Autologous platelet-rich plasma (PRP) in chronic penile lichen sclerosus: the impact on tissue repair and patient quality of life
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Lichen sclerosus (LS) is a chronic inflammatory skin condition that frequently involves the anogenital region. Ongoing research is focused on finding more effective treatments for tissue repair and reducing symptoms. The aim of this study is to evaluate the effectiveness of platelet-rich plasma (PRP) local injections in penile LS.
Forty-five male patients affected by penile LS underwent injections of autologous PRP in the affected skin areas. Age at diagnosis and at first treatment, number of treatments, clinical conditions (phimosis, splitting, inflammation, synechiae, meatus stenosis), symptoms (pain, burning, itching), and functional impairment were considered. Treatment efficacy was also evaluated through the Investigator’s Global Assessment (IGA) on a six-point Likert scale and the Dermatology Life Quality Index (DLQI).
The patient age at LS diagnosis was 36.20 ± 9.19 years, while the mean age at the first PRP treatment was 42.96 ± 11.32 years (p < 0.001). The number of treatments/patient ranged from 2 to 10. The follow-up was 17.60 ± 5.63 months. After PRP injections, it was observed in all patients a significant improvement in clinical conditions, with reduction/disappearance of symptoms. Topical steroid therapy, interrupted before PRP treatment, was not restarted by any patient. Only one patient underwent a later circumcision procedure. Both IGA scale and DLQI score showed a significant difference (p < 0.001) before and after PRP treatment.
PRP treatment in penile LS seems to be helpful to regenerate scarring, reduce symptoms, and improve patient quality of life. Further studies are necessary to evaluate long-term results.
KeywordsPRP Platelet-rich plasma Lichen sclerosus Male genitalia Penile disease Tissue repair Quality of life
Compliance with ethical standards
Conflict of interest
All the authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study received authorization for publication by the Regional Ethics Committee (358REG2016).
Specific informed consent was obtained from all patients included in the study.
- 14.Papp KA, Langley RG, Lebwohl M, Krueger GG, Szapary P et al (2008) Efficacy and safety of ustekinumab, a human interleukin-12/23 monoclonal antibody, in patients with psoriasis: 52-week results from a randomised, double-blind, placebo-controlled trial (PHOENIX 2). Lancet 371:1675–1684CrossRefPubMedGoogle Scholar
- 16.DLQI Instructions for use and scoring. Department of Dermatology of Cardiff University (2016). http://www.cardiff.ac.uk/dermatology/quality-of-life/dermatology-quality-of-life-index-dlqi/dlqi-instructions-for-use-and-scoring. Accessed May 5, 2016
- 17.Commission Directive 2005/28/EC (2005) Laying down principles and detailed guidelines for good clinical practice as regards investigational medicinal products for human use, as well as the requirements for authorisation of the manufacturing or importation of such products. OJ L 91, 9.4.2005, pp 13–19Google Scholar
- 18.World Medical Association Declaration of Helsinki (1964) Ethical Principles for Medical Research Involving Human Subjects. Adopted by the 18th WMA General Assembly, Helsinki, FinlandGoogle Scholar
- 20.Mangera A, Osman N, Chapple C (2016) Recent advances in understanding urethral lichen sclerosus. F1000 Research, 5, F1000 Faculty Rev–96. doi: 10.12688/f1000research.7120.1
- 32.Piccin A, Di Pierro AM, Tagnin M, Russo C, Fustos R, Corvetta D, Primerano M, Magri E, Conci V, Gentilini I, Burchia E, Negri G, Mazzoleni G, Gastl G, Fontanella F (2016) Healing of a soft tissue wound of the neck and jaw osteoradionecrosis using platelet gel. Regen Med 11:459–463CrossRefPubMedGoogle Scholar
- 47.Sánchez M, Fiz N, Azofra J, Usabiaga J, AdurizRecalde E et al (2012) A randomized clinical trial evaluating plasma rich in growth factors (PRGF-Endoret) versus hyaluronic acid in the short-term treatment of symptomatic knee osteoarthritis. Arthroscopy 28:1070–1078. doi: 10.1016/j.arthro.2012.05.011 CrossRefPubMedGoogle Scholar
- 48.Vaquerizo V, Plasencia MA, Arribas I, Seijas R, Padilla S, Orive G, Anitua E (2013) Comparison of intra-articular injections of plasma rich in growth factors (PRGF-Endoret) versus Durolane hyaluronic acid in the treatment of patients with symptomatic osteoarthritis: a randomized controlled trial. Arthroscopy 29:1635–1643. doi: 10.1016/j.arthro.2013.07.264 CrossRefPubMedGoogle Scholar
- 49.Celis S, Reed F, Murphy F, Adams S, Gillick J, Abdelhafeez AH, Lopez PJ (2014) Balanitis xerotica obliterans in children and adolescents: a literature review and clinical series. J PediatrUrol 10:34–39Google Scholar
- 51.World Health Organization, Department of Reproductive Health and Research and Joint United Nations Programme on HIV/AIDS (UNAIDS) (2007). Male circumcision: Global trends and determinants of prevalence, safety and acceptability. http://www.who.int/reproductivehealth/publications/rtis/9789241596169/en/. Accessed 8 Dec 2016