Cattaneo Antonio, De Magnis Angelina, Botti Elena, Sonni Lorella, Carli Paolo, Taddei Gian Luigi
Departments of Obstetrics and Gynecology, of Dermatology and of Pathology, University of Florence, Careggi, Viale Morgagni 85, 50100 Florence, Italy.
J Reprod Med. 2003 Jun;48(6):444-8.
To assess the efficacy and safety of treating vulvar lichen sclerosus with mometasone furoate, a synthetic analogue of beclomethasone.
Thirty-one consecutive patients with biopsy-proven vulvar lichen sclerosus (LS) seen at the Florence Vulvar Clinic were entered into the study. Each subject's symptoms and the gross appearance of the lesions were recorded using a severity score according to the authors' previous studies. The patients were treated with a regimen of 0.1% mometasone furoate cream applications to the affected areas once daily for 4 weeks and then twice weekly for 8 weeks. After 12 weeks of treatment, the subjects were asked to rate the changes in their symptoms and were reevaluated by the same examiner for the gross appearance of the lesions. In every patient the before/after treatment total severity scores were compared using Wilcoxon's signed-rank test for statistical significance.
With mometasone furoate all the patients had a significant improvement (P < .001) in the gross aspects of the disease and a very dramatic decrease in symptoms (P < .001), with nearly all the subjects having complete symptomatic remission. Compliance was excellent, and no side effects were observed.
The improved risk/benefit ratio of mometasone furoate may minimize the possible long-term side effects expected when using a very potent topical steroid. Therefore, momentasone furoate cream may be an alternative to clobetasol propionate for treatment of vulvar LS, with similar efficacy but higher levels of safety and tolerability.
评估糠酸莫米松（倍氯米松的合成类似物）治疗外阴硬化性苔藓的疗效和安全性。
连续纳入31例在佛罗伦萨外阴诊所经活检证实为外阴硬化性苔藓（LS）的患者进行研究。根据作者之前的研究，使用严重程度评分记录每个受试者的症状和病变的总体外观。患者接受如下治疗方案：将0.1%糠酸莫米松乳膏每天一次涂抹于患处，持续4周，然后每周两次，持续8周。治疗12周后，要求受试者对其症状变化进行评分，并由同一名检查者对病变的总体外观进行重新评估。对每位患者治疗前后的总严重程度评分进行比较，采用Wilcoxon符号秩检验以确定统计学意义。
使用糠酸莫米松后，所有患者的疾病总体状况均有显著改善（P < .001），症状也有非常显著的减轻（P < .001），几乎所有受试者的症状完全缓解。依从性良好，未观察到副作用。
糠酸莫米松改善的风险/效益比可能会将使用强效外用类固醇时预期的潜在长期副作用降至最低。因此，糠酸莫米松乳膏可作为丙酸氯倍他索治疗外阴LS的替代药物，疗效相似，但安全性和耐受性更高。
