Treatment for female external genital lichen sclerosus: from standards to innovations
Lichen sclerosus is one of the most common female external genital diseases. The limiting factor for the success of treatment for vulvar lichen sclerosus is a lack of consensus on the etiopathogenesis of the disease and accordingly targeted treatments. Topical glucocorticosteroids and calcineurin inhibitors are now the first-line therapy. Despite a variety of drugs for the treatment of vulvar lichen sclerosus, there are more and more cases of resistance and adverse reactions to traditional therapy, and considering the young age of patients, the search for new technologies in the treatment of vulvar lichen sclerosus is becoming urgent. The article reviews methods for treating the disease in accordance with international protocols and Russian recommendations. In addition, it describes minimally invasive techniques, such as high-frequency focused ultrasound (HIFU), photothermal vulvar tissue reconstruction using carbon dioxide, erbium, and neodymium lasers, platelet-rich plasma (PRP), and autologous stem-cell transplantation, which are currently actively used and have a great therapeutic potential to influence the foci of lichen sclerosus.Sokolova A.V., Apolikhina I.A.
Keywords
vulvar lichen sclerosus
topical corticosteroids
laser exxposure
PRP
HIFU
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Received 29.04.2020
Accepted 25.06.2020
About the Authors
Inna A. Apolikhina, MD, obstetrician&gynecologist, professor, National Medical Research Center for Obstetrics, Gynecology and Perinatology named after V.I. Kulakov, Moscow, Russian Federation; First Moscow State Medical University named after I.M. Sechenov, Moscow, Russian Federation.Тel.: +7(495)735-10-55. E-mail: apolikhina@inbox.ru.
4, Oparina str., Moscow, 117997, Russian Federation.
Anastasia V. Sokolova, MD, obstetrician&gynecologist, post-graduate student National Medical Research Center for Obstetrics, Gynecology and Perinatology named
after V.I. Kulakov, Moscow, Russian Federation. Тel.: +7(915)455-31-32. E-mail: stasia0590@mail.ru.
4, Oparina str., Moscow, 117997, Russian Federation
For citation: Sokolova A.V., Apolikhina I.A. Treatment for female external genital lichen sclerosus: from standards to innovations.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2020; 7: 37-46 (in Russian).
https://dx.doi.org/10.18565/aig.2020.7.37-46