Ulcers in pretibial epidermolysis bullosa. Grafting with autologous meshed split-thickness skin and allogeneic cultured keratinocytes

Beele, H.

doi:10.1001/archderm.131.9.990

Cited by 8 publications

(11 citation statements)

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“…Furue found a decreased number of anchoring fibrils, which were qualitatively defective, in the normal‐appearing skin of the pretibial region. This fact may explain the therapeutic successes by skin grafting (4–6).…”

Section: Discussionmentioning

confidence: 94%

“…In the second step, a modified non‐adhesive negative pressure therapy using a non‐adhesive foil to avoid skin irritation, blistering or formation of new ulcers was used for wound bed preparation (3). After two cycles of negative pressure therapy, we grafted the ulcers with meshed split‐thickness grafts (4–6). During the regular follow‐up at our outpatient wound's clinic for 8 months, the patient showed progressive improvement and almost complete healing of the grafted ulcers.…”

Section: Case Presentationmentioning

confidence: 99%

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Chronic leg ulcers as a rare cause for the first diagnosis of epidermolysis bullosa dystrophica

Bafaraj¹,

Cesko²,

Weindorf³

et al. 2012

International Wound Journal

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Chronic leg ulcers occur most frequently in the elderly population as a result of an underlying vascular disease especially chronic venous insufficiency. But it also occurs less commonly in younger people due to other aetiologies, for example, infections, vasculitis, neoplasia or genetic diseases. The following case report presents chronic leg ulcers as a rare cause for the first diagnosis of dystrophic epidermolysis bullosa. We report about a 21-year-old man with painful chronic leg ulcers resistant to different wound treatments for 4 months. After exclusion of the more common vascular aetiologies and reviewing the patient's family history, we considered an epidermolysis bullosa dystrophica which could be confirmed by genetic analyses. We treated the patient with debridement, modified negative pressure therapy with non-adhesive foil and skin grafting. The chronic leg ulcers healed completely. This case report demonstrates that the family history and genetic diseases should be considered as rare causes for therapy-refractory chronic leg ulcers, especially in young patients.

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Section: Discussionmentioning

confidence: 94%

Section: Case Presentationmentioning

confidence: 99%

Chronic leg ulcers as a rare cause for the first diagnosis of epidermolysis bullosa dystrophica

Bafaraj¹,

Cesko²,

Weindorf³

et al. 2012

International Wound Journal

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“…Grafting also had a moderate analgesic effect (3). Dystrophic epidermolysis bullosa has been treated with autologous meshed split‐thickness skin and allogeneic cultured keratinocytes with success (4, 5). In an open uncontrolled study 15 patients with epidermolysis bullosa were treated with tissue‐engineered skin.…”

Section: Discussionmentioning

confidence: 99%

Recessive Epidermolysis Bullosa Dystrophicans (Hallopeau‐Siemens)—Improvement of Wound Healing by Autologous Epidermal Grafts on an Esterified Hyaluronic Acid Membrane

Wollina

Konrad

Fischer

2001

The Journal of Dermatology

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Epidermolysis bullosa dystropicans of the Hallopeau-Siemens type (HS-EBD) is an autosomal-recessive blistering disease. Skin fragility due to mutations in structural proteins is responsible for further development of chronic and painful wounds, skin infections and sepsis. There is no causative treatment available. We present a case report with HS-EBD and longstanding painful wounds treated with autologous keratinocytes on an esterified hyaluronic acid membrane. Two out of three wounds treated showed a complete take of the graft. They improved markedly with a stable result over 12 months until now. Even autologous keratinocyte grafting may have a beneficial effect on chronic wounds in HS-EBD despite the fact that the genetic defects are unchanged.

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“…Academic researchers eventually agreed that allogeneic cells are likely to function by providing growth factors, not by engraftment [71,72]. There has been no identification of which growth factors are critical, only general statements that "various growth factors" [73] or "large numbers of growth factors" [74] might explain the beneficial effects.…”

Section: Allogeneic Cell Approachesmentioning

confidence: 99%

Human cell therapy for venous leg ulcers

Slade¹,

Jacobson²,

Lu³

2015

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Non-healing, chronic venous leg ulcers are sometimes mistakenly described as acute wounds that progress from hemostasis to inflammation but then become stuck in the inflammatory phase of healing. Typical explanations for this include colonization by bacteria, tissue infection, or the formation of bacterial biofilms. When standard care with debridement and compression bandaging fails to promote healing, therapeutic approaches shift to more aggressive surgical debridement, antimicrobial therapy, and the use of biological dressings or autologous grafts. A pathophysiologic view of persistent venous hypertension reveals the primary role of dermal inflammation, leading eventually to skin ulceration in a manner distinctly different from an acute wound. Subsequent to ulceration, additional inflammatory responses to invading pathogens can become important, but the underlying inflammatory state must be controlled before healing can take place, even with the use of skin grafts or cultured autologous skin cells. The prior belief that allogeneic keratinocytes and fibroblasts could engraft has given way to a more sophisticated consideration of the immunologic interplay between inflamed tissue and applied cells. This review briefly summarizes the history of cell therapy for venous leg ulcers, with a focus on concepts that have been tested in clinical trials, and a consideration of future development approaches.

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Ulcers in pretibial epidermolysis bullosa. Grafting with autologous meshed split-thickness skin and allogeneic cultured keratinocytes

Cited by 8 publications

References 0 publications

Chronic leg ulcers as a rare cause for the first diagnosis of epidermolysis bullosa dystrophica

Chronic leg ulcers as a rare cause for the first diagnosis of epidermolysis bullosa dystrophica

Recessive Epidermolysis Bullosa Dystrophicans (Hallopeau‐Siemens)—Improvement of Wound Healing by Autologous Epidermal Grafts on an Esterified Hyaluronic Acid Membrane

Human cell therapy for venous leg ulcers

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