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Polydeoxyribonucleotide Dermal Infiltration in Male Genital Lichen Sclerosus: Adjuvant Effects during Topical Therapy

DOI: 10.1155/2013/654079

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Abstract:

Background. Lichen sclerosus (LS) is an autoimmune inflammatory skin disease that leads to tissue sclerosis. Actually, the first-line treatment consists of local steroid as clobetasol propionate (CP). Polydeoxyribonucleotide (PDRN) has demonstrated anti-inflammatory effects through the reduction of cytokine production and growth stimulation of fibroblast. Objective. To evaluate the efficacy of intradermal administration of PDRN in male patients suffering from genital lichen sclerosus in addition to topical 0.05% CP, as compared to administering 0.05% CP without PDRN injection. Patients/Methods. A group of male patients ( = 28; aged 25 to 65) suffering from LS were observed during topical therapy or subdermal in addition to topical therapy. Disease activity at baseline was evaluated on Investigator’s Global Assessment (IGA) and the Dermatology Life Quality Index (DLQI). We used polydeoxyribonucleotide in a commercial preparation for human use and a topical CP emulsion. Results. After therapy, in all group A patients there has been a regression of most of clinical pathological signs, while there has been a moderate improvement in all group B patients. Conclusions. On site intradermal administration of PDRN, associated with CP 0.05% cream, seemed to be associated with a clinical improvement of lichen sclerosus better than CP used in single therapy. 1. Introduction Several researchers have shed new light on the importance of the action of extracellular nucleotides and nucleosides in increasing cell proliferation and reducing inflammation. PDRN, an A2A adenosine receptor, acts as mitogen for fibroblasts, endothelial cells, and preadipocytes [1, 2] working with different growth factors (VEGF, PGF, and FGF). PDRN is used in plastic and dermatologic surgery, and recently in urology, for its regenerative properties, restorative effects in ischemic skin flaps [3], and being used to improve intratesticular vascularisation [4]. Recently, the effects of PDRN have been analysed in a number of tissues, such as corneal epithelium [5], human bone [6], and skin [3]. PDRN is involved in protective and regenerative effects on UV-irradiated mouse cell cultures [7] and UV-irradiated dermal fibroblast [8]. PDRN has shown proliferation effects in human preadipocytes, which represent the richest reservoir of human adult stem cells [9]. In the light of these preliminary results, and because of these specific properties, we decided to perform the clinical observation, before and after therapy, of a local subdermal administration of PDRN in lichen sclerosus genital lesions,

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