Kryochirurgie – ultima ratio oder chirurgische Alternative beim vulvären Lichen sclerosus et atrophicus (LSAV)?

Kastner, Ulrike; Altmeyer, Peter

doi:10.1046/j.1610-0387.2003.03517.x

Cited by 8 publications

(5 citation statements)

References 19 publications

(29 reference statements)

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“…Pain was also significantly reduced. Our results confirm the data of two studies in the literature [10, 11]. August and Milward [10] described an improvement of pruritus of 75% a short time after cryosurgery and of 50% 3 years after surgical treatment in 12 patients.…”

Section: Discussionsupporting

confidence: 90%

“…August and Milward [10] described an improvement of pruritus of 75% a short time after cryosurgery and of 50% 3 years after surgical treatment in 12 patients. Kastner and Altmeyer [11]reported a loss of pruritus in 88% 16 months after cryosurgery in 17 patients.…”

Section: Discussionmentioning

confidence: 99%

“…Today, vulvar surgery is not recommended unless an associated malignancy is present. The efficiency of cryosurgery in the treatment of LS cannot be completely evaluated so far [8, 9, 10, 11]. …”

Section: Introductionmentioning

confidence: 99%

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The Outcome after Cryosurgery and Intralesional Steroid Injection in Vulvar Lichen sclerosus Corresponds to Preoperative Histopathological Findings

Stücker¹,

Grape²,

Bechara³

et al. 2005

Dermatology

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Background: Vulvar lichen sclerosus (LS) still presents a therapeutic challenge. Questions: The aim of the present study was to investigate whether there is a correlation between preoperative histopathological findings in female LS and long-term results after cryosurgery and intralesional steroid injections. Material and Methods: 22 females with LS, mean age 65.3 ± 10.5 years, were treated with cryosurgery (–186°C) using the contact method with 1 freeze-thaw cycle per lesion and intralesional triamcinolone acetonide injection. The time between surgery and follow-up examination was 27.8 ± 14.6 months. We compared the clinical outcome and the thickness of the epidermis, the zone of sclerosis and the inflammatory infiltrate in biopsy specimens taken before treatment. Results: In 14 of 22 patients, a relapse after cryosurgery occurred (median after 7.5 months). Patients would ‘moderately’ recommend cryosurgery for LS (2.2 ± 0.9; minimum: 0, optimum: 4). Pruritus was significantly reduced (visual analog scale: preoperative 7.1 ± 2.6 vs. postoperative 2.0 ± 2.4; p = 0.001) even in patients with relapse (preoperative 7.6 ± 2.4 vs. postoperative 3.1 ± 2.28; p = 0.001). Women with relapse showed a significantly higher composed thickness of epidermis, sclerosis and inflammatory infiltrate (430 ± 139.0 µm) than those without relapse (314 ± 41.2 µm; p = 0.046). Conclusion: In our patients, cryosurgery and intralesional steroid injections were efficient in the treatment of LS. Patients showing relapse had a thicker epidermis and a stronger inflammatory infiltrate. Therefore a treatment of LS should be performed at an early stage of the disease.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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The Outcome after Cryosurgery and Intralesional Steroid Injection in Vulvar Lichen sclerosus Corresponds to Preoperative Histopathological Findings

Stücker¹,

Grape²,

Bechara³

et al. 2005

Dermatology

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“…Cryotherapy has been used as a treatment modality for VLS refractory to medical management [36]. Temperature of -186°C under general anesthesia has been used in the past to treat VLS.…”

Section: Cryotherapymentioning

confidence: 99%

“…Postoperative wound care can be done with emollients, compresses, and antiseptic solution. It has been used successfully in children with good acceptance [36]. Cryotherapy may be used as a second-line therapy option in the treatment of long-standing VLS resistant to treatment.…”

Section: Cryotherapymentioning

confidence: 99%

Treatment Options in Vulvar Lichen Sclerosus: A Scoping Review

Singh¹,

Mishra²,

Ghatage³

2021

Cureus

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Vulvar lichen sclerosus (VLS) is a chronic inflammatory disorder, which affects women of all ages. The aim of this review is to focus on first-line, second-line, and maintenance therapies as well as follow-up of women with VLS. With numerous controversies, we decided to conduct a scoping review on this subject. A review protocol was developed, and the Knowledge Resource Services website was used to run a search of articles pertaining to VLS with keywords "Vulvar," "Vulval," and "Lichen Sclerosus." The search was limited to published data from the last 10 years, i.e., July 2009 onward, and researches published in English language. A total of 338 articles pertaining to VLS were obtained. Out of this, 62 were original articles related to management of VLS. Effective treatments such as high-potency topical steroids are now the standard of care and first-line treatment. Follow-up may be done every three to six months for the first two years and then at least yearly to ensure adequacy of treatment and encourage compliance. Long-term follow-up in specialist clinics is recommended for women who have persistent complaints, thickened skin, or history of neoplastic lesion. Monitoring young patients yearly is recommended as there are chances of recurrence.

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UV-A1 Phototherapy vs Clobetasol Propionate, 0.05%, in the Treatment of Vulvar Lichen Sclerosus

et al. 2014

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Kryochirurgie – ultima ratio oder chirurgische Alternative beim vulvären Lichen sclerosus et atrophicus (LSAV)?

Abstract: Cryotherapy is an effective therapeutic option for LSAV. It has few side effects and seems to be an attractive alternative especially in children.

Cited by 8 publications

References 19 publications

The Outcome after Cryosurgery and Intralesional Steroid Injection in Vulvar Lichen sclerosus Corresponds to Preoperative Histopathological Findings

The Outcome after Cryosurgery and Intralesional Steroid Injection in Vulvar Lichen sclerosus Corresponds to Preoperative Histopathological Findings

Treatment Options in Vulvar Lichen Sclerosus: A Scoping Review

UV-A1 Phototherapy vs Clobetasol Propionate, 0.05%, in the Treatment of Vulvar Lichen Sclerosus

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