Effectiveness of Topical Application of Heterologous Platelet Rich Plasma (PRP) in Oral Mucous Membrane Pemphigoid. A Report of a Case †
by
, ,
Andrea Gabusi
1,*
,
Camilla Loi
2,
Davide Bartolomeo Gissi
1,
Andrea Spinelli
1,
Antonio Bernardi
1 and
Marina Buzzi
3 1
Department of Biomedical and Neuromotor Sciences, Section of Oral Sciences, University of Bologna,
40125 Bologna, Italy
2
Department of Experimental, Diagnostic and Specialty Medicine – DIMES, Section of Dermatology,
University of Bologna, 40138 Bologna, Italy
3
Department of Experimental, Diagnostic and Specialty Medicine – DIMES, Univeristy of Bologna, Cord
Blood Bank and Cardiovascular Tissue Bank at Transfusion Medicine of S. Orsola- Malpighi Hospital;
40138 Bologna, Italy
*
Author to whom correspondence should be addressed.
†
Presented at the XV National and III International Congress of the Italian Society of Oral Pathology and
Medicine (SIPMO), Bari, Italy, 17–19 October 2019.
Proceedings 2019, 35(1), 57; https://doi.org/10.3390/proceedings2019035057
Published: 12 December 2019
(This article belongs to the Proceedings of The XV National and III International Congress of the Italian Society of Oral Pathology and Medicine)
1. Introduction
Mucous membrane pemphigoid (MMP) is a rare, predominantly mucosal subepithelial blistering disorder triggered by autoantibody reactivity to several basement membrane antigens including BP180, BP230, laminin 332, and type VII collagen. Disease control is usually achieved with steroids and mycophenolate mofetil, azathioprine, or dapsone. However, long term use of steroids is well known to expose the patient to the risk of moderate to severe side effects.[1] For this reason, the use of alternative therapies or corticosteroid sparing agents to control disease is highly attractive[1,2]. In the present paper we describe the management of a case of mucous membrane pemphigoid treated with topical application of heterologous PRP.
2. Case Report
A 35 years old female patient affected by oral MMP and non-respondent to initial treatment with local corticosteroids was selected for heterologous PRP- based compassionate treatment with the intention to avoid systemic steroid and immunosuppressant administration. The Pemphigus Disease Area Index (PDAI) was used to assess clinical disease activity before and after treatment. Pain level changes were assessed through VAS scale from 0 to 10. Periodontal plaque index(FMPS) and bleeding on probing(FMBS) indexes were also collected to assess any improvements in periodontal situation before and after treatment. Patient underwent 7 topical applications of heterologous PRP and endpoint for clinical evaluation was set, approximately 1 month following the last session. No clinical side effects were recorded. PDAI values improved from 10 to 3. VAS score, which was reported to be 6/10 at the beginning of treatment (main complaint included the impossibility to eat crispy or hard food due to pain exacerbation and gingival bleeding) dropped to 2/10 at re-examination. Before treatment, levels of FMBS scored 30% but decreased to 9% at the end of PRP. Similarly, FMPS levels scored 26% at the beginning of treatment and dropped to 6% at the end of treatment.
3. Conclusions
Within the limits of a case report, topical applications of heterologous PRP seems to be a safe procedure for the management of patients with oral mucous membrane pemphigoid. In our case, regenerative and immunomodulatory properties of PRP achieved not only a significant improvement in both signs and symptoms of diseases but also a better control of periodontal inflammation. PRP topical application is an attractive therapeutic option to be studied at larger scale as adjunctive steroid sparing treatment for MMP.
References
- Hussein, M.; Hassan, A.S.; Abdel Raheem, H.M.; Doss, S.S.; EL-Kaliouby, M.; Saleh, N.A.; Saleh, M.A. Platelet-rich plasma for resistant oral erosions of pemphigus vulgaris: A pilot study. Wound Repair Regen. 2015, 23, 953–955. [Google Scholar] [CrossRef]
- Mays, J.W.; Carey, B.P.; Posey, R.; Gueiros, L.A.; France, K.; Setterfield, J.; Woo, S.B.; Sollecito, T.P.; Culton, D.; Payne, A.S.; et al. World Workshop of Oral Medicine VII: A systematic review of immunobiologic therapy for oral manifestations of pemphigoid and pemphigus. Oral Dis. 2019, 25 (Suppl. 1), 111–121. [Google Scholar] [CrossRef] [PubMed]
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
MDPI and ACS Style
Gabusi, A.; Loi, C.; Gissi, D.B.; Spinelli, A.; Bernardi, A.; Buzzi, M. Effectiveness of Topical Application of Heterologous Platelet Rich Plasma (PRP) in Oral Mucous Membrane Pemphigoid. A Report of a Case. Proceedings 2019, 35, 57. https://doi.org/10.3390/proceedings2019035057
AMA Style
Gabusi A, Loi C, Gissi DB, Spinelli A, Bernardi A, Buzzi M. Effectiveness of Topical Application of Heterologous Platelet Rich Plasma (PRP) in Oral Mucous Membrane Pemphigoid. A Report of a Case. Proceedings. 2019; 35(1):57. https://doi.org/10.3390/proceedings2019035057
Chicago/Turabian StyleGabusi, Andrea, Camilla Loi, Davide Bartolomeo Gissi, Andrea Spinelli, Antonio Bernardi, and Marina Buzzi. 2019. "Effectiveness of Topical Application of Heterologous Platelet Rich Plasma (PRP) in Oral Mucous Membrane Pemphigoid. A Report of a Case" Proceedings 35, no. 1: 57. https://doi.org/10.3390/proceedings2019035057
