Fractional CO2 laser therapy for vulvar lichen sclerosus in adults

Abstract

Fractional CO2 laser therapy for vulvar lichen sclerosus in adults Xiaojuan Wang1,2,† , Yisong Chen1,2,† , Luwen Wang3 , Zhong Lin4 , Keqin Hua1,2, * 1Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, 200090 Shanghai, China 2 Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, 200025 Shanghai, China 3Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, 450015 Zhengzhou, Henan, China 4Department of Gynecology, Liuzhou Maternal and Child Health Hospital, 545001 Liuzhou, Guangxi, China *Correspondence: professorhua09@163.com (Keqin Hua) † These authors contributed equally. DOI:10.31083/j.ceog4806211 This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/). Submitted: 30 March 2021 Revised: 10 May 2021 Accepted: 20 May 2021 Published: 15 December 2021 Background: The CO2 laser has been used to treat vulvar lichen sclerosus (VLS) with a significant reduction in symptoms, and there is a paucity data on the efficacy, sexual function, and quality of life (QOL) improved. This study was to evaluate the efficacy of fractional CO2 laser for VLS and assess sexual function and QOL from multi-centers. Methods: The women with biopsy-proved VLS who were treated with CO2 fractional laser were enrolled between January 2017 and December 2018 from three centers. The visual analogue scale (VAS) was to assess clinical symptoms. The Female sexual distress scale-revised (FSDS) was to evaluate the patients' sexual activity, and the family Dermatology Life Quality Index (DLQI) was to evaluate the QOL. Results: A total of 119/122 patients (mean 44.5 years, 27–72 years) completed the treatment with fractional CO2 laser and following-up. The clinical symptoms and QOL were improved significantly from baseline to follow-up (3 months and 12 months post-treatment) according to the following measures: itching score, 7.65 (1.07, 0–10) versus 4.52 (1.23, 0–10) versus 0.96 (1.49, 0–4); burning score, 6.9 (1.66, 0–10) versus 3.82 (1.79, 0–8) versus 0.98 (1.42, 0–4); DLQL score, 14.24 (5.64, 0– 30) versus 8.7 (1.9, 0–15) versus 5.7 (2.3, 0–10); FSDS score, 15.48 (11.3, 0–51) versus 12.51 (10.59, 0–45) versus 7.87 (9.34, 0–50). Conclusion: In conclusion, the fractional CO2 laser was effective and safe for treating VLS, which significantly ameliorated the annoying symptoms and improved the quality of life. Keywords Fractional CO2 laser; Vulvar lichen sclerosus; Efficacy