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

Terras, Sarah; Gambichler, Thilo; Moritz, Rose K. C.; Stücker, Markus; Kreuter, Alexander

doi:10.1001/jamadermatol.2013.7733

Cited by 45 publications

(46 citation statements)

References 40 publications

(46 reference statements)

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“…A significant reduction in the corium thickness and a significant increase in dermal density in 20 MHz ultrasound scanning as well as significant histopathological reduction in the inflammatory infiltrate were only observed after clobetasol treatment, but not after UVA1 phototherapy. The authors conclude that UVA1 was inferior to topical corticosteroids with respect to practicability, relief of itch and improvement of quality of life (Terras ).…”

Section: Phototherapymentioning

confidence: 98%

Evidence‐based (S3) Guideline on (anogenital) Lichen sclerosus

Kirtschig

Becker²,

Günthert

et al. 2015

Acad Dermatol Venereol

258

155

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Lichen sclerosus (LS) is an inflammatory skin disease that usually involves the anogenital area. All patients with symptoms or signs suspicious of lichen sclerosus should be seen at least once initially by a physician with a special interest in the disease in order to avoid delay in diagnosis, as early treatment may cure the disease in some and reduce or prevent scarring. The diagnosis is made clinically in most cases. Biopsies should only be performed under certain circumstances. The gold standard for treatment remains potent to very potent topical steroids; however, mild and moderate disease in boys and men may be cured by circumcision. Certain triggers should be avoided.

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Section: Phototherapymentioning

confidence: 98%

Evidence‐based (S3) Guideline on (anogenital) Lichen sclerosus

Kirtschig

Becker²,

Günthert

et al. 2015

Acad Dermatol Venereol

258

155

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“…60 Summary Management of patients with VVLP and VLS can be challenging. A randomized trial comparing 3 months of mediumdose UVA1 phototherapy (4 times/wk) to once daily clobetasol propionate 0.05% ointment in 30 women with VLS revealed that the 2 treatments had similar impact on clinician grading of VLS but that UVA1 had less impact on pruritus and quality of life.…”

Section: Physical Treatment Modalitiesmentioning

confidence: 99%

Lichen Sclerosus and Lichen Planus in Women and Girls

Schlosser¹,

Mirowski

2015

Clinical Obstetrics &Amp; Gynecology

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Lichen planus and lichen sclerosus are common, chronic inflammatory vulvar dermatoses with significant morbidity. The course may wax and wane but disease often persists for decades. These autoimmune diseases have varied clinical presentations that extend beyond the genitalia. Management is best undertaken using a multidisciplinary approach and active patient involvement. The first-line treatment of both conditions is superpotent topical corticosteroids. Supportive measures and adjunct therapies can optimize patient outcomes. Patients who fail to improve despite correct medication use should be re-evaluated, and clinicians should be vigilant in detecting concomitant contact dermatitis, secondary infection, and malignancy.

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“…Nevertheless, the current gold standard, say high-potent glucocorticosteroids, was superior to UV-A1, particularly with respect to practical considerations, reduction of pruritus, and quality of life improvement. However, we suggested to consider UV-A1 phototherapy as potential second-line treatment for VLiS (50). Moreover, our study group investigated epigenetic changes in 10 patients with LiS before and after a medium-dose UV-A1 (up to 50 J/cm 2 , 4 times weekly for 3 month) treatment compared to healthy controls.…”

Section: Introductionmentioning

confidence: 99%

Ultraviolet A1 Phototherapy for Fibrosing Conditions

Gambichler

Schmitz

2018

Front. Med.

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In this article we describe efficacy and safety aspects of ultraviolet A1 (UV-A1) phototherapy in fibrosing conditions. UV-A1 is a specific phototherapeutic modality that is defined by a selective spectral range (340–400 nm). UV-A1 includes distinct modes of action qualifying this method for therapy of a variety of conditions, in particular fibrosing skin diseases. Concerning efficacy of UV-A1 phototherapy in fibrosing conditions, the best evidence obtained from randomized controlled trials exists for localized scleroderma. Moreover, fibrosing disorders such as lichen sclerosus and graft-vs.-host disease can be treated successfully by means of UV- A1. Regarding the optimal dosage regimen medium-dose UV-A1 seems to be linked to the best benefit/risk ratio. Possible acute adverse events of UV-A1 phototherapy include erythema and provocation of photodermatoses. Skin ageing and skin cancer formation belong to the chronic adverse events that may occur after long-term UV-A1 phototherapy.

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

Abstract: clinicaltrials.gov Identifier: NCT01400022.

Cited by 45 publications

References 40 publications

Evidence‐based (S3) Guideline on (anogenital) Lichen sclerosus

Evidence‐based (S3) Guideline on (anogenital) Lichen sclerosus

Lichen Sclerosus and Lichen Planus in Women and Girls

Ultraviolet A1 Phototherapy for Fibrosing Conditions

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