Blue diode laser as supportive therapy for the management of vulvar lichen sclerosus
https://doi.org/10.4081/dr.2024.10046
Accepted: 6 August 2024
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Vulvar lichen sclerosus is a chronic inflammatory condition characterized by the thinning and atrophy of the skin and mucosa surrounding the vulva and anus. This study evaluates the efficacy of a treatment protocol utilizing blue-diode laser photobiomodulation in managing vulval lichen sclerosus symptoms in a cohort of 12 female patients. The treatment protocol consisted of laser sessions for 3 times a week for 2 weeks, and follow-up sessions over a 16-week period. Objective and subjective parameters were assessed before treatment, at the end of treatment, and at 4-month follow-up visits. Results demonstrated significant reductions in subjective symptoms such as itching and pain, as well as improvements in objective signs including erythema and fissures. No side effects were observed, indicating the safety and tolerability of laser treatment. These findings suggest that photobiomodulation can be an effective therapeutic option for patients with vulval lichen sclerosus, with future research aimed at refining treatment protocols and evaluating its long-term benefits.
Kirtschig G, Becker K, Günthert A, et al (2015) Evidence-based (S3) Guideline on (anogenital) Lichen sclerosus. J Eur Acad Dermatol Venereol 29:e1-43. https://doi.org/10.1111/jdv.13136 DOI: https://doi.org/10.1111/jdv.13136
Gulin SJ, Lundin F, Seifert O (2023) Comorbidity in patients with Lichen sclerosus: a retrospective cohort study. Eur J Med Res 28:338. https://doi.org/10.1186/s40001-023-01335-9 DOI: https://doi.org/10.1186/s40001-023-01335-9
Lewis FM, Tatnall FM, Velangi SS, et al (2018) British Association of Dermatologists guidelines for the management of lichen sclerosus, 2018. Br J Dermatol 178:839–853. https://doi.org/10.1111/bjd.16241 DOI: https://doi.org/10.1111/bjd.16241
Sun XY, Xiao YP, Sun YX, et al (2024) [Clinical and pathological analysis of 345 cases of vulvar lichen sclerosus and a preliminary study on the frequency of maintenance treatment]. Zhonghua Fu Chan Ke Za Zhi 59:56–63. https://doi.org/10.3760/cma.j.cn112141-20230909-00094
Zivanovic I, Gamper M, Fesslmeier D, et al (2024) Nd:YAG/Er:YAG dual laser compared with topical steroid to treat vulvar lichen sclerosus: A randomised controlled trial. BJOG 131:740–749. https://doi.org/10.1111/1471-0528.17737 DOI: https://doi.org/10.1111/1471-0528.17737
Ou S, Wang H, Liu W, et al (2024) Combination of high-frequency electrocautery therapy and ALA-PDT in hyperkeratotic vulvar lichen sclerosus: Series of seven cases. Photodiagnosis Photodyn Ther 45:103924. https://doi.org/10.1016/j.pdpdt.2023.103924 DOI: https://doi.org/10.1016/j.pdpdt.2023.103924
Hargis A, Ngo M, Kraus CN, Mauskar M (2024) Systemic Therapy for Lichen Sclerosus: A Systematic Review. J Low Genit Tract Dis 28:84–90. https://doi.org/10.1097/LGT.0000000000000775 DOI: https://doi.org/10.1097/LGT.0000000000000775
Casabona F, Gasparini G, Cozzani E, et al (2023) Improvement in quality of life and sexual function in patients affected by vulvar lichen sclerosus treated wth combined autologous platelet-rich plasma and fat grafting. Eur J Dermatol 33:249–254. https://doi.org/10.1684/ejd.2023.4480 DOI: https://doi.org/10.1684/ejd.2023.4480
Singh N, Ghatage P (2020) Etiology, Clinical Features, and Diagnosis of Vulvar Lichen Sclerosus: A Scoping Review. Obstet Gynecol Int 2020:7480754. https://doi.org/10.1155/2020/7480754 DOI: https://doi.org/10.1155/2020/7480754
Gobbo M, Rico V, Marta GN, et al (2023) Photobiomodulation therapy for the prevention of acute radiation dermatitis: a systematic review and meta-analysis. Support Care Cancer 31:227. https://doi.org/10.1007/s00520-023-07673-y DOI: https://doi.org/10.1007/s00520-023-07673-y
Gobbo M, Bussani R, Perinetti G, et al (2019) Blue diode laser versus traditional infrared diode laser and quantic molecular resonance scalpel: clinical and histological findings after excisional biopsy of benign oral lesions (Erratum). J Biomed Opt 24:1. https://doi.org/10.1117/1.JBO.24.2.029803 DOI: https://doi.org/10.1117/1.JBO.24.2.029803
Rupel K, Zupin L, Colliva A, et al (2018) Photobiomodulation at Multiple Wavelengths Differentially Modulates Oxidative Stress In Vitro and In Vivo. Oxid Med Cell Longev 2018:6510159. https://doi.org/10.1155/2018/6510159 DOI: https://doi.org/10.1155/2018/6510159
Rupel K, Zupin L, Brich S, et al (2021) Antimicrobial activity of amphiphilic nanomicelles loaded with curcumin against Pseudomonas aeruginosa alone and activated by blue laser light. J Biophotonics 14:e202000350. https://doi.org/10.1002/jbio.202000350 DOI: https://doi.org/10.1002/jbio.202000350
DI Meo N, Nan K, Noal C, et al (2018) Blue diode laser: a new strategy for the management of lichen sclerosus et atrophicus. G Ital Dermatol Venereol 153:289–291. https://doi.org/10.23736/S0392-0488.17.05506-7 DOI: https://doi.org/10.23736/S0392-0488.17.05506-7
Finlay AY, Khan GK (1994) Dermatology Life Quality Index (DLQI)--a simple practical measure for routine clinical use. Clin Exp Dermatol 19:210–216. https://doi.org/10.1111/j.1365-2230.1994.tb01167.x DOI: https://doi.org/10.1111/j.1365-2230.1994.tb01167.x
Zanotta N, Ottaviani G, Campisciano G, et al (2020) Photobiomodulation modulates inflammation and oral microbiome: a pilot study. Biomarkers 25:677–684. https://doi.org/10.1080/1354750X.2020.1825812 DOI: https://doi.org/10.1080/1354750X.2020.1825812
Gobbo M, Ottaviani G, Rupel K, et al (2016) Same strategy for pitfalls of radiotherapy in different anatomical districts. Lasers Med Sci 31:471–479. https://doi.org/10.1007/s10103-015-1857-8 DOI: https://doi.org/10.1007/s10103-015-1857-8
Krause E, Neumann S, Maier M, et al (2023) LASER treatment in gynaecology -A randomized controlled trial in women with symptomatic lichen sclerosus. Eur J Obstet Gynecol Reprod Biol 287:171–175. https://doi.org/10.1016/j.ejogrb.2023.06.003 DOI: https://doi.org/10.1016/j.ejogrb.2023.06.003
Gil-Villalba A, Ayen-Rodriguez A, Naranjo-Diaz MJ, Ruiz-Villaverde R (2023) Laser Therapy for Vulvar Lichen Sclerosus, a Systematic Review. Life (Basel) 13:2146. https://doi.org/10.3390/life13112146 DOI: https://doi.org/10.3390/life13112146
Belotto R, Correa L, Martins WK, et al (2019) Topic corticosteroid and photobiomodulation treatment impact on vulvar lichen sclerosus: clinical, inflammatory and reparative analysis. Lasers Surg Med 51:S39‐S40. https://doi.org/10.1002/lsm.23059 DOI: https://doi.org/10.1002/lsm.23059
Bizjak Ogrinc U, Senčar S, Luzar B, Lukanović A (2019) Efficacy of Non-ablative Laser Therapy for Lichen Sclerosus: A Randomized Controlled Trial. J Obstet Gynaecol Can 41:1717–1725. https://doi.org/10.1016/j.jogc.2019.01.023 DOI: https://doi.org/10.1016/j.jogc.2019.01.023
Maghfour J, Ozog DM, Mineroff J, et al (2024) Photobiomodulation CME Part I: Overview and Mechanism of Action. J Am Acad Dermatol S0190-9622(24)00186–5. https://doi.org/10.1016/j.jaad.2023.10.073 DOI: https://doi.org/10.1016/j.jaad.2023.10.073
Figurová M, Ledecký V, Karasová M, et al (2016) Histological Assessment of a Combined Low-Level Laser/Light-Emitting Diode Therapy (685 nm/470 nm) for Sutured Skin Incisions in a Porcine Model: A Short Report. Photomed Laser Surg 34:53–55. https://doi.org/10.1089/pho.2015.4013 DOI: https://doi.org/10.1089/pho.2015.4013
Webb C, Dyson M (2003) The effect of 880 nm low level laser energy on human fibroblast cell numbers: a possible role in hypertrophic wound healing. J Photochem Photobiol B 70:39–44. https://doi.org/10.1016/s1011-1344(03)00053-8 DOI: https://doi.org/10.1016/S1011-1344(03)00053-8
Zupin L, Ottaviani G, Rupel K, et al (2019) Analgesic effect of Photobiomodulation Therapy: An in vitro and in vivo study. J Biophotonics 12:e201900043. https://doi.org/10.1002/jbio.201900043 DOI: https://doi.org/10.1002/jbio.201900043
Marzec A, Olejek A, Stopinska K, et al (2023) The use of CO2 laser in vulvar lichen sclerosus treatment - molecular evidence. Ginekol Pol. https://doi.org/10.5603/GP.a2023.0044 DOI: https://doi.org/10.5603/GP.a2023.0044
Kofler L, Charalambous A, Kussini J, Steinert M (2023) Treatment of vulvar lichen sclerosus et atrophicus by ablative microspot erbium:YAG laser. J Dtsch Dermatol Ges 21:179–180. https://doi.org/10.1111/ddg.14955 DOI: https://doi.org/10.1111/ddg.14955
Ricci E, Pittarello M (2023) Blue light photobiomodulation for reactivation of healing in wounds not responding to standard therapy. J Wound Care 32:695–703. https://doi.org/10.12968/jowc.2023.32.11.695 DOI: https://doi.org/10.12968/jowc.2023.32.11.695
Zhang D, Leong ASW, McMullin G (2023) Blue light therapy in the management of chronic wounds: a narrative review of its physiological basis and clinical evidence. Wounds 35:91–98. https://doi.org/10.25270/wnds/22097 DOI: https://doi.org/10.25270/wnds/22097
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