Experience on the use of photodynamic therapy in vulvovaginal lichen plane

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Abstract

BACKGROUND: Lichen plane (LP) occurs in 0.5%–1% of the population. The exact epidemiology of genital LP is unknown. According to various data, LP occurs in 4–9% of all cases of vulvar lesions. The LP of the oral cavity and the vulva occurs in 19–57% of cases. The clinical forms of LP that occur in the anogenital region in women include the erosive, papulosquamous, and less often hypertrophic forms. No distinct guidelines are available for the treatment of vulvar LP. Except for the use of photodynamic therapy (PDT), no randomized controlled trials have been conducted for the treatment of erosive vulvar LP. The research results have shown that PDT can be effective in lichen plane of the oral cavity.

AIM: To evaluate the effectiveness of PDT in women with genital LP compared to topical glucocorticosteroids.

MATERIALS AND METODS: The study group included 15 patients with a diagnosis of vulvar LP. The patients were divided into two groups depending on the treatment method. Group 1 patients were treated with PDT. Group 2 patients – with topical 0.05% betamethasone cream once daily for 1.5 months.

RESULTS: Six months after the last procedure, the regression on the genital LP rating scale was 32% in group 1 patients and 25% in group 2 patients. The severity of pain, according to the visual analog scale, was 29% in group 1 and 22% in group 2. As for adverse events, in group 1, four patients experienced a burning sensation and dryness for 2–3 days after the procedure, and one patient, after two procedures, had blood discharge, which ceased after 1 day. In group 2, five patients complained of burning and dryness during treatment, two patients had acute candidiasis during treatment, and one patient had bacterial vaginosis.

CONCLUSION: The use of PDT can reduce the frequency of use of corticosteroid drugs in the genital area and accordingly reduce the frequency of steroid adverse events, such as atrophy and secondary infection.

About the authors

Sergey I. Surkichin

FSBI DPO "Central State Medical Academy" of the Administrative Department of the President of the Russian Federation

Author for correspondence.
Email: surkichinsi24@mail.ru
ORCID iD: 0000-0003-0521-0333

Candidate of Medical Sciences, Associate Professor of the Department of Dermatovenereology and Cosmetology

Russian Federation, Moscow

Luidmila S. Holupova

FSBI DPO "Central State Medical Academy" of the Administrative Department of the President of the Russian Federation

Email: karsekals@gmail.com
ORCID iD: 0000-0002-2781-4587

Assistant at the Department of Dermatovenereology and Cosmetology

Russian Federation, Moscow

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