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

Lichen sclerosus (LS) is a chronic scleroatrophic dermatosis of unknown etiology that usually affects the anogenital area and occasionally the extragenital sites, with 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 medicine-based therapies on SCC onset in the context of genital LS. Patients with LS treated at our institute from March 2013 to December 2022 were reviewed. A total of 319 patients, including 34 treated with adipose-derived stem cell (ADSCs) grafts, 31 treated with ADSCs grafts and platelet-rich plasma (PRP), and 254 treated with 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 symptomatic LS patients despite prolonged first-line medical treatment. Studying the 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 in non-responders to conventional therapy represent an important innovative tool.