Medical treatment of squamous hyperplasia and lichen sclerosus of the vulva.

OBJECTIVE

To evaluate the efficacy of medical treatment in patients with lichen sclerosus (LS), squamous hyperplasia (SH) and lichen sclerosus with associated squamous hyperplasia.

METHODS

Forty-eight patients with non-neoplastic epithelial disorders of the vulva, SH in 23 (47.9%), LS in 20 (41.6%) and LS with associated SH in five (10.5%) were diagnosed and treated in our clinic. Patients with LS were treated with 2% testosterone ointment. Topical fluorinated corticosteroids was the treatment of choice in patients with SH. Patients with LS with associated SH were treated with topical fluorinated corticosteroid application followed by testosterone propionate ointment.

RESULTS

The clinical response rate of SH to first-line therapy was 95.6% with a correlation of 90.5% with histological reversal; this rate was 80% with a histological correlation of 81.3% in LS. The remission rates of SH and LS patients following a full course of therapy were 100% and 90%, respectively. In LS with associated SH patients, 90% responded to standard therapy with a remission rate of 100% after completion of a full course of therapy.

CONCLUSION

Medical therapy of lichen sclerosus and squamous hyperplasia was very effective with a good clinical and histologic correlation.