A double-blind, randomized prospective study evaluating topical clobetasol propionate 0.05% versus topical tacrolimus 0.1% in patients with vulvar lichen sclerosus.
BACKGROUND
Vulvar lichen sclerosus is a chronic condition usually responsive to topical corticosteroids.


OBJECTIVE
We sought to evaluate the efficacy (reduction of signs and symptoms) and safety of clobetasol propionate 0.05% and tacrolimus 0.1% in the treatment of vulvar lichen sclerosus.


METHODS
This double-blind, randomized study comparing 2 treatments over a 3-month period, enrolled 58 female patients with newly diagnosed vulvar lichen sclerosus or untreated vulvar lichen sclerosus for at least 1 month.


RESULTS
In all, 55 patients were included in the statistical analysis. A total of 28 patients were assigned to the tacrolimus group and 27 patients to the clobetasol group. Both groups showed a significant difference in the decrease of symptoms and signs of lichen sclerosus. At the end of the study, 28 participants (19 tacrolimus and 9 clobetasol) still had some clinical signs of lichen sclerosus (χ(2) = 6.56, P = .015). However, a significantly higher number of patients in the clobetasol group (n = 15) had absence of signs and symptoms of lichen sclerosus (χ(2) = 10.35, P = .002; χ(2) = 10.35, P = .002). No adverse events were reported.


CONCLUSIONS
Short length of trial and recruitment through our vulvar disease referral center are limitations.


CONCLUSIONS
This study showed that topical clobetasol propionate was significantly more effective in treating vulvar lichen sclerosus than topical tacrolimus.
Department of Dermatology, Ste-Justine Hospital, University of Montreal, Montreal, Quebec, Canada; Vulvar Disease Division, Ste-Justine Hospital, University of Montreal, Montreal, Quebec, Canada; Department of Dermatology, Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal, Quebec, Canada. Electronic address: rouleaufunaro@videotron.ca.
Deana
D
Funaro
Department of Dermatology, Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal, Quebec, Canada.
Audrey
A
Lovett
Department of Gynecology, Ste-Justine Hospital, University of Montreal, Montreal, Quebec, Canada.
Nathalie
N
Leroux
Department of Dermatology, Ste-Justine Hospital, University of Montreal, Montreal, Quebec, Canada.
Julie
J
Powell
D000287:Administration, Topical; D000328:Adult; D002990:Clobetasol / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008875:Middle Aged; D009824:Ointments; D011446:Prospective Studies; D016559:Tacrolimus / Q000008:administration & dosage*; D016896:Treatment Outcome; D007724:Vulvar Lichen Sclerosus / Q000188:drug therapy*
D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D009824:Ointments; D002990:Clobetasol; D016559:Tacrolimus
anogenital; carcinoma; clobetasol propionate; lichen sclerosus; tacrolimus; topical calcineurin inhibitor; vulva