Prepubertal‐Onset Vulvar Lichen Sclerosus: The Importance of Maintenance Therapy in Long‐Term Outcomes

Abstract

Our data support previous studies regarding initial treatment with potent TCS but additionally suggest maintenance treatment with individualized regimens that achieve objective normality in addition to symptom control provide optimal outcomes.

Lichenoid vulvar disease: A review

“…Ellis and Fischer (2015) also demonstrated that after initial induction treatment with ultra-potent topical steroid medications, maintenance therapy in children with individualized regimens (using low or mid-potency topical steroid medications) results in improved patient outcomes. In their cohort of 46 children, those who were adherent to maintenance therapy were more likely to achieve complete disease suppression and less likely to have scarring compared with those who were nonadherent (Ellis and Fischer, 2015).…”

“…Ultra-potent topical steroid medications should be used as a first-line treatment in children as well and there are data to support their safety and efficacy in the prepubertal population (Ellis and Fischer, 2015, Fischer and Rogers, 1997). Intralesional corticosteroid medications can be effective, especially for thick, hyperkeratotic plaques (Mazdisnian et al, 1999).…”

“…In their cohort of 46 children, those who were adherent to maintenance therapy were more likely to achieve complete disease suppression and less likely to have scarring compared with those who were nonadherent (Ellis and Fischer, 2015). …”

The treatment of vulval lichen sclerosus in prepubertal girls: a critically appraised topic

“…We then subdivided the papers into groups according to the treatment used. Twenty-one studies included topical steroids 2,6,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] and eight used other topical treatments. 27,[30][31][32][33][34][35][36] One study included patients treated with both topical steroids and calcineurin inhibitors.…”

“…Rarely, girls are asymptomatic, and the diagnosis of LS is incidental . In many girls, the disease remits at puberty, but this cannot be assumed, and some studies describe a more chronic course where resolution does not always occur and continued treatment is necessary . In those who continue to experience symptoms and exhibit signs of active disease requiring treatment, prolonged follow‐up is necessary.…”