The treatment of vulval lichen sclerosus with a very potent topical steroid (clobetasol Propionate 0.05%) cream

Abstract

The clinical and histological response to 12 weeks of treatment with a very potent topical fluorinated steroid was studied in 15 patients with vulval lichen sclerosus (LS) who were treated with twice daily applications of clobetasol propionate 0.05% cream (Dermovate, Glaxo U.K.). Thirteen patients completed the study and all showed a marked clinical improvement. Histological measurements of skin biopsies taken before and after treatment showed a significant reduction in the characteristic features of LS. One patient developed contact sensitivity to clobetasol propionate. There was no evidence of infection or skin atrophy during the study. Patients completing the study have been followed up for up to 22 months and have been maintained in remission with moderately potent topical steroids which had previously been ineffective.

Successful Treatment of Vulvar Lichen Sclerosus With Topical Tacrolimus

“…19 Today, topical application of potent corticosteroid ointment is considered the treatment of choice. 2 However, in our patient, only moderate temporal improvement was observed followed by prompt relapse after tapering of the corticosteroid use.…”

“…Potent corticosteroids applied topically are generally considered the first-line treatment. [1][2][3] None of the therapeutic regimens used in our patient, however, were sufficiently beneficial. The patient continued to refrain from sexual intercourse owing to severe vulvar discomfort.…”

Paediatric vulval lichen sclerosus

“…41 Prior to this it had been considered inappropriate to use potent preparations on the vulva. Previous reported treatments with weak topical corticosteroids, topical testosterone and progesterone were ineffective, leaving the impression that LS was a very difficult condition to treat.…”

Ultrapotent Topical Corticosteroid Treatment of Childhood Genital Lichen Sclerosus

“…Ultrapotent topical corticosteroid application was more effective and resulted in fewer adverse effects than topical testosterone or topical progesterone therapy. [13][14][15][16] The use of ultrapotent topical corticosteroids for children with genital lichen sclerosus has rarely been described, and concerns about the risk of associated cutaneous adverse effects have limited its routine use. 6,[17][18][19][20][21] We investigated the efficacy and safety of treatment of genital lichen sclerosus with a 6-week course of twice daily application of ultrapotent topical corticosteroid.…”