Long-term supportive therapy in the treatment of vulvar lichen sclerosus: the importance of combination therapy and the role of moisturizers

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Дәйексөз келтіру

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Рұқсат жабық Рұқсат ақылы немесе тек жазылушылар үшін

Аннотация

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.

Толық мәтін

Рұқсат жабық

Авторлар туралы

Svetlana 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

Ресей, Moscow; Moscow

Diana Makovskaya

K+31 West JSC

Хат алмасуға жауапты Автор.
Email: md.makovskaya@gmail.com
ORCID iD: 0000-0003-0159-8641

obstetrician-gynecologist

Ресей, Moscow

Evgenia Fotina

K+31 West JSC

Email: md.makovskaya@gmail.com

obstetrician-gynecologist

Ресей, Moscow

Yuliya 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

Ресей, Moscow

Әдебиет тізімі

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2. Fig. 1. Patient S., 43 years old. Diagnosis: SLV. A, B. Data of physical examination before therapy: atrophy, whitish appearance and compaction of the edge of the labia minora (middle third) and perineal body. The right labia minora is almost completely fused with the labia majora. C. Data of physical examination 6 months after treatment with Er:YAG laser Fotona No. 4 and PRp n93 with an interval of 1 month. The condition against the background of using the intimate hygiene gel Intensive moisturizing "Saforel" in combination with the cream-emollient moisturizing for the intimate area "Saforel"

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3. Fig. 2. Description of the microscopic specimen of patient S., 43 years old, after a punch biopsy of the vulvar skin: multilayered squamous epithelium of uneven thickness, hyperkeratosis with focal parakeratosis. Edema, swelling and compaction of the collagen fibers of the papillary dermis. Diagnosis: Sclerosing lichen of the vulva. Staining with hematoxylin and eosin. Magnification 40x

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