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Photodynamic Therapy for Vulvar Lichen Sclerosus—A Systematic Review

Prodromidou, Anastasia MD1; Chatziioannou, Eftychia MD1; Daskalakis, Georgios MD, PhD2; Stergios, Kostantinos MD3; Pergialiotis, Vasilios MD, MSc, PhD1

Journal of Lower Genital Tract Disease: January 2018 - Volume 22 - Issue 1 - p 58–65
doi: 10.1097/LGT.0000000000000362
Original Research Articles: Vagina and Vulva
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Objective Lichen sclerosus (LS) is a disease affecting mostly genital and perianal areas. Photodynamic therapy (PDT) has gained interest during the past years. The present study accumulates current evidence on the efficacy of PDT in the management of vulvar LS.

Methods We used Medline (1966–2017), Scopus (2004–2017), ClinicalTrials.gov (2008–2017) and Cochrane Central Register of Controlled Trials CENTRAL (1999–2017) databases in our primary search along with the reference lists of electronically retrieved full-text papers.

Results Eleven studies were finally included in our systematic review, which recruited 337 women. The existing evidence supports that PDT results in significant relief of symptoms related to LS, hence remains confusing in evaluating the progress in the clinical appearance of the lesion. No major adverse effects were reported during therapy and during the posttreatment period. Pathologic findings seem to be conflicting, as current data do not unanimously support a beneficial histological effect.

Conclusions According to the findings of our study, PDT seems to be promising in the treatment of patients with vulvar LS. Nonetheless, current knowledge is extremely limited, and further observational studies with large patient series are needed in the field to elucidate the efficacy of PDT.

Photodynamic therapy seems promising therapy of vulvar lichen sclerosus, but current knowledge is limited and further studies are needed to elucidate the efficacy of photodynamic therapy.

1Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, National and Kapodistrian University of Athens, Greece; 2First Department of Obstetrics and Gynecology, Alexandra Maternity Hospital, National and Kapodistrian University of Athens, Greece; and 3West Hertfordshire Hospitals NHS Trust, Watford General Hospital, United Kingdom

Correspondence to: Anastasia Prodromidou, MD, Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, National and Kapodistrian University of Athens, Athens, Greece, 00306972751000. E-mail: a.prodromidou@hotmail.com

The authors have declared they have no conflicts of interest.

This work received no funding.

Copyright © 2018 by the American Society for Colposcopy and Cervical Pathology