Dexamethasone-induced healing of chronic leg ulcers in a patient with defective organization of the extracellular matrix of fibronectin.
Previous investigations have shown that skin fibroblasts derived from patients affected by Ehlers-Danlos syndrome (EDS) lack an organized extracellular matrix (ECM) of fibronectin (FN). As retarded wound healing is a sign of EDS, we hypothesized that a young healthy man suffering from chronic recalcitrant leg ulcers might be affected by a defect of FN-ECM organization similar to that observed in EDS. Immunofluorescence of cultured skin fibroblasts obtained from skin biopsies from the patient and a control demonstrated that the patient's fibroblasts lacked FN-ECM organization, in contrast with those of the control; this was restored by 10-7 mol/L dexamethasone (DEX) in vitro. DEX treatment of the patient was associated with healing of his leg ulcers. In conclusion, DEX may be effective in reversing impaired wound healing associated with a lack of FN-ECM organization
De Panfilis
G
G
Department of Dermatology, Spedali Civili di Brescia, Azienda Spedali Civili, p.le Spedali Civili, 1 I-25125 Brescia, Italy.
Ghidini
A
A
Graifemberghi
S
S
Barlati
S
S
Zoppi
N
N
Colombi
M
M
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D003907:Dexamethasone / Q000627:therapeutic use*; D005353:Fibronectins / Q000378:metabolism; D006801:Humans; D007871:Leg Ulcer / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D008297:Male; D014945:Wound Healing / Q000187:drug effects
D000893:Anti-Inflammatory Agents; D005353:Fibronectins; D003907:Dexamethasone