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Efficacy of 5-Aminolevulinic Acid (ALA)-Photodynamic Therapy (PDT) in Refractory Vulvar Lichen Sclerosus: Preliminary Results
BACKGROUND: As a chronic inflammatory skin disease of unknown etiology, vulvar lichen sclerosus (VLS) mainly affects postmenopausal and perimenopausal women. The main clinical manifestations of VLS include itching, burning pain, and sexual dysfunction, which can lead to a decline in quality of life....
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
International Scientific Literature, Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7802375/ https://www.ncbi.nlm.nih.gov/pubmed/33411697 http://dx.doi.org/10.12659/MSM.927406 |
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author | Zhang, Fenghua Li, Daoyun Shi, Lijuan Gu, Yijia Xu, Yun Wu, Changping |
author_facet | Zhang, Fenghua Li, Daoyun Shi, Lijuan Gu, Yijia Xu, Yun Wu, Changping |
author_sort | Zhang, Fenghua |
collection | PubMed |
description | BACKGROUND: As a chronic inflammatory skin disease of unknown etiology, vulvar lichen sclerosus (VLS) mainly affects postmenopausal and perimenopausal women. The main clinical manifestations of VLS include itching, burning pain, and sexual dysfunction, which can lead to a decline in quality of life. The existing treatment options include topical corticosteroid ointment, estrogen, and traditional Chinese medicine; however, their therapeutic effects on VLS remain unsatisfactory. MATERIAL/METHODS: Thirty patients with VLS and routine treatment failure were treated with 5-aminolevulinic acid (ALA)-photodynamic therapy (PDT). A 20% ALA water-in-oil emulsion was applied to the vulvar lesions and sealed with plastic film for 3 h. Patients were irradiated at a power density of 60 to 90 mW/cm(2) with a red light at a wavelength of 635±15 nm for 20 min, delivering a total dose of 100 to 150 J/cm(2) per session. The treatment was repeated 3 times every 2 weeks. The objective parameters, female sexual function index (FSFI) and quality of life (QoL) scores, were used before and after treatment to evaluate the clinical curative effect. RESULTS: All patients completed 3 treatment cycles of ALA-PDT and follow-up visits. The clinical symptoms of pruritus completely disappeared in 27 cases, and itching improved from severe to mild in 3 cases. The pathological changes of all patients were objectively improved. FSFI score decreased significantly after treatment (P<0.001). The main adverse effects of ALA-PDT were pain, erythema, and swelling. These adverse effects were temporary and tolerable. The QoL score was significantly improved after treatment (P<0.001). CONCLUSIONS: ALA-PDT is an effective and safe approach for the treatment of VLS. |
format | Online Article Text |
id | pubmed-7802375 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | International Scientific Literature, Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-78023752021-01-13 Efficacy of 5-Aminolevulinic Acid (ALA)-Photodynamic Therapy (PDT) in Refractory Vulvar Lichen Sclerosus: Preliminary Results Zhang, Fenghua Li, Daoyun Shi, Lijuan Gu, Yijia Xu, Yun Wu, Changping Med Sci Monit Clinical Research BACKGROUND: As a chronic inflammatory skin disease of unknown etiology, vulvar lichen sclerosus (VLS) mainly affects postmenopausal and perimenopausal women. The main clinical manifestations of VLS include itching, burning pain, and sexual dysfunction, which can lead to a decline in quality of life. The existing treatment options include topical corticosteroid ointment, estrogen, and traditional Chinese medicine; however, their therapeutic effects on VLS remain unsatisfactory. MATERIAL/METHODS: Thirty patients with VLS and routine treatment failure were treated with 5-aminolevulinic acid (ALA)-photodynamic therapy (PDT). A 20% ALA water-in-oil emulsion was applied to the vulvar lesions and sealed with plastic film for 3 h. Patients were irradiated at a power density of 60 to 90 mW/cm(2) with a red light at a wavelength of 635±15 nm for 20 min, delivering a total dose of 100 to 150 J/cm(2) per session. The treatment was repeated 3 times every 2 weeks. The objective parameters, female sexual function index (FSFI) and quality of life (QoL) scores, were used before and after treatment to evaluate the clinical curative effect. RESULTS: All patients completed 3 treatment cycles of ALA-PDT and follow-up visits. The clinical symptoms of pruritus completely disappeared in 27 cases, and itching improved from severe to mild in 3 cases. The pathological changes of all patients were objectively improved. FSFI score decreased significantly after treatment (P<0.001). The main adverse effects of ALA-PDT were pain, erythema, and swelling. These adverse effects were temporary and tolerable. The QoL score was significantly improved after treatment (P<0.001). CONCLUSIONS: ALA-PDT is an effective and safe approach for the treatment of VLS. International Scientific Literature, Inc. 2021-01-07 /pmc/articles/PMC7802375/ /pubmed/33411697 http://dx.doi.org/10.12659/MSM.927406 Text en © Med Sci Monit, 2021 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) ) |
spellingShingle | Clinical Research Zhang, Fenghua Li, Daoyun Shi, Lijuan Gu, Yijia Xu, Yun Wu, Changping Efficacy of 5-Aminolevulinic Acid (ALA)-Photodynamic Therapy (PDT) in Refractory Vulvar Lichen Sclerosus: Preliminary Results |
title | Efficacy of 5-Aminolevulinic Acid (ALA)-Photodynamic Therapy (PDT) in Refractory Vulvar Lichen Sclerosus: Preliminary Results |
title_full | Efficacy of 5-Aminolevulinic Acid (ALA)-Photodynamic Therapy (PDT) in Refractory Vulvar Lichen Sclerosus: Preliminary Results |
title_fullStr | Efficacy of 5-Aminolevulinic Acid (ALA)-Photodynamic Therapy (PDT) in Refractory Vulvar Lichen Sclerosus: Preliminary Results |
title_full_unstemmed | Efficacy of 5-Aminolevulinic Acid (ALA)-Photodynamic Therapy (PDT) in Refractory Vulvar Lichen Sclerosus: Preliminary Results |
title_short | Efficacy of 5-Aminolevulinic Acid (ALA)-Photodynamic Therapy (PDT) in Refractory Vulvar Lichen Sclerosus: Preliminary Results |
title_sort | efficacy of 5-aminolevulinic acid (ala)-photodynamic therapy (pdt) in refractory vulvar lichen sclerosus: preliminary results |
topic | Clinical Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7802375/ https://www.ncbi.nlm.nih.gov/pubmed/33411697 http://dx.doi.org/10.12659/MSM.927406 |
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