Vulvar lichen sclerosus. A comprehensive approach to treatment
Authors:   V.I.Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russian Federation, Mezhevitinova E.A. , Prilepskaya V.N. ,   V.I.Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russian Federation, Kepsha M.A. ,   V.I.Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russian Federation, Yurova M.V. ,   V.I.Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russian Federation, Abakarova P.R. ,   V.I.Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russian Federation, Nazarova N.M. ,   V.I.Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russian Federation, Dovletkhanova E.R. ,   V.I.Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russian Federation, Mgeryan A.N. ,   V.I.Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russian Federation
Published: February 2024

Vulvar lichen sclerosus (VLS) is a dermatosis characterized by a lymphocytic reaction and genital skin lesions that significantly affects the quality of life. Due to limited efficacy, current treatment options require further improvement in terms of a new understanding of etiopathogenetic mechanisms and long-lasting recurrent course of the disease. Objective. To compare the efficacy and safety of monotherapy with glucocorticosteroids (GCs) and combination therapy with GCs and Superlimf® cream (lanolin with vitamin-mineral protein-peptide complex “Superlimf®”) in women with VLS. Patients and methods. The study included 60 patients aged 20 to 68 years with histologically confirmed VLS. All patients were divided into two groups: group 1 – 28 patients receiving topical GCs, group 2 – 32 patients receiving topical GCs in combination with Superlimf® cream balm. Efficacy was measured by clinical outcomes 3 months after therapy initiation. Dermatology life quality index (DLQI), LS-S index (surface area) and LS-A index (disease activity) were used to objectify the evaluation of the initial degree of lesions and disease dynamics with therapy. Results. Clinical improvement (complete disappearance of itching, reduced inflammation, epithelialization of erosions and fissures, decreased severity of depigmentation and atrophy, statistically significant reduction in severity according to DLQI, LS-S and LS-A indices) was achieved in 16 patients in group 1 and in 22 patients in group 2 (57% and 68%, respectively). However, patients in group 2 had more statistically significant improvements in some aspects of life (itching, burning, painfulness, relationship, sexual function, study, work, sports), which reflected greater satisfaction with the treatment received. No adverse events were registered in both groups during 3 months of follow-up. At the same time, patients in group 2 subjectively reported more favorable tolerability of therapy: respondents more often noted enhanced comfort in the area of GCs application due to the absence of severe manifestations of steroid-induced skin atrophy. Conclusion. The use of Superlimf® cream balm as part of combination therapy for VLS is safe and increases the efficacy of treatment in comparison with GCs monotherapy. Key words: vulva, dermatosis, lichen, cytokines