Topical proline therapy in prolidase deficiency

Abstract

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Clinical Genetics of Prolidase Deficiency: An Updated Review

“…There were no obvious triggering factors, apart from a trauma described in three patients [16,34,35]. The ulcers may also arise on a previously weakened skin by pruritic or eczematous lesions [8,16,42,44]. Examination of the blood vessels by angiography of the lower extremities in one patient did not show occlusion [8]; venous Doppler examination was reported as normal in another patient [44].…”

“…Recurrent infections, namely respiratory infections, pneumonia or upper respiratory tract infections [47], are present in 76% (37/49) of patients (Figure 1a). [4,8,10,12,17,21,22,28,31,32,35,38,44,45]. In a retrospective study performed on 21 patients in Israel by Nir et al, 57% of patients, with ages ranging from 10 to 33 years, had a history of recurrent pulmonary infections, and 47% had a diagnosis of chronic lung disease.…”

Topical tacrolimus therapy in the management of lower extremity ulcers due to prolidase deficiency

“…The ulcers are resistant to treatment and do not respond to standard ulcer treatments (eg, wound dressings) . Topical treatment with 5% proline in ointment has shown some potential to be effective, especially in combination with 5% glycine . Hyperbaric oxygen therapy has also been used with marginal success in decreasing ulcer extension …”

Refractory leg ulcers in prolidase deficiency with antiphospholipid antibody positivity responding to aspirin‐hydroxychloroquine‐vitamin C combination therapy

“…These include topical proline, proline and glycine, diphenylhydantoin, tacrolimus, oral ascorbic acid, manganese, dapsone, steroids, combined oral‐topical growth hormone therapy, erythrocyte suspension, hyperbaric oxygen therapy, and therapeutic apheresis. Oral proline therapy has not been successful 4,5 …”

“…Refractory leg ulcers in prolidase deficiency with antiphospholipid antibody positivity responding to aspirinhydroxychloroquine-vitamin C combination therapy Oral proline therapy has not been successful. 4,5 A patient of PD with Crohn's disease having vasculopathic cutaneous ulcers was successfully managed with low-molecular-weight heparin. 6 In another report of PD with associated SLE, an induction therapy with rituximab followed by immunosuppressants led to the control of lupus nephritis and skin ulcers.…”