Multimodal OCT Control for Early Histological Signs of Vulvar Lichen Sclerosus Recurrence after Systemic PDT: Pilot...

Area of Science:

• Dermatology
• Medical Imaging
• Oncology

Background:

• Vulvar lichen sclerosus (VLS) is a chronic condition often requiring advanced treatments like photodynamic therapy (PDT).
• Early detection of VLS recurrence is crucial for managing this condition effectively.
• Current methods for monitoring VLS recurrence can be invasive or delayed.

Purpose of the Study:

• To evaluate a non-invasive multimodal optical coherence tomography (OCT) approach for early detection of VLS recurrence post-PDT.
• To correlate OCT findings with histological examinations for VLS recurrence.
• To assess the potential of OCT in guiding treatment adjustments for VLS.

Main Methods:

• Systemic photodynamic therapy (PDT) using Photodithazine® was administered to patients with VLS.
• Multimodal OCT, including structural, angiography, and lymphangiography, was employed over 6 months post-PDT.
• Histological examinations were performed before and 3 months after PDT to interpret OCT data.
• Quantitative OCT parameters, such as attenuation coefficient and vessel density, were analyzed.

Main Results:

• A statistically significant difference in OCT parameters was observed between patients with (Group I) and without (Group II) early VLS recurrence 3 months post-PDT.
• In Group II, OCT parameters indicated skin structure recovery by 3 months post-PDT.
• In Group I, OCT parameters did not reach levels seen in Group II even after 6 months, suggesting persistent recurrence.

Conclusions:

• Multimodal OCT is a viable non-invasive tool for monitoring early histological signs of VLS recurrence after PDT.
• OCT findings can guide timely treatment adjustments, potentially avoiding delayed clinical manifestations.
• This approach offers a promising strategy for managing chronic and recurrent VLS.