Abstract
Background
Photodynamic therapy (PDT) is an alternative treatment modality for vulvar lichen sclerosus (VLS) which is a chronic inflammatory mucosal condition. In literature, no consensus of optimal parameters of PDT for VLS is reached so far.
Objectives
The aim of this narrative review is to develop a standardized treatment protocol for PDT in VLS.
Methods
A systematic literature search was conducted to identify studies reporting on PDT in VLS and used treatment parameters, side-effects, and clinical outcomes were summarized.
Results
Thirteen studies used 5-aminolevulinic acid (5-ALA) with concentrations of 20%, 10%, 5% and three studies used methyl aminolevulinate (MAL). Generally, the light source was red light (median 630 nm). Light dose varied between 9 and 180 J/cm2 and light intensity between 40 and 700 mW/cm2. Incubation period with the photosensitizer ranged from 2 to 6 h. All studies showed a substantial improvement in VLS-related pruritus, burning and pain.
Conclusions
Based on a literature review, we suggest the following protocol for PDT in VLS: 5% 5-ALA as a photosensitizer applied for 3 h under occlusion before irradiation at the dose of 120 J/cm2 with red light (590–760 nm) and intensity of 204 mW/cm2.
Acknowledgments
The authors thank Thomas Vandendriessche, Magdalena Jans and Krizia Tuand, the biomedical reference librarians of the KU Leuven Libraries – 2Bergen – learning Center Désiré Collen (Leuven, Belgium) for their help with setting up valid and sound search terms.
Disclosure statement
The authors report no conflict of interest.