**3.7 Alternative treatment**

Positive results are reported with LASER ablation treatment, which is applied with LASER CO, 1–2 mm deep with complete healing 6 weeks after surgery and low relapse rates. It is considered a method of nonresponse to other forms of treatment.

Photodynamic therapy (topical application of the 5-aminolevulinic acid photosensitizer and exposure to argon laser light for 1–2 alphas in 1–3 sessions) is also used with very good results.

#### **3.8 General considerations for patients during treatment**

Patients with LS have thin skin, which is not considered a "satisfactory" barrier to the loss of moisture, and it would be a failure not to mention some general measures.


A lesion that resides in the vulva or in the vaginal opening and continues after the skin lesion is absent is secondary to a sensory disorder. This pain does not correspond to topical administration of corticosteroids. A 5% xylocaine ointment is therapeutically administered; on failure, administration of amitriptyline is recommended [72–75].

#### **3.9 Failure of treatment**

On unsuccessful treatment with corticosteroids, the following should be checked: patient compliance, misdiagnosis or coexistence of other disease entities, contact dermatitis, secondary candidiasis, VIN, SCC, psoriasis, or pemphigoid vulgaris.

If the symptoms persist after the medical repair of the damage, it is a secondary sensory disorder.

#### **3.10 Follow-up**

The risk of malignant transformation of LS is very small. Even if malignant transformation occurs, the progression of the disease is slow. However, patients should be screened at the end of the first trimester of treatment after 6 months and then yearly.

One-month follow-up requires patients with a poor response to corticosteroid therapy, and they are usually those in whom squamous cell hyperplasia coexists and are therefore susceptible to malignant transformation.

### **4. Conclusion**

Vulva pathology is varied. Between all the described lesions, precancer conditions should be recognized early in order to stop the evolution. Strong dermocorticoids are the major local treatment on many vulvae chronic diseases. In specific conditions, local immune modulators or laser are necessary.

#### **Acknowledgements**

Many thanks to midwives (Mrs. Maria Strofali and Mrs. Stavroula Falaga) of family planning center, Democritus University of Thrace, Greece for their clinical support and examination of women, who visited our family planning examination center.

**45**

**Author details**

Panagiotis Tsikouras1

Dimitrios Tzeferakos2

Stefanos Zervoudis2

Greece

Anastasia Bothou1

provided the original work is properly cited.

*Depigmentation's Disorders of the Vulva, Clinical Management*

*DOI: http://dx.doi.org/10.5772/intechopen.83595*

© 2019 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium,

\*, Xanthoula Anthoulaki1

and Georgios Galazios1

, Elefterios Chatzimichael1

1 Department of Obstetrics and Gynecology, Democritus University of Thrace,

3 Department of Obstetrics and Gynecology, University of West Attica, Greece

2 Department of Obstetrics and Gynecology, Rea Hospital, Athens, Greece

, Fotis Gasparos2

, Anna Chalkidou1

\*Address all correspondence to: ptsikour@med.duth.gr

, Theodora Deftereou1

, Georgios Iatrakis3

, Georgia Saradi<sup>2</sup>

,

,

,

*Depigmentation's Disorders of the Vulva, Clinical Management DOI: http://dx.doi.org/10.5772/intechopen.83595*

*Depigmentation*

used with very good results.

**3.9 Failure of treatment**

sensory disorder.

**3.10 Follow-up**

**4. Conclusion**

**Acknowledgements**

Photodynamic therapy (topical application of the 5-aminolevulinic acid photosensitizer and exposure to argon laser light for 1–2 alphas in 1–3 sessions) is also

Patients with LS have thin skin, which is not considered a "satisfactory" barrier to the loss of moisture, and it would be a failure not to mention some general measures.

2.Gentle moisturizing products such as, e.g., Vaseline should be used to improve

3.Good hygiene, avoidance of irritants and allergens, use of cotton lingerie, and

A lesion that resides in the vulva or in the vaginal opening and continues after the skin lesion is absent is secondary to a sensory disorder. This pain does not correspond to topical administration of corticosteroids. A 5% xylocaine ointment is therapeutically administered; on failure, administration of amitriptyline is recommended [72–75].

On unsuccessful treatment with corticosteroids, the following should be checked: patient compliance, misdiagnosis or coexistence of other disease entities, contact dermatitis, secondary candidiasis, VIN, SCC, psoriasis, or pemphigoid vulgaris.

If the symptoms persist after the medical repair of the damage, it is a secondary

The risk of malignant transformation of LS is very small. Even if malignant transformation occurs, the progression of the disease is slow. However, patients should be screened at the end of the first trimester of treatment after 6 months and then yearly. One-month follow-up requires patients with a poor response to corticosteroid therapy, and they are usually those in whom squamous cell hyperplasia coexists and

Vulva pathology is varied. Between all the described lesions, precancer conditions should be recognized early in order to stop the evolution. Strong dermocorticoids are the major local treatment on many vulvae chronic diseases. In specific

Many thanks to midwives (Mrs. Maria Strofali and Mrs. Stavroula Falaga) of family planning center, Democritus University of Thrace, Greece for their clinical support and examination of women, who visited our family planning examination center.

**3.8 General considerations for patients during treatment**

1.Excessive drying after bathing should be avoided.

are therefore susceptible to malignant transformation.

conditions, local immune modulators or laser are necessary.

the moisture of the affected skin.

avoidance of tight and hot clothes.

**44**
