{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T11:33:45Z","timestamp":1788089625088,"version":"build-2803163510"},"reference-count":7,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Vulvar lichen sclerosus (VLS) is a chronic inflammatory dermatological\u2010gynecological condition. Conventional first\u2010line treatment comprises topical corticosteroids; however, many patients remain refractory. Energy\u2010based devices, including radiofrequency (RF), have shown promising results in VLS, with symptomatic and functional improvement. Exosomes are vesicles containing bioactive molecules involved in tissue regeneration; their lyophilized form, stabilized for topical application, has been combined with energy\u2010based therapies with satisfactory results in other dermatological conditions. To our knowledge, this is the first report of ablative RF combined with topical lyophilized exosomes for VLS. We present the case of a 38\u2010year\u2010old woman with biopsy\u2010confirmed VLS refractory to standard treatment, who underwent ablative fractional RF combined with topical lyophilized exosomes derived from amniotic fluid stem cells. The patient showed improvement in pruritus, dyspareunia, and sexual function, and reported satisfaction with the combined therapy.<\/jats:p>","DOI":"10.1002\/ijgo.71178","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T06:27:50Z","timestamp":1782282470000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Combined radiofrequency and topical exosomes in atrophic vulvar lichen sclerosus: A case report"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-8639-7826","authenticated-orcid":false,"given":"Luisa Mendonca","family":"de Oliveira","sequence":"first","affiliation":[{"name":"Instituto Multidisciplinar em Sa\u00fade Universidade Federal da Bahia  Vit\u00f3ria da Conquista Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1380-6930","authenticated-orcid":false,"given":"Narciso DiLorenzo Machado","family":"Dias","sequence":"additional","affiliation":[{"name":"Instituto Multidisciplinar em Sa\u00fade Universidade Federal da Bahia  Vit\u00f3ria da Conquista Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3341-1213","authenticated-orcid":false,"given":"Jacqueline Maia","family":"Ferraz","sequence":"additional","affiliation":[{"name":"Instituto Multidisciplinar em Sa\u00fade Universidade Federal da Bahia  Vit\u00f3ria da Conquista Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6627-5101","authenticated-orcid":false,"given":"Patricia","family":"da Silva Oliveira","sequence":"additional","affiliation":[{"name":"Instituto Multidisciplinar em Sa\u00fade Universidade Federal da Bahia  Vit\u00f3ria da Conquista Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"crossref","DOI":"10.3389\/fmed.2023.1106318","article-title":"Lichen sclerosus: the 2023 update","volume":"10","author":"De Luca DA","year":"2023","journal-title":"Front Med (Lausanne)"},{"key":"e_1_2_7_3_1","doi-asserted-by":"crossref","DOI":"10.6061\/clinics\/2021\/e2567","article-title":"Microablative fractional radiofrequency as a therapeutic option for vulvar lichen sclerosus: a pilot study","volume":"76","author":"Kamilos MF","year":"2021","journal-title":"Clinics (Sao Paulo)"},{"key":"e_1_2_7_4_1","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.jdcr.2021.09.028","article-title":"Nonablative radiofrequency in the treatment of refractory vulvar lichen sclerosus: a case series","volume":"17","author":"Balbinotti RR","year":"2021","journal-title":"JAAD Case Rep"},{"key":"e_1_2_7_5_1","doi-asserted-by":"crossref","first-page":"90","DOI":"10.52198\/23.STI.43.GY1743","article-title":"The novel use of bipolar radiofrequency microneedling in the treatment of lichen sclerosus","volume":"43","author":"Blusewicz TA","year":"2023","journal-title":"Surg Technol Int"},{"key":"e_1_2_7_6_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.ntm.2024.100048","article-title":"Exosomes for skin treatment: therapeutic and cosmetic applications","volume":"3","author":"Sreeraj H","year":"2024","journal-title":"Nano TransMed"},{"issue":"3","key":"e_1_2_7_7_1","doi-asserted-by":"crossref","first-page":"707","DOI":"10.3390\/cells9030707","article-title":"Therapeutic advances of stem cell\u2010derived extracellular vesicles in regenerative medicine","volume":"9","author":"Yin L","year":"2020","journal-title":"Cells"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-1744288"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.71178","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijgo.71178","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.71178","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T06:27:52Z","timestamp":1782282472000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/ijgo.71178"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,23]]},"references-count":7,"alternative-id":["10.1002\/ijgo.71178"],"URL":"https:\/\/doi.org\/10.1002\/ijgo.71178","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,23]]},"assertion":[{"value":"2026-04-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ijgo.71178"}}