Disciplina de Ginecologia, Departamento de Obstetricia e Ginecologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.
Patologia, Instituto do Cancer do Estado de Sao Paulo (ICESP), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.
Clinics (Sao Paulo). 2021 Mar 26;76:e2567. doi: 10.6061/clinics/2021/e2567. eCollection 2021.
To assess the clinical response to and the histomorphometric effects of microablative fractional radiofrequency (MFR) in women with symptomatic vulvar lichen sclerosus (VLS).
This was a pilot study on the use of MFR for the treatment of VLS. Upon recruitment and at each treatment session, all participants were examined and each of their symptoms were rated on a visual analog scale. After the procedure, the participants completed a satisfaction questionnaire. We compared the morphometric findings of vulvar biopsies performed at enrollment and after the last treatment session. The participants were divided into three groups according to previous treatment with corticosteroids: G1, no previous treatment; G2, treated for up to 5 years; and G3, treated for >5 years.
This study included 26 women. After two to three sessions, most participants in all groups became either "asymptomatic" or "much better" than before treatment and were "very satisfied" or "satisfied" with the intervention. Pruritus and burning sensation were the most frequently reported symptoms. Nearly 40% of the participants in all groups reported complete remission of symptoms. The improvement was rated as moderate or higher by 80%, 76%, and 66% of the women in groups 1, 2, and 3, respectively. The improvement of symptoms persisted for 11 months (range, 7-16 months), on average, after the treatment. Type III collagen concentration significantly increased and was associated with important symptom improvement. Tissue trophism and vascularization also increased but did not reach statistical significance, probably because of the small number of cases.
MFR may be an effective and safe treatment for symptomatic VLS.
评估微剥脱性分数射频（MFR）治疗女性外阴硬化性苔藓（VLS）的临床疗效和组织形态计量学效果。
这是一项关于 MFR 治疗 VLS 的初步研究。在招募时和每次治疗时，所有参与者都接受了检查，并对其症状进行了视觉模拟评分。治疗后，参与者完成了满意度问卷。我们比较了招募时和最后一次治疗后外阴活检的形态计量学发现。根据先前是否使用皮质类固醇治疗，将参与者分为三组：G1 组，无先前治疗；G2 组，治疗时间长达 5 年；G3 组，治疗时间>5 年。
这项研究共纳入 26 名女性。在 2-3 次治疗后，所有组的大多数参与者均变为“无症状”或“比治疗前好得多”，并对干预措施“非常满意”或“满意”。瘙痒和烧灼感是最常报告的症状。所有组中近 40%的参与者报告症状完全缓解。80%、76%和 66%的 1、2 和 3 组女性分别将改善程度评为中度或更高。症状的改善在治疗后平均持续 11 个月（7-16 个月）。III 型胶原浓度显著增加，并与重要的症状改善相关。组织营养和血管化也增加，但没有达到统计学意义，可能是因为病例数量较少。
MFR 可能是治疗有症状的 VLS 的有效且安全的方法。
