Rheumatology Unit, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria, Policlinico di Modena, Via del Pozzo 71, 41100 Modena, Italy.
Rheumatol Int. 2012 Sep;32(9):2929-32. doi: 10.1007/s00296-011-2038-0. Epub 2011 Jul 27.
Systemic sclerosis (SSc) is characterized by microvascular damage and fibrosis of the skin and internal organs. Non-healing skin ulcers, mainly non-venous leg ulcers, represent one of the most challenging complications. Platelet gel (PG) is a hemocomponent containing numerous growth factors, potentially useful for tissue reparation. This pilot open study aimed to evaluate the effect of PG in 12 SSc patients with skin ulcers resistant to conventional therapies from at least 6 months. PG was applied in the wound bed twice weekly for 2 weeks, then once a week for 12 weeks; in all cases, the ongoing treatments remained unchanged at the time of PG applications. Skin ulcers were evaluated at 0, 12 and 24 weeks; the patient's quality of life was also evaluated using the visual analogical scale (VAS) and the health assessment questionnaire (HAQ). During the 6-month follow-up, the skin ulcers consistently improved in 10/12 patients, with complete healing in 4. At the last evaluation, wound size reduced from 23.4 ± 14.9 SD to 2.3 ± 2.2 SD cm(2) (p < 0.0001). Patient's quality of life markedly improved: VAS decreased from 87.08 ± 13.5 to 57.9 ± 12.6; p < 0.0001 and HAQ from 0.73 ± 0.43 to 0.57 ± 0.22; p < 0.0001. PG may represent a novel therapeutic option for SSc skin ulcers refractory to conventional treatments.
系统性硬化症（SSc）的特征是微血管损伤和皮肤及内脏器官纤维化。非愈合性皮肤溃疡，主要是非静脉性腿部溃疡，是最具挑战性的并发症之一。血小板凝胶（PG）是一种含有多种生长因子的血液成分，可能对组织修复有用。这项开放性初步研究旨在评估 PG 在 12 例对至少 6 个月常规治疗无效的 SSc 皮肤溃疡患者中的疗效。PG 在创面床每周应用 2 次，持续 2 周，然后每周应用 1 次，共 12 周；在所有情况下，PG 应用时持续治疗均保持不变。皮肤溃疡在 0、12 和 24 周时进行评估；患者的生活质量也使用视觉模拟量表（VAS）和健康评估问卷（HAQ）进行评估。在 6 个月的随访中，12 例患者中有 10 例皮肤溃疡持续改善，其中 4 例完全愈合。在最后一次评估时，创面面积从 23.4 ± 14.9 SD 减少到 2.3 ± 2.2 SD cm(2)（p < 0.0001）。患者的生活质量明显改善：VAS 从 87.08 ± 13.5 降至 57.9 ± 12.6（p < 0.0001），HAQ 从 0.73 ± 0.43 降至 0.57 ± 0.22（p < 0.0001）。PG 可能是一种治疗常规治疗无效的 SSc 皮肤溃疡的新方法。
