How is lichen sclerosus treated?

Objectives:

The purpose of this study was to compare patient satisfaction with the topical immune system modulator tacrolimus to topical clobetasol during treatment for vulvovaginal erosive lichen planus.

Study Design:

Subjects who had been diagnosed with vulvovaginal erosive lichen planus between June 2000 and May 2001 received a mail survey regarding clinical satisfaction and response to treatment with clobetasol and tacrolimus. Satisfaction was assessed with a 100-mm visual analogue scale (very unsatisfied, 0; very satisfied, 100). Satisfaction was compared with the use of a paired t-test.

Results:

Nineteen subjects met the inclusion criteria; 17 subjects (89%) returned completed surveys. Sixteen of the 17 women reported clobetasol therapy, and 11 of the 17 subjects acknowledged the use of tacrolimus therapy. All but 1 of the women who received tacrolimus had been treated previously with clobetasol therapy. All subjects reported experiencing sexual pain before their initial examination. After treatment with clobetasol, 2 of 16 women reported pain-free intercourse. Two additional women reported pain-free intercourse after switching to tacrolimus therapy. Ten subjects who had used both treatments rated tacrolimus therapy as significantly more satisfactory than clobetasol therapy (63 vs 38 mm; P=.03).

Conclusion:

The use of topical tacrolimus improves satisfaction and may result in better clinical outcomes than therapy with clobetasol for the treatment of vulvovaginal erosive lichen planus.

Please click on the required question.

• 1 What skin conditions may affect the vulva?
• 2 Which viral infections can affect the genitalia?
• 3 What problems can occur to people with herpes simplex?
• 4 What are genital warts?
• 5 What is lichen sclerosus?
• 6 How is lichen sclerosus treated?
• 7 What could be causing my vulval irritation?
• 8 How could my vulval irritation be treated?
• 9 What is a Bartholin's cyst / abscess?
• 10 How is a Bartholin's cyst / abscess treated?
• 11 What is vulvodynia?
• 12 How can my vulvodynia be treated?
• 13 What is vestibulitis?
• 14 How can my vestibulitis be treated?
• 15 Where can I obtain further information?
• 16 Support Groups.

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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.

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