الفهرس 
List of abbreviationsOnly 14 pages are availabe for public view
 |  | from | 127 |  |  |
| | | from | 127 | | |
Abstract
To the best of our knowledge, this was the first cross-sectional
study to assess the efficacy of autologous intralesional PRP injection in
the treatment of patients with PHN.
Post herpetic neuralgia is defined as pain persisting more than 3
months after the onset of the herpetic rash in the same affected area. The
PHN is the most frequent chronic complication of HZ and the most
common NP resulting from infection.
The pathophysiology of PHN is poorly understood, different
pathophysiologic processes seem to be involved with the development of
HZ and PHN. Pain relieve in PHN is a challenge and drugs and/or
techniques schemes used for relieving NP provide only temporary relief
of pain and some are not effective at all. Further, many such medications
have serious side effects and some can lead to serious disability to the
patients.
Recent in-vitro and animal research has demonstrated that PRP
and/or SCs therapy could play an important role in the treatment of NP.
PRP is a biological product defined as a portion of the plasma fraction of
autologous blood with a platelet concentration above the baseline. Among
platelet-released factors that promote axon regeneration are EGF, VEGF,
IGF-1, PDAF, and others.
The objective of the study was to evaluate the efficacy of
autologous intralesional PRP injection in the treatment of patients with
PHN. A cross-sectional study was conducted including 45 patients with
PHN from those attending the Dermatology outpatient clinics at Sohag
University Hospitals. The study was approved by the Research and
Ethical Committees at the Faculty of Medicine, Sohag University in
November 2020. Informed written consents were obtained from
participants.
All patients were subjected to medical history, general
examination, dermatological evaluation, laboratory investigations
(complete blood count, coagulation profile), (VAS), (NRS), and (VRS),
were taken; (done at baseline, before every session and 3 months after
last session) and SF-36 questionnaire to evaluate the satisfaction of the
patients (done at baseline, before every session and 3 months after the
last session).
The mean age of the patients with PHN was 56.73 ± 12.2 years
with 23 (51.1%) of them were females. 44.4% of patients with PHN
reported associated comorbidities; 28.9% of them were diabetic.
Regarding dermatological examination; the commonest dermatome
involved in PHN was thoracic.
There were significant improvements as regards VAS, NRS, and
VRS values during the active treatment phase (Baseline/2nd session/3rd
session/4th session), and during the follow-up phase (3 months follow up).
As regards patient satisfaction; PRP treatment resulted in improved
patient quality of life as assessed by SF-36 scores. Significant
improvements were evident for all domains through the reduction of
patient dissatisfaction.
There was a statistically significant correlation between patient’s
response to treatment (VAS and VRS at the end of follow-up) and age of
the patients, duration of PHN, and aggravating factors. There was a
highly significant moderate correlation between both scales (VAS and
VRS) and patient‟s age in years and who having aggravating factors.
Likewise; there was a significant moderate positive correlation between
scales (VAS and VRS) and the disease duration, medical comorbidities,
and associated myalgia.
Finally, this study concluded that autologous intralesional PRP
injection was an effective and well-tolerated therapeutic option for
patients with PHN.
Recommendations
We recommend further studies with repeated autologous
intralesional PRP injections, longer follow-up periods, and larger
sample size groups are needed, for evaluating its efficacy and
safety.
We still need randomized, placebo-controlled, clinical trials to be
certain that autologous intralesional PRP does, in fact, relieve
PHN.
We recommend further studies comparing autologous intralesional
PRP with other treatment modalities in the treatment of PHN.
We recommend further studies which evaluate the effect of using
ultrasound-guided perineural PRP injection technique.