富血小板血浆治疗硬皮病相关溃疡:单中心经验与文献综述

IF 2.3 Q2 DERMATOLOGY
A. Condorelli, A. Paganelli, Chiara Marraccini, Elena Ficarelli, Alfonso Motolese, Luca Contu, Alberico Motolese
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引用次数: 0

摘要

系统性硬化症(SS)是一种复杂的结缔组织疾病,以血管病变和进行性纤维化为特征,主要被认为是一种自身免疫性疾病。SS 可影响多个器官和组织,包括皮肤、呼吸系统、胃肠道、泌尿生殖系统、心血管系统和肌肉骨骼系统。皮肤受累很常见,大约 50% 的患者会出现 SS 相关溃疡,尤其是数字溃疡。这些溃疡不仅会引起疼痛,还会严重影响患者的生活质量,严重时还会导致感染、坏疽和截肢。寻找治疗硬皮病相关溃疡的新型疗法仍是一个持续的研究领域。富血小板血浆(PRP)已被研究用于治疗难以愈合的溃疡,包括糖尿病溃疡、压迫性溃疡和血管性溃疡。在这项研究中,我们分享了用 PRP 治疗硬皮病溃疡的经验。研究选取了十名确诊为硬皮病、慢性皮肤溃疡持续至少六周且对常规治疗无效的患者。研究人员制备了同源 PRP 凝胶,每周涂抹一次,持续时间长达八周。对溃疡进行 PRP 治疗前后的照片记录,并使用视觉模拟量表(VAS)评估疼痛程度。我们还对有关在 SS 中使用 PRP 的文献进行了系统性回顾。病例分析结果显示,10 名患者中包括 8 名女性和 2 名男性,中位年龄为 52.5 岁,溃疡面积从 0.78 平方厘米到 28.26 平方厘米不等。溃疡位于手指、腿部和脚跟,并伴有各种形式的 SS,包括局限性和弥漫性皮肤受累。雷诺现象很普遍,有两名患者出现器官受累。在 PRP 治疗结束时,溃疡的平均面积明显缩小,溃疡面积减少了 78%。疼痛程度也明显改善,VAS评分降低。在对文献进行系统性修订方面,我们检索到 45 例使用 PRP 治疗方案治疗 SS 的病例。然而,其中只有少数病例(16 例)接受了 PRP 治疗,用于治疗 SS 相关溃疡。所有病例的伤口大小和疼痛都得到了改善。综上所述,这些数据凸显了使用同源 PRP 治疗硬皮病溃疡的潜在益处,强调了其对缩小溃疡面积和缓解疼痛的积极影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Platelet-rich plasma for the treatment of scleroderma-associated ulcers: a single-center experience and literature review
Systemic sclerosis (SS) is a complex connective tissue disease characterized by vasculopathy and progressive fibrosis, primarily considered an autoimmune disorder. SS can affect multiple organs and tissues, including the skin, respiratory, gastrointestinal, genitourinary, cardiovascular, and musculoskeletal systems. Skin involvement is common, and SS-related ulcers, especially digital ulcers, occur in roughly 50% of patients. These ulcers not only cause pain but also significantly impact patients' quality of life, and in severe cases, they can lead to infection, gangrene, and amputation. The search for novel therapies for scleroderma-related ulcers remains an ongoing research area. Platelet-rich plasma (PRP) has been investigated as a potential treatment for difficult-to-heal ulcers, including diabetic, pressure, and vascular ulcers. In this study, we share our experience in treating scleroderma ulcers with PRP. Ten patients with confirmed SS and chronic skin ulcers lasting at least six weeks, which had not responded to conventional treatments, were selected for the study. Homologous PRP gel was prepared and applied once a week for up to eight weeks. The ulcers were documented photographically before and after PRP treatment, and pain levels were assessed using a visual analog scale (VAS). We also conducted a systematic review of the literature focusing on the use of PRP in the setting of SS. The results from our casuistry showed that the ten patients, including eight females and two males with a median age of 52.5 years, had ulcer sizes ranging from 0.78 cm2 to 28.26 cm2. The ulcers were located on fingers, legs, and heels, and they were associated with various forms of SS, including limited and diffuse cutaneous involvement. Raynaud's phenomenon was prevalent, and two patients exhibited organ involvement. The average ulcer size at the end of PRP treatment decreased significantly, with a 78% reduction in ulcered area. Pain levels also markedly improved, as indicated by a reduction in VAS scores. With regards to systematic revision of literature, we retrieved 45 cases of SS treated with PRP-based therapeutic regimes. However, only a minority of them (n=16) underwent PRP treatment for the treatment of SS-related ulcers. An improvement in wound size and pain has been documented in all cases. Taken together, these data highlight the potential benefits of using homologous PRP in the treatment of scleroderma ulcers, emphasizing its positive impact on ulcer size reduction and pain relief.
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来源期刊
Dermatology Reports
Dermatology Reports DERMATOLOGY-
CiteScore
1.40
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0.00%
发文量
74
审稿时长
10 weeks
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