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

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.