Alteration of T-cell subpopulations and lipid peroxidation in the blood of patients with vulvar non-neoplastic epithelial disorder

Кравченко

Journal of obstetrics and women's diseases

2021

This article overviews modern literature data on vulvar dystrophies. The increase in the number of patients with dystrophic diseases of the vulva, a pronounced tendency towards rejuvenation, the complexity of diagnosis, frequent recurrence of the disease and low effectiveness of therapy make this issue extremely urgent. Until now, morphologists have not developed a single classification, and among clinicians, a specific etiopathogenetic concept of development of vulvar dystrophies has not been determined. There are many theories of the disease development. The process starts asymptomatically and is not diagnosed in a timely manner, and due to the localization in the intimate area, it is characterized by low circulation and an increase in the number of neglected cases. Only a comprehensive, timely started treatment with the right choice of drugs and methods of activating reparative processes will prevent development of the disease and reduce the duration of the main symptoms and the likelihood of relapses, exacerbations, and complications.

Vulvar dystrophies: a modern view of the problem

Кравченко

Journal of obstetrics and women's diseases

2021

<p>Lichen sclerosus: the role of oxidative stress in the pathogenesis of the disease and its possible transformation into carcinoma</p>

Paulis

Berardesca²

2019

RRU

Lichen sclerosus (LS) is an autoimmune chronic inflammatory disease usually involving the anogenital skin of both sexes; more rarely LS exclusively involves extragenital areas. As a chronic inflammatory disease, in most cases, LS evolves and progresses causing scleroatrophy of the skin or scars which may cause stenosis in the affected areas. A few LS patients are at risk of developing squamous cell carcinoma in their lifetime, but appropriate long-term treatment diminishes the possibility of a malignant evolution. Oxidative stress (OS) has been proven to play a role not only in the pathogenesis of LS, but also in the development and progression of the disease. OS, by causing DNA damage and lipid peroxidation, contributes directly to the possible malignant transformation of LS. Moreover, the increase in oxidative DNA damage is associated with mutations in tumor suppressor genes. Considering the role that OS plays in LS, therapeutic use of antioxidants appears to be rational and possible, in association with other treatments. Antioxidants would counteract the oxidative DNA damage, which is the most important factor for the progression of LS and its malignant transformation.

Fundamentalʹnaâ i kliničeskaâ medicina

Antioxidants in treatment of kraurosis vulvae

Kiseleva

Махмутходжаев

Михеенко

2022

Aim. To study impact of ethylmethylhydroxypyridine succinate, an antioxidant, on the efficacy of photodynamic therapy (PDT) of kraurosis vulvae (vulvar lichen sclerosus).Materials and Methods. The study enrolled 90 patients with kraurosis vulvae who were randomised into 3 groups receiving: 1) PDT and ethylmethylhydroxypyridine succinate 1 week after the start of the PDT for 1 month; 2) PDT without ethylmethylhydroxypyridine succinate; 3) low-level laser therapy on the perineal region. Clinical manifestations of kraurosis vulvae were dynamically assessed before the treatment and 1, 6, and 12 months post treatment. The severity of vulvar itching was evaluated using visual analogue scale. LS-A index was calculated to determine the disease activity, whilst LS-S index was applied to quantify the affected vulvar area.Results. PDT demonstrated higher therapeutic efficacy in treatment of kraurosis vulvae than low-level laser therapy. Addition of ethylmethylhydroxypyridine succinate to the treatment protocol improved the results of PDT, as remission of vulvar itching within 12 months was achieved in 73% of patients who received PDT in conjunction with ethylmethylhydroxypyridine succinate and only in 47% of participants receiving PDT alone (p = 0.042). One month post treatment, the intensity of itching according to visual analogue scale was 2.0 points in patients who received combined treatment and 4.5 points in those receiving PDT alone (p < 0.001). Vulvar epithelialization also occurred earlier in patients receiving combined treatment (48 ± 5 days versus 54 ± 3 days in those receiving PDT alone, p < 0.001). Upon 12 months of observation, disease activity and affected vulvar area were significantly lower in patients receiving combined treatment (LS-A 4.0; LS-S 1.0) as compared to the PDT alone (LS-A 6.5; LS-S 3.0, p = 0.004 and < 0.001, respectively).Conclusion. Addition of ethylmethylhydroxypyridine succinate to photodynamic therapy demonstrated high efficacy against kraurosis vulvae and can be recommended for its treatment.