Photodynamic therapy in the treatment of vulvar lichen sclerosus et atrophicus

Abstract

Lichen sclerosus (LS) is a chronic inflammatory disease that is 6–10 times more common in women than in men. LS affects between 1 in 1,000 and 1 in 300 people in the general population, but the exact prevalence is unknown since the disease is often asymptomatic. Objective: to evaluate the effectiveness of PDT in patients with LS in comparison with standard therapy methods. Material and methods: The study included 45 patients diagnosed with LS aged from 45 to 72 years (median age was 59 years). Depending on the therapy performed, the groups were divided into subgroups: Group 1A — patients with LS who were prescribed therapy with external glucocorticoids, Group 1B — patients with LS who were prescribed photodynamic therapy, Group 1C — patients with LS who were prescribed combined treatment: external glucocorticoids + PDT. Results: The study developed a special visual analogue scale to assess the objective condition of the vulva. VAS included the following parameters: pigmentation, skin pattern, turgor (skin fold straightening time), presence of cracks or erosions, and moisture. According to the data obtained, a complex treatment method using photodynamic therapy in patients with vulvar lichen sclerosus et atrophicus causes a higher effect than drug therapy and mono-PDT, which is confirmed by the dynamics of the total VAS index: 50.8 % compared with 28.2 % and 35.1 % in the comparison groups, respectively, therefore, it can be recommended for use in practical healthcare.