| 287 |
Case Study
|
The use of bilayered cell therapy* in the treatment of a hand mitten deformity in recessive scarring epidermolysis bullosa Thomas Serena, MD, FACS, Mary Beth Cermak, MD, Michele Kaufman, JD, PA-C Background: The recessive scarring form of epidermolysis bullosa (EB) can lead to disabling hand deformities with loss of function. Treatment consists of frequent hand surgeries to separate the fingers. Apligraf, a bi-layered cell therapy*, has been shown to be effective in several case studies in patients with various forms of epidemolysis bullosa. There is also evidence that the Apligraf persists in EB patients, which may account for its success in this population Case Study: An 8-year-old female with the recessive scarring form of EB developed a mitten deformity of the right hand. She had undergone numerous procedures to separate the digits of her fingers. In fact, she required finger separation every six months in order to maintain hand function. Dermagraft had been employed in the past to prevent repeat scarring without success. After surgical division of the scars we applied bi-layered cell therapy in the web spaces of the fingers of the right hand. At 3 months she continued to have a functional hand particularly in the first web space. There was a small amount of recurrent scarring in the other web spaces which has not required surgical intervention Conclusion: Bi-layered cell therapy can be an important adjunct in the treatment of scarring forms of EB. In this case it was successfully employed to maintain hand function *Apligraf¨, Organogenesis, Canton, MA Falabella A, Valencia I, Eaglstein W, Schachner L. Tissue-Engineered Skin (Apligraf) in the Healing of Patients With Epidermolysis Bullosa Wounds. Arch Dermatol. 2000;136:1225Ð1230. Fivenson DP, Scherschun L, Choucair M, Kukuruga D, Young J, Shwayder T.Graftskin therapy in epidermolysis bullosa. J Am Acad Dermatol. 2003;48(6):886Ð892 Griffiths M, et al. Tissue Eng. 2004;10(7Ð8):1180Ð1195. |
|