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Continuous vs. tapering application of the potent topical corticosteroid mometasone furoate in the treatment of vulvar lichen sclerosus: results of a randomized trial.连续与逐渐减少应用强效外用皮质激素糠酸莫米松治疗外阴硬化性苔藓:一项随机试验的结果。
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Combining topical tretinoin with mometasone furoate in the treatment of vulvar lichen sclerosus: Results of dermoscopic assessment.联合外用维 A 酸和糠酸莫米松治疗外阴硬化性苔藓:皮肤镜评估结果。
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本文引用的文献

1
Outcome domains in lichen sclerosus.
Br J Dermatol. 2020 Nov;183(5):966-968. doi: 10.1111/bjd.19253. Epub 2020 Jul 27.
2
Novel Therapeutic Approaches and Targets for Treatment of Vulvar Lichen Sclerosus.治疗外阴硬化性苔藓的新型治疗方法与靶点
Curr Pharm Biotechnol. 2021;22(1):99-114. doi: 10.2174/1389201021666200516154310.
3
Association of Topical Corticosteroids With Reduced Vulvar Squamous Cell Carcinoma Recurrence in Patients With Vulvar Lichen Sclerosus.局部皮质类固醇与外阴硬化性苔藓患者外阴鳞状细胞癌复发减少相关。
JAMA Dermatol. 2020 Jul 1;156(7):813-814. doi: 10.1001/jamadermatol.2020.1074.
4
Adult Vulvar Lichen Sclerosus: Can Experts Agree on the Assessment of Disease Severity?成人外阴硬化性苔藓:专家能否就疾病严重程度的评估达成一致?
J Low Genit Tract Dis. 2020 Jul;24(3):295-298. doi: 10.1097/LGT.0000000000000534.
5
British Association of Dermatologists guidelines for the management of lichen sclerosus, 2018.英国皮肤科医师协会2018年扁平苔藓硬化症管理指南
Br J Dermatol. 2018 Apr;178(4):839-853. doi: 10.1111/bjd.16241.
6
Clearance in vulvar lichen sclerosus: a realistic treatment endpoint or a chimera?外阴硬化性苔藓的清除:现实的治疗终点还是幻想?
J Eur Acad Dermatol Venereol. 2018 Jan;32(1):96-101. doi: 10.1111/jdv.14516. Epub 2017 Sep 7.
7
Continuous vs. tapering application of the potent topical corticosteroid mometasone furoate in the treatment of vulvar lichen sclerosus: results of a randomized trial.连续与逐渐减少应用强效外用皮质激素糠酸莫米松治疗外阴硬化性苔藓:一项随机试验的结果。
Br J Dermatol. 2015 Dec;173(6):1381-6. doi: 10.1111/bjd.14074. Epub 2015 Oct 28.
8
Evidence-based (S3) Guideline on (anogenital) Lichen sclerosus.基于循证医学的(肛门生殖器)硬化性苔藓(S3)指南。
J Eur Acad Dermatol Venereol. 2015 Oct;29(10):e1-43. doi: 10.1111/jdv.13136. Epub 2015 Jul 22.
9
Long-term Management of Adult Vulvar Lichen Sclerosus: A Prospective Cohort Study of 507 Women.成人外阴硬化性苔藓的长期管理:507 例女性前瞻性队列研究。
JAMA Dermatol. 2015 Oct;151(10):1061-7. doi: 10.1001/jamadermatol.2015.0643.
10
A double-blind, randomized prospective study evaluating topical clobetasol propionate 0.05% versus topical tacrolimus 0.1% in patients with vulvar lichen sclerosus.一项评估 0.05%丙酸氯倍他索与 0.1%他克莫司乳膏治疗外阴硬化性苔藓患者的双盲、随机前瞻性研究。
J Am Acad Dermatol. 2014 Jul;71(1):84-91. doi: 10.1016/j.jaad.2014.02.019. Epub 2014 Apr 3.

更长时间的皮质类固醇治疗是否能改善外阴硬化性苔藓的清除率?来自单中心、对照、开放标签研究的结果。

Does longer duration of corticosteroid treatment improve clearance in vulvar lichen sclerosus? Results from a single centre, comparative, open label study.

机构信息

Department of Medical Sciences, Section of Dermatology and Infectious Diseases, University of Ferrara, Ferrara, Italy.

Research Innovation Office, S. Anna University Hospital of Ferrara, Ferrara, Italy.

出版信息

Dermatol Ther. 2021 Jul;34(4):e14955. doi: 10.1111/dth.14955. Epub 2021 May 4.

DOI:10.1111/dth.14955
PMID:33835646
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8459264/
Abstract

A complete clearance of vulvar lichen sclerosus (VLS) is achieved in a minority of patients treated with a standard 12-week duration corticosteroid treatment. The aim of this pragmatic, retrospective, open label, comparative trial was to assess the effectiveness, in terms of complete clearance, of a 24-week treatment with mometasone furoate 0.1% ointment (MMF) and to compare it with a 12-week therapy. We included VLS patients treated with MMF administered for five consecutive days/week for 24 weeks (group A). The following were assessed: (a) clearance in Global Subjective Score (GSS), Global Objective Score (GOS) or both, (b) changes of these parameters and dyspareunia at treatment completion compared to baseline, (c) safety profile. All these assessments were compared with the same outcomes recorded among VLS patients who had previously undergone a 12-week MMF treatment (group B). Twenty-nine patients were included in group A and 32 in group B. The rates of patients who achieved the clearance of GSS, GOS or both parameters did not significantly differ between groups A and B. The groups did not differ in any of the effectiveness outcomes assessed. A 24-week duration corticosteroid treatment does not seem to provide significant therapeutic benefits in comparison with standard 12-week courses, especially considering the occurrence of complete clearance.

摘要

外阴硬化性苔藓(VLS)患者经标准 12 周皮质类固醇治疗后,仅有少数患者可完全清除病变。本研究采用实用、回顾性、开放标签、对照试验的方法,旨在评估莫米松糠酸酯 0.1%软膏(MMF)24 周治疗的有效性(以完全清除为标准),并与 12 周治疗进行比较。我们纳入了接受 MMF 治疗的 VLS 患者,治疗方案为每周连续 5 天用药,共 24 周(A 组)。评估内容包括:(a)GSS 和/或 GOS 评分完全清除率;(b)与基线相比,治疗结束时这些参数和性交困难的变化;(c)安全性特征。将这些评估与 VLS 患者之前接受的 12 周 MMF 治疗(B 组)的相同结果进行比较。A 组有 29 例患者,B 组有 32 例患者。A 组和 B 组在 GSS、GOS 或两者均完全清除的患者比例方面无显著差异。两组在评估的任何有效性结果方面均无差异。与标准的 12 周疗程相比,24 周皮质类固醇治疗似乎并不能提供显著的治疗益处,尤其是考虑到完全清除的发生。