Long-term supportive therapy in the treatment of vulvar lichen sclerosus: the importance of combination therapy and the role of moisturizers
- Authors: Kamoeva S.V.1,2, Makovskaya D.S.1, Fotina E.V.1, Dobrokhotova Y.E.2
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Affiliations:
- K+31 West JSC
- N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
- Issue: No 7 (2024)
- Pages: 158-164
- Section: Guidelines for the Practitioner
- URL: https://journals.eco-vector.com/0300-9092/article/view/635310
- DOI: https://doi.org/10.18565/aig.2024.170
- ID: 635310
Cite item
Abstract
Vulvar lichen sclerosus (VLS) is a chronic inflammatory immune-mediated disease that affects vulva, perineum and anogenital area. Progression of the disease can lead to structural changes of the vulva, including resorption of the labia minora, clitoral fusion, vaginal stenosis and the development of vulvar intraepithelial neoplasia (VIN)/squamous cell carcinoma. The treatment of VLS is aimed at relieving the symptoms of severe itching, preventing or inhibiting the structural changes, minimizing the risk of developing VIN/squamous cell carcinoma and improving sexual function. Despite the effectiveness of topical glucocorticosteroid (tGCS) therapy, especially in the early or mild stage of the disease, the treatment of VLS still remains difficult. Long-term use of corticosteroids can cause skin atrophy, disruption of the protective barrier, and increased risk of infection. There is a need for an alternative to tGCS as additional moisturizers in case of long-term therapy of vulvar inflammatory dermatoses. Supportive therapy with emollients should be administered during the first-line therapy for VLS and after achieving remission with anti-inflammatory treatment. This article reviews current treatments for VLS, as well as aspects of good female intimate hygiene and the role of emollients as adjunct to supportive therapy.
Conclusion: Due to the studied and proven properties of burdock, the Saforelle line products for intimate hygiene (Biocodex, France) are effective and safe not only for maintaining healthy intimate hygiene, but they can also be prescribed as a part of the complex treatment of vulvovaginal infections and vulvar dermatoses.
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About the authors
Svetlana V. Kamoeva
K+31 West JSC; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Email: md.makovskaya@gmail.com
ORCID iD: 0000-0002-7238-9911
Dr. Med. Sci., Professor, Deputy Chief Physician on Obstetrics and Gynecology, «К+31» West JSC; Associate Professor at the Department of Obstetrics and Gynecology, Pirogov Russian National Research Medical University, Ministry of Health of Russia
Russian Federation, Moscow; MoscowDiana S. Makovskaya
K+31 West JSC
Author for correspondence.
Email: md.makovskaya@gmail.com
ORCID iD: 0000-0003-0159-8641
obstetrician-gynecologist
Russian Federation, MoscowEvgenia V. Fotina
K+31 West JSC
Email: md.makovskaya@gmail.com
obstetrician-gynecologist
Russian Federation, MoscowYuliya E. Dobrokhotova
N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Email: md.makovskaya@gmail.com
ORCID iD: 0000-0002-7830-2290
Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology
Russian Federation, MoscowReferences
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