Advancing Management of Oral Lesion Patients with Epidermolysis Bullosa: In Vivo Evaluation with Optical Coherence Tomography of Ultrastructural Changes after Application of Cord Blood Platelet Gel and Laser Photobiomodulation

Abstract

Background: Inherited epidermolysis bullosa (EB) is a group of genetic disorders with skin fragility and blistering. The use of Cord Blood Platelet Gel (CBPG) in combination with laser photobiomodulation (PBM) leads to a reduction in lesions. The aim of this study is to evaluate clinical and morphometric changes with Optical Coherence Tomography (OCT) during GPC-PBM therapy. Methods: OCT scanning before the first session (T0), with relative measurement of the thicknesses of the epithelium (EP) and lamina propria (LP), and three consecutive sessions (once daily for 3 days) of CBPG and PBM applications were performed. A new OCT scan at the end of the three sessions (T1) and a week after (T2) were performed. All OCT scans were compared with the values of healthy reference tissues of the same site. Results: A statistically confirmed increase in EP thickness and a decrease in LP thickness with a progressive reduction in inflammatory content were highlighted. This case series did not have recurrences in the treated sites, or adverse reactions to therapy. Conclusions: This study shows the advantages of OCT monitoring in evaluating the effects of therapy at an ultrastructural level with a possibility of obtaining objective, precise, and repeatable measurements with an atraumatic device.

Keywords

• epidermolysis bullosa (EB)
• dystrophic epidermolysis bullosa (DEB)
• optical coherence tomography (OCT)
• laser photobiomodulation (PBM)
• cord blood platelet gel (CBPG)