Vulvar lichen sclerosus


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Abstract

Objective. To evaluate the efficiency and safety of photodynamic therapy (PDT) in the treatment of vulvar lichen sclerosus (VLS). Materials and methods. The study group included 15 female patients diagnosed with VLS. 1% chlorin E6 cream was used as a photosensitizer; a Harmony red light-emitting diode phototherapy device at a 660-nm wavelength, 30-min exposure, 100-J/cm2 pulse laser energy, and 100-mW/cm2 power was applied as a source of radiation. PDT was performed once every seven days (the average was 5-7 times) depending on the effect achieved. To evaluate the efficiency of PDT, the investigators used a visual analog scale, the Dermatology Life Quality Index, and vulvoscopy; overall satisfaction with the cycle of the procedures was also assessed. Results. The female patients postoperatively showed a significant reversal of itching, burning, pain, and dyspareunia. Vulvoscopy indicated the greatest effect of the procedures in treating subepithelial ecchymoses and telangiectasias (81.32%), as well as erosions and f issures (72.54%). A partial remission of lichenification with hyperkeratosis was seen in 53.23% of cases. The lowest atrophy response was observed in 32.45% of cases. The average therapeutic satisfaction score was 2.7 at the last visit. No serious adverse reactions occurred either during or after treatment. Conclusion. This investigation has demonstrated that PDT with chlorin E6 as a photosensitizer at a 660-nm wavelength, 30-minute exposure, 100-J/cm2 pulse laser energy, and 100-mW/cm2 power, once every 7 days (5-7 times) is a highly effective and safe treatment for VLS. Given the great potential benefits for patients, a large-scale clinical trial is needed to achieve the optimal parameters of PDT and to introduce the latter into practical healthcare.

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About the authors

Sergey I. Surkichin

Central State Medical Academy, Presidential Administration of the Russian Federation

Email: surkichinsi24@mail.ru
PhD, Associate Professor of the Department of Dermatovenerology and Cosmetology Moscow, Russia

Larisa S. Kruglova

Central State Medical Academy, Presidential Administration of the Russian Federation

Email: kruglovals@mail.ru
Dr. Med. Sci., Head of the Department of Dermatovenerology and Cosmetology Moscow, Russia

Inna A. Apolikhina

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: i_apolikhina@oparina4.ru
Dr. Med. Sci., Head of the Department of Aesthetic Gynecology and Rehabilitation, V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia; Professor of the Department of Obstetrics, Gynecology, Perinatology and Reproductology, Institute of Professional Education, I.M. Sechenov First MSMU, Ministry of Health of Russia (Sechenov University). Moscow, Russia

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