Abstract
Purpose of investigation: Purpose of this investigation was to determine the possibilities of non-surgical, medical treatment of high-grade squamous intraepithelial lesion (HSIL) of the vulva and differentiated type of vulvar intraepithelial lesions (VIN) and to determine the effect of medical treatment by local and systemic immunomodulators in relation to different histological types. Materials and Methods: The study included five patients with different histological types of VIN. The patients were given: systemic immunomodulator and antivirotics. After that, the patients initially included in the study were followed for a year, while the follow-up of the older patients group is still ongoing, and it has been six months since the completion of the treatment. Results: Combined medical therapy has positive therapeutic effect in the treatment of young HPV-positive adolescent patients with HSIL of the vulva. Medical treatment in HPV negative women with differentiated type VIN is less efficient, achieving partial remission in only 33% of patients. Conclusion: Combined medical therapy achieved better effects in hyperpigmented multifocal type of VIN.
Highlights
Vulvar intraepithelial neoplasia (VIN) is a premalignant disease of the squamous epithelium, showing a proliferation of abnormal keratinocytes of the vulvar epidermis without invasion of the basement membrane
Depending on the thickness of the epithelium affected by these atypical keratinocytes, analog to cervical ones, VIN is considered as a separate entity
This paper presents initial experiences of a planned large study on possibilities of medical treatment of VIN
Summary
Vulvar intraepithelial neoplasia (VIN) is a premalignant disease of the squamous epithelium, showing a proliferation of abnormal keratinocytes of the vulvar epidermis without invasion of the basement membrane. Considering the fact that VIN I represents cytopathogenic effects of HPV infection only, in 2004 International Society for the Study of Vulvovaginal Disease (ISSVD) reclassified VIN into a single-grade system, including only high-grade intraepithelial lesions of the vulva (VIN II and VIN III) [1]. The first one is the usual-type VIN that is more common in younger women and is related to high-risk, oncogenic HPV types, smoking, and immunodeficiency. The second one is a differentiated type VIN that tends to occur in older, postmenopausal women, associated with chronic vulvar dermatoses, lichen sclerosus, and is most commonly HPV-negative. The second, differentiated type VIN is more commonly associated with invasive carcinoma and high recurrence rates are common [2, 3]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Clinical and Experimental Obstetrics & Gynecology
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
