Lichen Sclerosus

Lichen Sclerosus is a skin condition that occurs mostly in post-menopausal women. The skin around the genitals and anus can turn shiny and smooth and spots grow into patches. Skin over the spots turns thin and crinkled and can tear easily and become scarred. Itching, changes in skin color, pain, bleeding and blisters can also occur. Causes of LS may be auto-immune or hormonal but overall the exact cause is poorly understood. Other areas of the body can be affected but those usually resolve without treatment. LS is not contagious. Diagnosis can be confirmed on skin biopsy. Without treatment, patches on the genitals can lead to scarring and pain or become cancerous. LS can cause scars that narrow the vagina interfering with sexual intercourse. Treatment has traditionally involved surgical excision (not always possible especially in women) and powerful topical steroids which can help mitigate itching and scarring but can promote thinning of the skin and fungal infections. Optimization of estrogen levels is also helpful. More advanced treatment includes retinoids (vitamin A like compounds), UV light therapy, or Tacrolimus (immune suppressant). SVF containing adult mesenchymal stem cells has anti-inflammatory effects and therefore may be effective in healing the abnormal patches of skin associated with LS. Our protocol also addresses the auto-immune component of LS by administration of intra-venous SVF in addition to local injections. Additional growth factors in the form of autologous platelet rich plasma are used for the local injections into LS lesions. Multiple treatments may be required over the course of a year.

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