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Why do some patients with vulval lichen sclerosus on long‐term topical corticosteroid treatment experience ongoing poor quality of life?

OBJECTIVE: To identify reasons for ongoing poor quality of life (pQOL) in a subset of long‐term topical corticosteroid‐treated vulval lichen sclerosus (VLS) patients. METHODS: A prospective cross‐sectional study of patients attending a dermato‐gynaecology practice in Sydney, Australia, comparing VLS...

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Detalles Bibliográficos
Autores principales: Wijaya, Marlene, Lee, Geoffrey, Fischer, Gayle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9828553/
https://www.ncbi.nlm.nih.gov/pubmed/36208206
http://dx.doi.org/10.1111/ajd.13926
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author Wijaya, Marlene
Lee, Geoffrey
Fischer, Gayle
author_facet Wijaya, Marlene
Lee, Geoffrey
Fischer, Gayle
author_sort Wijaya, Marlene
collection PubMed
description OBJECTIVE: To identify reasons for ongoing poor quality of life (pQOL) in a subset of long‐term topical corticosteroid‐treated vulval lichen sclerosus (VLS) patients. METHODS: A prospective cross‐sectional study of patients attending a dermato‐gynaecology practice in Sydney, Australia, comparing VLS patients with good quality of life (gQOL) and pQOL, in pre‐treatment and long‐term treatment groups, using the Vulval Quality of Life Index (VQLI). Demographics, VQLI scores and treatment characteristics were compared between gQOL and pQOL patients. RESULTS: A total of 255 biopsy‐proven VLS patients, 67 in pre‐treatment and 188 in long‐term treated groups were considered. There were 33 (49.3%) pQOL patients in pre‐treatment and 13 (6.9%) in treatment groups (p < 0.001). The highest‐scoring domain in treated pQOL patients was sexuality (1.7 [interquartile range (IQR) 1.0–2.0]), followed by anxiety [1.3 (IQR 1.0–1.5]), symptoms (1.0 [IQR 0.5–1.5]) and activities of daily living (0.7 [IQR 0.3–1.0]). Compared to treated gQOL, treated pQOL had significantly higher proportions of patients with partial treatment adherence (8 [61.5%] vs 42 [24.0%], p = 0.006), suboptimal disease control (7 [53.8%] vs 20 [11.4%], p < 0.001), scarring progression (3 [23.1%] vs 7 [4.0%], p = 0.024) and urinary incontinence (5 [38.5%] vs 27 [15.4%], p = 0.049). CONCLUSIONS: Only a minority of long‐term treated VLS patients reported ongoing pQOL. Of those who did, sexuality and anxiety domains were found to be the main sources of distress. Three major areas distinguishing gQOL from pQOL patients were (1) treatment adherence and disease control, (2) psychological factors and (3) urinary incontinence.
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spelling pubmed-98285532023-01-10 Why do some patients with vulval lichen sclerosus on long‐term topical corticosteroid treatment experience ongoing poor quality of life? Wijaya, Marlene Lee, Geoffrey Fischer, Gayle Australas J Dermatol Original Research OBJECTIVE: To identify reasons for ongoing poor quality of life (pQOL) in a subset of long‐term topical corticosteroid‐treated vulval lichen sclerosus (VLS) patients. METHODS: A prospective cross‐sectional study of patients attending a dermato‐gynaecology practice in Sydney, Australia, comparing VLS patients with good quality of life (gQOL) and pQOL, in pre‐treatment and long‐term treatment groups, using the Vulval Quality of Life Index (VQLI). Demographics, VQLI scores and treatment characteristics were compared between gQOL and pQOL patients. RESULTS: A total of 255 biopsy‐proven VLS patients, 67 in pre‐treatment and 188 in long‐term treated groups were considered. There were 33 (49.3%) pQOL patients in pre‐treatment and 13 (6.9%) in treatment groups (p < 0.001). The highest‐scoring domain in treated pQOL patients was sexuality (1.7 [interquartile range (IQR) 1.0–2.0]), followed by anxiety [1.3 (IQR 1.0–1.5]), symptoms (1.0 [IQR 0.5–1.5]) and activities of daily living (0.7 [IQR 0.3–1.0]). Compared to treated gQOL, treated pQOL had significantly higher proportions of patients with partial treatment adherence (8 [61.5%] vs 42 [24.0%], p = 0.006), suboptimal disease control (7 [53.8%] vs 20 [11.4%], p < 0.001), scarring progression (3 [23.1%] vs 7 [4.0%], p = 0.024) and urinary incontinence (5 [38.5%] vs 27 [15.4%], p = 0.049). CONCLUSIONS: Only a minority of long‐term treated VLS patients reported ongoing pQOL. Of those who did, sexuality and anxiety domains were found to be the main sources of distress. Three major areas distinguishing gQOL from pQOL patients were (1) treatment adherence and disease control, (2) psychological factors and (3) urinary incontinence. John Wiley and Sons Inc. 2022-10-08 2022-11 /pmc/articles/PMC9828553/ /pubmed/36208206 http://dx.doi.org/10.1111/ajd.13926 Text en © 2022 The Authors. Australasian Journal of Dermatology published by John Wiley & Sons Australia, Ltd on behalf of Australasian College of Dermatologists. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research
Wijaya, Marlene
Lee, Geoffrey
Fischer, Gayle
Why do some patients with vulval lichen sclerosus on long‐term topical corticosteroid treatment experience ongoing poor quality of life?
title Why do some patients with vulval lichen sclerosus on long‐term topical corticosteroid treatment experience ongoing poor quality of life?
title_full Why do some patients with vulval lichen sclerosus on long‐term topical corticosteroid treatment experience ongoing poor quality of life?
title_fullStr Why do some patients with vulval lichen sclerosus on long‐term topical corticosteroid treatment experience ongoing poor quality of life?
title_full_unstemmed Why do some patients with vulval lichen sclerosus on long‐term topical corticosteroid treatment experience ongoing poor quality of life?
title_short Why do some patients with vulval lichen sclerosus on long‐term topical corticosteroid treatment experience ongoing poor quality of life?
title_sort why do some patients with vulval lichen sclerosus on long‐term topical corticosteroid treatment experience ongoing poor quality of life?
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9828553/
https://www.ncbi.nlm.nih.gov/pubmed/36208206
http://dx.doi.org/10.1111/ajd.13926
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