Prospective observational study of the efficacy of mixed methylene blue compound injection for treatment of vulvar non‐neoplastic epithelial disorders

Li, Yanli; Shi, Jie; Tan, Wenfu; Ma, Qing; Wu, Xingjiang; Gao, Han

doi:10.1002/ijgo.13007

Cited by 6 publications

(4 citation statements)

References 12 publications

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“…In conclusion, the treatment effectively alleviated itching in VLS patients, and SHAP decreased significantly. Recurrence rates were relatively low [104]. PRISM may be more reliable than DLQI in capturing changes in disease-related burden post-treatment, as well as accurately quantifying baseline burden.…”

Section: Vls: Insights Into Conventional Therapeutic Approachesmentioning

confidence: 94%

Vulvar Lichen Sclerosus: Navigating Sex Hormone Dynamics and Pioneering Personalized Treatment Paradigm

Popa,

Dumitrascu,

Petca

et al. 2024

JPM

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Vulvar lichen sclerosus (VLS) is a frequently overlooked inflammatory disorder affecting the skin and mucous membranes of the vulva. With a propensity for atrophy, severe scarring, functional impairment, and malignant evolution, VLS is a disease that recurs frequently; early diagnosis, rapid treatment, and ongoing patient follow-up are essential. Potent topical corticosteroids (TCSs) are now widely recognized as the most effective treatment for achieving remission in VLS, but considering the potential complications of long-term treatment with potent TCSs, understanding the evolution of VLS during puberty becomes particularly crucial in determining the necessity for aggressive or more conservative therapeutic interventions. Emerging treatments, including PRP (platelet-rich plasma), stem cell therapy, and energy-based lasers like fractional CO2 and Nd-YAG, are being investigated to identify more effective VLS treatments than ultrapotent topical corticosteroids. However, more research is needed to assess the efficacy and safety of these new medicines. Topical clobetasol 0.05% ointment daily for 4–12 weeks is the gold standard for treating VLS. This article is a narrative review of the English-language medical literature from 2017 to November 2023, following three main sections concerning VLS: studies of the evolution amid pubertal hormonal changes; studies of the outcomes of personalized conventional therapies; and studies addressing the spectrum of innovative modalities for VLS.

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Section: Vls: Insights Into Conventional Therapeutic Approachesmentioning

confidence: 94%

Vulvar Lichen Sclerosus: Navigating Sex Hormone Dynamics and Pioneering Personalized Treatment Paradigm

Popa,

Dumitrascu,

Petca

et al. 2024

JPM

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“…The pathological alterations often observed in non-neoplastic lesions of the vulvar epithelium lichen simplex chronicus (LSC) and lichen sclerosus. The prevalence of the disease is 1.38%, with a high incidence in perimenopausal women ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

“…In recent years, Li et al have found that CO 2 lattice laser can remarkably improve regional cutaneous microcirculation due to the micropore thermal effect ( 1 , 2 ). Moreover, a few cases of nonneoplastic lesions of the vulvar epithelium treated with the CO 2 lattice laser have been reported.…”

Section: Introductionmentioning

confidence: 99%

A retrospective comparative cohort study of ultra-pulse CO2 lattice laser and glucocorticoids in the treatment of vulvar epithelial nonneoplastic lesions

Wei¹,

Li²,

Zhang³

et al. 2023

Ann Transl Med

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Background: A comparison of topical glucocorticoids with CO 2 fractional laser treatment was conducted to investigate the differences in the efficacy of non-neoplastic vulvar epithelial lesion treatments in different pathological types and to provide a scientific basis for the management of these disorders. This paper was to study the difference of curative effect of different pathological types of non-tumor vulvar epithelial lesions and provide scientific basis for the treatment of these diseases. Methods:From November 2016 to July 2018, 178 cases of vulvar lichen simplex chronicus (LSC) or lichen sclerosus were confirmed with vulvar biopsy at our institute. Finally, 160 patients were enrolled in this trial. The patients were divided into 2 groups: a group treated with topical hormone and a group treated with CO 2 lattice laser therapies. There were 80 cases in each group, including 40 with LSC and 40 with lichen sclerosus. Patients applied 1 gram of progesterone cream and betamethasone cream to the affected area in the morning and evening, respectively, once a day for 3 months. The efficacy was evaluated with the Patient Global Impression of Change (PGI-C) subjective symptom improvement scale and clinical efficacy evaluation scale. The formula was applied to calculate the curative effect index. Results:The PGI-C scores at 1, 3, and 6 months of treatment showed that the laser treatment group had remarkably superior outcomes to the glucocorticoid treatment group. The clinical efficacy score scale at 3and 6-month treatments indicated a significantly greater curative effect in the laser than in the glucocorticoid treatment (P=0.006 and P=0.002 respectively). In the glucocorticoid group, the clinical effects of different pathological subtypes were significantly different following the 1-and 3-month treatments. The efficacy of treatment for LSC was better than that for lichen sclerosus. Following the 3-and 6-month treatments, the clinical effect for LSC was better than that of lichen sclerosus (3 months: 95% vs. 75%; 6 months: and 95% vs. 70%).Conclusions: Ultrapulse CO 2 lattice laser was more effective than was glucocorticoid therapy in the treatment of vulvar epithelial non-tumor-like lesions.

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“…At the same time, the side effects of excessive drug use should be given attention to. Reports have shown the effectivity of laser [5], phototherapy [6], mixed methylene blue compound injection [7] and pimecrolimus cream [8] in treating VLSC. The wearing of silk fabric underwear may also be effective in the management of VLSC [9], but further research is needed.…”

Section: Introductionmentioning

confidence: 99%

Comparison of efficacy and safety of high-intensity focused ultrasound at different powers for patients with vulvar lichen simplex chronicus

Jiang

2021

International Journal of Hyperthermia

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Objective: To compare the efficacy and safety of the treatment of vulvar lichen simplex chronicus (VLSC) using high-intensity focused ultrasound (HIFU) at different powers. Methods: This retrospective study included 152 patients with VLSC. Among these patients, 70 were treated with HIFU at low power (level 2), and 82 were treated at normal power (level 3). The treatment responses, recurrence rates and intra-and postoperative complications were all compared. Results: No statistically significant differences were found between the two groups in age, disease course, menopause status, lesion size and severity of symptoms. All patients received one session of HIFU therapy, and the treatment process was successful. No difference was found in the total response rate between the two groups at 1 (85.7% versus 87.8%, p ¼ .35), 6 (80% versus 80.5%, p ¼ .65) and 12 (80% versus 80.5%, p ¼ .73) months after HIFU therapy. No significant difference was observed in the recurrence rate between the two groups at 6 (5.7% versus 9.8%, p ¼ .36) and 12 (22.9% versus 26.8%, p ¼ .57) months after HIFU treatment. Patients in the low-power group had a lower incidence of blisters (10% versus 23.3%, p ¼ .04). Conclusion:Based on our results, low-power HIFU treatment can achieve a therapeutic effect similar to normal power HFU treatment for VLSC, but its incidence of side effects is lower.

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Prospective observational study of the efficacy of mixed methylene blue compound injection for treatment of vulvar non‐neoplastic epithelial disorders

Cited by 6 publications

References 12 publications

Vulvar Lichen Sclerosus: Navigating Sex Hormone Dynamics and Pioneering Personalized Treatment Paradigm

Vulvar Lichen Sclerosus: Navigating Sex Hormone Dynamics and Pioneering Personalized Treatment Paradigm

A retrospective comparative cohort study of ultra-pulse CO2 lattice laser and glucocorticoids in the treatment of vulvar epithelial nonneoplastic lesions

Comparison of efficacy and safety of high-intensity focused ultrasound at different powers for patients with vulvar lichen simplex chronicus

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