Safety and Efficacy of Human Fibroblast Lysate Cream for Vulvar Lichen Sclerosus: A Randomized Placebo-Controlled Trial

Goldstein, Andrew T.; Burrows, Lara J.; Belkin, Zoe R.; Pfau, Richard; Bremmer, Matthew; Goldfinger, Corrie; Dreher, Frank

doi:10.2340/00015555-2052

Cited by 7 publications

(5 citation statements)

References 9 publications

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“…The most common signs measured were hyperkeratosis, erosion, atrophy, erythema, and purpuric lesions and/or itching-related excoriations. Both discrete 15 and continuous scales 4 – 9 , 18 , 20 , 21 , 23 , 27 , 29 , 32 , 36 – 42 were used to measure these signs. In addition to determining the specific sign, some studies added measurements of lesion size 28 , 29 , 38 , 41 , 43 as well as the duration of the lesion.…”

Section: Resultsmentioning

confidence: 99%

“… 14 , 20 , 21 , 26 , 46 , 48 , 51 , 54 – 58 Finally, some studies focused on the quality-of-life effects of this disease as well as interference with sexual functioning. 18 , 22 , 35 , 48 , 59 , 60 …”

Section: Resultsmentioning

confidence: 99%

“… 62 A meta-analysis in 2012 concluded that the limited evidence available supports clobetasol propionate, mometasone furoate, and pimecrolimus for treating adult vulvar lichen sclerosus. 63 Since then, many additional randomized controlled trials have been completed studying treatments including clobetasol propionate, mometasone furoate, fibroblast lysate cream, and topical tacrolimus 5 , 18 , 20 , 37 , 63 – 66 ; however, as trials between different research groups have been completed with individual nonstandardized severity scales, comparison of results is challenging and imprecise.…”

Section: Discussionmentioning

confidence: 99%

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Development of the Adult Vulvar Lichen Sclerosus Severity Scale—A Delphi Consensus Exercise for Item Generation

Sheinis

Selk

2018

J Low Genit Tract Dis

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Development of the Adult Vulvar Lichen Sclerosus Severity Scale—A Delphi Consensus Exercise for Item Generation

Sheinis

Selk

2018

J Low Genit Tract Dis

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“…Local application of human fibroblast lysate cream, containing anti-inflammatory cytokines as well as wound-healing growth factors, has been found to be useful in treatment [27].…”

Section: Other Local Pharmacologic Agentsmentioning

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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“…It also contains wound-healing growth factors, like EGF, FGFs and VEGF. In a small double blind, placebo-controlled trial including 30 VLS patients, HFLC applied for 12 weeks did not provide significant improvement compared to placebo [169].…”

Section: Miscellaneous Topical Treatmentsmentioning

confidence: 82%

Vulvar Lichen Sclerosus from Pathophysiology to Therapeutic Approaches: Evidence and Prospects

et al. 2021

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Vulvar lichen sclerosus (VLS) is a chronic, distressing, inflammatory disease with an enormous impact on quality of life. Treatment goals are relieving symptoms, reversing signs and preventing anatomical changes. Despite the availability of numerous therapeutic options, treatment outcome may not be entirely satisfactory and a definitive cure does not exist. This may be due to the fact that the exact VLS etiopathogenesis remains unknown. The objectives of this paper were to review the most up-to-date knowledge on VLS etiopathogenesis and to consider the available therapies through the lens of a plausible pathogenetic model. An electronic search on both VLS etiopathogenesis and its treatment was performed using the National Library of Medicine PubMed database. Based on current knowledge, it is conceivable that various, heterogeneous environmental factors acting on a genetic background trigger an autoimmune, Th-1 response, which leads to a chronic inflammatory state. This, in turn, can determine both tissue and micro-vascular injury and activation of signaling pathways involved in fibroblast and collagen metabolism. This pathogenetic sequence may explain the effectiveness of anti-inflammatory treatments, mostly topical corticosteroids, in improving VLS clinical-pathological changes. Further deepening of the disease pathways will presumably allow key mediators to become new therapeutic targets and optimize the available treatments.

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Safety and Efficacy of Human Fibroblast Lysate Cream for Vulvar Lichen Sclerosus: A Randomized Placebo-Controlled Trial

Cited by 7 publications

References 9 publications

Development of the Adult Vulvar Lichen Sclerosus Severity Scale—A Delphi Consensus Exercise for Item Generation

Development of the Adult Vulvar Lichen Sclerosus Severity Scale—A Delphi Consensus Exercise for Item Generation

Treatment Options in Vulvar Lichen Sclerosus: A Scoping Review

Vulvar Lichen Sclerosus from Pathophysiology to Therapeutic Approaches: Evidence and Prospects

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