Vulvovaginal photodynamic therapy vs. topical corticosteroids in genital erosive lichen planus: a randomized controlled trial

Vulval conditions may present to a variety of clinicians, such as dermatologists, gynaecologists and general practitioners.Women with these conditions are best managed by a multidisciplinary approach, which includes clear referral pathways between disciplines or access to a specialist multidisciplinary vulval service. Informed consent is a prerequisite for all examinations, investigations and treatments. Consent is particularly important for intimate examinations of the anogenital area, and a chaperone should be offered in all cases. All efforts should be made to maintain a patient's dignity. Depending on symptoms and risk factors, screening for sexually transmitted infections (STI) should be considered. If the patient presents with vulval itch, particularly if also complaining of increased vaginal discharge, vulvaginal candidiasis should be excluded. Sexual dysfunction should be considered in all patients with vulval complaints, either as the cause of the symptoms or secondary to symptoms, and assessed if appropriate. This guideline covers several aspects, such as diagnosis and treatment, of the more common vulval conditions (relatively) often encountered at vulval clinics, i.e. vulval dermatitis (eczema), psoriasis, lichen simplex chronicus, lichen sclerosus, lichen planus, vulvodynia and vulval intraepithelial neoplasia (VIN).

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“…Treatment There is only one randomized controlled trial evidence to guide treatment of vulval erosive lichen planus. 68,69 Topical Treatment…”

Section: Managementmentioning

confidence: 99%

2016 European guideline for the management of vulval conditions

Meijden

Boffa

Harmsel

et al. 2017

Acad Dermatol Venereol

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“…Prednisolone 5 mg pessaries have also been shown to be effective; however, some patients find these methods uncomfortable. Recent studies have reported positive outcomes with alternative formulations such as hydrocortisone acetate 10% foam …”

Section: Topical Therapiesmentioning

confidence: 99%

“…Algorithmic approach to treating VVLP. (Step 1) High‐potency steroids (i.e., clobetasol propionate 0.05% ointment) applied twice daily and then tapered once disease is controlled. Topical calcineurin inhibitor (i.e., tacrolimus 0.1% ointment) is another option that can be used in a similar regimen.…”

Section: Systemic Therapiesmentioning

confidence: 99%

Update on treatments for erosive vulvovaginal lichen planus

2019

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Vulvovaginal lichen planus (VVLP) is a debilitating disease that causes significant pain and psychological distress. Management is made difficult by the chronic course of the disease and its resistance to treatment. While topical steroids have been accepted as the first-line treatment, they fail to achieve symptomatic control in approximately 40% of patients.Second-line therapies include other topical treatments such as calcineurin inhibitors, systemic therapies including oral steroids, methotrexate, mycophenolate mofetil, biologics, and tacrolimus, and procedural options including surgery and dilation, photodynamic therapy, and ultrasound. This review provides an overview of the current treatments and explores the level of evidence supporting each of them.

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“…Photodynamic therapy (PDT) is a recently described treatment for patients with VLP and was found to have an equivalent efficacy to clobetasol ointment in a randomized controlled trial of 40 patients (Helgesen et al, 2015). Finally, patients with labial adhesions may benefit from surgery (Guerrero and Venkatesan, 2015).…”

Section: Lichen Planusmentioning

confidence: 99%

Lichenoid vulvar disease: A review

Fruchter

Melnick

Pomeranz

2017

International Journal of Women's Dermatology

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Vulvar dermatoses are common, potentially debilitating conditions that can be seen by a variety of medical specialists. Lichenoid vulvar diseases, namely lichen sclerosus (LS), lichen planus (LP), and lichen simplex chronicus (LSC), can all negatively impact patients’ quality of life and LS and LP also have an association with squamous cell carcinoma. It is essential that dermatologists are familiar with the unique features of each of these conditions to ensure the appropriate management and follow up. Herein, we provide an update on the epidemiology, clinical presentation, histopathology, and treatment of patients with vulvar LS, LP, and LSC.

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Vulvovaginal photodynamic therapy vs. topical corticosteroids in genital erosive lichen planus: a randomized controlled trial

Abstract: Vulvovaginal HAL-PDT seems to be an effective and safe treatment for GELP.

Cited by 31 publications

References 34 publications

2016 European guideline for the management of vulval conditions

2016 European guideline for the management of vulval conditions

Update on treatments for erosive vulvovaginal lichen planus

Lichenoid vulvar disease: A review

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