Measuring perceived benefit and disease-related burden in patients affected with vulvar lichen sclerosus after a standard topical corticosteroid treatment. Results from a cohort study using Pictorial Representation of Illness and Self-measure and Dermatology Life Quality Index.

Abstract

Improvement in suffering after treatment has been poorly investigated in women affected with vulvar lichen sclerosus (VLS). We performed an observational study on a cohort of VLS patients for assessing the effect of a 12-week topical corticosteroid treatment on their VLS-related burden, as measured with Pictorial Representation of Illness and Self-Measure (PRISM) and Dermatology Life Quality Index (DLQI). Demographics and disease-related subjective and objective scores (at baseline, T0, and at the control visit, T1) were recorded. The PRISM and DLQI were administered at T0 and T1. We assessed the variation of PRISM and DLQI at T1 compared to baseline and the relevance of several variables on these changes. Sixty-three patients were included. A significant improvement was found in both PRISM and DLQI after treatment. A higher coefficient of variations was observed for PRISM and DLQI as compared to subjective and objective scores. Improvement of global subjective score after treatment was the sole variable associated with PRISM and DLQI variations. The corticosteroid treatment led to a significant decrease in the impact of VLS on patients' well-being, in terms of suffering and quality of life impairment. PRISM seems a reliable instrument for integrating clinicians' and patients' perspectives for a comprehensive VLS management.