Psoralen–UVA treatment for generalized prepubertal extragenital lichen sclerosus et atrophicus

Dalmau, Joan; Baselga, Eulàlia; Roé, Esther; Alomar, A.

doi:10.1016/j.jaad.2005.08.017

Cited by 21 publications

(7 citation statements)

References 11 publications

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“…Similarly, Spanish researchers have described the successful initial treatment of extragenital LS with oral PUVA phototherapy in a 10-year-old girl. 53 This particular patient had a significant recurrence 18 months after successful initial treatment and opted not to have further PUVA. In contrast, British clinicians have described a case of a 14-year-old girl with asymptomatic extragenital LS arising from moderate sunburn and subsequent sun exposure.…”

Section: Other Potential Therapiesmentioning

confidence: 96%

Paediatric vulval lichen sclerosus

Smith

Fischer

2009

Aust J Dermatology

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Lichen sclerosus (LS) in children is uncommon; however, it is an important differential diagnosis in any pre-pubertal child presenting with chronic vulval symptoms. The long-term prognosis is unknown; however, recent data suggests that the assumption that the condition will resolve at puberty may be incorrect. Children with LS require long-term management with topical corticosteroids, which remains the treatment of choice, as well as long-term follow up. We review the current literature on paediatric vulval LS.

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Section: Other Potential Therapiesmentioning

confidence: 96%

Paediatric vulval lichen sclerosus

Smith

Fischer

2009

Aust J Dermatology

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“…A 10-year-old girl with LS on the trunk was treated with systemic PUVA with peroral methoxsalen 30 mg (0.75 mg/kg) and a total UVA dose of 61 J/cm 2 [134]. After 3 months of oral PUVA there were no new lesions and previous ones resolved completely or with residual hyperpigmentation.…”

Section: Treatmentmentioning

confidence: 99%

Diagnosis and Treatment of Lichen Sclerosus

2012

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Lichen sclerosus (LS) is a chronic, inflammatory, mucocutaneous disorder of genital and extragenital skin. LS is a debilitating disease, causing itch, pain, dysuria and restriction of micturition, dyspareunia, and significant sexual dysfunction in women and men. Many findings obtained in recent years point more and more towards an autoimmune-induced disease in genetically predisposed patients and further away from an important impact of hormonal factors. Preceding infections may play a provocative part. The role for Borrelia is still controversial. Trauma and an occlusive moist environment may act as precipitating factors. Potent and ultrapotent topical corticosteroids still head the therapeutic armamentarium. Topical calcineurin inhibitors are discussed as alternatives in the treatment of LS in patients who have failed therapy with ultrapotent corticosteroids, or who have a contraindication for the use of corticosteroids. Topical and systemic retinoids may be useful in selected cases. Phototherapy for extragenital LS and photodynamic therapy for genital LS may be therapeutic options in rare cases refractory to the already mentioned treatment. Surgery is restricted to scarring processes leading to functional impairment. In men, circumcision is effective in the majority of cases, but recurrences are well described. Anogenital LS is associated with an increased risk for squamous cell carcinoma of the vulva or penis. This review updates the epidemiology, clinical presentation, histopathology, pathogenesis, and management of LS of the female and male genitals and extragenital LS in adults and children.

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“…Most patients with extragenital LS are initially treated with potent topical corticosteroids with variable results. Other reported treatments include topical retinoids, topical tacrolimus or pimecrolimus, oral steroids, cyclosporine, phototherapy, laser therapy, and surgical excision 6–8 . Patients with severe and refractory disease may be treated with high‐dose corticosteroids combined with low‐dose methotrexate therapy 9 …”

Section: Discussionmentioning

confidence: 99%