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

Marinella Tedesco; Barbara Bellei; Lavinia Alei; Monia Di Prete; Carlo Cota; Tiziano Pallara; Antonio Bonadies; Alessandra Latini; Stefania De Fazio; Emilia Migliano

doi:10.4081/dr.2024.10079

Authors

Marinella Tedesco
marinella.tedesco@ifo.it
Department of Plastic and Reconstructive Surgery, San Gallicano Dermatological Institute IRCCS, Rome, Italy. https://orcid.org/0000-0001-5816-5834
Barbara Bellei Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, Rome, Italy. https://orcid.org/0000-0002-3883-5500
Lavinia Alei Department of Plastic and Reconstructive Surgery, San Gallicano Dermatological Institute IRCCS, Rome, Italy.
Monia Di Prete Genetic Research, Molecular Biology and Dermatopathology Unit, San Gallicano Dermatological Institute, Rome, Italy. https://orcid.org/0000-0002-3881-8540
Carlo Cota Genetic Research, Molecular Biology and Dermatopathology Unit, San Gallicano Dermatological Institute, Rome, Italy.
Tiziano Pallara Department of Plastic and Reconstructive Surgery, San Gallicano Dermatological Institute IRCCS, Rome, Italy. https://orcid.org/0000-0001-7138-8098
Antonio Bonadies Department of Plastic and Reconstructive Surgery, San Gallicano Dermatological Institute IRCCS, Rome, Italy. https://orcid.org/0000-0002-8054-7190
Alessandra Latini Lichen Sclerosus Unit, Department of Dermatology, STI, Environmental Health, Tropical and Immigration, San Gallicano Dermatological Institute, IRCCS, Rome, Italy.
Stefania De Fazio International liaison SICPRE Italian Society of Plastic and Reconstructive Regenerative Surgery, Vice President of ISPRES International Society of Plastic Regenerative Surgeons, Italy.
Emilia Migliano Department of Plastic and Reconstructive Surgery, San Gallicano Dermatological Institute IRCCS, Rome, Italy. https://orcid.org/0000-0002-5316-8937

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.

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Tedesco, M., Bellei, B., Alei, L., Di Prete, M., Cota, C., Pallara, T., Bonadies, A., Latini, A., De Fazio, S., & Migliano, E. (2024). Regenerative therapies in lichen sclerosus genitalis patients and possible efficacy in preventing squamous cell carcinoma development: a long-term follow-up pilot study. Dermatology Reports. https://doi.org/10.4081/dr.2024.10079