Abstract
In this article, the authors analyzed and systematized the main aspects of the treatment of vulvar dystrophic diseases (VDD). The traditional methods of treatment of this pathology are surgical intervention and non-surgical methods (high-intensity laser radiation, laser CO2 coagulation, vaporization with radiation intensity of more than 1000 W/cm2 of treatment, chemotherapy and immune-modulatory therapy). Despite the effectiveness of these methods, their main deficiency is the high incidence of local recurrence of the disease (from 17% to 48%). The authors present the PDT method as an alternative, organ-preserving and highly effective therapeutic option. Most studies are devoted to the use of 5-ALA and chlorin-based photosensitizers in the treatment of VDD. The authors studied in detail the world experience of PDT for VDD, analyzed and systematized the results of treatment, advantages and disadvantages of the method.
Highlights
In recent years there has been an increase in the number of vulvar dystrophic diseases (VDDs), making from 0.6% up to 6% of all cases in the gynecological incidence [1, 2]
Vulvar leukoplakia is the main manifestation of squamous cell hyperplasia, which is a VDD characterized by lesion of stratified squamous noncornified epithelium
The results of the clinical use of the Photodynamic therapy (PDT) method in combination with photolon PS in treatment of patients with background and precancerous vulvar diseases testify to its high therapeutic efficacy, few complications or side reactions and good cosmetic results
Summary
In recent years there has been an increase in the number of vulvar dystrophic diseases (VDDs), making from 0.6% up to 6% of all cases in the gynecological incidence [1, 2]. Ivanova L.V. et al presented the results of treatment of 4 patients with vulvar dysplasia I-II degree using PDT method with radachlorine (0.35% solution) in the form of intravenous drip infusion and 1% introvaginal gel. Khashukoieva A.Z. et al performed PDT with the use of photoditazine as PS at a dose of 1 mg/kg, 50 patients with VDDs were tested: sclerotic lichen was verified in 32 of them, 10 had squamous cell hyperplasia, and 8 had mixed dystrophy. The same team of authors presents data on 82 patients with benign vulvar diseases treated with PDT: photoditazine was administered to 64 of them as intravenous drip at a dose of 1 mg/kg (group 1), 18 patients had an application of 0.5% penetration gel (group 2). These parameters for the control group were 70.5%, respectively [34]
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