Journal of pediatric and adolescent gynecology · 2025
Pediatric Vulvar Lichen Sclerosus: Is a One-Size-Fits-All Prolonged Induction Therapeutic Regimen Effective? A Referral Center Experience.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Boero Veronica, Caia Carlotta, Mastrangelo Maria, Accomasso Francesca, Restelli Elisa, Cavalli Riccardo, Montefusco Francesca, Libutti Giada, Berrettini Alfredo, Pesce Elisa, Pillinini Chiara, Cetera Giulia E, Somigliana Edgardo
Аннотация
STUDY OBJECTIVE: To evaluate the efficacy and safety of a prolonged 6-month induction regimen using ultrapotent topical corticosteroids and daily emollient in the treatment of pediatric vulvar lichen sclerosus (pVLS).
METHODS: This retrospective observational study included 94 girls with clinical diagnosis of pVLS between 2021 and 2025. All patients underwent a standardized treatment protocol with clobetasol propionate 0.05% ointment applied daily for 30 days, every other day for 30 days, and twice weekly for 120 days, alongside daily application of a vitamin E-based emollient. Clinical evaluations and symptom assessments were conducted at baseline (T0), 3 months (T1), and 6 months (T2).
RESULTS: Symptom remission was achieved in 83% of patients, with marked reductions in itching from 80% (T0) to 13% (T2), *P* < .001, and burning from 36% (T0) to 8% (T2), *P* < .001. Dysuria, dyschezia, and nocturnal awakenings resolved completely by the T1 follow-up. Significant improvements in clinical signs were observed in vulvar area. Improvements in perianal signs were more modest but statistically significant for fissures/erosions (P < .001) and hyperkeratosis/lichenification (P = .018). No significant changes were observed in anatomical alterations. Mild, self-limiting side effects were reported in 8% of patients at T1 and in only 1% at T2. No serious adverse events occurred.
CONCLUSION: A prolonged induction regimen with ultrapotent topical corticosteroids demonstrates high efficacy with a substantial symptom and sign resolution and favorable safety profile.
METHODS: This retrospective observational study included 94 girls with clinical diagnosis of pVLS between 2021 and 2025. All patients underwent a standardized treatment protocol with clobetasol propionate 0.05% ointment applied daily for 30 days, every other day for 30 days, and twice weekly for 120 days, alongside daily application of a vitamin E-based emollient. Clinical evaluations and symptom assessments were conducted at baseline (T0), 3 months (T1), and 6 months (T2).
RESULTS: Symptom remission was achieved in 83% of patients, with marked reductions in itching from 80% (T0) to 13% (T2), *P* < .001, and burning from 36% (T0) to 8% (T2), *P* < .001. Dysuria, dyschezia, and nocturnal awakenings resolved completely by the T1 follow-up. Significant improvements in clinical signs were observed in vulvar area. Improvements in perianal signs were more modest but statistically significant for fissures/erosions (P < .001) and hyperkeratosis/lichenification (P = .018). No significant changes were observed in anatomical alterations. Mild, self-limiting side effects were reported in 8% of patients at T1 and in only 1% at T2. No serious adverse events occurred.
CONCLUSION: A prolonged induction regimen with ultrapotent topical corticosteroids demonstrates high efficacy with a substantial symptom and sign resolution and favorable safety profile.