Abstract:
A method of treating folliculitis and other cutaneous infected conditions by an electrical spark discharge at the location of the cutaneous lesion, with intensity and duration sufficient to cause inhibition or destruction of the causative infective agent. Significant or permanent damage to the normal tissue or other harmful result is avoided by the utilization of a low discharge power and a short duration of application, as well as by an indirect application of the discharge.

Description:
BACKGROUND OF THE INVENTION 
     This invention relates to an electro-medical treatment of the type in which a high-frequency alternating current of low power and high tension is applied to an affected site via a non-contacting electrode which serves as one end of a spark gap. Such application of high-frequency alternating current, when utilized for the removal of undesired skin growths, etc., has sometimes been designated in the prior art as fulguration, and has been referred to in numerous publications relating to electro-surgery. 
     In the prior art, reference has been made to treating skin conditions by using an electrical corona discharge in air to generate ultraviolet radiation. Many references to epilating devices operating on an electrical discharge exist in the prior art. The prior art contains references to corona discharge devices for releiving pain and inducing local immunization by diathermy heat in underlying tissues. Nerve stimulators utilizing an air discharge to a skin-contacting electrode to generate a transcutaneous current pulse exist in the prior art. Dessicating devices for mild destruction of tissue by means of a relatively weak spark are well-known in electrosurgery, as are coagulating devices for producing severe destruction of tissue by means of a strong spark discharge. 
     Quite surprisingly, in the light of the long history, extensive experimentation, study and evaluation of medically-related electrical discharge devices, it has now been discovered that cutaneous conditions such as pyoderma conditions and fungous conditions of the skin can be rapidly and effectively treated by the use of a properly-generated and controlled electrical spark discharge applied directly to the site of the cutaneous lesion. In spite of the possible trauma and risk of spreading infection known to be associated with disturbance, electrical or otherwise, of an infected site, it has now been realized that an electrical spark applied in accordance with the present invention has been found to produce rapid elimination of the aforementioned cutaneous infection without tissue scarring, epilation or other significant adverse effects. The described treatment is obviously advantageous over conventional antibiotic treatment for rapidity, and avoidance of allergic reaction and other antibiotic side effects. It is also obviously advantageous over such previously-used treatments as UV and x-ray, for reduced risk to the patient, as well as rapidity. Moreover, a new treatment is always advantageous, for it is well-known that no treatment is effective in all cases, particularly when relapsing or chronic, and some cases persist despite all existing treatment. 
     SUMMARY OF THE INVENTION 
     While the concept of applying an electrical spark discharge to an affected site to destroy undesired tissue, etc., is well-known in the prior art, in accordance with the present invention such an electric discharge is utilized without significant injury to tissue to effect a treatment of conditions such as folliculitis simplex, furuncle, carbuncle, etc. The above-described utilization for treatment of such conditions is not known in the literature. 
     Folliculitis simplex is regarded as a pyogenic infection of the hair follicles, often caused by staphylococci. The elementary lesion is regarded as a follicular pustule and the hair bulb itself is usually unaffected. The surrounding skin may be somewhat reddened in this condition but there is no crusting. A furuncle is regarded as a follicular and sebaceous-gland infection. It may be single or multiple. It tends to occur in crops. A patient may have one or two lesions and then be free of involvement or he may have furuncles almost continuously for many months. A furuncle is a solitary boil, and a carbuncle appears as a group of boils run together or as one large boil with several pus pockets. 
     Since some folliculitis conditions such as furuncles and carbuncles are considered under some conditions to become life-endangering, and to in some cases require hospitalization or even operation, especially those occurring on or about the nose, upper lip, back of neck or beneath the eye, a simple and effective treatment for folliculitis conditions is obviously advantageous. 
     One object of this invention is to provide a method of treating a folliculitis condition as described above with an electrical spark type of discharge whereby no tissue is significantly injured and no scarring results. 
     It is another object of this invention to provide a mechanism whereby the effective intensity of the discharge is controllable. 
     Another object of this invention is to provide a mechanism which ensures against harmful results by utilizing a discharge of very low current. 
     This method comprises applying the discharge from a suitable non-contacting electrode device to the affected follicle or follicles for one or two seconds, this period of time being sufficient to deactivate, i.e., inhibit or destroy, the causative agent, e.g., bacterial, but insufficient to cause significant tissue damage at the utilized effective intensity of the discharge. A second contact to make a return path for the current is not necessary. The reason, of course, is that at the ringing frequency of the electrode discharge, the capacitance between the patient and the surrounding space and grounded surfaces presents a relatively low impedance. The electrode may be of any desired shape or bluntness, however an electrode of fine diameter may be desirable to restrict the discharge to a small area. The application of the electrical discharge as described results in healing of the follicle site with no permanent loss of hair from the treated follicle, and the treatment is rendered relatively painless by a temporary benumbing effect of the current. During application the discharge tends to jump automatically to the affected follicle because said follicle is usually slightly raised above the surrounding epidermal surface as a result of inflammation consequent to the folliculitis condition. Owing to the low power utilized the spark discharge tends to exhibit a bright yellow appearance, rather than a bluish appearance characteristic of higher power as conventionally associated with fulguration. Since the causative agent of the aforesaid follicle conditions is generally regarded as bacterial, which is a type of infective agent which is considered to be relatively unaffected by current per se, some factor other than current is apparently responsible for deactivation of the causative agent of the folliculitis as a consequence of treatment by the abovedescribed method in accordance with the present invention. Thus, for example, direct contact of the electrode to the skin surface is apparently not found to be efficacious, since with such contact essentially only current flow is produced. 
     The positioning or moving of the electrode can be accomplished, of course, by hand, or possibly also by machine. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS 
     The sole FIGURE, FIG. 1, is a schematic diagram of a circuit suitable for utilization with an electrode device in accordance with the method of the present invention. 
    
    
     DESCRIPTION OF THE PREFERRED EMBODIMENTS 
     The drawing of FIG. 1 illustrates a high-frequency circuit associated with the electrode, with a control circuit for controlling the effective intensity of the discharge, which may be regarded herein as a product of the pulse repetition rate, the pulse duty cycle and the amplitude of the discharge. Indicated schematically is a power transformer 27 in conjuction with a rectifier diode 26 and a filter capacitor 25, for providing B+ to pulsing circuit 32 via decoupling resistor 24 and filter capacitor 23, and to the collector circuit of transformer driver circuit 33. Circuit 33 drives a small Tesla-coil type of transformer, transformer 29, which is connected at the high end of the secondary to a said electrode 30 via an electrode lead 35. Said power transformer 27 is connected to an a.c. line via a switch 28. The lower end of the secondary of transformer 29 is connected to terminal 31 to provide an optional return path, if desired, for the current associated with the spark discharge. 
     In this embodiment, Tesla transformer driver circuit 33 comprises two power transistors 20 and 21, having bases, collectors and emitters connected in parallel to increase power-handling capability, with the paralleled collectors being connected to the lower end of transformer 29 primary via diode 22. Said driver circuit 33 operates analogously to a mechanical interrupter, alternately grounding and open-circuiting the lower end of said primary of transformer 29. Diode 22 serves to block any reverse flyback voltage from appearing at the collector terminals of transistors 20 and 21. 
     Pulsing circuit 32 comprises a relaxation oscillator circuit, including unijunction transistor 5, charging capacitor 3, charging potentiometer 1, emitter-current-limiting resistor 2 and base resistor 4; a pulse-stretching circuit, including blocking capacitor 6, discharging diode 7, base-current-limiting resistor 8, discharging transistor 9, charging capacitor 17, charging resistor 10, collector-current-limiting resistor 11, switching transistor 12 and collector resistor 13; and a buffer circuit, including transistors 14 and 16, base-current-limiting resistor 15, emitter resistor 19, drive-current-adjusting potentiometer 34 and drive-current-limiting resistor 18. 
     The afore-described pulse-stretching circuit operates similarly to a one-shot to extend the width of the output pulse of the afore-described relaxation oscillator circuit, to provide a pulse of optimum duty cycle, said duty cycle being adjustable via potentiometer 10. The pulse frequency is adjustable via potentiometer 1, and is typically about 1 kHz. The base drive level to the afore-mentioned driver circuit 33 is adjustable via potentiometer 34, to adjust the amplitude of, and hence to provide a convenient control of the effective intensity as heretofore defined of, the spark discharge from electrode 30. The spark is typically adjusted for a maximum length of about 1/16&#34;, without return path. The maximum spark length obtainable between the electrode 30 and return-path terminal 31 is limited to about 1/4&#34; for the application herein disclosed. 
     While a Tesla device as described is a convenient way to generate an effective electrode voltage waveform, the actual voltage-generating means, of course, is immaterial, and any other means that will produce an equivalent voltage waveform may be utilized to implement this method of treatment. 
     Of course the above-described circuit is shown in an illustrative, rather than a limiting, sense. 
     Besides exhibiting usefulness for treating folliculitis conditions as described above, this method of applying an electrical spark discharge may be utilized to ameliorate other cutaneous infected conditions, including, for example, various forms of tinea. For such conditions a more blunt electrode device may be utilized to effect distribution of the discharge over a wider area, and said electrode may also be moved in position so as to effect an overall coverage of an affected zone. However, for such tinea conditions as infected nail conditions, a finer-diameter electrode device may be advantageous to allow improved penetration of the discharge to the keratophilic trichophyton, etc., causative fungal agent, augmented by increased effective intensity. 
     In most cases, the treatment method according to the present invention may give best results when utilized with a relatively dry cutaneous surface; otherwise a considerable portion of the effect of the electrical spark discharge may be dissipated by conduction associated with surface moisture. 
     It may be noted that while heat-related sterilizing effects are known to accompany the previously-mentioned method of fulguration, a primary purpose of fulguration is to destroy unwanted tissue, and for this purpose direct electrode contact is often utilized, the destructive effect being substantially attributed to the current; on the other hand a primary purpose of the treatment method according to the present invention is to deactivate a causative infective agent, e.g., bacterial, fungal, etc., which is at least partially protected by the cutaneous tissue, i.e., skin, nails or hair, without significant or permanent damage to said tissue, in a manner not previously known, in which it is advantageous that direct contact not be made since the deactivating effect is apparently not directly attributable to the current. 
     The foregoing invention can now be practiced by those skilled in the art. From the above, it will be seen that the treatment method according to the present invention is capable of use in a variety of situations. 
     In general, it will be understood that changes in the details herein described and illustrated for the purpose of explaining the nature of the invention may be made by those skilled in the art, without departing from the spirit and scope of the invention as expressed in the appended claims. It is, therefore, intended that these details be interpreted as illustrative, and not in a limiting sense.