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Lichen Sclerosus: A 5-Year Follow-Up After Topical, Subdermal, or Combined Therapy

Ventolini, Gary MD; Swenson, Krista M. MD; Galloway, Michael L. DO

Journal of Lower Genital Tract Disease:
doi: 10.1097/LGT.0b013e31823da7e8
Original Articles

Objective: The purpose of our study was to compare clinical data regarding patients with pruritic lichen sclerosus (LS) at moderate or severe stages using 2 different therapies with a 5-year follow-up.

Materials and Methods: The study was approved by the institutional review board and was presented as a retrospective clinical data review of patients with pruritic biopsy diagnosis LS who underwent therapy at our university private practice from 2002 to 2005. We compared the results of a weekly topical application of high-potency steroid (HPS) with a combined HPS and monthly anesthetic/steroid subdermal injection (ASI). Outcomes were timed to achieve pruritus-free status, the number of symptomatic recurrences, and patient satisfaction with therapy.

Results: Fifty-four patients were diagnosed with LS between 2002 and 2005. There were 13 patients who had mild-stage, 25 who had moderate-stage, and 16 who had severe-stage LS. Five-year follow-up data on 17 patients with moderate-stage LS and 14 patients with severe-stage LS were obtained. Time to pruritus free was 6 weeks with ASI and 19 weeks with HPS for moderate-stage LS (p = .04) and 9 weeks with ASI and 24 weeks with HPS for severe-stage LS (p = .03). Recurrences were more frequent on HPSfor moderate-stage LS (p = .04) but not significant with HPS for severe-stage LS (p = .15). Only ASI was successful at treating patients with recalcitrant pruritus.

Conclusions: In our population, patients with symptomatic moderate-stage LS seem to have a more rapid and prolonged response to ASI than to HPS but are less satisfied with the injections.

Author Information

Boonshoft School of Medicine, Wright State University, Dayton, OH

Reprint requests to: Gary Ventolini, MD, Boonshoft School of Medicine, Wright State University, Dayton, OH. E-mail:

©2012The American Society for Colposcopy and Cervical Pathology