Regenerative therapies in lichen sclerosus genitalis patients and possible efficacy in preventing squamous cell carcinoma development: a long-term follow-up pilot study

Abstract

Lichen sclerosus (LS) is a chronic scleroatrophic dermatosis of unknown etiology that usually affects the anogenital area and occasionally the extragenital sites, which has no definitive cure. LS patients are at higher risk of developing squamous cell carcinoma (SCC) in their lifetime compared to the general population. Through a retrospective study, we evaluated the impact of regenerative medicinebased therapies on SCC onset in the context of genital LS. LS patients treated in our institute from March 2013 to December 2022 were reviewed. A total of 319 patients, including 34 treated with adipose-derived stem cells (ADSCs) graft, 31 treated with ADSCs graft and PRP, and 254 treated with platelet-rich plasma (PRP) were identified. In parallel, data extracted from the histologic institutional database searching for SCC in the anogenital area were matched to surgical records. None of the 319 LS patients developed skin SCC in the anogenital area. Our data suggest that cellular and acellular therapies achieving therapeutic control prevent continuous tissue remodeling and its evolution and, therefore, neoplastic degeneration. Regenerative approaches are considered a valid strategy for treating LS patients symptomatic despite prolonged first-line medical treatment. Studying genital carcinogenesis of LS cases, we reported for the first time a protective role of PRP, ADSCs, and combined therapies. Thus, in terms of cancer prevention, we propose that regenerative therapies ameliorating disease control of non-responders to conventional therapy represent an important innovative tool.

Keywords

• genital lichen sclerosus
• squamous cell carcinoma
• adipose-derived stem cells
• plateletrich plasma (PRP)