Bunjaj Armando, Brandao Lucas, Siracuse Kelly, Soti Varun
Neurological Surgery, Lake Erie College of Osteopathic Medicine, Elmira, USA.
Internal Medicine, Lake Erie College of Osteopathic Medicine, Elmira, USA.
Cureus. 2023 Dec 11;15(12):e50356. doi: 10.7759/cureus.50356. eCollection 2023 Dec.
Psoriasis is a chronic and recurring condition characterized by scaly red plaques. The most common variant, plaque-type psoriasis, presents distinct clinical features. It profoundly impacts psychological and mental well-being, resulting in depression, anxiety, and suicidal thoughts. Psoriasis occurs due to disruptions in the skin's innate and adaptive immune response triggered by trauma, infection, or medications. Treatment options include topical therapies such as corticosteroids and vitamin D analogs, phototherapy, conventional systemic agents such as methotrexate (MTX), and biologics that target pro-inflammatory cytokines. There has been growing interest in platelet-rich plasma (PRP) as a potential treatment option for plaque psoriasis, given its lower toxicity compared to existing approaches. However, its use is not yet widespread in clinical practice due to the limited awareness of its effectiveness. This review aims to investigate the efficacy of PRP therapy for plaque psoriasis. To conduct a comprehensive analysis, we followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, thoroughly searching PubMed, Elton Bryson Stephens Company (EBSCO), and ClinicalTrials.gov between February and July 2023. Our focus was on patients diagnosed with plaque psoriasis, and we found multiple studies that demonstrated promising results of PRP either as monotherapy or in combination with current treatments such as MTX. The clinical evidence strongly supports the effectiveness of PRP in treating plaque psoriasis. PRP significantly improves dermatological symptoms and enhances patient and physician satisfaction. Research suggests that PRP reduces the expression of interleukin (IL) 17, a pro-inflammatory mediator, explaining its mechanism of action in treating plaque psoriasis. However, additional clinical trials with larger sample sizes, including PRP as a separate treatment group and comparisons with positive and control groups, are necessary to reinforce its efficacy in plaque psoriasis patients and elucidate other potential mechanisms underlying its beneficial effects.
银屑病是一种慢性复发性疾病，其特征为鳞屑性红色斑块。最常见的类型是斑块型银屑病，具有独特的临床特征。它对心理和精神健康有深远影响，可导致抑郁、焦虑和自杀念头。银屑病的发生是由于创伤、感染或药物引发皮肤固有免疫和适应性免疫反应紊乱所致。治疗选择包括外用疗法，如皮质类固醇和维生素D类似物、光疗、传统的全身用药，如甲氨蝶呤（MTX），以及针对促炎细胞因子的生物制剂。鉴于富血小板血浆（PRP）与现有方法相比毒性较低，它作为斑块型银屑病的一种潜在治疗选择，受到越来越多的关注。然而，由于对其有效性的认识有限，它在临床实践中的应用尚未广泛。本综述旨在研究PRP疗法治疗斑块型银屑病的疗效。为了进行全面分析，我们遵循系统评价和Meta分析的首选报告项目（PRISMA）指南，在2023年2月至7月期间全面检索了PubMed、艾尔顿·布赖森·斯蒂芬斯公司（EBSCO）和临床试验.gov。我们关注的是被诊断为斑块型银屑病的患者，发现多项研究表明PRP作为单一疗法或与MTX等现有治疗方法联合使用都有令人鼓舞的结果。临床证据有力地支持了PRP治疗斑块型银屑病的有效性。PRP能显著改善皮肤症状，提高患者和医生的满意度。研究表明，PRP可降低促炎介质白细胞介素（IL）-17的表达，这解释了其治疗斑块型银屑病的作用机制。然而，需要进行更多样本量更大的临床试验，将PRP作为一个单独的治疗组，并与阳性和对照组进行比较，以加强其在斑块型银屑病患者中的疗效，并阐明其有益效果背后的其他潜在机制。
