Use of Neem oil and <i>Hypericum perforatum</i> for treatment of calcinosis-related skin ulcers in systemic sclerosis

Giuggioli, Dilia; Lumetti, Federica; Spinella, Amelia; Cocchiara, Emanuele; Sighinolfi, Gianluca; Citriniti, Giorgia; Colaci, Michele; Salvarani, Carlo; Ferri, Clodoveo

doi:10.1177/0300060519882176

Cited by 21 publications

(16 citation statements)

References 32 publications

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“…A significant improvement (reduction of lesion size, erythema, fibrin and calcium deposits) was observed for the remaining lesions, and no lesions relapsed during the follow-up period. (79) Anti-inflammatories. Since the pathophysiology of adult and juvenile myositis is the presence of chronic inflammation, prognosis has significantly improved over the last decades with the use of corticosteroids as first line treatment.…”

Section: Pharmacologic Therapies For Calcinosismentioning

confidence: 99%

Management of Calcinosis Cutis in Rheumatic Diseases

Elahmar

Feldman

2022

J Rheumatol

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Calcinosis (hydroxyapatite and calcium phosphate crystal deposition) within the extracellular matrix of the dermis and subcutaneous tissue is a frequent manifestation of adult and pediatric systemic autoimmune rheumatic diseases, specifically systemic sclerosis, dermatomyositis, mixed connective tissue disease and systemic lupus erythematosus. In this article, we review classification of calcinosis, highlight mechanisms that may contribute to the pathogenesis of calcinosis and summarize the evidence evaluating non-pharmacologic and pharmacologic interventions for the treatment of calcinosis.

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Section: Pharmacologic Therapies For Calcinosismentioning

confidence: 99%

Management of Calcinosis Cutis in Rheumatic Diseases

Elahmar

Feldman

2022

J Rheumatol

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“…Although different systemic or topical treatments have been proposed for the treatment of calcinosis, 23‐27 in our experience the use of a standard protocol of mechanical debridement with a scalpel, aimed at removing the calcium deposits was able to treat all the DUs with SC, although we observed a longer healing time in this group of patients 12 . This longer time may be linked to the difficult removal of the calcium deposit, which is painful for the patients, even if topical anaesthetics are applied.…”

Section: Discussionmentioning

confidence: 68%

The impact of skin calcinosis on digital ulcers in patients with SSc: clinical and prognostic stratification using the “wound bed score”

Barsotti

Vicennati

Battista

et al. 2020

International Wound Journal

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Digital ulcers (DUs) represent one of the major burdens for patients with systemic sclerosis (SSc), especially when associated with skin calcinosis (SC). The aim of this work is to evaluate the impact of SC in DUs of patients with SSc for clinical characteristics and prognosis assessed by the wound bed score (WBS). We prospectively enrolled 55 patients with DUs and SSc followed in our dedicated wound care clinic. For all the patients we collected clinical and anthropometric data and characteristics of the DU, and we calculated the WBS for each DU. Ninety‐nine DUs were evaluated (24 with SC). SC was prevalent in limited cutaneous SSc (75%) and in patients with longer disease duration (P = 0.02). SC‐DUs were prevalent at the fingertip (P = 0.04). The healing time was significantly higher in patients with SC (10.4 ± 7.9 weeks) compared with non‐SC (7.0 ± 5.7 weeks) P = 0.03. The WBS negatively correlated with the time to achieve complete healing (r = −0.237 P = 0.023) and the correlation was maintained in the non‐SC (r = −0.46, P = 0.033). DUs in SSc patients with SC are common and difficult to heal. When DUs are treated in dedicated centres, the prognosis is good. The WBS is fast and easy and maybe commonly applied in clinical practice.

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“…Frequently, SSc-SU become infected and resist standard treatments. Based on our experience, we have developed a holistic approach to SU treatment, from a global patient assessment to local and systemic SU treatment and innovative regenerative therapy [ 12 – 15 ]. Nevertheless, a significant percentage of scleroderma skin ulcers still represent a challenging clinical problem.…”

Section: Discussionmentioning

confidence: 99%

“…Standard systemic and local approaches may support wound healing [ 9 – 11 ]. In our experience [ 12 – 15 ], the therapeutic approach for SSc-SU should be invariably tailored to the individual patient on the basis of both the general clinical conditions and careful evaluation of a single skin wound. Systemic and local treatments encompass both pathogenetic and symptomatic drugs, as well as different nonpharmacological measures [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Photobiomodulation Therapy: A New Light in the Treatment of Systemic Sclerosis Skin Ulcers

et al. 2022

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Introduction Skin ulcers (SU) represent one of the most frequent manifestations of systemic sclerosis (SSc), occurring in almost 50% of scleroderma patients. SSc-SU are often particularly difficult to treat with conventional systemic and local therapies. In this study, a preliminary evaluation of the role and effectiveness of blue light photobiomodulation (PBM) therapy with EmoLED ® in the treatment of scleroderma skin ulcers (SSc-SU) was performed. Methods We retrospectively analyzed 12 consecutive SSc patients with a total of 15 SU on finger hands. All patients were treated with adequate systemic therapy and local treatment for SU; after a standard skin ulcer bed preparation with debridement of all lesions, EmoLED ® was performed. All patients were locally treated every week during 2 months of follow-up; SU data were collected after 4 weeks (T4) and 8 weeks (T8). Eight SSc patients with comparable SU were also evaluated as controls. Results The application of EmoLED ® in addition to debridement apparently produced faster healing of SU. Complete healing of SU was recorded in 41.6% cases during EmoLED ® treatment. Significant improvements in SU area, length, and width, wound bed, and related pain were observed in EmoLED ® patients from T0 to T8. Control subjects treated with standard systemic/local therapies merely showed an amelioration of SU area and width at the end of the follow-up. No procedural or post-procedural adverse events were reported. Conclusions The positive clinical results and the absence of side effects suggest that EmoLED ® could be a promising tool in the management of SSc-SU, with an interesting role to play in the healing process in addition to conventional systemic and local treatments.

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Use of Neem oil and Hypericum perforatum for treatment of calcinosis-related skin ulcers in systemic sclerosis

Cited by 21 publications

References 32 publications

Management of Calcinosis Cutis in Rheumatic Diseases

Management of Calcinosis Cutis in Rheumatic Diseases

The impact of skin calcinosis on digital ulcers in patients with SSc: clinical and prognostic stratification using the “wound bed score”

Photobiomodulation Therapy: A New Light in the Treatment of Systemic Sclerosis Skin Ulcers

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