To Compare Inflammatory Biomarkers Before and After Treatment With Clobetasol or Fractional CO2 Laser, in Women With Histologically Confirmed Vulvar Lichen Sclerosus, Without Prior Corticosteroid Treatment.

NCT ID: NCT07240519

Last Updated: 2025-11-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-06-22

Study Completion Date

2026-06-30

Brief Summary

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The present study is a Clinical trial that compares clobetasol ointment versus Fractional CO2 laser for vulvar lichen sclerosus (VLE) treatment confirmed by histology, with no previous treatment. Lichen sclerosus is a chronic inflamatory disease that affects the vulvar skin in the majority of cases, generally in peri and post menopause. The main symptom is pruritus, along with dispareunia and vulvar pain. If not treated, it can leads to vulvar anatomy distortion and altough small, there is risk of neoplastic transformation towards pre cancer and invasive vulvar cancer. Clobetasol ointment is the standard treatment, but prolonged use can cause some adverse effects, such as thinning the skin, fungal infections, and exacerbation of symptoms. Forty participants are being randomized to clobetasol group, three months with reducing frequency and the other group of participants, to fractional dioxid carbon (CO2) laser for three sessions four weeks apart. At the beggining and three months after the completion of each treatment, a punch biopsy will be taken for every participant. The principal aim is to compare some inflamatory biomarkers before and after each treatment and compare them by imunohistoquemestry at Imunology and Imunogenetic Laboratory in Fiocruz, Rio de janeiro, Brazil.

Secondary outcomes include clinical response and changes in vulvar anatomy, assessed using the Sheinis \& Selk questionnaire before and after each treatment, as well as the evaluation of some clinical aspects, such as improvement in itching, dyspareunia and appearance of the vulva, along with satisfaction with the treatment, using the Visual Analogue Scale (VAS) from 1 to 10.

With this study, the investigators want to know if fractional CO2 laser can reduce the inflammatory process and symptoms in vulvar lichen sclerosus such as itching, and if this could be an alternative treatment for this condition.

Detailed Description

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Conditions

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Vulvar Lichen Sclerosus

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Forty women will be randomized after histological confirmation of vulvar lichen sclerosus for one of the two arms. 20 women will be allocated to clobetasol group and 20 women will be allocated to CO2 laser group
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Paricipants randomized for Clobetasol ointment group

Participants in this group will apply clobetasol propionate 0.05% ointment to the vulvar affected area in an amount sufficient to cover the finger tip according to standard treatment protocol:

every day in the first month every other day in the second month twice a week (for example: Mondays and Thursdays) in the third month

Group Type ACTIVE_COMPARATOR

Fractional microablative CO2 Laser

Intervention Type DEVICE

In this study the investigators use the laser device without any topic esteroid previous or during the period of laser sessions

Participants randomized for Fractional Carbon dioxide (CO2 ) laser group treatment

Fractional microablative CO2 laser An anesthetic ointment provided by the principal investigator, applied on vulva skin, perineal area and vulvar vestibule 30 - 45 minutes before the Session of CO2 laser.

Three sessions spaced four weeks apart, with instructions after each session, such as avoiding sexual intercourse for five days and using a product like petroleum jelly for relief for a few days.

Group Type EXPERIMENTAL

Fractional microablative CO2 Laser

Intervention Type DEVICE

In this study the investigators use the laser device without any topic esteroid previous or during the period of laser sessions

Interventions

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Fractional microablative CO2 Laser

In this study the investigators use the laser device without any topic esteroid previous or during the period of laser sessions

Intervention Type DEVICE

Eligibility Criteria

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Exclusion Criteria

\-
Minimum Eligible Age

21 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Universidade Federal do Rio de Janeiro

OTHER

Sponsor Role lead

Responsible Party

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Andréa Cytryn

Principal investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Andrea Cytryn, Master of Science in Health

Role: PRINCIPAL_INVESTIGATOR

Department of Gynecology, Institute of Gynecology, Federal University of Rio de janeiro

Locations

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Institute of Gynecology of the Federal University of Rio de Janeiro

Rio de Janeiro, Rio de Janeiro, Brazil

Site Status RECRUITING

Countries

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Brazil

Central Contacts

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Andréa Cytryn, Master Degree

Role: CONTACT

+55 21 98123 0332

Yara Lúcia M. Furtado de Melo, PhD in Surgical Sciences

Role: CONTACT

+ 55 21 999826257

Facility Contacts

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Yara Lúcia M Furtado de Melo, PhD

Role: primary

+ 55 21 99982 6257

References

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Krause E, Neumann S, Maier M, Imboden S, Knabben L, Mueller MD, Kuhn A. LASER treatment in gynaecology -A randomized controlled trial in women with symptomatic lichen sclerosus. Eur J Obstet Gynecol Reprod Biol. 2023 Aug;287:171-175. doi: 10.1016/j.ejogrb.2023.06.003. Epub 2023 Jun 8.

Reference Type RESULT
PMID: 37352640 (View on PubMed)

Preti M, Vieira-Baptista P, Digesu GA, Bretschneider CE, Damaser M, Demirkesen O, Heller DS, Mangir N, Marchitelli C, Mourad S, Moyal-Barracco M, Peremateu S, Tailor V, Tarcan T, De EJB, Stockdale CK. The clinical role of LASER for vulvar and vaginal treatments in gynecology and female urology: An ICS/ISSVD best practice consensus document. Neurourol Urodyn. 2019 Mar;38(3):1009-1023. doi: 10.1002/nau.23931. Epub 2019 Feb 11.

Reference Type RESULT
PMID: 30742321 (View on PubMed)

Tasker F, Kirby L, Grindlay DJC, Lewis F, Simpson RC. Laser therapy for genital lichen sclerosus: A systematic review of the current evidence base. Skin Health Dis. 2021 Jun 15;1(3):e52. doi: 10.1002/ski2.52. eCollection 2021 Sep.

Reference Type RESULT
PMID: 35663131 (View on PubMed)

Burkett LS, Siddique M, Zeymo A, Brunn EA, Gutman RE, Park AJ, Iglesia CB. Clobetasol Compared With Fractionated Carbon Dioxide Laser for Lichen Sclerosus: A Randomized Controlled Trial. Obstet Gynecol. 2021 Jun 1;137(6):968-978. doi: 10.1097/AOG.0000000000004332.

Reference Type RESULT
PMID: 33957642 (View on PubMed)

Filippini M, Sozzi J, Farinelli M, Verdelli A. Effects of Fractional CO2 Laser Treatment on Patients Affected by Vulvar Lichen Sclerosus: A Prospective Study. Photobiomodul Photomed Laser Surg. 2021 Dec;39(12):782-788. doi: 10.1089/photob.2021.0053.

Reference Type RESULT
PMID: 34878932 (View on PubMed)

Singh N, Ghatage P. Etiology, Clinical Features, and Diagnosis of Vulvar Lichen Sclerosus: A Scoping Review. Obstet Gynecol Int. 2020 Apr 21;2020:7480754. doi: 10.1155/2020/7480754. eCollection 2020.

Reference Type RESULT
PMID: 32373174 (View on PubMed)

Farrell AM, Dean D, Millard PR, Charnock FM, Wojnarowska F. Cytokine alterations in lichen sclerosus: an immunohistochemical study. Br J Dermatol. 2006 Nov;155(5):931-40. doi: 10.1111/j.1365-2133.2006.07414.x.

Reference Type RESULT
PMID: 17034521 (View on PubMed)

Krapf JM, Mitchell L, Holton MA, Goldstein AT. Vulvar Lichen Sclerosus: Current Perspectives. Int J Womens Health. 2020 Jan 15;12:11-20. doi: 10.2147/IJWH.S191200. eCollection 2020.

Reference Type RESULT
PMID: 32021489 (View on PubMed)

Related Links

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Other Identifiers

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52132021000005275

Identifier Type: -

Identifier Source: org_study_id

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