Aikaterini Gkouvi, MD
Key words: genital lichen sclerosus, heterologous type I collagen, intradermal injection treatment, dermal biorevitalization, connective tissue regeneration
Introduction: Genital Lichen Sclerosus (GLSc) is a chronic, progressive, inflammatory dermatosis affecting mainly the genital mucous membranes in both sexes. Advanced disease has a considerable impact on the quality of life and it is associated with increased risk of squamous cell carcinoma (SCC), vulvar or of the penis. There is no definitive cure for GLSc nor is there a comprehensive treatment to cover all patients.
Materials and methods: We evaluated the compliance, the efficacy, and safety of Heterologous Type I Collagen (HTIC) intradermal injections to 9 patients (6 females and 3 males) with diagnosis of biopsy proven active GLSc, relatively unresponsive to topical steroid treatment. The patients received 4 treatments, once every two weeks.
Results: All patients exhibited a decrease of the surface area of the lesions after the first treatment with complete resolution after the third treatment (5 females and 2 males) and after the fourth treatment (1 female and one male). Pruritus, soreness, discomfort and dyspareunia were significantly improved and complet ely resolved after the second treatment. The patients did not experience any relapse for the next 24 months under maintenance treatment.
Discussion: The exact etiology of LS is not known but several theories have been postulated. A genetic predisposition is apparent. A strong association with autoimmune disorders has been reported and both bacterial and viral pathogens have been implicated in its etiology.
Conclusion: HT1C is a potential new, promising treatment option for GLSc, which needs further assessment in randomized controlled trials.