Treatment of vulvar lichen sclerosus with a fractional CO2 laser — case report

Abstract

Vulvar lichen sclerosus (VLS) belongs to the group of autoimmune, chronic inflammatory skin disorders and is most frequent in females after their 50s. This disease might lead to vulvar scarring, sexual dysfunction and neoplasm transformation. For that reason, treatment of VLS is still considered an important clinical issue from the borderline of gynaecology and dermatology. Classical treatment includes the use of corticosteroids, which help to relieve symptoms, prevent further scarring of the vulva, reduce inflammation and reduce the risk of malignant transformation. Due to the resistance of some patients to local treatment and its complications, however, the use of fractional CO2 lasers in the treatment of VLS has been proposed. A 41-year-old female patient presented to a gynaecologist with symptoms such as itching, burning, and cracking of the vulva skin. A tissue sample was taken from the affected area and a histopathological examination confirmed the initial diagnosis. Treatment with topical glucocorticosteroids was applied, but no improvement was noticed. For that reason, a CO2 fractional laser was applied to the therapy with complementary treatment in the form of topical glucocorticosteroids. After 1.5 years, regression of lesions on the skin of the vulva was observed. This case report highlight the effectiveness of fractioned CO2 laser in the treatment of VLS resistant to glucocorticosteroid monotherapy.