By: Tony Edwards for Scars1
Patients who suffer from scleroderma scarring and wounds may benefit from new stem-cell therapies using cells created from the patient’s own bone marrow, according to research by dermatologists and surgeons in Rhode Island.
If you think you or your child may have scleroderma, make an appointment with your physician, nurse practitioner, or your child’s pediatrician immediately. This may lead to further appointments with a rheumatologist (an arthritis specialist) or a dermatologist (skin specialist).
While there is no cure for scleroderma, there are pharmaceutical treatments available. Talk with your physician about which treatments may be appropriate and discuss any other conditions that you may have that might impact drug effectiveness.
If you smoke, quit now. The nicotine in cigarettes decreases blood flow to the toes and fingers, which are some of the more likely sites for skin ulceration.
Monitor your pain. Digital ulcers can be painful and if they occur at night, can disrupt your sleep, which is vital to your recovery. Talk with your physician about any pain you experience.
Cut out the caffeine. Like nicotine, caffeine also reduces the flow of blood to your extremities.
Scleroderma, also known as systemic sclerosis, is a painful, chronic connective tissue disease. According to the Scleroderma Foundation, an estimated 300,000 people in the United States suffer from this disease, across all ages, genders, races, and ethnicities. Exactly what causes some people to develop scleroderma (often between the ages of 25 to 55) is unknown and there is no known cure for the condition.
Patients with scleroderma often suffer from severe scars on their skin, as well as potential thickening of their internal organs, which can be fatal. Early recognition and treatment is essential for people with this condition.
Dermatologists at the Roger Williams Medical Center in Providence, Rhode Island, were frustrated at the lack of success they had in treating scleroderma finger ulcers with bioengineered skin alone. These finger ulcers are often seen in patients with scleroderma and are difficult to treat, painful, disruptive of sleep, and can potentially lead to an amputation or worse if left untreated.
Bioengineered skin, essentially a substitute skin known by the trade names Apligraf, Integra, or Dermagraft, is used to help grow new skin or serve as a temporary skin graft until other grafts can be used on the wound or scar. Bioengineered skin has been used successfully in many cases including skin ulcer treatment and for burn victims.
The researchers hit upon the idea of using a kind of stem cell known as a mesenchymal stem cell along with the bioengineered skin to help heal these wounds. In a small study conducted in Rhode Island, a team of four researchers treated three patients with ulcers from scleroderma with this combination of stem cells and bioengineered skin.
According to Vincent Falanga, MD, the chairman of the department of dermatology and skin surgery at the Roger Williams Medical Center and the lead author of the study, the patients saw dramatic wound healing, including reduced scarring and, perhaps just as importantly, rapid pain relief.
Mesenchymal stem cells, unlike embryonic stem cells, are taken from the bone marrow in a patient’s hip. The stem cells are then taken to a laboratory, where enough cells are grown to cover the wound or scar area. Dr. Falanga noted that surgeons need a huge number of these cells to cover a wound area, on the order of 1.5 to 2 million cells per square centimeter. The wounds are then treated, first with the stem cells, then with the bioengineered skin immediately afterwards.
Dr. Falanga said he was hopeful that treatment of other conditions, such as some forms of cancer, may benefit from this research into using this combination of stem cells and bioengineered skin.