Vulvar lichen sclerosus: comparative between propionate clobetasol, photodynamic therapy and low intensity laser therapy

• Grant number: 15/05259-8
• Support Opportunities: Regular Research Grants
• Start date: October 01, 2015
• End date: September 30, 2017
• Field of knowledge: Interdisciplinary Subjects
• Principal Investigator: Daniela de Fátima Teixeira da Silva
• Grantee: Daniela de Fátima Teixeira da Silva
• Host Institution: Universidade Nove de Julho (UNINOVE). Campus Vergueiro. São Paulo , SP, Brazil
• Associated researchers: Renata Aparecida Belotto

Abstract

Vulvar lichen sclerosus (VLS) is a lymphocyte-mediated disease of little-known etiology that can cause intense itching and stenosis, hindering evacuation and urination. It can also limit the sex life due to severe local pain and trauma. The standard treatment for this disease is the use of topical corticosteroids to restrict clinical symptoms and to try to lengthen the intervals between episodes. Photodynamic therapy (PDT), which combines light radiation with a photosensitizing agent, and low-level laser therapy (LLLT) can promote effective immunomodulatory responses at the application site by means of photophysical and photochemical phenomena from the molecular to the systemic level, which promote their use in chronic dermatoses. The aim is to study and compare the effects of PDT, LLLT, and topical corticosteroid in VLS by means of clinical, histological, immunohistochemical and spectroscopic responses. The study will be prospective, randomized, and controlled, conducted with 60 patients with histological diagnoses of VLS from the Genitoscopy department of the Pérola Byington Hospital in São Paulo. There will be 3 groups with ten patients each. Each group will correspond to one type of treatment: clobetasol propionate, LLLT, and PDT. The clinical course will be monitored by measuring local temperature, itching, clamping (atrophy), and the appearance of the lesion. Histologically, the slides will be classified according to the Hewitt grading and will have the ordering of collagen fibers verified by confocal microscopy and polarized light microscopy. Immunohistochemical analysis will be done using the markers IFN-³, TGF-², CD4, CD8, IL-1, p53, Ki-67 and of collagens type I, III and IV. Finally, the spectroscopic evaluation will be done by reflectance. Descriptive and inferential statistical analyses will be conducted to compare the groups and for associations between different responses. (AU)

Scientific publications

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

BELOTTO, RENATA A.; CHAVANTES, MARIA CRISTINA; TARDIVO, JOAO PAULO; DOS SANTOS, ROBERTO EUZEBIO; MARQUES FERNANDES, RAQUEL CIVOLANI; RATTO TEMPESTINI HORLIANA, ANNA CAROLINA; PAVANI, CHRISTIANE; TEIXEIRA DA SILVA, DANIELA FATIMA. Therapeutic comparison between treatments for Vulvar Lichen Sclerosus: study protocol of a randomized prospective and controlled trial. BMC WOMENS HEALTH, v. 17, AUG 10 2017. (15/05259-8, 12/50680-5)