MMP9 and hereditary spastic paraplegia: Although no consensus exists in the management of extensive bullous lesions in HSP, the anti-inflammatory effect of corticosteroids is likely to be beneficial in the treatment of HSP patients with severe cutaneous involvement through inhibition of AP-1 binding activity in the nucleus in association with a reduction of nuclear factor-kappa B (NF-κB), one of the major proinflammatory transcription factors, and decreased MMP-2 and MMP-9 concentrations in plasma levels [15].