Department of Dermatology, Cairo University School of Medicine, Kasr Al Ainy hospital, Al-Manial, Cairo, PO 11956, Egypt.
Arch Dermatol Res. 2018 May;310(4):375-381. doi: 10.1007/s00403-018-1824-x. Epub 2018 Mar 10.
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.
寻常型天疱疮（PV）的口腔糜烂是一个治疗挑战。在这项工作中，我们比较了皮质类固醇局部注射（ILS）和自体富血小板血浆（PRP）治疗 PV 口腔糜烂的效果。在这项随机双盲的分侧口腔研究中，11 例 PV 患者的一侧颊黏膜分别注射 10mg/ml 曲安奈德和 1 毫升自体 PRP，每 14 天注射一次，共 3 个月。在治疗前后记录临床改善百分比、天疱疮疾病面积指数和疼痛评分。在招募的 11 例患者中，只有 9 例完成了研究。9 例患者中有 7 例（78%）在 PDAI 和/或疼痛评分方面有所改善。接受皮质类固醇注射的侧口腔 PDAI 平均值从 2.3 降至 0.9。接受 PRP 注射的侧口腔 PDAI 平均值从 2.6 降至 1.0。在治疗 PV 口腔糜烂时，自体 PRP 与 ILS 在临床改善、PDAI 和疼痛评分方面没有显著差异。当 ILS 禁忌时，自体 PRP 可用于治疗耐药性 PV 口腔糜烂。
