Systematic review and meta-analysis of randomized controlled trials on topical interventions for genital lichen sclerosus

Chi, Ching‐Chi; Kirtschig, Gudula; Baldo, Maha; Lewis, Fiona M.; Wang, Shuhui; Wojnarowska, Fenella

doi:10.1016/j.jaad.2012.02.044

Cited by 87 publications

(76 citation statements)

References 24 publications

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“…The most used is clobetasol propionate 0.05% ointment, but the less potent mometasone furoate has shown a similar efficacy [8]. We demonstrated that mometasone furoate has shown a reduction in mean symptom and sign scores compared with baseline in both treatments.…”

Section: Discussionmentioning

confidence: 70%

Vulvar lichen sclerosus: could a moisturizing and healing product reduce the prolonged use of topical steroid?

Murina¹,

Vicariotto²,

Francesco³

et al. 2017

Clin Obstet Gynecol Reprod Med

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Section: Discussionmentioning

confidence: 70%

Vulvar lichen sclerosus: could a moisturizing and healing product reduce the prolonged use of topical steroid?

Murina¹,

Vicariotto²,

Francesco³

et al. 2017

Clin Obstet Gynecol Reprod Med

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“…Topical clobetasol propionate is the gold standard in the treatment of vulval LS in women and girls (10). Long-term use of either very potent or moderate topical corticosteroids appears to be effective and safe (11). Our patient was treated with topical clobetasol propionate cream for three months.…”

Section: Discussionmentioning

confidence: 92%

A Pediatric Case of Disseminated Lichen Sclerosus – a Case Report

Gocev

Nikolovska

Dohcheva-Karajovanov

2017

Serbian Journal of Dermatology and Venereology

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Lichen sclerosus (LS) is an uncommon chronic inflammatory skin disorder with a predilection for the anogenital area, characterized by porcelain white papules, plaques and atrophic patches. We report a prepubertal, 12-year-old girl who presented with chronic, disseminated pearly, flat-topped papules, plaques and atrophic patches located on the trunk, limbs and in the anogenital area, consistent with LS based on clinical and histologic findings. Potent and ultrapotent topical corticosteroids should be considered as first-line treatment. The ultraviolet A1 (UVA1) and calcipotriol for extragenital lesions, as well as calcineurin inhibitors for anogenital lesions, are other treatment options for pediatric LS. Lichen sclerosus is an uncommon chronic inflammatory skin disorder with a predilection for the anogenital area, characterized by porcelain white papules, plaques or atrophic patches. It was first described in 1887, by Hallopeau. Since then, many synonyms have been in use, notably 'guttate scleroderma,' 'white spot disease,' 'dermatitis lichenoides chronica atrophicans" or Csillag's disease,' 'kraurosis vulvae,' 'vulvar dystrophy, 'balanitis xerotica obliterans', 'lichen albus or Von Zumbusch Disease', or 'lichen sclerosus et atrophicus'. Since not all cases of LS et atrophicus exhibit atrophic tissue, 'et atrophicus' was dropped and replaced by 'lichen sclerosus,' which is now used for genital and extragenital lesions (1). LS is mostly seen in females with two peak ages of presentation: prepubertal girls and postmenopausal women. The prevalence rate of vulvar LS ranges between 1:70 to 1:1000 in women and 1:900 in children (2, 3).The patogenesis of LS has not yet been completly elucidatet; however, genetic factors and autoimmunity have been implicated. The most common autoimmune diseases associated with LS were autoimmune thyroiditis (12 %), alopecia areata (9%), vitiligo (6%), and pernicious anemia (2%) (4, 5). Hormonal, environmental, and infectious factors have also been implicated as possible causes of this disease.Initially, the lesions are pearly, flat-topped papules that coalesce into plaques, over time becoming atrophic patches. Telangiectasias, follicular plugging and bullous lesions may also be seen. The most common location is the anogenital area, although extragenital lesions can be present, mostly affecting buttocks, breasts, submammary area, neck, back, chest, axillae and wrists. Oral mucosal involvement has also been reported. Extragenital lesions are rare, especially in children.We report a prepubertal female child with LS with genital and disseminated extragenital lesions. Case ReportA 12-year-old prepubertal girl with a 12-month history of numerous mildly pruritic hypochromic lesions distributed on the trunk, limbs, and genital area was referred to the University Clinic of Dermatology, Skopje, Macedonia. She had visited several physicians due to these complaints which were misdiagnosed as vitiligo, tinea, psoriasis and verrucae planae. She used various ointments such as

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“…In contrast, welldesigned, vulvovaginal clinical trials and observational studies, such as in vulvodynia, lichen sclerosus and mucosal / erosive lichen planus, are relatively small in number. [7][8][9] In spite of the research neglect, vulvovaginal disorders fall within the top ten ambulatory visits by women and lead to multiple return visits, development of sexual dysfunction, progression of chronic pain, and a negative impact on overall quality-of-life 10 . Clinically, many vulvovaginal complaints are infrequently raised by patients in discussion with the healthcare provider, based on devastating biopsychosexual implications that results in a 'suffering-in-silence'.…”

Section: Define the Issue-specific To Vulvovaginal Diseasementioning

confidence: 99%

Core Outcome Sets for Clinical Trials and Observational Studies in Vulvovaginal Disease

Foster

Stockdale

Simpson

et al. 2017

J Low Genit Tract Dis

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Systematic review and meta-analysis of randomized controlled trials on topical interventions for genital lichen sclerosus

Cited by 87 publications

References 24 publications

Vulvar lichen sclerosus: could a moisturizing and healing product reduce the prolonged use of topical steroid?

Vulvar lichen sclerosus: could a moisturizing and healing product reduce the prolonged use of topical steroid?

A Pediatric Case of Disseminated Lichen Sclerosus – a Case Report

Core Outcome Sets for Clinical Trials and Observational Studies in Vulvovaginal Disease

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