title: Management of lichen sclerosus with triamcinolone ointment: effectiveness in reduction of patient symptom scores.
abstract: OBJECTIVE
  To determine whether topical triamcinolone ointment effectively reduces patient's symptoms for the management of lichen sclerosus (LS).
  
  
  METHODS
  A retrospective chart review of LS patients seen during 2004 to 2008 in the Saint Louis University Vulvar Clinic was conducted. Inclusion criteria were biopsy-confirmed LS and age 18 years and older. Data were collected at the initial visit and at 6 to 10 weeks, 3 months, and 6 months of follow-up. Effectiveness was assessed using symptom scores on a Likert scale. Data were analyzed using either paired t tests or nonparametric Wilcoxon signed rank tests using a p value less than.05 to denote statistical significance.
  
  
  RESULTS
  Of 41 women, 34 met inclusion criteria. Vulvar pruritus was the most frequently reported vulvar symptom, occurring in 32 (94.1%) of 34 women. Dyspareunia, vulvar burning, and vulvar pain were reported in 17 (54.8%) of 31, 22 (64.7%) of 34, and in 13 (38.2%) of 34 women, respectively. Statistically significant reductions in mean symptom scores between the initial and the 6- to 10-week follow-up visits were found for dyspareunia, vulvar burning, vulvar pruritus, and pain (p values < .05 to < .001) and at 3-month follow-up visits for dyspareunia, vulvar burning, and vulvar pruritus (p < .05). Complete symptom relief was reported for 8 (47.1%) of 17 women with dyspareunia, 19 (86.4%) of 22 women with vulvar burning, 23 (71.9%) of 32 women with vulvar pruritus, and 12 (92.3%) of 13 women with vulvar pain.
  
  
  CONCLUSIONS
  Topical triamcinolone ointment is an effective treatment for the management of LS based on the significant reduction of patient symptom scores. Inherent risks with long-term use of high-potency corticosteroids should prompt all practitioners to consider triamcinolone ointment as a safer long-term treatment for patients with LS.
authors.affiliation: Department of Obstetrics, Gynecology, and Women's Health, Saint Louis University, Saint Louis, MO, USA. leca@slu.edu
authors.forename: Cherie
authors.initials: C
authors.lastname: LeFevre
authors.forename: Susan
authors.initials: S
authors.lastname: Hoffstetter
authors.forename: Sara
authors.initials: S
authors.lastname: Meyer
authors.forename: Jeffery
authors.initials: J
authors.lastname: Gavard
mesh_terms: D000328:Adult; D004414:Dyspareunia / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D005831:Genital Diseases, Female / Q000188:drug therapy* / Q000453:epidemiology; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D018459:Lichen Sclerosus et Atrophicus / Q000188:drug therapy*; D008875:Middle Aged; D008923:Missouri / Q000453:epidemiology; D009824:Ointments / Q000627:therapeutic use; D011539:Pruritus Vulvae / Q000188:drug therapy / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014221:Triamcinolone / Q000627:therapeutic use*
chemical_list: D005938:Glucocorticoids; D009824:Ointments; D014221:Triamcinolone