Lichen Sclerosis
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Lichen Sclerosis
- This topic has 10 replies, 7 voices, and was last updated 3 years, 10 months ago by
Susan Sklar.
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September 9, 2021 at 1:19 pm #31118
I have a 65 year old woman with lichen sclerosis on her thighs bilaterally and vulva. Steroid cream application did not help. I had her use an old fashioned gyn treatment with topical testosterone. This did not help. I’m thinking TA-1 for the autoimmune aspect of the disorder and possibly TB-4 for anti-fibroblast effect. Has anyone had experience with injecting into skin lesions? Or would the usual subcutaneous intraabdominal injection work? Thanks in advance.
September 9, 2021 at 6:10 pm #31119Susan: could you not get it compounded as a topical ? What about kpv or LL37 support as well. Pondering.
September 9, 2021 at 7:08 pm #31120Robin
Thanks. Great suggestions!
Susan
September 20, 2021 at 10:38 am #31121Hello @drerikaeshealth-com and @byurthgmail-com, would love to have your inputs here.
Thank you! 🙂
September 20, 2021 at 12:27 pm #31122Susan-
I’ll leave the peptide responses to those adult docs who have the most experience with these. And while of course, it goes without saying that getting to the underlying inflammatory cause is best long term…..
in the short term, at least in kids… we use Elidel or Protopic with great results (as opposed to reaching for the steroids). Also (again, at least in kids) it is worth getting it under control sooner rather than later (while working on the under lying cause)… as the scaring-down it can cause of the vagina needs to be stopped before it happens.
-Cynthia
September 20, 2021 at 7:58 pm #31123Low dose Naltrexone can be VERY helpful in Lichen sclerosis!
Dr Yurth
September 30, 2021 at 6:06 pm #31124Hello @drsklarsklarcenter-com,
Here’s a video response from Dr. Seeds’ SSRP Office Hours 9/21/21 at 10:25 please watch below:
Thank you! 🙂
October 2, 2021 at 12:31 pm #31126Great info Dr Seeds. I just saw a patient with widespread Lichen Sclerosus 2 days ago – not responding to steroid therapy. Has T1DM and ruptured breast implant for the last 6 months (she just revealed that to me 2 days ago ) – definitely Autoimmune dysfunction. Have patient seeing Plastics ASAP! In the meantime, I am thinking of using the regiment Dr Seeds mentioned in the video. I also advised her on the Light therapy by DERM for her to look into. Any thoughts join that addition @drsklarsklarcenter-com ?
Thanks
Dr Morris
February 3, 2022 at 10:33 am #31127Claim your CME here: https://earnc.me/jzakfu
February 6, 2022 at 11:46 am #31128Dr. Seeds video response (transcription edited for readability)
(Transcriber’s note: Articles on stem cell treatment, reviews of Lichen Sclerosus, and the forms for FSFI (female sexual function inventory) and DLQI (dermatology life quality index) are found in the Zotero Group SSRPI at the URL Zotero.org. Just search for the group SSRPI. You will find these resources in the folder Cases/Lichen Sclerosus.)
Wow. Okay. I’ll try to answer this in a couple of different steps.
This is an autoimmune disease, and it’s more of a TH-1 disease pushed forward by interferon gamma. It has to do with increasing chemokine receptors, chemokine ligands, and other chemokine receptors that are on leukocytes or white cells. So, it’s all about inflammatory response and it’s definitely TH1 dominated. So, I absolutely go at problems like this with immune modulators like TA1 and TB4 and TA1 to kind of help turn off the TH1 dominated part of this, which is more of the chemokine attractive aspects of the leukocytes, and that is up regulating interleukin-10, that can have a good influence on this. So, Thymosin alpha 1, I think, is very important in these type of autoimmune problems. I think, initially, you have to use TA1. You have to go pretty high with the dosing, and it doesn’t have to be specific to the area, but it’s going to be part of the protocol that you’re going to use daily. You could kind of think of it as going at it for two weeks, because you want to see if you have some initial change, right? You go at it with two weeks at high dosing, like 50 IUs. 50 IUs daily for two weeks. And at the same time, I would suggest TB 4, that you can use subcutaneously in the plaque areas. You kind of have to move it around, but you’re going to allow about 30 IUs on each side. So. it’s going to be 60 IU total on both sides, It’s just a little bit (5 IUs) here and (5 IUs) here. It’s just little injections in the areas. I combine something like a GHK Cu KPV cream. You can even have them compound with a little bit of a ascorbic acid in that, too, which will help with that leukoplakia. You can use that two to four weeks to see the changes that I think that are going to be more (than you saw with the steroids) if the steroids did not work for you.
You know, there are a lot of approaches with this. Stem cells is an approach in which smaller studies have shown results changing this process.
I’d be interested if this is in the vulva area, is there some dyspareunia? Are there problems with intercourse, sex life? Is it, is she painful in that area too, because then it becomes more of an issue, more of a secondary issue definitely, thinking about that next step if this doesn’t work. I think the stem cell approach is a really good option to think about. I can talk to you more about that, too, if you’re interested, because there have been some papers written specifically on that.
Then intermittently use the peptides, meaning like once a week, using a high dose (of TA1) at 50 IUs, and then, the TB4 , and doing it , going all the way down to once a week , but you’re going to have some type of process . You’re probably going to have to continue as I’ve seen, unless you go the stem cell route, which can eradicate it , and I haven’t seen follow-up studies , and I personally haven’t done the stem cells for this specifically. So, I don’t have any personal experience with the stem cell part, but with the TA1 and the TB4, I do, and with the GHK Cu and KPV cream combined, I do, but I haven’t used the ascorbic yet, and that’s something new I’ve added, and I’ve used it for other things, but I think if you add ascorbic acid, it will be even better with that. It may sting around the vulva area, you have to be a little careful with the ascorbate, because it might burn a little bit. So, that’s one thing you’ve got to just be focused on. I don’t think it’s going to be that high of a percentage that it causes that much irritation.
So those are my thoughts, I hope that’s helpful. I have some other ideas. Well, that’s a good place to start. Let’s keep this conversation going because this is a great case to follow. So, bring this back to us with what you’ve done, because everybody can learn a lot from this, including me, okay? So, come back to me and tell me I’m wrong, (I want you) to come back and say, “Oh, Doctor Seeds, what are you talking about?” I think you’re going to come back and say, hey, we made some progress. So, let’s keep talking.
(Keren) And would it be the Sub-Q injection?
So, what she’s talking about, the Sub-Q injection outside of the area of where this plakia basically is. The TA1 can be outside of the area, doesn’t have to be specific. The TB4 needs to be in those areas, just spattered around, you know, like 5 IUs here, 5 IUs here, 5 IUs here, 5 IUs here, just so you get all that area. and I would use every bit of between 30 to 60 IUs each time you do that, and that’s just once a day.
I’m leaving a lot to you. That’s something that we worked through over many years. There’s a lot that’s been written on it, with multiple modalities of treatment, laser treatments, CO2 treatments, high vitamin A. So, there’s a lot of stuff people have tried. I think you’re on the right track.
(Transcriber’s note: Articles on stem cell treatment, reviews of Lichen Sclerosus, and the forms for FSFI (female sexual function inventory) and DLQI (dermatology life quality index) are found in the Zotero Group SSRPI at the URL Zotero.org. Just search for the group SSRPI. You will find these resources in the folder Cases/Lichen Sclerosus.)
February 6, 2022 at 8:42 pm #31129Dr. Seeds,
What do you mean by IU? Do you mean 0.5 ml in an insulin syringe?
Thanks.
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