Abstract
BackgroundLichen sclerosus is an inflammatory dermatosis of unknown etiology which currently has no cure. Most treatment guidelines recommend the use of ultrapotent topical corticosteroids. However, the relapse rate is usually high. Through a retrospective study we evaluated the efficacy and safety of stromal vascular fraction of adipose tissue as therapy for lichen sclerosus.Material and methods For this retrospective review, we obtained data on patients with vulvar lichen sclerosus treated with autologous fat grafting enriched with adipose derived stromal vascular fraction cells. Data collected through a modified vulvo-vaginal symptoms questionnaire were analyzed before treatment, six months and 24 months after treatment. The 19 items questionnaire was subdivided in four categories: symptoms, signs, social functioning and sexual functioning. Global scores and partial scores for each category were analyzed using paired t-test. For all statistical analyses, a value of p ≤ 0.05 was considered statistically significant. All data are presented as mean ± SD.ResultsThirty nine patients were included in the study. Thirty seven patients (94.87%) experienced a significant decrease in global score at six months and 24 months after treatment (p < 0.05). Decrease in scores were also statistically significant between pretreatment and 24 months after treatment for each of the four questionnaire categories - symptoms, signs, social functioning and sexual functioning (p < 0.05).ConclusionsThis retrospective study showed that the use of autologous fat grafting enriched with adipose derived stromal vascular fraction is safe and leads to significant and long lasting improvement in patients with vulvar lichen sclerosus.
Highlights
Vulvar dermatoses is the term which groups different diseases such as lichen sclerosus, lichen simplex chronicus and lichen planus
Decrease in scores were statistically significant between pretreatment and 24 months after treatment for each of the four questionnaire categories - symptoms, signs, social functioning and sexual functioning (p < 0.05). This retrospective study showed that the use of autologous fat grafting enriched with adipose derived stromal vascular fraction is safe and leads to significant and long lasting improvement in patients with vulvar lichen sclerosus
The purpose of this study is to evaluate the efficacy and safety of a treatment based on fat grafting enriched with adipose derived stromal vascular fraction (SVF) cells as numerous studies conclude there is evidence of anti-inflammatory and immunoregulatory properties of this heterogeneous cell population
Summary
Vulvar dermatoses is the term which groups different diseases such as lichen sclerosus, lichen simplex chronicus and lichen planus. Lichen sclerosus is an inflammatory disease that primarily affects the skin of female external genitalia and glans and foreskin of male patients [1]. 6% of these patients have extra-genital involvement and between 85% -98% have anogenital involvement [2]. It is the second leading cause of non-neoplastic vulvar disease, with an estimated prevalence of 1:300-1:1000. It is considerably more common in women than in men at a ratio of 10: 1 and, it may appear throughout life, is more frequent in perimenopausal women and girls. Through a retrospective study we evaluated the efficacy and safety of stromal vascular fraction of adipose tissue as therapy for lichen sclerosus.
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