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Platelet- rich plasma (PRP) in Dermatologic disease

Dr Anahita Vali ,Dermatologist &Venereologist



Platelet-rich plasma (PRP) is blood plasma that has been enriched with platelets. As a concentrated source of autologous platelets, PRP contains (and releases through degranulation) several different growth factors and other cytokines that stimulate healing of bone and soft tissue, naturally without subjecting the patient to any significant risk The platelets are activated by the addition of thrombin and calcium chloride, which induces the release of the mentioned factors from alpha granules. In humans, the typical baseline blood platelet count is approximately 200,000 per µL; therapeutic PRP concentrates the platelets by roughly five-fold .The growth factors and other cytokines present in PRP include: (platelet-derived growth factor,transforming growth factor beta,fibroblast growth factor,,insulin-like growth factor 1,insulin-like growth factor 2,vascular endothelial growth factor,epidermal growth factor,Interleukin 8,keratinocyte growth factor)

In humans, PRP has been used as a medical treatment  for nerve injury,tendinitis, osteoarthritis, sports injuries in professional athletes, cardiac muscle injury, bone repair and regeneration, plastic surgery,and oral surgery &dermatology.The aim of this study is a review on the indications of PRP in dermatology.

Method: a literature search  of pubmed, google scholar and medscape was conducted of all English language articles published from  1930- 2015 and personal experiences of physicians. Available data are largely based on case series.

 Result: PRP is “a promising, but not proven, treatment option for joint, tendon, ligament, and muscle injuries”. Negative clinical results are associated with poor quality PRP produced by inadequate single spin devices. The fact that most gathering devices capture a percentage of a given thrombocyte count is a bias, since there is significant inter-individual variability in the platelet concentration of human plasma. More is not necessarily better in this case. The variability in platelet concentrating techniques may alter platelet degranulation characteristics that could affect clinical outcomes.Sufficient concentrates and release of these growth factors through autologous platelet gels may be capable of expediting wound healing . What is the evidence to support PRP use in wound healing? studies have demonstrated:

healing of post-traumatic and vascular wounds, diabetic and chronic ulcers with a combination of PRP and autologous fat supported by a 3-dimensional matrix of hyaluronic acid

cosmetic improvement of scars with fat grafts mixed with PRP, followed by skin resurfacing with nonablative laser

healing of open and chronic wounds of the heel and ankle with a combination of PRP and hyaluronic acid

healing of dehiscent infected sternal wounds with local application of PRP.

Case studies have also shown that for patients who may have moderate wrinkling due to exposure to sunlight and/or simply due to age can benefit from PRP treatment.

Results show that when PRP is applied by superficial or deep dermal injection, skin texture, tone and firmness can improve within 3 weeks with ongoing improvements over the next few months. Areas commonly treated using the PRP for rejuvenation include cheeks, around the eyes, jawline, back of hands, neck, knees, elbows, upper arms and post-pregnancy stretch marks. PRP used successfully in treatment of therapy in patients with facial ageing and alopecia (androgenetic and areata)..

Conclusion: PRP is a method of cellular stimulation by the mediators released from platelets. PRP  used in different fields of medicine for tissues repair and regeneration e.g. in dermatology as a safe and promising method in treatment of alopecia , chronic  ulcers,aging , dark cicles around eyes,…

Key words: PRP,alopecia,chronic ulcers, dermatology, aging

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