Ferri C, Giuggioli D, Sebastiani M, Colaci M
Department of Internal Medicine, University of Modena e Reggio Emilia, Medical School, Modena, Italy.
Clin Exp Dermatol. 2007 May;32(3):287-90. doi: 10.1111/j.1365-2230.2007.02363.x.
Systemic sclerosis (SSc) is frequently complicated by skin ulcers, often unresponsive to traditional treatments. A preliminary evaluation of the effects of recombinant human erythropoietin (rHuEPO) was carried out in 14 patients with SSc with nonhealing, severe cutaneous ulcers. Patients received rHuEPO subcutaneously at a dosage of 150 IU/kg 3 times weekly for 2 weeks, twice weekly for the next 2 weeks, and then once weekly for 1 month. At follow-up 3-6 months from the beginning of the treatment, six patients showed complete resolution of the skin ulcers, while a significant reduction (> 60%) in lesional areas was obtained in the other eight patients (mean +/- SD ulcer area reduced from 27.6 +/- 28 to 5.3 +/- 7.8 cm(2); P<0.005). Moreover, patients' quality of life significantly improved (pain, as measured on visual analogue scale reduced from 96 +/- 5 to 46 +/- 17 points; P=0.0001; disability as measured by the Health Assessment Questionnaire-Disability Index reduced from 1.6 +/- 0.5 to 0.9 +/- 0.4 points; P=0.0001). The rHuEPO may represent a novel treatment of nonhealing scleroderma skin ulcers, suggesting some important aetiopathological implications.
系统性硬化症（SSc）常并发皮肤溃疡，且对传统治疗往往无反应。对14例患有不愈合严重皮肤溃疡的SSc患者进行了重组人促红细胞生成素（rHuEPO）疗效的初步评估。患者皮下注射rHuEPO，剂量为150 IU/kg，每周3次，共2周，接下来2周每周2次，然后每周1次，持续1个月。在治疗开始后3 - 6个月的随访中，6例患者的皮肤溃疡完全愈合，另外8例患者的皮损面积显著减少（> 60%）（平均±标准差溃疡面积从27.6±28减小至5.3±7.8 cm²；P<0.005）。此外，患者的生活质量显著改善（视觉模拟量表测量的疼痛从96±5分降至46±17分；P = 0.0001；健康评估问卷 - 残疾指数测量的残疾程度从1.6±0.5降至0.9±0.4分；P = 0.0001）。rHuEPO可能代表了一种治疗不愈合硬皮病皮肤溃疡的新方法，提示了一些重要的病因病理意义。
