{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T03:00:02Z","timestamp":1793156402575,"version":"4.5.0"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:00:00Z","timestamp":1753315200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Vulvar lichen sclerosus (VLS) is a chronic inflammatory dermatosis that impairs the quality of life through symptoms such as itching, pain, and atrophy, and has limited response to conventional corticosteroid therapy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The authors of this study aim to evaluate the safety and efficacy of the Lichen-SVF protocol, a regenerative treatment combining nanofat and mechanically isolated stromal vascular fraction (SVF) for moderate-to-severe VLS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In this prospective, open-label study, the authors included 18 women with moderate-to-severe VLS and participants ranged from 24 to 81 years old, reflecting the broad clinical spectrum of this condition. Each received a single treatment involving intra- and subdermal injection of autologous nanofat (40\u2005cc) and SVF (2-3\u2005cc) into vulvar and perianal regions. Clinical follow-up occurred at 1, 3, 6, and 12 months. Symptom severity (clinical score system, CSS), itching (5D Itch Scale), quality of life (Skindex-29), and sexual function (Female Sexual Function Index, FSFI) were assessed using validated scales. Pre- and 12-month biopsies were analyzed histologically and immunohistochemically for markers such as stromal hyalinization, microvascular density, and T-cell infiltration.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Statistically significant reductions in CSS symptoms (from 20.12 to 4.71, P = .0025), CSS signs (from 5.79 to 2.00, P = .0014), and Itching 5D (from 6.82 to 2.35, P = .0136) were observed at 12 months. The quality of life improved (Skindex-29: from 42.88 to 24.82, P = .0313). FSFI scores showed nonsignificant improvement. Histologically, a marked reduction in stromal hyalinization (P = .0036) and CD3+ T-cell infiltration (P = .0068), along with increased microvascular density (P = .0121), confirmed regenerative effects. No serious adverse events occurred.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The Lichen-SVF protocol offers a safe and effective regenerative option for women with VLS who do not respond to standard treatments. As low-dose corticosteroids were maintained throughout follow-up, the protocol should be viewed as a complementary approach that enhances, rather than replaces, conventional therapy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Level of Evidence: 4 (Therapeutic)<\/jats:title>\n                  <jats:p\/>\n               <\/jats:sec>","DOI":"10.1093\/asj\/sjaf148","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T04:34:58Z","timestamp":1753331698000},"page":"1166-1174","source":"Crossref","is-referenced-by-count":4,"title":["Clinical and Histopathological Investigation of Stromal Vascular Fraction and Nanofat in Vulvar Lichen Sclerosus"],"prefix":"10.1093","volume":"45","author":[{"given":"Patricia","family":"Gutierrez-Ontalvilla","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agustina","family":"Gomez 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