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Vulvar Lichen Sclerosus in Adults.
Vulvar Lichen Sclerosus in Adults. The group I topi¬cal steroid ointment clobetasol propionate is reported ef¬fective for all age groups. The following regimen was re¬ported for adults. Apply the ointment twice daily for 1 month and then once daily for 1 month; then taper down within the next month to two applications per week and remain on that regimen until a follow-up examination at 3 months after the initial visit. Treatment is then on an “as needed” basis. Follow-up examinations are important when using superpotent topical steroids.
Less potent topical steroids, such as mometasone fu¬roate 0.1% and triamcinolone acetonide 0.1% ointment, have also been shown to be very effective. PMID: 24160287 A large study showed that treatment with clo-betasol ointment resulted in a complete remission in 54% of patients. The probability of remission was significantly associated with age. The incidence of remission at 3 years was 72% in women younger than age 50 and 23% in women between the ages of 50 and 70, but in women older than 70 years of age, none achieved remission. The incidence of relapse was 50% at 16 months and 84% at 4 years from initial treatment. Patients’ tolerance of long-term ultrapotent topical steroids was excellent and no atrophic events were observed. The eight observed vulvar SCC (9.6%) cases occurred in previously untreated or ir¬regularly treated vulvar LS lesions. PMID: 24160287
Alternative Treatment Schedules. Mometasone fu¬roate and triamcinolone may act as alternatives to clo¬betasol propionate for treatment of vulvar LS, especially for long-term therapy, with similar efficacy but higher levels of safety and tolerability. Use once-daily applica¬tion of a topical steroid for 4 weeks, tapering to alternate days for 4 weeks, followed by once or twice weekly ap¬plication as maintenance. In general, a typical 30-gm tube of a topical steroid should last approximately 3 to 6 months.
Maintenance Therapy. Patients traditionally have been instructed to apply a topical steroid on demand after their LS has been stabilized with an ultrapotent topical steroid. Studies support a proactive approach to long-term therapy. Relapse rate was lower in patients who ap¬plied mometasone furoate 0.1% ointment biweekly for 52 weeks. PMID: 23398459 Long-term maintenance therapy of vulvar LS with a moisturizing cream can main¬tain the symptom relief induced by topical corticoste¬roids. This treatment may also be associated with a reduc¬tion in topical corticosteroid use. PMID: 17603391
Less potent topical steroids, such as mometasone fu¬roate 0.1% and triamcinolone acetonide 0.1% ointment, have also been shown to be very effective. PMID: 24160287 A large study showed that treatment with clo-betasol ointment resulted in a complete remission in 54% of patients. The probability of remission was significantly associated with age. The incidence of remission at 3 years was 72% in women younger than age 50 and 23% in women between the ages of 50 and 70, but in women older than 70 years of age, none achieved remission. The incidence of relapse was 50% at 16 months and 84% at 4 years from initial treatment. Patients’ tolerance of long-term ultrapotent topical steroids was excellent and no atrophic events were observed. The eight observed vulvar SCC (9.6%) cases occurred in previously untreated or ir¬regularly treated vulvar LS lesions. PMID: 24160287
Alternative Treatment Schedules. Mometasone fu¬roate and triamcinolone may act as alternatives to clo¬betasol propionate for treatment of vulvar LS, especially for long-term therapy, with similar efficacy but higher levels of safety and tolerability. Use once-daily applica¬tion of a topical steroid for 4 weeks, tapering to alternate days for 4 weeks, followed by once or twice weekly ap¬plication as maintenance. In general, a typical 30-gm tube of a topical steroid should last approximately 3 to 6 months.
Maintenance Therapy. Patients traditionally have been instructed to apply a topical steroid on demand after their LS has been stabilized with an ultrapotent topical steroid. Studies support a proactive approach to long-term therapy. Relapse rate was lower in patients who ap¬plied mometasone furoate 0.1% ointment biweekly for 52 weeks. PMID: 23398459 Long-term maintenance therapy of vulvar LS with a moisturizing cream can main¬tain the symptom relief induced by topical corticoste¬roids. This treatment may also be associated with a reduc¬tion in topical corticosteroid use. PMID: 17603391
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外阴硬化性苔藓成人。我topi¬cal激素软膏丙酸氯倍他索组报道ef¬fective为所有年龄组。以下方案为re¬ported成人。每天两次应用药膏1个月，然后每天一次，1个月; 那么接下来的一个月内逐渐变小，以每周两个应用程序，并保持在该方案直到初次访问后的后续检查3个月。治疗主要是然后在“按需”的基础。随访检查使用超高效的外用类固醇时是很重要的。<br>少强效局部类固醇，如糠fu¬roate0.1％和曲安奈德0.1％软膏，也被证明是非常有效的。结论：24160287一项大型研究显示，与10 - betasol软膏治疗导致完全缓解的患者54％。缓解的可能性随着年龄显著相关。缓解3年发病率女性比50岁和50岁到70岁之间的女性23％年轻的72％，但女性比70岁以上，没有达到缓解。复发的发生率在16个月，50％，在从最初的治疗4年84％。患者的长期ultrapotent局部类固醇药物的耐受性良好，没有观察到萎缩性事件。八个观察外阴SCC（9.6％）例发生在先前未处理的或处理过的ir¬regularly外阴LS病变。<br>替代治疗方案。糠酸fu¬roate和曲可以作为替代clo¬betasol丙酸治疗外阴LS的，尤其是对于长期治疗，具有疗效相似，但安全性和耐受性的更高水平。使用外用类固醇的每日一次applica¬tion4周，逐渐变细到隔日4周，接着一次或维护每周两次ap¬plication。一般而言，局部甾族化合物的典型的30克管应持续约3至6个月。<br>维持治疗。传统的患者已指示按需应用外用类固醇后的LS已经稳定与ultrapotent外用类固醇。研究支持积极的态度，长期治疗。复发率谁ap¬plied糠酸莫米松0.1％软膏双周52周的患者更低。结论：用保湿霜外阴LS的23398459长期维持治疗可以main¬tain通过局部corticoste¬roids引起的症状缓解。这种治疗方法也可以用在外用皮质类固醇使用reduc¬tion有关。结论：17603391
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伏尔瓦·利琴·斯列罗苏斯在成人。I topi_cal 类固醇药膏氯贝塔醇丙酸盐被报告对所有年龄组具有感染性。以下方案为成人提供。每天涂抹两次，为期1个月，然后每天涂抹一次，为期1个月;然后在下个月内减少至每周两份申请，并一直保留到首次访问后3个月的后续检查。然后，治疗是在"根据需要"的基础上进行的。后续检查是重要的，当使用超能局部类固醇.<br>不太有效的局部类固醇， 如莫美他酮 fu_roate 0.1% 和三氨基诺酮醋酸 0.1% 软膏， 也已被证明是非常有效的.PMID：24160287 一项大型研究表明，使用氯贝索膏治疗可使 54% 的患者完全缓解。缓解的可能性与年龄显著相关。50岁以下的妇女3岁缓解率为72%，50至70岁妇女为23%，但在70岁以上的妇女中，没有一个获得缓解。16个月复发的发生率为50%，最初治疗4年后复发的发生率为84%。患者对长期超强局部类固醇的耐受性极强，未观察到萎缩性事件。八个观测到的外阴 SCC （9.6%）病例发生在以前未治疗或未定期治疗的外阴 LS 病变中。PMID： 24160287<br>替代治疗时间表。莫美他酮富罗酮和三氨基诺酮可作为氯ββ醇丙酸的替代物，用于治疗外阴LS，特别是长期治疗，具有类似的疗效，但安全性和耐性水平较高。使用一次每日施用局部类固醇4周，逐渐减少至4周的替代天，然后每周一次或两次作为维护。一般来说， 一个典型的 30 gm 管的局部类固醇应该持续大约 3 到 6 个月.<br>维护治疗。患者传统上已被指示应用局部类固醇按需后，他们的 LS 已稳定与超能局部类固醇.研究支持对长期治疗采取积极主动的方法。在52周内，每两周服用莫美他酮毛虫0.1%的患者中，复发率较低。PMID： 23398459 用保湿霜对外阴 LS 的长期维持治疗可以主要缓解局部皮质胶质引起的症状缓解。这种治疗也可能与局部皮质类固醇使用中的还原相关。PMID： 17603391
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外阴硬化性苔藓和成虫。据报道，I组外用类固醇软膏丙酸氯倍他索对所有年龄组都有效。以下是成年人的治疗方案。每日两次，每次1个月，然后每日一次，每次1个月；然后在下个月内逐渐减少到每周两次，并在首次就诊后的3个月内进行随访检查。然后根据需要进行治疗。使用超强效局部类固醇时，后续检查很重要。<br>低强度的局部类固醇，如4.1%莫米松和0.1%曲安奈德软膏，也被证明是非常有效的。PMID:24160287一项大型研究表明，用氯倍他索软膏治疗54%的患者病情完全缓解。缓解的可能性与年龄显著相关。在3岁时，50岁以下妇女的缓解率为72%，50岁至70岁妇女的缓解率为23%，但70岁以上妇女的缓解率均未达到。16个月和4年后复发率分别为50%和84%。患者对长期超强效外用类固醇的耐受性良好，未观察到任何萎缩事件。观察到的8例外阴鳞状细胞癌（9.6%）发生在既往未治疗或定期治疗的外阴病变中。PMID:24160287<br>替代治疗计划。糠酸莫米松和曲安奈德可替代丙酸氯倍他索用于外阴治疗，尤其是长期治疗，疗效相似，但安全性和耐受性较高。每天使用一次外用类固醇，持续四周，逐渐变细至每隔一天，持续四周，然后每周使用一次或两次作为保养品。一般来说，一个典型的30-gm管的局部类固醇应该持续大约3-6个月。<br>治疗维持。传统上，在使用超强效局部类固醇稳定了患者的LS后，指导患者按需应用局部类固醇。研究支持一种前瞻性的长期治疗方法。应用糠酸莫米松0.1%软膏每两周一次，持续52周，复发率较低。PMID:23398459外阴保湿霜长期维持治疗，可维持外阴皮质类固醇引起的症状缓解。这种治疗也可能与减少局部皮质类固醇使用有关。PMID:17603391<br>
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