Efficacy of superoxide dismutase in local treatment of epidermolysis bullosa

Abstract

Epidermolysis bullosa (EB) is a group of genetically and clinically heterogeneous diseases characterized by the formation of blisters and erosions on the skin and mucous membranes as a result of slight friction or trauma. Numerous extra­dermal manifestations, such as blisters and corneal and mucous erosions, enamel hypoplasia, stenoses or strictures of the respiratory, gastrointestinal and urogenital systems, pylorus atresia, muscular dystrophy and cancer can accompany various EB subtypes. The detection rate of epidermolysis bullosa in the world is 17 cases per million live newborns. The latest EB classification, approved in 2008, includes four forms of EB, depending on the level of skin/epidermis lesion. These include: simple BE, border BE, dystrophic BE and Kindler syndrome. Objective — to study the effectiveness of the enzyme superoxide dismutase as a cream in case of local treatment of skin lesions in EB.Materials and methods. On the basis of a retrospective analysis of specific literature data and the results of our own research, the effectiveness of superoxide dismutase in its local use in epidermolysis bullosa was analyzed.Results and discussion. Under our supervision there was 3 year old girl with dystrophic epidermolysis bullosa that was diagnosed after birth. The diagnosis of dystrophic epidermolysis bullosa was confirmed by the results of a biopsy. With the consent of the parents, six different areas of the skin of this patient were treated twice a day with a cream of superoxide dismutase (SOD). The term of the corresponding treatment was 3 months. Superoxide dismutase was applied to the following areas: right knee, left thigh, right hand, left ear, right ear, buttocks. Treatment was good tolerated. Significant clinical improvement was observed as soon as the second week of treatment. In two of the six affected areas, which before were considered as chronic, complete wound healing was observed. New blisters did not appear. Significant improvement of skin condition and epithelization of skin lesions in the dystrophic form of epidermolysis bullosa were observed already after a 2­week course of topical application of SOD. After 3 months, in most areas where superoxide dismutase was used, complete healing was observed. Conclusions. Our studies confirm that superoxide dismutase can be used to improve the condition of wounds in patients with epidermolysis bullosa.