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Proactive maintenance therapy with a topical corticosteroid for vulvar lichen sclerosus: preliminary results of a randomized study.
MedLine Citation:
PMID:  23398459     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: the chronic and relapsing nature of vulvar lichen sclerosus (VLS) represents a challenge for its long-term management after an effective treatment with topical corticosteroids. OBJECTIVE: to assess the effectiveness of proactive, twice-weekly application of mometasone furoate 0.1% ointment, compared with daily topical vitamin E or cold cream, in keeping VLS in remission and reducing the risk of relapse after a 3-month treatment with topical corticosteroid. METHODS: 27 patients affected with VLS were enrolled into a 12-week active treatment phase (AP) with topical 0.1% mometasone furoate ointment once daily. Those who achieved disease remission entered a 52-week maintenance phase (MP) in which patients were randomized to apply either mometasone furoate 0.1% ointment twice weekly or a cold cream once daily or topical vitamin E once daily. The primary efficacy parameters were the relapse rate and the mean time of relapse. RESULTS: 25 patients considered to have been completely or almost completely healed after the AP entered the MP. By the end of the 52-week MP, 10 patients (40%) experienced a relapse: 5 in the vitamin E group (55.6%) and 5 in the cold cream group (62.5%), while no patient in the mometasone furoate 0.1% ointment group had a relapse. The occurrence of VLS relapse for patients in therapy with both vitamin E and cold cream was significantly higher than for those in proactive therapy with topical corticosteroid. The median time to relapse was the same (21.6 weeks) for the vitamin E and the emollient groups. CONCLUSIONS: once VLS has been stabilized with topical corticosteroids, twice-weekly proactive application of 0.1% mometasone furoate ointment over 56 weeks was found to be an effective and safe therapy option in maintaining VLS remission and in preventing the occurrence of relapse.
Authors:
A Virgili; S Minghetti; A Borghi; M Corazza
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-2-12
Journal Detail:
Title:  The British journal of dermatology     Volume:  -     ISSN:  1365-2133     ISO Abbreviation:  Br. J. Dermatol.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-2-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0004041     Medline TA:  Br J Dermatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
©The Authors BJD © 2013 British Association of Dermatologists.
Affiliation:
Department of Clinical and Experimental Medicine, Section of Dermatology, University of Ferrara.
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