Vulvar lichen sclerosus is a chronic condition usually responsive to topical corticosteroids.
We sought to evaluate the efficacy (reduction of signs and symptoms) and safety of clobetasol propionate 0.05% and tacrolimus 0.1% in the treatment of vulvar lichen sclerosus.
This double-blind, randomized study comparing 2 treatments over a 3-month period, enrolled 58 female patients with newly diagnosed vulvar lichen sclerosus or untreated vulvar lichen sclerosus for at least 1 month.
In all, 55 patients were included in the statistical analysis. A total of 28 patients were assigned to the tacrolimus group and 27 patients to the clobetasol group. Both groups showed a significant difference in the decrease of symptoms and signs of lichen sclerosus. At the end of the study, 28 participants (19 tacrolimus and 9 clobetasol) still had some clinical signs of lichen sclerosus (χ2 = 6.56, P = .015). However, a significantly higher number of patients in the clobetasol group (n = 15) had absence of signs and symptoms of lichen sclerosus (χ2 = 10.35, P = .002; χ2 = 10.35, P = .002). No adverse events were reported.
Short length of trial and recruitment through our vulvar disease referral center are limitations.
This study showed that topical clobetasol propionate was significantly more effective in treating vulvar lichen sclerosus than topical tacrolimus.Le texte complet de cet article est disponible en PDF.
Key words : anogenital, carcinoma, clobetasol propionate, lichen sclerosus, tacrolimus, topical calcineurin inhibitor, vulva
Abbreviations used : VAS, VAS-BP, VAS-PR
| Sponsored by an Astellas Pharma research grant for an investigator-initiated study.
| Disclosure: Dr Powell served on the advisory board for Astellas Pharma and Dr Funaro received from Astellas Pharma a grant for an investigator-initiated study and received a bursary in a research competition. Drs Lovett and Leroux have no conflicts of interest to declare.