Tratamiento de liquen escleroso y atrófico vulvar con láser de dióxido de carbono fraccionado. Presentación de cuatro casos

Mendieta-Eckert, Marta; Bilbao, Juan; Estévez, I. Zabalza; Gundin, Nerea Landa

doi:10.1016/j.ad.2019.03.021

Actas Dermo-Sifiliográficas

2021

DOI: 10.1016/j.ad.2019.03.021

|View full text |Cite

Tratamiento de liquen escleroso y atrófico vulvar con láser de dióxido de carbono fraccionado. Presentación de cuatro casos

Marta Mendieta-Eckert¹,

Juan Bilbao²,

I. Zabalza Estévez

et al.

Help me understand this report

Search citation statements

Order By: Relevance

Paper Sections

Select...

Citation Types

Supporting

Mentioning

Contrasting

Year Published

2021

2022

Publication Types

Select...

Article3

Relationship

Self Cite0

Independent3

Authors

Journals

Cited by 3 publications

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Fractional CO₂ laser treatment as adjunctive therapy to topical steroids for managing vulvar lichen sclerosus

Stewart¹,

Javaid²,

Schallen

et al. 2021

Lasers Surg Med

View full text Add to dashboard Cite

Objectives: Uncontrolled vulvar lichen sclerosus (VLS) is often associated with distressful symptoms of genital itch, irritation, and pain and can lead to a pathological process including anatomical changes, scarring, and an elevated risk of cancer in the genital area. First-line topical corticosteroid as monotherapy is frequently not adequate to fully suppress disease activity and control symptoms. This study evaluated the efficacy of fractional CO 2 laser treatments as adjunctive therapy where recalcitrant VLS had been improved, but not adequately controlled, with topical corticosteroid treatment. Outcomes were evaluated up to 12 months after a series of CO 2 laser treatments delivered via a fractional handpiece. Materials and Methods: Women with a diagnosis of VLS supported by histologic findings on biopsy and/or clinical signs on physical examination received up to five monthly laser treatments. Subjects maintained existing topical corticosteroid and any exogenous hormone treatment during the study. Investigators assessed severity (0 = not present, 1 = mild, 2 = moderate, or 3 = severe) of clinical signs and architectural changes present before adjunctive study interventions and at followup visits. Subjects reported the presence of clinical symptoms and impact on quality of life on 4-or 5-point Likert scales. The validated Female Sexual Function Index (FSFI) was used to assess changes in sexual function. Four subjects were biopsied before adjunctive laser treatment and at follow-up. Results: Twelve females, 11 postmenopausal, with a mean age of 57 ± 10 years received three to five monthly CO 2 laser treatments. Significant improvement in all prominent clinical signs and architectural changes were reported at the 3-and 6-month follow-ups after the treatment series. Significant improvement was maintained at the 12-month follow-up, with 89% of subjects showing at least onepoint improvement in elasticity compared to baseline; 86% in lichenification; 88% in sclerosis; and 80% in whitening and parchment-like skin. Labial fusion and the extent of disease improved in 50% of patients. Ulcerations present in three subjects at baseline resolved after treatment. Subjects reported 86% improvement in dyspareunia and 83% in skin tearing. Quality of life improved significantly after treatment (p < 0.01). The 6-month follow-up FSFI showed significant improvement in sexual function compared to baseline (p < 0.05), with a mean point improvement of 4.5. Histology findings after treatment showed some positive improvement, as a decrease in dermal hyalinized zone thickness. There were no treatment complications or adverse events related to the treatment. Conclusions: Fractional CO 2 laser treatment outcomes showed improvement in predominant clinical signs and architectural changes in VLS recalcitrant to topical corticosteroid treatment. Adjunctive laser treatment relieved symptoms and

show abstract

Fractional CO₂ laser treatment as adjunctive therapy to topical steroids for managing vulvar lichen sclerosus

Stewart¹,

Javaid²,

Schallen

et al. 2021

Lasers Surg Med

View full text Add to dashboard Cite

show abstract

Fractionated Carbon Dioxide Laser for the Treatment of Vulvar Lichen Sclerosus

Mitchell

Goldstein

Heller

et al. 2021

Obstetrics &Amp; Gynecology

View full text Add to dashboard Cite

show abstract

The evidence behind the use of LASER for genitourinary syndrome of menopause, vulvovaginal atrophy, urinary incontinence and lichen sclerosus: A state‐of‐the‐art review

Mortensen

Christensen

Løkkegaard

2022

Acta Obstet Gynecol Scand

View full text Add to dashboard Cite

In recent years, LASER has been introduced as a minimally invasive treatment for a broad range of vaginal and vulvar symptoms and diseases. However, the efficacy and safety of vaginal and vulvar LASER has continuously been questioned. The aim of this study is to create an overview of the current literature and discuss the controversies within the use of LASER for genitourinary syndrome of menopause, vulvovaginal atrophy, urinary incontinence and lichen sclerosus. A search string was built in PubMed.The search was commenced on August 25, 2021 and closed on October 27, 2021. Two authors screened the studies in Covidence for inclusion according to the eligibility criteria in the protocol. The data were extracted from the studies and are reported inThe authors set up an internal protocol to use as a guideline for the review, listing the criteria and outcomes for this review. The eligibility criteria for this state-of-the-art review adhered to the principals of PICO-participants, interventions, comparison and outcome. Studies that investigated the effect of any vaginal and vulvar LASER on women with symptoms of GSM, VVA, UI or LS were eligible for inclusion. No outcome restrictions were applied.Only original studies were included; unpublished work, editorials, conference abstracts, reviews and meta-analysis were excluded.Likewise, in vivo studies on animals, histologic cohort studies, and studies of the effect of radiofrequency treatment were excluded.indications as a treatment should be kept on a research level until further high-quality evidence is available.

show abstract

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

customersupport@researchsolutions.com

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

Tratamiento de liquen escleroso y atrófico vulvar con láser de dióxido de carbono fraccionado. Presentación de cuatro casos

Cited by 3 publications

References 10 publications

Fractional CO₂ laser treatment as adjunctive therapy to topical steroids for managing vulvar lichen sclerosus

Fractional CO₂ laser treatment as adjunctive therapy to topical steroids for managing vulvar lichen sclerosus

Fractionated Carbon Dioxide Laser for the Treatment of Vulvar Lichen Sclerosus

The evidence behind the use of LASER for genitourinary syndrome of menopause, vulvovaginal atrophy, urinary incontinence and lichen sclerosus: A state‐of‐the‐art review

Contact Info

Product

Resources

About

Tratamiento de liquen escleroso y atrófico vulvar con láser de dióxido de carbono fraccionado. Presentación de cuatro casos

Cited by 3 publications

References 10 publications

Fractional CO2 laser treatment as adjunctive therapy to topical steroids for managing vulvar lichen sclerosus

Fractional CO2 laser treatment as adjunctive therapy to topical steroids for managing vulvar lichen sclerosus

Fractionated Carbon Dioxide Laser for the Treatment of Vulvar Lichen Sclerosus

The evidence behind the use of LASER for genitourinary syndrome of menopause, vulvovaginal atrophy, urinary incontinence and lichen sclerosus: A state‐of‐the‐art review

Contact Info

Product

Resources

About

Fractional CO₂ laser treatment as adjunctive therapy to topical steroids for managing vulvar lichen sclerosus

Fractional CO₂ laser treatment as adjunctive therapy to topical steroids for managing vulvar lichen sclerosus