mometasone-furoate and Vulvar-Diseases

Avoiding potentially irritating contact is a key point in vulvar lichen simplex chronicus (VLSC) management. This study aims to assess the use of nonirritating silk fabric underwear (Dermasilk) as an adjuvant tool in the treatment of VLSC.. Twenty women with VLSC were enrolled in a 1-week open-label active treatment phase with topical 0.1% mometasone furoate (MMF) ointment. Participants then entered a 4-week double-blind maintenance phase (MP) in which they were randomized to wear either silk fabric or cotton briefs. During MP, participants were allowed to use MMF on an "as-needed" basis. The main efficacy endpoints were to assess and compare the two intervention groups on the following: (1) number of participants who needed to apply MMF throughout MP; (2) mean number of MMF applications; (3) mean symptom-free interval before MMF reapplication; and (4) changes in the severity of symptoms and signs.. During MP, four women in the silk fabric briefs group applied MMF compared with six women in the cotton briefs group (relative risk, 0.66). The mean number of MMF applications was lower in the silk fabric briefs group than in the cotton briefs group (P = 0.074). VLSC symptom-free interval was 22.5 days in the silk fabric briefs group and 7.2 days in the cotton briefs group (P = 0.0003). At the end of MP, symptom improvement determined after corticosteroid use increased in the silk fabric briefs group but worsened in the cotton briefs group.. Silk fabric underwear may be a useful tool for the management of VLSC by diminishing external sources of irritation and may reduce use of corticosteroids.

Topics: Administration, Topical; Adolescent; Adult; Age of Onset; Aged; Clothing; Combined Modality Therapy; Cotton Fiber; Dermatologic Agents; Double-Blind Method; Female; Humans; Middle Aged; Mometasone Furoate; Neurodermatitis; Silk; Vulvar Diseases; Young Adult

To assess the efficacy and safety of treating vulvar lichen sclerosus with mometasone furoate, a synthetic analogue of beclomethasone.. Thirty-one consecutive patients with biopsy-proven vulvar lichen sclerosus (LS) seen at the Florence Vulvar Clinic were entered into the study. Each subject's symptoms and the gross appearance of the lesions were recorded using a severity score according to the authors' previous studies. The patients were treated with a regimen of 0.1% mometasone furoate cream applications to the affected areas once daily for 4 weeks and then twice weekly for 8 weeks. After 12 weeks of treatment, the subjects were asked to rate the changes in their symptoms and were reevaluated by the same examiner for the gross appearance of the lesions. In every patient the before/after treatment total severity scores were compared using Wilcoxon's signed-rank test for statistical significance.. With mometasone furoate all the patients had a significant improvement (P < .001) in the gross aspects of the disease and a very dramatic decrease in symptoms (P < .001), with nearly all the subjects having complete symptomatic remission. Compliance was excellent, and no side effects were observed.. The improved risk/benefit ratio of mometasone furoate may minimize the possible long-term side effects expected when using a very potent topical steroid. Therefore, momentasone furoate cream may be an alternative to clobetasol propionate for treatment of vulvar LS, with similar efficacy but higher levels of safety and tolerability.

Topics: Administration, Topical; Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents; Female; Glucocorticoids; Humans; Lichen Sclerosus et Atrophicus; Middle Aged; Mometasone Furoate; Pregnadienediols; Severity of Illness Index; Treatment Outcome; Vulvar Diseases

A case of vulval dermatitis and perioral dermatitis due to contact allergy to multiple class D corticosteroids, mometasone furoate and methylprednisolone aceponate is presented. Patch testing with commercially available corticosteroid creams is a simple and useful diagnostic test. Beware of delayed positive reaction, seen on day 8 of the repeat open application test on this patient.

Topics: Administration, Topical; Anti-Inflammatory Agents; Dermatitis, Allergic Contact; Dermatitis, Perioral; Diagnosis, Differential; Female; Glucocorticoids; Humans; Methylprednisolone; Middle Aged; Mometasone Furoate; Patch Tests; Pregnadienediols; Vulvar Diseases