TY - JOUR T1 - Proactive maintenance therapy with a topical corticosteroid for vulvar lichen sclerosus: preliminary results of a randomized study. AU - Virgili,A, AU - Minghetti,S, AU - Borghi,A, AU - Corazza,M, PY - 2013/02/05/accepted PY - 2013/2/13/entrez PY - 2013/2/13/pubmed PY - 2014/2/28/medline SP - 1316 EP - 24 JF - The British journal of dermatology JO - Br J Dermatol VL - 168 IS - 6 N2 - BACKGROUND: The chronic and relapsing nature of vulvar lichen sclerosus (VLS) represents a challenge for its long-term management after an effective treatment with topical corticosteroids. OBJECTIVES: To assess the effectiveness of proactive, twice-weekly application of mometasone furoate 0·1% ointment, compared with daily topical vitamin E or cold cream, in keeping VLS in remission and reducing the risk of relapse after 3 months of treatment with topical corticosteroid. METHODS: In total, 27 patients affected with VLS were enrolled into a 12-week active treatment phase (AP) with topical mometasone furoate 0·1% ointment once daily. Those who achieved disease remission entered a 52-week maintenance phase (MP) in which patients were randomized to apply either mometasone furoate 0·1% ointment twice weekly, a cold cream once daily or topical vitamin E once daily. The primary efficacy parameters were the relapse rate and the mean time to relapse. RESULTS: Twenty-five patients considered to have been completely or almost completely healed after the AP entered the MP. By the end of the 52-week MP, 10 patients (40%) experienced a relapse: five in the vitamin E group (56%) and five in the cold cream group (62%), while no patient in the mometasone furoate 0·1% ointment group had a relapse. The occurrence of VLS relapse for patients in therapy with both vitamin E and cold cream was significantly higher than for those in proactive therapy with topical corticosteroid. The median time to relapse was the same (21·6 weeks) for the vitamin E and the emollient groups. CONCLUSIONS: Once VLS has been stabilized with topical corticosteroids, twice-weekly proactive application of mometasone furoate 0·1% ointment over 56 weeks was found to be an effective and safe therapy option in maintaining VLS remission and in preventing the occurrence of relapse. SN - 1365-2133 UR - https://www.unboundmedicine.com/medline/citation/23398459/Proactive_maintenance_therapy_with_a_topical_corticosteroid_for_vulvar_lichen_sclerosus:_preliminary_results_of_a_randomized_study_ L2 - https://doi.org/10.1111/bjd.12273 DB - PRIME DP - Unbound Medicine ER -