<p>Vulvar Lichen Sclerosus: Current Perspectives</p>

Abstract

Vulvar lichen sclerosus (LS) is a chronic, inflammatory dermatosis that may lead to scarring of the vulva and sexual dysfunction. LS affects women of all ages and often goes unrecognized and underreported. Uncertainty continues to exist around its pathogenesis, histologic diagnosis, and treatment. However, there have been great advances in our understanding of autoimmunogenic targets in disease formation and progression. In addition, there has been recent investigation of potential non-steroid-based treatments, including plateletrich plasma therapy and energy-based modalities such as the fractional CO 2 laser, photodynamic therapy, and high intensity focused ultrasound. Refinement of surgical techniques for restoring vulvar anatomy and treating clitoral phimosis, introital stenosis, and vulvar granuloma fissuratum is leading to improved patient outcomes. This review summarizes current perspectives on the pathogenesis, symptomatology, diagnosis, and treatment for vulvar lichen sclerosus.

Microablative fractional radiofrequency as a therapeutic option for vulvar lichen sclerosus: a pilot study

“…A cohort study involving 27 women with symptomatic LS reported that 89% had complete regression of pruritus and pain after three or four fractioned CO 2 laser sessions 4-6 weeks apart ( 14 ). In addition, double-blind, randomized, placebo-controlled trials comparing fractional CO 2 laser with topical corticosteroid treatment for women with VLS are missing in the literature ( 31 ).…”

Therapeutic Assessment of High-Intensity Focused Ultrasound for Vulvar Lichen Sclerosus by Active Dynamic Thermal Imaging and Hyperspectral Imaging—A Preliminary Study

“…In this paper, we explored the absorption spectrum of the affected labia majora. For further analysis, 6×10 4 ROIs of a size of 1 × 1 pixel within the treatment areas of the labia majora of every patient were selected randomly. Figures 8C,F show the reflectance absorption curves of all selected ROIs for P 15 and P 19 .…”

“…Vulvar Lichen Sclerosus (VLS) is a chronic mucocutaneous disorder, which is likely to lead to impairment in sexual function and the potential for malignant transformation [1][2][3][4]. Early diagnosis, prompt treatment, and appropriate follow-up are extremely important to prevent these negative sequelae [4][5][6].…”

“…Considering the serious side effects of traditional treatment, high-intensity focused ultrasound (HIFU) treatment, which uses ultrasound as a carrier of energy, has gradually gained popularity as an alternative treatment for VLS [2,4,[12][13][14][15][16]. Propagating harmlessly, HIFU causes a sufficient local rise in temperature for the thermal destruction of target tissues without damaging surrounding or overlying tissues [17].…”

Photodynamic therapy in the treatment of patients with vulvar premalignant diseases. First experience of its use in Ukraine

“…На данный момент опубликованы результаты ряда работ, показывающих положительные аспекты применения ФДТ с различными классами фотосенсибилизирующих агентов (в том числе 5-аминолевулиновая кислота и ее производные, хлориновые ФС и др.). Авторами исследований отмечена достаточно высокая частота полных клинических и морфологических регрессий при применении ФДТ у данных категорий пациенток [9][10][11][12][13][14][15].…”