Title : Clinical experience with topical secretome gel for wound healing of erosive skin lesions: a case series
Abstract:
Background: Erosions and ulcers are common end-points of several inflammatory dermatoses, including pemphigus vulgaris, Behçet’s disease, and vesiculobullous allergic contact dermatitis. Beyond pain and functional limitation, these lesions represent a barrier failure state in which persistent inflammation, mechanical irritation, and secondary infection risk can delay re-epithelialization and worsen post-inflammatory sequelae. Wound healing in inflammatory skin disease requires coordinated control of inflammation, restoration of epithelial integrity, and tissue remodeling. Topical secretome gel is a cell-free preparation enriched with paracrine bioactive mediators (e.g., growth factors, cytokines/chemokines, and extracellular vesicles) derived from conditioned culture products. By design, secretome-based topical therapy aims to support wound repair through immunomodulation, enhancement of keratinocyte migration and proliferation, promotion of angiogenesis, and optimization of granulation and remodeling, offering a practical adjunct to standard disease-directed treatment.
Observation: The secretome used in this series was derived from umbilical cord–mesenchymal stromal cells processed in a GMP-compliant laboratory with donor screening and quality control, expanded in adherent culture, and subjected to standard safety and identity testing prior to use. Conditioned medium was collected following 24-hour hypoxic conditioning, concentrated using tangential flow filtration, and formulated aseptically into a medical gel using a polymer-based vehicle with humectants to support stability, moist wound environment, and sustained topical delivery. Patient A had pemphigus vulgaris with flaccid blisters over the trunk and thighs that progressed to painful erosions with crusting and subsequently evolved into hyperpigmented patches consistent with re-epithelialization. Patient B had suspected Behçet’s disease with recurrent painful genital ulceration and mucocutaneous erosions, with follow-up demonstrating gradual drying of lesions, absence of new lesions, and sustained improvement of genital and oral involvement. Patient C developed vesiculobullous allergic contact dermatitis following glove exposure, progressing from erythema to vesiculation and crusted hand erosions, with reduced pruritus and progressive drying on short-interval follow-up. In all cases, topical secretome gel was used as an adjunctive wound-care strategy to support closure of erosions and symptomatic relief across distinct inflammatory wound phenotypes.
Key message: Across autoimmune blistering disease, inflammatory vasculitis/ulcerative mucocutaneous disease, and vesiculobullous contact dermatitis, topical secretome gel appears feasible and well tolerated as an adjunct for wound healing. Practical advantages include cell-free topical delivery, multimodal pro-repair signaling that may rebalance inflammation while supporting re-epithelialization, compatibility with standard therapies, and potential benefits for patient comfort and healing quality. Prospective studies with standardized endpoints are warranted to define efficacy, optimal duration, and patient selection in inflammatory dermatologic wounds.
