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Autologous platelet-rich plasma and triamcinolone acetonide intralesional injection in the treatment of oral erosions of pemphigus vulgaris: a pilot study

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Abstract

Oral erosions of pemphigus vulgaris (PV) represent a therapeutic challenge. In this work we compared intralesional injection of steroids (ILS) and autologous platelet-rich plasma (PRP) treatment of oral erosions of PV. In this split–mouth randomized double blind study, one side of the buccal mucosa of 11 PV patients was injected with 10 mg/ml triamcinolone and the opposite side was injected with 1 millilitre of autologous PRP every 14 days for 3 months. The percentage of clinical improvement, pemphigus disease area index and pain score were recorded before and after therapy. Out of 11 recruited patients, only 9 completed the study. Seven out of the nine patients (78%) showed improvement in PDAI and/or pain score. The mean oral PDAI of the steroid injected sides decreased from 2.3 to 0.9. The mean oral PDAI of the PRP injected sides decreased from 2.6 to 1.0. No significant difference was detected in clinical improvement, PDAI and pain score between autologous PRP and ILS in the treatment of oral erosions of PV. Autologous PRP can be used for the treatment of resistant oral erosions of PV when ILS is contraindicated.

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References

  1. Albanese A, Licata ME, Polizzi B, Campisi G (2013) Platelet-rich plasma (PRP) in dental and oral surgery: from the wound healing to bone regeneration. Immun Ageing 10(1):23

    Article  PubMed Central  PubMed  Google Scholar 

  2. Bhanot S, Alex JC (2002) Current applications of platelet gels in facial plastic surgery. Facial Plast Surg 18(1):27–33

    Article  PubMed  Google Scholar 

  3. Bystryn JC, Rudolph JL (2005) Pemphigus Lancet 366(9479):61–73

    Article  PubMed  Google Scholar 

  4. Dougherty EJ (2008) An evidence-based model comparing the cost-effectiveness of platelet-rich plasma gel to alternative therapies for patients with nonhealing diabetic foot ulcers. Adv Skin Wound Care 21(12):568–575

    Article  PubMed  Google Scholar 

  5. El-Komy MH, Hassan AS, Raheem HM, Doss SS, El-Kaliouby M, Saleh NA et al (2015) Platelet-rich plasma for resistant oral erosions of pemphigus vulgaris: a pilot study. Wound Repair Regen 23(6):953–955

    Article  PubMed  Google Scholar 

  6. Firooz A, Tehranchi-Nia Z, Ahmed AR (1995) Benefits and risks of intralesional corticosteroid injection in the treatment of dermatological diseases. Clin Exp Dermatol 20(5):363–370

    Article  CAS  PubMed  Google Scholar 

  7. Fleming P, Drazek L, Shaw JC (2014) Hyperglycemia following intralesional corticosteroid injection in a patient with type I diabetes mellitus. J Cutan Med Surg 18(4):275–276

    Article  PubMed  Google Scholar 

  8. Fortuna G, Mignogna MD (2011) Clinical guidelines for the use of adjuvant triamcinolone acetonide injections in oro-pharyngeal pemphigus vulgaris: the oral medicine point of view. J Oral Pathol Med 40(4):359–360

    Article  PubMed  Google Scholar 

  9. Glatt HJ, Putterman AM, Van Aalst JJ, Levine MR (1991) Adrenal suppression and growth retardation after injection of periocular capillary hemangioma with corticosteroids. Ophthalmic Surg 22(2):95–97

    CAS  PubMed  Google Scholar 

  10. Gharote HP, Nair PP, Kasetty S, Thomas S, Kulkarni A (2012) Pemphigus vulgaris—a report of three cases. BMJ Case Rep 2012

  11. Laing ME, Fallis B, Murphy GM (2007) Anaphylactic reaction to intralesional corticosteroid injection. Contact Dermatitis 57(2):132–133

    Article  CAS  PubMed  Google Scholar 

  12. Martinez-Zapata MJ, Marti-Carvajal AJ, Sola I, Exposito JA, Bolibar I, Rodriguez L et al (2016) Autologous platelet-rich plasma for treating chronic wounds. Cochrane Database Syst Rev 25(5):CD006899

    Google Scholar 

  13. Marx RE (2001) Platelet-rich plasma (PRP): what is PRP and what is not PRP? Implant Dent 10(4):225–228

    Article  CAS  PubMed  Google Scholar 

  14. Meschi N, Castro AB, Vandamme K, Quirynen M, Lambrechts P (2016) The impact of autologous platelet concentrates on endodontic healing: a systematic review. Platelets 27(7):613–633

    Article  CAS  PubMed  Google Scholar 

  15. Mignogna MD, Fortuna G, Leuci S, Adamo D, Dell’Aversana Orabona G, Ruoppo E (2010) Adjuvant triamcinolone acetonide injections in oro-pharyngeal pemphigus vulgaris. J Eur Acad Dermatol Venereol 24(10):1157–1165

    Article  CAS  PubMed  Google Scholar 

  16. Reddy PD, Zelicof SB, Ruotolo C, Holder J (1995) Interdigital neuroma. Local cutaneous changes after corticosteroid injection. Clin Orthop Relat Res 317:185–187

    Google Scholar 

  17. Robinson JC, Lozada-Nur F, Frieden I (1997) Oral pemphigus vulgaris: a review of the literature and a report on the management of 12 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 84(4):349–355

    Article  CAS  PubMed  Google Scholar 

  18. Rosenbach M, Murrell DF, Bystryn JC, Dulay S, Dick S, Fakharzadeh S et al (2009) Reliability and convergent validity of two outcome instruments for pemphigus. J Invest Dermatol 129(10):2404–2410

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  19. Saleh MA, Hashimoto R, Kase Y, Amagai M, Yamagami J (2015) Low pathogenicity of anti-desmoglein 3 immunoglobulin G autoantibodies contributes to the atypical clinical phenotypes in pemphigus. J Dermatol 42(7):685–689

    Article  CAS  PubMed  Google Scholar 

  20. Vinay K, Kanwar AJ, Mittal A, Dogra S, Minz RW, Hashimoto T (2015) Intralesional rituximab in the treatment of refractory oral pemphigus vulgaris. JAMA Dermatol 151(8):878–882

    Article  PubMed  Google Scholar 

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Correspondence to Marwah Adly Saleh.

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EL-Komy, M.H.M., Saleh, N.A. & Saleh, M.A. Autologous platelet-rich plasma and triamcinolone acetonide intralesional injection in the treatment of oral erosions of pemphigus vulgaris: a pilot study. Arch Dermatol Res 310, 375–381 (2018). https://doi.org/10.1007/s00403-018-1824-x

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  • DOI: https://doi.org/10.1007/s00403-018-1824-x

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