Topical steroids can change course of vulvar lichen sclerosus

(HealthDay)—For adult patients with vulvar lichen sclerosus (VLS), long-term preventive topical corticosteroid (TCS) treatment is associated with improved outcomes, according to a study published online June 12 in JAMA Dermatology. The research was published to coincide with the World Congress of Dermatology, held from June 8 to 13 in Vancouver, Canada.

Andrew Lee, M.B.B.S., from Sydney Medical School Northern at the University of Sydney, and colleagues examined the impact of long-term preventive TCS treatment of various potencies, adjusted to meet a target outcome of normal skin color and texture. Data were collected from a prospective longitudinal cohort study involving 507 women with biopsy-proved VLS.

The researchers found that potent TCS, followed by regular preventive TCS treatment, induced remission. Overall, 29.6 and 70.4 percent of patents were considered partially compliant and fully compliant with treatment. During follow-up, 0 and 4.7 percent of the fully compliant and partially compliant patients had biopsy-proven squamous cell carcinoma or vulvar intraepithelial neoplasia (P < 0.001). Symptom suppression occurred in 93.3 and 58.0 percent of fully and partially compliant patients, respectively (P < 0.001). During follow-up, 3.4 and 40.0 percent of patients, respectively, had adhesions and scaring (P < 0.001), and 1.1 and 2.0 percent, respectively, had reversible TCS-induced cutaneous atrophy (P = 0.43).

"Individualized preventive TCS regimens that achieve objective normality of skin color and texture and are used by compliant patients who attend regular long-term follow-up visits may modify the course of the disease," the authors write.