Photodynamic Therapy in the Treatment of Vulvar Lichen Sclerosus: A Systematic Review of the Literature

Vulvar lichen sclerosus (VLS) is a chronic inflammatory disease involving the genital skin and mucous membrane. Patients exhibit focal atrophy and destructive scarring, with an increased risk of malignant transformation. Due to objective symptoms as well as subjective complaints, patients with VLS experience emotional distress, lowered mood, and sexual dysfunction, which is reflected in impaired health-related quality of life. Thus, the necessity of implementing appropriate therapy at the earliest possible stage of the disease in order to avoid serious complications is highlighted. We presented the systematic review of available literature, performed with MEDLINE, Cinahl, Central, Scopus, and Web of Science databases. We identified a total of twenty relevant studies which indicate that photodynamic therapy (PDT) is a valuable therapeutic modality in the treatment of VLS.

Vulvar Lichen Sclerosus et Atrophicus in girls

The review is devoted to diagnosing and treating lichen sclerosus (LS), a chronic inflammatory dermatosis with a predisposition to lesions of the anogenital region in girls. An essential role in the aetiology of this form of pathology is attributed to genetic mutations, injuries, infections and autoimmune diseases, and hormonal and local factors. The peak incidence is observed in 4-6 year girls, accounting for 7-15% of all cases of vulvar LS. The main goal of pharmacotherapy for vulvar LS is to relieve clinical symptoms and prevent scarring and adhesions. The authors analyzed international and domestic publications from 2017 to 2021. PubMed and Google Academy databases were used for the search, keywords: lichen sclerosus, girls. The retrospective and prospective cohort, randomized clinical trials, case series and literature reviews, and clinical guidelines were considered. Our review presents modern data on the diagnosis and treatment of SL in girls, which will be useful for both pediatric gynecologists and doctors of related specialties. The first symptoms of LS are usually nonspecific and are misdiagnosed by non-profile specialists. Some symptoms of LS may disappear spontaneously after menarche, and the course of the disease may be latent. This is why it is generally accepted that the epidemiology of LS is underestimated. Despite this, it can be assumed that the etiology and pathogenesis of LS is probably multifactorial. This review describes several leading etiological factors regarding the potential etiopathogenesis of vulvar LS in girls.