A double-blind, randomized prospective study evaluating topical clobetasol propionate 0.05% versus topical tacrolimus 0.1% in patients with vulvar lichen sclerosus

Funaro, Deana; Lovett, Audrey; Leroux, Nathalie; Powell, Julie

doi:10.1016/j.jaad.2014.02.019

Cited by 76 publications

(53 citation statements)

References 19 publications

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“…The efficacy and safety of topical tacrolimus in the treatment of LS is reported in several case series and is recently confirmed in a comparative randomized studies (Funaro ).…”

Section: Topical Calcineurin Inhibitors/non‐antibiotic Macrolidesmentioning

confidence: 69%

Evidence‐based (S3) Guideline on (anogenital) Lichen sclerosus

Kirtschig

Becker²,

Günthert

et al. 2015

Acad Dermatol Venereol

254

155

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Lichen sclerosus (LS) is an inflammatory skin disease that usually involves the anogenital area. All patients with symptoms or signs suspicious of lichen sclerosus should be seen at least once initially by a physician with a special interest in the disease in order to avoid delay in diagnosis, as early treatment may cure the disease in some and reduce or prevent scarring. The diagnosis is made clinically in most cases. Biopsies should only be performed under certain circumstances. The gold standard for treatment remains potent to very potent topical steroids; however, mild and moderate disease in boys and men may be cured by circumcision. Certain triggers should be avoided.

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“…The efficacy and safety of topical tacrolimus in the treatment of LS is reported in several case series and is recently confirmed in a comparative randomized studies (Funaro ).…”

Section: Topical Calcineurin Inhibitors/non‐antibiotic Macrolidesmentioning

confidence: 69%

Evidence‐based (S3) Guideline on (anogenital) Lichen sclerosus

Kirtschig

Becker²,

Günthert

et al. 2015

Acad Dermatol Venereol

254

155

View full text Add to dashboard Cite

show abstract

“…Topical calcineurin inhibitors are not licensed for the treatment of LS. However, the efficacy of topical tacrolimus 0.1% has been demonstrated in the treatment of vulval LS (Ib, A) and when used for 16–24 weeks in males and females with genital and extra‐genital LS (IIb, B). Topical tacrolimus 0.03% ointment appears to be an effective treatment for children with anogenital LS and as maintenance treatment (twice a week), possibly reducing recurrences (III, B).…”

Section: Lichen Sclerosusmentioning

confidence: 99%

2016 European guideline for the management of vulval conditions

Meijden

Boffa

Harmsel

et al. 2017

Acad Dermatol Venereol

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Vulval conditions may present to a variety of clinicians, such as dermatologists, gynaecologists and general practitioners.Women with these conditions are best managed by a multidisciplinary approach, which includes clear referral pathways between disciplines or access to a specialist multidisciplinary vulval service. Informed consent is a prerequisite for all examinations, investigations and treatments. Consent is particularly important for intimate examinations of the anogenital area, and a chaperone should be offered in all cases. All efforts should be made to maintain a patient's dignity. Depending on symptoms and risk factors, screening for sexually transmitted infections (STI) should be considered. If the patient presents with vulval itch, particularly if also complaining of increased vaginal discharge, vulvaginal candidiasis should be excluded. Sexual dysfunction should be considered in all patients with vulval complaints, either as the cause of the symptoms or secondary to symptoms, and assessed if appropriate. This guideline covers several aspects, such as diagnosis and treatment, of the more common vulval conditions (relatively) often encountered at vulval clinics, i.e. vulval dermatitis (eczema), psoriasis, lichen simplex chronicus, lichen sclerosus, lichen planus, vulvodynia and vulval intraepithelial neoplasia (VIN).

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“…The resulting complex inhibits phosphatase calcineurin, thus blocking T-cell activation and cytokine release. [31]…”

Section: Topical Treatmentmentioning

confidence: 99%

Vulvar lichen sclerosus et atrophicus

Nair

2017

J Mid-life Health

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Vulvar lichen sclerosus (VLS) is a chronic inflammatory dermatosis characterized by ivory-white plaques or patches with glistening surface commonly affecting the vulva and anus. Common symptoms are irritation, soreness, dyspareunia, dysuria, and urinary or fecal incontinence. Anogenital lichen sclerosus (LS) is characterized by porcelain-white atrophic plaques, which may become confluent extending around the vulval and perianal skin in a figure of eight configuration. Thinning and shrinkage of the genital area make coitus, urination, and defecation painful. LS is not uncommon in India and present as an itchy vulvar dermatosis which a gynecologist may mistake for candidal vulvovaginitis. There is often a delay in diagnosis of VLS due to its asymptomatic nature and lack of awareness in patients as well as physicians. Embarrassment of patients due to private nature of the disease and failure to examine the genital skin properly are the other reasons for delay in diagnosis. There is no curative treatment for LS. Various medications available only relieve the symptoms. Chronic nature of the disease affects the quality of life. Proper and regular follow-up is required as there are chances of the development of squamous cell carcinoma.

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A double-blind, randomized prospective study evaluating topical clobetasol propionate 0.05% versus topical tacrolimus 0.1% in patients with vulvar lichen sclerosus

Cited by 76 publications

References 19 publications

Evidence‐based (S3) Guideline on (anogenital) Lichen sclerosus

Evidence‐based (S3) Guideline on (anogenital) Lichen sclerosus

2016 European guideline for the management of vulval conditions

Vulvar lichen sclerosus et atrophicus

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