the consent of the patient, an application was made of a composition containing a 50% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 to the vaginal granuloma, at a dose of 0.6 ml. 15-20 minutes after the application, moderate swelling of the post-hysterectomic granuloma was observed, and its surface turned yellowish-gray. A day later, there was a darkening and mummification of the granuloma. No systemic toxic or side effects were recorded. After 32-35 days, the dome of the vagina was cleansed of mummified scabs and for another 30-40 days the vaginal mucosa in the granuloma was moderately hyperemic. Subsequent monitoring of the patient did not reveal any pathological changes from the side of the vaginal dome.

Epicrisis №8

Patient U., born in 1940, turned to the clinic of aesthetic medicine in Kiron (Israel) on January 15, 2005 with complaints of spotting from the vagina after sexual intercourse. Since 2000, the patient has menopause. For the first time spotting appeared six months before treatment, then she sought medical help. She was consulted and examined by a gynecologist, the use of tampons with sea buckthorn oil was recommended. The proposed treatment had no effect. On visual examination, the cervical mucosa is dull, slightly yellowish, with a hemorrhagic spot with a diameter of up to 5.0 mm. Performed colposcopy, cytological examination of smears from the cervix, cervical biopsy. The conclusion of the cytologist and morphologist: signs of mucosal atrophy with hemorrhage. Microbiological examination of smears from the cervix did not reveal pathogenic microflora. Ultrasound and magnetic resonance imaging of the pelvis did not reveal any pathological changes in the internal genital organs. Gynecologist's conclusion: contact bleeding from the cervix. After obtaining the consent of the patient, an application was made of a composition containing a 30% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 to the cervix, in a dose of 0.5 ml. 15-20 minutes after application, a moderate swelling of the cervix was observed, and its surface acquired a yellowish-gray color. A day later, there was a darkening and mummification of the cervical mucosa. No systemic toxic or side effects were recorded. After 36-40 days, the cervix cleared of mummified scabs and for another 30-35 days the mucous membrane of the cervix was moderately hyperemic. Contact bleeding stopped after treatment, and subsequent monitoring of the patient did not reveal any pathological changes in the cervical mucosa.

Epicrisis №9

Patient T., born in 1976, turned to the clinic of aesthetic medicine in Kiron (Israel) on March 30, 2005 complaining of a large birthmark on her neck, which was slowly increasing in size. According to the patient, a birthmark has been present since birth. She was previously consulted by an oncologist, the removal of a birthmark was recommended. An objective examination of the anterior lateral surface of the left neck in its middle third had a papillomatous formation of an oval shape 3.3 × 1.7 cm in size, on a wide base, brown in color, painless on palpation. The conclusion of the dermatologist: intradermal nevus. A biopsy of the nevus was performed. The conclusion of the pathomorphologist: intradermal melanocytic nevus. Given the large size of the nevus, it was decided to destroy it. After obtaining the consent of the patient, without anesthesia, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, to the nevus, at a dose of 0.15 ml. After 18-20 minutes, the nevus changed color to gray-yellow, after 25-30 minutes a thin strip of hyperemic skin appeared around the nevus, and after 22 hours the nevus turned black and mummified. No general toxic or other side effects were observed. Between the 18th day and the 30th day after application, the mummified nevus tissue was separated from the underlying skin. At the location of the nevus, a section of hyperemic skin was exposed, which subsequently, slowly, over the course of 45-60 days, acquired the usual color for the surrounding skin. Subsequent monitoring of the patient did not reveal any pathological changes on the skin at the location of the nevus or other areas of the skin.

Epicrisis number 10

Patient G., born in 1964, turned to the clinic of aesthetic medicine in Kiron (Israel) on April 2, 2005 with a complaint about the presence of a tumor-like formation on the skin of the right half of the chest. The specified education appeared more than ten years before treatment and slowly increased in size. When viewed on the posterolateral surface of the chest at the level of the 7th rib, a tumor-like formation in the form of a body-colored plaque, round in shape with a diameter of 2.0 cm, on a narrow base, with an uneven surface protruding above the skin up to 0.5 cm was determined. Dermatologist's conclusion: mild papillomatous epidermal nevus. A biopsy of the nevus was performed, the conclusion of the pathomorphologist: epidermal nevus. With the consent of the patient, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, to the nevus, at a dose of 0.15 ml. 20-25 minutes after application, the surface of the nevus acquired a yellowish-gray color. After 30 minutes, a slight swelling of the skin around the nevus and a strip of hyperemia appeared, and after 24 hours there was a darkening and mummification of the nevus. No systemic toxic or side effects were recorded. After 35-45 days, the mummified scabs of the nevus spontaneously separated from the underlying skin. At the location of the nevus, a section of hyperemia was observed for 60 days, according to the area of the corresponding area of the nevus. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the nevus.

Epicrisis number 11

Patient D., born in 1945, turned to the clinic of aesthetic medicine in Kiron (Israel) on March 13, 2005 with a complaint about the presence of a flat warty formation on the skin of the left zygomatic region. The duration of the disease was more than 5-6 years. When viewed on the skin of the left zygomatic region, there was an irregular formation 4.1 × 3.4 cm in size, with an uneven warty surface, clear borders, yellowish-brown in color, protruding 2-3 mm above the skin, covered with greasy crusts. The conclusion of the dermatologist: seborrheic keratosis. A biopsy of the indicated area of the skin, the conclusion of the pathomorphologist: seborrheic keratosis. After obtaining the consent of the patient without anesthesia, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 on keratosis-affected skin at a dose of 0.15 ml. After 20 minutes after application, the treated skin surface changed to gray, after 25-30 minutes a thin strip of hyperemia and slight edema appeared around it. After 24 hours, there was a darkening and mummification of the skin altered by keratosis. 32 days after application, the mummified scabs were separated by fragments from the underlying skin areas. At its location for 70 days, a section of moderate hyperemia was observed, according to the area of the corresponding application area of the composition. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of seborrheic keratosis.

Epicrisis №12

Patient V., born in 1982, turned to the Clinic of Aesthetic Medicine in Kiron (Israel) on May 6, 2005 with a complaint about the presence of a birthmark on the inner surface of the left forearm. The specified birthmark appeared shortly after birth, gradually increasing in size. When viewed on the inner surface of the left forearm in the middle third there was a brown spot with a diameter of 16 mm, uniformly pigmented, without hair. The conclusion of the dermatologist: nevus. Performed a biopsy of the nevus, the conclusion of the pathomorphologist: borderline melanocytic nevus. Given the melanoma risk of the border nevus, it was decided to carry out its local destruction. After obtaining the patient’s consent, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, to the nevus, at a dose of 0.1 ml. 20 minutes after application, the surface of the nevus acquired a yellowish-gray color. After 30 minutes, a slight swelling of the skin around the nevus appeared, and after 24 hours, darkening and mummification of the nevus were observed. No systemic toxic or side effects were recorded. After 28 days, the mummified scabs spontaneously separated from the surface of the skin. At the location of the nevus, a site of hyperemia was observed for 70 days, according to the area of the corresponding area of the nevus. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the nevus.

Epicrisis number 13

Patient O. 1974, b., Turned to the clinic of aesthetic medicine in Kiron (Israel) on March 19, 2005 with a complaint about the presence of a birthmark on the right thigh. The indicated spot was noted from childhood. When viewed on the front surface of the right thigh in the upper third, there was a pigmented papule with a rounded shape with a diameter of 10 × 12 mm, without hair. The conclusion of the dermatologist: nevus. Performed a biopsy of the nevus, the conclusion of the pathomorphologist: mixed melanocytic nevus. Given the patient’s desire, it was decided to carry out local destruction of the nevus. After obtaining the patient’s consent, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, to the nevus, at a dose of 0.1 ml. 25-28 minutes after application, the surface of the nevus acquired a yellowish-gray color. After 32 minutes, a slight swelling of the skin and a strip of hyperemia around the nevus appeared, and after a day its darkening and mummification were observed. No systemic toxic or side effects were recorded. After 33 days, the mummified scabs separated from the underlying skin. At the location of the nevus, a site of hyperemia was observed for 70 days, according to the area of the corresponding area of the nevus. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the nevus.

Epicrisis №14

Patient T., born in 1970, went to the clinic of aesthetic medicine in Kiron (Israel) 03/22/2005 complaining of the presence of a birthmark on the right shoulder. The indicated spot appeared three years ago. When viewed on the anterolateral surface of the right shoulder in the lower third, a rounded brown papule with a diameter of 6 mm was determined, around which there was a zone of depigmented skin with a diameter of 13 mm. The conclusion of the dermatologist: halo nevus. Performed a biopsy of the nevus, the conclusion of the pathomorphologist: nevus with signs of inflammatory infiltration. Given the results of the histological examination and the patient's desire, it was decided to carry out local destruction of the nevus. After obtaining consent, an application was made of a composition containing an 80% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, to the nevus, at a dose of 0.07 ml. 20 minutes after application, the surface of the nevus acquired a yellowish-gray color. After 25 minutes, a slight swelling of the skin and a strip of hyperemia around the nevus appeared, and after a day darkening and mummification of the nevus were observed. No systemic toxic or side effects were recorded. After 30 days, the mummified scabs separated from the underlying skin. At the location of the nevus, a section of hyperemia over the area of the nevus was observed for 70 days. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the nevus.

Epicrisis №15

Patient K., born in 1982, turned to the clinic of aesthetic medicine in Kiron (Israel) 02/30/2005 with a complaint about the appearance of a nodule on the right cheek. The indicated nodule appeared six months ago and rapidly increased in size. On examination, on the right cheek there was a hemispherical knot of pale pink color, with a smooth surface with a diameter of 7 mm, without hair. The conclusion of the dermatologist: Spitz nevus. Performed a biopsy of the nevus, the conclusion of the pathomorphologist: spindle cell nevus. Given the results of histological examination and the request of the patient, it was decided to carry out local destruction of the nevus. After obtaining the consent of the patient, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, to the nevus, at a dose of 0.06 ml. 15-18 minutes after application, the surface of the nevus acquired a yellowish-gray color. After 25 minutes, a slight swelling of the skin around the nevus appeared, and after 24 hours there was a darkening and mummification of the nevus. No systemic toxic or side effects were recorded. After 28 days, the mummified scabs spontaneously separated from the underlying skin. At the location of the nevus, a site of hyperemia was observed for 42 days, and then increased skin pigmentation, according to the area of the corresponding area of the nevus. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the nevus.

Epicrisis number 16

Patient F., born 1979 appealed to the clinic of aesthetic medicine in Kiron (Israel) 02/06/2005 with a complaint about the presence of a pigmented plaque on the left lower leg. The indicated plaque appeared five years before treatment. When viewed on the outer surface of the left lower leg in the middle third, a blue-black papule, round in shape with a diameter of 5 mm, was determined. The conclusion of the dermatologist: Nevus Reed. Performed a biopsy of the nevus, the conclusion of the pathomorphologist: pigmented spindle cell nevus of Reed. Given the results of histological examination and the patient’s desire, it was decided to carry out local destruction of the nevus. After obtaining the consent of the patient, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, to the nevus, at a dose of 0.04 ml. 25 minutes after application, the surface of the nevus acquired a yellowish-gray color. After 35 minutes, a slight swelling of the skin and a strip of hyperemia around the nevus appeared, and after a day its darkening and mummification were observed. No systemic toxic or side effects were recorded. After 40 days, the mummified scabs separated from the underlying skin. At the location of the nevus, a site of hyperemia was observed for 55 days, and then hyperpigmentation, corresponding to its area. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the nevus.

Epicrisis №17

Patient X., born in 1968, turned to the clinic of aesthetic medicine in Kiron (Israel) on May 12, 2005 with a complaint about the presence of a pigmented node on his back. The specified node appeared in adolescence. When viewed in the lumbar region on the right, a knot of dark blue color was determined, with an uneven surface of a round shape, with a diameter of 3.0 mm. The conclusion of the dermatologist: blue nevus. Performed a biopsy of the nevus, the conclusion of the pathomorphologist: cell blue nevus. Given the results of histological examination and the size of the nevus, it was decided to conduct local destruction of the nevus. After obtaining the patient’s consent, an application was made of a composition containing an 80% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, to the nevus, at a dose of 0.15 ml. 25 minutes after application, the surface of the nevus acquired a yellowish-gray color. After 30 minutes, moderate swelling of the skin and a strip of hyperemia around the nevus appeared, and after a day darkening and mummification of the nevus were observed. No systemic toxic or side effects were recorded. After 50 days, the mummified scabs of the nevus separated from the underlying skin. At the location of the nevus for 60 days there was observed a site of retraction and hyperemia of the skin, and then hyperpigmentation, according to the area of the corresponding area of the nevus. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the nevus.

Epicrisis №18

A patient L., born in 1980, turned to the clinic of aesthetic medicine in Kiron (Israel) on April 16, 2005 with a complaint about the presence of a large birthmark on her chest. The specified birthmark was found immediately at birth and gradually increased in size. When viewed on the front surface of the chest, almost along the midline, at the level of the 8th rib, a formation with a warty surface, with an uneven brown color, 29 × 27 mm in size, covered with hair was determined. The conclusion of the dermatologist: congenital giant hair nevus. Performed a biopsy of the nevus, the conclusion of the pathomorphologist: congenital melanocytic nevus. Given the results of histological examination and the size of the nevus, it was decided to conduct local destruction of the nevus. After obtaining the consent of the patient, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, to the nevus, at a dose of 1.5 ml. 20 minutes after application, the surface of the nevus acquired a yellowish-gray color. After 25 minutes, a moderate swelling of the skin and a thin strip of hyperemia around the nevus appeared, and after a day darkening and mummification of the nevus were observed. No systemic toxic or side effects were recorded. In the period from 40 to 50 days after application, exfoliation of mummified scabs of nevus from the underlying skin was observed. At the location of the nevus, a section of skin hyperemia with subsequent pigmentation was observed for 60 days, the area corresponding to the area of the nevus. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the nevus.

Epicrisis №19

Patient Sh., Born in 1955, turned to the clinic of aesthetic medicine in Kiron (Israel) on March 18, 2005 with a complaint about the presence of age spots on the skin of the chest. These spots appeared a year before treatment. When examined on the skin of the left half of the chest at the level of the 7th rib, under the nipple there was a formation with an uneven warty surface, with a mottled color of dark brown color, with fuzzy borders, with a diameter of 8.0 mm. At the base of the formations, a zone of hyperemia was determined. The conclusion of the dermatologist: dysplastic nevus. Performed a biopsy of the nevus, the conclusion of the pathomorphologist: dysplastic melanocytic nevus. Given the results of histological examination, a high melanoma hazard of the nevus, it was decided to conduct local destruction of the nevus. After obtaining the patient’s consent, an application was made of a composition containing an 80% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, to the nevus, at a dose of 0.15 ml. 25 minutes after application, the surface of the nevus acquired a yellowish-gray color. After 30 minutes, moderate swelling of the skin and a thin strip of hyperemia around the nevus appeared, and after a day its darkening and mummification were observed. No systemic toxic or side effects were recorded. In the period from 50 to 60 days after application, exfoliation of mummified scabs of nevus from the underlying skin was observed. At the location of the nevus, a section of skin hyperemia with subsequent pigmentation was observed for 60 days, the area corresponding to the area of the nevus. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the nevus.

Epicrisis №20

Patient B., born in 1959, turned to the clinic of aesthetic medicine in Kiron (Israel) on January 16, 2002 complaining of a brown spot on her left thigh. The age of the spot was more than 20 years, but over the past 3-4 months there has been a change in the color of the spot and an increase in its area. When viewed from the back of the left thigh in the middle third, there was a brown spot with pinkish-gray and black blotches, slightly rising above the skin level, with distinct irregularly shaped edges and a corolla of hyperemia around the spot, 6x6 mm in size, with a glossy surface. After consulting a dermatologist, a biopsy was performed. Conclusion of the pathomorphologist: superficially spreading melanoma, stage I. Given the results of histological examination, it was decided to carry out local destruction of melanoma. After obtaining the consent of the patient, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 to the tumor in a dose of 0.15 ml. 30 minutes after application, the tumor surface turned yellowish-gray. After 35 minutes, moderate swelling of the skin and a strip of hyperemia around the tumor appeared, and after 24 hours its darkening and mummification were observed. No systemic toxic or side effects were recorded. In the period from 40 to 60 days after application, exfoliation of mummified scabs of the tumor from the underlying skin was observed. At the location of the tumor, a section of skin hyperemia was observed for 70 days, followed by hyperpigmentation, according to the area of the corresponding tumor area. Observation of the patient did not reveal any pathological changes in the skin at the location of the tumor or its metastases in the surrounding skin, nearby lymph nodes or metastases in distant organs and tissues.

Epicrisis №21

Patient D., born in 1940, turned to the clinic of aesthetic medicine in Kiron (Israel) on December 15, 2001 with a complaint about the presence of a brown spot on the skin of the right shoulder. This stain appeared 4 years before treatment, but over the past six months it began to increase rapidly in size. When viewed on the skin of the right shoulder girdle, there was a brown spot in places of black color, with a dull surface of irregular shape with clear borders, 28 × 31 mm in size. The conclusion of the dermatologist: melanoma type malignant lentigo. Performed a biopsy of the tumor, the conclusion of the pathomorphologist: melanoma type malignant lentigo. Given the results of histological examination, it was decided to conduct local destruction of the tumor. After obtaining the consent of the patient, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 to the tumor at a dose of 0.15 ml. 20 minutes after the application, the surface of the tumor turned yellowish-gray. After 25 minutes, moderate swelling of the skin and a strip of hyperemia around the tumor appeared, and after a day its darkening and mummification were observed. No systemic toxic or side effects were recorded. In the period from 45 to 50 days after application, exfoliation of mummified scabs of the tumor from the underlying skin was observed. At the location of the tumor for 60 days, a section of skin hyperemia was observed followed by pigmentation, according to the area of the corresponding tumor area. Observation of the patient in the subsequent period did not reveal any pathological changes in the skin at the location of the tumor or its metastases in the surrounding skin, nearby lymph nodes or metastases in distant organs and tissues.

Epicrisis №22

Patient A., born in 1952, turned to the clinic of aesthetic medicine in Kiron (Israel) 02/14/2001 complaining of the presence of a brown tumor on the skin of the back. The specified tumor formed at the site of the birthmark six months ago, the last month began to increase rapidly. When viewed in the subscapular region on the left, a knot of light brown color with clear round-shaped boundaries with a diameter of 5 mm with a smooth shiny surface was determined. The conclusion of the dermatologist: nodular melanoma. A biopsy was performed, the conclusion of the pathomorphologist: nodular nodular melanoma, stage I. Given the results of morphological studies, it was decided to conduct local destruction of the tumor. After obtaining the consent of the patient, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 to the tumor at a dose of 0.15 ml. 20 minutes after the application, the surface of the tumor turned yellowish-gray. After 25 minutes, moderate swelling of the skin and a strip of hyperemia around the tumor appeared, and after 24 hours its darkening and mummification were observed. No systemic toxic or side effects were recorded. In the period from 42 to 45 days after application, exfoliation of mummified scabs of the tumor from the underlying skin was observed. At the location of the tumor for 70 days, a section of skin hyperemia was observed followed by pigmentation, according to the area of the corresponding area of the base of the tumor. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the tumor or its metastases in the surrounding skin, nearby lymph nodes or metastases in distant organs and tissues.

Epicrisis №23

Patient C., born in 1989, came to the clinic of aesthetic medicine in Kiron (Israel) 02/28/2004 complaining of the appearance of dark brown spots on the back. These spots appeared at the age of 10 years, but were small, weakly pigmented and did not cause concern. Over the past three months, spots have darkened and increased in size. When viewed on the back on the left at the level of the 10th rib, along the mid-scapular line, four pigmented spots of dark brown color were defined, with clear borders, rounded in diameter with 4.0, 6.0, 7.0 and 7.0 mm in diameter , without hair. The conclusion of the dermatologist: youthful lentigo. A biopsy of one of the spots was performed, the conclusion of the pathomorphologist: lentigo simple (simplex). Given the results of histological examination and the patient’s desire, it was decided to carry out local destruction of age spots. After obtaining the patient’s consent, an application was made of a composition containing an 80% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, on spots, at a dose of 0.15 ml. 20 minutes after application, the surface of the spots turned yellowish-gray. After 25 minutes, a slight swelling of the skin and a strip of hyperemia around the spots appeared, and after a day their darkening and mummification were observed. No systemic toxic or side effects were recorded. After 25 days, the mummified scabs separated from the underlying skin. Plots of hyperemia were observed at the location of the spots for 35 days, according to the area corresponding to the original spot area. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the lentigo.

Epicrisis №24

Patient N., born in 1968, turned to the clinic of aesthetic medicine in Kiron (Israel) on April 13, 2005 with a complaint about the presence of itchy nodules on the right lower leg. These nodules appeared in adolescence; previous treatment was unsuccessful. When viewed on the inner surface of the right lower leg in the middle third there were linearly located psoriasis-like papules. The conclusion of the dermatologist: an inflammatory linear warty epidermal nevus. A biopsy of the nevus was carried out, the conclusion of the pathomorphologist: inflammatory linear warty epidermal nevus. With the consent of the patient, an application was made of a composition containing an 80% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, to the nevus, in a dose of 0.1 ml. 20 minutes after application, the surface of the nevus acquired a yellowish-gray color. After 35 minutes, a slight swelling of the skin around the nevus appeared, and after 24 hours its darkening and mummification were observed. No systemic toxic or side effects were recorded. After 27 days, the mummified scabs of the nevus spontaneously separated from the underlying skin. At the location of the nevus, a site of hyperemia followed by pigmentation was observed for 45 days, according to the area of the corresponding area of the nevus. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the nevus.

Epicrisis №25

Patient G., born in 1949, came to the clinic of aesthetic medicine in Kiron (Israel) 02.21.2005, complaining of the presence of a tumor on the right thigh. The specified tumor appeared two years before treatment. When viewed on the inner surface of the right thigh in the upper third, a domed tumor, round in shape, 6 mm in diameter, brown, with an uneven surface was determined. Around the tumor there was a skin peeling zone, partially covered with crusts. The conclusion of the dermatologist: clear cell acanthoma. Performed a biopsy of the tumor, the conclusion of the pathomorphologist: clear cell acanthoma. Given the results of morphological studies and the patient’s desire, it was decided to carry out local destruction of the tumor. After obtaining consent, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, on a tumor, in a dose of 0.1 ml. 20 minutes after the application, the surface of the tumor turned yellowish-gray. After 25 minutes, a slight swelling of the skin and a strip of hyperemia around the tumor appeared, and after a day darkening and mummification were observed. No systemic toxic or side effects were recorded. After 40 days, the mummified scabs of the tumor separated from the underlying skin. At the location of the tumor, a plot of hyperemia and skin retraction was observed for 65 days, according to the area of the corresponding tumor area. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the tumor.

Epicrisis №26

Patient I., born in 1941, turned to the clinic of aesthetic medicine in Kiron (Israel) on 09.06.2005 with a complaint about the presence of a tumor in the parietal region of the scalp. The indicated tumor appeared three years before treatment, gradually increasing in size. When examined on the skin of the right parietal region, a cone-shaped tumor of red-pink color with a smooth surface, dense consistency, a diameter of 5.0 mm and a height of 6.0 mm was determined. The conclusion of the dermatologist: skin horn. Performed a biopsy of the tumor, the conclusion of the pathomorphologist: skin horn. Considering the results of histological examination and the patient’s desire, it was decided to carry out local tumor destruction. After obtaining the patient’s consent, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, to the tumor, in a dose of 0.15 ml. 20 minutes after the application, the surface of the tumor turned yellowish-gray. After 25 minutes, a slight swelling of the skin and a strip of hyperemia around the tumor appeared, and after a day its darkening and mummification were observed. No systemic toxic or side effects were recorded. After 55 days, the mummified scabs of the tumor separated from the underlying skin. At the location of the tumor, a site of hyperemia and then hyperpigmentation was observed for 40 days, according to the area of the corresponding area of the skin horn.

Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the skin horn.

Epicrisis №27

Patient U., born in 1953, turned to the clinic of aesthetic medicine in Kiron (Israel) 05/27/2005 complaining of the presence of a tumor on the chin. The described tumor appeared six months ago and rapidly increased. When viewed on the skin of the chin, there was a dome-shaped tumor 1.7 cm in diameter, crimson in color with a crater-like depression in the center, filled with gray-brown keratose masses. Around the tumor there was a dense pink roller. The conclusion of the dermatologist: giant keratoacanthoma. Performed a biopsy of the tumor, the conclusion of the pathomorphologist: keratoacanthoma in the stabilization stage. Given the results of morphological studies and the patient’s desire, it was decided to carry out local tumor destruction. After obtaining the patient’s consent, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, to the tumor, in a dose of 0.2 ml. 15 minutes after application, the surface of the tumor turned yellowish-gray. After 20 minutes, a slight swelling of the skin around the tumor appeared, and after 24 hours its darkening and mummification were observed. No systemic toxic or side effects were recorded. After 35 days, the mummified scabs of the tumor spontaneously separated from the underlying skin. At its location, a plot of hyperemia was observed for 60 days, and then increased skin pigmentation, according to the area of the corresponding tumor area. Subsequent monitoring of the patient did not reveal recurrence of the tumor.

Epicrisis №28

Patient E., born in 1977, went to the clinic of aesthetic medicine in Kiron (Israel) on June 14, 2005 with a complaint about the presence of warts on the skin of both hands. These warts appeared several months ago, increasing in size and quantity. When viewed on the back surface of both hands near the 1st, 2nd and 3rd fingers, multiple dense round epidermal papules with a diameter of 1.0 to 4.0 mm, with a rough surface of a pale pink color, were determined. The conclusion of the dermatologist: simple warts. A biopsy of the largest wart was performed, the conclusion of the pathomorphologist: a simple wart. In agreement with the patient, an application of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 was performed on warts at a dose of 0.2 ml. 15 minutes after application, the surface of the warts turned yellowish-gray. After 20 minutes, a slight swelling of the skin around the warts appeared, and after 24 hours they were darkened and mummified. No systemic toxic or side effects were recorded. After 22-28 days, the mummified scabs of warts spontaneously separated from the underlying skin. At the location of the warts, sections of hyperemia were observed for 30 days, according to the area of the corresponding area of their bases. Subsequent monitoring of the patient after treatment did not reveal any pathological changes in the skin at the location of the warts or their recurrence.

Epicrisis №29

Patient Ch., Born in 1970, turned to the clinic of aesthetic medicine in Kiron (Israel) on 05/11/2005 complaining of the presence of warts on the heels of both feet. These warts appeared six months ago after injuring the skin of the feet. When viewed on the sole surface of both feet in the heel area, there were several dense rounded formations with clear boundaries with a diameter of 0.4 to 8.0 mm, with a rough surface, pink in color, with small black dots, painful on palpation. The conclusion of the dermatologist: plantar warts. A biopsy of one of the warts was performed, the conclusion of the pathomorphologist: plantar wart. With the consent of the patient, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, on warts, at a dose of 0.25 ml. 20 minutes after application, the surface of the warts turned yellowish-gray in color, and after 24 hours they were darkened and mummified. No systemic toxic or side effects were recorded. After 35-40 days, the mummified scabs of warts spontaneously separated from the underlying skin. Plots of hyperemia were observed at the location of the warts for 25 days, according to the area of the corresponding area of their bases. Subsequent monitoring of the patient after treatment did not reveal any pathological changes in the skin at the location of the warts or their recurrence.

Epicrisis №30

Patient Y., born in 1989, turned to the clinic of aesthetic medicine in Kiron (Israel) on January 18, 2005 with a complaint about the presence of warts on the skin of her hands. These warts appeared a few months before treatment. When viewed on the back surface of the hands and forearms, more than two dozen flat dense papules of a polygonal shape with a size of 1.0 to 3.0 mm, with a smooth surface of light brown color, rising above the skin level were determined. The conclusion of the dermatologist: flat warts. A biopsy of one of the large warts was performed, the conclusion of the pathomorphologist: a flat wart. With the consent of the patient, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, on warts, at a dose of 0.2 ml. 20 minutes after application, the surface of the warts turned yellowish-gray. After 25 minutes, a slight swelling of the skin around the warts appeared, and after a day their darkening and mummification were observed. No systemic toxic or side effects were recorded. After 20-26 days, the mummified scabs of warts spontaneously separated from the underlying skin. At the location of the warts, sections of hyperemia were observed for 40 days, according to the area of the corresponding area of their bases. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the warts or their recurrence.

Epicrisis №31

Patient A., born in 1941, turned to the clinic of aesthetic medicine in Kiron (Israel) on 05/11/2005 with a complaint of the appearance of a focus of redness and peeling on the skin of the neck. The disease is several months old. When viewed on the lateral surface of the neck, a skin area was determined with not very clear boundaries of 3.4 × 3.7 cm in size, covered with dirty brown horn masses, upon removal of which a hyperemic slightly rough skin surface was opened. The conclusion of the dermatologist: actinic (solar) keratosis. A biopsy of the changed area of the skin, the conclusion of the pathomorphologist: radiation keratosis, hyperplastic type. Considering the results of the morphological study and the patient’s desire, it was decided to carry out local destruction of the area of the skin affected by keratosis. After obtaining the patient’s consent, an application of a composition containing 80% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 was applied to the changed area of the skin at a dose of 0.15 ml. 20 minutes after application, its surface acquired a yellowish-gray color. After 25 minutes, a slight edema and a strip of hyperemia appeared around it, and after a day its darkening and mummification were observed. No systemic toxic or side effects were recorded. After 32 days, the mummified scabs separated from the underlying skin. At the site of keratosis, a site of hyperemia followed by pigmentation was observed for 50 days, according to the area of the corresponding area of the therapeutic application. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of keratosis.

Epicrisis number 32

Patient Yu., Born in 1938, turned to the clinic of aesthetic medicine in Kiron (Israel) on March 6, 2005 with a complaint about the presence of foci of altered skin on the palms of the hands. The duration of the disease was more than 5-6 years, the number of lesions during this time increased. Previously, the patient had long contact with arsenic compounds. When viewed on the palmar surface of the hands there were multiple dirty gray papules with a hyperkeratic surface, with a diameter of 0.5 to 4.0 mm. The conclusion of the dermatologist: arsenic keratosis. A biopsy of one of the papules was carried out, the conclusion of a pathomorphologist: keratosis, with signs of moderate dysplasia. With the consent of the patient, an application was made of a composition containing 80% solution of 2-chlorocaprylic acid and its salt in a ratio of 500: 1, on papules, at a dose of 0.15 ml. 20 minutes after application, the surface of the papules turned yellowish-gray in color, and a day later they were darkened and mummified. No systemic toxic or side effects were recorded. After 35 days, the mummified scabs separated from the underlying skin. At the location of the papules, sections of hyperemia were observed for 40 days, according to the area of the corresponding area of the therapeutic application. Subsequent monitoring of the patient after treatment did not reveal any pathological changes in the skin at the location of the papules or their recurrence.

Epicrisis №33

Patient P., born in 1935, turned to the clinic of aesthetic medicine in Kiron (Israel) March 16, 2005 with a complaint about the presence of a plaque on the mucous membrane of her right cheek. The duration of the disease was 4-5 months. When examined on the mucosa of the right cheek along the line of contact of the teeth, a grayish-white plaque was found, slightly raised above the mucosa, irregular in shape, with a uniform surface, hard to the touch, measuring 1.9 × 2.7 cm. Dermatologist's conclusion: oral leukoplakia. A biopsy of the changed area of the mucosa was performed. The conclusion of the pathomorphologist: oral leukoplakia. Given the results of morphological studies and the patient’s desire, it was decided to carry out local destruction of the mucosal area affected by leukoplakia. After obtaining the patient’s consent, an application was made of a composition containing a 30% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 to an altered section of the mucosa at a dose of 0.1 ml. 15 minutes after application, the mucous membrane turned yellow. After 20 minutes, a slight swelling of the mucous membrane appeared at the place of application, and after a day its darkening and mummification were observed. No systemic toxic or side effects were recorded. After 23-26 days, the mummified scabs separated from the underlying mucosa. At the location of leukoplakia, a section of hyperemia was observed for 30 days, according to the area of the corresponding area of the medical application. Subsequent monitoring of the patient did not reveal any pathological changes in the mucosa at the location of leukoplakia.

Epicrisis №34

Patient I., born in 1935, turned to the clinic of aesthetic medicine in Kiron (Israel) on December 15, 2001 with a complaint about the appearance of a plaque on the skin of her right lower leg. The duration of the disease was more than ten years. When examined on the skin of the outer surface of the right tibia in the upper third, a plaque of irregular outlines, raised above the skin, formed by the fusion of reddish lenticular papules with slight peeling and clear borders, 5.3 × 4.6 cm in size, was determined. White scales located on the surface of the plaque were easily removed without signs of bleeding, exposing a red, wet surface. Dermatologist Conclusion: Bowen's Disease. A biopsy of the changed area of the skin was performed, the conclusion of the pathomorphologist: intraepidermal squamous cell carcinoma (Bowen's disease). Given the results of the histological examination and the patient’s desire, it was decided to carry out local destruction of the affected skin area. After obtaining consent, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, on an altered area of the skin, at a dose of 0.2 ml. 20 minutes after the application, its surface acquired a yellowish-gray color. After 30 minutes, a slight swelling and a strip of hyperemia appeared around her, and after a day her darkening and mummification were observed. No systemic toxic or side effects were recorded. After 30-35 days, the mummified scabs separated from the underlying skin. At the location of the tumor, a site of hyperemia was observed for 50 days, followed by pigmentation, according to the area of the corresponding area of the treatment application. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the tumor or its recurrence.

Epicrisis №35

Patient S., born in 1929, turned to the clinic of aesthetic medicine in Kiron (Israel) on 02.11.2001 with a complaint about the presence of a tumor on his right thigh. The tumor appeared a year before treatment, gradually increasing in size. When viewed on the outer surface of the right thigh in the upper third there was a dome-shaped knot, red-pink in color, covered with rounded crusts with a diameter of 14 mm, of dense consistency, inactive, bleeding during trauma. Around the formation, a peeling zone of the skin, partially covered with crusts, was determined. Dermatologist's opinion: infiltrating squamous cell carcinoma of the skin. Performed a biopsy of the tumor, the conclusion of the pathomorphologist: infiltrating squamous cell carcinoma of the skin. Given the results of morphological studies and the patient’s desire, it was decided to carry out local destruction of the tumor. After obtaining consent, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, on a tumor, in a dose of 0.15 ml. 20 minutes after the application, the surface of the tumor turned yellowish-gray. After 25 minutes, a slight swelling of the skin and a strip of hyperemia around the tumor appeared, and after a day darkening and mummification were observed. No systemic toxic or side effects were recorded. After 35-38 days, the mummified scabs of the tumor separated from the underlying skin. At the location of the tumor, an area of hyperemia and skin retraction with subsequent pigmentation was observed for 80 days, according to the area of the corresponding area of the medical application. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the tumor, its metastases or recurrence.

Epicrisis №36

Patient P., born in 1936, turned to the clinic of aesthetic medicine in Kiron (Israel) on 05.03.2001 with a complaint about the presence of a nodule on her right cheek. The described tumor appeared about 1 year ago and slowly progressed in size. On examination, on the right cheek, at the level of the wing of the nose, a waxy translucent nodule was found, hard to the touch, 5 mm in diameter, with a smooth surface, with translucent full-blooded capillaries. The conclusion of the dermatologist: basal cell carcinoma, nodular form. Performed a biopsy of the site, the conclusion of the pathomorphologist: nodular basal cell carcinoma, stage I. Given the results of the morphological study and the patient’s desire, it was decided to carry out local tumor destruction. After obtaining the patient’s consent, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 to the tumor at a dose of 0.05 ml. 15 minutes after application, the surface of the tumor turned yellowish-gray. After 20 minutes, slight swelling of the skin and a strip of hyperemia around the tumor appeared, and after 24 hours, the tumor was darkened and mummified. No systemic toxic or side effects were recorded. After 40-45 days, the mummified scabs of the tumor spontaneously separated from the underlying skin. At the location of the tumor, a site of hyperemia was observed for 50 days, and then increased pigmentation, according to the area of the corresponding area of the treatment application. Subsequent monitoring of the patient after treatment did not reveal any pathological changes in the skin at the location of the tumor, its metastases or recurrence.

Epicrisis №37

Patient R., born in 1939, turned to the clinic of aesthetic medicine in Kiron (Israel) 02.21.2001 with a complaint about the presence of plaques on the skin of the abdomen. The duration of the disease was more than five years. On examination, in the epigastric region there was a plaque-shaped rounded lesion of pink color, with areas of peeling and crust formation, 3.4 cm in diameter, the edge of which consisted of small shiny translucent nodules. Dermatologist's conclusion: superficial basal cell carcinoma. Performed a biopsy of the tumor, the conclusion of the pathomorphologist: superficial basal cell cancer. Given the results of the morphological study and the patient’s desire, it was decided to carry out local tumor destruction. After obtaining the consent of the patient, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, to the tumor, in a dose of 0.2 ml. 20 minutes after the application, its surface acquired a yellowish-gray color. After 25 minutes, a slight swelling and a strip of hyperemia appeared around her, and after a day her darkening and mummification were observed. No systemic toxic or side effects were recorded. After 40-45 days, the mummified scabs separated from the underlying skin. At the location of the tumor for 60 days, a site of hyperemia and then pigmentation was observed, according to the area of the corresponding area of the treatment application. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the tumor, metastases or its recurrence.

Epicrisis №38

Patient N., born in 1942, turned to the clinic of aesthetic medicine in Kiron (Israel) 02.24.2001 with a complaint about the presence of education on the back of the neck. The specified formation appeared about 2-3 years ago, slowly increasing in size. When examined on the skin, in the lower third, an ulcerative tumor lesion of irregular shape was determined, with uneven undercut edges, an uneven bottom, bright pink in color, a depth of 1.0-1.5 mm, partially covered with a dark brown crust. The size of the tumor lesion was 1.0 × 1.3 cm, around it there was a zone of hyperemia, 2-3 mm wide. Dermatologist's conclusion: metatyptic skin cancer. Performed a biopsy of the tumor, the conclusion of the pathomorphologist: metatypical skin cancer. Given the results of morphological studies, it was decided to conduct local destruction of the tumor. After obtaining the consent of the patient, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 to the tumor at a dose of 0.15 ml. 15 minutes after application, the surface of the tumor turned yellowish-gray. After 20 minutes, moderate swelling of the skin appeared and hyperemia around the tumor intensified, and after 24 hours its darkening and mummification were observed. No systemic toxic or side effects were recorded. In the period from 35 to 45 days after application, exfoliation of mummified scabs of the tumor from the underlying skin was observed. At the location of the tumor, a section of skin hyperemia was observed for 60 days, followed by pigmentation, according to the area of the corresponding area of the treatment application. Observation of the patient after treatment did not reveal any pathological changes in the skin at the location of the tumor or its metastases in the surrounding skin, nearby lymph nodes or metastases in distant organs and tissues.

Epicrisis №39

Patient D., born in 1980, turned to the clinic of aesthetic medicine in Kiron (Israel) on January 26, 2005 with a complaint about the presence of nodules in the eyelids and neck. The duration of the disease was more than 1 year. When viewed on the skin of the eyelids, the front and side surfaces of the neck, there were multiple, symmetrical, dense, rounded nodules, flesh-colored, with a diameter of 0.5 to 3.0 mm, slightly rising above the skin level. The conclusion of the dermatologist: syringoma, disseminated form. A biopsy of one of the nodules in the neck was performed, the conclusion of the morphologist: syringoma. Considering the results of the morphological study and the patient’s urgent request, it was decided to carry out local destruction by syringing. After obtaining the patient’s consent, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 to all syringes present in a dose of 0.2 ml. 15 minutes after application, the surface of the skin above the syringes turned yellowish-gray. After 25 minutes, a slight swelling of the skin appeared around them, and after 24 hours, darkening and mummification of the treated skin areas were observed. There were no systemic toxic or side effects. After 30-35 days, the mummified scabs spontaneously separated from the underlying skin. At their location for 45-55 days hyperemia was observed, and then increased skin pigmentation, the area corresponding to the area of therapeutic application. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the syring.

Epicrisis №40

Patient V., born in 1943, turned to the clinic of aesthetic medicine in Kiron (Israel) on April 20, 2005 with a complaint about the presence of a node on the right cheek. The described tumor appeared more than five years ago, slowly increasing in size. On examination, on the right cheek there was a knot towering above the skin, hard to the touch, 12 mm in diameter, covered with unchanged skin. The conclusion of the dermatologist: adenoma of the sebaceous gland. Performed a biopsy of the tumor, the conclusion of the pathomorphologist: adenoma of the sebaceous gland. Given the results of morphological studies and the patient’s desire, it was decided to carry out local tumor destruction. After obtaining the consent of the patient, an application was made of a composition containing a 90% solution of phenylchloroacetic acid and its salt in a ratio of 500: 1, to the tumor, at a dose of 0.15 ml. 10 minutes after application, the surface of the skin above the tumor acquired a yellowish-gray color. After 25 minutes, a slight swelling of the skin appeared, and after 24 hours, darkening and mummification of the skin and the underlying tumor were observed. No systemic toxic or side effects were recorded. After 42-46 days, the mummified scabs of the tumor spontaneously separated, and at the location of the tumor for 50 days there was a site of hyperemia and skin retraction, and then its increased pigmentation, according to the area of the corresponding area of the treatment application. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the tumor or its recurrence.

Epicrisis №41

Patient C., born in 1966, turned to the clinic of aesthetic medicine in Kiron (Israel) on March 30, 2005, complaining of the presence of age spots on the skin of his back. Spots appeared at age 15, gradually increasing in size. When viewed on the skin of the back, there were multiple spots of brown and dark brown in color, irregular in shape with a jagged serrated border, rough surface, covered with thick dark hair, sizes from 2.0 × 3.0 mm to 10.0 × 16.0 mm. The conclusion of the dermatologist: pigmented hair epidermal nevus (Becker nevus). A biopsy of one of the nevuses was performed, the conclusion of the pathomorphologist: pigmented hair epidermal nevus. Given the results of a morphological study, it was decided to carry out local destruction of the nevi. After obtaining the patient’s consent, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, to the nevi, in a dose of 0.4 ml. 15-20 minutes after application, the surface of the nevus acquired a yellowish-gray color. After 25 minutes, moderate skin edema and a thin strip of hyperemia appeared around them, and after a day their darkening and mummification were observed. No systemic toxic or side effects were recorded. In the period from 30 to 45 days after application, exfoliation of mummified scabs of nevuses from the underlying skin was observed. At the location of the nevi, within 60 days, areas of skin hyperemia were observed followed by pigmentation, according to the area of the corresponding area of the medical application. Observation of the patient after treatment did not reveal any pathological changes in the skin at the location of the nevi.

Epicrisis №42

Patient G., born in 1965, turned to the clinic of aesthetic medicine in Kiron (Israel) on 03.06.2005 with a complaint about the presence of a plaque on the right temporal part of the head. The indicated plaque appeared in childhood, slowly increasing in size. When examined on the skin of the right temporal region in the scalp, there was a flat, soft, elastic plaque with a shiny surface, round in shape, 1.7 mm in diameter, 2.0 mm high. The conclusion of the dermatologist: nevus of the sebaceous glands (Yadasson). A biopsy of the nevus was performed, the conclusion of the pathomorphologist: sebaceous nevus. Given the results of morphological studies and the threat of malignant transformation, it was decided to carry out local destruction of the nevus. After obtaining the consent of the patient, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, to the nevus, at a dose of 0.15 ml. 20 minutes after application, the surface of the nevus acquired a yellowish-gray color. After 25 minutes, a slight swelling of the skin and a strip of hyperemia around the nevus appeared, and after a day its darkening and mummification were observed. No systemic toxic or side effects were recorded. After 40 days, the mummified scabs of the nevus separated from the underlying skin. At the location of the nevus, a site of hyperemia was observed for 42 days, according to the area of the corresponding area of the therapeutic application. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the nevus.

Epicrisis №43

Patient O., born in 1970, went to the clinic of aesthetic medicine in Kiron (Israel) 02/10/2005 with a complaint about the presence of a tumor-like formation on the skin of the scalp. The indicated tumor appeared in adolescence, slowly increasing in size. When viewed in the occipital region of the scalp, a dense, mobile, papule of flesh-colored, rounded shape, 1.4 cm in diameter was determined. Conclusion of a dermatologist: trichoepithelioma. Performed a biopsy of the tumor, the conclusion of the pathomorphologist: trichoepithelioma. Given the results of the morphological study and the patient’s desire, it was decided to carry out local tumor destruction. After obtaining consent, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, on a tumor, in a dose of 0.1 ml. After 15-20 minutes after application, the tumor surface turned yellowish-gray. After 25 minutes, a slight swelling of the skin and a strip of hyperemia around the tumor appeared, and after a day darkening and mummification were observed. No systemic toxic or side effects were recorded. After 40 days, the mummified scabs of the tumor separated from the underlying skin. At the location of the tumor, a site of hyperemia and a slight skin retraction was observed for 50 days, the area corresponding to the area of the treatment application. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the tumor or its recurrence.

Epicrisis №44

Patient B., born in 1954, turned to the clinic of aesthetic medicine in Kiron (Israel) on 06/18/2005 with a complaint about the presence of a tumor on her forehead. The indicated tumor appeared several years ago and gradually increased in size. When viewed on the skin of the forehead above the left eyebrow, there was a dense movable dome-shaped knot of the color of normal skin, 9.0 mm in diameter, with an enlarged pore at its apex and a hair bundle growing from it. The conclusion of the dermatologist: trichofolliculoma. Performed a biopsy of the tumor, the conclusion of the pathomorphologist: highly differentiated tumor of the hair follicle (trichofolliculoma). Given the results of the morphological study and the patient’s desire, it was decided to carry out local tumor destruction. After obtaining the consent of the patient, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, to the tumor, in a dose of 0.1 ml. 15 minutes after application, the surface of the tumor turned yellowish-gray. After 25 minutes, a slight swelling of the skin and a strip of hyperemia around the tumor appeared, and after 24 hours, the tumor was darkened and mummified. No systemic toxic or side effects were recorded. After 35-45 days, the mummified scabs of the tumor spontaneously separated from the underlying skin. At the location of the tumor, a site of hyperemia was observed for 50 days, and then increased skin pigmentation, according to the area of the corresponding base area of the tumor. Subsequent monitoring of the patient did not reveal her recurrence.

Epicrisis №45

Patient E., born in 1937, turned to the clinic of aesthetic medicine in Kiron (Israel) March 15, 2001 with a complaint about the presence of a pigmented node on the skin of the chest. The indicated tumor appeared several years ago and slowly increased in size. When viewed on the skin of the anterolateral surface of the chest on the left, along the anterior axillary line, at the level of the nipple, there was a dense, flat, with an uneven surface, almost black, with a diameter of 9.0 mm. The conclusion of the dermatologist: basal cell carcinoma, nodular form. Performed a biopsy of the tumor, the conclusion of the pathomorphologist: pigmented basal cell carcinoma. Given the results of morphological studies and the patient’s desire, it was decided to carry out local tumor destruction. After obtaining the patient’s consent, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 to the tumor, in a dose of 0.1 ml. 15 minutes after application, the surface of the tumor turned yellowish-gray. After 25 minutes, a slight swelling of the skin and a strip of hyperemia around the tumor appeared, and after 24 hours its darkening and mummification were observed. No systemic toxic or side effects were recorded. After 40-45 days, the mummified scabs of the tumor spontaneously separated from the underlying skin. At the location of the tumor, a site of hyperemia was observed for 50 days, and then increased pigmentation, according to the area of the corresponding area of the base of the tumor. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the tumor, its metastases or recurrence.

Epicrisis №46

Patient R., born in 1976, turned to the clinic of aesthetic medicine in Kiron (Israel) on June 14, 2005 with a complaint about the presence of multiple nodules on the skin of the chest. These nodules appeared several years ago, slowly increasing in size. On examination, on the front surface of the chest there are multiple nodes towering above the skin, white in color, hard to the touch, with a diameter of 1.0 to 7.0 mm. Dermatologist's conclusion: multiple epidermal cysts. A biopsy of one of the cysts was performed, the conclusion of the pathomorphologist: funnel cyst. Given the results of morphological studies and the patient’s desire, it was decided to carry out local destruction of the cysts. After obtaining the consent of the patient, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 to all existing epidermal cysts at a dose of 0.2 ml. 15 minutes after application, the surface of the skin above the cysts acquired a yellowish-gray color. After 25 minutes, slight swelling and a strip of hyperemia of the skin around the cysts appeared, and after 24 hours, darkening and mummification of the skin with the underlying tissue of the cysts were observed. No systemic toxic or side effects were recorded. After 30-45 days, the mummified scabs spontaneously separated, and at the location of the cysts, areas of hyperemia and retraction of the skin, and then its increased pigmentation, were observed over the area of the corresponding area of the medical application for 45-60 days.

Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the cysts or their recurrence.

Epicrisis №47

Patient P., born in 1982, turned to the clinic of aesthetic medicine in Kiron (Israel) on May 26, 2005 with a complaint of a red spot on the front of the neck. The indicated spot was present at birth. When viewed on the front surface of the neck, a red spot with telangiectasias, irregularly shaped with clear boundaries, 5.1 × 6.5 cm in size, was determined by the midline of the dermatologist. Conclusion of a dermatologist: congenital telangiectasia (Unna nevus). A spot biopsy was performed, the conclusion of the pathomorphologist: capillary malformation (congenital telangiectasia). Given the results of morphological studies and the patient’s desire, it was decided to carry out local destruction of the spot. After obtaining the patient’s consent, an application of a composition containing 80% solution of 2-chloropropionic acid and its salt in a ratio of 400: 1 was performed on a skin area with telangiectasia at a dose of 0.2 ml. 15 minutes after application, the surface of the skin with telangiectasia acquired a yellowish-gray color. After 20 minutes, a slight swelling of the skin and a strip of hyperemia around the spot appeared, and after a day its darkening and mummification were observed. No systemic toxic or side effects were recorded. After 30-39 days, the mummified scabs of the spot were separated from the underlying skin. At the location of telangiectasia, a site of hyperemia was observed for 45 days, followed by increased pigmentation, according to the area of the corresponding area of the therapeutic application. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the telangiectasia.

Epicrisis №48

Patient G., born in 1980, turned to the clinic of aesthetic medicine in Kiron (Israel) on April 12, 2005 with a complaint about the presence of a pink spot on the left mammary gland. The indicated spot was found at birth and increased in size as they mature. When viewed from the left mammary gland to the right of the nipple, there was a spot of irregular shape, bright pink in color, with clear borders, disappearing with dioscopy, 38 × 32 mm in size. The conclusion of the dermatologist: the nevus is flaming (a spot of the color of port wine). Given the data of the clinical examination and the results of dioscopy, it was decided to carry out local destruction of the flaming nevus. After obtaining the consent of the patient, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 to a skin area with a nevus, in a dose of 0.1 ml. 15 minutes after application, the surface of the nevus acquired a yellowish-gray color. After 20 minutes, moderate swelling of the skin and a strip of hyperemia around the nevus appeared, and after a day its darkening and mummification were observed. No systemic toxic or side effects were recorded. In the period from 35 to 42 days after application, exfoliation of mummified scabs of flaming nevus from the underlying skin was observed. At the spot location, a section of skin hyperemia was observed for 60 days with subsequent pigmentation, according to the area of the corresponding area of the treatment application. Further monitoring of the patient did not reveal any pathological changes in the skin at the location of the flaming nevus.

Epicrisis №49

Patient T., born in 1986, turned to the clinic of aesthetic medicine in Kiron (Israel) on March 31, 2005 complaining of a skin area with thin dilated vessels on the left cheek. These skin changes were detected at birth and increased in size as they grew. On examination, the skin of the left cheek had a skin area with a diffuse network of dilated vessels that disappear with dioscopy, 13 × 31 mm in size. The conclusion of a dermatologist: teleangiectatic nevus. Given the clinical data and the results of dioscopy, it was decided to carry out local destruction of the telangiectatic nevus. After obtaining the patient’s consent, an application of a composition containing 80% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 was performed on a skin area affected by nevus in a dose of 0.15 ml. 15 minutes after application, the surface of the nevus acquired a yellowish-gray color. After 20 minutes, moderate swelling of the skin and a thin strip of hyperemia around the nevus appeared, and after a day darkening and its mummification were observed. No systemic toxic or side effects were recorded. In the period from 30 to 40 days after application, exfoliation of mummified scabs of nevus from the underlying skin was observed. At the location of the nevus, a site of skin hyperemia was observed for 50 days, followed by pigmentation, according to the area of the corresponding area of the medical application. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the nevus.

Epicrisis №50

Patient V., born in 1960, turned to the clinic of aesthetic medicine in Kiron (Israel) on 05/11/2005 complaining of the presence of a dark purple spot on the back. The described spot appeared in early childhood and increased in size as the patient grew. When viewed on the skin of the back surface of the chest on the left, at the level of the 8th rib, there was a paravertebral node of cyanotic-crimson color, a soft-elastic consistency with a clear border, with a wrinkled surface under which 3.0 × 2 dilated veins were visible , 6 cm. The conclusion of the dermatologist: venous malformation (blue vesiculate nevus). Considering the clinical data and the patient’s desire, it was decided to carry out local destruction of the nevus. After obtaining the consent of the patient, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, to the nevus, at a dose of 0.15 ml. 15 minutes after application, the surface of the nevus acquired a yellowish-gray color. After 25 minutes, a slight swelling of the skin and a strip of hyperemia around the nevus appeared, and after 24 hours its darkening and mummification were observed. No systemic toxic or side effects were recorded. After 40-45 days, the mummified scabs of the nevus spontaneously separated from the underlying skin. At the location of the nevus, a site of hyperemia and retraction of the skin, and then its increased pigmentation, was observed for 50 days, according to the area of the corresponding area of the medical application. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the nevus.

Epicrisis №51

Patient Y., born in 1963, turned to the clinic of aesthetic medicine in Kiron (Israel) 02/26/2005 with a complaint about the presence of a nodule in the left inguinal region. This nodule was detected at birth and slowly increased as the patient grew. When examined on the skin of the inguinal region on the left, almost above the inguinal fold, a hyperkeratotic vascular nodule of dark red color, irregular configuration, easily bleeding, 6.0 mm in diameter was determined. The conclusion of the dermatologist: angiokeratoma limited. A biopsy was performed, the conclusion of the pathomorphologist: angiokeratoma. Given the results of morphological studies and the patient’s desire, it was decided to carry out local destruction of angiokeratoma. After obtaining consent, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, to the region of angiokeratoma, at a dose of 0.05 ml. 15 minutes after application, the surface of the tumor turned yellowish-gray. After 25 minutes, a slight swelling of the skin and a strip of hyperemia around the angiokeratoma appeared, and after a day darkening and its mummification were observed. No systemic toxic or side effects were recorded. After 35-40 days, the mummified scabs of the tumor separated from the underlying skin. At the location of angiokeratoma, a plot of hyperemia and then pigmentation was observed for 60 days, according to the area of the corresponding area of the therapeutic application. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the angiokeratoma.

Epicrisis №52

Patient X., born in 1963, turned to the clinic of aesthetic medicine in Kiron (Israel) on January 27, 2005 with a complaint about the presence of a node on the right thigh. The specified node appeared about three months ago, after a stab wound. When viewed on the outer surface of the right thigh, in the lower third, there was a densely elastic, domed papule of bright red color, with a shiny, easily bleeding surface, 12 mm in diameter. The conclusion of the dermatologist: pyogenic granuloma. Performed a biopsy of the granuloma, the conclusion of the pathomorphologist: pyogenic granuloma. Given the results of morphological studies and the patient’s desire, it was decided to carry out local destruction of the granuloma. After obtaining the consent of the patient, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, to the granuloma, at a dose of 0.1 ml. 15 minutes after application, the surface of the pyogenic granuloma acquired a yellowish-gray color. After 25 minutes, a slight swelling of the skin and a strip of hyperemia around the granuloma appeared, and after 24 hours, darkening and its mummification were observed. No systemic toxic or side effects were recorded. After 45-50 days, the mummified scabs of granulomas spontaneously separated, and at its location for 60 days a patch of skin hyperemia was observed, and then its increased pigmentation, according to the area of the corresponding area of the treatment application. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the pyogenic granuloma.

Epicrisis №53

Patient P., born in 1937, turned to the clinic of aesthetic medicine in Kiron (Israel) on June 15, 2005 with a complaint about the presence of several nodules on the skin of the chest that appeared 5-6 years ago and gradually increased in size. When viewed on the front surface of the chest there were more than a dozen randomly located rounded domed nodules of soft consistency of violet-red color, with a diameter of 2.0-3.0 mm. The conclusion of the dermatologist: senile angioma. A biopsy of one of the nodules was performed, the conclusion of the pathomorphologist: capillary hemangioma. Given the results of morphological studies and the patient’s desire, it was decided to carry out local destruction of the nodules. After obtaining the consent of the patient, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, on nodules, at a dose of 0.1 ml. 15 minutes after application, the surface of the angiomas turned yellowish-gray. After 25 minutes, moderate swelling of the skin and a strip of hyperemia around the angiomas appeared, and after a day their darkening and mummification were observed. No systemic toxic or side effects were recorded. After 30-40 days, the mummified scabs of angiomas separated from the underlying skin. At their location for 65 days, areas of hyperemia of the skin were observed, according to the area of the corresponding area of the medical application. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the angiomas.

Epicrisis №54

Patient S., born 1933 He applied to the clinic of aesthetic medicine in Kiron (Israel) 03/10/2001 with a complaint about the presence of spots on the skin of the feet. These spots appeared about 1 year ago and gradually increased in size. When viewed on the back surface of the feet, painless reddish-cyanotic spots of irregular shape, with a smooth surface, with clear edges, ranging in size from 0.6 × 1.0 cm to 3.4 × 3.7 cm were symmetrically determined. There were single hemorrhagic spots around these spots rashes in the form of ecchymoses. The conclusion of the dermatologist: Kaposi's sarcoma, spotted stage. When examining the patient’s blood, antibodies to type 1 and 2 HIV were not detected. Tumor biopsy performed. The conclusion of the pathomorphologist: Kaposi's sarcoma, stage of the spot. Given the results of morphological studies and the patient’s desire, it was decided to carry out local tumor destruction. After obtaining the consent of the patient, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, on a tumor, at a dose of 0.20 ml. 25 minutes after application, the surface of the spots turned yellowish-gray. After 35 minutes, a slight swelling of the skin and a strip of hyperemia appeared around the spots, and after 24 hours their darkening and mummification were observed. No systemic toxic or side effects were recorded. After 40-60 days, the mummified scabs of the tumor spontaneously separated from the underlying skin. At the location of the tumor, a site of hyperemia was observed for 70 days, and then increased pigmentation, according to the area of the corresponding area of the treatment application. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the tumor, its metastases or recurrence.

Epicrisis №55

A patient L., born in 1982, turned to the clinic of aesthetic medicine in Kiron (Israel) on May 15, 2005 with a complaint about the presence of vesicles on the skin of axillary hollows. These vesicles were found at birth and gradually increased in size. When viewed in the armpits, groups of vesicles located on a swollen, sealed base, ranging in size from 2.5 to 5.5 mm, were determined. When piercing one of the bubbles, lymph was released. The conclusion of the dermatologist: cystic lymphangioma. Given the results of the clinical study and the patient’s desire, it was decided to carry out local destruction of all available lymphangiomas. After obtaining the patient’s consent, an application was made of a composition containing a 70% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 for lymphangiomas at a dose of 0.1 ml. 15 minutes after the application, the surface of the lymphangiomas turned yellowish-gray. After 25 minutes, a slight swelling of the skin and a strip of hyperemia around the lymphangiomas appeared, and after 24 hours their darkening and mummification were observed. No systemic toxic or side effects were recorded. After 35-38 days, the mummified scabs of lymphangiomas spontaneously separated from the underlying skin. At their location for 60 days, areas of hyperemia and then hyperpigmentation of the skin were observed, according to the area of the corresponding area of the therapeutic application. Subsequent monitoring of the patient after treatment did not reveal recurrence of lymphangiomas.

Epicrisis №56

Patient A., born in 1959, turned to the clinic of aesthetic medicine in Kiron (Israel) on April 27, 2005 with a complaint about the presence of tumors in the neck and armpits. Tumors appeared several years ago and slowly increased in size. When viewed on the front surface of the neck, under the mammary glands and in the armpits, there were more than a dozen tumors on a thin stalk, round or oval in shape, of soft consistency, covered with sagging skin of a pale pink color, with a diameter of 1.0 to 6.0 mm. Dermatologist's conclusion: multiple soft fibromas. A biopsy of one of the tumors was performed, the conclusion of the pathomorphologist: skin fibroma. Given the results of morphological studies and the patient’s desire, it was decided to carry out local destruction of all existing fibroids. After obtaining consent, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 to all existing fibromas at a dose of 0.2 ml. 15 minutes after application, the surface of the tumors turned yellowish-gray. After 25 minutes, a slight swelling of the skin and a strip of hyperemia around the tumors appeared, and after 24 hours their darkening and mummification were observed. No systemic toxic or side effects were recorded. After 20-30 days, the mummified scabs of tumors spontaneously separated from the underlying skin. At the location of the tumors for 40 days, areas of hyperemia with subsequent hyperpigmentation were observed, according to the area of the corresponding area of the therapeutic application. Observation of the patient after treatment did not reveal recurrence of tumors.

Epicrisis №57

Patient E., born in 1940, turned to the clinic of aesthetic medicine in Kiron (Israel) on 05/20/2005 complaining of plaques on the upper eyelids. These plaques appeared more than five years ago, slowly increasing in size. When viewed on the skin of the upper eyelids, symmetrically, closer to the inner corners of the eyes, there were slightly raised soft yellow plaques 1.9 × 1.0 cm in size. Dermatologist's conclusion: xanthelasma. A biopsy of one of the plaques was performed, the conclusion of the pathomorphologist: xanthoma. Given the results of morphological studies and the patient’s desire, it was decided to carry out local destruction of xanthelasma. After obtaining the consent of the patient without anesthesia, an application of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 was performed on the plaque area at a dose of 0.1 ml. 15 minutes after application, the surface of the plaques acquired a yellowish-gray color. After 25 minutes, moderate swelling of the skin and a strip of hyperemia around the plaques appeared, and after a day their darkening and mummification were observed. No systemic toxic or side effects were recorded. After 30-35 days, the mummified xanthomas separated from the underlying skin. At their location for 45 days, areas of skin hyperemia and then hyperpigmentation were observed, according to the area of the corresponding area of the medical application. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the xanthoma.

Epicrisis №58

Patient B., born in 1957, turned to the clinic of aesthetic medicine in Kiron (Israel) on March 22, 2005 with a complaint about the presence of a nodule on her forehead. The indicated nodule appeared three years before treatment and slowly increased in size. When viewed on the skin of the forehead above the right eyebrow, there was a dense, domed papule, reddish in color, with a smooth surface with a diameter of 6.0 mm. The conclusion of the dermatologist: fibrous papule. Performed a biopsy of the tumor, the conclusion of the pathomorphologist: fibrous papule. Given the results of the morphological study and the patient’s desire, it was decided to carry out local destruction of the fibrous papule. After obtaining consent, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, on the tumor area, at a dose of 0.05 ml. 15 minutes after application, the surface of the tumor turned yellowish-gray. After 25 minutes, a slight swelling of the skin and a strip of hyperemia around the tumor appeared, and after a day its darkening and mummification were observed. No systemic toxic or side effects were recorded. After 30 days, the mummified scabs of the tumor spontaneously separated from the underlying skin. At the location of the fibrous papule, a site of hyperemia and then hyperpigmentation was observed for 45 days, according to the area of the corresponding area of the medical application. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the fibrous papule.

Epicrisis №59

Patient S., born in 1937, turned to the clinic of aesthetic medicine in Kiron (Israel) on 02.26.2001 with a complaint about the presence of a tumor on her left cheek. The indicated tumor appeared about six months ago and increased in size. When examined on the skin of the left cheek, a tight knot with fuzzy borders with a diameter of 0.9 cm was determined. The skin above it was slightly pink in color, with a slight ulceration at the top of the knot. The conclusion of the dermatologist: merkelioma. Performed a biopsy of the tumor, the conclusion of the pathomorphologist: primary cutaneous neuroendocrine carcinoma (a tumor from Merkel cells). Given the results of the morphological study and the patient’s desire, it was decided to carry out local tumor destruction. After obtaining the consent of the patient, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, to the tumor, in a dose of 0.1 ml. 15 minutes after application, the surface of the tumor turned yellowish-gray. After 25 minutes, a slight swelling of the skin and a strip of hyperemia around the tumor appeared, and after 24 hours its darkening and mummification were observed. No systemic toxic or side effects were recorded. After 35-37 days, the mummified scabs of the tumor spontaneously separated from the underlying skin. At the location of the tumor, a plot of hyperemia was observed for 60 days, and then increased pigmentation, according to the area of the corresponding area of the treatment application. Subsequent monitoring of the patient after treatment did not reveal tumor metastases or its recurrence.

Epicrisis №60

Patient I., born in 1965, turned to the clinic of aesthetic medicine in Kiron (Israel) 03.03.2005, complaining of the presence of multiple tumors on the body. These tumors appeared in adolescence, combined with multiple spots that arose in the first years of life. When examined on the patient’s body, a lot of randomly located coffee-with-milk stains and more than three dozen soft consistency tumors covered with unchanged skin with a diameter of 1.0 to 3.0 cm were determined. When pressed, the tumors easily moved into the subcutaneous tissue, every second the tumor was on a leg. Consulted by a dermatologist, conclusion: neurofibromatosis, skin form. Given the clinical data and the patient's desire, it was decided to carry out local tumor destruction. In agreement with the patient, without anesthesia, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 to existing tumors, in a dose of 2.0 ml. 15-20 minutes after application, the surface of the tumors acquired a yellowish-gray color. After 25 minutes, a slight swelling of the skin and a strip of hyperemia around the tumors appeared, and after a day their darkening and mummification were observed. No systemic toxic or side effects were recorded. After 30-40 days, the mummified scabs of tumors spontaneously separated from the underlying skin. At their location for 60 days, areas of hyperemia and then hyperpigmentation were observed, according to the area of the corresponding area of the medical application. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of tumors or their recurrence.

Epicrisis No. 61

Patient I., born in 1947, turned to the clinic of aesthetic medicine in Kiron (Israel) on March 7, 2005 with a complaint about the presence of tumors in the axillary and inguinal areas. These tumors appeared about five years ago before treatment and slowly increased in size. When viewed in the armpits and in the inguinal folds, there were more than a dozen round, soft, inelastic outgrowths on the leg, compressed at the base, dark red in diameter from 1.0 to 4.0 mm. The conclusion of the dermatologist: multiple fibroepithelial polyps (acrochordones). A biopsy of one of the tumors was performed, the conclusion of the pathomorphologist: fibroepithelial polyp. Given the results of the morphological study and the patient’s desire, it was decided to carry out local destruction of all existing tumors. After obtaining the consent of the patient, without anesthesia, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 to all existing fibroepithelial polyps in a dose of 0.2 ml. 15 minutes after application, the surface of the tumors turned yellowish-gray. After 25 minutes, a slight swelling of the skin and a strip of hyperemia around the tumors appeared, and after 24 hours their darkening and mummification were observed. No systemic toxic or side effects were recorded. After 28-36 days, the mummified scabs of tumors spontaneously separated from the underlying skin. At the location of the tumors for 55 days there were areas of hyperemia with subsequent hyperpigmentation, according to the area of the corresponding area of the treatment application. Observation of the patient after treatment did not reveal any pathological changes at the location of the tumors or their recurrence.

Epicrisis №62

Patient D., born in 1936, turned to the clinic of aesthetic medicine in Kiron (Israel) 02.21.2005, complaining of the presence of nodules on the face and neck. These nodules appeared 4-5 years before treatment, gradually increasing in size. When viewed on the skin of the face and lateral surfaces of the neck, there were more than a dozen randomly arranged solitary papules of red-brown color with umbilical depression and hyperkeratosis in the center, with a diameter of 1.0-6.0 mm. The conclusion of the dermatologist: warty diskeratoma. A biopsy of one of the nodules was performed, the conclusion of the pathomorphologist: warty diskeratoma. Given the results of the morphological study and the patient’s desire, it was decided to carry out local destruction of the nodules. After obtaining consent, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, on nodules, at a dose of 0.15 ml. 15 minutes after application, the surface of the nodules acquired a yellowish-gray color. After 25 minutes, moderate swelling of the skin and a strip of hyperemia appeared around them, and after a day their darkening and mummification were observed. No systemic toxic or side effects were recorded. After 35-40 days, the mummified scabs of tumors separated from the underlying skin. At their location for 50 days, areas of hyperemia of the skin were observed, according to the area of the corresponding area of the medical application. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the nodules or their recurrence.

Epicrisis No. 63

Patient V., born in 1939, turned to the clinic of aesthetic medicine in Kiron (Israel) on June 13, 2005 with a complaint about the presence of nodes on the skin of her forearms and legs. These nodes appeared three years before treatment and slowly increased in size. When viewed on the outer surface of the forearms and on the outer surface of the legs, there were more than a dozen flat papules with a clearly defined border, slightly pigmented, located on an erymatous base, 0.1-0.7 cm in diameter. Dermatologist's conclusion: multiple large-cell acanthomas. A biopsy of one of the nodes was performed, the conclusion of the pathomorphologist: large-cell acanthoma. Given the results of morphological studies and the patient’s desire, it was decided to carry out local destruction of the nodes. After obtaining the consent of the patient, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 to all available nodes in a dose of 0.2 ml. 15-20 minutes after application, the surface of the nodes acquired a yellowish-gray color. After 25 minutes, a slight swelling of the skin and a strip of hyperemia around them appeared, and after 24 hours their darkening and mummification were observed. No systemic toxic or side effects were recorded. After 35-45 days, the mummified scabs of nodes spontaneously separated from the underlying skin. At their location, for 40-50 days, areas of hyperemia and then increased skin pigmentation were observed, according to the area of the corresponding area of the medical application. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the nodes or their recurrence.

Epicrisis number 64

Patient R., born in 1951, turned to the clinic of aesthetic medicine in Kiron (Israel) on May 13, 2005 with a complaint about the presence of a node on the skin of the left thigh. The duration of the disease was more than two years. When viewed on the outer surface of the left thigh in the upper third there was a solitary papule of violet color, with a Wickham net, 10 mm in diameter. The conclusion of the dermatologist: benign lichen keratosis. A node biopsy was performed, the conclusion of the pathomorphologist confirmed the opinion of a dermatologist: benign lichen-like keratosis. Given the results of the morphological study and the patient’s desire, it was decided to carry out local destruction of the site. After obtaining the consent of the patient, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 per node in a dose of 0.1 ml. 15 minutes after application, its surface acquired a yellowish-gray color. After 25 minutes, a slight swelling and a strip of hyperemia appeared around it, and after a day its darkening and mummification were observed. No systemic toxic or side effects were recorded. After 32 days, the mummified scabs separated from the underlying skin. At the site of the site, a site of hyperemia was observed for 50 days, according to the area of the corresponding area of the therapeutic application. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the site of the node or its recurrence.

Epicrisis №65

Patient T., born in 1938, turned to the clinic of aesthetic medicine in Kiron (Israel) on June 30, 2005 with a complaint about the presence of warty nodes on both hands. The indicated nodes appeared more than three years ago; their appearance was preceded by the formation of gray easily detached small nodules. Prior to this, the patient worked for 20 years at an oil refinery. When viewed on the back surface of both hands and forearms, there were multiple papules, with a warty surface, pale grayish in color, with a diameter of 2-4 mm. The conclusion of the dermatologist: tar keratosis. A biopsy of one of the papules was completed, the conclusion of the pathomorphologist: tar keratosis. Given the results of the morphological examination and the patient’s desire, it was decided to carry out local destruction of the papules. After obtaining the consent of the patient, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 to all available papules at a dose of 0.2 ml. 15 minutes after application, the surface of the papules turned yellowish-gray. After 25 minutes, a slight swelling of the skin around the papules appeared, and after 24 hours their darkening and mummification were observed. No systemic toxic or side effects were recorded. After 25-30 days, the mummified scabs of papules spontaneously separated, and at their location for 30 days there were areas of hyperemia with subsequent hyperpigmentation, according to the area of the corresponding area of the medical application. Further monitoring of the patient did not reveal any pathological changes in the skin at the location of the papules or their recurrence.

Epicrisis №66

Patient B., born in 1933, turned to the clinic of aesthetic medicine in Kiron (Israel) on January 23, 2002 complaining of the presence of a tumor on the skin of her chest. The indicated tumor appeared about 1 year ago and gradually increased in size. When viewed in the subclavian region on the right, a mushroom-shaped node with a warty surface of dense consistency was found, on a wide base, easily bleeding with minimal trauma, brown-red in size, 1.2 × 1.1 × 1.0 cm. Dermatologist's conclusion: warty squamous cell carcinoma . Performed a biopsy of the tumor, the conclusion of the pathomorphologist: warty squamous cell carcinoma, stage I. Given the results of the morphological study and the patient’s desire, it was decided to carry out local tumor destruction. After obtaining the consent of the patient, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 to the tumor at a dose of 0.15 ml. 15 minutes after application, the surface of the tumor turned yellowish-gray. After 25 minutes, a slight swelling of the skin and a strip of hyperemia around the tumor appeared, and after 24 hours its darkening and mummification were observed. No systemic toxic or side effects were recorded. After 30-35 days, the mummified scabs of the tumor spontaneously separated from the underlying skin. At the location of the tumor for 60 days, a site of hyperemia and skin retraction, and then hyperpigmentation, was observed, according to the area of the corresponding area of the medical application. Subsequent monitoring of the patient did not reveal recurrence of the tumor or its metastases.

Epicrisis №67

Patient R., born in 1949, turned to the clinic of aesthetic medicine in Kiron (Israel) on 03.02.2002 with a complaint about the presence of a nodule on her right cheek. The indicated nodule appeared about a year ago and slowly increased in size. When examined on the skin of the right cheek, a firm, round, painless nodule of a whitish color with a diameter of 5.0 mm was determined. The conclusion of the dermatologist: sebaceous carcinoma. Performed a biopsy of the nodule, the conclusion of the pathomorphologist: sebaceous carcinoma. Given the results of morphological studies and the patient’s desire, it was decided to carry out local destruction of the nodule. After obtaining the consent of the patient, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, per nodule, at a dose of 0.05 ml. 15 minutes after application, its surface acquired a yellowish-gray color. After 25 minutes, a slight swelling of the skin and a strip of hyperemia around the nodule appeared, and after 24 hours its darkening and mummification were observed. No systemic toxic or side effects were recorded. After 31 days, the mummified scabs of the nodule spontaneously separated from the underlying skin. At the site of the nodule, a site of hyperemia was observed for 45 days, followed by pigmentation, according to the area of the corresponding area of the treatment application. Observation of the patient after treatment did not reveal recurrence of the tumor or its metastases.

Epicrisis №68

Patient F., born in 1968, turned to the clinic of aesthetic medicine in Kiron (Israel) on May 16, 2005 with a complaint about the presence of multiple nodes on the head and neck. These nodules appeared more than six months ago and gradually increased in size. When viewed on the skin of the scalp, near the auricles, on the side of the neck on the right there were multiple randomly located pulsating nodes of soft consistency, red in color, with a diameter of 2.0 to 9.0 mm. The conclusion of the dermatologist: angiolymphoid hyperplasia with eosinophilia (epithelioid hemangioma). A biopsy of one of the nodes was performed, the conclusion of the pathomorphologist: angiolymphoid hyperplasia with eosinophilia. Given the clinical data and the results of morphological studies, it was decided to carry out local destruction of hemangiomas. After obtaining the consent of the patient, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 to all available hemangiomas at a dose of 0.3 ml. 15 minutes after application, the surface of the hemangiomas turned yellowish-gray. After 25 minutes, moderate swelling of the skin and a thin strip of hyperemia around the hemangiomas appeared, and after a day their darkening and mummification were observed. No systemic toxic or side effects were recorded. In the period from the 25th to the 35th day after application, exfoliation of mummified scabs of hemangiomas from the underlying skin was observed. At their location for 45 days, areas of skin hyperemia were observed followed by pigmentation, according to the area of the corresponding area of the treatment application. Observation of the patient after treatment did not reveal any pathological changes in the skin at the location of epithelial hemangiomas.

Epicrisis №69

Patient S., born in 1970, went to the clinic of aesthetic medicine in Kiron (Israel) on 02.28.2005, complaining of the presence of a node on the right thigh. The indicated node appeared about six months ago and slowly increased in size. When viewed on the outer surface of the right thigh in the lower third, a dense intradermal rounded knot with blurred borders and edges merging with normal skin, slightly rising above its level, blue-black in color, 1.3 cm in diameter was determined.Dermatologist's conclusion: benign fibrous histiocytoma ( dermatofibroma). A node biopsy was performed, the conclusion of the pathomorphologist: benign fibrous histiocytoma. Given the results of morphological studies and the patient’s desire, it was decided to carry out local destruction of dermatofibroma. After obtaining consent, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, to the area of the site, in a dose of 0.1 ml. 20 minutes after the application, the surface of the node acquired a yellowish-gray color. After 25 minutes, a slight swelling of the skin and a strip of hyperemia appeared around it, and after a day its darkening and mummification were observed. No systemic toxic or side effects were recorded. After 35 days, the mummified scabs of the site separated from the underlying skin. At its location for 48 days, a site of hyperemia and then hyperpigmentation was observed, according to the area of the corresponding area of the therapeutic application. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the dermatofibroma.

Epicrisis №70

Patient X., born in 1934, turned to the clinic of aesthetic medicine in Kiron (Israel) on April 25, 2005 with a complaint about the presence of a rapidly growing node on the skin of the left shoulder joint. The specified node appeared two months before treatment and rapidly increased in size. When viewed on the front surface of the left shoulder joint, a tight knot with a smooth surface, red, 1.4 cm in diameter was determined. Dermatologist's conclusion: atypical fibroxanthoma. A node biopsy was performed, the conclusion of the pathomorphologist: atypical fibroxanthoma. Given the results of the morphological study and the patient’s desire, it was decided to carry out local destruction of the site. After obtaining the consent of the patient, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1, to the tumor, in a dose of 0.1 ml. 15 minutes after application, the surface of the node acquired a yellowish-gray color. After 25 minutes, a slight swelling of the skin and a strip of hyperemia around the node appeared, and after 24 hours, darkening and mummification of the node were observed. No systemic toxic or side effects were recorded. After 37 days, the mummified scabs of the site spontaneously separated from the underlying skin. At the site of the site, a site of hyperemia was observed for 65 days, and then increased pigmentation, the area corresponding to the area of the treatment application. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the fibroxanthoma or its recurrence.

Epicrisis number 71

Patient A., born in 1940, turned to the clinic of aesthetic medicine in Kiron (Israel) on June 20, 2005 with a complaint about the presence of a node on the scalp. The specified node appeared two years before treatment and slowly increased in size. Upon examination, the skin of the occipital region of the head had a dense solitary node, raised above the skin, with ulceration in the center, 1.0 cm in diameter. Dermatologist's conclusion: hair tumor. A node biopsy was performed, the conclusion of the pathomorphologist: hair tumor (proliferating tricholemal cyst). Given the results of the morphological study and the patient’s desire, it was decided to carry out local tumor destruction. After obtaining the consent of the patient, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 to the tumor at a dose of 0.15 ml. 15 minutes after application, the surface of the tumor turned yellowish-gray. After 25 minutes, a slight swelling of the skin and a strip of hyperemia appeared around her, and after 24 hours, her darkening and mummification were observed. No systemic toxic or side effects were recorded. After 37 days, the mummified scabs of the tumor spontaneously separated from the underlying skin. At the location of the tumor, a section of hyperemia was observed for 30 days, and then increased skin pigmentation, according to the area of the corresponding area of the treatment application. Subsequent monitoring of the patient did not reveal any pathological changes in the skin at the location of the hair tumor or its recurrence.

Epicrisis number 72

Patient D., born in 1979, turned to the clinic of aesthetic medicine in Kiron (Israel) on 05.06.2005 with a complaint about the presence of nodes on the buttocks. These nodes were detected at birth and slowly increased in size as the patient grew. When viewed on the buttocks and partially on the back of the thighs, more than a dozen dome-shaped nodes, soft consistency, covered with smooth skin-colored skin, with a diameter of 4.0 to 12.0 mm were randomly determined. The conclusion of the dermatologist: lipomatous nevi. A biopsy of one of the nodes was performed, the conclusion of the pathomorphologist: adipose tissue. Given the results of the morphological study and the patient’s desire, it was decided to carry out local destruction of all existing lipomatous nevi. After obtaining the consent of the patient, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 to all available nevi in a dose of 0.3 ml. 15 minutes after application, the surface of the nodes acquired a yellowish-gray color. After 25 minutes, a slight swelling of the skin and a strip of hyperemia around the nodes appeared, and after 24 hours they were darkened and mummified. No systemic toxic or side effects were recorded. After 30-35 days, the mummified scabs of the nevi spontaneously separated from the underlying skin. At their location for 60 days, areas of hyperemia were observed with skin retraction and subsequent pigmentation, according to the area of the corresponding area of the medical application. Observation of the patient after treatment did not reveal a recurrence of lipomatous nevi.

Epicrisis number 73

The patient Ch., Born in 1955, turned to the clinic of aesthetic medicine in Kiron (Israel) on March 21, 2005 with a complaint about the increased formation of wrinkles on her face. Small superficial wrinkles appeared in the patient several years ago, attempts to eliminate them using cosmetics were unsuccessful. When viewed on the skin of the face in the cheeks, around the eyes, nasolabial folds, forehead, a grid of small shallow wrinkles was determined, giving the skin a flabby appearance. The conclusion of the dermatologist: facial wrinkles. Considering the clinical data and the patient’s desire, it was decided to conduct a deep peeling of the facial skin. After obtaining the patient’s consent, a tampon was applied to apply a composition containing a 50% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 to areas of the skin with excessive wrinkle formation in a dose of up to 2.0 ml. After 20 minutes after application, the surface of the skin of the face acquired a light yellow color, and after 24 hours, surface mummification of the epidermis was observed. No systemic toxic or side effects were recorded. After 7-9 days, the mummified scabs of the epidermis spontaneously separated from the underlying skin. After that, her mild hyperemia was noted for 10 days. As a result, three weeks after the application, a significant decrease in the number of fine wrinkles on the skin of the face was observed, and in some areas (cheeks) they almost disappeared. Further monitoring of the patient after peeling did not reveal any pathological changes on her skin.

Epicrisis number 74

Patient N., born in 1969, went to the Clinic of Aesthetic Medicine in Kiron (Israel) on 05.22.05, complaining of the presence of itchy red wet spots between the toes, with the destruction and exfoliation of the nails on the I and II- x toes. The duration of the disease was six months. Before treatment, a dermatologist diagnosed with candidiasis of the skin of the feet was observed, the treatment was not successful. When examined in the interdigital spaces of the I-II, II-III toes of both legs, there were exudative pale pink spots with a touch, the nails on the I and II toes were corroded and exfoliated in the distal sections, the subungual beds were yellowish in color. Microscopic examination of scrapings from affected areas of the skin revealed Druze fungus. The conclusion of the dermatologist: candidiasis of the skin of the feet with subungual lesion. After obtaining the consent of the patient without anesthesia, an application was made of a composition containing a 90% solution of 2-chloropropionic acid and its salt in a ratio of 500: 1 to the affected areas of the skin at a dose of 0.15 ml. After 15-20 minutes, the treated skin areas turned yellow, a slight swelling and hyperemia appeared around them, and after 24 hours they darkened and mummified. After 14-16 days after treatment, the mummified areas were freely separated from the skin, and after two to three months, restoration of the shape and color of the nails was observed. Subsequent monitoring of the patient did not reveal a relapse of candidiasis.

LITERATURE

1. RF patent 2118160.

2. US patent 3920835.

3. US patent 3988470.

4. RF patent 2302261.

5. U.S. Patent 4,595,591.

6. Copyright certificate of the USSR 229447.

7. RF patent 2212243.

8. RF patent 2226861.

0. U.S. Patent 4,824,955.

10. EP 1293498.

11. RF patent 2261243.

12. John G. Perry. Chemical Engineer Handbook, ed. Chemistry, Leningrad Department., 1969, Volume 1, p. 62.

Claims (4)

1. A drug for the treatment of benign, viral, precancerous and non-metastatic malignant skin lesions, dysplastic (pre-tumor) and inflammatory lesions of visible mucous, viral, fungal lesions of the skin and nails, as well as for the correction of wrinkles and senile age spots, containing their intravital devitalization, containing alpha halocarboxylic acid and its zinc salt of the general formula
R- (CH ₂ ) _m —CXY-COOH and [R- (CH ₂ ) _m —CXY-COO] ₂ Zn,
where Y = Cl, Br or J, X = H or Y, m = 1-10, R = H, aryl, cycloalkyl, alkyl of the general formula C _n H _{2n + 1} n = 1-5, in a ratio of 500: 1 up to 10: 1 and water in an amount of from 1.5 to 70.0 wt.%. 2. The method of producing a medicine according to claim 1, characterized in that zinc oxide is added to the aqueous solution of alpha-halocarboxylic acid and stirred at a temperature of 40-120 ° C for 10-60 minutes 3. The method for producing a medicine according to claim 1, characterized in that alpha-halocarboxylic acid and its zinc salt are mixed, the purity of which is at least 97.5%. 4. A method for the treatment of benign, viral, precancerous and malignant non-metastatic lesions of the skin, dysplastic (pre-tumor) and inflammatory lesions of visible mucous, viral, fungal lesions of the skin and nails, as well as for the correction of wrinkles and senile pigment spots by their intravital devitalization, including the use of drug funds according to claim 1.