title: Use of Platelet-rich Plasma for Vulvovaginal Autoimmune Conditions Like Lichen Sclerosus.
abstract: BACKGROUND
  Lichen sclerosus (LS) is an inflammatory dermatosis with autoimmune pathogenesis. Although relatively common, its true incidence is unknown and likely underestimated. LS is usually anogenital, but in around 10% of patients, it can present as extragenital lesions. Continuous administration of topical corticosteroids is the mainstay of medical treatment. Other treatments are available but are only occasionally prescribed along with or instead of topical steroids. Injection of platelet-rich plasma (PRP) into affected areas has been reported to result in the regeneration of normal skin. In this study, we aimed to evaluate the safety, symptom resolution, and objective improvement in patients with autoimmune condition like genital LS after treatment with PRP.
  
  
  METHODS
  Over a 2-year period at FBW Gynaecology Plus, we had a total of 28 patients with confirmed LS on biopsy, unresponsive to topical steroid treatment. After acquiring informed consent, patients' own blood was centrifuged on site and injected under local anesthesia to the external genitalia.
  
  
  RESULTS
  Almost all of our patients showed clinical improvement in the size of their lesions, and in 8 cases, lesions totally disappeared after treatment with PRP. Symptoms disappeared in 15 of the 28 patients after treatment, with no need for further steroid therapy in 23 patients. Thirteen women experienced partial symptom relief.
  
  
  CONCLUSIONS
  Based on our limited findings, we hypothesize that PRP presents a potential alternative to topical steroids for treatment of vulvovaginal autoimmune conditions such as LS. A larger pilot and/or randomized controlled trial study is required to evaluate this finding further.
authors.affiliation: FBW Gynaecology Plus, Adelaide, South Australia, Australia; Urogynaecology Clinic, Flinders Medical Centre, Adelaide, South Australia; Department of Obstetrics, Gynaecology and Reproductive Medicine, Flinders University, Adelaide, South Australia, Australia; Northern Sydney Local Health District, Sydney, New South Wales, Australia; Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia; Faculty of Health Sciences, University of Adelaide, Adelaide, South Australia, Australia; Australian Skin Face Body, Geelong, Victoria, Australia; and Urogynaecology Clinic, Flinders Medical Centre, Adelaide, South Australia, Australia.
authors.forename: Fariba
authors.initials: F
authors.lastname: Behnia-Willison
authors.affiliation: FBW Gynaecology Plus, Adelaide, South Australia, Australia; Urogynaecology Clinic, Flinders Medical Centre, Adelaide, South Australia; Department of Obstetrics, Gynaecology and Reproductive Medicine, Flinders University, Adelaide, South Australia, Australia; Northern Sydney Local Health District, Sydney, New South Wales, Australia; Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia; Faculty of Health Sciences, University of Adelaide, Adelaide, South Australia, Australia; Australian Skin Face Body, Geelong, Victoria, Australia; and Urogynaecology Clinic, Flinders Medical Centre, Adelaide, South Australia, Australia.
authors.forename: Nina Reza
authors.initials: NR
authors.lastname: Pour
authors.affiliation: FBW Gynaecology Plus, Adelaide, South Australia, Australia; Urogynaecology Clinic, Flinders Medical Centre, Adelaide, South Australia; Department of Obstetrics, Gynaecology and Reproductive Medicine, Flinders University, Adelaide, South Australia, Australia; Northern Sydney Local Health District, Sydney, New South Wales, Australia; Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia; Faculty of Health Sciences, University of Adelaide, Adelaide, South Australia, Australia; Australian Skin Face Body, Geelong, Victoria, Australia; and Urogynaecology Clinic, Flinders Medical Centre, Adelaide, South Australia, Australia.
authors.forename: Behrang
authors.initials: B
authors.lastname: Mohamadi
authors.affiliation: FBW Gynaecology Plus, Adelaide, South Australia, Australia; Urogynaecology Clinic, Flinders Medical Centre, Adelaide, South Australia; Department of Obstetrics, Gynaecology and Reproductive Medicine, Flinders University, Adelaide, South Australia, Australia; Northern Sydney Local Health District, Sydney, New South Wales, Australia; Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia; Faculty of Health Sciences, University of Adelaide, Adelaide, South Australia, Australia; Australian Skin Face Body, Geelong, Victoria, Australia; and Urogynaecology Clinic, Flinders Medical Centre, Adelaide, South Australia, Australia.
authors.forename: Nadia
authors.initials: N
authors.lastname: Willison
authors.affiliation: FBW Gynaecology Plus, Adelaide, South Australia, Australia; Urogynaecology Clinic, Flinders Medical Centre, Adelaide, South Australia; Department of Obstetrics, Gynaecology and Reproductive Medicine, Flinders University, Adelaide, South Australia, Australia; Northern Sydney Local Health District, Sydney, New South Wales, Australia; Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia; Faculty of Health Sciences, University of Adelaide, Adelaide, South Australia, Australia; Australian Skin Face Body, Geelong, Victoria, Australia; and Urogynaecology Clinic, Flinders Medical Centre, Adelaide, South Australia, Australia.
authors.forename: Madeleine
authors.initials: M
authors.lastname: Rock
authors.affiliation: FBW Gynaecology Plus, Adelaide, South Australia, Australia; Urogynaecology Clinic, Flinders Medical Centre, Adelaide, South Australia; Department of Obstetrics, Gynaecology and Reproductive Medicine, Flinders University, Adelaide, South Australia, Australia; Northern Sydney Local Health District, Sydney, New South Wales, Australia; Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia; Faculty of Health Sciences, University of Adelaide, Adelaide, South Australia, Australia; Australian Skin Face Body, Geelong, Victoria, Australia; and Urogynaecology Clinic, Flinders Medical Centre, Adelaide, South Australia, Australia.
authors.forename: Ian W
authors.initials: IW
authors.lastname: Holten
authors.affiliation: FBW Gynaecology Plus, Adelaide, South Australia, Australia; Urogynaecology Clinic, Flinders Medical Centre, Adelaide, South Australia; Department of Obstetrics, Gynaecology and Reproductive Medicine, Flinders University, Adelaide, South Australia, Australia; Northern Sydney Local Health District, Sydney, New South Wales, Australia; Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia; Faculty of Health Sciences, University of Adelaide, Adelaide, South Australia, Australia; Australian Skin Face Body, Geelong, Victoria, Australia; and Urogynaecology Clinic, Flinders Medical Centre, Adelaide, South Australia, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: O'Shea
authors.affiliation: FBW Gynaecology Plus, Adelaide, South Australia, Australia; Urogynaecology Clinic, Flinders Medical Centre, Adelaide, South Australia; Department of Obstetrics, Gynaecology and Reproductive Medicine, Flinders University, Adelaide, South Australia, Australia; Northern Sydney Local Health District, Sydney, New South Wales, Australia; Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia; Faculty of Health Sciences, University of Adelaide, Adelaide, South Australia, Australia; Australian Skin Face Body, Geelong, Victoria, Australia; and Urogynaecology Clinic, Flinders Medical Centre, Adelaide, South Australia, Australia.
authors.forename: Joseph
authors.initials: J
authors.lastname: Miller