Singh Nilanchali, Mishra Neha, Ghatage Prafull
Gynecologic Oncology, Tom Baker Cancer Centre, Calgary, CAN.
Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, Greater Noida, IND.
Cureus. 2021 Feb 24;13(2):e13527. doi: 10.7759/cureus.13527.
Vulvar lichen sclerosus (VLS) is a chronic inflammatory disorder, which affects women of all ages. The aim of this review is to focus on first-line, second-line, and maintenance therapies as well as follow-up of women with VLS. With numerous controversies, we decided to conduct a scoping review on this subject. A review protocol was developed, and the Knowledge Resource Services website was used to run a search of articles pertaining to VLS with keywords "Vulvar," "Vulval," and "Lichen Sclerosus." The search was limited to published data from the last 10 years, i.e., July 2009 onward, and researches published in English language. A total of 338 articles pertaining to VLS were obtained. Out of this, 62 were original articles related to management of VLS. Effective treatments such as high-potency topical steroids are now the standard of care and first-line treatment. Follow-up may be done every three to six months for the first two years and then at least yearly to ensure adequacy of treatment and encourage compliance. Long-term follow-up in specialist clinics is recommended for women who have persistent complaints, thickened skin, or history of neoplastic lesion. Monitoring young patients yearly is recommended as there are chances of recurrence.
外阴硬化性苔藓(VLS)是一种慢性炎症性疾病,影响各年龄段的女性。本综述的目的是聚焦于VLS女性患者的一线、二线和维持治疗以及随访。鉴于存在众多争议,我们决定对该主题进行一项范围综述。制定了综述方案,并利用知识资源服务网站,使用关键词“外阴”“女阴”和“硬化性苔藓”搜索与VLS相关的文章。搜索限于过去10年(即2009年7月起)发表的数据以及以英文发表的研究。共获得338篇与VLS相关的文章。其中,62篇为与VLS治疗相关的原创文章。高效外用糖皮质激素等有效治疗方法现已成为标准治疗和一线治疗。在最初两年,每三到六个月进行一次随访,之后至少每年随访一次,以确保治疗充分并鼓励患者依从。对于有持续症状、皮肤增厚或肿瘤病变史的女性,建议在专科诊所进行长期随访。由于存在复发的可能性,建议每年对年轻患者进行监测。