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Obstetrics and Gynegology2021№8
Vulvar lichen sclerosus

Vulvar lichen sclerosus

DOI
https://dx.doi.org/10.18565/aig.2021.8.160-165

Surkichin S.I., Kruglova L.S., Apolikhina I.A.

1) Central State Medical Academy, Presidential Administration of the Russian Federation, Moscow, Russia; 2) Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, Moscow, Russia; 3) I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), Moscow, Russia
Objective. To evaluate the efficiency and safety of photodynamic therapy (PDT) in the treatment of vulvar lichen sclerosus (VLS).
Materials and methods. The study group included 15 female patients diagnosed with VLS. 1% chlorin E6 cream was used as a photosensitizer; a Harmony red light-emitting diode phototherapy device at a 660-nm wavelength, 30-min exposure, 100-J/cm2 pulse laser energy, and 100-mW/cm2 power was applied as a source of radiation. PDT was performed once every seven days (the average was 5–7 times) depending on the effect achieved. To evaluate the efficiency of PDT, the investigators used a visual analog scale, the Dermatology Life Quality Index, and vulvoscopy; overall satisfaction with the cycle of the procedures was also assessed.
Results. The female patients postoperatively showed a significant reversal of itching, burning, pain, and dyspareunia. Vulvoscopy indicated the greatest effect of the procedures in treating subepithelial ecchymoses and telangiectasias (81.32%), as well as erosions and fissures (72.54%). A partial remission of lichenification with hyperkeratosis was seen in 53.23% of cases. The lowest atrophy response was observed in 32.45% of cases. The average therapeutic satisfaction score was 2.7 at the last visit. No serious adverse reactions occurred either during or after treatment.
Conclusion. This investigation has demonstrated that PDT with chlorin E6 as a photosensitizer at a 660-nm wavelength, 30-minute exposure, 100-J/cm2 pulse laser energy, and 100-mW/cm2 power, once every 7 days (5–7 times) is a highly effective and safe treatment for VLS. Given the great potential benefits for patients, a large-scale clinical trial is needed to achieve the optimal parameters of PDT and to introduce the latter into practical healthcare.

Keywords

vulvar lichen sclerosus
photodynamic therapy
the photosensitizer chlorin E6
Full text (in Russian)

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Received 27.01.2021

Accepted 28.04.2021

About the Authors

Sergey I. Surkichin (Corresponding author), PhD, Associate Professor of the Department of Dermatovenerology and Cosmetology, Central State Medical Academy of the Presidential Administration, Moscow, Russia. Tel.: +7(916)691-43-42. E-mail: surkichinsi24@mail.ru. ORCID: 0000-0003-0521-0333.
121359, Russia, Moscow, Marshala Timoshenko str., 19-1А.
Larisa S. Kruglova, Dr. Med. Sci., Head of the Department of Dermatovenerology and Cosmetology, Central State Medical Academy of the Presidential Administration, Moscow, Russia. E-mail: kruglovals@mail.ru. ORCID: 0000-0002-5044-5265. 121359, Russia, Moscow, Marshala Timoshenko str., 19-1А.
Inna A. Apolikhina, Dr. Med. Sci., Head of the Department of Aesthetic Gynecology and Rehabilitation, V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia; Professor of the Department of Obstetrics, Gynecology, Perinatology and Reproductology, Institute of Professional Education, I.M. Sechenov First MSMU, Ministry of Health of Russia (Sechenov University). E-mail: i_apolikhina@oparina4.ru. ORCID: 0000-0002-4581-6295. 117997, Russia, Moscow, Oparina str., 4; 119991, Russia, Moscow, Trubetskaya str., 8-2.

For citation: Surkichin S.I., Kruglova L.S., Apolikhina I.A. Vulvar lichen sclerosus.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2021; 8: 160-165 (in Russian)
https://dx.doi.org/10.18565/aig.2021.8.160-165

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