Dermoscopy for monitoring therapeutic response to hybrid cooperative complexes of hyaluronic acid in women with vulvar lichen sclerosus and atrophy

TL;DR

This study explores using hyaluronic acid complexes to treat vulvar lichen sclerosus and atrophy, showing improved symptoms and quality of life in patients.

Contribution

Preliminary evidence of HCC of hyaluronic acid's efficacy in treating vulvar lichen sclerosus and atrophy.

Findings

DLQI and FSFI scores significantly improved at 1, 3, and 6 months post-treatment.

Dermatoscopic features like scales and vascularization decreased significantly.

No side effects were reported with HCC treatment.

Abstract

Vulvar Lichen Sclerosus (VLS) is a chronic relapsing inflammatory disease involving the anogenital region, resulting in vulvar atrophy and distressing symptoms. A preliminary prospective observational study was conducted to investigate the efficacy of hybrid cooperative complexes (HCC) of low- and high-molecular weight hyaluronic acid (HA) for the treatment of female patients with vulvar atrophy and lichen sclerosus.

Female patients with coexisting vulvar atrophy and lichen sclerosus (N=15) received two HCC injections at 32 mg/ml (one month apart). At baseline, 1-month, 3-months, and 6-months post-treatment, patients were assessed for reference dermatoscopic parameters using videodermatoscopy, symptoms, quality of life (Dermatology Life Quality Index [DLQI]) and sexual function (Female Sexual Function Index [FSFI]). The hypoechoic band was evaluated using ultrasound.

Both DLQI and FSFI scores improved with HCC treatment, with significant improvements at 1-month, 3-months and 6-months post-treatment vs baseline (p<0.05 for all). The thickness, homogeneity and smoothness of the hypoechoic band increased post-treatment. No side effects or complications were reported. The reference dermatoscopic features of vascularisation, blue grey dots, purpuric lesions, horny pearls, scales, ice silvers structures or whitish background were reduced at 6-months post-treatment vs baseline; significant reductions were observed for scales (baseline vs 1-month and 6-months post-treatment; p<0.05 for both). Scores for pain, itching, and burning were reduced at 1-month, 3-months and 6-months post-treatment vs baseline (p<0.05 for all).

These preliminary results add to the growing body of evidence highlighting the promising efficacy of HCC of HA for the treatment of VLS.

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