Combination of high-frequency electrocautery therapy and ALA-PDT in hyperkeratotic vulvar lichen sclerosus: Series of seven cases

Photodiagnosis Photodyn Ther. 2024 Feb:45:103924. doi: 10.1016/j.pdpdt.2023.103924. Epub 2023 Dec 5.

Abstract

Significance: ALA-PDT effectively treats Vulvar lichen sclerosus et atrophicus (VLSA), but it requires multiple repetitions for satisfactory results. To enhance efficacy, we employed a combination of high-frequency electrocautery therapy and ALA-PDT in treating seven VLSA patients.

Approach: Lesions and leukoplakia in the seven women with VLSA were removed using a high-frequency generator. PDT was administered after wound healing, and it was repeated six times. Follow-up assessments were carried out at 1, 3, and 6 months to evaluate the severity of pruritus and investigate lesion repigmentation.

Results: Following the combined therapy, the disappearance of pruritus was observed in all patients, and normal color and thickness were restored to their skin. Two patients reported mild pruritus with a score of 2 one month after treatment, which persisted until the 6-month follow-up, while the remaining patients remained free from pruritus. No recurrence of skin lesions was observed in any of the patients.

Conclusions: The combined therapy for the treatment of VLSA is found to be convenient, effective, and easily promotable.

Keywords: High-frequency electrocautery therapy; PDT; VLSA; Vulvar lichen sclerosus et atrophicus.

MeSH terms

  • Electrocoagulation
  • Female
  • Humans
  • Lichen Sclerosus et Atrophicus* / drug therapy
  • Photochemotherapy* / methods
  • Photosensitizing Agents / therapeutic use
  • Pruritus / drug therapy
  • Vulvar Lichen Sclerosus* / drug therapy

Substances

  • Photosensitizing Agents