Treatment Modalities for Genital Lichen Sclerosus: A Systematic Review
department or school: Medicine, Faculty of
department or school: Non UBC
department or school: Dermatology and Skin Science, Department of
data provider: DSpace
identifier citation: Dermato 4 (4): 136-172 (2024)
creator: Conte, Santina
creator: Daraj Mohamed, Sarah
creator: Shergill, Mahek
creator: Yacovelli, Alexandra
creator: Johnston, Leah
creator: Starkey, Samantha
creator: Cohen, Yossi
creator: Law, Angela
creator: Litvinov, Ivan V.
creator: Mukovozov, Ilya
issued: 2025-01-02T21:02:59Z
issued: 2024-10-19
description: Background: Lichen sclerosus (LS) is a chronic, inflammatory dermatosis that affects both genital and extragenital sites. It is often difficult to treat and may lead to a variety of complications if not adequately treated. The mainstay of therapy involves topical corticosteroids, topical calcineurin inhibitors, and systemic immunomodulators. Although a variety of topical, oral, and procedural therapies are available, a review comparing relative efficacy is lacking. To this end, this systematic review aimed to summarize the literature regarding treatment modalities and their respective response rates in patients with genital LS. Methods: A literature search was conducted in accordance with PRISMA guidelines. Results: This review qualitatively summarizes information from 31 randomized controlled trials, encapsulating a total of 1507 patients with LS, the majority of which were female (n = 1374, 91%). Topical corticosteroids, the mainstay of therapy for LS, were discussed throughout the literature, and proved to be more efficient than topical calcineurin inhibitors, topical hormonal therapy, topical vitamin E oil and cold cream. However, other treatment modalities proved to be more efficient than topical corticosteroids, including CO₂ and Nd:YAG laser therapies, and the addition of polydeoxyribonucleotide intradermal injections, to steroid therapy. Finally, other modalities that proved to be efficient in the treatment of LS included silk undergarments, human fibroblast lysate cream, platelet-rich plasma, acitretin, and surgical intervention. The risk of bias was assessed using the Cochrane risk-of-bias tool for randomized trials. Limitations included the inclusion of only randomized controlled trials, moderate or high risk of bias, and heterogeneity in treatment regimens, among others. Conclusion: Although high-potency topical corticosteroids have validated efficacy in the management of LS, other treatment modalities, including steroid-sparing agents and/or procedural …
aggregated CHO: https://circle.library.ubc.ca/rest/handle/2429/90013
note: Citation: Conte, S.; Daraj Mohamed,S.; Shergill, M.; Yacovelli, A.; Johnston,L.; Starkey, S.; Cohen, Y.; Law, A.;Litvinov, I.V.; Mukovozov, I.Treatment Modalities for GenitalLichen Sclerosus: A SystematicReview. Dermato 2024, 4, 136–172.https://doi.org/10.3390/dermato4040014Academic Editor: Thilo GambichlerReceived: 4 August 2024Revised: 12 October 2024Accepted: 15 October 2024Published: 19 October 2024Copyright: © 2024 by the authors.Licensee MDPI, Basel, Switzerland.This article is an open access articledistributed under the terms andconditions of the Creative CommonsAttribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).Systematic ReviewTreatment Modalities for Genital Lichen Sclerosus:A Systematic ReviewSantina Conte 1 , Sarah Daraj Mohamed 1, Mahek Shergill 2 , Alexandra Yacovelli 1, Leah Johnston 3,Samantha Starkey 4 , Yossi Cohen 1, Angela Law 5,6, Ivan V. Litvinov 7 and Ilya Mukovozov 8,*1 Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H4A 3J1, Canada;santina.conte@mail.mcgill.ca (S.C.); sarah.darajmohamed@mail.mcgill.ca (S.D.M.);alexandra.yacovelli@mail.mcgill.ca (A.Y.); yossi.cohen@mail.mcgill.ca (Y.C.)2 Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON L8P 1H6, Canada;mahek.shergill@medportal.ca3 Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z5, Canada;leah.johnston2@ucalgary.ca4 Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada;samantha.starkey@nemours.org5 Department of Dermatology and Skin Science, University of British Columbia,Vancouver, BC V5Z 4E8, Canada; angela.m.law@gmail.com6 Providence Health Care Dermatology, Mount Saint Joseph Hospital, Vancouver, BC V5T 3N4, Canada7 Division of Dermatology, Department of Medicine, McGill University, Montreal, QC H4A 3J1, Canada;ivan.litvinov@mcgill.ca8 Toronto Dermatology Centre, Toronto, ON M3H 5Y8, Canada* Correspondence: mukovoi@gmail.com; Tel.: +1-416-633-0001Abstract: Background: …
has type: Article
is shown at: 10.14288/1.0447643
language: eng
peer review status: Reviewed
provider: Vancouver : University of British Columbia Library
publisher: Multidisciplinary Digital Publishing Institute
publisher DOI: 10.3390/dermato4040014
rights: CC BY 4.0
rights URI: https://creativecommons.org/licenses/by/4.0/
scholar level: Faculty
scholar level: Researcher
subject: lichen sclerosus
subject: treatment
subject: management
subject: response
subject: steroids
subject: surgery
type: Text
identifier URI: http://hdl.handle.net/2429/90013