Σφακιανάκης Αλέξανδρος
ΩτοΡινοΛαρυγγολόγος
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Κυριακή 17 Δεκεμβρίου 2017

5-Aminolevulinic acid photodynamic therapy in refractory vulvar lichen sclerosus et atrophicus: series of ten cases

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Publication date: Available online 16 December 2017
Source:Photodiagnosis and Photodynamic Therapy
Author(s): Ting Lan, Yongzhen Zou, Michael R. Hamblin, Rui Yin
BackgroundVulvar lichen sclerosus et atrophicus (VLSA) is a chronic inflammatory skin disease of unknown etiology that mainly affects postmenopausal and perimenopausal women. The primary clinical symptoms of VLSA are itching, burning pain, and dyspareunia that can results in decreased quality of life. Existing therapies including topical corticosteroid ointment, topical calcineurin inhibitors, estrogens, are not very effective for treatment of VLSA.ObjectiveTo evaluate the effectiveness and safety of 5-aminolevulinic acid mediated photodynamic therapy (ALA-PDT) in the treatment of VLSA.Materials and MethodsTen patients with VLSA who had failed conventional treatment received ALA-PDT. 10% 5-ALA in an oil-in-water emulsion was applied to the lesions and occluded with plastic film for 3 h, when the lesions were irradiated with 100 mW/cm2, 635 ± 15 nm red light for 20 minutes. Treatments were repeated three times at 2-week intervals. Objective and subjective symptoms and signs of the vulvar lesions based on horizontal visual analogue scales were recorded at each treatment and 1, 3, and 6 months after the last session. The quality of life was assessed using dermatology life quality index (DLQI) questionnaire.ResultsAll patients completed three ALA-PDT treatments and the follow-up visits. Clinical symptoms of itching disappeared completely in nine patients, one patient had itching decreased from severe to mild. All subjects showed objective improvement in lesions. The DLQI of all cases improved after treatment. The main side-effects of ALA-PDT were pain, erythema, and swelling. Side-effects were transient and tolerable. All patients reported being "satisfied" or "very satisfied" with their outcomes.ConclusionsALA-PDT is an effective and safe approach for the treatment of VLSA



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