[논문]Genital Lichen Sclerosus in Male Patients: A New Treatment with Polydeoxyribonucleotide

doi:10.1159/000443184

Genital Lichen Sclerosus in Male Patients: A New Treatment with Polydeoxyribonucleotide

Urologia internationalis, v.97 no.1, 2016년, pp.98 - 103

Zucchi, Alessandro , Cai, Tommaso , Cavallini, Giorgio , D'Achille, Giuseppe , Pastore, Antonio Luigi , Franco, Giorgio , Lepri, Luca , Costantini, Elisabetta

Abstract ▼ AI-Helper

Lichen sclerosus (LS) is an inflammatory and chronic disease that causes itching, pain, dysuria, urinary retention, dyspareunia and sexual dysfunction, in both men and women. The first line pharmacological treatment is based on the use of topical steroids, which have proved their efficacy in 60-70% of cases but with a high rate of relapses in time (50-80% of the patients of both sexes). The purpose of our non-randomised prospective pilot study was to evaluate the efficacy and tolerability of a new loco regional therapy with polydeoxyribonucleotides (PDRN) in the treatment of male genital LS. PDRN is an healing and anti-dystrophic drug with anti-inflammatory effects, through the reduction of cytokine. Twenty one male patients suffering from genital LS were recruited. All the patients were submitted to treatment using loco-regional intradermal injections with PDRN. Dermatology Life Quality Index (DLQI), International Index of Erectile Function (IIEF-5) and PGI-I questionnaires were administered at baseline and at the end of treatment in order to evaluate the results of this treatment. The statistical evaluation of the data obtained with the DLQI questionnaire showed a marked improvement of the overall conditions in terms of quality of life, with an average change of scores from 15 to 4 (p < 0.0001). PGI-I questionnaire showed that 80% of the patients treated considered their post-treatment conditions as ‘improved'. There was no significant change in terms of sexual function according to the IIEF questionnaire (p = 0.189). The results obtained show the excellent tolerability and the therapeutic efficacy of PDRN, with clear improvement of the local symptoms and of the quality of life.

주제어

참고문헌 (33)

1 Lipscombe TK, Wayte J, Wojnarowska F, et al: A study of clinical and aetiological factors and possible associations of lichen sclerosus in males. Australas J Dermatol 1997;38:132-136. 10.1111/j.1440-0960.1997.tb01129.x 9293659
2 Azurdia RM, Luzzi GA, Byren I, et al: Lichen sclerosus in adult men: a study of HLA associations and susceptibility to autoimmune disease. Br J Dermatol 1999;140:79-83. 10.1046/j.1365-2133.1999.02611.x 10215772
3 Meyrick Thomas RH, Ridley CM, McGibbon DH, et al: Lichen sclerosus et atrophicus and autoimmunity: a study of 350 women. Br J Dermatol 1988;118:41-46. 10.1111/j.1365-2133.1988.tb01748.x 3342175
4 Murphy R: Lichen sclerosus. Dermatol Clin 2010;28:707-715. 10.1016/j.det.2010.07.006 20883914
5 Cooper SM, Ali I, Baldo M, et al: The association of lichen sclerosus and erosive lichen planus of the vulva with autoimmune disease: a case-control study. Arch Dermatol 2008;144:1432-1435. 10.1001/archderm.144.11.1432 19015417
6 Birenbaum DL, Young RC: High prevalence of thyroid disease in patients with lichen sclerosus. J Reprod Med 2007;52:28-30. 17286064
7 Leese GP, Flynn RV, Jung RT, et al: Increasing prevalence and incidence of thyroid disease in Tayside, Scotland: the Thyroid Epidemiology Audit and Research Study (TEARS). Clin Endocrinol (Oxf) 2008;68:311-316. 10.1111/j.1365-2265.2007.03051.x 17970771
8 Powell J, Wojnarowska F, Winsey S, et al: Lichen sclerosus premenarche: autoimmunity and immunogenetics. Br J Dermatol 2000;142:481-484. 10.1046/j.1365-2133.2000.03360.x 10735954
9 Oyama N, Chan I, Neill SM, et al: Autoantibodies to extracellular matrix protein 1 in lichen sclerosus. Lancet 2003;362:118-123. 10.1016/S0140-6736(03)13863-9 12867112
10 Edmonds EV, Oyama N, Chan I, et al: Extracellular matrix protein 1 autoantibodies in male genital lichen sclerosus. Br J Dermatol 2011;165:218-219. 10.1111/j.1365-2133.2011.10326.x 21428972
11 Bunker CB: Male genital lichen sclerosus and tacrolimus. Br J Dermatol 2007;157:1079-1080. 10.1111/j.1365-2133.2007.08179.x 17854373
12 Bunker CB, Edmonds E, Hawkins D, et al: Re: Lichen sclerosus: review of the literature and current recommendations for management. J Urol 2007;178:2268-2276; J Urol 2009;181:1802-1803. 10.1016/j.juro.2007.08.024 17936829
13 Edmonds EV, Hunt S, Hawkins D, et al: Clinical parameters in male genital lichen sclerosus: a case series of 329 patients. J Eur Acad Dermatol Venereol 2012;26:730-737. 10.1111/j.1468-3083.2011.04155.x 21707769
14 Edmonds EV, Bunker CB: Nuclear magnetic resonance spectroscopy of urine in male genital lichen sclerosus. Br J Dermatol 2010;163:1355-1356. 10.1111/j.1365-2133.2010.09980.x 20716210
15 Eisendle K, Grabner T, Kutzner H, et al: Possible role of Borrelia burgdorferi sensu lato infection in lichen sclerosus. Arch Dermatol 2008;144:591-598. 10.1001/archderm.144.5.591 18490585
16 Friedrich EG Jr, Kalra PS: Serum levels of sex hormones in vulvar lichen sclerosus, and the effect of topical testosterone. N Engl J Med 1984;310:488-491. 10.1056/NEJM198402233100803 6537989
17 Clifton MM, Garner IB, Kohler S, et al: Immunohistochemical evaluation of androgen receptors in genital and extragenital lichen sclerosus: evidence for loss of androgen receptors in lesional epidermis. J Am Acad Dermatol 1999;41:43-46. 10.1016/S0190-9622(99)70404-4 10411409
18 Edmonds EV, Hunt S, Hawkins D, et al: Clinical parameters in male genital lichen sclerosus: a case series of 329 patients. J Eur Acad Dermatol Venereol 2012;26:730-737. 10.1111/j.1468-3083.2011.04155.x 21707769
19 Cooper SM, Gao XH, Powell JJ, et al: Does treatment of vulvar lichen sclerosus inﬂuence its prognosis? Arch Dermatol 2004;140:702-706. 10.1001/archderm.140.6.702 15210461
20 Renaud-Vilmer C, Cavelier-Balloy B, Porcher R, et al: Vulvar lichen sclerosus: effect of long-term topical application of a potent steroid on the course of the disease. Arch Dermatol 2004;140:709-712. 10.1001/archderm.140.6.709 15210462
21 Fistarol SK, Itin PH: Anti-inflammatory treatment. Curr Probl Dermatol 2011;40:58-70. 10.1159/000321051 21325840
22 Yesudian PD: The role of calcineurin inhibitors in the management of lichen sclerosus. Am J Clin Dermatol 2009;10:313-318. 10.2165/11310750-000000000-00000 19658443
23 Chi CC, Kirtschig G, Baldo M, Brackenbury F, Lewis F, Wojnarowska F: Topical interventions for genital lichen sclerosus. Cochrane Database Syst Rev 2011;12:CD008240. 10.1002/14651858.CD008240.pub2 22161424
24 Fistarol SK, Itin PH: Diagnosis and treatment of lichen sclerosus - an update. Am J Clin Dermatol 2013;14:27-47. 10.1007/s40257-012-0006-4 23329078
25 Basra MK, Fenech R, Gatt RM, Salek MS, Finlay AY: The Dermatology Life Quality Index 1994-2007: a comprehensive review of validation data and clinical results. Br J Dermatol 2008;159:997-1035. 10.1111/j.1365-2133.2008.08832.x 18795920
26 Viktrup L, Hayes RP, Wang P, et al: Construct validation of patient global impression of severity (PGI-S) and improvement (PGI-I) questionnaires in the treatment of men with lower urinary tract symptoms secondary to benign prostatic hyperplasia. BMC Urol 2012;12:30. 10.1186/1471-2490-12-30 23134716
27 Yalcin I, Bump RC: Validation of two global impression questionnaires for incontinence. Am J Obstet Gynecol 2003;189:98-101. 10.1067/mob.2003.379 12861145
28 Funaro D: Lichen sclerosus: a review and practical approach. Dermatol Ther 2004;17:28-37. 10.1111/j.1396-0296.2004.04004.x 14756888
29 Laino L, Suetti S, Sperduti I: Polydeoxyribonucleotide dermal infiltration in male genital lichen sclerosus: adjuvant effects during topical therapy. Dermatol Res Pract 2013;2013:654079. 10.1155/2013/654079 24489537
30 Guizzardi S, Galli C, Govoni P, Boratto R, Cattarini G, Martini D, Belletti S, Scandroglio R: Polydeoxyribonucleotide (PDRN) promotes human osteoblast proliferation: a new proposal for bone tissue repair. Life Sci 2003;73:1973-1983. 10.1016/S0024-3205(03)00547-2 12899922
31 Rubegni P, De Aloe G, Mazzatenta C, Cattarini L, Fimiani M: Clinical evaluation of the trophic effect of polydeoxyribonucleotide (PDRN) in patients undergoing skin explants. A pilot study. Curr Med Res Opin 2001;17:128-131. 10.1185/030079901317010793 11759182
32 Sini P, Denti A, Cattarini G, Daglio M, Tira Me, Balduini C: Effect of polydeoxyribonucleotides on human fibroblasts in primary culture. Cell Biochem Funct 1999;17:107-114. 10.1002/(SICI)1099-0844(199906)17:2<107::AID-CBF815>3.3.CO;2-R 10377956
33 Bitto A, Minatoli L, Polito F, Altavilla D, Cattarini G, Squadrito F: Polydeoxyribonucleotide improves angiogenesis and wound healing in experimental burn wounds. Purinergic Signal 2006;2:290-291.

내보내기 구분	파일저장 인쇄 메일전송
구성항목	기본정보 상세정보 관리번호, 논문명, 저널/프로시딩명, 저자 , 발행년, 권, 호, 시작페이지, 끝페이지, 발행기관 관리번호, 논문명, 대등논문명, 저자 , 저널/프로시딩명, 발행기관, 발행년, 발행언어, 권, 호, 시작페이지, 끝페이지, ISBN, ISSN, 주제분야, 키워드, 초록(한글), 초록(영문), 저자(소속기관)
저장형식	Text(ASCII format) Excel format RefWorks Direct Export RIS format (for Reference Manager, ProCite, EndNote), Scholar's Aids, Mendeley
메일정보	받는사람 (필수) @ 보내는사람 (선택) @ 제목 내용 KISTI 검색결과 이메일 서비스
안내	총 건의 자료가 검색되었습니다. 다운받으실 자료의 인덱스를 입력하세요. (1-10,000) 검색결과의 순서대로 최대 10,000건 까지 다운로드가 가능합니다. 데이타가 많을 경우 속도가 느려질 수 있습니다.(최대 2~3분 소요) 다운로드 파일은 UTF-8 형태로 저장됩니다. 파일의 내용이 제대로 보이지 않을실 때는 웹브라우저 상단의 보기 -> 인코딩 -> 자동선택 여부를 확인하십시오. ~ Text(ASCII format) Excel format

연합인증

Genital Lichen Sclerosus in Male Patients: A New Treatment with Polydeoxyribonucleotide

Abstract ▼ AI-Helper

주제어

참고문헌 (33)

이 논문을 인용한 문헌

관련 콘텐츠

원문 URL 링크

이 논문과 함께 이용한 콘텐츠

AI-Helper ※ AI-Helper는 오픈소스 모델을 사용합니다.

선택된 텍스트