Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche, Sezione di Chirurgia Plastica e Ricostruttiva, Università di Palermo, Palermo, Italy.
Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro", Sezione di Reumatologia, University of Palermo, Palermo, Italy.
Arthritis Res Ther. 2019 Dec 13;21(1):286. doi: 10.1186/s13075-019-2062-0.
Systemic sclerosis is a systemic connective tissue disease characterized by endothelium damage, fibrosis, and subsequent atrophy of the skin. Perioral fibrosis produces a characteristic microstomia together with microcheilia, both of which cause severe difficulties and affects patients' daily life, such as eating and oral hygiene. Since there are no effective and specific therapies, we have aimed at evaluating the response to filler injections of hyaluronic acid together with platelet-rich plasma.
Ten female patients aged between 18 and 70 were included in this study. Each patient was treated with three filler injections of hyaluronic acid and platelet-rich plasma at an interval of 15 to 20 days. Follow-up check-ups were recorded 1, 3, and 24 months after the end of the treatment. During the therapy and the subsequent follow-up, we evaluated the mouth's opening, freedom of movement of the lips, and skin elasticity.
After the treatment, patients had achieved good results already after the first injection and the improvement was maintained in the following months, up to 2 years. In particular, 8 (80%) patients showed a greater mouth's opening and increased upper lip's thickness during 1-month follow-up and maintained these results after 2 years (maximum mouth's opening T0 47.61; T3 49.23; T4 48.60 p < 0.0001. Upper lip's thickness T0 4.20; T3 4.75; T4 4.45 p < 0.0001). Moreover, distance between upper and lower incisors (T0 27.05; T3 29.03; T4 28.14 p < 0.0001), inter-commissural distance (T0 49.12; T3 51.44; T4 50.31: p < 0.0001), and lower lip's thickness (T0 3.80; T3 4.85, 5.10; T4 4.25; p < 0.0001) were increased in all of patients in 1-month follow-up, keeping these benefits after 24 months and having a significant increase of skin elasticity 1 month after the end of therapy.
Our study demonstrates that filler injections of hyaluronic acid and platelet-rich plasma represent an efficient local therapeutic alternative for patients affected by scleroderma. The treatment has significantly improved patients' quality of living.
系统性硬化症是一种系统性结缔组织疾病，其特征为内皮损伤、纤维化和随后的皮肤萎缩。口周纤维化导致特征性小口畸形，同时伴有小口裂，这两者都会导致严重的困难，并影响患者的日常生活，如进食和口腔卫生。由于目前尚无有效的特异性治疗方法，我们旨在评估透明质酸联合富血小板血浆填充剂注射的反应。
本研究纳入了 10 名年龄在 18 至 70 岁之间的女性患者。每位患者均接受了三次透明质酸和富血小板血浆填充剂注射，间隔 15 至 20 天。在治疗结束后 1、3 和 24 个月进行随访检查。在治疗过程中和随后的随访中，我们评估了口腔张开度、嘴唇活动度和皮肤弹性。
治疗后，患者在第一次注射后即取得良好效果，并且在接下来的几个月中持续改善，可维持至 2 年。具体而言，8 名（80%）患者在 1 个月随访时表现出口腔张开度增加和上唇厚度增加，并在 2 年后保持这些结果（最大口腔张开度 T0 47.61；T3 49.23；T4 48.60，p<0.0001。上唇厚度 T0 4.20；T3 4.75；T4 4.45，p<0.0001）。此外，上、下切牙之间的距离（T0 27.05；T3 29.03；T4 28.14，p<0.0001）、口裂间距离（T0 49.12；T3 51.44；T4 50.31，p<0.0001）和下唇厚度（T0 3.80；T3 4.85，5.10；T4 4.25，p<0.0001）在所有患者的 1 个月随访中均增加，并在 24 个月后保持这些改善，并且在治疗结束后 1 个月皮肤弹性显著增加。
我们的研究表明，透明质酸联合富血小板血浆填充剂注射是一种有效的局部治疗选择，可用于治疗硬皮病患者。该治疗显著改善了患者的生活质量。
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