A double-blind, randomized prospective study evaluating topical clobetasol propionate 0.05% versus topical tacrolimus 0.1% in patients with vulvar lichen sclerosus

作者：Funaro Deana^*; Lovett Audrey; Leroux Nathalie; Powell Julie

来源：Journal of the American Academy of Dermatology, 2014, 71(1): 84-91.

DOI：10.1016/j.jaad.2014.02.019

• anogenital
• carcinoma
• clobetasol propionate
• lichen sclerosus
• tacrolimus
• topical calcineurin inhibitor
• vulva

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.
Method: 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 (chi(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 (chi(2) = 10.35, P = .002; chi(2) = 10.35, P = .002). No adverse events were reported.
Limitations: Short length of trial and recruitment through our vulvar disease referral center are limitations.
Conclusion: This study showed that topical clobetasol propionate was significantly more effective in treating vulvar lichen sclerosus than topical tacrolimus.

• 出版日期2014-7