A therapeutic approach for female, relapsing genital lichen sclerosus: a single-center study.

Objective: To assess the efficacy of methylprednisolone aceponate 0.1% (MPA 0.1%) in female genital lichen sclerosus (GLS) and efficacy of MPA, tacrolimus or emollient for prevention of flares. Methods: A single-center, retrospective study was conducted. At baseline, female patients with relapsing GLS ( n = 46) were treated with MPA 0.1% applied once daily for 8 weeks. Visual Analog Scale (VAS) score for vulvar pruritus and Investigator's Global Assessment (IGA) score were recorded at baseline, weeks 8 and 20. At week 8, patients responsive to treatment ( n = 38) were further treated with MPA 0.1% twice weekly ( n = 15), tacrolimus once daily ( n = 13) or topical emollient once daily ( n = 10), as maintenance therapy until week 20. Result: Both VAS and IGA median score was significantly decreased from baseline to week 8 ( p = 0.000). At week 20, both median VAS and IGA scores differed significantly between patients treated with emollient and patients treated with MPA 0.1% ( p = 0.000) and patients treated with emollient and patients treated with tacrolimus ( p = 0.000); patients treated with MPA 0.1% presented no significant difference in either median VAS score ( p = 0.032) or median IGA score ( p = 0.636) at week 20 compared to patients treated with tacrolimus. Conclusions: MPA 0.1% is effective in relapsing female GLS. MPA 0.1% and tacrolimus have equal efficacy in preventing relapses. [ABSTRACT FROM AUTHOR]