Interferon alpha-2b treatment of symptomatic chronic vulvodynia associated with koilocytosis

In an open study with identical criteria for diagnosis, 16 female patients with typical symptoms of chronic vulvodynia associated with acetowhitening of the vestibular epithelium and koilocytosis in biopsy specimens received recombinant interferon alpha-2b 5 MIU intralesionally 3 times weekly for 3 weeks or subcutaneously 3 times weekly for 8 weeks. Three months after end of therapy, clinical symptoms had disappeared in 7 (70%) of the 10 patients treated intralesionally, compared with only one (16%) of the 6 patients treated subcutaneously. In addition, the last 3 (30%) patients in the first group had a partial response to therapy. The acetowhitening persisted in all patients. The koilocytosis remained unchanged in 13 (81%) of the 16 patients. Our results indicate that recombinant interferon alpha-2b administered intralesionally seems to be efficacious in reducing clinical symptoms in vulvodynia with suspected human papillomavirus infection but does not eliminate the infection. Subcutaneous administration had neither symptomatic nor antiviral effect. A placebo-controlled study is needed, but with our present knowledge we recommend intralesionally administered interferon as a symptomatic treatment of vulvodynia.