{"title":"评估光动力疗法对外阴硬皮病的治疗效果以及对患者生活质量和性功能的影响。","authors":"","doi":"10.1016/j.pdpdt.2024.104226","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Vulvar lichen sclerosus (VLS) is often associated with irritable symptoms of itching, burning pain and can lead to scarring, architectural changes and sexual dysfunction as well as a decline in quality of life. The etiology of the disease is unknown. This study sought to assess the therapeutic effects of Photodynamic Therapy (PDT) in VLS, and improvment of patient quality of life and sexual funtion.</div></div><div><h3>Methods</h3><div>From January 2022 to April 2023, a total of 65 patients with vulvar sclerosus (VLS) were treated with PDT in our hospital. All 65 patients were divided into two groups: early-stage group and late-stage group. The Cattaneo scoring method, the Dermatology Life Quality Index (DLQI) and the Female Sexual Function Index (FSFI) scores were used to evaluate the clinical effectiveness of the treatment on patients’ symptoms and clincal signs, quality of life as well as sexual function before and at 6-month after treatment.</div></div><div><h3>Results</h3><div>The total effective rate of early-stage patients was significantly greater than that of late-stage patients at 6-month after PDT treatment (90.91 % [40/44] vs 76.19 % [16/21], <em>p</em> < 0.05). At 6-month follow-up, the symptoms and clinical signs of patients in early-stage group were significantly improved compared with baseline, the average scores of itching, skin elasticity, whitening and lesion range were significantly lower than the scores before treatment (<em>p</em> < 0.05). In late-stage group, The decrease in scores of itching, whitening and lesion range at the 6-months follow-up is significant(<em>p</em> < 0.05), but skin elasticity (<em>p</em> = 0.0625). On post-treatment follow-up examination, FSFI score was seen to have significantly improved in early-stage patients(from a median score of 17.45 to 21.1, <em>p</em> < 0.05); DLQI also significantly improved after treatment (from a median score of 7 to 4, <em>p</em> < 0.05). In late stage patients, The DLQI score improved significantly after treatment (from a median score of 18 to 15, <em>p</em> < 0.05). However, the improvement in sexual function is not statistically significant (pre-treatment: median=10.55, post-treatment: median=10, <em>p</em> = 0.1865).</div></div><div><h3>Conclusion</h3><div>Photodynamic therapy can effectively improve most symptoms and clinical signs, as well as quality of life of patients with VLS, especially for earlly stage patients. Moreover, improvement in sexual function is observed in early stage patients after PDT treatment. This study suggests that early and timely PDT treatment are recommended to achieve better results.</div></div>","PeriodicalId":20141,"journal":{"name":"Photodiagnosis and Photodynamic Therapy","volume":null,"pages":null},"PeriodicalIF":3.1000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Evaluation of the therapeutic effects of photodynamic therapy in vulvar lichen sclerosus and impact on patient quality of life and sexual funtion\",\"authors\":\"\",\"doi\":\"10.1016/j.pdpdt.2024.104226\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Vulvar lichen sclerosus (VLS) is often associated with irritable symptoms of itching, burning pain and can lead to scarring, architectural changes and sexual dysfunction as well as a decline in quality of life. The etiology of the disease is unknown. This study sought to assess the therapeutic effects of Photodynamic Therapy (PDT) in VLS, and improvment of patient quality of life and sexual funtion.</div></div><div><h3>Methods</h3><div>From January 2022 to April 2023, a total of 65 patients with vulvar sclerosus (VLS) were treated with PDT in our hospital. All 65 patients were divided into two groups: early-stage group and late-stage group. The Cattaneo scoring method, the Dermatology Life Quality Index (DLQI) and the Female Sexual Function Index (FSFI) scores were used to evaluate the clinical effectiveness of the treatment on patients’ symptoms and clincal signs, quality of life as well as sexual function before and at 6-month after treatment.</div></div><div><h3>Results</h3><div>The total effective rate of early-stage patients was significantly greater than that of late-stage patients at 6-month after PDT treatment (90.91 % [40/44] vs 76.19 % [16/21], <em>p</em> < 0.05). At 6-month follow-up, the symptoms and clinical signs of patients in early-stage group were significantly improved compared with baseline, the average scores of itching, skin elasticity, whitening and lesion range were significantly lower than the scores before treatment (<em>p</em> < 0.05). In late-stage group, The decrease in scores of itching, whitening and lesion range at the 6-months follow-up is significant(<em>p</em> < 0.05), but skin elasticity (<em>p</em> = 0.0625). On post-treatment follow-up examination, FSFI score was seen to have significantly improved in early-stage patients(from a median score of 17.45 to 21.1, <em>p</em> < 0.05); DLQI also significantly improved after treatment (from a median score of 7 to 4, <em>p</em> < 0.05). In late stage patients, The DLQI score improved significantly after treatment (from a median score of 18 to 15, <em>p</em> < 0.05). However, the improvement in sexual function is not statistically significant (pre-treatment: median=10.55, post-treatment: median=10, <em>p</em> = 0.1865).</div></div><div><h3>Conclusion</h3><div>Photodynamic therapy can effectively improve most symptoms and clinical signs, as well as quality of life of patients with VLS, especially for earlly stage patients. Moreover, improvement in sexual function is observed in early stage patients after PDT treatment. This study suggests that early and timely PDT treatment are recommended to achieve better results.</div></div>\",\"PeriodicalId\":20141,\"journal\":{\"name\":\"Photodiagnosis and Photodynamic Therapy\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Photodiagnosis and Photodynamic Therapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1572100024002643\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Photodiagnosis and Photodynamic Therapy","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1572100024002643","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
Evaluation of the therapeutic effects of photodynamic therapy in vulvar lichen sclerosus and impact on patient quality of life and sexual funtion
Background
Vulvar lichen sclerosus (VLS) is often associated with irritable symptoms of itching, burning pain and can lead to scarring, architectural changes and sexual dysfunction as well as a decline in quality of life. The etiology of the disease is unknown. This study sought to assess the therapeutic effects of Photodynamic Therapy (PDT) in VLS, and improvment of patient quality of life and sexual funtion.
Methods
From January 2022 to April 2023, a total of 65 patients with vulvar sclerosus (VLS) were treated with PDT in our hospital. All 65 patients were divided into two groups: early-stage group and late-stage group. The Cattaneo scoring method, the Dermatology Life Quality Index (DLQI) and the Female Sexual Function Index (FSFI) scores were used to evaluate the clinical effectiveness of the treatment on patients’ symptoms and clincal signs, quality of life as well as sexual function before and at 6-month after treatment.
Results
The total effective rate of early-stage patients was significantly greater than that of late-stage patients at 6-month after PDT treatment (90.91 % [40/44] vs 76.19 % [16/21], p < 0.05). At 6-month follow-up, the symptoms and clinical signs of patients in early-stage group were significantly improved compared with baseline, the average scores of itching, skin elasticity, whitening and lesion range were significantly lower than the scores before treatment (p < 0.05). In late-stage group, The decrease in scores of itching, whitening and lesion range at the 6-months follow-up is significant(p < 0.05), but skin elasticity (p = 0.0625). On post-treatment follow-up examination, FSFI score was seen to have significantly improved in early-stage patients(from a median score of 17.45 to 21.1, p < 0.05); DLQI also significantly improved after treatment (from a median score of 7 to 4, p < 0.05). In late stage patients, The DLQI score improved significantly after treatment (from a median score of 18 to 15, p < 0.05). However, the improvement in sexual function is not statistically significant (pre-treatment: median=10.55, post-treatment: median=10, p = 0.1865).
Conclusion
Photodynamic therapy can effectively improve most symptoms and clinical signs, as well as quality of life of patients with VLS, especially for earlly stage patients. Moreover, improvement in sexual function is observed in early stage patients after PDT treatment. This study suggests that early and timely PDT treatment are recommended to achieve better results.
期刊介绍:
Photodiagnosis and Photodynamic Therapy is an international journal for the dissemination of scientific knowledge and clinical developments of Photodiagnosis and Photodynamic Therapy in all medical specialties. The journal publishes original articles, review articles, case presentations, "how-to-do-it" articles, Letters to the Editor, short communications and relevant images with short descriptions. All submitted material is subject to a strict peer-review process.