Read So, I have Vulvar Lichen Sclerosus. What do I do now?: Patricia Gutiérrez Ontalvilla, MD, PhD

So, I have Vulvar Lichen Sclerosus. What do I do now?: Patricia Gutiérrez Ontalvilla, MD, PhD

Patricia Gutiérrez Ontalvilla

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Description:A monograph guide to vulvar lichen sclerosus and its current treatments.SUMMARY OF THE BOOKLichen sclerosus (LS) is a chronic inflammatory disease with a propensity for appearing in the anogenital region. The cause of LS is unknown and is probably multifactorial, although an autoimmune mechanism is increasingly being advocated given the association of the disease with autoimmune diseases in 21–28% of cases and the presence of circulating antibodies against an extracellular matrix protein in these patients. The prevalence of the disease is unknown, but it is more frequent than once thought, as we will see later.In women, the most frequent location is the vulvar and perianal area, where it usually presents in a figure-of-eight shape. The symptoms most commonly reported by patients are severe pruritus (itching) and pain, which can cause dysuria (pain when urinating), dyspareunia (pain with sexual intercourse), or pain during defecation. When the disease is severe and advanced, there is a loss of the labia minora, burial of the clitoris, and a narrowing of the introitus, which makes sexual intercourse difficult. Most data suggest that LS is not intrinsically precancerous, but nonetheless, the fact that it is considered a chronic scarring entity in a humid environment may promote carcinogenesis.Regarding the current therapies for LS, the first line of treatment is the topical use of ultra-potent corticosteroids for 3 months. An improvement in symptoms is seen in most patients with this treatment, but complete disease remission is only seen in 20% of patients and only when treated during the early stages of the pathology. Moreover, topical corticosteroids do not cure the disease or eliminate the possibility of relapse. Recent studies have shown that autologous adipose tissue (obtained from the patient herself) has anti-inflammatory and immunomodulatory properties. Furthermore, platelet-rich plasma (PRP) from patients themselves is also a source of growth factors, which can accelerate and improve the healing and tissue regeneration processes in these lesions.In the few studies published to date, biopsy results after treatment by injection of autologous fatty tissue with or without PRP (Casabona, Onesti, Boero, and Goldstein), have demonstrated a marked reduction in fibrosis and chronic inflammation and reduced dermal oedema. At a clinical level, an improvement in trophism (cell maturation) in the skin and mucosa, greater elasticity of the introitus, and a decrease in phimosis (burial of the clitoris), together with an increase in the volume of both the labia majora and minora, was seen.Given all the above, it seemed appropriate to conduct a clinical trial (the LIQUENIA Trial) to test whether treatment using the patient’s own adipose tissue enriched with autologous PRP, could achieve any improvements in the affected parts of the vulva. Researchers studied whether the LIQENIA treatment improved the whitish plaques, erosions, and fissures, elasticity of the affected vulvar areas, or symptoms of the disease, therefore improving the quality of life and sexual function of patients affected by vulvar LS from the early stages of treatment, and whether this effect was sustained in the long term.We have made it easy for you to find a PDF Ebooks without any digging. And by having access to our ebooks online or by storing it on your computer, you have convenient answers with So, I have Vulvar Lichen Sclerosus. What do I do now?: Patricia Gutiérrez Ontalvilla, MD, PhD. To get started finding So, I have Vulvar Lichen Sclerosus. What do I do now?: Patricia Gutiérrez Ontalvilla, MD, PhD, you are right to find our website which has a comprehensive collection of manuals listed.
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Description: A monograph guide to vulvar lichen sclerosus and its current treatments.SUMMARY OF THE BOOKLichen sclerosus (LS) is a chronic inflammatory disease with a propensity for appearing in the anogenital region. The cause of LS is unknown and is probably multifactorial, although an autoimmune mechanism is increasingly being advocated given the association of the disease with autoimmune diseases in 21–28% of cases and the presence of circulating antibodies against an extracellular matrix protein in these patients. The prevalence of the disease is unknown, but it is more frequent than once thought, as we will see later.In women, the most frequent location is the vulvar and perianal area, where it usually presents in a figure-of-eight shape. The symptoms most commonly reported by patients are severe pruritus (itching) and pain, which can cause dysuria (pain when urinating), dyspareunia (pain with sexual intercourse), or pain during defecation. When the disease is severe and advanced, there is a loss of the labia minora, burial of the clitoris, and a narrowing of the introitus, which makes sexual intercourse difficult. Most data suggest that LS is not intrinsically precancerous, but nonetheless, the fact that it is considered a chronic scarring entity in a humid environment may promote carcinogenesis.Regarding the current therapies for LS, the first line of treatment is the topical use of ultra-potent corticosteroids for 3 months. An improvement in symptoms is seen in most patients with this treatment, but complete disease remission is only seen in 20% of patients and only when treated during the early stages of the pathology. Moreover, topical corticosteroids do not cure the disease or eliminate the possibility of relapse. Recent studies have shown that autologous adipose tissue (obtained from the patient herself) has anti-inflammatory and immunomodulatory properties. Furthermore, platelet-rich plasma (PRP) from patients themselves is also a source of growth factors, which can accelerate and improve the healing and tissue regeneration processes in these lesions.In the few studies published to date, biopsy results after treatment by injection of autologous fatty tissue with or without PRP (Casabona, Onesti, Boero, and Goldstein), have demonstrated a marked reduction in fibrosis and chronic inflammation and reduced dermal oedema. At a clinical level, an improvement in trophism (cell maturation) in the skin and mucosa, greater elasticity of the introitus, and a decrease in phimosis (burial of the clitoris), together with an increase in the volume of both the labia majora and minora, was seen.Given all the above, it seemed appropriate to conduct a clinical trial (the LIQUENIA Trial) to test whether treatment using the patient’s own adipose tissue enriched with autologous PRP, could achieve any improvements in the affected parts of the vulva. Researchers studied whether the LIQENIA treatment improved the whitish plaques, erosions, and fissures, elasticity of the affected vulvar areas, or symptoms of the disease, therefore improving the quality of life and sexual function of patients affected by vulvar LS from the early stages of treatment, and whether this effect was sustained in the long term.We have made it easy for you to find a PDF Ebooks without any digging. And by having access to our ebooks online or by storing it on your computer, you have convenient answers with So, I have Vulvar Lichen Sclerosus. What do I do now?: Patricia Gutiérrez Ontalvilla, MD, PhD. To get started finding So, I have Vulvar Lichen Sclerosus. What do I do now?: Patricia Gutiérrez Ontalvilla, MD, PhD, you are right to find our website which has a comprehensive collection of manuals listed.
Our library is the biggest of these that have literally hundreds of thousands of different products represented.

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So, I have Vulvar Lichen Sclerosus. What do I do now?: Patricia Gutiérrez Ontalvilla, MD, PhD

So, I have Vulvar Lichen Sclerosus. What do I do now?: Patricia Gutiérrez Ontalvilla, MD, PhD

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