Abstract:
Psoriasis in humans is treated by applying to the affected skin area 2-6 times a day an ointment containing ursolic acid and oleanolic acid in the weight ratio of 3:1 dispersed in a vaseline/lanolin carrier. An homogenous ointment may be prepared by dissolving the acids in ethyl ether, adding the carrier, warming until homogeneous and heating to remove the ether.

Description:
BACKGROUND OF THE INVENTION 
     Psoriasis is a chronic skin disease which progresses gradually, the main signs and symptoms of which are papulosquamous and itching. The present treatment of psoriasis is symptomatic and is based on the administration of steroids, antibiotics, keratolytics, antiseptics and in some cases cytostatic drugs. The treatment of posoriasis with the presently available drugs is considered satisfactory. 
     SUMMARY OF THE INVENTION 
     The present invention relates to an improved composition for the treatment of psoriasis based on a mixture of ursolic acid and oleanolic acid in a weight ratio of 3:1, dissolved in a petroleum jelly/lanolin carrier, preferably containing propyl paraben and methyl paraben as preservatives. The invention also relates to the method for preparation of the composition and the method of treatment of psoriasis with the composition. 
    
    
     DESCRIPTION OF PREFERRED EMBODIMENTS 
     The composition comprises (in parts by weight) 
     
         ______________________________________Ursolic acid      0.3-0.9Oleanolic acid    0.1-0.3Petroleum jelly   30-90Lanolin anhydrous 10-30and optionallyPropyl paraben    0.02Methyl paraben    0.005______________________________________ 
    
     The composition may be prepared as follows: 
     A mixture of the oleanolic and ursolic acids is dissolved in the necessary quantity of ethyl ether. A mixture of the lanolin/petroleum jelly is added to the ether solution which is then warmed in order to dissolve the ingredients and form a homogeneous mixture. To this mixture, the necessary quantity of methyl paraben and propyl paraben, dissolved in a small quantity of ethyl alcohol, is added. The whole is warmed to to remove the ether. 
     The above method is necessary only if a completely homogeneous mixture is desire. If not, the ingredients may be simply mixed and shaken well. 
     The obtained product is a yellow ointment having a slight odor like lanolin. It is stable under ambient conditions of temperature, moisture and light. 
     The composition according to the invention has been clinically tested on humans afflicted with psoriasis. Even after the first application of this ointment, the itching ceases and the rest of the symptoms subside. 
     After the first week of treatment, exfoliation and elimination of the psoriatic area occur and in psoriasis of recent onset, complete cure follows in about 70-80% of the cases. During the second week of treatment the recent cases of psoriasis are completely cured and the characteristic white spots are left in the psoriatic areas, which again subside in a few days. The chronic severe forms of psoriasis are cured in 50-60% of the cases. During the third week of treatment, the usual psoriasis cases are cured. The recommended dosage is 2-6 times daily according to the severity of the case. Continuous application of the above ointment for 4 months did not reveal any side effects. It is not necessary to combine this drug with any other. 
     The drug may be identified as follows: 
     0.1 g of the ointment is dissolved in 10 ml of ethyl ether. A small quantity is chromatographed in layer (silica gel layer 0.25 mm) using toluene:acetic acid:acetone 100:0.07:3 as the solvent. After the chromatography, the chromatogram is sprayed with a 20% solution of SbCl 3  in methanol and warmed to 100° C. Two characteristic blue spots are seen: the ursolic acid spot with Rf 0.065 and the oleanolic acid with Rf 0.125. 
     The above composition was used in the treatment of psoriasis on 40 patients of different age/sex distribution and duration of the disease. The clinical results are shown in the following table. 
     
         ______________________________________                                 Duration    Patient&#39;s             Duration Distribution                                 ofPatient&#39;s    age      of disease                      of         treatmentsex      (in years)             (in years)                      Psoriasis  (in days)______________________________________1.  female   30       7      Upper-lower                                   20                        extremities2.  male     43       28     Whole body 403.  male     48       27     Whole body 424.  female   12       1/12   Upper-lower                                   12                        extremities5.  male     74       8      Elbows     156.  female   40       1      Whole body 157.  male     66       43     Lower extremities                                   358.  male     44       24     Whole body 459.  female   38       1      Hand extremities                                   1510. male     17       3      Upper-lower                                   25                        extremities11. male     12       3      &#34;          2212. female   16       2      &#34;          2513. female   17       3      &#34;          3014. male     12       4      Whole body 3515. male     14       9      &#34;          4016. female   12       4      &#34;          4017. female   50       10     &#34;          4518. male     64       30     &#34;          6019. male     50       30     &#34;          4020. male     75       10     Hand extremities                                   3021. female   35       5      &#34;          3022. male     50       4      Elbows     3523. male     18       5      Whole body 5024. male     74       20     Hand extremities                                   3025. male     52       22     Whole body 4026. male     55       30     &#34;          6527. male     53       25     &#34;          7028. male     21       5      &#34;          4029. male     44       8      Upper-lower                                   30                        extremities30. male     40       7      &#34;          3231. male     43       8      &#34;          3532. female   35       3      Hand extremities                                   2533. female   55       20     Whole body 6034. female   75       40     Upper-lower                                   50                        extremities35. male     48       8      Upper extremities                                   4536. female   45       5      Upper-lower                                   30                        extremities37. female   65       10     Feet       2038. male     12       2      Whole body 3039. female   32       5      &#34;          2040. male     22       6      &#34;          60______________________________________ 
    
     The above table reveals that this concentration of acids has therapeutic effects on psoriasis. Itching as well as other subjective symptoms cease completely from the first week of treatment. 
     After the first week of treatment one can see desquamation of psoriasis, diminution of the extent and heading of new forms of psoriasis in percentages up to 70-80%. During the second week of treatment the recent forms of psoriasis heal almost completely and in the sites of the rash, white patches remain which disappear within a few days. Grave chronic forms of psoriasis heal in percentages up to 50-60%. During the third week of treatment mild forms of psoriasis heal completely and the skin comes back to its normal condition. 
     Grave forms of psoriasis show a considerable improvement up to 60-70%. The rash becomes reddish and a regeneration of the skin is noticed. 
     Very serious whole body psoriatic patients show improvement within 40-70 days from the beginning of treatment. 
     The main characteristic qualities of the drug action are the ceasing of pruritus and the gradual disappearance of psoriatic lesicus. 
     A biopsy was done on a 74 year-old man on the 20th day of treatment and the result was as follows: 
     The microscopic examination of the spindle-shaped skin specimen was 2.5×1.0 cm in size and revealed a hyperkeratosis in the center, acanthosis and hyperkeratosis of the epidermis as well as lymphocytic inflammatory infiltrates around the vessels of the cutis. Perakeratosis or absence of the granulak stratum was not observed except in minimal foci. In the epidermis and close to the above few foci, few formations in the form of microabcesses of MUNRO and spongiotic vesicles of COGOJ were observed. 
     Summary 
     Restricted, focal, residual lesion of psoriasis. 
     Young subjects (under 16 years) compared to older individuals respond more rapidly to treatment. 
     The treatment in patients, who have been given cortisone treatment in the past, takes longer. 
     Two patients had a relapse of their psoriasis within 3 years during their aforementioned treatment, but this fact cannot be evaluated, because they stopped the therapy before the complete disappearance of the signs of psoriasis. After repeating their treatment they were completely cured. 
     The successful treatment of psoriasis is confirmed by biopsy, but since this procedure is usually objected to by the patients, it is recommended to continue the treatment 5 days after the complete disappearance of the symptoms. 
     The mechanism of the action of the composition, as well as the etiology of psoriasis are unknown.