Novel Therapeutic Approaches and Targets for Treatment of Vulvar Lichen Sclerosus

Author(s): Alessandro Borghi*, Monica Corazza

Journal Name: Current Pharmaceutical Biotechnology

Volume 22 , Issue 1 , 2021


Become EABM
Become Reviewer
Call for Editor

Graphical Abstract:


Abstract:

Background: Vulvar Lichen Sclerosus (VLS) is a chronic inflammatory disease with a huge impact on a person’s quality of life. A correct therapy is required for relieving symptoms, reversing signs and preventing further anatomical changes.

Objective: The main objective of the present paper is to provide suggestions for the best treatment approach, based on the available evidence. Treatment strategies are divided on the basis of the treatment phase, distinguishing options for initial, acute or attack treatment and those for long-term, maintenance treatment.

Methods: An electronic search was performed using the National Library of Medicine PubMed database. All the studies evaluating treatment of vulvar lichen sclerosus published in the English literature were analyzed, including controlled studies, case series, guidelines and reviews.

Results: Current evidence identifies ultra-potent and potent corticosteroids, administered for 12 weeks, as the first-line recommended treatment for active VLS. Topical calcineurin inhibitors, tacrolimus and pimecrolimus, are effective and safe alternatives. Long-term maintenance strategies aimed at preventing recurrences are required, after the initial treatment phase. Maintenance treatment mostly consists in topical corticosteroids, administered i) on an “as needed” basis (“reactive” scheme), ii) on a continuative regimen, iii) on a low-dose, intermittent regimen (“proactive” scheme). Further investigations are needed for better defining the placement of other options within the VLS therapeutic algorithm, including retinoids, physical and systemic treatments.

Conclusion: The available evidence provides useful indications for the management of VLS. Both the identification of new therapeutic targets and the optimization of the available options represent the main objectives of future research.

Keywords: Vulvar lichen sclerosus, active treatment, maintenance treatment, topical corticosteroid, topical calcineurin inhibitor, retinoid, physical treatment.

[1]
Fistarol, S.K.; Itin, P.H. Diagnosis and treatment of lichen sclerosus: An update. Am. J. Clin. Dermatol., 2013, 14(1), 27-47.
[http://dx.doi.org/10.1007/s40257-012-0006-4] [PMID: 23329078]
[2]
Niamh, L.; Naveen, S.; Hazel, B. Diagnosis of vulval inflammatory dermatoses: A pathological study with clinical correlation. Int. J. Gynecol. Pathol., 2009, 28(6), 554-558.
[http://dx.doi.org/10.1097/PGP.0b013e3181a9fb0d] [PMID: 19851203]
[3]
Regauer, S.; Liegl, B.; Reich, O. Early vulvar lichen sclerosus: A histopathological challenge. Histopathology, 2005, 47(4), 340-347.
[http://dx.doi.org/10.1111/j.1365-2559.2005.02209.x] [PMID: 16178888]
[4]
Borghi, A.; Corazza, M.; Minghetti, S.; Bianchini, E.; Virgili, A. Dermoscopic features of vulvar lichen sclerosus in the setting of a prospective cohort of patients: New observations. Dermatology (Basel), 2016, 232(1), 71-77.
[http://dx.doi.org/10.1159/000439198] [PMID: 26574744]
[5]
Borghi, A.; Virgili, A.; Corazza, M. dermoscopy of inflammatory genital diseases: Practical insights. Dermatol. Clin., 2018, 36(4), 451-461.
[http://dx.doi.org/10.1016/j.det.2018.05.013] [PMID: 30201154]
[6]
Bleeker, M.C.; Visser, P.J.; Overbeek, L.I.; van Beurden, M.; Berkhof, J. Lichen sclerosus: Incidence and risk of vulvar squamous cell carcinoma. Cancer Epidemiol. Biomarkers Prev., 2016, 25(8), 1224-1230.
[http://dx.doi.org/10.1158/1055-9965.EPI-16-0019] [PMID: 27257093]
[7]
Halonen, P.; Jakobsson, M.; Heikinheimo, O.; Riska, A.; Gissler, M.; Pukkala, E. Lichen sclerosus and risk of cancer. Int. J. Cancer, 2017, 140(9), 1998-2002.
[http://dx.doi.org/10.1002/ijc.30621] [PMID: 28124469]
[8]
Carli, P.; Cattaneo, A.; De Magnis, A.; Biggeri, A.; Taddei, G.; Giannotti, B. Squamous cell carcinoma arising in vulval lichen sclerosus: A longitudinal cohort study. Eur. J. Cancer Prev., 1995, 4(6), 491-495.
[http://dx.doi.org/10.1097/00008469-199512000-00008] [PMID: 8580785]
[9]
Lansdorp, C.A.; van den Hondel, K.E.; Korfage, I.J.; van Gestel, M.J.; van der Meijden, W.I. Quality of life in Dutch women with lichen sclerosus. Br. J. Dermatol., 2013, 168(4), 787-793.
[http://dx.doi.org/10.1111/bjd.12137] [PMID: 23252667]
[10]
Virgili, A.; Borghi, A.; Toni, G.; Minghetti, S.; Corazza, M. Prospective clinical and epidemiologic study of vulvar lichen sclerosus: analysis of prevalence and severity of clinical features, together with historical and demographic associations. Dermatology (Basel), 2014, 228(2), 145-151.
[http://dx.doi.org/10.1159/000356163] [PMID: 24516059]
[11]
Pérez-López, F.R.; Ceausu, I.; Depypere, H.; Erel, C.T.; Lambrinoudaki, I.; Rees, M.; Schenck-Gustafsson, K.; Tremollieres, F.; van der Schouw, Y.T.; Simoncini, T. EMAS, Spanish menopause society. EMAS clinical guide: Vulvar lichen sclerosus in peri and postmenopausal women. Maturitas, 2013, 74(3), 279-282.
[http://dx.doi.org/10.1016/j.maturitas.2012.12.006] [PMID: 23291001]
[12]
Haefner, H.K.; Aldrich, N.Z.; Dalton, V.K.; Gagné, H.M.; Marcus, S.B.; Patel, D.A.; Berger, M.B. The impact of vulvar lichen sclerosus on sexual dysfunction. J. Womens Health (Larchmt.), 2014, 23(9), 765-770.
[http://dx.doi.org/10.1089/jwh.2014.4805] [PMID: 25162790]
[13]
Corazza, M.; Virgili, A.; Minghetti, S.; Borghi, A. Dyspareunia in vulvar lichen sclerosus: An overview of a distressing symptom. G. Ital. Dermatol. Venereol., 2020, 155(3), 299-305.
[http://dx.doi.org/10.23736/S0392-0488.17.05849-7] [PMID: 29249126]
[14]
Dalziel, K.L. Effect of lichen sclerosus on sexual function and parturition. J. Reprod. Med., 1995, 40(5), 351-354.
[PMID: 7608874]
[15]
Burrows, L.J.; Creasey, A.; Goldstein, A.T. The treatment of vulvar lichen sclerosus and female sexual dysfunction. J. Sex. Med., 2011, 8(1), 219-222.
[http://dx.doi.org/10.1111/j.1743-6109.2010.02077.x] [PMID: 20955314]
[16]
Kreuter, A.; Kryvosheyeva, Y.; Terras, S.; Moritz, R.; Möllenhoff, K.; Altmeyer, P.; Scola, N.; Gambichler, T. Association of autoimmune diseases with lichen sclerosus in 532 male and female patients. Acta Derm. Venereol., 2013, 93(2), 238-241.
[http://dx.doi.org/10.2340/00015555-1512] [PMID: 23224274]
[17]
Cooper, S.M.; Ali, I.; Baldo, M.; Wojnarowska, F. The association of lichen sclerosus and erosive lichen planus of the vulva with autoimmune disease: A case-control study. Arch. Dermatol., 2008, 144(11), 1432-1435.
[http://dx.doi.org/10.1001/archderm.144.11.1432] [PMID: 19015417]
[18]
Sherman, V.; McPherson, T.; Baldo, M.; Salim, A.; Gao, X.H.; Wojnarowska, F. The high rate of familial lichen sclerosus suggests a genetic contribution: An observational cohort study. J. Eur. Acad. Dermatol. Venereol., 2010, 24(9), 1031-1034.
[http://dx.doi.org/10.1111/j.1468-3083.2010.03572.x] [PMID: 20202060]
[19]
Gao, X.H.; Barnardo, M.C.; Winsey, S.; Ahmad, T.; Cook, J.; Agudelo, J.D.; Zhai, N.; Powell, J.J.; Fuggle, S.V.; Wojnarowska, F. The association between HLA DR, DQ antigens, and vulval lichen sclerosus in the UK: HLA DRB112 and its associated DRB112/DQB10301/04/09/010 haplotype confers susceptibility to vulval lichen sclerosus, and HLA DRB10301/04 and its associated DRB10301/04/DQB10201/02/03 haplotype protects from vulval lichen sclerosus. J. Invest. Dermatol., 2005, 125(5), 895-899.
[http://dx.doi.org/10.1111/j.0022-202X.2005.23905.x] [PMID: 16297186]
[20]
Trietsch, M.D.; Nooij, L.S.; Gaarenstroom, K.N.; van Poelgeest, M.I. Genetic and epigenetic changes in vulvar squamous cell carcinoma and its precursor lesions: A review of the current literature. Gynecol. Oncol., 2015, 136(1), 143-157.
[http://dx.doi.org/10.1016/j.ygyno.2014.11.002] [PMID: 25448458]
[21]
Rotondo, J.C.; Borghi, A.; Selvatici, R.; Magri, E.; Bianchini, E.; Montinari, E.; Corazza, M.; Virgili, A.; Tognon, M.; Martini, F. Hypermethylation-induced inactivation of the irf6 gene as a possible early event in progression of vulvar squamous cell carcinoma associated with lichen sclerosus. JAMA Dermatol., 2016, 152(8), 928-933.
[http://dx.doi.org/10.1001/jamadermatol.2016.1336] [PMID: 27223861]
[22]
Rotondo, J.C.; Borghi, A.; Selvatici, R.; Mazzoni, E.; Bononi, I.; Corazza, M.; Kussini, J.; Montinari, E.; Gafà, R.; Tognon, M.; Martini, F. Association of retinoic acid receptor β gene with onset and progression of lichen sclerosus-associated vulvar squamous cell carcinoma. JAMA Dermatol., 2018, 154(7), 819-823.
[http://dx.doi.org/10.1001/jamadermatol.2018.1373] [PMID: 29898214]
[23]
Tran, D.A.; Tan, X.; Macri, C.J.; Goldstein, A.T.; Fu, S.W. Lichen Sclerosus: An autoimmunopathogenic and genomic enigma with emerging genetic and immune targets. Int. J. Biol. Sci., 2019, 15(7), 1429-1439.
[http://dx.doi.org/10.7150/ijbs.34613] [PMID: 31337973]
[24]
Terlou, A.; Santegoets, L.A.M.; van der Meijden, W.I.; Heijmans-Antonissen, C.; Swagemakers, S.M.A.; van der Spek, P.J.; Ewing, P.C.; van Beurden, M.; Helmerhorst, T.J.; Blok, L.J. An autoimmune phenotype in vulvar lichen sclerosus and lichen planus: A Th1 response and high levels of microRNA-155. J. Invest. Dermatol., 2012, 132(3 Pt 1), 658-666.
[http://dx.doi.org/10.1038/jid.2011.369] [PMID: 22113482]
[25]
Farrell, A.M.; Dean, D.; Millard, P.R.; Charnock, F.M.; Wojnarowska, F. Cytokine alterations in lichen sclerosus: An immunohistochemical study. Br. J. Dermatol., 2006, 155(5), 931-940.
[http://dx.doi.org/10.1111/j.1365-2133.2006.07414.x] [PMID: 17034521]
[26]
Oyama, N.; Chan, I.; Neill, S.M.; Hamada, T.; South, A.P.; Wessagowit, V.; Wojnarowska, F.; D’Cruz, D.; Hughes, G.J.; Black, M.M.; McGrath, J.A. Autoantibodies to extracellular matrix protein 1 in lichen sclerosus. Lancet, 2003, 362(9378), 118-123.
[http://dx.doi.org/10.1016/S0140-6736(03)13863-9] [PMID: 12867112]
[27]
Fujimoto, N.; Terlizzi, J.; Aho, S.; Brittingham, R.; Fertala, A.; Oyama, N.; McGrath, J.A.; Uitto, J. Extracellular matrix protein 1 inhibits the activity of matrix metalloproteinase 9 through high-affinity protein/protein interactions. Exp. Dermatol., 2006, 15(4), 300-307.
[http://dx.doi.org/10.1111/j.0906-6705.2006.00409.x] [PMID: 16512877]
[28]
Ren, L.; Zhao, Y.; Huo, X.; Wu, X. MiR-155-5p promotes fibroblast cell proliferation and inhibits FOXO signaling pathway in vulvar lichen sclerosis by targeting FOXO3 and CDKN1B. Gene, 2018, 653, 43-50.
[http://dx.doi.org/10.1016/j.gene.2018.01.049] [PMID: 29339071]
[29]
Zhao, Y.; Zhao, S.; Li, H.; Qin, X.; Wu, X. Expression of galectin-7 in vulvar lichen sclerosus and its effect on dermal fibroblasts. Oncol. Lett., 2018, 16(2), 2559-2564.
[http://dx.doi.org/10.3892/ol.2018.8897] [PMID: 30013650]
[30]
Virgili, A.; Borghi, A.; Cazzaniga, S.; Di Landro, A.; Naldi, L.; Minghetti, S.; Verrone, A.; Stroppiana, E.; Caproni, M.; Nasca, M.R.; D’Antuono, A.; Papini, M.; Di Lernia, V.; Corazza, M. GLS Italian Study Group. New insights into potential risk factors and associations in genital lichen sclerosus: Data from a multicentre Italian study on 729 consecutive cases. J. Eur. Acad. Dermatol. Venereol., 2017, 31(4), 699-704.
[http://dx.doi.org/10.1111/jdv.13867] [PMID: 27515901]
[31]
Chi, C.C.; Kirtschig, G.; Baldo, M.; Lewis, F.; Wang, S.H.; Wojnarowska, F. Systematic review and meta-analysis of randomized controlled trials on topical interventions for genital lichen sclerosus. J. Am. Acad. Dermatol., 2012, 67(2), 305-312.
[http://dx.doi.org/10.1016/j.jaad.2012.02.044] [PMID: 22483994]
[32]
Kirtschig, G.; Becker, K.; Günthert, A.; Jasaitiene, D.; Cooper, S.; Chi, C.C.; Kreuter, A.; Rall, K.K.; Aberer, W.; Riechardt, S.; Casabona, F.; Powell, J.; Brackenbury, F.; Erdmann, R.; Lazzeri, M.; Barbagli, G.; Wojnarowska, F. Evidence-based (S3) Guideline on (anogenital) Lichen sclerosus. J. Eur. Acad. Dermatol. Venereol., 2015, 29(10), e1-e43.
[http://dx.doi.org/10.1111/jdv.13136] [PMID: 26202852]
[33]
Lewis, F.M.; Tatnall, F.M.; Velangi, S.S.; Bunker, C.B.; Kumar, A.; Brackenbury, F.; Mohd Mustapa, M.F.; Exton, L.S. British Association of Dermatologists guidelines for the management of lichen sclerosus, 2018. Br. J. Dermatol., 2018, 178(4), 839-853.
[http://dx.doi.org/10.1111/bjd.16241] [PMID: 29313888]
[34]
Dalziel, K.L.; Millard, P.R.; Wojnarowska, F. The treatment of vulval lichen sclerosus with a very potent topical steroid (clobetasol propionate 0.05%) cream. Br. J. Dermatol., 1991, 124(5), 461-464.
[http://dx.doi.org/10.1111/j.1365-2133.1991.tb00626.x] [PMID: 2039723]
[35]
Carli, P.; Cattaneo, A.; Giannotti, B. Clobetasol propionate 0.05% cream in the treatment of vulvar lichen sclerosus: Effect on the immunohistological profile. Br. J. Dermatol., 1992, 127(5), 542-543.
[http://dx.doi.org/10.1111/j.1365-2133.1992.tb14858.x] [PMID: 1467299]
[36]
Dalziel, K.L.; Wojnarowska, F. Long-term control of vulval lichen sclerosus after treatment with a potent topical steroid cream. J. Reprod. Med., 1993, 38(1), 25-27.
[PMID: 8441126]
[37]
Lorenz, B.; Kaufman, R.H.; Kutzner, S.K. Lichen sclerosus. Therapy with clobetasol propionate. J. Reprod. Med., 1998, 43(9), 790-794.
[PMID: 9777618]
[38]
Bracco, G.L.; Carli, P.; Sonni, L.; Maestrini, G.; De Marco, A.; Taddei, G.L.; Cattaneo, A. Clinical and histologic effects of topical treatments of vulval lichen sclerosus. A critical evaluation. J. Reprod. Med., 1993, 38(1), 37-40.
[PMID: 8441129]
[39]
Bornstein, J.; Heifetz, S.; Kellner, Y.; Stolar, Z.; Abramovici, H. Clobetasol dipropionate 0.05% versus testosterone propionate 2% topical application for severe vulvar lichen sclerosus. Am. J. Obstet. Gynecol., 1998, 178(1 Pt 1), 80-84.
[http://dx.doi.org/10.1016/S0002-9378(98)70631-3] [PMID: 9465808]
[40]
Goldstein, A.T.; Creasey, A.; Pfau, R.; Phillips, D.; Burrows, L.J. A double-blind, randomized controlled trial of clobetasol versus pimecrolimus in patients with vulvar lichen sclerosus. J. Am. Acad. Dermatol., 2011, 64(6), e99-e104.
[http://dx.doi.org/10.1016/j.jaad.2010.06.011] [PMID: 21353334]
[41]
Funaro, D.; Lovett, A.; Leroux, N.; Powell, J. A double-blind, randomized prospective study evaluating topical clobetasol propionate 0.05% versus topical tacrolimus 0.1% in patients with vulvar lichen sclerosus. J. Am. Acad. Dermatol., 2014, 71(1), 84-91.
[http://dx.doi.org/10.1016/j.jaad.2014.02.019] [PMID: 24704090]
[42]
Terras, S.; Gambichler, T.; Moritz, R.K.; Stücker, M.; Kreuter, A. UV-A1 phototherapy vs. clobetasol propionate, 0.05%, in the treatment of vulvar lichen sclerosus: A randomized clinical trial. JAMA Dermatol., 2014, 150(6), 621-627.
[http://dx.doi.org/10.1001/jamadermatol.2013.7733] [PMID: 24696010]
[43]
Virgili, A.; Borghi, A.; Toni, G.; Minghetti, S.; Corazza, M. First randomized trial on clobetasol propionate and mometasone furoate in the treatment of vulvar lichen sclerosus: Results of efficacy and tolerability. Br. J. Dermatol., 2014, 171(2), 388-396.
[http://dx.doi.org/10.1111/bjd.12910] [PMID: 24641522]
[44]
Shi, L.; Miao, F.; Zhang, L.L.; Zhang, G.L.; Wang, P.R.; Ji, J.; Wang, X.J.; Huang, Z.; Wang, H.W.; Wang, X.L. Comparison of 5-aminolevulinic acid photodynamic therapy and clobetasol propionate in treatment of vulvar lichen sclerosus. Acta Derm. Venereol., 2016, 96(5), 684-688.
[http://dx.doi.org/10.2340/00015555-2341] [PMID: 26775671]
[45]
Garzon, M.C.; Paller, A.S. Ultrapotent topical corticosteroid treatment of childhood genital lichen sclerosus. Arch. Dermatol., 1999, 135(5), 525-528.
[http://dx.doi.org/10.1001/archderm.135.5.525] [PMID: 10328191]
[46]
Smith, Y.R.; Quint, E.H. Clobetasol propionate in the treatment of premenarchal vulvar lichen sclerosus. Obstet. Gynecol., 2001, 98(4), 588-591.
[PMID: 11576572]
[47]
Patrizi, A.; Gurioli, C.; Medri, M.; Neri, I. Childhood lichen sclerosus: A long-term follow-up. Pediatr. Dermatol., 2010, 27(1), 101-103.
[http://dx.doi.org/10.1111/j.1525-1470.2009.01050.x] [PMID: 20199428]
[48]
Casey, G.A.; Cooper, S.M.; Powell, J.J. Treatment of vulvar lichen sclerosus with topical corticosteroids in children: A study of 72 children. Clin. Exp. Dermatol., 2015, 40(3), 289-292.
[http://dx.doi.org/10.1111/ced.12519] [PMID: 25477189]
[49]
Cattaneo, A.; De Magnis, A.; Botti, E.; Sonni, L.; Carli, P.; Taddei, G.L. Topical mometasone furoate for vulvar lichen sclerosus. J. Reprod. Med., 2003, 48(6), 444-448.
[PMID: 12856516]
[50]
Virgili, A.; Borghi, A.; Minghetti, S.; Corazza, M. Mometasone fuoroate 0.1% ointment in the treatment of vulvar lichen sclerosus: A study of efficacy and safety on a large cohort of patients. J. Eur. Acad. Dermatol. Venereol., 2014, 28(7), 943-948.
[http://dx.doi.org/10.1111/jdv.12219] [PMID: 23879234]
[51]
Murina, F.; Rehman, S.; Di Francesco, S.; Mantegazza, V.; Felice, R.; Bianco, V. Vulvar lichen sclerosus: A comparison of the short-term topical application of clobetasol dipropionate 0.05% versus mometasone furoate 0.1%. J. Low. Genit. Tract Dis., 2015, 19(2), 149-151.
[http://dx.doi.org/10.1097/LGT.0000000000000065] [PMID: 25023331]
[52]
Chi, C.C.; Kirtschig, G.; Baldo, M.; Brackenbury, F.; Lewis, F.; Wojnarowska, F. Topical interventions for genital lichen sclerosus. Cochrane Database Syst. Rev., 2011, (12)CD008240
[PMID: 22161424]
[53]
Borghi, A.; Corazza, M.; Minghetti, S.; Toni, G.; Virgili, A. Continuous vs. tapering application of the potent topical corticosteroid mometasone furoate in the treatment of vulvar lichen sclerosus: Results of a randomized trial. Br. J. Dermatol., 2015, 173(6), 1381-1386.
[http://dx.doi.org/10.1111/bjd.14074] [PMID: 26280156]
[54]
Corazza, M.; Virgili, A.; Toni, G.; Borghi, A. Mometasone furoate in the treatment of vulvar lichen sclerosus: Could its formulation influence efficacy, tolerability and adherence to treatment? J. Dermatolog. Treat., 2018, 29(3), 305-309.
[http://dx.doi.org/10.1080/09546634.2017.1360990] [PMID: 28753097]
[55]
Baggish, M.S.; Sze, E. Subdermal decadron and bupivacaine to treat symptomatic lichen sclerosus. J. Gynecol. Surg., 1995, 11, 245.
[http://dx.doi.org/10.1089/gyn.1995.11.245]
[56]
Mazdisnian, F.; Degregorio, F.; Mazdisnian, F.; Palmieri, A. Intralesional injection of triamcinolone in the treatment of lichen sclerosus. J. Reprod. Med., 1999, 44(4), 332-334.
[PMID: 10319301]
[57]
Stücker, M.; Grape, J.; Bechara, F.G.; Hoffmann, K.; Altmeyer, P. The outcome after cryosurgery and intralesional steroid injection in vulvar lichen sclerosus corresponds to preoperative histopathological findings. Dermatology (Basel), 2005, 210(3), 218-222.
[http://dx.doi.org/10.1159/000083513] [PMID: 15785050]
[58]
Baggish, M.S.; Ventolini, G. Lichen sclerosus: Subdermal steroid injection therapy. A large, long-term follow-up study. J. Gynecol. Surg., 2006, 22, 137-141.
[http://dx.doi.org/10.1089/gyn.2006.22.137]
[59]
Lin, A.N. Innovative use of topical calcineurin inhibitors. Dermatol. Clin., 2010, 28(3), 535-545.
[http://dx.doi.org/10.1016/j.det.2010.03.008] [PMID: 20510763]
[60]
Hengge, U.R.; Krause, W.; Hofmann, H.; Stadler, R.; Gross, G.; Meurer, M.; Brinkmeier, T.; Frosch, P.; Moll, I.; Fritsch, P.; Müller, K.; Meykadeh, N.; Marini, A.; Ruzicka, T.; Gollnick, H. Multicentre, phase II trial on the safety and efficacy of topical tacrolimus ointment for the treatment of lichen sclerosus. Br. J. Dermatol., 2006, 155(5), 1021-1028.
[http://dx.doi.org/10.1111/j.1365-2133.2006.07446.x] [PMID: 17034535]
[61]
Virgili, A.; Lauriola, M.M.; Mantovani, L.; Corazza, M. Vulvar lichen sclerosus: 11 women treated with tacrolimus 0.1% ointment. Acta Derm. Venereol., 2007, 87(1), 69-72.
[http://dx.doi.org/10.2340/00015555-0171] [PMID: 17225019]
[62]
Sotiriou, E.; Apalla, Z.; Patsatsi, A.; Panagiotidou, D. Topical tacrolimus for recalcitrant vulvar lichen sclerosus. Eur. J. Dermatol., 2009, 19(5), 515-516.
[http://dx.doi.org/10.1684/ejd.2009.0733] [PMID: 19502156]
[63]
Kim, G.W.; Park, H.J.; Kim, H.S.; Kim, S.H.; Ko, H.C.; Kim, B.S.; Kim, M.B. Topical tacrolimus ointment for the treatment of lichen sclerosus, comparing genital and extragenital involvement. J. Dermatol., 2012, 39(2), 145-150.
[http://dx.doi.org/10.1111/j.1346-8138.2011.01384.x] [PMID: 22044240]
[64]
Li, Y.; Xiao, Y.; Wang, H.; Li, H.; Luo, X. Low-concentration topical tacrolimus for the treatment of anogenital lichen sclerosus in childhood: Maintenance treatment to reduce recurrence. J. Pediatr. Adolesc. Gynecol., 2013, 26(4), 239-242.
[http://dx.doi.org/10.1016/j.jpag.2012.11.010] [PMID: 24049806]
[65]
Mazzilli, S.; Diluvio, L.; Di Prete, M.; Rossi, P.; Orlandi, A.; Bianchi, L.; Campione, E. Tacrolimus 0.03% ointment for treatment of paediatric lichen sclerosus: A case series and literature review. J. Int. Med. Res., 2018, 46(9), 3724-3728.
[http://dx.doi.org/10.1177/0300060518778219] [PMID: 30058419]
[66]
Oskay, T.; Sezer, H.K.; Genç, C.; Kutluay, L. Pimecrolimus 1% cream in the treatment of vulvar lichen sclerosus in postmenopausal women. Int. J. Dermatol., 2007, 46(5), 527-532.
[http://dx.doi.org/10.1111/j.1365-4632.2006.03185.x] [PMID: 17472689]
[67]
Nissi, R.; Eriksen, H.; Risteli, J.; Niemimaa, M. Pimecrolimus cream 1% in the treatment of lichen sclerosus. Gynecol. Obstet. Invest., 2007, 63(3), 151-154.
[http://dx.doi.org/10.1159/000096736] [PMID: 17085943]
[68]
Nissi, R.; Kotila, V.; Knuuti, E.; Väre, P.O.; Kauppila, S. Altered p53 and Bcl-2 expression in keratinocytes of vulvar lichen sclerosus during pimecrolimus treatment. Br. J. Dermatol., 2009, 161(4), 958-960.
[http://dx.doi.org/10.1111/j.1365-2133.2009.09388.x] [PMID: 19659469]
[69]
Ling, M.; Gottlieb, A.; Pariser, D.; Caro, I.; Stewart, D.; Scott, G.; Abrams, K. A randomized study of the safety, absorption and efficacy of pimecrolimus cream 1% applied twice or four times daily in patients with atopic dermatitis. J. Dermatolog. Treat., 2005, 16(3), 142-148.
[http://dx.doi.org/10.1080/09546630510033159] [PMID: 16096179]
[70]
Goldstein, A.T.; Marinoff, S.C.; Christopher, K. Pimecrolimus for the treatment of vulvar lichen sclerosus: A report of 4 cases. J. Reprod. Med., 2004, 49(10), 778-780.
[PMID: 15568399]
[71]
Boms, S.; Gambichler, T.; Freitag, M.; Altmeyer, P.; Kreuter, A. Pimecrolimus 1% cream for anogenital lichen sclerosus in childhood. BMC Dermatol., 2004, 4(1), 14.
[http://dx.doi.org/10.1186/1471-5945-4-14] [PMID: 15485581]
[72]
Goldstein, A.T.; Marinoff, S.C.; Christopher, K. Pimecrolimus for the treatment of vulvar lichen sclerosus in a premenarchal girl. J. Pediatr. Adolesc. Gynecol., 2004, 17(1), 35-37.
[http://dx.doi.org/10.1016/j.jpag.2003.11.013] [PMID: 15010037]
[73]
Fritsch, P.O. Retinoids in psoriasis and disorders of keratinization. J. Am. Acad. Dermatol., 1992, 27(6 Pt 2), S8-S14.
[http://dx.doi.org/10.1016/S0190-9622(08)80253-8] [PMID: 1460124]
[74]
Griffiths, C.E.; Russman, A.N.; Majmudar, G.; Singer, R.S.; Hamilton, T.A.; Voorhees, J.J. Restoration of collagen formation in photodamaged human skin by tretinoin (retinoic acid). N. Engl. J. Med., 1993, 329(8), 530-535.
[http://dx.doi.org/10.1056/NEJM199308193290803] [PMID: 8336752]
[75]
Bikowski, J.B. Mechanisms of the comedolytic and anti-inflammatory properties of topical retinoids. J. Drugs Dermatol., 2005, 4(1), 41-47.
[PMID: 15696984]
[76]
DiGiovanna, J.J. Retinoid chemoprevention in the high-risk patient. J. Am. Acad. Dermatol., 1998, 39(2 Pt 3), S82-S85.
[http://dx.doi.org/10.1016/S0190-9622(98)70451-7] [PMID: 9703130]
[77]
Virgili, A.; Corazza, M.; Bianchi, A.; Mollica, G.; Califano, A. Open study of topical 0.025% tretinoin in the treatment of vulvar lichen sclerosus. One year of therapy. J. Reprod. Med., 1995, 40(9), 614-618.
[PMID: 8576875]
[78]
Borghi, A.; Corazza, M.; Minghetti, S.; Virgili, A. Topical tretinoin in the treatment of vulvar lichen sclerosus: An advisable option? Eur. J. Dermatol., 2015, 25(5), 404-409.
[http://dx.doi.org/10.1684/ejd.2015.2595] [PMID: 26243060]
[79]
Markowska, J.; Wiese, E. Dystrophy of the vulva locally treated with 13-cis retinoic acid. Neoplasma, 1992, 39(2), 133-135.
[PMID: 1528311]
[80]
Kaya, G.; Saurat, J.H. Restored epidermal CD44 expression in lichen sclerosus et atrophicus and clinical improvement with topical application of retinaldehyde. Br. J. Dermatol., 2005, 152(3), 570-572.
[http://dx.doi.org/10.1111/j.1365-2133.2005.06396.x] [PMID: 15787834]
[81]
Borghi, A.; Minghetti, S.; Toni, G.; Virgili, A.; Corazza, M. Combined therapy in vulvar lichen sclerosus: Does topical tretinoin improve the efficacy of mometasone furoate? J. Dermatolog. Treat., 2017, 28(6), 559-563.
[http://dx.doi.org/10.1080/09546634.2016.1277178] [PMID: 28024127]
[82]
Corazza, M.; Maietti, E.; Toni, G.; Virgili, A.; Borghi, A. Combining topical tretinoin with mometasone furoate in the treatment of vulvar lichen sclerosus: Results of dermoscopic assessment. Dermatol. Ther. (Heidelb.), 2018, 31(6)e12735
[http://dx.doi.org/10.1111/dth.12735] [PMID: 30334327]
[83]
Origoni, M.; Ferrari, D.; Rossi, M.; Gandini, F.; Sideri, M.; Ferrari, A. Topical oxatomide: An alternative approach for the treatment of vulvar lichen sclerosus. Int. J. Gynaecol. Obstet., 1996, 55(3), 259-264.
[http://dx.doi.org/10.1016/S0020-7292(96)02768-3] [PMID: 9003951]
[84]
Gupta, S.; Saraswat, A.; Kumar, B. Treatment of genital lichen sclerosus with topical calcipotriol. Int. J. STD AIDS, 2005, 16(11), 772-774.
[http://dx.doi.org/10.1258/095646205774763234] [PMID: 16303082]
[85]
Borghi, A.; Corazza, M.; Minghetti, S.; Toni, G.; Virgili, A. Avocado and soybean extracts as active principles in the treatment of mild-to-moderate vulvar lichen sclerosus: Results of efficacy and tolerability. J. Eur. Acad. Dermatol. Venereol., 2015, 29(6), 1225-1230.
[http://dx.doi.org/10.1111/jdv.12617] [PMID: 25187178]
[86]
Sideri, M.; Origoni, M.; Spinaci, L.; Ferrari, A. Topical testosterone in the treatment of vulvar lichen sclerosus. Int. J. Gynaecol. Obstet., 1994, 46(1), 53-56.
[http://dx.doi.org/10.1016/0020-7292(94)90309-3] [PMID: 7805984]
[87]
Joura, E.A.; Zeisler, H.; Bancher-Todesca, D.; Sator, M.O.; Schneider, B.; Gitsch, G. Short-term effects of topical testosterone in vulvar lichen sclerosus. Obstet. Gynecol., 1997, 89(2), 297-299.
[http://dx.doi.org/10.1016/S0029-7844(97)81071-X] [PMID: 9015039]
[88]
Parker, L.U.; Bergfeld, W.F. Virilization secondary to topical testosterone. Cleve. Clin. J. Med., 1991, 58(1), 43-46.
[http://dx.doi.org/10.3949/ccjm.58.1.43] [PMID: 2070514]
[89]
Goldstein, A.T.; Burrows, L.J.; Belkin, Z.R.; Pfau, R.; Bremmer, M.; Goldfinger, C.; Dreher, F. Safety and efficacy of human fibroblast lysate cream for vulvar lichen sclerosus: A randomized placebo-controlled trial. Acta Derm. Venereol., 2015, 95(7), 847-849.
[PMID: 25634582]
[90]
Gambichler, T.; Schmitz, L. Ultraviolet A1 phototherapy for fibrosing conditions. Front. Med. (Lausanne), 2018, 5, 237.
[http://dx.doi.org/10.3389/fmed.2018.00237] [PMID: 30211165]
[91]
Kreuter, A.; Gambichler, T.; Avermaete, A.; Happe, M.; Bacharach-Buhles, M.; Hoffmann, K.; Jansen, T.; Altmeyer, P.; von Kobyletzki, G. Low-dose ultraviolet A1 phototherapy for extragenital lichen sclerosus: Results of a preliminary study. J. Am. Acad. Dermatol., 2002, 46(2), 251-255.
[http://dx.doi.org/10.1067/mjd.2002.118552] [PMID: 11807437]
[92]
Prasad, S.; Coias, J.; Chen, H.W.; Jacobe, H. Utilizing UVA-1 phototherapy. Dermatol. Clin., 2020, 38(1), 79-90.
[http://dx.doi.org/10.1016/j.det.2019.08.011] [PMID: 31753195]
[93]
Beattie, P.E.; Dawe, R.S.; Ferguson, J.; Ibbotson, S.H. UVA1 phototherapy for genital lichen sclerosus. Clin. Exp. Dermatol., 2006, 31(3), 343-347.
[http://dx.doi.org/10.1111/j.1365-2230.2006.02082.x] [PMID: 16681572]
[94]
Reichrath, J.; Reinhold, U.; Tilgen, W. Treatment of genito-anal lesions in inflammatory skin diseases with PUVA cream photochemotherapy:An open pilot study in 12 patients. Dermatology,(Basel),, 2002, 205(3), 245-248.
[http://dx.doi.org/10.1159/000065858] [PMID: 12399671]
[95]
Prodromidou, A.; Chatziioannou, E.; Daskalakis, G.; Stergios, K.; Pergialiotis, V. Photodynamic therapy for vulvar lichen sclerosus-a systematic review. J. Low. Genit. Tract Dis., 2018, 22(1), 58-65.
[http://dx.doi.org/10.1097/LGT.0000000000000362] [PMID: 29271859]
[96]
Hillemanns, P.; Untch, M.; Pröve, F.; Baumgartner, R.; Hillemanns, M.; Korell, M. Photodynamic therapy of vulvar lichen sclerosus with 5-aminolevulinic acid. Obstet. Gynecol., 1999, 93(1), 71-74.
[PMID: 9916959]
[97]
Sotiriou, E.; Apalla, Z.; Patsatsi, A.; Panagiotidou, D. Recalcitrant vulvar lichen sclerosis treated with aminolevulinic acid-photodynamic therapy: A report of five cases. J. Eur. Acad. Dermatol. Venereol., 2008, 22(11), 1398-1399.
[http://dx.doi.org/10.1111/j.1468-3083.2008.02661.x] [PMID: 18331310]
[98]
Olejek, A.; Steplewska, K.; Gabriel, A.; Kozak-Darmas, I.; Jarek, A.; Kellas-Sleczka, S.; Bydliński, F.; Sieroń-Stołtny, K.; Horak, S.; Chełmicki, A.; Sieroń, A. Efficacy of photodynamic therapy in vulvar lichen sclerosus treatment based on immunohistochemical analysis of CD34, CD44, myelin basic protein, and Ki67 antibodies. Int. J. Gynecol. Cancer, 2010, 20(5), 879-887.
[http://dx.doi.org/10.1111/IGC.0b013e3181d94f05] [PMID: 20606538]
[99]
Imbernón-Moya, A.; Martínez-Pérez, M.; Churruca-Grijelmo, M.; Lobato-Berezo, A.; Vargas-Laguna, E.; Fernández-Cogolludo, E.; Aguilar-Martínez, A.; Gallego-Valdés, M.Á. Photodynamic therapy as a therapeutic alternative in vulvar lichen sclerosus: Series of 8 cases. Photodermatol. Photoimmunol. Photomed., 2016, 32(5-6), 307-310.
[http://dx.doi.org/10.1111/phpp.12242] [PMID: 27098754]
[100]
Osiecka, B.J.; Jurczyszyn, K.; Nockowski, P.; Murawski, M.; Ziółkowski, P. Photodynamic therapy with green light for the treatment of vulvar lichen sclerosus - Preliminary results. Photodiagn. Photodyn. Ther., 2017, 17, 185-187.
[http://dx.doi.org/10.1016/j.pdpdt.2016.11.015] [PMID: 27919664]
[101]
Maździarz, A.; Osuch, B.; Kowalska, M.; Nalewczyńska, A.; Śpiewankiewicz, B. Photodynamic therapy in the treatment of vulvar lichen sclerosus. Photodiagn. Photodyn. Ther., 2017, 19, 135-139.
[http://dx.doi.org/10.1016/j.pdpdt.2017.05.011] [PMID: 28526592]
[102]
Preti, M.; Vieira-Baptista, P.; Digesu, G.A.; Bretschneider, C.E.; Damaser, M.; Demirkesen, O.; Heller, D.S.; Mangir, N.; Marchitelli, C.; Mourad, S.; Moyal-Barracco, M.; Peremateu, S.; Tailor, V.; Tarcan, T.; De, E.J.B.; Stockdale, C.K. The clinical role of LASER for vulvar and vaginal treatments in gynecology and female urology: An ICS/ISSVD best practice consensus document. Neurourol. Urodyn., 2019, 38(3), 1009-1023.
[http://dx.doi.org/10.1002/nau.23931] [PMID: 30742321]
[103]
Bizjak Ogrinc, U.; Senčar, S.; Luzar, B.; Lukanović, A. Efficacy of non-ablative laser therapy for lichen sclerosus: A randomized controlled trial. J. Obstet. Gynaecol. Can., 2019, 41(12), 1717-1725.
[http://dx.doi.org/10.1016/j.jogc.2019.01.023] [PMID: 30981618]
[104]
Stuart, G.C.; Nation, J.G.; Malliah, V.S.; Robertson, D.I. Laser therapy of vulvar lichen sclerosus et atrophicus. Can. J. Surg., 1991, 34(5), 469-470.
[PMID: 1913392]
[105]
Kartamaa, M.; Reitamo, S. Treatment of lichen sclerosus with carbon dioxide laser vaporization. Br. J. Dermatol., 1997, 136(3), 356-359.
[http://dx.doi.org/10.1111/j.1365-2133.1997.tb14943.x] [PMID: 9115915]
[106]
Peterson, C.M.; Lane, J.E.; Ratz, J.L. Successful carbon dioxide laser therapy for refractory anogenital lichen sclerosus. Dermatol. Surg., 2004, 30(8), 1148-1151.
[PMID: 15274708]
[107]
Lee, A.; Lim, A.; Fischer, G. Fractional carbon dioxide laser in recalcitrant vulval lichen sclerosus. Australas. J. Dermatol., 2016, 57(1), 39-43.
[http://dx.doi.org/10.1111/ajd.12305] [PMID: 25755049]
[108]
Rojavin, Y.; Salgado, C.J.; Hsu, P.W.; Liu, J.; Aikins, J.K. The surgical management of vulvar lichen sclerosus refractory to medical management. J. Plast. Reconstr. Aesthet. Surg., 2008, 61(7), 848-849.
[http://dx.doi.org/10.1016/j.bjps.2007.10.076] [PMID: 18439888]
[109]
Regauer, S. Residual anogenital lichen sclerosus after cancer surgery has a high risk for recurrence: A clinicopathological study of 75 women. Gynecol. Oncol., 2011, 123(2), 289-294.
[http://dx.doi.org/10.1016/j.ygyno.2011.07.010] [PMID: 21802125]
[110]
Rouzier, R.; Haddad, B.; Deyrolle, C.; Pelisse, M.; Moyal-Barracco, M.; Paniel, B.J. Perineoplasty for the treatment of introital stenosis related to vulvar lichen sclerosus. Am. J. Obstet. Gynecol., 2002, 186(1), 49-52.
[http://dx.doi.org/10.1067/mob.2002.119186] [PMID: 11810083]
[111]
Gurumurthy, M.; Morah, N.; Gioffre, G.; Cruickshank, M.E. The surgical management of complications of vulval lichen sclerosus. Eur. J. Obstet. Gynecol. Reprod. Biol., 2012, 162(1), 79-82.
[http://dx.doi.org/10.1016/j.ejogrb.2012.01.016] [PMID: 22397746]
[112]
Bradford, J.; Fischer, G. Surgical division of labial adhesions in vulvar lichen sclerosus and lichen planus. J. Low. Genit. Tract Dis., 2013, 17(1), 48-50.
[http://dx.doi.org/10.1097/LGT.0b013e31824f1427] [PMID: 22885642]
[113]
Brauer, M.; van Lunsen, R.H.; Laan, E.T.; Burger, M.P. A qualitative study on experiences after vulvar surgery in women with lichen sclerosus and sexual pain. J. Sex. Med., 2016, 13(7), 1080-1090.
[http://dx.doi.org/10.1016/j.jsxm.2016.04.072] [PMID: 27209180]
[114]
Rangatchew, F.; Knudsen, J.; Thomsen, M.V.; Drzewiecki, K.T. Surgical treatment of disabling conditions caused by anogenital lichen sclerosus in women: An account of surgical procedures and results, including patient satisfaction, benefits, and improvements in health-related quality of life. J. Plast. Reconstr. Aesthet. Surg., 2017, 70(4), 501-508.
[http://dx.doi.org/10.1016/j.bjps.2016.12.008] [PMID: 28188018]
[115]
Frappell, J.; Rider, L.; Riadin, L.; Ebeid, E.; Asmussen, T.; Morris, R. Double opposing zplasty with VY advancement of the perineum: long-term results of a new technique as an alternative to Fenton’s operation for narrowing and splitting of the skin at the posterior vaginal fourchette. Eur. J. Obstet. Gynecol. Reprod. Biol., 2018, 223, 46-49.
[http://dx.doi.org/10.1016/j.ejogrb.2018.02.003] [PMID: 29477552]
[116]
Burger, M.P.; Obdeijn, M.C. Complications after surgery for the relief of dyspareunia in women with lichen sclerosus: A case series. Acta Obstet. Gynecol. Scand., 2016, 95(4), 467-472.
[http://dx.doi.org/10.1111/aogs.12852] [PMID: 26799364]
[117]
Ostrzenski, A. A new, hydrodissection with reverse V-plasty technique for the buried clitoris associated with lichen sclerosus. J. Gynecol. Surg., 2010, 26(1), 41-48.
[http://dx.doi.org/10.1089/gyn.2009.0047]
[118]
Kroft, J.; Shier, M. A novel approach to the surgical management of clitoral phimosis. J. Obstet. Gynaecol. Can., 2012, 34(5), 465-471.
[http://dx.doi.org/10.1016/S1701-2163(16)35243-4] [PMID: 22555140]
[119]
Flynn, A.N.; King, M.; Rieff, M.; Krapf, J.; Goldstein, A.T. Patient satisfaction of surgical treatment of clitoral phimosis and labial adhesions caused by lichen sclerosus. Sex. Med., 2015, 3(4), 251-255.
[http://dx.doi.org/10.1002/sm2.90] [PMID: 26797058]
[120]
Casabona, F.; Priano, V.; Vallerino, V.; Cogliandro, A.; Lavagnino, G. New surgical approach to lichen sclerosus of the vulva: The role of adipose-derived mesenchymal cells and platelet-rich plasma in tissue regeneration. Plast. Reconstr. Surg., 2010, 126(4), 210e-211e.
[http://dx.doi.org/10.1097/PRS.0b013e3181ea9386] [PMID: 20885230]
[121]
Boero, V.; Brambilla, M.; Sipio, E.; Liverani, C.A.; Di Martino, M.; Agnoli, B.; Libutti, G.; Cribiù, F.M.; Del Gobbo, A.; Ragni, E.; Bolis, G.; Bolis, G. Vulvar lichen sclerosus: A new regenerative approach through fat grafting. Gynecol. Oncol., 2015, 139(3), 471-475.
[http://dx.doi.org/10.1016/j.ygyno.2015.10.014] [PMID: 26499935]
[122]
Goldstein, A.T.; King, M.; Runels, C.; Gloth, M.; Pfau, R. Intradermal injection of autologous platelet-rich plasma for the treatment of vulvar lichen sclerosus. J. Am. Acad. Dermatol., 2017, 76(1), 158-160.
[http://dx.doi.org/10.1016/j.jaad.2016.07.037] [PMID: 27986140]
[123]
Tedesco, M.; Pranteda, G.; Chichierchia, G.; Paolino, G.; Latini, A.; Orsini, D.; Cristaudo, A.; Foddai, M.L.; Migliano, E.; Morrone, A. The use of PRP (Platelet-Rich Plasma) in patients affected by genital lichen sclerosus: Clinical analysis and results. J. Eur. Acad. Dermatol. Venereol., 2019, 33(2), e58-e59.
[http://dx.doi.org/10.1111/jdv.15190] [PMID: 30051614]
[124]
Griffin, M.F.; Almadori, A.; Butler, P.E. Use of lipotransfer in scleroderma. Aesthet. Surg. J., 2017, 37(Suppl. 3), S33-S37.
[http://dx.doi.org/10.1093/asj/sjx067]
[125]
Yotsu, R.R.; Hagiwara, S.; Okochi, H.; Tamaki, T. Case series of patients with chronic foot ulcers treated with autologous platelet-rich plasma. J. Dermatol., 2015, 42(3), 288-295.
[http://dx.doi.org/10.1111/1346-8138.12777] [PMID: 25615024]
[126]
Eshtiaghi, P.; Sadownik, L.A. Fact or fiction? adipose-derived stem cells and platelet-rich plasma for the treatment of vulvar lichen sclerosus. J. Low. Genit. Tract Dis., 2019, 23(1), 65-70.
[http://dx.doi.org/10.1097/LGT.0000000000000440] [PMID: 30252710]
[127]
Goldstein, A.T.; Mitchell, L.; Govind, V.; Heller, D. A randomized double-blind placebo-controlled trial of autologous platelet-rich plasma intradermal injections for the treatment of vulvar lichen sclerosus. J. Am. Acad. Dermatol., 2019, 80(6), 1788-1789.
[http://dx.doi.org/10.1016/j.jaad.2018.12.060] [PMID: 30639885]
[128]
Bousema, M.T.; Romppanen, U.; Geiger, J.M.; Baudin, M.; Vähä-Eskeli, K.; Vartiainen, J.; Vuopala, S. Acitretin in the treatment of severe lichen sclerosus et atrophicus of the vulva: A double-blind, placebo-controlled study. J. Am. Acad. Dermatol., 1994, 30(2 Pt 1), 225-231.
[http://dx.doi.org/10.1016/S0190-9622(94)70021-4] [PMID: 8288782]
[129]
Buxton, P.K.; Priestley, G.C. Para-aminobenzoate in lichen sclerosus et atrophicus. J. Dermatolog. Treat., 1990, 1(5), 255-256.
[http://dx.doi.org/10.3109/09546639009086746]
[130]
Mørk, N.J.; Jensen, P.; Hoel, P.S. Vulval lichen sclerosus et atrophicus treated with etretinate (Tigason). Acta Derm. Venereol., 1986, 66(4), 363-365.
[PMID: 2430416]
[131]
Romppanen, U.; Tuimala, R.; Ellmen, J.; Lauslahti, K. Treatment of dystrophic changes of the vulva with etretinate or placebo. Curr. Ther. Res. Clin. Exp., 1987, 42, 211-218.
[132]
Bulbul Baskan, E.; Turan, H.; Tunali, S.; Toker, S.C.; Saricaoglu, H. Open-label trial of cyclosporine for vulvar lichen sclerosus. J. Am. Acad. Dermatol., 2007, 57(2), 276-278.
[http://dx.doi.org/10.1016/j.jaad.2007.03.006] [PMID: 17442452]
[133]
Nayeemuddin, F.; Yates, V.M. Lichen sclerosus et atrophicus responding to methotrexate. Clin. Exp. Dermatol., 2008, 33(5), 651-652.
[http://dx.doi.org/10.1111/j.1365-2230.2008.02721.x] [PMID: 18507666]
[134]
Kreuter, A.; Tigges, C.; Gaifullina, R.; Kirschke, J.; Altmeyer, P.; Gambichler, T. Pulsed high-dose corticosteroids combined with low-dose methotrexate treatment in patients with refractory generalized extragenital lichen sclerosus. Arch. Dermatol., 2009, 145(11), 1303-1308.
[http://dx.doi.org/10.1001/archdermatol.2009.235] [PMID: 19917961]
[135]
Diakomanolis, E.S.; Haidopoulos, D.; Syndos, M.; Rodolakis, A.; Stefanidis, K.; Chatzipapas, J.; Michalas, S. Vulvar lichen sclerosus in postmenopausal women: A comparative study for treating advanced disease with clobetasol propionate 0.05%. Eur. J. Gynaecol. Oncol., 2002, 23(6), 519-522.
[PMID: 12556095]
[136]
Lee, A.; Bradford, J.; Fischer, G. Long-term management of adult vulvar lichen sclerosus: A prospective cohort study of 507 women. JAMA Dermatol., 2015, 151(10), 1061-1067.
[http://dx.doi.org/10.1001/jamadermatol.2015.0643] [PMID: 26070005]
[137]
Cooper, S.M.; Gao, X.H.; Powell, J.J.; Wojnarowska, F. Does treatment of vulvar lichen sclerosus influence its prognosis? Arch. Dermatol., 2004, 140(6), 702-706.
[http://dx.doi.org/10.1001/archderm.140.6.702] [PMID: 15210461]
[138]
Bradford, J.; Fischer, G. Long-term management of vulval lichen sclerosus in adult women. Aust. N. Z. J. Obstet. Gynaecol., 2010, 50(2), 148-152.
[http://dx.doi.org/10.1111/j.1479-828X.2010.01142.x] [PMID: 20522071]
[139]
LeFevre, C.; Hoffstetter, S.; Meyer, S.; Gavard, J. Management of lichen sclerosus with triamcinolone ointment: Effectiveness in reduction of patient symptom scores. J. Low. Genit. Tract Dis., 2011, 15(3), 205-209.
[http://dx.doi.org/10.1097/LGT.0b013e31820a3b6f] [PMID: 21558963]
[140]
Anderson, K.; Ascanio, N.M.; Kinney, M.A.; Krowchuk, D.P.; Jorizzo, J.L. A retrospective analysis of pediatric patients with lichen sclerosus treated with a standard protocol of class I topical corticosteroid and topical calcineurin inhibitor. J. Dermatolog. Treat., 2016, 27(1), 64-66.
[http://dx.doi.org/10.3109/09546634.2015.1054777] [PMID: 26138407]
[141]
Schmitt, J.; von Kobyletzki, L.; Svensson, A.; Apfelbacher, C. Efficacy and tolerability of proactive treatment with topical corticosteroids and calcineurin inhibitors for atopic eczema: Systematic review and meta-analysis of randomized controlled trials. Br. J. Dermatol., 2011, 164(2), 415-428.
[http://dx.doi.org/10.1111/j.1365-2133.2010.10030.x] [PMID: 20819086]
[142]
Virgili, A.; Minghetti, S.; Borghi, A.; Corazza, M. Proactive maintenance therapy with a topical corticosteroid for vulvar lichen sclerosus: Preliminary results of a randomized study. Br. J. Dermatol., 2013, 168(6), 1316-1324.
[http://dx.doi.org/10.1111/bjd.12273] [PMID: 23398459]
[143]
Corazza, M.; Borghi, A.; Minghetti, S.; Toni, G.; Virgili, A. Clobetasol propionate vs. mometasone furoate in 1-year proactive maintenance therapy of vulvar lichen sclerosus: Results from a comparative trial. J. Eur. Acad. Dermatol. Venereol., 2016, 30(6), 956-961.
[http://dx.doi.org/10.1111/jdv.13166] [PMID: 25904498]
[144]
Gajewska, M.; Jagodzinska, A.; Wielgos, M. Evaluation of the effectiveness of treatment of vulvar lichen sclerosus et atrophicus. Analysis of own material and review of the literature. Neuroendocrinol. Lett., 2018, 39(5), 417-421.
[PMID: 30664348]
[145]
Virgili, A.; Minghetti, S.; Borghi, A.; Corazza, M. Long-term maintenance therapy for vulvar lichen sclerosus: The results of a randomized study comparing topical vitamin E with an emollient. Eur. J. Dermatol., 2013, 23(2), 189-194.
[http://dx.doi.org/10.1684/ejd.2013.1987] [PMID: 23607963]
[146]
Simonart, T.; Lahaye, M.; Simonart, J.M. Vulvar lichen sclerosus: Effect of maintenance treatment with a moisturizer on the course of the disease. Menopause, 2008, 15(1), 74-77.
[PMID: 17603391]
[147]
Borghi, A.; Virgili, A.; Minghetti, S.; Toni, G.; Corazza, M. Clearance in vulvar lichen sclerosus: A realistic treatment endpoint or a chimera? J. Eur. Acad. Dermatol. Venereol., 2018, 32(1), 96-101.
[http://dx.doi.org/10.1111/jdv.14516] [PMID: 28796915]
[148]
Nerantzoulis, I.; Grigoriadis, T.; Michala, L. Genital lichen sclerosus in childhood and adolescence-a retrospective case series of 15 patients: Early diagnosis is crucial to avoid long-term sequelae. Eur. J. Pediatr., 2017, 176(10), 1429-1432.
[http://dx.doi.org/10.1007/s00431-017-3004-y] [PMID: 28856426]
[149]
Günthert, A.R.; Duclos, K.; Jahns, B.G.; Krause, E.; Amann, E.; Limacher, A.; Mueller, M.D.; Jüni, P. Clinical scoring system for vulvar lichen sclerosus. J. Sex. Med., 2012, 9(9), 2342-2350.
[http://dx.doi.org/10.1111/j.1743-6109.2012.02814.x] [PMID: 22759453]


Rights & PermissionsPrintExport Cite as

Article Details

VOLUME: 22
ISSUE: 1
Year: 2021
Published on: 16 May, 2020
Page: [99 - 114]
Pages: 16
DOI: 10.2174/1389201021666200516154310
Price: $65

Article Metrics

PDF: 47
HTML: 2