Optical coherence tomography to evaluate the recovery of the skin after fractional CO2 laser treatment of Vulvar Lichen Sclerosus
Arseniy L. Potapov1, Anastasiya E. Bychkova2, Alexander A. Moiseev3, Maria M. Karabut1, Alexandra V. Asaturova2, Inna A. Apolikhina2, Natalia D. Gladkova1, Marina A. Sirotkina1.
1 Privolzhsky Research Medical University, Nizhny Novgorod, Russia;
2 National Medical Research Center for Obstetrics, Gynecology and Perinatology named after academician V.I. Kulakov, Moscow, Russia;
3 Institute of Applied Physics RAS, Nizhny Novgorod, Russia.
Abstract
Vulvar lichen sclerosus (VLS) is a chronic, relapsing autoimmune skin disease affecting the anogenital area in women. The VLS is characterized by persistent, debilitating symptoms (itching, burning, pain), which are accompanied by inflammatory and sclerotic changes in the dermis. Standard treatment includes topical ultrapotent corticosteroids or calcineurin inhibitors, however, this therapy has a high relapse rate and significant side effects. One of the alternative treatments for VLS that has demonstrated high clinical efficacy is fractional CO2 laser. The question of an objective assessment of the success of therapy remains relevant, since the clinical assessment is based on the subjective symptoms and feelings of patients. In this paper, we propose to use optical coherence tomography (OCT) as a non-invasive quantitative method for assessing the recovery of the skin structure and microcirculation. The study included 9 patients with VLS and 7 patients without skin pathology. OCT was performed for patients with VLS before, immediately after, 1 and 3 months after fractional CO2 laser treatment. Before treatment, patients with VLS were observed: thinning of the epidermis, a picture of a pronounced lesion of the connective tissue of the dermis (low contrast of the dermoepidermal junction, low signal from the dermis, the absence of blood and lymphatic vessels on OCT angiographic images). Quantification of the OCT data demonstrated restoration of epidermal thickness and blood vessel density to the normal vulvar skin range at 1 month after treatment. The values of the density of the lymphatic vessels increased, but did not reach the range of values of normal vulvar tissue. 3 months after therapy, the effect persisted.
Speaker
Arseniy Potapov
Privolzhsky Research Medical University
Russia
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