EFFICACY OF PLATELET-RICH FIBRIN FOR ORAL LESIONS IN PEMPHIGUS VULGARIS

Authors:

Abstract:

Persistent oral lesions in pemphigus vulgaris cause pain, impair nutrition, and may heal slowly despite systemic treatment. This retrospective study included 58 patients treated during 2019–2024: 27 received platelet-rich fibrin plus standard systemic therapy and 31 received standard therapy alone. Outcomes were oral lesion intensity and area, pain, and time to complete epithelialization. Mean reductions in lesion intensity were 9.4 and 4.3 points, reductions in lesion area were 8.6 and 3.8 points, and reductions in pain were 4.8 and 2.6 points in the intervention and control groups, respectively; all between-group comparisons yielded p<0.001. Median healing time was 13 versus 24 days. Complete epithelialization within 21 days occurred in 89 % (24/27) versus 48 % (15/31) of patients. No serious adverse events were recorded. Platelet-rich fibrin may therefore accelerate mucosal healing and improve symptom control as an adjunct to systemic treatment.

Keywords:

pemphigus platelet-rich fibrin mouth mucosa wound healing pain measurement regenerative medicine

References:

1. Al-Hallak N, Hamadah O, Mouhamad M, Kujan O. Efficacy of injectable platelet-rich fibrin in the treatment of symptomatic oral lichen planus. Oral Dis. 2023;29(5):2256–2264. doi: 10.1111/odi.14261.
2. Al-Maawi S, Becker K, Schwarz F, Sader R, Ghanaati S. Efficacy of platelet-rich fibrin in promoting the healing of extraction sockets: a systematic review. Int J Implant Dent. 2021;7(1):117. doi: 10.1186/s40729-021-00393-0.
3. Bennardo F, Liborio F, Barone S, Antonelli A, Buffone C, Fortunato L, et al. Efficacy of platelet-rich fibrin compared with triamcinolone acetonide as injective therapy in the treatment of symptomatic oral lichen planus: a pilot study. Clin Oral Investig. 2021;25(6):3747–3755. doi: 10.1007/s00784-020-03702-w.
4. He W, Li K, Hu X, Hua H, Wei P. Direct immunofluorescence analysis of oral Tzanck smears for pemphigus vulgaris: a diagnostic test. J Oral Pathol Med. 2021;50(10):1050–1056. doi: 10.1111/jop.13239.
5. Hijazi AH, Al-Hamed FS, Tamimi F, Al-Maweri SA, Hamdan N, Psutka DJ, et al. Regenerative potential of platelet concentrates in chronic oral mucosal lesions. J Oral Biol Craniofac Res. 2024;14(2):216–221. doi: 10.1016/j.jobcr.2024.02.007.
6. Joly P, Horvath B, Patsatsi A, Uzun S, Bech R, Beissert S, et al. Updated S2K guidelines on the management of pemphigus vulgaris and foliaceus initiated by the European Academy of Dermatology and Venereology. J Eur Acad Dermatol Venereol. 2020;34(9):1900–1913. doi: 10.1111/jdv.16752.
7. Kasperkiewicz M, Ellebrecht CT, Takahashi H, Yamagami J, Zillikens D, Payne AS, et al. Pemphigus. Nat Rev Dis Primers. 2017;3:17026. doi: 10.1038/nrdp.2017.26.
8. Miron RJ, Fujioka-Kobayashi M, Hernandez M, Kandalam U, Zhang Y, Ghanaati S, et al. Injectable platelet rich fibrin: opportunities in regenerative dentistry. Clin Oral Investig. 2017;21(8):2619–2627. doi: 10.1007/s00784-017-2063-9.
9. Miron RJ, Fujioka-Kobayashi M, Bishara M, Zhang Y, Hernandez M, Choukroun J. Platelet-rich fibrin and soft tissue wound healing: a systematic review. Tissue Eng Part B Rev. 2017;23(1):83–99. doi: 10.1089/ten.TEB.2016.0233.
10. Ormond M, McParland H, Donaldson ANA, Andiappan M, Cook RJ, Escudier M, et al. An Oral Disease Severity Score validated for use in oral pemphigus vulgaris. Br J Dermatol. 2018;179(4):872–881. doi: 10.1111/bjd.16265.
11. Saglam E, Ozsagir ZB, Unver T, Alinca SB, Toprak A, Tunali M. Efficacy of injectable platelet-rich fibrin in erosive oral lichen planus: a split-mouth randomized controlled clinical trial. J Appl Oral Sci. 2021;29:e20210180. doi: 10.1590/1678-7757-2021-0180.
12. Samiraninezhad N, Rezazadeh H, Rezazadeh H, Mardaninezhad R, Tabesh A, Rezazadeh F. Platelet-rich fibrin in the management of oral mucosal lesions: a scoping review. BMC Oral Health. 2024;24(1):1189. doi: 10.1186/s12903-024-04981-5.
13. Schmidt E, Kasperkiewicz M, Joly P. Pemphigus. Lancet. 2019;394(10201):882–894. doi: 10.1016/S0140-6736(19)31778-7.
14. Sindhuja T, De D, Handa S, Goel S, Mahajan R, Kishore K. Pemphigus Oral Lesions Intensity Score: a novel scoring system for assessment of severity of oral lesions in pemphigus vulgaris. Front Med. 2020;7:449. doi: 10.3389/fmed.2020.00449.
15. Varela HA, Souza JCM, Nascimento RM, Araújo RF Jr, Vasconcelos RC, Cavalcante RS, et al. Injectable platelet rich fibrin: cell content, morphological, and protein characterization. Clin Oral Investig. 2019;23(3):1309–1318. doi: 10.1007/s00784-018-2555-2.
16. Wang F, Zhang X, Yao Y, Wang J, Shi Y, Liu T, et al. Pemphigus oral lesions area index: a new scoring scale for assessing oral pemphigus vulgaris. Oral Dis. 2025;31(1):160–167. doi: 10.1111/odi.15054.
17. Werth VP, Joly P, Mimouni D, Maverakis E, Caux F, Lehane P, et al. Rituximab versus mycophenolate mofetil in patients with pemphigus vulgaris. N Engl J Med. 2021;384(24):2295–2305. doi: 10.1056/NEJMoa2028564.

Publication:

«World of Medicine and Biology» Vol. 22 No. 97 (2026), pp. 130-134
UDC 616.527-085.382:616.311

DOI:

https://doi.org/10.26724/2079-8334-2026-3-97-130-134