Clobetasol Compared With Fractionated Carbon Dioxide Laser f
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Fractionated carbon dioxide laser is an effective treatment for Lichen Sclerosus and is not associated with serious adverse effects, finds a recent study.

The objective was to compare 6-month safety and efficacy outcomes of fractionated CO2 laser (laser) with topical clobetasol propionate (steroid) for treatment of symptomatic vulvar lichen sclerosus.

Researchers conducted a single-center randomized controlled trial that compared fractionated CO2 laser with steroid treatment for patients with biopsy-proven lichen sclerosus. Randomization was stratified by prior clobetasol propionate use. The primary outcome was the mean change in the Skindex-29 score at 6 months.

A total sample size of 52 participants was recruited to detect a mean difference of 16 points on the Skindex-29 with 80% power, based on a one-sided two-sample t-test, accounting for 10% attrition. Secondary outcomes included validated subjective and objective measures. Intention-to-treat, per protocol, and regression analysis based on prior steroid exposure were performed.

--No significant difference was found in baseline demographics, symptoms, and physician assessment scores.

--There was greater improvement in the Skindex-29 score in the laser arm at 6-months.

--Overall, 89% of patients in the laser group rated symptoms as being “better or much better” compared with 62% of patients in the steroid group.

--More patients were “satisfied or very satisfied” with laser treatment compared with steroid treatment.

--After stratification for previous steroid use, the significant change of Skindex-29 score was only seen in the previously exposed group.

--There was one adverse event in each group: minor burning and blistering at the laser site and reactivation of genital herpes 1 week after starting steroid.

Fractionated CO2 laser treatment showed significant improvement in subjective symptoms and objective measures compared with clobetasol propionate, without serious safety or adverse events at 6 months.

Obstetrics & Gynecology