Long-term supportive therapy in the treatment of vulvar lichen sclerosus: the importance of combination therapy and the role of moisturizers

DOI

https://dx.doi.org/10.18565/aig.2024.170

Kamoeva S.V., Makovskaya D.S., Fotina E.V., Dobrokhotova Yu.E.
1) K+31 West JSC, Moscow, Russia; 2) N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia

Vulvar lichen sclerosus (VLS) is a chronic inflammatory immune-mediated disease that affects vulva, perineum and anogenital area. Progression of the disease can lead to structural changes of the vulva, including resorption of the labia minora, clitoral fusion, vaginal stenosis and the development of vulvar intraepithelial neoplasia (VIN)/squamous cell carcinoma. The treatment of VLS is aimed at relieving the symptoms of severe itching, preventing or inhibiting the structural changes, minimizing the risk of developing VIN/squamous cell carcinoma and improving sexual function. Despite the effectiveness of topical glucocorticosteroid (tGCS) therapy, especially in the early or mild stage of the disease, the treatment of VLS still remains difficult. Long-term use of corticosteroids can cause skin atrophy, disruption of the protective barrier, and increased risk of infection. There is a need for an alternative to tGCS as additional moisturizers in case of long-term therapy of vulvar inflammatory dermatoses. Supportive therapy with emollients should be administered during the first-line therapy for VLS and after achieving remission with anti-inflammatory treatment. This article reviews current treatments for VLS, as well as aspects of good female intimate hygiene and the role of emollients as adjunct to supportive therapy.
Conclusion: Due to the studied and proven properties of burdock, the Saforelle line products for intimate hygiene (Biocodex, France) are effective and safe not only for maintaining healthy intimate hygiene, but they can also be prescribed as a part of the complex treatment of vulvovaginal infections and vulvar dermatoses.

Authors’ contributions: Makovskaya D.S. – developing the concept and design of the article, collecting the materials, processing and analyzing the materials on the subject of the study, writing the manuscript; Fotina E.V. – editing the text; Kamoeva S.V., Dobrokhotova Yu.E. – editing the text, approval of the manuscript for publication.
Conflicts of interest: Authors declare lack of the possible conflicts of interest.
Funding: The study was conducted without sponsorship.
Patient Consent for Publication: The patient provided informed consent for the publication of images and description of the clinical observation (informed consent dated February 12, 2024).
For citation: Kamoeva S.V., Makovskaya D.S., Fotina E.V., Dobrokhotova Yu.E. Long-term supportive therapy
in the treatment of vulvar lichen sclerosus: the importance of combination therapy and the role of moisturizers.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2024; (7): 158-164 (in Russian)
https://dx.doi.org/10.18565/aig.2024.170

vulvar lichen sclerosus

lichen sclerosus

intimate hygiene

burdock extract

emollients

vulvar dermatoses

Full text (in Russian)

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Received 16.07.2024

Accepted 26.07.2024

Svetlana V. Kamoeva, Dr. Med. Sci., Professor, Deputy Chief Physician on Obstetrics and Gynecology, «К+31» West JSC, 121552, Russia, Moscow, Orshanskaya str., 16/2; Associate Professor at the Department of Obstetrics and Gynecology, Pirogov Russian National Research Medical University, Ministry of Health of Russia, 117997, Russia, Moscow, Ostrovityanov str., 1, +7(909)970-38-74, https://orcid.org/0000-0002-7238-9911
Diana S. Makovskaya, obstetrician-gynecologist, «К+31» West JSC, 121552, Russia, Moscow, Orshanskaya str., 16/2, md.makovskaya@gmail.com,
https://orcid.org/0000-0003-0159-8641
Evgenia V. Fotina, obstetrician-gynecologist, «К+31» West JSC, 121552, Russia, Moscow, Orshanskaya str., 16/2, https://orcid.org/0000-0002-3718-4340
Yuliya E. Dobrokhotova, Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology, Pirogov Russian National Research Medical University,
Ministry of Health of Russia, 117997, Russia, Moscow, Ostrovityanov str., 1, https://orcid.org/0000-0002-7830-2290.
Corresponding author: Diana S. Makovskaya, md.makovskaya@gmail.com

Long-term supportive therapy in the treatment of vulvar lichen sclerosus: the importance of combination therapy and the role of moisturizers

Kamoeva S.V., Makovskaya D.S., Fotina E.V., Dobrokhotova Yu.E.

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