Low-frequency ultrasonic cavitation in the treatment of vulvar burns after photodynamic therapy with photodithazine
Background. Lichen sclerosus et atrophicus is the most common benign vulvar disease. Photodynamic therapy is one of the high-tech methods for its treatment. PDT sessions are generally well tolerated by patients, show good results, and leave no scars. However, incorrect interpretations in calculating the light doses, which are very frequent in the Russian literature, can lead to that the lesion foci remain underradiated and, as a consequence, to the insufficiency or lack of a therapeutic effect, to the overdose of laser irradiation, and to the negative side effects of treatment.Apolikhina I.A., Chochueva A.S., Gorbunova E.A., Saidova A.S., Bulgakova N.N., Zulfigarova T.S.
Description. The present clinical case describes the efficiency of low-frequency ultrasonic cavitation in the treatment of vulvar burning surface inflammation arising after photodynamic therapy with photodithazine. The authors believe that the case is of practical interest to gynecologists as a fairly infrequent complication.
Conclusion. Ultrasonic cavitation for burning and inflammatory diseases of the lower genital tract is a current, minimally invasive treatment with a high level of efficiency and safety. As shown in the example of the described clinical case, it can be successfully used in the treatment of complications caused by incorrect applications of photodynamic therapy in the treatment of vulvar dystrophic diseases.
Keywords
photodynamic therapy
lichen sclerosis et atrophicus
low-frequency ultrasonic cavitation
Supplementary Materials
- Fig. 1. Patient P., 58 years, the area of the vulva before treatment.
- Fig. 2.1. Patient P., 58 years. After 4 LFUSC procedure
- Fig. 2.2. Patient P., 58 years. After 8 LFUSC procedure
- Fig. 2.3. Patient P., 58 years. One month after treatment
- Fig. 2.4. Patient P., 58 years. 6 months after treatment
References
1. Горбунова Е.А., Аполихина И.А. «Белые пятна» на карте врачебных знаний. Современные принципы диагностики и терапии склероатрофического лишая. StatusPraesens. 2015; 4: 92-8. [Gorbunova E.A., Apolikhina I.A. „White spots” on the map of medical knowledge. Modern principles of diagnostics and therapy of sclerotrophic lichen. StatusPraesens. 2015; 4: 92-8. (in Russian)]
2. Бебнева Т.Н., Пекуль Л.В. Трудности диагностики и лечения заболеваний вульвы. В кн.: Материалы I Национального конгресса «Онкология репродуктивных органов: от профилактики и раннего выявления к эффективному лечению». 19-21 мая 2016, Москва. [Bebneva T.N., Pekul L.V. Difficulties in diagnosing and treating vulvar diseases. In the book: Proceedings of the First National Congress “Oncology of Reproductive Bodies: From Prevention and Early Detection to Effective Treatment”. May 19-21, 2016, Moscow. (in Russian)]
3. Манухин И.Б., Кондриков Н.И., Крапошина Т.П. Заболевания наружных половых органов у женщин. М.: МИА, 2002. 303с. [Manuhin I.B., Kondrikov N.I., Kraposhina T.P. Diseases of external genital organs in women. Moscow: MIA, 2002. 303p. (in Russian)]
4. Жаров А.В., Важенин А.В. Оптимизация лечения больных раком вульвы. Челябинск; 2005. 131с. [Zharov A.V., Vazhenin A.V. Optimization of treatment of patients with vulvar cancer. Chelyabinsk; 2005. 131p. (in Russian)]
5. Agostinis P., Berg K., Cengel K.A., Foster T.H., Girotti A.W., Gollnick S.O. et al. Photodynamic therapy of cancer: an update. CA Cancer J. Clin. 2011; 61(4): 250-81.
6. Денисова E.Д., Аполихина И.А., Булгакова Н.Н. Флюоресцентная диагностика и фотодинамическая терапия: возможности применения при заболеваниях нижних отделов половых путей. Акушерство и гинекология. 2010; 3: 17-21. [Denisova E.D., Apolikhina I.A., Bulgakova N.N. Fluorescent diagnostics and photodynamic therapy: possibilities of use in diseases of the lower genital tract. Akusherstvo i ginekologiya/Obstetrics and gynecology. 2010; (3): 17-21. (in Russian)]
7. Денисова Е.Д., Аполихина И.А., Булгакова Н.Н. Флуоресцентная диагностика и фотодинамическая терапия остроконечных кондилом вульвы с препаратом аласенс. Акушерство и гинекология. 2011; 8: 112-6. [Denisova E.D., Apolikhina I. A., Bulgakova N.N. Fluorescence diagnosis and photodynamic therapy for vulvar condylomata acuminata. Akusherstvo i ginekologiya/Obstetrics and gynecology. 2011; (8): 112-6. (in Russian)]
8. Чулкова Е.А., Макаров И.О., Соколов В.В. Современные аспекты флуоресцентной диагностики и фотодинамической терапии с 5-аминолевуленовой кислотой («Аласенс») при фоновых и предраковых заболеваниях вульвы. Журнал акушерства и женских болезней. 2009; 58(5): m91-2. [Chulkova E.A., Makarov I.O., Sokolov V.V. Modern aspects of fluorescent diagnostics and photodynamic therapy with 5-aminolevulenic acid (“Alasens”) with background and precancerous diseases of the vulva. Zhurnal akusherstva i zhenskih bolezney. 2009; 58(5): m91-2. (in Russian)]
9. Zawislak A.A., McCluggage W.G., Donnelly R.F., Maxwell P., Price J.H., Dobbs S.P. et al. Response of vulval lichen sclerosus and squamous hyperplasia to photodynamic treatment using sustained topical delivery of aminolevulinic acid from a novel bioadhesive patch system. Photodermatol. Photoimmunol. Photomed. 2009; 25(2): 111-3.
10. Чулкова Е.И. Флуоресцентная диагностика и фотодинамическая терапия фоновых и предраковых заболеваний вульвы с применением 20 % мази Аласенс: автореф. дисс. … канд. мед. наук. М.; 2007. 27с. [Chulkova E.I. Fluorescent diagnostics and photodynamic therapy of background and precancerous diseases of vulva with application of 20% of ointment. Alasens: the author’s abstract. diss. ... cand. med. sciences. Moscow; 2007. 27p. (in Russian)]
11. Странадко Е.Ф., Маркичев Н.А., Рябов М.В. Фотодинамическая терапия в лечении злокачественных новообразований различных локализаций. Пособие для врачей. М.; 2002: 1-24. [Stranadko E.F., Markichev N.A., Ryabov M.V. Photodynamic therapy in the treatment of malignant neoplasms of various localizations. A manual for doctors. Moscow; 2002: 1-24. (in Russian)]
12. Обоскалова Т.А., Глухов Е.Ю., Лаврентьева И.В., Богданова А.М., Козырева Е.Н., Нефф Е.И., Плотко Е.Э. и др. Профилактика и лечение воспалительных заболеваний в акушерстве и гинекологии с использованием метода ультразвуковой кавитации лекарственных растворов. Практическое руководство для врачей. Екатеринбург: Издательство «Vip-Ural»; 2014. 68с. [Oboskalova T.A., Gluhov E.Yu., Lavrenteva I.V., BogdanovaТA.M., Kozyireva E.N., Neff E.I., Plotko E.E. et al. Prevention and treatment of inflammatory diseases in obstetrics and gynecology using the method of ultrasonic cavitation of medicinal solutions. A practical guide for doctors. Ekaterinburg: Publishing house “Vip-Ural”; 2014. 68p. (in Russian)]
13. Корнеев Ю.А., Коршунов А.П., Погадаев В.И. Медицинская и биологическая физика. М.: Медицинская книга, Н.Новгород: Изд-во НГМА; 2011. 250с. [Korneev Yu.A., Korshunov A.P., Pogadaev V.I. Medical and Biological Physics. Moscow: Meditsinskaya kniga, N.Novgorod: Izd-vo NGMA; 2011. 250p. (in Russian)]
Received 20.03.2017
Accepted 28.04.2017
About the Authors
Apolikhina Inna Anatolievna, MD, Head of the Department of Aesthetic Gynecology and Rehabilitation, Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia; Professor of the Department of Obstetrics, Gynecology, Perinatology and Reproduction, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: i_apolikhina@oparina4.ruChochueva Adalina Sagitovna, resident of the 1st year of training, Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +79262628361
Gorbunova Elena Alekseevna, the doctor of the department of aesthetic gynecology and rehabilitation, Research Center of Obstetrics, Gynecology, and Perinatology,
Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: el_gorbunova@oparina4.ru
Saidova Aina Salavdinovna, MD, doctor obstetrician-gynecologist of the department of aesthetic gynecology and rehabilitation, Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +79262066051. E-mail: dr.saidova@gmail.com
Bulgakova Nadezhda Nikolaevna, Ph.D., associate professor, senior researcher, A.M. Prokhorov General Physics Institute, Russian Academy of Sciences.
119991, Russia, Moscow, Vavilova str. 38. Tel.: +74991350297
Zulfigarova Telli Suleymanovna, a student of the 6th year of the pediatric faculty, N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia. 117997, Russia, Moscow, Ostrovityanova str. 1
For citations: Apolikhina I.A., Chochueva A.S., Gorbunova E.A., Saidova A.S., Bulgakova N.N., Zulfigarova T.S. Low-frequency ultrasonic cavitation in the treatment of vulvar burns after photodynamic therapy with photodithazine. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (10): 144-9. (in Russian)
https://dx.doi.org/10.18565/aig.2017.10.144-149
Similar Articles
