The effect of topical corticosteroids on Ki67 and p53 expression in vulval lichen sclerosus.
BACKGROUND
Topical corticosteroids have become the treatment of choice for genital lichen sclerosus (LS) and are believed to be required for long-term relief of symptoms.


OBJECTIVE
To compare vulval LS that had been treated with topical corticosteroids, vulval LS that had not received topical corticosteroids, and histologically normal vulval skin.


METHODS
We used immunohistochemistry to look for Ki67 expression and abnormal p53 expression.


RESULTS
We found a statistically significant difference for p53 overexpression, with increased levels seen when comparing corticosteroid-treated LS with normal genital skin (P = 0.011). Ki67 expression was also significantly higher in the corticosteroid-treated group compared with normal genital skin (P = 0.001), and increased levels were also found in the treated group compared with untreated LS (P = 0.05).


CONCLUSIONS
Our data suggest that topical corticosteroids have an effect on cell cycle proteins in genital skin and, in particular, genital skin with LS changes.
Department of Obstetrics and Gynaecology, Royal Free and University College Medical School (Royal Free Campus), Rowland Hill Street, London NW3 2PF, U.K.
K J
KJ
Rolfe
J C
JC
Crow
W M N
WM
Reid
E
E
Benjamin
A B
AB
MacLean
C W
CW
Perrett
D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000494:pharmacology*; D002648:Child; D005260:Female; D005938:Glucocorticoids; D006801:Humans; D007124:Immunoenzyme Techniques; D019394:Ki-67 Antigen / Q000187:drug effects* / Q000378:metabolism; D018459:Lichen Sclerosus et Atrophicus / Q000188:drug therapy* / Q000378:metabolism; D008875:Middle Aged; D016159:Tumor Suppressor Protein p53 / Q000187:drug effects* / Q000378:metabolism; D014844:Vulva / Q000378:metabolism; D014845:Vulvar Diseases / Q000188:drug therapy* / Q000378:metabolism
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D019394:Ki-67 Antigen; D016159:Tumor Suppressor Protein p53