820 Filling Injection of Platelet-rich Plasma Gel as A New Method to Treat En Coup de Sabre Scleroderma

Abstract

Platelet-rich Plasma (PRP) plays an important role on the tissue regeneration process. A new preparatioin method of PRP provides an filling injection product which was named Platelet-rich Plasma Gel (PRPG) and could provied synergic effects on skin elasticity, dermal remodeling and re-vascularization. The aim of this pilot study was to assess the clinical benefit of PRPG filling injection on the treatment of en coup de sabre scleroderma. Five patients who were diagnosed under the confirmation of histopathology, and assessed by ultrasonography. Treatment was administered with PRP at a concentration 3.5 times above baseline. And under sterile condition, pre-seperated PRP was aspirated into several needle tubes, gradually heated in a dry bath machine, and prepare PRPG under the terminal temperature of 70 centigrade for 14 minutes. Under swelling anesthesia, subcutaneous tissue gaps were formed. Then PRPG was safely filled in these gaps without the risk of injection into the blood vessels. Therefore, a kind of structure mimic subcutaneous soft tissue was performed to slowly release cell and growth factors which enhance the regeneration effects on the remodeling of dermal tissue and reconstruction of vascular network. The subjective symptoms of pain and tightness were significantly relieved after at least one time of injecton. And after completion of 3 cycles of treatments at monthly intervals, objective lesions showed the improvement of skin elatisity, dermal thickness, subcutaneous tissue thickness and subcutaneous vascular network density. Even hair growth can be observed in those atrophy scalp filed. The main limitations of this study were the low number of cases, lack of a comparison group and the difficulty of identifying the exact role of each factor which would be studied in next clinical trial. However, PRPG is a good alternative of tissue filler substitution instead of hyaluronic acid and collagen, and represents a new and potentially regenerative treatment option for en coup de sabre scleroderma with minimal associated side effects.