Abstract
Objective: Lichen sclerosus (LS) is a chronic progressive skin disease of inflammatory etiology, which often occurs in the female external genital area and presents therapeutic dilemmas. This condition can affect women from adolescence to senescence. Intense and recalcitrant pruritus is a symptomatic hallmark of LS. The aim of our long-term study was to quantify the termination of pruritus, reduction of active disease progression, and cessation of scarring in response to a program of subdermal steroid injection regimen for LS. Study Design: The primary outcome of our study was to quantify the number and intervals of steroid injections required to obtain the cessation of active disease progression and symptoms of itching and pain. The study was a clinical chart review of 88 patients who were referred to a specialized vulvovaginal clinic at a large private hospital. Referrals came from general obstetricians and gynecologists, family physicians, and dermatologists. Results: Sixty-two (62) patients (72.9%) clinically manifested a reduction on their active disease progression that persisted after 60 months, whereas on 10 patients (11.8%), their disease remained stable and on 13 patients (15.3%), their disease continued to progress. Seventy-two (72) patients (81.8%) of 88 total patients became pruritus free after 4 injection treatments were given; however, 31 of those patients (35.2%) required intermittent topical triamcinolone for pruritus relief between their monthly injections. Every other month or greater, injection intervals were required to prevent relapse in all patients. Conclusions: In our study, the majority of the patients with advanced symptomatic vulvar LS obtained rapid symptomatic pruritus relief after serial (monthly) subdermal steroid injections. Maintenance treatments were thereafter required to control pruritus, to prevent disease progression, and subsequent additional vulvar scarring. (J GYNECOL SURG 22:137)
Get full access to this article
View all access options for this article.