Modulating diseased skin with tissue engineering: actinic purpura treated with Apligraf

Abstract

Background: Actinic purpura (AP) is an important medical issue and quality of life issue in the elderly. Current treatment of AP is limited to prevention of cutaneous aging.

Objective: To assess the utility of tissue engineered skin (Apligraf, Organogenesis, Canton, MA) as a tissue modulator in diseased skin and as treatment for AP.

Methods: A thin partial-thickness section of AP was removed from the forearm of an elderly gentleman and replaced with fenestrated Apligraf. Healing, durability and cosmetic outcome were assessed.

Results: Apligraf-treated skin healed rapidly with good clinical "take." Lack of new skin tears and resultant erosions or ulcer formation suggests improved durability of the Apligraf-treated area occurred.

Conclusion: These results suggest that tissue engineered skin modulates aged dermal tissue to behave in a more sturdy fashion. Furthermore, in selected cases Apligraf may represent a treatment option for AP.