tretinoin and Vulvar-Diseases

To study the use of topical tretinoin for treating vulvar lichen sclerosus.. An open, uncontrolled clinical study on 22 patients affected by histologically confirmed vulvar lichen sclerosus. Topical 0.025% tretinoin was applied once a day, five days a week, for one year. Clinical and histologic parameters were evaluated before and after therapy, and statistical analysis was performed.. Symptoms, gross appearance and histopathologic features improved in a highly significant manner (P < .001). Cutaneous side effects were observed but rapidly disappeared, and no patient left the study for this reason. Maintenance of results was observed at the 4-13-month follow-up visits.. Topical tretinoin seems feasible for use in the topical treatment of vulvar lichen sclerosus.

Topics: Administration, Topical; Adult; Aged; Biopsy; Dose-Response Relationship, Drug; Female; Humans; Keratolytic Agents; Lichen Sclerosus et Atrophicus; Middle Aged; Skin Diseases; Time Factors; Tretinoin; Vulva; Vulvar Diseases

Topical application of 13-cis retinoic acid resulted in complete disappearance of dystrophy of the vulva in 33 out of 53 patients, among them in 9 patients with recurrence after vulvectomy and in 14 patients with previous unsuccessful conservative treatment. Partial disappearance of dystrophy was seen in 15 patients, usually after 1 to 2 months of daily retinoid treatment. Side-effects of treatment (except for one) could be managed. Serum retinol level in patients was found to be lower as compared to that in healthy subjects. The results suggest that patients with chronic epithelial vulvar dystrophies could benefit from local retinol treatment, especially in cases with recurrence after vulvectomy and in cases with advanced dystrophies qualified until now for vulvectomy.

Topics: Administration, Topical; Adult; Aged; Epithelium; Female; Follow-Up Studies; Humans; Middle Aged; Tretinoin; Vitamin A; Vulvar Diseases

Hidradenitis suppurativa, a chronic relapsing disease of apocrine gland-bearing areas, most frequently occurs in the axillae, groin, perineal, and perianal regions. Hidradenitis of vulva is frequently misdiagnosed and inadequately treated. The case of a 15-year-old nulliparous black female adolescent referred for evaluation of multiple draining fistulas of the anogenital region is presented. Diagnostic studies for granulomatous disease were negative. Results of a barium enema were normal and biopsies were compatible with the diagnosis of hidradenitis suppurativa. She was treated for 22 weeks with isotretinoin, 1 mg/kg daily, with an excellent response. Side effects were minor and included cheilitis, mild xerosis, and a transient elevation of serum alkaline phosphatase levels. Few patients with severe hidradenitis have been responsive to this synthetic vitamin A derivative. A review of the literature indicates that the results of treatment with isotretinoin for hidradenitis have been at best equivocal. Isotretinoin should never be used during pregnancy because of known teratogenic effects. Women of childbearing age must use effective contraception during treatment.

Topics: Adolescent; Anus Diseases; Female; Humans; Inflammation; Isotretinoin; Perineum; Suppuration; Sweat Gland Diseases; Tretinoin; Vulvar Diseases