Fact or Fiction? Adipose-Derived Stem Cells and Platelet-Rich Plasma for the Treatment of Vulvar Lichen Sclerosus

Eshtiaghi, Panteha; Sadownik, Leslie

doi:10.1097/lgt.0000000000000440

Cited by 25 publications

(21 citation statements)

References 17 publications

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“…Similarly, platelet-rich plasma (PRP) therapy acts as a regenerative agent as it has tissue factors for cell growth, migration, repair, proliferation, and regeneration. It is still in experimental stages with few reports of successful management of patients with VLS [39]. Prospective randomized trials are needed to provide an evidence base for this therapy.…”

Section: Role Of Adipose-derived Stem Cells and Platelet-rich Plasma mentioning

confidence: 99%

Treatment Options in Vulvar Lichen Sclerosus: A Scoping Review

Singh¹,

Mishra²,

Ghatage³

2021

Cureus

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Vulvar lichen sclerosus (VLS) is a chronic inflammatory disorder, which affects women of all ages. The aim of this review is to focus on first-line, second-line, and maintenance therapies as well as follow-up of women with VLS. With numerous controversies, we decided to conduct a scoping review on this subject. A review protocol was developed, and the Knowledge Resource Services website was used to run a search of articles pertaining to VLS with keywords "Vulvar," "Vulval," and "Lichen Sclerosus." The search was limited to published data from the last 10 years, i.e., July 2009 onward, and researches published in English language. A total of 338 articles pertaining to VLS were obtained. Out of this, 62 were original articles related to management of VLS. Effective treatments such as high-potency topical steroids are now the standard of care and first-line treatment. Follow-up may be done every three to six months for the first two years and then at least yearly to ensure adequacy of treatment and encourage compliance. Long-term follow-up in specialist clinics is recommended for women who have persistent complaints, thickened skin, or history of neoplastic lesion. Monitoring young patients yearly is recommended as there are chances of recurrence.

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Section: Role Of Adipose-derived Stem Cells and Platelet-rich Plasma mentioning

confidence: 99%

Treatment Options in Vulvar Lichen Sclerosus: A Scoping Review

Singh¹,

Mishra²,

Ghatage³

2021

Cureus

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“…Sporadic data in the literature reported that the application of lipofilling and autologous (PRP) are effective for the therapeutic management of LS 18‐23,43‐46 . The simultaneous use of lipofilling and PRP has been previously reported in a single case report and in a study including 15 female LS patients lacking a control group of patients treated only with lipofilling in comparison to the combinatory therapy 18,46 .…”

Section: Discussionmentioning

confidence: 99%

“…Casabona et al in 2010 first described the use of homologous fat grafting and platelet‐rich plasma (PRP) in LS treatment to reduce atrophy and scarring and improve skin tropism 18 . Then, other groups reported successful treatment of LS patients using fat grafting, stromal vascular fraction (SVF) enriched fat grafting, or purified adipose‐derived stem cells 19‐23 …”

Section: Introductionmentioning

confidence: 99%

“…18 Then, other groups reported successful treatment of LS patients using fat grafting, stromal vascular fraction (SVF) enriched fat grafting, or purified adipose-derived stem cells. [19][20][21][22][23] The great therapeutic potential of the adipose tissue is explained by the presence of highly concentration of pluripotent mesenchymal stem cells (MSC), endothelial progenitor cells, T cells, B cells, mast cells, and adipose-resident macrophages and of a vast array of bioactive secretory factors that collectively are referred as adipose-derived stromal vascular fraction (AD-SVF). [24][25][26][27][28] Several recent discoveries suggest that the adipose-derived secretome possesses similar reparative properties as their cellular counterparts.…”

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confidence: 99%

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Adipose tissue stromal vascular fraction and adipose tissue stromal vascular fraction plus platelet‐rich plasma grafting: New regenerative perspectives in genital lichen sclerosus

Tedesco

Bellei

Garelli

et al. 2020

Dermatologic Therapy

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Lichen sclerosus (LS) is a chronic relapsing, inflammatory skin disorder usually involving the anogenital region of both sexes lacking a resolutive therapy. This study compared adipose tissue derived-stromal vascular fraction (AD-SVF) and AD-SVF-enriched plateletrich plasma (PRP) therapy in the management of genital LS patients. Additionally, in vitro evaluation of cells and growth factors contained in the injected SVF has been evaluated as possible predictive factors for treatment outcome. The study population was 40 patients diagnosed with LS who were symptomatic despite medical treatment. Patients (age 43-78 years) randomized into two groups using a 1:1 allocation ratio, were evaluated clinically and assessing dermatology life quality index (DLQI) before and 6 months after treatment. Both procedures demonstrated a strong safety profile with no complications linked to the therapy. After 6 months, both treatments allowed for a significant improvement respect to baseline. Combinatory therapy demonstrated decreased efficacy in late stage patients. No correlations have been found between clinical and biological findings. AD-SVF and AD-SVF plus PRP are safe and effective regenerative approaches for genital LS patients. Clinical results support the preferential use of combinatory therapy for early stage patients confirming a synergic effect of AD-SVF and PRP. In contrast, AD-SVF plus PRP is discouraged for late stage patients. K E Y W O R D S adipose-derived stromal vascular factors (AD-SVF), genital lichen sclerosus, growth factors, immunomodulatory factors, mesenchymal stem cell (MSC), platelet-rich plasma (PRP) 1 | INTRODUCTION Lichen sclerosus (LS) is a chronic relapsing, inflammatory mucocutaneous disorder which affects both gender with a common localization at the anogenital region. LS etiology is unclear. However, autoimmunity seems to play a significant pathogenetic role as evidenced by the association with many autoimmune disorders. 1-3 The diagnosis of LS may be challenging, particularly during the onset and early stages. Thus the incidence rate, reported between 0.1% to 3% and 1.7%, is considered an underestimate. 4,5 Women are more commonly affected than men. 6 The diagnosis is usually based on clinical signs and symptoms, but histological confirmation is recommended. Commonly, Marinella Tedesco and Barbara Bellei contributed equally to this manuscript.

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“…TPRP for MGLSc has been advocated to be a safe and effective option; however, no prospective studies have yet been done in men 7,8 . The putative mechanism is promoting healthy tissue formation by releasing growth factors; an analgesic role has also been postulated 9‐12 …”

Section: Introductionmentioning

confidence: 99%

Platelet‐rich plasma for male genital lichen sclerosus resistant to conventional therapy: First prospective study

Navarrete

Echarte

Sujanov

et al. 2020

Dermatologic Therapy

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Ultrapotent topical corticosteroids and circumcision are usually effective for male genital lichen sclerosus (MGLSc); however, refractory cases are often referred to our Male Genital Dermatology Unit. Treatment with autologous platelet-rich plasma (TPRP) has recently been advocated as a safe and effective treatment option, but there have been no prospective studies in men to date. The objective of this study is to assess the safety and efficacy of TPRP for MGLSc resistant to conventional therapy. A prospective, open-label, single-arm, therapeutic study was carried out in this study. Inclusion criteria: resistant to conventional therapy for at least 6 months. Procedure: infiltration of 0.1 mL/cm 2 PRP every 8 weeks. Monthly data recording: visual appearance with photographs and external scoring by an expert using Investigator's Global Assessment Scale (IGA scale 0-5), symptoms (scale 0-5), quality of life (QoL; Dermatology Life Quality Index [DLQI]), and complications. No. of patients included was n = 5. No. of patients excluded during treatment was n = 1. Mean initial IGA: 3.6. Mean initial DLQI: 6. TPRP n = 34 (range: 2-9; average: 6.8 per patient). Mean IGA at 18 months: 3.25. Mean DLQI at 18 months: 1.25. All patients reported being completely asymptomatic at 10 months. No. of patients with complications is n = 1 (balanitis). TPRP seems to be safe and effective, regarding symptom control and improvement in QoL; however, visual changes were minimal. K E Y W O R D S balanitis xerotica obliterans, lichen sclerosus et atrophicus, platelet-rich plasma 1 | INTRODUCTION Male genital lichen sclerosus (MGLSc) is an acquired, chronic, inflammatory dermatosis. It affects the glans and the inner prepuce, with hypopigmented plaques, erythema, infiltration, lichenification, and deformity (phimosis, balanoprepucial adhesions, meatal stenosis, and naviculomeatal valve insufficiency). The main symptom is male dyspareunia, with a significant impact on quality of life (QoL). 1,2 There have been no randomized controlled trials in MGLSc. Ultrapotent corticosteroids are the first line of treatment, achieving about 50% healing; however, their efficacy in reversing scarring sequelae is limited. 1-4 Retrospective studies suggest that circumcision can be curative in 90%-100% of cases, and should be offered before intralesional or systemic therapy is considered. 1-5 The Investigator's Global Assessment (IGA) scale has been used to assess physical signs in LSc studies, and to assess response to treatment with platelet-rich plasma (TPRP). 6,7 TPRP for MGLSc has been advocated to be a safe and effective option; however, no prospective studies have yet been done in men. 7,8 The putative mechanism is promoting healthy tissue formation by releasing growth factors; an analgesic role has also been postulated. 9-12

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Fact or Fiction? Adipose-Derived Stem Cells and Platelet-Rich Plasma for the Treatment of Vulvar Lichen Sclerosus

Cited by 25 publications

References 17 publications

Treatment Options in Vulvar Lichen Sclerosus: A Scoping Review

Treatment Options in Vulvar Lichen Sclerosus: A Scoping Review

Adipose tissue stromal vascular fraction and adipose tissue stromal vascular fraction plus platelet‐rich plasma grafting: New regenerative perspectives in genital lichen sclerosus

Platelet‐rich plasma for male genital lichen sclerosus resistant to conventional therapy: First prospective study

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