Fibroblast injection vs. fibroblasts on amniotic membrane in RDEB

Summary Epidermolysis bullosa (EB) is a blistering disorder caused by at least 18 variable gene mutations (meaning ‘mistakes’ in certain genes). Recessive dystrophic EB (RDEB) is a distinct subtype of EB that is caused by different mutations in the type‐VII collagen gene (COL7A1). Different methods of application of cells called fibroblasts have been examined to treat RDEB. This study, from Iran, aimed to compare the effects of injections of fibroblasts (called cultured allogeneic fibroblasts) in healing RDEB wounds, with that of fibroblasts seeded on amniotic membrane scaffolds (FAMS – a type of skin graft), or ‐ as a control group ‐ standard wound care (SWC) with petroleum jelly gauze as controls. Seven patients were recruited, and seven wounds were assessed in each patient: three wounds were treated with injection of intradermal fibroblasts, three were treated with FAMS, and one was dressed with SWC. Changes in wound size were assessed after 2 and 12 weeks of treatment. A scoring system called QWS was also used to assess wound severity. Additionally, biopsies and tests were performed to detect type‐VII collagen. In both treated areas, the QWS and wound size were decreased, whereas there were no changes in control group. After 2 and 12 weeks of treatment, the wound size was decreased in wounds that were treated with fibroblast injection compared with those treated with FAMS, but no significant changes were found in control group. Linked Article: Moravvej et al. Br J Dermatol 2018; 179:72–79