The effectiveness of photodynamic therapy using a nanocapsulated oligopeptide of 5-aminolevulinic acid in the complex treatment of the genital lichen sclerosus: A case report

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Abstract

Lichen sclerosus et atropicus is an autoimmune dermatosis belonging to the group of localized scleroderma, most often affecting the skin of the anogenital area. The disease is characterized by slow development with chronization, visualized as areas of atrophy and induration of the affected tissues, causes unbearable itching, pain, dysuria, as well as sexual dysfunction in men and women.

The etiology of the disease has not yet been studied. However, genetic predisposition is becoming more likely, given that at least 10% of patients have a family history.

Topical corticosteroids are currently the generally accepted method of treating lichen sclerosus. Other treatments include pharmaceuticals (for example, testosterone, progesterone, tacrolimus, 5-fluorouracil and retinoids), surgical excision, cryosurgery, laser therapy and ultraviolet radiation, but none of these treatments is satisfactory and does not lead to stabilization of the skinpathological process.

A clinical case of complex effective treatment of genital lichen sclerosus et atrophicus by photodynamic photoporation using 5-aminolevulenic acid in a 19-year-old patient with a severe course of the disease, early manifestation in the neonatal period and a total vulvar skin lesion is presented.

About the authors

Elena S. Snarskaya

I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

Author for correspondence.
Email: snarskaya-dok@mail.ru
ORCID iD: 0000-0002-7968-7663
SPIN-code: 3785-7859

MD, Dr. Sci. (Med.), Professor

Russian Federation, 8/2 Trubetskaya street, 119992 Moscow

Lidiya M. Shnakhova

I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

Email: shnakhova_l_m@staff.sechenov.ru
ORCID iD: 0000-0003-3000-0987
SPIN-code: 5549-5823

Assistant Lecturer

Russian Federation, 8/2 Trubetskaya street, 119992 Moscow

Lyaman F. Shamilova

I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

Email: lyaman.doc@gmail.com
ORCID iD: 0000-0002-7271-3910
SPIN-code: 7358-7561

Graduate Student

Russian Federation, 8/2 Trubetskaya street, 119992 Moscow

References

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Supplementary files

Supplementary Files
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1. JATS XML
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2. Fig. 1. The composition of the complex photosensitizer 5-ALA in the gel form.

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3. Fig. 2. Patient H., 19 years old, diagnosis “Genital lichen sclerosus”, incondition at initial admission to the hospital (July 2022): there is pronounced sclerosis, narrowing of the vestibule of the vagina, partial reduction of the labia minora.

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4. Fig. 3. The second course of complex therapy (Nov, 2022): there is a partial softening of the foci of rashes on the skin of the labia majora and the repigmentation in the area of the entrance to the vagina.

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5. Fig. 4. The third admission to the hospital (April, 2023): there is complete repigmentation of sclerosed foci in the vulva area, as well as their palpatory softening.

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