Department of Dermatovenereology, Tianjin Medical University General Hospital, Tianjin Institute of Sexually Transmitted Disease, Tianjin 300052, China.
Department of Dermatovenereology, Tianjin Medical University General Hospital, Tianjin Institute of Sexually Transmitted Disease, Tianjin 300052, China.
Photodiagnosis Photodyn Ther. 2023 Jun;42:103537. doi: 10.1016/j.pdpdt.2023.103537. Epub 2023 Mar 24.
Vulvar intraepithelial neoplasia (VIN) is a precancerous lesion on the vulvar epidermis that does not invade or metastasize to surrounding stroma; it manifests as atypical intraepithelial hyperplasia on the vulva. Most patients with VIN are diagnosed early, and treatment with standardized therapy often leads to complete regression of symptoms. The treatment of VIN is still a challenge for clinicians because, in most cases, surgery is destructive and risky. However, photodynamic therapy (PDT) was recommended as a new treatment for VIN. Herein, we report the case of a patient with a large-area high-grade VIN lesion complicated by human papillomavirus infection. The patient could not undergo surgical treatment. However, treatment with PDT was performed in our outpatient department. There was slight pain during the treatment after multi-point injection of micro-lidocaine (0.05 mL/dot) was given. No recurrence was noted after 13 months of follow-up. More importantly, scarring and other major side effects were not detected. Therefore, PDT can be a useful alternative treatment for patients with VIN with large lesions or multifocal high-grade VIN.
外阴上皮内瘤变（VIN）是一种发生在外阴表皮的癌前病变，不侵犯或转移到周围基质；它在外阴表现为不典型上皮内增生。大多数 VIN 患者被早期诊断，标准化治疗通常可导致症状完全消退。VIN 的治疗仍然是临床医生面临的挑战，因为在大多数情况下，手术具有破坏性且风险较高。然而，光动力疗法（PDT）被推荐为 VIN 的一种新的治疗方法。在此，我们报告了一例大面积高级别 VIN 病变合并人乳头瘤病毒感染的患者。该患者不能进行手术治疗。然而，我们在门诊为其进行了 PDT 治疗。多点注射（每点 0.05 mL）小剂量利多卡因后，治疗过程中仅有轻微疼痛。随访 13 个月后未见复发。更重要的是，未发现瘢痕等严重副作用。因此，对于有大面积病变或多灶性高级别 VIN 的患者，PDT 可以是一种有用的替代治疗方法。
