Treatment of vulvovaginal lichen planus with vaginal hydrocortisone suppositories.
OBJECTIVE
To estimate the effectiveness of vaginal hydrocortisone suppositories in the treatment of vulvovaginal lichen planus.


METHODS
A nonprobability sample of 60 patients diagnosed with vulvovaginal lichen planus were treated with intravaginal hydrocortisone 25-mg suppositories (1-1/2) twice a day. The dose was tapered to two times a week dosing after several months to maintain symptom-free disease. The participants' charts were reviewed and pretreatment symptoms and physical examination were compared to posttreatment symptoms and physical examination. Data were analyzed using McNemar chi(2).


RESULTS
The sample population included mostly white (86.7%) patients with a mean age of 58 years. Forty-three participants had complete data with follow-up subjectively and objectively after treatment. Most symptoms (eg, vulvar burning, pruritus, dyspareunia, vaginal discharge) were improved and the improvement was found to be statistically significant. Sexual activity was unchanged in the women. Additionally, most physical findings by examination (eg, erythema, erosions, vulvar and vaginal lesions) were improved and the improvement was found to be statistically significant. Vaginal stenosis did not significantly improve. Treatment was continued in 35 patients with a mean duration of 28.1 months. There was overall improvement in 81% subjectively and in 76.8% objectively.


CONCLUSIONS
Intravaginal hydrocortisone suppositories are an effective treatment for vulvovaginal lichen planus.
Anderson
Melissa
M
Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas 77030, USA.
Kutzner
Susan
S
Kaufman
Raymond H
RH
D000282:Administration, Intravaginal; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage*; D008010:Lichen Planus / Q000175:diagnosis / Q000188:drug therapy*; D008875:Middle Aged; D011336:Probability; D011446:Prospective Studies; D012494:Sampling Studies; D013488:Suppositories; D016896:Treatment Outcome; D014623:Vaginal Diseases / Q000175:diagnosis / Q000188:drug therapy; D014845:Vulvar Diseases / Q000175:diagnosis / Q000188:drug therapy
D013488:Suppositories; D006854:Hydrocortisone