Dermatologic Therapy | 2019
The use of 308‐nm excimer lamp as a novel treatment for vulvar lichen simplex chronicus
Abstract
A 49-year-old woman was addressed to our department for a severe vulvar pruritus persisting for 5 years. Her past medical history was unremarkable apart from a hysterectomy 4 years ago. Her symptoms had a major psychological impact and severely altered her quality of life. She repeatedly received local and oral antifungal treatments without significant improvement. Physical examination revealed an erythematous vulva with lichenification and a whitish maceration of the inguinal folds (Figure 1). A skin biopsy was performed and sent for histopathological examination which showed an eczematous pattern and no signs in favor of lichen sclerosis. These clinical and histological findings pleaded for lichen simplex. Treatment with topical corticosteroids class II and antihistamines was initiated for a month but no improvement was observed. We then opted for a treatment with an excimer lamp which emits at 308 nm in the ultraviolet B (UVB) spectrum. The initial dose was 0.25 joules/cm. Thirteen sessions with a frequency of two sessions per week were performed (increase by 0.05 joules per session). The patient reported a complete regression of the pruritus sensation. A significant improvement of the lichenified aspect of the skin was noted (Figure 2). No recurrence was observed after a follow-up of 2 years.