Fat Grafting Improves Fibrosis and Scarring in Vulvar Lichen Sclerosus: Results From a Prospective Cohort Study

Almadori, Aurora; Hansen, Esther; Boyle, Deborah; Zenner, Nicole; Swale, V. J.; Reid, Wendy; Maclane, Allan; Butler, Peter E. M.

doi:10.1097/lgt.0000000000000520

Cited by 19 publications

(31 citation statements)

References 23 publications

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“…The rationale of this regenerative approach is the presence of stem cell progenitors within adipose tissue capable of differentiating into different mesenchymal tissues and producing anti-inflammatory and immunomodulatory effects. The results of fat grafting are promising; however, further studies are required [38].…”

Section: Fat Graftingmentioning

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: Fat Graftingmentioning

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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“…The rationale behind using AFG to correct the leakage around TEP relies, on one hand, on increasing the tissue bulk around the prosthesis by injecting the lipoaspirate (padding effect), and on the other hand, on ameliorating the dystrophic tissues and scarring via a paracrine effect mediated by the ASCs (regenerative effect) [ 21 ]. Autologous tissue-assisted regenerative procedures, mainly based on lipotransfer, have already been explored with encouraging results to assist the closure of different types of fistula, including tracheoesophageal, pharyngo-cutaneous, and perianal fistulas [ 22 , 23 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

Regenerative Strategy for Persistent Periprosthetic Leakage around Tracheoesophageal Puncture: Is It an Effective Long-Term Solution?

Parrilla

Almadori

Longobardi

et al. 2021

Cells

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Autologous tissue-assisted regenerative procedures have been considered effective to close different types of fistula, including the leakage around tracheoesophageal puncture. The aim of this study was to retrospectively review 10 years of lipotransfer for persistent periprosthetic leakage in laryngectomized patients with voice prosthesis. Clinical records of patients who experienced periprosthetic leakage from December 2009 to December 2019 were reviewed. Patients receiving fat grafting were included. The leakage around the prosthesis was assessed with a methylene blue test. Twenty patients experiencing tracheoesophageal fistula enlargement were treated with fat grafting. At the one-month follow-up, all patients were considered improved with no leakage observed. At six months, a single injection was sufficient to solve 75% of cases (n 15), whereas 25% (n 5) required a second procedure. The overall success rate was 80% (n 16). Results remained stable for a follow-up of 5.54 ± 3.97 years. Fat grafting performed around the voice prosthesis, thanks to its volumetric and regenerative properties, is a valid and lasting option to solve persistent periprosthetic leakage.

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Fat Grafting Improves Fibrosis and Scarring in Vulvar Lichen Sclerosus: Results From a Prospective Cohort Study

Cited by 19 publications

References 23 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

Regenerative Strategy for Persistent Periprosthetic Leakage around Tracheoesophageal Puncture: Is It an Effective Long-Term Solution?

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